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e / Use BLUE or BLACK ink
I For Office Use t`
Permit r 3
City Of Eapn -7 I
9 Permit Fee: t
3830 Pilot Knob Road I l
Eagan MN 55127
t Date Received: I
Phone: (651) 675-5675` l
Fax: (651) 675-5694 l' I
P Staff:
L--.-----'---- -I
2014 COMMERCIAL BUILDING PERMIT APPLICATION
Date: Site Address: 10)- 191-7 . / 910 / ~ Lv &A -
Tenant Name: L414-1,1 yr fR,'J~ Oaf, (Tenant is: New I Existing) Suite #
Former Tenant:
Name: f_ -7j9/Vr7 F? '7 Phone: t~', 770
Property Owner Address i City / Zip: ~1U, ~,/1, ►
Applicant is: Owner _X Contractor
T e of Work Description of work: -'e44et- e A" " 4-A44
Yp
Construction Cost:
Name: /v oP,1y e 5-r C o 4 Tl e k try' a Ltcense
Contractor Address: t- 13 City: 17
State: Zip: 55 311 Phone:
Contact: J( 44 0,kA"OO Email:
Name: Registration
Architect/Engineer Address: City:
Stater Zip Phone:
Contact Person: Email:
Licensed plumber installing new sewer/water service: Phone
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information 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) 454-0002 for protection against underground utility damage.
Cali 48 hours before you intend to dig to receive locates of underground utilities. www.got)herstateonecall.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 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 ch requires a review and approval of plans.
x ,r sM 3~'1
Applicant's Printed Name is _nt's Signat
Page 1 of 3
For Office Use '
Permit#: ` I c>te2
'' 4 # 1,' &1,tp0
,.„.,,,N. ., .,„„,, EAGAN Permit Fee:
Staff:
..maw.. L. J
1
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 Payment Recvd: Yes _No
(651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694
Email: buildindinsoections(cr citvofeagan.com Plans: Electronic Paper
Plan Submittal: eplans@citvofeagan.com L
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: SI' "--'1 rSite Address: / I '7 7 'r, i LU) )I' I t
Tenant: Suite#:
.
Property /_ �`''�I L`���i �,,!
Owner Name:
�/ ti•
�14 �1;d_r 'hone: " i lJ �4 '
Name: I i�(9l'lf 1t�v AKffie#.
p r igis1 �
Contractor /5 7 l ty: y /h W Zip:S�Q a C�
Address: �"� /2 I D� State
Phone:6s / 7 a; 5/ Email , • A e J I CO Li C i 1` 'Co
New (` Replacement _Repair _Rebuild _Modify Space Work in R.O.W.
1 Type of Work
p
Description of work: C
i COMMERCIAL New Construction Modify Space
Irrigation System( yes/—no)( RPZ/—PVB)
• Rain sensors required on irrigation systems 1
1 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.
Domestic:Size&Type Fire: 1 ,
1 Avg.GPM High demand devices? Yes No Flushometers—Yes No
COMMERCIAL FEES Contract Value$ .3 R 0 0 x.01
1 $60.00 Permit Fee Minimum
' $60.00 PVB/RPZ Permit(includes State Surcharge) =$ Permit Fee
=$ Surcharge
1 Surcharge=Contract Value x$0.0005
If the project valuation is over$1 million, please call for Surcharge =$ TOTAL FEE
Following fees apply when installing a new lawn irrigation system $ Water Permit
Contact the City's Engineering Department,(651)675-5646,for required fee amounts. $ Treatment Plant
$ Water Supply&Storage i
_— _^A_ —,— $ --- State Surcharge
1 Y =$ TOTAL FEE
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at
www.citvofeagan.com/subscribe.
CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground uti' •-mage.
I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with e o• ances and •--s• the City of Eagan;that I understand this is not a
permit,but only an application fo a permit,and work is not to start wi ut a permit;that the work will be in ••arae wi the : •rove• plan in the case of work which requires a review
and a val of plans.
x e 61j-keips0 x 4Le 4, er: /, •. .4.iziwl
Applicant's Printed Name Applicant's Signature
FOR OFFICE USE Approved By: -›4 Date: T 'l(
Required inspections: _Under Ground Rough-In _Air Test Gas Test _Final PRV Required:_Yes_No
Meter Related Items: Meter Size Radio Read Manometer Staff:
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