4105 Blackhawk Rd - Welll Sealing Permit8/2/2011 2 :44:09 PM
7034
® 01 /01
DATE: August 2, 2011
Property Owner:
Well Owner:
WELL LOCATION:
WELL INFORMATION:
Diameter:
Casing Depth:
Total Depth:
Static Water Level:
Aquifer:
COMMENTS:
t COUNTY
ENVIRONMENTAL MANAGEMENT DEPARTMENT
GROUNDWATER PROTECTION SECTION
14955 Galaxie Avenue • Apple Valley, MN 55124
952.891.7557 • Fax 952.891.7588 • www.co.dakota.mn.us
� U � i-L
MUNICIPAL NOTICE OF WELL ,pERMIT APPLICATION
TO: Tom Colbert/Wayne Schwanz (EM) Fax #: (651) 675 -5694
RE: Well Permit #: 11- H294934 Well Type: Domestic
Municipality: Eagan Environmental Specialist: Rutten
The Water and Land Management Section of the Dakota County Environmental Management Department has received the
following permit application for the well described. If you require further review of the application or if you have any
questions or concerns about it, contact the Environmental Specialist listed above or our office at (952) 891 -7557. If there is
no response from your office within 24 HOURS (excluding weekends and holidays), we will assume that you have no
objections to the issuance of the permit. Please note that permit issuance is always conditioned on the permit applicant's
observance of and compliance with all applicable state, county, and municipal laws and codes.
Well Contractor: Hartmann Well Company
Date Application Received: 07/29/2011
Anticipated Drilling Date: Time:
Anticipated Grouting Date: Time:
Richard Hanson
Richard Hanson
PLS Coordinates: 1/4, NE 1/4, SW 1/4, SE 1/4, Sec 20 Town 027 Range 23
Street Address: 4105 Blackhawk RD
PIN Number: 100200003077
7744
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