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EA187675 - Plumbing - Fixtures - Issued Date 11/01/2023 PERMIT City of Eagan Permit Type: Plumbing 3830 Pilot Knob Rd Permit Number: EA187675 Eagan, MN 55122 --- -• E AGAN (651)675-5675 1111111111111111111111111111111111111111111111111 www.cityofeagan.com * E R 1 8 7 6 7 S * Date Issued: 11/1/2023 Site Address: 4106 Nicols Rd Lot: 3 Block: 2 Addition: Cedar Grove 1st PID:10-16700-02-030 Use: * 1 (0 — 1670 0 - 02 - 030 Description: Sub Type: Fixtures Work Type: Replace Description: Meter Size Meter Tvbe 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: Minnesota Rusco Sandra K Carroll 5010 Hwy 169 N 4106 Nicols Rd Brooklyn Park MN 55428 Eagan MN 55122 (952)935-9669 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 rFor Office Use l ------ p I Permit#: 16-76'15 � I EAGANECEIVE Permit Fee: I I OCT 2 4 2023 Date Received: l0 NA- 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 651 675-5675 1 FAX: 651 675-5694 Staff: bu ild inginspections aC�citvofeagan.com BY: ————————————————— RESIDENTIAL PLUMBING PERMIT APPLICATION Date: 10/24/23 Site Address: 4106 Nicols Rd Eagan, MN 55122 Unit#: Applicant is: ❑ Owner 14 Contractor Name: James and Sandra Mischler Homeowner Address: 4106 Nicols Rd city: Eagan State: MN Zip: 55122 Phone: 651-454-8024 Email: Type of Work —New V Replacement —Repair —Rebuild _Modify Space —Work in R.O.W. Description of work: Direct replacement of existing shower wet space,wall surround, and plumbing fixtures. Tankless Water Heater Lawn Irrigation(—RPZ/—PVB) Standard Water Heater Description Add Plumbing Fixtures(—Main/—Lower Level) Water Softener Septic System Description: tub, sink, toilet Connection to City Water from Well New Abandonment Company: MN Rusco Contact: Kelli Gugisberg Plumbing Address: 5010 Hwy 169 N City: New Hope Contractor MN . 55428 952-935-966 . kelli@minnesotarusco.com State: Zip. Phone: Email. License#: PC805612 Expiration Date: 12/31/24 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.gogherstateonecall.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. X Kelli Gugisberg X Ae• 044t �� Applicant's Printed Name Applicant's*ign6Aure FOR OFFICE USE: Reviewed By: Date Meter Size(if applicable): Required,lnspections: =Urrder Ground_ Rough-inAlr Test �Gs Test I�aname#er Final