3591 Sawgrass TrPR
Name: Phone:
C ,
CON TRACTOR'
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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
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