3350 Dodd Rd �; �
l
Use BLl1E or BLACK Ink
�---------- ---i
� For Office Us���'i� I
�1 I j �
C�� O� LLL Ull �V GV i Permit F� . /O/.�S j
� � ���� � Permit ee I
3830 Pilot Knob Road i i
Eagan MN 55122 S�p O g 1�'�I� � Date Received: r�w( j
Phone: (651)675-5675 i �(, i
Fax: (651)675-5694 I Staff: �
I �
�����������������J
2014 COMMERCIAL BUILDING PERMIT APPLICATION ��'�
Q �!, ^ �
Date: "' l Site Address: �/�� 'J�A� �d��
Tenant Name: � � N�.R. (Tenant is: New/ Existing) Suite#:
Former Tenant:
Name: �PIIFIEO �1�'EENI �t�G Phone:(95��5����35
PCOpei�/Qwt1�C Address/City/Zip: ��� ��� ��� c��L�'�
Applicant is: Owner�" �Contractor
r
D
NE l,tltNA�cu s' Il'E GRc�L F�
�� S
�
Typ�of Wdrk Description of work.
D Z �r�l
Construction Co� �D v��
Name: License#:✓� 1 � V� ��
au . n4
C�ntt'a�tor Address: 1385 FBtmdS�Road Ciry:
St Paul,MN 551 i&2731 Q/ C
State: Zip: Phone: � � Z —p co�J �3 3 ��
' Do�� �=}�1�1� R,UDEAU Email:`�A.hEIC� �$TR�10��kU . CO M
Name:I�REcI�. 6�R r�E� . M U��-L E� Registration#: � Z ��1
Archite ngjMger' Address�' �IJS G'AN�t�I, e4�E �;ry: tNVER ��VE NGl'S� M�
State:�(� Zip: �"� S��� Phone: � 'r'��"4�� —����
Contact Person:J�M ICREGN Email: KO MA 1�a•�M
Licensed plumber installing new sewer/water service: �� Phone#:
NOTE:P�ans and supporting documents'that yacr submit are considerqed to be p+�b1�c it�for�a�orr. Por��c�t" .'
the information may be c/assifi�i as non-pubiic if you provide�speci�i�r�ea�ns#hat wo�rit�.��n�t���j,r�i
conc/uale that the are trade��cre#s.
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.4opherstateonecall.orq
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 ich re uires a review and a proval of plans.
X�/�.�t t t� S. `�'R�DE,a�1 X � �
ApplicanYs Printed Name AppiicanYs Signature
Page 1 of 3
�; � ,,,,
� �3��� (��o�C �� l � �15�
DO NOT WRITE BELOW THIS LINE
SUB TYPES
Foundation Public Facility Exterior Alteration-Apartments
� Commercial/Industrial Accessory Building _ Exterior Alteration-Commercial
_ Apartments _ Greenhouse/Tent _ Exterior Alteration-Public Facility
Miscellaneous Antennae
WORK 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-give PCA handout to applicant
DESCRIPTION ��
Valuation ��►6aQ Occupancy �_ / M�CES System
Plan Review Code Edition �S��SAC Units
(25%_100%_ , i Zoning i�= City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Sprinklers
Type of Construction � Width
REQUIRED INSPECTIONS
Footings(New Building) Sheetrock
Footings(Deck) Final/C.O.Required
Footings(Addition) �/ Final i No C.O.Required
Foundation Other:
Drain Tile Pool:_Footings AidGas 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
(�� � /�
Reviewed By: f�'41�� , Building Inspector Reviewed By: ` ' , Planning
COMMERCIAL FEES
Base Fee �t'�D�Q r�s Water Quality
Surcharge l�� 0(� Water Sampling Fee
Plan Review Water Supply 8�Storage(WAC)
MCES SAC Storm Sewer Trunk
City SAC Sewer Trunk
S&W Permit 8�Surcharge Water Trunk
Treatment Plant Street Lateral
Treatment Plant(Irrigation) Street
Park Dedication Water Lateral
Trail Dedication Other:
Water Quality TOTA o��
Page2of3