EA188100 - Plumbing - Single Fam - Issued Date 11/17/2023 PERMIT
City of Eagan 4 , Permit Type: Plumbing
3830 Pilot Knob Rd ���;*_ �;�F°� Permit Number: EA188100
Eagan,MN 55122.
E A G A N
(651)675-5675 1111111111111 IN 11111111111111111111111111111111
www.cityofeagan.com * E R 1 8 8 1 0 0 *
Date Issued: 11/17/2023
Site Address: 4979 Royale PI
Lot: 26 Block: 3 Addition: Eagan Royale
PID:10-22475-03-260
Use: * 10 - 2z47S - 03 - 360 *
Description:
Sub Type: Single Fam
Work Type: Alteration
Description: Shower wet space,wall surround,fixtures
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:
Minnesota Rusco Samuel S IV Thorpe
5010 Hwy 169N 4979 Royale PI
Brooklyn Park MN 55428 Saint Paul MN 55122--338
(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 I
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I Permit#:� a I6 i
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Permit Fee:
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Date Received: I
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 I j
(651)675-5675 1 FAX: (651)675-5694 Staff:
buildinginspections6i' cityofeagan.com ————————————————
RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: 11/17/23 site Address: 4979 Royale PI Eagan, MN 55122 Unit#:
i
Applicant is: ❑ Owner � Contractor )
Name: Lynelle ThorpeN�..��...,���..�.. � N
Homeowner Address: 4979 Royale PI City.. Eagan
State: MN Zi 55122 Phone: 612-998-348' Email: skip.s.thorpe@gmail.com
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
Standard Water Heater Lawn Irrigation (—RPZ/—PVB)
V
Description Water Softener Add Plumbing Fixtures(—Main/—Lower Level)
Septic System Description: shower/tub
New Abandonment Connection to City Water from Well
Company: MN Rusco Contact: Kelli Gugisberg
Plumbing Address: 5010 Hwy 169 N City; New Hope
Contractor
state: MN Zip: 55428 phone: 952-935-966..c
Email: kelli@minnesotarusco.com
i PC805612 12/31/23
License#: Expiration Date:
RES I DE NTIA L 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.
X Kelli Gugisberg X ��' o��L;e
Applicant's Printed Name Applicant's ig ture
FOR OFFICE USE
Reviewed By: Date:
Meter Size (if applicable):
Required Inspections: Under Ground Rough-In Air Test Gas Test Manometer Final