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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 r----------------, I For Office VS0 I a®•®' ��t! e I Permit#: �P I A G A 0"'No a.� I I Permit Fee:, ( I I I Date Received: I I I Staff: ----------------- I 2023 SEWER & WATER PERMIT Date: ;9— a-627-13—13 Site Address:a%3 a 11 / Property 1 Name: -R-tAC' YOU- 1�C, C V' Phone: t0�1' a1(�s °y-1DO Owner ' Address/Ci 1Zi : v p S� ryl T\J. 1 -.1- I 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 f Phonel&d6ll"1 39_2'7 Email: kL1 _T—ko_ `t-1 9C lV13rl o Pipelayer Training Certification#: or Master Plumber License#: w - Property Use: Type of Service: ' Type of Work: Residential ❑ Sewer&Water is ❑ New �4e, d ❑ (� Repair,Description:Sewer Only l 4 e �_ � ❑ 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, x_ t lG�If` �f�21p�. x 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 If you have a hearing or speech disability,contact us through your preferred telecommunications relay service.