3643 1/2 Vermilion Ct N �
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=� ������.� j For Office Use j
��+ O}'�T� �n y � Permit#: ��CO O ��—I
L� � 1� � �l � �� SEP 15 2014 `' � � Permit Fee: I
3830 Pilot Knob Road � � � �^- �
Eagan MN 55122 , �' j Date Received: � �✓ " y�
Phone:(651)675-5675 ��'� "�---- I i
Fax:(651)675-5694 I Staff: �� I
�------------------�
2014 COMMERCIAL PLUMBING PERMIT APPLICATION
❑ Please submit two(2)sets of plans with all commercial applications.
Date: � � � Site Address: �,���-{ �. S � ]��rn r L l.�i G� ��7"� ti �
Tenant: ���Z rn i �L� G a� i�Al1 y�,�-j�� 1��10rv��� Suite#:
Property � . � � � /� �' G 5T'arc �'i�' L�-5s� G o
C)1Nfler� ' " Name:_G_1�°�2 i`►�i C..�� [� �A�RJ�/�-� L�-'Yn�'z hone: G'i:5 3-- ",�S� ���,��.L
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Name ��l�c���t/L. ��_�%n�3 i�c /�L- License#: ���'1 (3S�°��>(�
� Gpn�raC�OM' c: ity: /j'1!a-�'(Y== �"�1�� State: Zip: S�
_ ; Address: – –=�b� c�ti�� - L �
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,W�i ��, � � Pf10f1@: "� � -�-� Efll81�'. ��� � ��f' � V� � 'C-��Y�
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� New �Replacement _Repair _Rebuild _Modify Space Work in R.O.W.
�Type�if Work � — f —
- �'�
' Description of work:
�
�� = COMMERCIAL _New Construction _Modify Space
���'� ��� �Irrigation System(_yes l_no)(�RPZ/_PVB)
• Rain sensors required on irrigation`systems
��C1Y11���/��.�� . Avg.GPM (2"turbo required unless smaller size allowed by Public Works) �
, _Meters Call(651)675-5646 to verity that tests passed prior to qickinq up meter.
������ ��, '�� Domestic:Size&Type Fire: 1
` �'�� ���� Avg.GPM High demand devices?_Yes No Flushometers_Yes No
COMMERCIAL FEES Contract Value$ �` . �7�; x.01
$55.00 Permit Fee Minimum
_$ "S'�• L'� Permit Fee
'If contract value is LESS than$10,010,Surcharge=$5.00 =$ ;'�>G� Surcharge"
**If contract value is GREATER than$10,010, Surcharge=Contract Value x$0.0005
**"If the project valuation is over$1 million, please call for Surcharge =$ fn D• L�% 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
_$ � C�� � TOTAL FEE
CALL BEFORE YOU DIG. Call GopherState One Call at(657)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 ��� �,� LL-� X �
ApplicanYs�Printed Name Applicant' ignature
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Require;d Inspec�i�ns`��� ` Un�#e�'�r'ai��rid s k#�c�ugh Ir� ,�Cr�est ���'T�s� Final �RV;I�equired�h. �es_No
, � ;�� � Radt€��ead Manai��t�r Staff:. , � �
IVlet�r,Rekated��ems � Me��r�ize'i<. t�._ x �`
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