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3196 Alden Pond Lane ~ SEWER & WATERPERMIT of USE *NLY CITY OF EAGAN' PERMIT DATE 9Z 9 3830 Pilot Knob Rd. _ WATER PERMIT # 19955 lEWER PERMIT #' P.Q,. 211 tATEF # �. S.P. RECEIPT Egan, MN 55121 , READER # B.P. ICEIPT DATE METER ` 'z S &W< Rec C .3961 issue DATE * _ASTER PUMP "2 SITE ADDRESS 3196 41 n . Pond PERMITREt 1ESTEO LOT _ _ BLOC1E- 2 SEG/St B -' , �--- APPLICANT: ' • t i ' -`= n Inc • WER ..6GATER TAPS A DRESS ; . 171 ° 'W . A ty Rd 13 COMMAND= ,. 1 SIDENTIAf. co STATE R e a i e +T Zip 55 5 633 3 -,2 4 . . 1 W _ __ EXISTING PLUMBER 14a. j or. ADDRESS. 0 50 I Ilt y 5 1 AGREBE'l l OMPLY WITH C�1TY OF CITY, STATE 31ap1e:Cfove. zip 55369 EAEGANORO,I IANCEES . PHONE �424R6680 OWNER: 222(3 IV Limi tRC Pprtnershj ADDRESS 1711 :1Y. G" ritr Ltd: B 3.` SIGNATURE WHEN liNTER ISSUED #_ CIT'y, STATE : Rosev *,ile 2�i . ziP 55113 PHONE: 636r,8050' PLEASE ALLOW TWO a , DAYS FOR PflOCISS1NO.ftli STOINtSaVelt MOMS, CONTACT ENGINEERING DEPT. � y ,C " ' !f' Z7-77, , Jf 4 r For Office Use ', ?io , ::::e: ..,:, E (-2 L.,,,:Li \., . .. APR 26 2019 Date Received: tf.L2'1 ,/ 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651)675-5675 I TDD:(651)454-8535 i FAX:(651)675-5694 Staff: buildinoinspectionsOcitvofeagan.com _ 2019 RESIDENTIAL PLUMBING PER IT APPLICATION q '� Date:�� �� I Site Address:31 ti " - -' " A,IPV tfJ' / Tenant: 1�r\i‘ IV l — Suite#: Ip Resident/Ow,' Name: nern 1 k t• , O.' ',► Phone: � 1 ` J 0-., , r Address I City/Zip: i IFolp � l �� Name: MILBERT COMPANY dba CULLIGAN WATER .6 License#: WC641376 Cotracto'r Address: 1801 50TH STREET EAST City: INVER GROVE HEIGHTS State: MN Zip: 55077 Phone: 651-451-2241 Contact: BILL MILBERT Email: gloria.abas©culligan4water.com New —Replacement Repair Rebuild Modify Space Work in ROA.Type of Work — — Description of work: Water Heater Lawn Irrigation(—RPZ/ PVB)• _ x Water Softener Add Plumbing Fixtures ( Main/_Lower Level) Description -Septic System Description: New Abandonment —Connection to City Water from Well RESIDENTIAL FEES ` _____..._,._.. $60.00 Water Heater,Water Softener, or Water Heater and Softener(includes State Surcharge) $60.00 Lawn Irrigation(includes State Surcharge) $60.00 New fixtures, adding or removing piping(includes State Surcharge) $60.00 Septic System Abandonment $100.00 New Residential (fee collected with Building Permit) $115.00 New Septic System (includes County fee and State Surcharge) $60.00 Connecting to City Water from Well* +$290 for Meter and$190 for Radio Read =$540 *Sewer&Water Permit also required for connection charges _ __ TOTAL FEES$ 60'0 , CALL BEFORE YOU DIG. Call Gopher State Ono Call at(651)454.0002 for protection against underground utility damage, Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.orq You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's websito at www.cityofoagan.com/subscribe. 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 per 't, but on an application for a permit, and work is not to start without a permit; that the work will be in accordance withal approved plan I therc s of wor vhich requires a.review and approval of plans. X LALI 4.4111111 , Applicant's Printed Name Applicant's Signature Page 1 of-2. i