1380 Lone Oak Rd - Well Sealing7?? oa oa a c I
ORD4VANCE YO. 114:
WELL CONSTRUCfION AND ABANDONMENT
WELL PERNIlT
•^'?"Cs D.a,HOTA COUNTY PUBLIC HEALTH DEPARTMENT
ENVIRONMII`1'TAL AF.ALTH SERVICES SECTION
_ WATER QUALITY MANAGEMENT UN1T
$? -
33 E Wentworth Ave, West SL Paul, MN 55118
Telephone: (612)450-260'1
WHEREASi, the
PERMITTBB/DBB: Rimmes-Bauer, Inc.
ADDRE38: 21830 Lillehei Avenue
Hastinqs, AIIi 55033
Pezmit No.
90-9156
has submitted a permit application, has paid the sum oP one
hundred ($100.00) dollars to the County of Dakota as required by
Ordinance Number 114 and has complied with all of the
requirements of said Ordinance necessary for obtaining this
permit to permanently seal the well described herein:
An abandoned well with a casing diameter of 4 inches and depth(s)
of 340 feet will be permanently sealed. The well shall be
cleaned of equipment and debris, disinfected, neat cement
pressure grouted and terminated at least two feet below grade.
The well is located in the municipality of Eagan on the property
of:
Owner: John Shields Well Location (if different):
Address: 1380 Lone Oak Road
Telephone: Eagan, lYII1
NOA, THEREFORS; Rimmes-Bauer, Inc. is hereby permitted and
authori2ed to permanently seal the well(s) described and located
above for the period September 1990 to September 1991 subject to
all provisions of said Ordinance, the Minnesota Water Well
Construction Code and any conditions attached on the reverse side
of this permit form.
1990. ?
Given under my hand this llth day 7=a?"-v
NON-TI2ANSFERABLB
f?PG'I?'?AL IIEXLTH SPECIALIST
ATTF.ST ? YLQ.
ENVIRONMENTAL HEALTH SUPERVISOR PUBLIC HEALTH DIRECTOR