2108 Water Lilly Lanes U 0, v -0 j 0o ?-) 14 2 95-7
2012 MECHANICAL PERMIT APPLICATION
❑ Please submit two (2) sets of plans with all commercial applications.
Date: ,A 111)17- Site Address: _ 2-109
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Tenant: r ,I - n 1P71 1° 1 A_S
Suite #:
Name: ` 7W (—I (,� r Phone: ✓� b O 2 /
Address / City / Zip: v "L%'i L4 I 5S) -2-2-
Name: W.f f )LH 1-} 6 (t License #: D 2-2 D c�
Address: C I bq V V & �I b n City:
State: - Zip: c JSC)33 Phone:
Contact: _lid Email_ �(�YyL(q j`�]C_�Y1f'.1�.S6Y1 liYl��(t3U
_Additional __ Alteration - Demolition
New Construction
Install Piping
Gas
COMMERCIAL
Interior Improvement
Processed
Exterior HVAC Unit
Under / Above ground Tank (_ Install / _ Remove)
$60.00 Minimum Add -on or alteration to an existing unit (includes $5.00 State Surcharge) j� f,
$100.00 Fire repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) = $ CPO,
1 06 TOTAL FEE
COMMERCIAL FEES:
$75.00 Underground tank installation /removal (includes $5.00 State Surcharge)
$60.00 Minimum (includes State Surcharge)
- If the Permit Fee is less than $10,010, surcharge is $ 5.00
- If the Permit Fee is > $10,010, surcharge increases by $.50 for each $1,000 Permit Fee
(i.e. a $10010- $11,010 Permit Fee requires a $ 5.50 surcharge)
OR Contract Value $
= $
Permit Fee
= $
Surcharge
= $
TOTAL FEE
X1%
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.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 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�
Applicant's Pri ted Name Applicant's
Date:
Tenant:
Ao 00.00
Tdb4�
Use BLUE or BLACK Ink
- -i
For Office Use
I Permit #:
I � I
I I
Permit Fee: / I
I Date Received: I
I I
Staff:
I
2012 RESIDENTIAL PLUMBING PERMIT APPLICATION
RESIDENTIAL FEES:
Site Address:
Suite #:
Name: or ( rl ri V71 P I dC Phone: jgS L 6% 1 `
Address / City / Zip:
Name:
Address:
State: Zip
Contact:
New Replacement
Description of work:
RESIDENTIAL
XWater Heater
Email:
—Repair —Rebuild _ Modify Space _ Work in R.O.W.
Lawn Irrigation L— RPZ / _ PVB)
Septic System
New
Abandonment
Water Softener
Add Plumbing Fixtures C_ Main /
Water Turnaround
Lower Level)
$60.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)
$60.00 Lawn Irrigation (includes $5.00 State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround' (includes $5.00 State Surcharge)
'Water Turnaround (add $189.00 if a 5/8" meter is required)
$105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge)
TOTAL FEES $
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.gopherstateonecall.om
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 >� x 1A, utcf e:,-Pkz1L4,,
Applicant's Print Name Applicant's Signatur
r.10
a~oa , al 0A I -.;I-\() (0 , aln 8 2110 1211; Use BLUE or BLACK Ink
2 t 4,► t t S t~- Ll4
I For Office Use
' 11~5a
Permit#:
Y I
' C"l3a.75
I Permit Fee:
3830 Pilot Knob Road 1 c I
Eagan MN 55122 1 Date Received: J
Phone: (651) 675-5675 1 j
Fax: (651) 675-5694 j Staff: I
t-----------------1
2013 COMMERCIAL BUILDING PERMIT APPLICATION
Date: Site Address:
Tenant Name: (Tenant is: New / Existing) Suite
Former Tenant:
Name: Phone:
Property Owner Address /City /Zip:
Applicant is: Owner Contractor
Description of work: '
Type of Work
Construction Cost:
Name: License
Address: - _ City.
Cot
State: /-ip: Phone:
Contact:— Email:
Name: Registration
Address: City:
Arch itect/ ngineer
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 then are trade secrets _ . .._fn _
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.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 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 re uires aview and approval of plans.
X tr` x t
Applicant's Printed Name Ap cant's Signature
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