EA190240 - Plumbing - Water Heater - Issued Date 04/15/2024 PERMIT
City of Eagan Permit Type: Plumbing
3830 Pilot Knob Rd ,a+;�� `�,®"� Permit Number: EA190240
Eagan, MN 55122 .m-� ���� EAGAN
(651)675-5675 111111111111 IN 11111111111111111111111111111111
www.cityofeagan.com * E A 1 9 0 2 4 0 *
Date Issued: 4/15/2024
Site Address: 4204 Malmo PI
Lot: I Block: 5 Addition: Wilderness Run 6th
PID:10-84355-05-010
Use: * 10 - 84355 - 05 - 0 10
Description:
Sub Type: Water Heater
Work Type: Replace
Description:
Meter Size Meter nVe Manufacturer Serial Number Remote Number Line Size
Comments:
Fee Summary: PL-Permit Fee(WS&/or WH) $64.00 0801.4087
Surcharge-Fixed $1.00 9001.2195
Total: $65.00
Contractor: Owner: - Applicant -
Danielle R Sieckert
4204 Malmo PI
Eagan MN 55123
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
1 r I For Office Use I
l i r r I I
I%k���� �•r�r 1 Permit#:
EAGAN I I
jPermit Fee: I
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Date Received: I
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 I
1
(651)675-5675 1 FAX: (651)675-5694 I Staff:
buildinginspections(a)citvofeaaan com I ______
RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: l 1 "JA V Site Address: � "1 Ma, Y I o V . Unit#:
Applicant is: Owner ❑ Contractor
Name:
Hdin @OWi el' Address: City:
State: zip: Phone: - v Email:
Type of Work` —New 4Replacement _Repair _Rebuild _Modify Space _Work in R.O.W.
Description of work:
Tankless Water Heater
Lawn Irrigation RPZ/ PVB)
Standard Water Heater
DeSCi",I 11011 Add Plumbing Fixtures Main/_Lower Level)
p Water Softener
Description:
Septic System
New Abandonment Connection to City Water from Well
Company: Contact:
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)
$65.00 Septic System Abandonment(includes State Surcharge)
TOTAL FEES$
CALL BEFORE YOU DIG. Contact Gopher State One Call at(651)454-0002 or www.gopherstateonecall.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 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'intheclause of work which requires a review and approvalof pla S.
x1JV1Y�1� J\�yT VIS x
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Applicants Panted Name Apolicants—ISignature
FOR OFFICE USE
Reviewed By: Date:
Meter Size(if applicable):
Required Inspections: Under Ground Rough-In Air Test Gas Test Manometer Final