4130 Rahn Rd B223
Use BLUE or BLACK Ink
For Office Use
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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:
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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
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Construction Cost: 8 S 10
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Name: nq `N ` r \ v License 1#: U I
Contractor Address: City: V~ ~N
State: r1
NCO _ Zip: Phone: U1__- n U- I I
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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.
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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
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