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4552 Villa Pkwy Use BLUE or BLACK Ink r - - - - - - - - - - - - - - - - - I For Office Use Permit 5 0;? City of EI Permit Fee: 1504 . OAS 3830 Pilot Knob Road Eagan MN 55122 ` I Date Received: 1~ ~ I Phone: (651) 675-5675 I I Fax: (651) 675-5694 I Staff: I I t-----------------I 2013 COMMERCIAL BUILDING PERMIT APPLICATION Date: j 3 Site Address: -5 th & Px,-YW - qJA I of /I Tenant Name:cr/,!G S (Tenant is: New / Existing) Suite Former Tenant: Name: Phone: Property Owner U00 1 1~1~'l ~zio y PDu Address/ City /Zip: J Applicant is: Owner Contractor Description of work: f1 h t :5 J I h Type of Work > fj' Construction Cost: ?2 v r V Name: 6 `Qf.Aen U License /3q6 I Contractor Address: a) ~ ~l> /71/G / It t City: (3"y 1 d e'i V State: n Zip: s5C . Phone: J3 0 0 ,f Contact: V '`4 /'j,4/Pk-7 Email: UQ} j -erA,,, 6 0 , C 0 Name: Registration Architect/Engineer Address: City: State: Zip: Phone: i 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 the 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.ora 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 ~V/ / fpl x Applicant's Printed Name Applica is Signature Page 1 of 3 r '-. For Office Use J /� t : Permit#: /sec! ( C.- E AG.,� A N Permit Fee: �. Staff: 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 rPayment Recvd: Yes No I (651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 Email: buildinginspections ar7.cityofeagan.com Plans:_Electronic Paper I Plan Submittal:eplans aC�.citvofeagan.com 2019 COMMERCIAL PLUMBING PERMIT APPLICATION ❑ Please submit two(2)sets of paper plans with all commercial applications as well as an electronic set of the submittal, submitted via email,CD or flash drive Date: 11/07/19 Site Address: 4552 Villa Drive Tenant: Erin Place Family Townhomes Suite#: Property Owner Name: Dakota County, Nick Sisterman Phone: (651)675-4480 Name: Norblom Plumbing License#: 643133 Contractor .Address: 1465 Selby Avenue City: StPaul State: MN Zip: 55104 Phone: (612)827-4033 Email: service@norblomplumbing.com New Construction Addition Modify Space Replacement Repair Rebuild Work in Right-Of-Way Description of work: Replace water heaters in units:A, B, C, D Type of Work Irrigation System( yes/_no)( RPZ/_PVB) • Rain sensors required on irrigation systems • Avg.GPM (2"turbo required unless smaller size allowed by Public Works) Meter Required—Call Utilities at(651)675-5200 to verity tests passed prior to picking up meter. Domestic:Size&Type Fire: 1 Average GPM High demand devices? Yes No Flushometers_Yes No COMMERCIAL FEESContract Value$ 3200.00 x.015 $60.00 Permit Fee Minimum $ 60.00 Permit Fee $60.00 PVB/RPZ Permit(includes State Surcharge) $ 1.60 Surcharge Surcharge=Contract Value x$0.0005 If the project valuation is over$1 million,please call City for Surcharge $ 61.60 TOTAL FEE The following fees may apply when installing a new lawn irrigation system or $ Water Permit connecting a new water service. $ Treatment Plant Contact the City's Engineering Department,(651)675-5646,for required fee amounts. $ Meter Fee $ Radio Read $ State Surcharge _$ TOTAL FEE You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeaaan.com/subscribe. CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. 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 Jeffrey L. Norblom x2 Applicant's Printed Name A icant's Signature Page 1 of 4