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
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® f I For Office Use
I #:Permit
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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.