EA188782 - Plumbing - Fixtures - Issued Date 01/16/2024City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675-5675
www.cityofeagan.com
PERMIT
Site Address: 2021 Jade Lane
Permit Type: Plumbing
Permit Number: EA188782
* E R 1 8 8 7 8 2
Date Issued: 1/16/2024
Lot: 14 Block: 4 Addition: Cedar Grove 3rd
PID:10-16702-04-140
Use: * 10— 16702-04-140*
Description:
Sub Type: Fixtures
Work Type: Alteration
Description: shower, toilet, sink
Meter Size Meter Tvue 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:
Owner:
Christian Poynter
2021 Jade Ln
Eagan MN 55122
- Applicant -
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
EAGAN
Site Address: 2021 Jade Lane
Permit Type: Plumbing
Permit Number: EA188782
* E R 1 8 8 7 8 2
Date Issued: 1/16/2024
Lot: 14 Block: 4 Addition: Cedar Grove 3rd
PID:10-16702-04-140
Use: * 10— 16702-04-140*
Description:
Sub Type: Fixtures
Work Type: Alteration
Description: shower, toilet, sink
Meter Size Meter Tvue 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:
Owner:
Christian Poynter
2021 Jade Ln
Eagan MN 55122
- Applicant -
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
LM
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
(651) 675-56751 FAX: (651) 675-5694
buildinginspections(a)citvofeagan.com
For Office Use I
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Permit Fee: T2 L!5
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Date Received:
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Staff:
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RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: 1/11/2024 site Address: 2021 Jade Lane Unit #:
Applicant is: 1Z Owner ❑ Contractor
Name: Christian Poynter
Homeowner Address: 2021 Jade Lane City: Eagan
State: MN Zi 55122 Phone: 715-456-3790 Email: ch ristian.poynter@icloud.com
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Type of Work V New _ Replacement —Repair _ Rebuild _ Modify Space _ Work in R.O.W.
Description of work: Plumbing for new bathroom in basement
Tankless Water Heater
Standard Water Heater Lawn Irrigation (_ RPZ /_ PVB)
'
Description Water Softener V Add Plumbing Fixtures (_ Main /V( Lower Level)
Septic System Description: Shower + toilet + sink
New Abandonment Connection to City Water from Well
Company: Contact:
t
Plumbing Address: City:
Contractor
State: Zip: Phone: Email:
_ 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) 65.00
TOTAL FEES $
CALL BEFORE YOU DIG. Contact Gopher State One Call at (651) 454-0002 or wvvw.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.
XChristian Poynter X
Applicant's Printed Name Applicant's Signature
FOR OFFICE USE
Reviewed By: Date:
Meter Size (if applicable):
Required Inspections: Under Ground Rough -In Air Test Gas Test Manometer Final