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1279 Timbershore Lane 2006 RESIDENTIAL PLUMBING-.PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 se complete for modifications to existing residential dwellings. <X151 se) ?? en W taw 1 1 1 Street Address V t & Unit # r` v 1 v` u? V O Telephone # tIW? ?) ` A%. ffig wne erty L I Tele hone # 1 tractor p - City !? - " ly State]Mk_ Zip ess Applicant is: _ Owner X Contractor - Other is System _ New _ Refurbished Submit 2 sets of plans and MPC license Includ es County fee $ 100.00 Per as-built $ 10.00 rations to existing dwelling $ 50.00 Add plumbing fixtures. This fee includes installation of a water softener and/or water _ heater at the same time. if you are installing only a water softener an afer do not complete this section; move to the heater next section rt¢ he , appliance(s) you are installing. ? vv ?? ?oo6 - Septic System Abandonment O _ Water Turnaround (add $130.00 if a 518" meter is required) ' Other . Water Softener _ Water Heater $ 15.00 new replacement Lawn Irrigation _RPZ _PVB -new -repair -rebuild 5 30.00 e Surcharge $ .50 ! : :$ =-v 31 reby apply for a Residential Plumbing Permit and acknowledge that the information is complete and accurate, that the X will be in conformance with the ordinances and codes of the City of Eagan and the plumbing codes; that I erstand this is not a permit, but only an application for a permit, work is not to start without a permit and work will be in xdanq witl the ap rov ar, in the event a plan is required to be reviewed and approved. l 4,9`1 o/ dicant's Pnnted Na Applicant's Signatu e