EA186144 - Sewer & Water - Residential - Issued Date 08/18/2023City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675-5675
www.cityofeagan.com
PERMIT
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Permit Type: Sewer & Water
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Permit Number: EA186144
EAGAN
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Date Issued: 8/18/2023
Site Address: 2079 Coral Lane
Lot: 17 Block: 4 Addition: Cedar Grove 2nd
PID:10-16701-04-170
Use:
Description:
Sub Type: Residential
Work Type: Sewer Only
Description: Repair
Meter Size Meter Type Manufacturer Serial Number
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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 Curtis A Otterness
14530 27th Ave N 19760 County Road 15
Plymouth MN 55447 Elk River MN 55330
(763) 519-3977
i'his 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
3f Minnesota Statutes and City of Eagan Ordinances.
Applicant/Permitee: Signature
Issued By: Signature
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Name: � -�- ,qtr°' License #. � rte. 0.3 � ka S `%
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Pipelayer Training Certification #. - _ _ or Master Plumber License #: P M V(-, %=
Property Use: a Type of Service: Type of Work:
aResidentiai a ❑ Sewer & Water ❑New
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❑ Commercial Sewer Only Repair, DescripR
tion:((r� t rr i1 rf� , C.P lEcb_E?
❑ Public Facility ❑ Water Only ❑ Disconnect
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t..✓ I understand that new water connections require a separate Plumbing Permit
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q p g t t and associated meter fees.
I hereby acknowledge that this information Is complete and accurate; that the work wilt 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 case of work which requires a review and approval of plans.
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Applicant's Printed Name r' Applicant's Signature
Fees:
Sewer Permit ($80:00)
Water Permit ($80.00)
S&W Repair/Disconnect ($80.00)
Sewer lateral
Sewer trunk
Water supply & storage
Water lateral
Water trunk
City SAC ($139:00/SAC unit)
Met Council SAC ($2,485/SAC unit)
Treatment Plant ($1,126.00/SAC unit)
State Surcharge
Total:
FOR OFFICE USE ONLY
Required Inspections: Sewer Only
$1.00 Additional Requirements:
Sewer Air Test
Mandrel Test
Sewer Lines Televised
Verify Meter Configuration
Water Only
Conductivity Test
Hydrostatic Test
Bacteria Test
Stand Pipe Inspection
Wet Tap
City R -O -W Permit
County R -O -W Permit
Plumbing Permit
PRV Required
3830 PILOT KNOB ROAD I EAGAN, MN 55122
(651) 675-5675 ( FAX: (651) 675-5694 buildinginsoections aecityofeaaan.com
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