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3591 Sawgrass TrPR Name: Phone: C , CON TRACTOR' �+ ,p Name: �J ` nr $0 1- I " 1 tl � License #: Z 3 `J' Z P�' I C '� c SiI l 35 v f-/ 1 S S' Address: ry c/ City: ��- "°��' State: 1 Zip: S'33 Phone: & / 2 _ SO f _5 / 7ff Email: TYP OF WO New Replacement Repair Rebuild Space Work in R.O. W. _Modify Description of work: -s- 3'7 1/ 4'??— •i tiz.1`7 a tA"''' 4 go u l �/ PERMIT TYPE . COMMERCIAL New Construction Modify Space Irrigation System ( yes / no) ()C RPZ / PVB) • Rain sensors required on irrigation systems • Avg. GPM (2" turbo required unless smaller size allowed by Public Works) Meters Call (651) 675 -5646 to verity that tests passed prior to picking up meter. Domestic: Size & Type / VI- Fire: 1 Avg. GPM High demand devices? No Flushometers Yes No COMMERCIAL FEES: $55.00 Minimum (includes _ Yes State Surcharge) OR Contract Value $ x 1% Required - If the Permit Fee is Tess = $ � � 00 Permit Fee / - on ALL new buildings and boulevard irrigation systems - = $ / -3L/ ` vO Radio Meter Read than $10,010, the surcharge is $5.00 = $ J - -7 , 0 0 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. $ *Z) 00 Water Permit Department, (651) 675 -5646, for required fee amounts. $ Treatment Plant $ Water Supply & Storage $ '5 ' ° LI State Surcharge TOTAL FEES $ "9 ' " 06 City of Eaall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675 -5675 Fax: (651) 675 -5694 / /') /o/ Applicant's P ed Name x Applicant's ,§nature Use BLUE or BLACK Ink For Office Use Permit #: /0 ` �] / --- M6-00 Permit Fee: Date Received: Staff: 2011 COMMERCIAL PLUMBING PERMIT APP CATION Date: Site Address: 3 57/ / �! c.t-'^1/2"`L -s 5 "1 Tenant: Suite #: CALL BEFORE YOU DIG. CaII 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 1 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 pe 't; that the w will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Approved FOR OFFICE USE Required Inspections. Under Ground _Rough In:;:_Air Test ; Gas Test Require Page 1 of 3