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1680 Meadow View RdMeadowview Road 1;1/0 1`Jl 1J`l`I`!1?IT/ i 1670-1680 Meadowview Rd This map is for reference use only. This is not a survey and is not indtended to be used as one. Aerial photo -Spring 2010 120 60 0 Feet City of Eagan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 NOV032016 Use BLUE or BLACK Ink For Office Use ^ z Permit #: Permit Fee: Date Received: - 3-1 Staff: 2015/FIRE SUPPRESSION SYSTEMS PERMIT APPLIC ION / Date: / -/6 Site Address: J F-0 it4 eer ck.c4j i%6ec) a^- Tenant: Suite #: Name: -firr r ccr r f Tn rs (-F?C' Ca rISO/Pt )r. Property Owner Type of Work Contractor Address / City / Zip: Phone: Applicant is: Owner f/ Contractor Description of work: )c)levs S oY) def r s/e, c) oc 1— As� Construction Cost: 560 Name: �r� TC� ILCt®Y'V License #: C(°' iKcD Address: 3000 (vt•-e —V+ I k Ed. City: 4-1 le 6A. _ State: AV Zip: s'ci l 7 Phone: 65- (-77 lg%y Contact: Email: atrO ScV1�5 '� cow Estimated Completion Date: / 5- FIRE PERMIT TYPE Sprinkler System (# of heads [3) Fire Pump Other: _ Standpipe DESCRIPTION OF WORK: FEES Commercial $60.00 Permit Fee Minimum includes State Surcharge WORK TYPE _ New Addition Alterations — Remodel Other: Residential *If contract value is GREATER than $2,010, Surcharge = Contract Value x $0.0005 If the project valuation is over $1 million, please call for Surcharge $100.00 Residential New (includes State Surcharge) 3/4" Displacement Fire Meter - $270.00 Educational Contract Value $ Soo . 00 =$ =$ _$ (2o bo Q. 00 6d 60 Permit Fee Surcharge* TOTAL FEE = $ 00 Fire Meter $ UC TOTAL FEE **Requirements: 2 complete sets of drawings and specifications, cut sheets on materials and components to be used I hereby apply for a Fire Suppression System permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Minnesota Building/Fire Codes; 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 approvallof plans. Tiof Applicant's Printed Name FOR OFFICE USE REQUIRED- 96 PurnpTest Central''Station Conditions of Issuance: Permit Reviewed by: