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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