EA188742 - Plumbing - Fixtures - Issued Date 01/12/2024City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675-5675
www.cityofeagan.com
PERMIT
A 6
Permit Type: Plumbing
Permit Number: EA188742
EAGAN
* E A 1 B B 7 4 2
Date Issued: 1/12/2024
Site Address: 4586 Maple Leaf Cir
Lot: 25 Block: 02 Addition: Ches Mar East 1st
PID:10-17150-02-250
Use: * 1 0— 1 7 1 5 0— 0 2— 2 5 0
Description:
Sub Type: Fixtures
Work Type: Alteration
Description: tub and sink
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 Ashley Tintes
5010 Hwy 169N 4586 Maple Leaf Cir
Brooklyn Park MN 55428 Eagan MN 55123
(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
-----------------
For Office Use I
Permit#: 4 I
I I
E
Permit Fee: toeEAGA 409 E IV I
I
Date Received:
3830 PILOT KNOB ROAD i EAGAN, MN 55122-1810 AN 0 9 2024
(651) 675-5675 i FAX: (651) 675-5694 Staff:
buildinginspectionsCa g:ltvofeagan.comBY: — — — — — — — — — — — — — — — — — --
RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: 1/9/24 site Address: 4586 Maple Leaf Cir Eagan, MN 55123 Unit#:
Applicant is: ❑ Owner 0 Contractor
Name: Ashley Tintes
Homeowner` Address: 4586 Maple Leaf Cir City: Eagan
�, state: MN ZiD: 55123 Phone: 320-522-2854 Email: ashley.tintes@gmaii.com
l
Type of Work — New 101 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.
i, Tankless Water Heater
Standard Water Heater Lawn Irrigation L_ RPZ /— PVB)
Description Add Plumbing Fixtures (— Main /— Lower Level)
p Water Softener
Septic System Description: tub & sink
New Abandonment Connection to City Water from Well
MN Rusco Kelli Gu Isber
Company: Contact: g g
Y e
5010 Hwy 169 N New Ho t
Plumbing Address: City: p
Contractor State: MZip. Phone: N 55428 952-935-966 Email.. kelli@minnesotarusco.com
PC805612 12/31/25
License #: Expiration Date:��
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.gol2herstateonecall.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
Applicant's Printed Name Applicant's n re
FOR OFFICE USE
Reviewed By: Date:
Meter Size (if applicable):
Required Inspections: Under Ground Rough -In Air Test Gas Test —Manometer Final