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EA182584 - Sewer & Water - Residential - Issued Date 05/01/2023 PERMIT City of Eagan e e Permit Type: Sewer& Water 3830 Pilot Knob Rd °;e ®®®, Permit Number: EA182584 Eagan,MN 55122 ®®®® --®® EAGAN (651)675-5675 111111111111 www.cityofeagan.com * E A 1 8 2 5 8 4 Date Issued: 5/1/2023 Site Address: 2116 Emerald Lane Lot: 1 Block: 5 Addition: Cedar Grove 1st PID:10-16700-05-010 Use: * 10 - 16700 - 05 - 010 * Description: Sub Type: Residential Work Type: Repair Description: 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: Surcharge-Fixed $1.00 9001.2195 SW-Sewer Permit Fee $80.00 6201.4532 Total: $81.00 Contractor: - Applicant - Owner: A Z Underground Kaela Ann Arcuri 5718 International Pkwy 2116 Emerald Ln Brooklyn Park MN 55428 Eagan MN 55122 (612)238-9701 This permit shall be null and void if work does not start within 180 days of issuance,or if work is suspended for 180 days or more after started. I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Applicant/Permitee: Signature ssued B : Signature ----------- i --- ® f I For Office Use I #:Permit � • eo ' 0 I d2' � 9' 1 Permit Fee: EAGAN Date Received: I I Staff: —————————————————J 2023 SEWER & WATER PERMIT Date: 5/1/2023 Site Address: 2116 Emerald Ln, Eagan, MN 55122 �prty Name: Jeffrey Arcuri Phone: 612-321-6409 owns" 2116 Emerald Ln, Eagan, MN 55122 Address/City/Zi. g Name: Grant Acquisition LLC DBA A-Z Undergrou License* PC772192 Contractor Address/City/Zip: 5718 International Pkwy Phone: 612-238-9701 Email: service@a-zunderground.com Pipelayer Training Certification#: or Master Plumber License#: PM059450 Property Use: Type of Service: Type of Work: 0 Residential ❑ Sewer&Water ❑ New a nenr deeewr eunu a cu+v uem(es n a•.io n e�an rowaree am sewer.-*Q me yam 101W emcee me on ❑ Commercial Sewer Only Repair, Description: ❑ Public Facility ❑ Water Only ❑ Disconnect 91 1 understand that new water connections require a separate Plumbing Permit and associated meter fees. I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit,but only an application for a permit,and work is not to start without a permit;that the work will be in accordance with the approved plan In the case of work which requires a review and approval of plans. x Molly Kroker x Applicant's Printed Name Applicant' Signature FORDFFICE U$� 11�L:Y Fees: Required Inspectipns: Sewer Only, Sewer permit($80.00) Sewer Air Test Water Permit(1:80.00) 'Mandrefts t I Si3�W Iepa(r/Disconnect($80.t30) ewer Ines Televised Sewer lateral Verify Meter Conttguratton Sewer trunk Water Only Water supply&storags Conductivity Test i Water lateralklydrostatic Test Water trunk Bacteria Test City SAC($139.00/SAC unit) Stand Pipe Inspection I Met Council SAC($2,485/SAC unit) Wet Tap Treatment Plant($1;126.00/SAC UhIt) r State Surcharge,, $100 Additional Requltimenta», Total; City R=Q'•W Permit County R-O-W.Permit Plumbing Permit PRV Required 3830 PILOT KNOB ROAD I EAGAN, MN 55122 (651)675-5675 1 FAX: (651)675-5694 buildinainsaections(&citvofeaaan.com If you have a hearing or speech disability,contact us through your preferred telecommunications relay service.