EA186285 - Plumbing - Fixtures - Issued Date 08/24/2023 PERMIT
City of Eagan Permit Type: Plumbing
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3830 Pilot Knob Rd
Permit Number: EA186285
Eagan, MN 55122 EAGAN
(651)675-5675
www.cityofeagan.com * E A 1 8 6 2 8 5
Date Issued: 8/24/2023
Site Address: 983 Kettle Creek Rd
Lot: 25 Block: 3 Addition: Lexington Square 7th
PID:10-45081-03-250 lull 11.111111111111111
Use: * 10 - 45081 - 03 - 850 *
Description:
Sub Type: Fixtures
Work Type: New
Description: Kitchen sink and dishwasher
Meter Size Meter Type 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:
Metro Air Kristin A Rosicky
16980 Welcome Ave SE 983 Kettle Creek Rd
Prior Lake MN 55372 Eagan MN 55123
(952)447-8124
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 Issued By: Signature
---------,
i j r For Office Use
I Permit#:
EAGAN
Permit Fee: I(J ✓ I
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I Date Received: I
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 I I
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651 675-5675 1 FAX: 651 675-5694 Staff:
buiIdinginspection s(cDcityof agan.com ------------------
RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: � cr A 3 Site Address: 3 I�e ftl e (i I < e 1C R 0( Unit#:
Applicant is: ❑ Owner 0 Contractor
Name:
Homeowner Address: City:
State: Zip: Phone: Email:
Type Of Work —New _Replacement _Repair _Rebuild Modify Space _Work in R.O.W.
Description of work:
Tankless Water Heater
Standard Water Heater Lawn Irrigation(_RPZ/_PVB)
Description Water Softener X Add Plumbing FixtuJres(_)4, Main Lower Level)
Septic
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Septic System Description: _j n
New Abandonment
Connection to City Water from Well
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Company: m /-r0 ��°�`�t nci (�� 0 + faCct:
Plumbing Address: com e Sr city: p rf(jr, G-CAk'tr
Contractor State:M I/V gS1), -
Zip S �Phone: YO Email:
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License#:
Expiration Date: I a-'3 —�3
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.gopherstateonecall.org 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.
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Applicant's PeinteclAgarne 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