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3055 Eagandale PlPROPERTY OWNER Name . 4E ,, 4 4 X,g ✓ ,39. 1.77 `,),..- Phone: 6'66' 75 7/0 Address / City / Zip; 3 5' z"- t /'L ,e "' 't ,'W 5 Applicant is: Owner / Contractor TYPE OF WORK Description of work: 00/ Construction Co!^l'v',c72s CONTRACTOR Name: 6- P/ /39/47/1/6- ivicieve.: ,'f,h' License #: 1 AddresS1 3 ,'/ be", ij / 271.. 1 /O City: .+; , &45. fEA?, / State: r1: .5 Zip: 75 ,'/I Phone: r Zz l .49!/ Contact:7.`.4-gN XM17iq144 Email: ARCHITECT / ENGINEER Name: Registration #: Address: City: State: Zip: Phone: Contact Person: Email: Licensed plumber installing new sewer /water service: Phone #: NO TE; Plans and supporting documents th information ma : be classified as non-public ,. " conc that you submit are considered to be p ub licor mation. Port of if yen provide s ecific reasons that ultl a t the Ce to lude `that ;they are trade secrets. , 4 City of Eagan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675 -5675 Fax: (651) 675 -5694 n f Date: - ' 2 / I/ Site Address: 3o Tenant Name: L_eal 04-461.6 .6 Applicant's Printed Name (Tenant is: New / r Applicant's Signature Use BLUE or BLACK Ink Permit #: qg 7 / / Permit Fee: 5 9 — . Date Received: 1- RECEIVE0 APR 262011 2011 COMMERCIAL BUILDING PERMIT APPLICATION Staff: 27 3oK6' ,l ip ✓, p, , Z. ;9r' 4'r✓. '3 Existing) Suite #: Former Tenant: CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454 -0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.orq 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 re a re ie an... proval of plans. Page 1 of 3 SUB TYPES Foundation Public Facility Apartments Lodging Greenhouse / Tent Miscellaneous Antennae WORK TYPES New Addition DESCRIPTION Valuation Plan Review (25% 100 %) Census Code #of Units # of Buildings Type of Construction REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) Foundation Drain Tile Commercial / Industrial Interior Improvement Exterior Improvement Alteration Repair Replace Water Damage Retaining Wall Occupancy Code Edition Zoning Stories Square Feet Length Width Roof: _Decking Insulation _Ice & Water Final Framing Fireplace: Rough In _Air Test _Final Insulation Meter Size: Final C/O Inspection: Schedule Fire Marshal to be present: COMMERCIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC S &W Permit & Surcharge Treatment Plant Treatment Plant (Irrigation) Park Dedication Trail Dedication Water Quality DO NOT WRITE BELOW THIS LINE Accessory Building Exterior Alteration - Apartments Exterior Alteration - Commercial Exterior Alteration - Public Facility Siding Demolish Building* Reroof Demolish Interior Windows Demolish Foundation Fire Repair Salon Owner Change *Demolition of entire building - give PCA handout to applicant Yes No Sheetrock Final / C.O. Required Final / No C.O. Required Other: Pool: _Footings _Air /Gas Tests Final Siding: Stucco Lath Stone Lath Brick Windows Retaining Wall Erosion Control Water Quality Water Supply & Storage (WAC) Storm Sewer Trunk Sewer Trunk Water Trunk Street Lateral Street Water Lateral Other: MCES System SAC Units City Water Booster Pump PRV Fire Sprinklers Reviewed By: , Building Inspector Reviewed By: TOTAL Planning Page 2 of 3 CITY OF+EAGAN WATER SERVICE PERMIT 3830 Pilot Knob Road P. O, Box 21199 PERMIT NO.: Eagan, MN 55121 DATE: Zoning: No. of Units: Owner: - — — Address: Site Address: Plumber: — Meter No.: Connection Charge: Size: Account Deposit: Reader No.: Permit Fee: 1 agree to comply with Hm City of Eagan Surcharge: Ordinances. Misc. Charges: � ✓ 19 3 Total: g 17//4 17//4 ° fr ' Dote Paid: Dote of Insp.: /d . Insp.: CITY OF EAGAN SEWER SERVICE PERMIT 3830 Pilot Knob Road P. O,,Box 21199 PERMIT NO.: Eagan, MN 55121 DATE: Zoning: Owner: No. of Units: Address: Site Address: Plumber: 1 agree to comply with the City of Eagan Connection Charge: Ordinances. Account Deposit: Permit Fee: By Surcharge: Date of Ins Misc. Charges: p.: Total:: i nsp.: Dote Paid: For Office/Use Permit /' 77� t o + /� ,® 4' '� 'r V "l/�' o • E AG N ,.� .e, Permit Fee: i Staff: 3830 PILOT KNOB ROADEAGAN, MN 55122-1810 r , I Payment Recvd: _Yes No (651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 Email: buildinginsoections@citvofeacian.com Plan Submittal:eplans@citvofeagan.com Plans: Electronic Paper l 2020 COMMERCIAL PLUMBING PERMIT APPLICATION ❑ Please submit two(2)sets of paper plans with all commercial applications as well as an electronic set of the submittal, submitted via email, CD or flash drive Date: O' c �" � 1 �.C.�, Site Address: ��SS �G�SCUnr_tG't, (Ccce Tenant: Suite#: Pfape U OWWf1er` "• Name: I—�(�)ct La I/"S Phone: (05-1 7S--ti-S-? �* Name: Pr 6-c,,4e-G4) .CC,61A Cc(,( License#: 1 H1 d-7 111 t Contractor Address: I s 7 ./(4( r .i c << (Zci City: X511 C(.[/Gee, State:M7-4' Zip: S37 Phone: C15-c) .'57220 Email: Cri4eL: h.e k CC 0 c(o--fec WLech-c i cif ,Cv7ti New Construction X[ Addition Modify Space Replacement Repair Rebuild Work in Right-Of-Way Description of work: 5-1 Ct l( tr /ti (2 T e of Work Irrigation System( yes/ no)(X RPZ/_PVB) • Rain sensors required on irrigation systems • Avg.GPM (2"turbo required unless smaller size allowed by Public Works) Meter Required—Call Utilities at(651)675-5200 to verity tests passed prior to picking up meter. Domestic:Size&Type Fire: 1 Average GPM High demand devices?_Yes No Flushometers_Yes_No COMMERCIAL FEES r/ Contract Value$ `13 0 + ( x.015 $60.00 Permit Fee Minimum $60.00 PVB/RPZ Permit(includes State Surcharge) $ �v CU Permit Fee Surcharge=Contract Value x$0.0005 $ Surcharge If the project valuation is over$1 million, please call City for Surcharge $ CC U+ 00 TOTAL FEE The following fees may apply when installing a new lawn irrigation system or $ Water Permit connecting a new water service. $ Treatment Plant Contact the City's Engineering Department,(651)675-5646,for required fee amounts. $ Meter Fee $ Radio Read $ State Surcharge =$ TOTAL FEE You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeaaan.com/subscribe. CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. 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. x L(-rl qi/i, t Applicant's Printed Name Applicant s Signature Page 1 of 4