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' - i. — . e+ t 'Y Naga 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: Page 1 of 3