EA182632 - Sewer & Water - Residential - Issued Date 05/02/2023 PERMIT
City of Eagan , , Permit Type: Sewer& Water
3830 Pilot Knob Rd mom°; ° a ®e® Permit Number: EA182632
Eagan,MN 55122
EAGAN
(651)675-5675 111111111111
www.cityofeagan.com * E R 1 8 2 6 3 2
Date Issued: 5/2/2023
Site Address: 2930 Burnside Ave
Lot: 2 Block: 3 Addition: Country Home Heights
PID:10-18300-03-020 111111 IN 1111111111 11111M
Use: * 10 - 18300 - 03 - 020 *
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:
Roto Rooter George L Willmarth
14530 27th Ave N 2930 Burnside
Plymouth MN 55447 Saint Paul MN 55121-434
(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
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a®•®' ��t! e I Permit#: �P I
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I Permit Fee:, ( I
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Date Received: I
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Staff:
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2023 SEWER & WATER PERMIT
Date: ;9— a-627-13—13 Site Address:a%3
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Property 1 Name: -R-tAC' YOU- 1�C, C V' Phone: t0�1' a1(�s °y-1DO
Owner
' Address/Ci 1Zi :
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Name: O4 K(�O? �Y`
� License#: P IYI.['5k(o
` contractor Addressrcity/Zip:_1�f�3 C�- �-7� h � � �v �L n p�`h �� � �6
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Phonel&d6ll"1 39_2'7 Email: kL1 _T—ko_ `t-1 9C lV13rl o
Pipelayer Training Certification#: or Master Plumber License#:
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Property Use: Type of Service: ' Type of Work:
Residential ❑ Sewer&Water is ❑ New �4e,
d ❑ (� Repair,Description:Sewer Only l 4
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❑ Public Facility 4-6
Water Only w ❑ Disconnect v P +o L�q,-+ e_,r j vte4eY
❑ 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 Iunderstand 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
dd[plan in the case of work which requires a review and approval of plans,
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Applicant's Printed Name Applicant's Signature
FOR OFFICE USE 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
Sewer lateral Verify Meter Configuration
Sewer trunk Water Only
Water supply'&storage Conductivity Test
Water lateral Hydrostatic Test
Water trunk Bacteria Test
City SAC.($1.39.00/SAC unit) Stand Pipe Inspection
Met Council SAC($2,485/SAC unit) Wet Tap
Treatment Plant($1,126.00/SAC unit)
State Surcharge $1.00 Additional Requirements:
Total: City R-O-W Permit
County R-O-W Permit
Plumbing Permit
PRV Required
3830 PILOT KNOB ROAD(EAGAN,MN 55122
(651)675.56751 FAX:(651)675-5694 buildinoinsoectionsOcitvofeaoan com
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