3917 Denmark Ave ' Use BLUE or BLACK Ink
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• � For Office Use �
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Cit of �a a� � F e r m i t#:
Y � i����� d�$��� i
3830 Pilot Knob Road I �
Eagan MN 55122 � �
Phone: (651) 675-5675 RECEIVED i Date Received: i
Fax: (651) 675-5694 � I
.�UN 0 4 1014 i Staff:--------------i
2014 COMMERCIAL BUILDING PERMIT APPLICATION �
Date: 1 W�Site Address: ��_�/ �� �.e!^/!�'''t� /�'�"'�
Tenant Name: —""'� (Tenant is: New/ Existing) Suite#:
Former Tenant: �
Name: /�' Phone:
PCOpe1"'ty OWllel' Address/City/Zip:
Applicant is: �Owner Contractor
�- � ,
Description of work: �1���� /V�� G('� : S���r
Type of Vllork. e�
` Construction Cost� 0 .
Name: � � • License#: �`
Contractor ': Address: p�V. , v�C �� City: �-�C�
' State:,��1 \/ Zip: �),5U w Phone: �L Z- '' r�g�� 3 J U
' Contact: Emaii: '''��/� /R'v v�
Name: �L� � ��( (/`� Registration#:
c
Architect/Engineer Address:�c.��L•�/S!/ __ city:
State:�Zip: _ Phone: ` ��Z / go3 sa�-�
: Contact Person: Email:
Licensed plumber installing new sewer/water service: Phone#:
NOTE:Plans and supporting documents that you submit are;considered to be putilic information.,.Portions of
the information rr►ay be classified as non-public if you pr.ovide specific reasons:fhat would permit the City fo
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.qopherstateonecall.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 which requires a revi approval of plans.
x OM ��" \- X
ApplicanYs Printed Nam Applicant's natu
Page 1 of 3
�� I� ��.�I m.,,k �✓.e� � 4 .
DO NOl' WRITE BELOW THIS LINE l�- �
SUB TYPES �.��b/�
_ Foundation �Public Facility�"�� _ Exterior Alteration-Apartments
_ Commercial/Industrial Accessory Building Exterior Alteration-Commercial
_ Apartments _ Greenhouse/Tent _ Exterior Alteration-Public Facility
Miscellaneous Antennae
1AIORK 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 y give PCA handout to applicant
�
� DESCRIPTION or
Valuation ��d� ��° Occupancy ----���"" MCES System --
Plan Review t�1,¢i✓�q� Code Edition �---^" ' SAC Units �
(25%_100%� ----� Zoning � City Water '"
Census Code Stories ----� Booster Pump ►------
#of Units Square Feet "'�"�' PRV ------
#of Buildings �.� Length �---�-����%� --Fire Sprinklers
_- r_.�--'
Type of Construction �.......-- Width �----�'�" �
R UIRED INSPECTIONS
Footings��y `,�� Sheetrock
Footings(Deck) �` Final/C.O. 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
� ",.,��r ., . .
Reviewed By: ` �' , Building Inspector Reviewed By: !' ..k��°'�� . , Planning
---��
COMMERCIAL FEES ,
Base Fee � R���� Water Quality
Surcharge ���. OU Water Sampling Fee
�
Plan Review �,,v,�l V�"�j Water Supply& Storage (WAC)
MCES SAC Storm Sewer Trunk
City SAC Sewer Trunk
S8�W Permit& Surcharge Water Trunk
Treatment Plant Street Lateral
Treatment Plant(Irrigation) Street
Park Dedication Water Lateral
Trail Dedication Other:
Water Quality TOTAL,�i �, � °�
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