EA188502 - Plumbing - Septic System - Issued Date 12/20/2023PERMIT
City of Eagan , , Permit Type: Plumbing
3830 Pilot Knob Rd " `' ' ' ' Permit Number: EA188502
EAGAN
Eagan, MN 55122 •••- ••-•
(651) 675-5675
www.cityofeagan.com * E R 1 8 8 SP1 2
Date Issued: 12/20/2023
Site Address: 4325 Nicols Rd
Lot: 001 Block: 029 Addition: Section 30
PID:10-03000-29-010
Use: * 1 0— 0 3 0 0 0— 2 9— 0 1 0
Description:
Sub Type: Septic System
Work Type: Abandonment
Description:
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:
Fee Summary: PL - Septic Abandonment $64.00 0801.4087
Surcharge -Fixed $1.00 9001.2195
Total: $65.00
Contractor: - Applicant -
Owner:
JM Hauling LLC
Herbert & Helen Adelmann
P.O. Box 285
4325 Nicols Rd
St. Paul Park MN 55071
Saint Paul MN 55122--191
(351) 3349371
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
LM I1/I5
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
(651) 675-56751 FAX: (651) 675-5694
buildinginspections(a�cityofeagan.com
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For Office Use
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RESIDENTIAL
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RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: 12/13/2023 Site Address: 4325 Nicols Road Unit#:
Applicant is: ❑ Owner 14 Contractor
Name: Dakota Community Development Agency
Homeowner Address: 1228 Town Centre Drive city: Eagan
State: MN Zi 55123 Phone: 651-675-4400 Email: lalfson@dakotacda.org
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Type of Work —New _Replacement —Repair _Rebuild _ Modify Space _ Work in R.O.W.
Description of work: Abandon septic system
Tankless Water Heater
Standard Water Heater
Lawn Irrigation (_ RPZ /_ PVB) Description Water Softener Add Plumbing Fixtures (_ Main /—
Lower Level)
Septic System Description:
Connection to City Water from Well
New V Abandonment
Company: JM Hauling LLC Contact: Jody MCDaniels
Plumbing Address: PO Box 258 City: St. Paul Park
Contractor State: MZip..Phone: Email. g@gN 55071 651-334-9371 mexcavatin 712 mail.com
License #: Expiration IR715168 n Date: : 12/31/23 (being renewed)
RESIDENTIAL FEES
$150.00 New Residential or Connection to City Water (includes State Surcharge)
$65.00 Water Heater, Water Softener, or Water Heater and Softener (includes State Surcharge)
$65.00 Lawn Irrigation (includes State Surcharge)
$65.00 New fixtures, adding, altering, or removing piping (includes State Surcharge)
$65.00 Septic System Abandonment (includes State Surcharge) 65.00
..TOTAL FEES $
CALL BEFORE YOU DIG. Contact Gopher State One Call at (651) 454-0002 or www.gopherstateonecall.org for protection against underground utility
damage. Contact Gopher State One Call 48 hours before you intend to dig to receive locates of underground utilities.
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 case of work which requires a review and approval of plans.
XJody McDaniels XJody MCDanielS Date:2023.1edbyJody41-06' 0'
Date: 2023.12.13 14:04:41 -0600'
Applicant's Printed Name Applicant's Signature
FOR OFFICE USE
Reviewed By: Date:
Meter Size (If applicable):,
RequiredInspections: Under Ground Rough -In Air Test Gas Test Manometer Final