EA189605 - Sewer & Water - Residential - Issued Date 03/12/2024 PERMIT
City of Eagan , , , , Permit Type: Sewer& Water
3830 Pilot Knob Rd •��;•� %;:, Permit Number: EA189605
Eagan, MN 55122 EAGAN
(651)675-5675
www.cityofeagan.com * E R 1 8 9 6 0 5
Date Issued: 3/12/2024
Site Address: 2096 Emerald Lane
Lot: 1 Block: 6 Addition: Cedar Grove 1st
PID:10-16700-06-010 1111 111111111111111111111 1111M
Use: * 10 — 16700 - 06 - 0 10 *
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:
Roto Rooter Frances Dipaola Tste Bornman
14530 27th Ave N 2096 Emerald Ln
Plymouth MN 55447 Eagan MN 55122
(763)519-3977
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
For Office Use— — I
0 Alk
.ra Permit#: n�
MM I
I
Permit Fee: _
I Date Received:
1
I
I Staff:
r------------------�
2024 SANITARY SEWER & WATER PERMIT
._
w
Date: 3/12/2024 site Address: 2096 Emerald LN .
:Ow:n
rty Name: Fran Bornman — �612-481-7435�� � ���
Phone:
er 2096 Emerald LN
Address/City/Zip:
Name: Roto Rooter License#. pC644621
Contractor
Address/City/Zip: 14530 27th ave N Plymouth MN 55447
Phone: 763-286-8291 Email: blaine.weiss@rrsc.com
1453 1
Pipelayer Training Certification#: or Master Plumber License# PM05865I
— rrv� w,
Property Use: Type of Service: Type of Work.
Residential ❑ Sanitary Sewer&Water ❑ New
i
i
❑ Commercial ® Sanitary Sewer Only ® Repair, Description: Repair and install CIPP liner
❑ Public Facility ❑ Water Only ❑ Disconnect
. .v„a .. . . ._.. . _.mw
❑ 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 Vwith 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 jtwitt 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.
xBlaine Weiss -
Applicant's Printed Name Appllnature
FOR OFFICE USE ON
Fees: Required`Inspections: Sanitary Sewer Only
Sanitary Sewer Permit($80.00) Sanitary Sewer Airiest
Water Permit($80.00) Mandrel Test
S&W Repair/Disconnect($80.00) Sanitary Lines Televised
Sanitary Sewer lateral
Sanitary Sewer trunk Verify Meter Configuration Water supply&storage Water Only
Conductivity Test
Water lateral
Water trunk Hydrostatic Test
Bacteria Test
City SAC($142.50/SAC unit) Stand Pips.inspection
Met Council SAC($2,485/SAC unit) Wan Tap
Treatment Plant($1,154.70/SAC unit)
State Surcharge $1.00 Additional Requirements:
Total: City R-O-W Permit
County R-O-W Permit
Plumbing Permit
PRV Required
3830 PILOT KNOB ROAD I EAGAN,MN 55122
(6a1)675-5675 FAX: Y 51 t575-5894 build i ectiar)s c i_k afc aq i�_c orn
If you have a hearingars each disability,contact us Clirou h cur referred toiecomrnunications relay service.