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4600 Stonecliffe DrPROPERTY OWNER Name: 'ECI...1 - +4Cfr Phone: _ CONTRACTOR Namegi . 4∎AZ.P4 S. �v .S. License #, (gq �4 ,l NSA-WO? r�1 Q Address: Lib NS 7f 1 (J � l�� - City; �\ Zip: Sc `I - 1 - State:MI Phone: Jc ^233 a1 l Email ,PA Y1I ...a‘ t A, ii is e TYPE OF WORK New Replacement Repair Rebuild _ Modify Space Work in R.O.W. T Description of work:c Cl t`U' — 1 -� -� cR ZS r '$ PERMIT TYPE COMMERCIAL New Construction _ Modify Space Irrigation System ( yes / _ no) RPZ / PVR) • Rain sensors required on irrigation ystems • 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 uo meter. _ Domestic: Size & Type Fire: 1 Avg. GPM High demand devices? _ Yes No Flushometers _ Yes No .__.. COMMERCIAL FEES: $60.00 Minimum (includes 55.00 State Surcharge) OR Contract Value $ x 1% Required - If the fpltnit Egg is lass = If the Permit Fee Is > $ Permit Fee on ALL new buildings and boulevard irrigation systems - $ Radio Meter Read than $10,010, the surcharge Is $5.00 $ Meter(s) $10,010, the surcharge Increases by $.50 for each $1,000 Permit Fee $ State Surcharge (i,e. a $10,010 - $11,000 Permit Fee requires a $5.50 surcharge) Following fees apply Contact the City's Engineering when installing a new lawn irrigation system $ Water Permit Department, (651) 675 -5646, for required fee smounts. $ Treatment Plant $ Water Supply 8 Storage $ State Surcharge ) • $ (fi TOTAL FEE # Pfr City of Iaau 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675 -5675 Fax; (651) 575 -5694 2012 COMMERCIAL PLUMBING PERMIT APPLICATION t Date: S , (l 2-' Site Address: ` ►e- Tenant b STL> NY \ \- Use BLUE or BLACK Ink For Office Use Permit ft: Permit Fee: Date Received: Staff; Suite #: J CALI. BEFORE YOU DIG. Call Gopher State One Call et (651) 454.0002 for protection against intend to dig to receive locates of underground utilities, www.qophersteteeneletim 1 hereby acknowledge that this Information is complete and accurate; that the work will be in Eagan; that I understand this Is not a permit. but only an application for a permit, and w accordance with the ved plan in the case of work which requires a review and approval Applicants Printed Name Required Inspections: Under Ground Rough -In Air Test Y Gas Test _ Final underground utility damage, Call 48 hours before you with the ordinances and codes of the City of permit: that the work will be in FOR OFFICE USE Approv =d Ey: Date: PRV Required: Yes Page 1 of 3 41,11 City of Eagan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 r Use BLUE or BLACK Ink For Office Use Permit#: I 3by Permit Fee: 381 • Date Received: CJ I e�1 TS Staff: 467 L 2013 COMMERCIAL PLUMBING PERMIT APPLICATION ❑ Please submit two (2) sets of plans with all commercial applications. Date: LI IN 13 Site Address: '4 b t r`.,5„rt r. CCS, t E F E D - Tenant: Suite #: r#Y Owner Name: 5 c, aJ-b S Fti e �. , Phone: S Z - Z7-1 --27 Qv `V .4—e Lwi--- NC7cylt:: t Contractor Name: &ITTl t --k a'.N NA ett-13 �tEivs el -ii LPRQ . License #: "i -.t c t --Sc." -Oa 0 Address: ►°tx=' rtiviERtLAiwf, e3:.v:�- E , City: B.i..ccai.n'ci,-SL—tvt-.1 State::''Y% t--1 Zip::;.5i-i 2-5— Phone: cl S' Z - Phone:iSZ` Z 1 —21®c, Email: s2R.v:` Z 0-1-t-tL -.PN (CAsn Ty•e of ' New Replacement Repair Rebuild Modify Space Work in R.O.W. — Description of work: 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) Y Meters Call (651) 675-5646 to verity that tests passed prior to picking up meter. Domestic: Size & Type Fire: 1 Avg. GPM High demand devices? _Yes No Flushometers _Yes _No COMMERCIAL FEES: $55.00 Minimum Contract Value $ ''- - `-;1 x 1% Required on *If the project valuation = $ Permit Fee ALL new buildings and boulevard irrigation systems 4 $ Radio Meter Read $ Meter(s) is over $1 million, please call for Surcharge $ $5.00 State Surcharge* Following fees apply Contact 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 FEE 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 the case of work which requires a review and approval o .fans. x R e'J EDLsr .J Applicant's Printed Name plicant's Signature Page 1 of 3 Use BLUE or BLACK Ink 2013 SEWER AND WATER CONNECTION AND AVAILABILITY CHARGES EXISTING COMMERCIAL PROPERTY (if applicable) Date: FOR OFFICE USE ONLY Property Owner: _PRN required Permit Address: Phone Number: City R -O W Permit , County R O W Plumber: Contact Name:,,.. .. ,.,� SEWER �� �1I�IATER Sewer Service Water Service Water lateral charge Water trunk Water supply storage Receipt #: Sewer lateral charge Sewer trunk City SAC @ $100/unit MCES SAC @ $2,435/unit , Date: Receipt #: , Date: Treatment Plant @ $801/unit Permit Fee State Surcharge *Plumbing Permit Required acquired with building permit Permit Fee $60.00 $60.00 State Surcharge $5.00 $5.00 TOTAL: — water meter to be TOTAL: SEWER.&WATER Sewer Service Water Service Sewer lateral charge Water lateral charge Sewer trunk Water trunk City SAC MCES SAC Receipt # , Date Water supply & storage Receipt # , Date Treatment plant Permit Fee State Surcharge *Plumbing Permit Required — water acquired with building permit $120.00 $5.00 meter to be TOTAL: Number of SAC units is determined by the Metropolitan Council Environmental Services (651) 602-1000. Sanitary Sewer Trunk Connection Charge applies if not charged sewer trunk by assessment in the past. 1-5 SAC units 1,780.00 per SAC unit 6-10 SAC units 8,900.00 plus 445.00 per SAC unit over 5 11+ SAC units 11,130.00 plus 178.00 per SAC unit over 10 Permit #: Permit Fee: Date Received: Staff: 7 Cc: City of Eagan Finance Department Page 2 of 3