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EA186098 - Sewer & Water - Residential - Issued Date 08/15/2023
PERMIT City of Eagan , , , , Permit Type: Sewer & Water 3830 Pilot Knob Rd 4��m„° °, Permit Number: EA186098 Eagan,MN nob R `»»® EAGA (651)675-5675 1111111111111 1IM111 1111111111 www.cityofeagan.com * E A 1 8 6 0 9 8 Date Issued: 8/15/2023 Site Address: 692 Oxford Rd Lot: 4 Block: 5 Addition: Hills of Stonebridge 3rd PID:10-32992-05-040 Use: * 1 0 - 32992 - 0S - 040 * Description: Sub Type: Residential Work Type: Sewer Only Description: Meter Size Meter Tempe 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: Ouverson Sewer&Water Inc Timothy L&Sarah.1 Wagner PO Box 247 692 Oxford Rd Loretto MN 55357 Saint Paul MN 55123--394 (612)751-6888 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 Issued By: Signature ---------i ® ! I For Office Use Rte ; �� 1 Q I I Permit#: l 6 b 0 1 PU EAGAN 1 Permit Fee: I 1 1 Date Received: ' 1 I I I I Staff: I ------------------- 2023 ----------------J2023 SEWER & WATER PERMIT Date: 8/15/23 Site Address: 692 Oxford Road Property Name: Tim Wagner Phone: 651-492-2842 owner Address/City/Zip: 692 Oxford Road, Eagan, MN ' Name: Ouverson Sewer & Water, Inc License#: MR86668 Contractor Address/City/Zip: 915 Blue Gentian Road, Suite 100, Eagan, MN 55121 Phone: 612-751-6888 Email: kelli@linemysewer.com Pipelayer Training Certification#: or Master Plumber License#:P R6441 00 Property Use: Type of Service: Type of Work: 1z Residential ❑ Sewer&Water ❑ New ❑ Commercial 14 Sewer Only Repair, Description: Excavate&repair broken pipe, NO ROW work ❑ Public Facility ❑ Water Only ❑ Disconnect ❑ 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 I understand this is not a permit,but only an application for a permit,and work is not toYanty'siSij'N out a permit; t the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. KL-Ili Ouverson X x Applicant's Printed Name App �ture FOR OFFICE USE ONLY Fees: Required Inspections: Sewer Only Sewer Permit($$0.00) Sewer Air Test Water Permit($8Q.00) Mandrel Test S&W Repair/Disconnect($80.00); Sewer"Lines,Televised Sewer lateral " Verify Meter Configuration Sewer"trunk Water Only Water supply&storageConductivity Test" Water lateralHydrostatic Test" Water trunk Bacteria'Test City SAC($"139.00/SAC unit) Stand Pips Inspection Met Council SAC;($2,485�/SAC unity Wet Tap . Treatment Plant r$1,12�.t?0/SAC;unit),, Mate Sur+~harge° $�.Ob Additi©nal Requirements: Total: City R-q-W Permit County R-O-W Permit Plumbing Permit ORV Required 3830 PILOT KNOB ROAD I EAGAN, MN 55122 (651)675-5675 1 FAX: (651)675-5694 buildinginspections(cD-cityofeagan.com If you have a hearing or speech disability, contact us through your preferred telecommunications relay service.