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4130 Rahn Rd B223 Use BLUE or BLACK Ink For Office Use / ( I 1 Permit#: { C?~1~L (l City of Ea aR F2 Z) ~1 I Permit Fee:- I 3830 Pilot Knob Road I I Eagan MN 55122 ;Date Received:. r' rf ; Phone: (651) 675-5675 I I Fax: (651) 675-5694 I Staff: ----------J 2013 COMMERCIAL /BU' ILDIING PERMIT APPLICATION Date: 3 Site Address: ,`\`J - Ut4 (T Z22-3 Tenant Name: (Tenant is: New Existing) Suite Former Tenant: Name: *Ok1'C,10~ , Phone: VJ ~'1 Property Owner K ( ~j(~~~ A Address /City /Zip: ~ CAS i ilUr 7l ILJ f,K(( jj . AA .3 1 o Applicant is: Owner Contractor Type of Work Description of work: Wk °\W(l, U 01421TNO~T A, i Construction Cost: 8 S 10 t\( ' Name: nq `N ` r \ v License 1#: U I Contractor Address: City: V~ ~N State: r1 NCO _ Zip: Phone: U1__- n U- I I ,1 ~ ~ 1 c Contactk~ J\J 0LMCSI1~~~ Email: U6 " bkl( Ct; J~/I/~-S) L . co Name: l,t bF (0 S (fin" eZCL I, C6y2egistration Architect/Engineer Address: City: State: Zip: Phone: I Contact Person: Email: Licensed plumber installing new sewer/water service:_ Phone M _ 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. 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 whic u' s a re 'ew and approval of plans. x (,LtlKV 6U0(04&((C- x Applicant's Printed Name Ap ican ' Sj nature ~ Page 1 of 3 4130 R&kn ~Id (Ahlf a(93 Iq~10 DO NOT WRITE BELOW THIS LINE SUB TYPES Foundation _ Public Facility _ Exterior Alteration-Apartments _ Commercial / Industrial _ Accessory Building _ Exterior Alteration-Commercial Apartments _ Greenhouse / Tent _ Exterior Alteration-Public Facility Miscellaneous Antennae WORK TYPES New _ Interior Improvement Siding _ Demolish Building* Addition _ Exterior Improvement Reroof _ Demolish Interior _ Alteration Repair Windows _ Demolish Foundation Replace -Water Damage Fire Repair _ Retaining Wall Salon Owner Change *Demolition of entire building - give PCA handout to applicant DESCRIPTION Valuation Occupancy A? I- MCES System r-- Plan Review j?D Code Edition Voa7IkSWG---SAC Units (25%_ 100%--) Zoning City Water Census Code Stories Booster Pump # of Units Square Feet PRV # of Buildings Length Fire Sprinklers Type of Construction V/yf- Width REQUIRED INSPECTIONS Footings (New Building) ✓ Sheetrock Footings (Deck) ~F.naL/-C.0. Required Footings (Addition) -Final / No C.O. Required Foundation Other: Drain Tile Pool: -Footings -Air/Gas Tests -Final Roof: -Decking -Insulation -Ice & Water -Final Siding: -Stucco Lath -Stone Lath -Brick Framing Windows Fireplace: -Rough In -Air Test -Final Retaining Wall Insulation Erosion Control Meter Size: Final C/O Inspection: Schedule Fire Marshal to be present: -Yes No Reviewed By: XL L. _,Building Inspector Reviewed By: , Planning COMMERCIAL FEES 0q Base Fee Water Quality Surcharge • Sd Water Supply & Storage (WAC) Plan Review Storm Sewer Trunk MCES SAC Sewer Trunk City SAC Water Trunk S&W Permit & Surcharge Street Lateral Treatment Plant Street Treatment Plant (Irrigation) Water Lateral Park Dedication Other: Trail Dedication Water Quality TOTAL Page 2 of 3