EA180268 - Sewer & Water - Residential - Issued Date 11/15/2022 PERMIT
City of Eagan Permit"': Sewer& Water
3830 Pilot Knob Rd Permit Number: EA180268 E
��'• -�-�
Eagan,MN 55122 •••• •-
(651)675-5675 ^�
www.cityofeagan.com * E R 1 8 0 2 6 8 *
Date Issued: 11/15/2022
Site Address: 4295 Sunrise Rd
Lot: 5 Block: 2 Addition: Sun Cliff 1st
PID: 10-72975-02-050 RNEWFUMMEMIMM
Use: * 10 - 72975 - 02 - 050 *
Description:
Sub Type: Residential
Work Type: Repair
Description: spot repair up to 10'to repair sanitary sewer
Meter Size Meter Tyne Manufacturer Serial Number Remote Number Line Size
Comments: Please call Utilities at(651)675-5200 for water turn ons,shut offs and meters.
Please call Engineering at(651)675-5646 to schedule inspections.
Fee Summary: Permit Fee-Sewer $74.00 6201.4532
Surcharge-Fixed $1.00 9001.2195
Total: $75.00
Contractor: - Applicant - Owner:
Roto Rooter Karl Ah Pook
14530 27th Ave N 1516 Oakbrooke Ln
Plymouth MN 55447 Eagan MN 55122
(763)519-3977
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 ssued B :Signature
-----------------
For Office Use
� I
a, # l Permit#:Ah G A
EA U I
jPermit Fee:.
Date Received: i
LM X1/15
Staff:
2022 SEINER WATER PERMIT
Date: ! i 5'��?oZ Site Address:
�.. .,... 0-Ict 5 tc h F l SProperty I
ii Owner Name: i't 1��a6 Phone: 19- 7 q3 3
Address/City/Zip: Ll qc ]�j S u_i1 h t S e 'Ipz- , , ecu;c0- Vr
; Name: License#: P (g{9 S
Address/City/Zip: Jr t.� �"2 +� L j �.�
Contractor - �� 11 �c) h
' Phona:l(d 3-5 l`�c3`i�7 Email: fir ' t0 YYLbe r%c O Q-Qs c4 on,
P
Pipelayer Training Certification#: or Master Plumber License#: 1 mbQ 0
Property Use: Type of Service € Type of Work:
Residential ❑ Sewer&Water ❑ New
s
a t
❑ Commercial Sewer Oni iy jD14-0
❑ Public Facility Water Only ❑ Disconnect P 'r� ``rte. S tQ a Ir--
❑ I understand that new water connections require a separate Plumbing Permit and associated meter fees.
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 apermit,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 In the case of work whichrequires a review and approval of plans.
40 x
Applicant's Printed Name Applicant's Signature
FOR OFFICE USE ONLY
Fees: Required Inspections: Sewer Only
Sewer Permit($74.00) 14- Sewer Air Test
Water Permit($74.00) Mandrel Test
S&W Repair/Disconnect($74.00) Sewer Lines Televised
Sewer lateral Verify Meter Configuration
Sewer trunk Water Only
Water supply&storage Conductivity Test
Water lateral Hydrostatic Test
Water trunk Bacteria Test
City SAG($131.50/SAC unit) Standpipe Inspection
Met Council SAC($2,485/SAC unit) Wet Tap
Treatment Plant($1,065.50/SAC unit)
State Surcharge $1.00 Additional Requirements:
Total City R-O-W Permit
CountyR-O•W Permit
Plumbing Permit
PRV Required
3830 PILOT KNOB ROAD I EAGAN, MN.55122
(651)675-5675(FAX:(651)675-5694 buildinainspectionsgDcityofeagan com
If you have a hearing or speech disability,contact us through your preferred telecommunications relay service.