EA184756 - Plumbing - Fixtures - Issued Date 06/21/2023 PERMIT
City of Eagan ® ® , ® Permit Type: Plumbing
3830 Pilot Knob Rd ®®0; ® ® ®® Permit Number: EA184756
Eagan,MN 55122 ®®®® ®®-® EAGAN
(651)675-5675 111111111111
www.cityofeagan.com * E R 1 8 4 7 5 6
Date Issued: 6/21/2023
Site Address: 3784 South Hills Ct
Lot: 12 Block: 2 Addition: South Hills 1st
PID:10-70790-02-120
Use: * 1 0 — 7 0 7 9 0 — 0 2 — 1 2 0
Description:
Sub Type: Fixtures
Work Type: Rebuild
Description: Bathroom remodel
Meter Size Meter Tyne Manufacturer Serial Number Remote Number Line Size
Comments:
Fee Summary: PL-Plumbing Permit Fee $64.00 0801.4087
Surcharge-Fixed $1.00 9001.2195
Total: $65.00
Contractor: - Applicant - Owner:
Diversified Plumbing&Heating Inc W Dustin&Zella W Tstes Mirick
125 E Railroad St 3784 South Hills Ct
Norwood Young Americ MN 55368 Eagan MN 55123-421
(952)583-9646
This permit shall be null and void if work does not start within 180 days of issuance,or if work is suspended for 180 days or more after
started.
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Applicant/Permitee: Signature sZed B . Signature
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® ® ® ® I For Office Use I
184756
I Permit#:
EAGAN
Permit Fee:
I
Date Received: 6/21/2023
3830 PILOT KNOB ROAD i EAGAN, MN 55122-1810 I I
(651)675-5675 i FAX: (651)675-5694 Staff:
buildinginspections _citvofeagan.com ----------------- '
RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: 6/20/23 Site Address: 3784 South Hills Court Unit#:
Applicant is: ❑ Owner 14 Contractor
Name: Dustin&Zella Mirick
Home oWher Address: City:
State: Zi : Phone: 651-452-2574 Email:
Type Of Work —New —Replacement —Repair V( Rebuild —Modify Space —Work in R.O.W.
Description of work: Bathroom remodel
Tankless Water Heater
Standard Water Heater Lawn Irrigation C_RPZ/ PVB)
-
Description Add Plumbing Fixtures (�Main/ Lower Level)
p Water Softener
Description: Bathroom remodel
Septic System
New Abandonment Connection to City Water from Well
Company: Diversified Plumbing & Heating Inc contact: Lisa Puncochar
Plumbing Address: 125 E Railroad St city. Norwood Young American
Contractor
State: MN Zip.. Phone: Email.. Lisa@diverisifiedph.com
9524480756 Lisa diverisifiedp h.com
License#: PC667869 Expiration Date: 12/31/23
RESIDENTIAL FEES
$150.00 New Residential or Connection to City Water(includes State Surcharge)
$65.00 Water Heater,Water Softener, or Water Heater and Softener(includes State Surcharge)
$65.00 Lawn Irrigation(includes State Surcharge)
$65.00 New fixtures,adding, altering,or removing piping(includes State Surcharge)
$65.00 Septic System Abandonment(includes State Surcharge)
TOTAL FEES$
CALL BEFORE YOU DIG. Contact Gopher State One Call at(651)454-0002 or www.aopherstateonecall.ora for protection against underground utility
damage. Contact Gopher State One Call 48 hours before you intend to dig to receive locates of underground utilities.
I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
x Lisa Puncochar x ,L Pu4cacW44.
Applicant's Printed Name Applicant's Signature
FOR OFFICE USE
Reviewed By: ' Date:
Meter Size(if applicable):
Required Inspections: Under Ground Rough-In Air Test Gas Test Manometer Final