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EA182837 - Sewer & Water - Residential - Issued Date 05/11/2023 PERMIT City of Eagan ® ® Permit Type: Sewer& Water 3830 Pilot Knob Rd ®®�® ® ® ®;® Permit Number: EA182837 Eagan, MN 55122 ®®®® m®®® EAGAN (651)675-5675 11111111111111111111111111111111111111111 IN IN * E R 1 8 2 8 3 7 www.cityofeagan.com Date Issued: 5/11/2023 Site Address: 3763 Brown Bear Tr Lot: 12 Block: 3 Addition: Blackhawk Forest PID:10-14325-03-120 Use: * 10 — 14325 - 03 — 120 * Description: Sub Type: Residential Work Type: Sewer Only Description: Repair Meter Size Meter Type 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: Krueger Excavating Inc Mary Jane Pedersen P.O.Box 729 3763 Brown Bear Tri Prior Lake MN 55372 Eagan MN 55122 (952)447-8335 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 ----------------, ® e I For Office Use "%� ��� j Pennn#: 182837 Permit Fee: E A C"IA N I Date Received: 511/23 I I I �—Staff----------------� 2023 SEWER & WATER PERMIT Date: 5-11-23 Site Address: 3763 Brown Bear Trail Propefty Name: Mike Sylvester Phone: 't9rttar' 3763 Brown Bear Address/Gity2lp: Name: Krueger Excavating Inc Lleense#: PB658581 Con�a�r Address/city2ip:7616 180th st E, Prior Lake MN 55372 Phone:952-292-0154 Email: tracy@kruegerexcavating.COm Pipelayer Training Certification#. PB658581 or Master Plumber License#: Property Use: Type of Service: Type of Work: 0 Residential ❑Sewer&water ❑ New ❑Commercial 0 Sewer Only 0 Repair,Description: repair sewer service a ❑ 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 lose of work which requires a review and approval of plans. xTracy Krueger x Applicant's Printed Name Applicant's Signature ►R"bFIFICE,USE ' SIJ t"et 7f1Nj onas $ewer,C7ni1+ SeWarPai { .fa"rAir lest 11 , Water Est}tit#t; Bd. Q} ". Manttraai Tot ` S&W Repair/Distannect($80.00) Sewer Liners Televisaad Sewer lateralverify Meter ConOg tration Sewer trunk Water Only Water supply'8 storage Conductivity Test Water lateral; Hydrostatic Test Water trunk Bacteria Test City SAG($t 3t3,t401SAC unit) Stead Pipeinspection Met C+o6Ci[QACiM151SAG unity . Wet Tap Trey#rnenPtan4 ,9k11pAGiihitj h . i Stats surfiarge $?:tit) Adeitivrrdt RegtpfreMs; Total: Tri lit`uegsr City R-?-V1i Pdtttt f County R-0-W perntlt Plumbing Permit p PRV Required' 3830 PILOT KNOB ROAD i EAGAN,MN 55122 (651)675-56751 FAX(651)675-5694 buildinainsosctions(alcitvofeaoanxorn If you have a hearing or speech disability,contact us through your preferred telecommunications relay service.