4145 Lexington Way SAC WAC
Use BLUE or BLACK Ink
For Office Use 1
M nn Permit /j ~c~c.~l Permit Fee: '7 1, 05!r
3830 Pilot Knob Road I I
Eagan MN 55122
Phone: (651) 675-5675 Date Received:
Fax: (651) 675-5694 I I
Staff:
I I
2014 SEWER AND WATER CONNECTION AND AVAILABILITY CHARGES
EXISTING RESIDENTIAL PROPERTY
Address: yiy Lax ih~~m. t~ FOR OFFICE USE ONLY
Property Owner: _ PRV required
Phone: Contact Name: - City R-O-W Permit
Plumber: County R-O-W Permit
Plumbing Permit
SEWER WATER
Sewer Service NA Wa Service
Sewer lateral charge lco' 3~t=' t i -3~ j7 Water la al charge
Sewer trunk Water trunk
City SAC @ $100/unit Water supply stora
MCES SAC @ $2,485/unit Receipt
Receipt Date: Treatment Plant @ 8/unit
Permit Fee $60.00 Permit Fee $60.00
State Surcharge $5.00 State S arge $5.00
TOTAL: "PI ing Permit Required - water meter to be
a quired with building permit TOTAL:
SEWER & WATER
Sewer Service
Water Service
ewer lateral charge
W. r lateral charge
Sewer unk
Water trun
City SAC
MCES SAC
Receipt # Date
Water supp , storage
Re pt # Date
Tr ment plant
ermit Fee $120.00
State Surcharge $5.00
'Plumbing Permit Required - water meter to be
acquired with building permit TOTAL:
Number of SAC units is determined by the Metropolitan Council Environmental Services (651) 602-1000.
CALL BEFORE YOU DIG. Call Gopher State One 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.org
Cc: City of Eagan Finance Department