3593 Sawgrass TrPRO
OW NER
Name: Phone:
CONTRACTOR
Name: 5 ".4 " -4- '6 0 d.. �l b r� " 7-41 C License #: L.eZ $ P
3
/ ,�/
/ 7 vP City: ,Cl / 1 .."n State: �° Zip: 07537P
Address: /(o 7/ 3✓ ! /'
/
Phone: Y I L Sot --11 71 Email:
TYP OF
WORK:
/`New Replaceme t Repair / Modify Space in R.O.W.
_ _
Description of work: 0 & 1) 4 �i % 9-/ (c t
PERMIT TYPE:
COMMERCIAL
New Construction Modify Space
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)
Meters Call (651) 675 -5646 to verity that tests passed prior to picking up meter.
Domestic: Size & Type /q-- 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
= $ - co Permit Fee
on ALL new buildings and boulevard irrigation systems - = $ /..q 0 Radio Meter Read
/
than $10,010, the surcharge is $5.00 = $ . 0O 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. $ '6 - C0 Water Permit
Department, (651) 675 -5646, for required fee amounts.
$ Treatment Plant
$ Water Supply & Storage
$ 6 - CO State Surcharge
TOTAL FEES $ '9o -0 0
•
4 4/ 11 City of Eaau
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
2011 COMMERCIAL PLUMBING PERMIT APPLICATION
Date: Site Address: 3 593 J a w gam'` Spy`' � /
Tenant: ! Suite #:
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
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 ..••rmit; that the +': k will be in accordance with the approved
plan in the case of work which requires a review and approval of plans.
x
A z$1,0 1 Applicant's Pri Name
Applicant' ignature
For Office Use
Permit #:
Use BLUE or BLACK Ink
A917
Permit Fee: 94
Date Received:
Staff:
prove
FOR OFFICE US
Required Inspections: U nder Grounc
�s Test
VRRequire
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