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
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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