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For I Office Use
l Permit Z~ U J
City of Ea
I t
3830 Pilot Knob Road i Permit Fee: d 1
Eagan MN 55122 1 l
Phone: (651) 675-5675 Date Received'
Fax: (651) 675-5694 l
l Staff: I
L-- ----1
2014 COMMERCIAL BUILDING PERMIT APPLICATION
1~'-r l
Dater 4-1-6-H Site Address: 0A, Ti~~✓~ltJ
Tenant Name: U/114l1 Jr rg"I 1 P fl (Tenant is: New / Existing] Suite
Former Tenant:
Name: 0- 719A r! 0 7 Phone: tom _770 Oec?
Property Owner Address / City l Zip: , L'#0 el? I 04
Applicant is: Owner Contractor
Description of work: -fet4A-
Type of Work
Construction Cost:
Name: NCR W e ! 04 Il"9~4 / License
Contractor Address: 6( 117 0,413 City: c'7r1(- flyL'~-
State: Zip; Phone: b I - L 1 / 1
Contact:i la t~'l' Email:
Name: _ A) /I Registration
Arch itectlEngineer Address: City:
State: 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) 45"002for protection against underground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities. www.aopherstateonecall.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 ich requires a review and approval of plans.
,fit r U
X
Applicant's Printed Name r is nt's Signat
Page l of 3
For Office Use
k f +. Permit#: / ✓ ) �p� 3
AGA
%,,. „. .g ,0E Permit Fee: tt•-
,
Staff:
OCT 3 U 20181
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 I
Email: buildinginspectionst citvofeagan.com I 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
DDate/0 - 3c) "" / 8iSite Address: f
Tenant: Suite#:
.
Property �--- j /�
_T Owner Name: A 1 //71' / / i ILr_A ,IJ 'hone ,_.,... f ,/S a . ., oa
Name: I 1�,. n-. 1..� 14Pi9A1IA, %L1'ttf'se#: 3 ( 7Li 1 5 / 0
IA,
cii
Contractor 11-4 1 S 7/f�A/Z e 6y W Zip:sso c? 7
Address: It : State/i)
i
Phone: Csz-- y/ t 7 9.; 7 Email
T) Pf ±+e--)- 5 14 se2 C m 1 L 1co
1 T New (si Replacement _Repair —Rebuild —Modify Space Work in R.O.W.
1 Type of Work : — r
Description of work C
COMMERCIAL _New Construction Modify Space 1
€ _Irrigation System( yes/—no)( RPZ/ PVB)
• 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 i
Avg.GPM High demand devices? Yes No Flushometers—Yes No
COMMERCIAL FEES _ ...,...n. Contract Value$ ® x.01
r $60.00 Permit Fee Minimum /
=$ 4'Q-6,0 Permit Fee
1 $60.00 PVB/RPZ Permit(includes State Surcharge) /
I =$ / C� C Surcharge f
Surcharge=Contract Value x$0.0005 I
If the project valuation is over$1 million, please call for Surcharge =$ ��/ - e6 6 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
I
$ Water Supply&Storage
j $ State Surcharge j
I =$ 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.citvofeaaan.com/subscribe.
CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground uti •amage.
I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with e or. ances and co--s o 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- o•an'e wi the - •rove•plan in the case of work which requires a review
and a val of plains.
€._ ej-kees :1,(.459-2--,_./________
Applicant's Printed Name Applicant's Signature �
FOR OFFICE USE Approved By: *<---T-1 Date: i v("3 z)/(
Required Inspections: _Under Ground Rough-In _Air Test _Gas Test YFinal PRV Required:_Yes_No
Meter Related Items: Meter Size Radio Read Manometer Staff:
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