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1811 Trailway Dr �a 'A' ° r a � '> ' x 4 _ 1��+ T��r �fS 41 ?^' { : _ ,, l' , ': -, .: ,,- .,- .,,-- ,- .-- ... : . x x l - ! ii.-4 s e rg II �. ,3 �+ ' t 1 t.. aR I ? vt �:- i n Fas .,' x..i� Y h • t • .` `; • • • I } Irk.. ;s+% . r Use BLUE or BLACK Ink < 3 I For Office Ose I' I 2_11i ~ Of EPermit I~1` ll~ I Permit 'Fee: ; 3830 Pilot Knob Road I - t Eagan MN 55122 I t_ Phone: (651) 675-5675 Date Received: Fax: (651) 675-5694 i I l Staff: L 2014 COMMERCIAL BUILDING PERMIT APPLICATION _ y Date: Site Address: 1? 0 41 Tenant Name: Ul!1lo ar (Tenant is: New / Existing) Suite Former Tenant: Name: 001-,)Q 242/51~_`z,0-I Phone: try " '770 ~41 flG) Property Owner Address / City/ Zip: 8/7 1 , Az, • Applicant is: Owner _ Contractor Type of Work Description of work: -,re,4A_ e fl-- ~ Construction Cost: F Name POP, w e 5~ C U ✓1license Contractor Address: (J L_ t) 5j t City: e"j°k State: lL Zip: 5"5311 Phone: b f i Contact: LT,- Email Name: Registration # Arch itectlEngineer I Address: City: State: Zip: Phone: Contact Person: ~ ..Email. Licensed plumber installing new sewer/water service: Phone { i NOTE, ,Plans and supporting documents that you submit are considered to be public information. Portions of the`i7rf wmation may be classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0082 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org 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 applicatiog 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 1ch requires a review and approval of plans. Applicant's` Printed Name is nVs SiinatutT' Page 1 of 3 i For Office UseS i i ;• Permit#: F----r—�� Z.-- ..... ,,, E AGA N permit Fee: Staff. _ 1-------- 3830 PILOT KNOB ROAD i EAGAN, MN 55122-1810 Payment Recvd: ___Yes — —No (651) 675-5675 (TDD: (651)454-8535 i FAX: (651)675-5694 Email; buildinginspectionse,citvofeagan.com I plans: — 2018 COMMERCIAL PLUMBING PERMIT APPLICATION ❑ Please submit two(2)sets of paper plans with all commercial applications as well as an electronic set of the submittal, submitted via email,CD or flash drive _/ _ Date: 1 .-"" (-2. S / CI Site Address: / I ) r L k) A t v ' —`. Suite# _ Tenant: A t. ' '.. ... ... .. �„a.+ _._�— -- Property — �„_ 3''� �j a. 35) c---- Owner Name: i. Y! ` 1 /, �,r4..A,,1_• -hone:t r,. •• `� - >, 0 1 , Name: I I a mall f L I ��i9 L , Agr se#: �~ Contractor Address: j MAR/$: City: e _ 667 State Zip: /L 11 I Phone: / 7 1�; 5 7 Email: ` . ± j^-!!-° rit I, IL d i New Replacement Repair Rebuild Modify Space __Work in R.O.W. i � Type of Work � �-. t Description of work. _6 _....../\00-9.A._ .._____.e_..4._ 12-_____________________!, .___`C_e`4.-- _7 t_..—...._._...._....._.__...�... _ —.. Space I COMMERCIAL ____New Construction Modify ` i _Irrigation System( yes/ no)(_RPZ/_PVB} i 1 . Rain sensors required on irrigation systems I Permit • Type • 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. I Domestic:Size&Type --— Fire: 1 _No Av GPM High demand devices? Yes No Flushometers_Yes —f COMMERCIAL FEES Contract Value $ OZ' O , $60.00 Permit Fee Minimum = $ Permit Fee $60.00 PVBIRPZ Permit (includes State Surcharge) = $ Surcharge I Surcharge=Contract Value x$0.0005 = $ TOTAL FEE i If the project valuation is over$1 million, please call for Surcharge I $ Water Permit Following fees apply when installing a new lawn irrigation system I Contact the City's Engineering Department, (651)675-5646,for required fee amounts. $ t Water TreatmentnPlant n Storage j Spply& $ State Surcharge `` I � T$ TOTAL FEE You may subscribe City to receive an electronic notification from the of proposed ordinances by signing up for an email update on the City's at www.citYo1sag6-n.comf/sub1cribe. r•el i BEFORE YOU PIG. Call Gopher State One Call at(651)454-0002 for protection against underground uti •• mage. a� t�City Eagan;that I untlerstand this is not a I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with n the •• •Ian in y of case of work unde requires a review permit, but only an application f a permit,and work is not to start ut a permit;that the work will be in and a vai of plans. , fi }e � X ' i X Applicant's Signature Applicant's Printed Name FOR OFFICE USE Approved By: Date: �. 11111, Air Test Gas Test Final PRV Required: Yes_.._No Rough-In �. Required Inspections: Under Ground 9 _ Meter Related Items: Meter Size Radio Read Manometer Staff: Page 1 of