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