3470 Golfview Dr CITY OF EAGAN WATER SERVICE PERMIT
38, 0 Pgot Knob Road
P.O. Box 21199 PERMIT NO.:
Eagan, MN 55121 DATE: -
Zoning: --- No. of Units:
Owner:
Address:
Site Addess:
Plumber:
Meter No.: Connection Charge:
Size: Account Deposit:
Reader No.: Permit Fee:
I agree to comply with the City of Eagan Surcharge:
Ordinances. Misc. Charges:
Total:
By Date Paid:
Date of Insp.: Insp.:
CITY OF EAGAN SEWER SERVICE PERMIT
3830 P.iloi Knob Road
P.4O. Box 21199 PERMIT NO.:
Eagan, MN 55121 DATE:
Zoning: No. of Units:
Owner:
Address:
Site Address:
Plumber:
1 agree to comply with the City of Eagan Connection Charge:
Ordinances. Account Deposit:
Permit Fee:
Surcharge:
By Misc. Charges:
Date of Insp.• Total:
Insp.: Date Paid:
Use BLUE or BLACK Ink
For Office Use I
I
Permit
City of EaEdn
I Permit Fee:
3830 Pilot Knob Road I
Eagan MN 55122 I Date Received:
Phone: (651) 675-5675 I
Fax: (651) 675-5694 I Staff: _
- - - - - - -
2013 COMMERCIAL PLUMBING PERMIT APPLICATION
❑ Please submit two (2) sets of plans with all commercial applications. WO# 47299
Date: 6-3-2013 Site Address: 3470 Golfview Drive
Tenant: Town Centre at Lexington Suite
Property..
Owner Name: Town Centre at Lexington Phone: Jim or Carl 651-452-8778
Name: Northland Mechanical Contractors, Inc. License PC643880
Contractor Address: 9001 Science Center Drive City: New Hope State: MN Zip; 55428
Phone: 763-544-5100 Email: ap@northiand-mn.com
Type of Work - New - Replacement - Repair 1 Rebuild - Modify Space - Work in R.O.W.
Description of work: Rebuilt (1) RPZ - S/N 114769
COMMERCIAL New Construction Modify Space
Irrigation System yes no) RPZ PVB)
• Rain sensors required on irrigation systems
Perm it,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.
n< Domestic: Size & Type Fire: 1
Avg. GPM High demand devices? Yes _No Flushometers _Yes No
COMMERCIAL FEES Contract Value $ 600.00 X.01
$55.00 Permit Fee Minimum = $ 55.00 Permit Fee
*If contract value is LESS than $10,010, Surcharge = $5.00 = $ 5.00 Surcharge*
**If contract value is GREATER than $10,010, Surcharge= Contract Value x $0.0005 60.00
***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
$ 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.oopherstateonecall.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 which requires a review and approval of plans.
x Michael Tieva xYuc
Applicant's Printed Name Applicants Signature
FOR OFFICE USE lApprove~_Sy: - Date:
Required Inspections: Under Grourtd tbWgh ICS AIC est ,Gas T st Fio" PRV,Requiredt`-Yes No
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