EA187910 - Plumbing - Fixtures - Issued Date 11/07/2023 PERMIT
City of Eagan , & , ® Permit Type: Plumbing
3830 Pilot Knob Rd %,,�', Permit Number: EA187910
Eagan, MN 55122 EAGAN
(651)675-5675
www.cityofeagan.com * E A 1 8 7 9 1 0
Date Issued: 11/7/2023
Site Address: 941 Jefferson Lane
Lot: 7 Block: 2 Addition: Lexington Pointe 3rd
PID:10-45072-02-070 VU
Use: * 10 - 45072 - 02 - 070 *
Description:
Sub Type: Fixtures
Work Type: Replace
Description: bath, sink,toilet
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:
Minnesota Rusco Scott J&Kathryn A Kluegel
5010 Hwy 169N 941 Jefferson Ln
Brooklyn Park MN 55428 Saint Paul MN 55123--260
(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
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For Office Use 1
AM
0 AFM
Permit#:
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E C E i y�p I Permit Fee:
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Date Received: I I
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 NOV 0 6 2023 1 I
(651)675-5675 ( FAX: (651)675-5694 1 U I Staff: 1
build inginspections(a)cityofeagan.com BY. I----------------
RESIDENTIAL PLUMBING PERMIT APPLICATION
11/6/23 941 Jefferson Ln Eagan,�MN 55123
Date: Site Address: Unit#:
Applicant is: ❑ Owner 14 Contractor
Name: Scott KI U eg e I
Homeowner Address: 941 Jefferson Ln city: Eagan
t
State:
MN Zi 55123 Phone:
651-783-621E Email kluegel6@gmail.com
Type Of WOrk'c —New Replacement —Repair _Rebuild _Modify Space _Work in R.O.W.
Direct replacement of existing shower wet space, wall surround, and plumbing fixtures.
�t
Description of work,
Tankless Water Heater
Lawn Irrigation (—RPZ/—PVB)
Standard Water Heater —
Descri tion V/ Add Plumbing Fixtures (L(Main/ Lower Level)
� p Water Softener
Septic System Description: bath, sink, toilet
New __Abandonment
Connection to City Water from Well
— _
Company: MN Rusco � Kelli Gugisberg
p y Contact:
I
5010 Hwy169 N New Hope
Plumbing ( Address: City: p
Contractor State., Zip.. Phone:MN 55428 952-935-966 Email. kelli@minnesotarusco.com
I
I PC805612 12/31/23
I License#: Expiration Date:
i^
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)
I $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.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 a�a&&
Applicant's Printed Name Applicant's ig ture 61
FOR OFFICE USE
Reviewed By Date:
Meter Size(if applicable):
Required Inspections: Under Ground Rough-in Air Test Gas Test Manometer Final