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<br />Environmental Health Services Section <br />121 East Seventh Place, Suite 220 <br />P.O. Box 64975 <br />St. Paul, Minnesota 55164-0975 <br />651/215-0836 <br />Minnesota Relay Service (Greater MN) 1/800/627-3529 <br />Minnesota Relay Service (Metro) 297-5353 <br /> <br />Office Use Only <br /> <br />Plan No. <br /> <br />Fee <br /> <br />PLAN REVIEW FEE SHEET <br /> <br />Deposit No. <br /> <br />Deposit Date <br /> <br />2 sets of plans are required. <br /> <br />If submitting plans via U.S. Mail, please use the above address. <br /> <br />If submitting plans via a courier service, etc., mail to the following address: <br />Minnesota Department of Health <br />Engineering Unit - Plan Review <br />121 East Seventh Place, Suite 220 <br />St. Paul, MN 55101 <br /> <br />This application must be completed and fee submitted before the plans will be reviewed. "X" PROJECT <br />TYPE(S) AND FILL IN TOTAL FEE SUBMITTED. <br /> <br />[X] Watermains <br />[] Well <br />[] Pumphouse <br />[] Chemical Feed <br />[] Treatment Plant (new) <br />[] Treatment Plant (renovation) <br />[] Storage (installation) <br />[] Storage (coating) <br />[] Booster Station <br /> <br />$ 150.00 Fees are additive for multiple <br />$ 250.00 project types included on <br />$ 150.00 one set of plans. <br />$ 150.00 <br />$1,000.00 <br />$ 250.00 <br />$ 300.00 <br />$ 100.00 <br />$ 150.00 <br /> <br />Total Fee Submitted <br /> <br />$ 150.00 <br /> <br />Payable to Minnesota Depm1ment of Health <br /> <br />~v~v~v~v~v~v~v~v~v~v~v~v~v~v~v~v~v~v~v~v~v~v~ <br /> <br />PLEASE TYPE OR PRINT THE FOLLOWING REQUIRED INFORMATION. <br /> <br />Is this a Drinking water revolving fund loan project? <br /> <br />Yes <br /> <br />x <br /> <br />No <br /> <br />Name of Project: <br />Project Location: <br />Owner's Name: <br /> <br />Pheasant Marsh Utility & Street Improvements Phase 1 <br />Centerville MN <br />City of Centerville <br />1880 Main Street, Centerville MN 55038-9794 <br />Bonestroo, Rosene, Anderlik & Associates, Inc. <br /> <br />Owner's Address: <br />.ubmitter's Name: <br />Submitter's Address: <br /> <br />2335 West Highway 36, St.Panl, MN 55113 <br /> <br />Submitter's Telephone Number: 651-636-4600 <br />