1278 Town Centre Dr - Suite 110 - Persis Indian Grill
.gal Use BLUE or BLACK Ink
For Office Use I
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City of Ea y\/0 L " I Permit
I Permit Fee: I
3830 Pilot Knob Road IRE- I
Eagan MN 55122 r I Date Received:
Phone: (651) 675-5675 Al i I
M Staff: J61 I
Fax: (651) 675-5694
2014 COMMERCIAL PLUMBING PERMIT APPLICATION kV
❑ Please ubm"t two (2) sets of plans with all commercial applications. Date: Site Address: _ / Z & Z 725
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Tenant: Suite
Property J t`a✓~ I~~
Owner Name: Phone:
Name: Lt 6E 6;~-r v 11 wi ISr License ~M C)4
Contractor Address: '-2-Z Ave-_ City: &e-7M&1 StateAn v? Zip: o
Phone: Email:
Type of Work - New - Replacement - Repair - Rebuild Modify Space _ Work in R.O.W.
Description of work:
COMMERCIAL New Construction X_ 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 $ Z;/0_0_90_ X.01
$55.00 Permit Fee Minimum
_ $ Permit Fee
*If contract value is LESS than $10,010, Surcharge = $5.00 = $ Surcharge*
**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 of to start without 7:: the work will be in
accordance with the approved plan in the case of work which requires a review and approval of p
X x
Applicant's Printed Name Applicant's Sig ure
FOR OFFICE USE Approved By: - Date: A &YI14f
Required Inspections: der Ground Rough-In Air Test -Gas Test Final PRV Required: Yes - No _if Meter Related Items: Meter Size Radio Read Staff:
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