EA182920 - Sewer & Water - Residential - Issued Date 05/16/2023 PERMIT
City of Eagan Permit Type: Sewer& Water
3830 Pilot Knob Rd ®a® ®®A'® Permit Number: EA182920
Eagan, MN 55122 ®a•• •--•
EAGAN
(651)675-5675 111111111111
www.cityofeagan.com * E R 1 8 2 9 2 0
Date Issued: 5/16/2023
Site Address: 3675 Canary Way
Lot: 004 Block: 001 Addition: Westbrook 1st
PID:10-83625-01-040 11111111111111111111111111 Igo
Use: * 10 - 8362S - 01 - 040 *
Description:
Sub Type: Residential
Work Type: Sewer Only
Description: Repair
Meter Size Meter lype 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:
Triple E Water and Sewer LLC John E Ranheim
5232 Hanson Ct N 3675 Canary Way
Brooklyn Center MN 55429 Saint Paul MN 55123--222
(763)207-8068
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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------------I :1
r For Office Use
I I
o e o ® I Permit#: I I
EAGAN Permit Fee: 1
1
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Date Received: !
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�—Staff:
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_-
2023 SEWER & WATER PERMIT
Date: 5/16/2023 site Address:
3675 Canary Way Eagan, MN, 55123 4 `
Property Name:
John Ranheim Phone:
6512480022
owner 3675 Canery Way Eagan, MN, 55123
Address/City/Zip:
Tri le a water and sewer PB710895
Name: P
License#:
Address/city/Zip: 5232 Hanson Ct N Crystal, MN, 55429
Contractor sam@eee-ws.com
Phone: 763 207 8068 Email: V
9386 or Master Plumber License#:
Pipelayer Training Certification#:
Property Use: Type of Service: Type of Work:
91 El Sewer&Water 11 New Residential Excavate and repair sanitary sewer In yard.Replace up to 8'with new PVC
Only Repair, Description:
[3 Commercial 14 Sewer Onl
❑ Public Facility
❑Water Only ❑ Disconnect
❑ 1 understand that new water connections require a separate Plumbing Permit and associated meter fees.cation for a permof Eagan;
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
that I understand this is not a permit,but only app it,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 es Digitally signed by Samuel Erickson
a review and approval of plans. Samuel Erickson Date:2023.05.15 09:49:12-05'00'
X Samuel Erickson Applicant's Signature
Applicant's Printed Name
_ "p4R OFFICE USE ONLY
r Requtred Inspections: Sewer Clnly
Edies. Sewer Air Test
Sewer Permit($80.00) Mandrel Test
Water Pert$$Q.00) Sewer Lines Televised
e 'ai!disconnect($80.00} Verify Meter Configuration *_.---
S&W R r Water Only
Sewer lateral Conductivity Test
Sewer trunk Hydrostatic Test
Water supPIY&storage Bacteria Teat
Water lateral Stand Pipe Inspection _--
Water trunk Wet Tap
City SAC($139.00/SAC unit) ;
Met otandi24851SAC unit)
TreatmntPlant`($1,126;p0/SAC unit) $100 Additional Requtremenx
State Surcharge City
to,w Permit
Total: Samuel Erickson County R-O W Permit.
Plumbing Permit _—
PRY Required
- J _ 3830 PILOT KNOB ROAD J EAGAN,MN 55122
our referred to
relay service.
(651)675-5675 i FAX: (65ca675-5694 nta t us throulgh y lnsp cferredonsa�cityofeaaan.com
If you have a hearing or speech disability,