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3925 Eagan Outlets Pkwy Suite 865 - Movado � s ��� � Use�BWE or BLAGK ink p�S �,� j Por c�ce use ---------� • R��ErvED �,� � P��„t#: �`'�� 1 � C1t Of �� �� � , , '"� ��� � � ��j Permit Fee: � � I, I 3830 Pilot Knob Road JUN � 1 �0 � 9 i �Q°�f�� i Ea an MN 55122 � D a t e R e c e i v e d: � i�hane: (651)675-5675 (�, Fax: (651)675-5694 � Staff: ►")�� � `�_������.��������J 2014 C4MMERCIAL BUILDING PEi�M1T APPLICATION Date: Site Address: �Z� r.+"''`C�J'V4 L/V�l.� �� ����IA�T,� Tenant Name: I'�CJY�� (Tenant is: d New! Existing) Suite#:_��� Forrner 1'enant: � Name: 1� Wll.vl �Iy Phone: �'T'��'�'�� � PCO�eI'�/ OW[teC Address/City/Zip: ZI� �• ���{,� �jl, ���t''��/�I����� �2�� Applicant is: �Owner �Contractor Type Of WOrk Description of work: �P���N� (���� � Construetion Cost: ���J�� Name: License#: � Address; / � 5 ' City; Contracfior �'�— State: 1�,� Zip:���.��_ Phone: �� �" ��,/ ~ �'� 9 � 7T � Contact: Email: - �t Yl.u� � S�u c.�e CG ���.�c � �� Name: /Y'�' Registration#: Address: lX � t� ��� Ci : �/ � AI'Glllt@Ct/E1tf�111�@I' � � tY w� � ` t State: ��� Zip: ��� 6� Phone: ��7"2tJ�/�"l��j' Contact Person: �� li�. � Emait:h1G�GN�Ft�1NII�,�7D��,�• � Licensed plumber instatling new seweNw�ater service; �hone#: NOTE:Plans artd sup�rting documents th�t yau submit are cansid�r�d to ke pukl�c informatfon. Porflo�►s af � the ir�formation may 6e classi�ed as nan-gubllc if you prqvide specific reasons that rn+au(d Rermif th►e City!o „� aan�lude that the are tr�de s�crefs. CALL BEFORE YOU DIG. Call Gapher State One Call at{651)454-0002 for protection against underground utility damage. Gal!48 hours before you intend to dig to receive loeates of underground utilities. www.qopherstateonecall.orq I hereby acknowledge that this informatian is compiete and accurate; that the work will be in confc3rmance with the ordinances and codes af the City o#Eagan; that I understand this is not a permit, but only an applicatio 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 i r quire a r iew nd approval of plans. X �� � � _ �, f�l X ApplicanYs Printed Name . Applican' ure Page 1 of 3 ..� ` �� �� �� � � � O�f C-e�-fS �°lC`,, ,� �� . /� DO NOT�RITE BELOW THiS LINE 7 � �'L�3 � SUB TYPES Foundation Public Facility E�cterior Aiteratian-Apartments �Commerciai/Industriat � Accessory Building � Exterior Aiteration-Commerciai _ Apartments _ GreenMouse f Terrt � Exterior Alteration-Public Facility Misceffaneous Arttennae woRK�r�r��s , _ New ✓tnterior lmprovement _ Siding _ Demolish�uilding* _ Addition � Exterior Improvemerit _ Reroof � Demolish Interior _ Alteration _ Repair _ Windows � Demotish Foundation _ Reptace _ Water Damage , Fire Repair _ Retaining Wall _ S�tlon OWner Change *Demolition of entire building-give PCA handout ta applica�rt D�SCRIPTfON �'' �a Q Yaluation ��7,�J Occupancy �+' MCES System �c�_ Pian Review ` �� Code Edition /�58�'�" SAC Units �„? (25°!0_10�%0� zoning City Water � Census Gode Storiss Booster Pump -��� #of Units Square Feet '�� PRV � #of Buildings Length Fire Sprinklers �/��_ Type of Constructian /B Width .._,_���_. REQUIRED INSPECTlONS Footings(New Buiiding) Sheetrock � Footings(Deck) �%Finai/G.O.Required Faotings{Additian) Final/No C.O.Required Foundation Other: Draln Tile Pooi:_Footings Air/Gas Tests _Final Raof:_Deeking ilnsulabon _fce&Water �Fina! Siding:iStueco Lath _Stane Lath _Brick v' Framing Windaws eFirepiace:,_Rough In �Air Test _Finai Retaining Wail ✓ Insutation Erosion Gontrot Meter Size: Finai G/Q Inspection: Schedule Fire Marsha(to be presenf:�Yes No Reviewed By: �(,�L�Q.- �--�`" , Buitding Inspector Reviewed By:_��'� . Ptanning COMMERCIAL PEES Base Fee �,�7S Water Quality Surcharge (0'�1�-s� Water Supply&Storage(WAG) Plan Review a�3• � Storm SewerTrunk MCES SAC Sewer Trunk City SAC Water Trunk S�W Permit�&Surcharge Street Latera{ Treatment Piant Street Treatment Plant(lrrigation) Water Laterai Parlc Dedicatian Other. Trai!Dedication Water Quality 70TA ���� Page2of3