EA189472 - Plumbing - Fixtures - Issued Date 03/04/2024 PERMIT
City of Eagan Permit Type: Plumbing
3830 Pilot Knob Rd ,,•;s %,;.', EAGAN
Permit Number: EA189472
Eagan, MN 55122
(651)675-5675 1111111111111 IN 11111111111111111111111111111111
www.cityofeagan.com * E A 1 8 9 4 7 2 *
Date Issued: 3/4/2024
Site Address: 1355 Balsam St E
Lot: 010 Block: 002 Addition: Wilderness Run 5th
PID:10-84354-02-100 HUM
Use: * la — B4354 — QC - 10 D *
Description:
Sub Type: Fixtures
Work Type: Alteration
Description: Kitchen Remodel
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:
Tony's Plumbing Michelle M Deysach
4572 LaSalle Avenue NE 1355 Balsam St E
St.Michael MN 55376 Eagan MN 55123-470
(612)578-2839
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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i 1 0 rFor Office Use -- I
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EAGAN
jPermit Fee: I
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I Date Received: i
3830 PILOT KNOB ROAD i EAGAN, MN 55122-1810 I t
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(651)675-5575 1 FAX:(651)675-5694 1 Stsff: � I
build inginsoectionsfa�cityofeagan.com ---------- _ __�
t RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: 3d —
y Site Address: 1355 0. Sam t� G
Unit#:
Applicant is: ❑Owner G1 Contractor
Name:
Hamowner 35S �a� rn S Gia Qa
Address:... � City: n
State:MN Zi : t5 3 Phone: Email:
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Type tyf walk —New Replacement Repair _Rebuild Modify Space Work in R.O.W.
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i' Description of work: e
Tankless Water Heater
Standard Water Heater Lawn Irdgation(_RPZ 1_ PVB)
v Add Plumbing Fixtures `� Main l Lower Level
laescoodisri ` —Water Softener s t--1 )
Description:S�t1� U luui2!' lil1CS -Fol- }`4t en sink
Septic System NeW Ven o+- - art 5 `7 icor t'riat fet-
New Abandonment onnection to ity Water rom elf t ;�e
sCompany:_....._t._oit �S iPK117+t1j 4 A r L th Contact: +�'t S 0. C2C r M t 0 eS-•
g 6b ��U i-A Ave. N . Ci ak����-
Pturitlbin Address: City:;Cont�ractar Stater"t) Zip: 5SE4
Phone: O ` ` _ 1a�`URq i
hE�-mail:�� i r
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License#:__P C Expiration Date: ( a^ 31 -Q pa 4
RESIDENTIAL FEES
$160.00: New Residential or Connection to City Water(includes State Surcharge)
$65.00 Water Heater,Water Softener,or Water Heater and Softener(includes State Surcharge)
$66.00 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)454-0062 or www.aoDherstateonecaU.ora 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 a owledge that this information is complete and accurate: that the work will be in conformance with the ordinances and codes of the City of
Eagan; 1 at 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
accorf c6 ith the a ed pl in"case of work which requires a review and approval of plans.
Appiica 's Pr ted Name Applicant's Signature
FOR qIFCE USE
t ` 'Reviewed By: Date
& -
Meter•51ze(tf appilcable)
Required inspecdons: der Ground —Rough-ln —Air Test Gas fest Manometer Fina(