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3450 Denmark Ave Use BLUE or BLACK Ink For Office Use I I Permit Z, lop 01? a~ I 400. City of Eap I 3830 Pilot Knob Road Permit Fee: Eagan MN 55122 I Date Received: I Phone: (651) 675-5675 I Fax: (651) 675-5694 Staff: 2014 COMMERCIAL PLUMBING PERMIT APPLICATION ❑ Please submitt two (2) sets of plans with all commercial applications. Date: 7 -f Site Address: 3 11 ~c VJ~-~'~Y`n ~ ~V ~►~~i~~ I ~ Tenant: F,J~. ~d Suite Property Owner Name: Phone: Name: f^ tMGJ° rv~Z License ~-c Contractor Address: ! l 0 f' K- C 4-,r- S. gD ~ J Zi City: 2 ~.i State: i ~ p: ~ 113- Phone: Email: Type of Work - New - Replacement - Repair < Rebuild - Modify Space _Work in R.O.W. Description of work: h r a- ~ ( T" Z- 5 / le h-r PLI\k~s G N t COMMERCIAL New Construction Modify Space Irrigation System yes / _ no) RPZ / _ PVB) • Rain sensors required on irrigation systems Permit Type Avg. GPM (2" turbo required unless smaller size allowed by Public Works) _ Meters Call (651) 675-5646 to verity that tests passed prior to picking up meter. Domestic: Size & Type Fire: 1 Avg. GPM High demand devices? Yes No Flushometers Yes No COMMERCIAL FEES Contract Value $ X.01 $55.00 Permit Fee Minimum _ $ Permit Fee *If contract value is LESS than $10,010, Surcharge = $5.00 = $ Surcharges `*If contract value is GREATER than $10,010, Surcharge = Contract Value x $0.0005 ""If the project valuation is over $1 million, please call for Surcharge = $ TOTAL FEE Following fees apply when installing a new lawn irrigation system $ Water Permit Contact the City's Engineering Department, (651) 675-5646, for required fee amounts. $ Treatment Plant $ Water Supply & Storage $ State Surcharge TOTAL FEE 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 pla x MG x Applicant's Printed Name Applicant's Sig ature FOR OFFICE USE Approved By: Date: Required Inspections: Under Ground -Rough-In Air Test -Gas Test -Final PRV Required: Yes No Meter Related Items: Meter Size Radio Read Staff: Page 1 of 3