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4498 Mallard Tr SCity of Eap 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 CYC Use BLUE or BLACK Ink For Office U Permit #: Permit Fee: eceived:S ?'�] 2011 COMMERCIAL PL MBING PERMIT 9 APPLICATION � S ' 1%r Date: 2 1/ site Address: C// �9�i ,p Tenant: (;vt 1 v ► I M�Qj� I�-- cf o (( Suite #: PROPERTY/IX& OWNER Name: i t Phone: 962 "-T'S / ��� CONTRACTOR Name: � License#: / P // Address: 9826 /?,I;er`/ City: 1-6. / State/Y7 Zip: ,c--, S O76- 171lulrr Phone: 6, - 2, — 2 7i:::Email: /`.'L'4 1• LL1,,,/ 0' i%S/Y co - TYPE OF WORK,`/ \.J New Replacement R air_ Reb ild Modify Space Work in R.O.W. _ _ _ _ Description of work: /? 4 a; 4, q / S 6.c l / 2 RP PERMIT TYPE COMMERCIAL New Construction Modify Space Irrigation System ( yes / no) ( RPZ / PVB) _ _ • Rain sensors required on irrigation systems • Avg. GPM (2" turbo required unless smaller size allowed by Public Works) Meters CaII (651) 675-5646 to verity that tests passed prior to oickino uo meter. Domestic: Size & Type Fire: 1 Avg. GPM High demand devices? Yes No Flushometers _Yes _No COMMERCIAL FEES: $55.00 Minimum (includes State Surcharge) OR Contract Value $ x 1% Required - If the Permit Fee is Tess _ $ Permit Fee on ALL new buildings and boulevard irrigation systems 4 = $ Radio Meter Read than $10,010, the surcharge is $5.00 = $ Meter(s) - If the Permit Fee is > $10,010, the surcharge increases by $.50 for each $1,000 Permit Fee • Permit Fee requires a $5.50 surcharge) = $ State Surcharge (i.e. a $10,010-$11,000 Following fees apply Call the City's Engineering when installing a new lawn irrigation system. $ Water Permit Department, (651) 675-5646, for required fee amounts. $ Treatment Plant $ Water Supply & Storage $ State Surcharge TOTAL FEES $ ,_ c.\--,-6-2'°--- 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.qopherstateonecall.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 these of work which uires a review and approval of plans. x ..A.)a /Z Applicant's Printed Name x Applicant's Signe ure pp n 9 FOR OFFICE USE Approved By: Required Inspections: Under Ground Rough-ln _Air Test ^,_,Gas Test Final PRV Required: Page 1 of 3 Q ? ,? ?? 2006 COMMERCIA.I. PLUMBING PERM[T APPLICATIf)N l 1, CITY OF Et4GAN ?j?j •', rn 3830 PiLOT KNOB IiOAB, EAGAN MN 55122 Date2) Q1O y ? ---'---_-- Site Address Bnit # Teuant Name Former Tenant Name Property Owner _ Telephone N { ) _ Contractoc y?G?-°C71 o Address CSty ? ? State "Lip ?So3? Teteptitsne#( _ ) License # Ex jres; p The Applipnt is _ Owner Coutractar Other Work'i'ype New IIidg Modify Spuee [rrigatioo Systemtk Yes No Work in pubtis r-o-w f easement? PVS: New _ Repa'vlRebuild Repiace _ Remove RHin sensors are r uired on 'trri 4on systeo¢s Drscription af Wor7c wE to mquiu ifFn'?x F em' g Yalve is tequimi oa mw semce_ ca11651 L7S5 W 6 l4leters - Call 65I fi75-53b0 to verify tfiat hydmstatic, ronduciivity, and b:u;terea [ests passed prior to nicicioe no meter. I=rigation Sizs 8c Type Avg GPM 2" turbo req'd valess smaller size attowed by Public Works Pire Size & Price 314" meter 167.00 Domestic Size & Tygc Avg GP111 incindes high demaod devices? _ Yes, No Fiushometers _ Yes _ No PRV Itequired _ Yes _ No ? i'ermit Fee $56.50 minimum (inelaaes State Surcharge) --I / Contract Vaiue $ _ x 1°l0 = $ PermitFec ? Meter(s) Required on ail new buildings 8c boulevazd urication systems g Radio Meter Read $ State Surcharge . ' ' 4f pennst Cee is less thm S1,040, sacxt+arye is $.54 I If permi[ fee is mert ffian YY,980, surCivlge Ss $.58 ior neh Sf,DUO owed. Pnilowing fees appiy whea Snsfaliiag acw }awn irrigaiioa system $ _? ._ Water Pttmit ? . Cail lhe Ciiy's F_ngineering [}epurtrneni, 65"75-5646, For mquire.d Fee smounts ? Treamtent Ptanr I I $ Water Supply & Storage $ Smte Surcharge $ ? Toml Fee ? ? I herehy :?pply tor a Cmnmerciul Humhing Perreit and ackuowlcdge iLai Ihe iafarmation is waqphYC and accutate; iLat tltc work will be in nfurmaace with thc uNmanc;q und codcs of the Ciry of Fzapn and wiW Nrc Piambing Codes, flnt I wdersbnd Mis is not a pnmil, 4ui }y an appt' ar a it and wosl: is not to ciart u? Mnut a?rmXP4- u?li be in nccmdacnx urith 1he appme¢d plan iu the case n(woric which a review al af p Apn7icanCs Printe_ cants Sie , • • CITY USE ONLY PERMIT #: 1 ' 6 tP ? 1 ? RECEIPT DATE: ? " ? ?"l? " ? I COMMMCIAL PLUMSIPH PFiiMiT 1°kPP1dCAT10F Cf[YOF SA6AF \ 9$SO PD.A7' HROB $D C7 U EA6i4P. !IR 55122 651-661-075 INCOMPLEIE APPLICATIONS W1LL NOT BE PROCESSED Date: -2- /9-G/ WORK TYPE New Bldg Add-on Repair 1RPZ PVB • Irrigation system ' Must complete reverse side of application also. Required meter size is 2" turbo nu less smaller size permitted by Public Works DESCRIPTION OF WORK 04?? i1? ik P Z-. To inquireif Pressure Reducing Valve is required on new service, call 651-681-4646 METERS - Call 651-681-4300 to verify that hydrostatic, conductivity, and bacteria tests passed prior to oickine uo meter Imgation Size & Type Fire Size & Type Domestic Size & Type Dces this include high demand devices? _ Yes _ No uu ? FLUSHOMETERS _ Yes _ No PRV REQUIRED Yes No y-- ._.___ Site Address: ? Tenant Name: ? /in e7ti/oy "/[? G?Q? Telephone #: (Area Code) Was there a previous tenant in this space? _ YN.. If Yes, Namei Installer Name: Telephone #: S?- 407 o (ArwCode) It1St2IICi Add7'CSS; City: iit FEES Contract price Avg GPM Avg GPM AvgGPM ? JUL 2 3 2001 ? State: 127li2t2 Zip Code.,!2? x 1% ($50.00 minimum) Contract Fee Meter(s) $ $ Required on all new buildings & boulevard irrigation systems Radio Meter Read $ Surcharge: $.50 Minimum. If eontraM fee exceeds $1,000, calculate at Stace Surcharge S 50 cents per $1,000 contract fee. Total From Reverse New Service $ Totsl $ SG. (5-D I hereby aclmowledge that I have read this applicarion, state that the information is coaect, and agree to comply with all applicable City of Eagan ordinances. It is the applicant's responsibility to notify the property owner that the Ciry of Eagan assumes no liability for any damages caused by the Ciry dwing its normal operanonal and maintenance acavities to the facilities-constructed under this permit within City property/right-of-way/easement. , SIGNATURE OF PERMITTEE CITY USE ONLY REQUIRED INSPECTIONS: _ U.G. _ Air Test _ Gas Test _ Rough In _ Final PLANS SUBMITTED APPROVED BY: BUILDING INSPECTOR 7(01166 CITY USE ONLY R17CEIPT #: 3? d?f SUBDRECEIPT DATE (PI S APPROVED BY: ,INSPECTOR 199$ PLUbI$1NH P£RNIIT (COMM£RC1AL) C1TY Of EAfiAN V•f./?.?vvK.t3$30 i'(LOT KNOB itD ? aa O? EAHik1V, IrIN 551EE (618) 6$1-4675 Please complele for: all commerciaUindustrial buildings multi-faznily buildings when separate building permits are no[ required for each dwelling unit backflow prevrnter ro be installed in commercial areas or residential boulevards Date: Work Type: )?__ New Bldg. _ Add-on _ Repair ? U.G. Sprinkler RPZ Description of Work: To inquire if Pressure Reducing Valve is required on new service, call 6814646. F$FS 1% of contract price or $25.00 minimum Contract Price: $ X 1% - $ - COMPLETE THIS AILEA ONLY iF INSTALLING UNDERGROUND SPRINKLER SYSTEM Service: Existing (if coming off domestic line) OR _ New Backflower Preventer Permit Fee»»»»»»»»»>>>»>>>>>>>>>>>>>>>>>> $ 25.00 Water Flow 22Q GPM & Water Meter 1" @ $189.00 OI 2" Turbo @ $871.00 $ ? 16 2 . ? ? If "new servrce"add Water Permit $ 50.00 = $ State Surcharge $ .50 = $ WAC $ 807.00 = $ gU Water Treatment $ 444.00 = Permit F.ee $ Stare surcharge is $.50 per $ I,000 of ep rmi! fee or minimum of $.50 per permit State Surcharge a • 50 Total Fee I hereby acknowledge that 1 have read this application, state that the information is correct, and agree to comply with all applicable City of Eagan ordinances. It is the applicant's responsibility to notify the property owner that the City of Eagan assumes no liability for any damages caused by the City during iu normal operational and maintenance activities to the facilities constructed under this permit within Ciry property/right-of-way/easement. ??- SITE ADDRESS: TENANTNAME: INSTALLERNAME: TELEPHONE #: VV? S'fREETADDRESS: v`?` ? CITY: ZIP: SIGNA'P'URE OF PERMITTEE