EA181984 - Sewer & Water - Residential - Issued Date 03/31/2023 PERMIT
City of Eagan Permit Type: Sewer& Water
3830 Pilot Knob ®,® ®,® , Permit Number: EA181984
Eagan,MN 551222 °a-• ••®� EAGAN
(651)675-5675
www.cityofeagan.com * E A 1 8 1 9 8 4
Date Issued: 3/31/2023
Site Address: 4072 Diamond Dr
Lot: 3 Block: 2 Addition: Cedar Grove 3rd
PID:10-16702-02-030 11111 IN 111111111111111111111111111111111111111111111111111 1111M
Use: * 10 - 16702 - 02 - 030 *
Description:
Sub Type: Residential
Work Type: Sewer Only
Description: Repair
Meter Size Meter lype 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: Surcharge-Fixed $1.00 9001.2195
SW-Sewer Permit Fee $80.00 6201.4532
Total: $81.00
Contractor: - Applicant - Owner:
Ouverson Sewer&Water Inc Cynthia A Seger
PO Box 247 4072 Diamond Dr
Loretto MN 55357 Saint Paul MN 55122--281
(612)751-6888
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
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For
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For office Use
eo► ; / 0 181984
Permit#:
EAGAN I
Permit Fee: ' Ce
3/31/2023 I
Date Received: I
I I
Staff: 1
I
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2023 SEWER & WATER PERMIT
Date: 3/31/23 Site Address: 4072 Diamond Dr
Property Name: Cindi Seger Phone: 641-454-6064
Owner 4072 Diamond Dr
Address/City/Zip:
Name: Ouverson Sewer & Water License#: MR86668
Contractor
Address/City/Zip: 915 Blue Gentian Rd Suite 1000, Eagan, MN 55121
Phone: 612-751-6888 Email: kelli@linemysewer.com
Pipelayer Training Certification#: or Master Plumber License#:P R644100
Property Use: Type of Service: Type of Work:
Residential ❑ Sewer&Water ❑ New
❑ Commercial 14 Sewer Only Repair, Description: Install approx 70ft of 4"/8°CIPP Hammerhead brand sewer lining
�
❑ Public Facility ❑ Water Only ❑ Disconnect
1 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 a permit,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 which requires a review and approval of plans.
XKelli Ouverson . .
J44717 d
Applicant's Printed Name ApplikintA Signature
QIP Q pIC IJSI ONLY
Fees: Required Inspections: Sewer Only
Sewer Permit($80.00) Sewer Air Test
Water Permit($80.00) Mandrel Test
! S&W Repair/Disconnect($80.00) Sewer Lines Televised
I Sewer lateral. Verify Meter Configuration
Sewer trunk Water Only
Water supply&storage Conductivity Test
Water lateral Hydrostatic Telt j
Water trunk s Bacteria Test
i City SAC($139.00fSAC unit) Stand Pipe Irispectiah
Met Council SAC($2,4,85/SAGunit) Wet Tai
Treatment Plant($1,126 Qt)1SAC unit)
State Surcharge $1.00 AddlttOne Requlrements:
Total: Kalil ouverson City R-O-w Permit
County;R-�Wi'Permit a
Plumbing Permit 3
PRV Required
3830 PILOT KNOB ROAD I EAGAN, MN 55122
(651)675-56751 FAX: (651)675-5694 buildinainspections ,—cityofeaaan.com
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