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3560 Blue Cross RdN CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS: PERMIT SUBTYPE: APPLICANT: TYPE OF WORK: { I?: I 111 liF id i r? I ) INSPECTION DATE INSPTR. • TYPE DATE INSPTR. I Id Pf t; t' ?N FtVVif W1 I) 14 E I PERMIT TYPE: Permit Number: Date Issued: F- 49-9/130 Permit No. it Holder Date Telephone # EtffCTFM U-6- S r?- 4 97- 0& PLUMBING HVAC Inspection Date Insp. Comments FOOTINGS M?f 11J,? FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG / FINAL HTG t S /? / ORSAT TEST BLDG FINAL BSMT R.I. BSMT FINAL DECK FTG DECK FINAL M ever 01 [1611 ,Z.r,Q. ?t a •? s? SITE ADDRESS Unit # Permit # 316??6 L I B Sect./Sub. BCS S1 INSPECTION INSPECTOR DATE COMMENTS - a s, z. Jut Am' P. A 5? 5-41 -9y wzw INSPECTION INSPECTOR DATE COMMENTS • 11 G t (?(-?a .Q.?e?.'vl c < <r . ?- Lf - .(s . ? y ;? a2 -Ala - S-a7 ?c ?c C ti /? h aT -? if ll & L( k be ce Lt. 4b it u It G ( LL lr A,0 d q f a--a V- hl1 Pa 0-? nv,, ` ` ?LJ y Slr o0 r0 25. O N a cr p' ?y q _ ?Onc?vcfi?,f /e _/?ou?. .nn,rr - CIi1J 4ir?? 3'? Serv.ce? ? 4 7- 2 / 00 1f CC (r ?? ?,? f 5 ? v N? • S 5. C? l?? r it e L r f)-g& SIT E ADDRESS?60 Unit # Permit B ( Sect./sub. •f GSS,44 &Z/ INSPECTION INSPECTOR DATE Comm -3 0 ti R N y .r f ?.'? . M q r ??? / DO S a? 3.? 9.Y . Gc.? ?a -8•Q ? ' CITY OF EAGAN 3830 PiTot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS: PERMIT PERMIT TYPE: Permit Number: Date Issued: 3560 DELTA DENTAL DR LOT: 1 BLOCK: 1 BCBSM EAST DESCRIPTION: (DELTA DENTAL) Building ,Permit Type ,psui'ldi'kg Work Type UBC Occupancy,, Construction,-f?lpe Zoning, Building 'Length; Bui;ldi-ng -Wid,th Bui'ldin'g istories - . S q la K F do-k ;.., C'e.q rsu? .C?gde- ? REMARKS: S & W PLBR - PLAN REVIEWED FEE SUMMARY- Base Fee Plan Review Surcharge SAC SAC % SAC Units Subtotal VALUATION $21,630.50 $14,059.83 $1,602.15 $17,000.00 100 $54,292.48 $7,043,000 CITY SAC S & W PERMIT S & W SURCHARGE TREATMENT PLANT Total Fee BUILDING 031636 04/13/98 $1,700.00 $100.00 $.50 $7.548.00 $63,640.98 CONTRACTOR: MCGIOUGH CONST CO 2737 N FAIRVIEW ST PAUL MN (61`2) 633-5050 - Applicant - 26335050 AVE 55113 OWNER: DELTA DENTAL 7807 CREEKRIDGE CIR BLOOMINGTON MN (612)829-2376 I -hereby," acknowledge, that I, have,,,read this, application; ar o ?tats that. the information is correct and agree.to comply wii,th all applfcaiil'e _State of A-n."` Statutes, and City,, of Eagarr1Ortiinanc,as._. ?r rc - _ w _ rr, ;.- APPLICANT/PE MITEE SIGNATURE ISSUED BY: GNAT COMM./IND. NEW B S3 A3 II-N PO 186 114 3 63,612 324 OFFICE/BANK ?? ;? atA 3 0 Qui %:N11 BY MIKE BARCK 41 a City of Eakan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 ----------------- I! Office Use I Permit #: Mg ? I I I r? ? Permit Fee: J(J I ? I Date Received: /??- j Staff: j ----------------- 2009 COMMERCIAL PLUMBING PERMIT APPLICATION Date: 0 - -Q % Site Address: ? 5 & 0 ? E L719 D 6 /?T9? bj? Tenant: L TA h E PTA L Suite #: PROPERTY Name: Phone: OWNER CONTRACTOR Name: #I?2 Q /-5 CO M14An.118 S License #: 05 8 Stec 3 - PM M Address: I?oq /yDh/T-R.Lr9L C/t2 City: 5T• P4 /t State:MAJ Zip: SJ5,1 // Phone: Cv S1- 60 2 ' G 5-0 0 Contact Person: PAU L 7W A ?d TYPE OF New Replacement Repair ulld Modify Space Work in R.O.W. - - WORK ? fi5 2 t . -e. v ? Description of work: PERMIT TYPE COMMERCIAL _ New Construction _ Modify Space Irrigation System (_ yes / _ no) (,? RPZ PV8) • Rain sensors required on irrigation systems • 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: Size & Price 3/4" meter 203.0 Avg. GPM High demand devices? _Yes _No Flushometers _Yes _No COMMERCIAL FEES: $50.50 Minimum (includes State Surcharge) OR Contract Value$ x 1% =$ Permit Fee Required on ALL new buildings and boulevard irrigation systems 4 = $ Radio Meter Read - If Rgynlt Fge is less than $1,000, surcharge is $ 50 =$ Meter(s) - If Permit Fee is > $1,000, surcharge increases by $.50 for each $1,000 $i,000 Permit Feo (i.e a $1.001 $2,000 Permit nee requires a $1.00 surchamel = $. State Surcharge Following fees apply when Installing a new lawn irrigation system., $ Water Permit Call the City's Engineering Department, (651) 675-5646, for required fee amounts. $ Treatment Plant $ Water Supply & Storage $ State Surcharge TOTAL FEES $ • S D 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 wthout 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 12#V z 7-)Q htO x r -1??r.ti Applicant's Printed Name Appltcanlr, Signature ? c. FOR OFFICE'USE ' App'roved By: Required Inspections:., -Under Ground -Rough.-In ' Air Test ' -Gas Test -Final PRV Required: , ', Yes No ; Page 1 of 3 2006 COMMERCIAL PLUMBING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 f.Gl _F'7GS(.7S Date/ dk% / 6 V -- - Site Address Unit # Tenant Name Former Tenant Name Property Owner Telephone # ( ) Contractor l VN Address City / State Zip ?L Z Telephone # (&j-7) License # Expires: The Applicant is Owner Contractor - Other Work Type New Bldg _ Modify Space _Irrigation System" --Yes -No Work in public r-o-w /easement? 1-RPZ _ PVB: _ New ?pair/Rebuild _ Replace _ Remove Rain sensors are reutred on irrigation systems Description of Work To inquve if Pressure Reducing Valve is requ'ved on new service, call 651.675-5646 Meters - Call 651.675-5300 to verify that hydrostatic, conductivity, and bacteria tests passed arior to nicking un meter. Irrigation Size & Type Avg GPM 2" turbo req'd unless smaller size allowed by Public Works Fire Size & Price 314" meter $167.00 Domestic Size & Type Avg GPM Includes high demand devices? -Yes-No Flushometers s No PRV Required _ Yes -No Permit Fee $50.50 minimum (includes State Surcharge) Contract Val x 1% Permit Fee $ Meter(s) Required on all new buildings & boulevard irrigation systems $ Radio Meter Read $ State Surcharge If nermit fee is less than $1,000, surcharge is $.50 If nennit fee is more than si,ooo, surcharge is $.So for each $1,000 owed. Following fees apply when installing new lawn irrigation system W $ Water Permit Call the City's Engineering Department, 651.675-5646, for required fee amounts g Treatment Plant $ Water Supply & Storage $ State Surcharge $ Total Fee ...a .,a "??,.nre rh"t e'work will be in conformance with the I hereby apply for a Commercial plumbing Femur ana acmowicugc wv u.c ,,,,?...•?..?•• mli=fs - -ordin ces and codes o f the City of Eagan and with the Plumbing Codes; that I understand y a lication fora permit, and work is not to e and approval of plans. start thout a p t; that the work will be in accordance with the approved plan in the case eques a Applicant's Printed Name- gnature CITY USE ONLY PERMIT # o RECEIPT DATE APPROVED BY: &rre C>. INSPECTOR - I ul COMMERCIAL MECHANICAL PERMIT APPLICATION CITY OF KA6AN 3630 PILOT KNOB RD EMAN, MN 55122 651-661-41675 Please complete for: all commercial/industrial buildings multi-family buildings when separate permits are not required for each dwelling unit DATE: O? SITE ADDRESS: 35 b0 Qe_-L'ja. a;,?I.jrpt FppC? OWNER NAME: t25tL.?A_ Dpt_ PHONE #: (,61_- 4(a - tAREA CODE) ???- TENANT NAME (IMPROVEMENTS ONLY): WAS THERE A PREVIOUS TENANT IN THIS SPACE? ?Y N. NAME: INSTALLER: Ut)TED 5H,Ef META ADDRESS: E5,20 aat-4 PV. PHONE#: (051 -_4-68-913(a (AREA CODE) CITY: ST• Pt?JI? STATE: MIV ZIP: 155111 WORK TYPE: New construction Install U.G. Tank Interior Improvement Remove U.G. Tank Processed Piping Specify Nature of Work: '456 C) 1 n P j 5b4 ? CAA "Pn When installing/removing underground tank, cafl 651-681-4675 for inspection by F Plumbing Iinspector. II U Fees: 1% of contract price OR $50.00 minimum fee, whichever is greater. Underground tank removal/installation = mmunum fee Contract price: $ x 1%= $ 50. 00 (Base Fee) State surcharge '4550 TOTAL S 50.5c) JUN 2 2 2001 I calculate at $.50 for each 51,000 Base Fee hn , Ai(Im c, ? SIGNATURE OF PER,MITTEE Updated 1/01 LA tz:? 1 OA G -L) COMMERCIAL 1, ?--t a s- v(? IA- t 6L ? NJC 13SYv? Eat BUILDING PERMIT APPLICATION CITY OF EAGAN 651-681-4675 Foundation Only New Construction Interior Improvement • Structural Plans (2) sets • Architectural Plans (2) sets • Architectural Plans (2) secs • Civil Plans (2) • Structural Plans (2) • Code Analysis (1) " • Certificate of Survey (1) • Civil Plans (2) • Project Specs (1) • Code Analysis (1) " • Landscaping Plans (2) • Key Plan (1) • Project Specs (1) • Code Analysis (1)'• • Master Exit Plan (1) • Spec. Insp- & Testing Schedule " • Certificate of Survey (1) • Energy Calculations (1) not always-' • Solis Report (1) • Spec. Insp. & Testing Schedule (1) " • Elec. Power & Lighting Form (1) not always" • Meter size must be established • Meter size must be established • Meter size must be established - if applicable • Project Specs (1) 1 • Energy Calculations (1) •' 1 1 • Electric Power & Lighting Form (1) 1 • Master Exit Plan (1) 1 1 • Fire Protection Plan (1)'• 1 1 • Soils Report (1) 1 • MC/ES SAC determination letter • MC/ES SAC determination letter MC/ES SAC determination letter call 651-602-1000 call 651-602-1000 call 651-602-1000 Contact Building Inspections for sample Food & beverage or lodging facilities: Plan must be submitted to Minnesota Department of Health - call 651-215-0700 for details. DATE WORK TYPE _ NEW " REMODEL CONSTRUCTION COSOZ ff O 0 SITE ADDRESS 3 \Sh`b OC4o\wk 6611 TENANT NAME ?CN V?` SUITE # FORMER TENANT NAME DESCRIPTION OF WORK ?d ki-ew do Vs D Name: S ai?Z Phone#: llp? V1AY n n , PROPERTY Last First ti c u u r OWNER Street Address le v City State zip Company C?70t?G?? ?Q 'Phone#(6 -1 ) 63y-5'bly CONTRACTOR b 571 ' d 4 S -25-ID Cell Street Address: Or ? 3 ? ? r trU %'e (? l?U C !V City ST• PALA State MN• zip S?7?/13 ARCHITECT/ ENGINEER Company _MO /AfE Phone # ( ) Name Registration # Street Address City State zip Licensed plumber installing new sewerlwater service: Phone M I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. ? /' Signature of Applicant: J l? ? I / / L3'? L'71A updated 1/( OFFICE USE ONLY SUBTYPE ? 01 Foundation ? 14 Apartments ? 15 Lodging 0 25 Miscellaneous WORK TYPE ? 31 New ? ? 32 Addition ? P 33 Alterations ? ? 34 Replacement ? ? 26 Public Facility ? 30 Accessory Bldg. ? 27 Commercial/In dustrial ? 32 Ext Alt - Apts. ? 28 Greenhouse ? 34 Ext Alt - Comm. ? 29 Antennae ? 35 Ext Alt - PF ? 37 Nail Salon 35 Tenant Impr ? 42 Demolish (Found) ? 46 Windows/Doors 36 Move Bldg ? 43 Reroof ? 47 Repair 37 Demolish (Bldg) ? 44 Siding ? 48 Authorization 38 Demolish (Int) ? 45 Fire Repair GENERAL INFORMATION Census Code 13-ioning SAC Code ? c, # of Stories No. of Units 1 Length No. of Bldgs. -t Width Const. (Actual) //-,gw Basement sq. ft. (Allowable) tt -,rFirst Floor sq. ft. UBC Occupancy- sq. ft. MISCELLANEOUS INSPECTIONS ? Gas Service Test ? Heating ? Insulation APPROVALS Planning Building- Engineering sq. ft. sq. ft. sq. ft. sq. ft. MC/ES System City Water Fire Sprinklered ? Plumbing ? Stucco/Stone Variance Permit Fee 1- Surcharge Plan Review (e 3 , 3 MC/ES SAC City SAC Water Supply & Storage S/W Permit S/W Surcharge Treatment Plant Park Dedication Trails Dedication Water Quality Other Copies , C?'DD o VALUATION $ /V % SAC SAC Units Meter Size Total y 2 .0 (,, J TO: PAT GEAGAN, CHIEF OF POLICE JON HOHENSTEIN, ASSISTANT TO THE CITY ADMINISTRATOR DALE WEGLEITNER, FIRE MARSHAL ELECTRICAL INSPECTOR PUBLIC WORKS/ ENGINEERING DIVISION /UTILITIES/STREETS GENE VANOVERBEKE, FINANCE DIRECTOR RICH BRASCH, WATER RESOURCES COORDINATOR MIKE RIDLEY, SENIOR PLANNER A' GREGG HOVE, SUPERVISOR OF FORESTRY ??-r- rD ?? . FROM: MIKE BARCK, CONSTRUCTION INSPECTOR (BUILDING) DATE: The _preliminary construction plans for 'D E 4-7,-4 Tom' - = r * ? ? '7. are in our plan review section for your review and comment. kx u Gc „T D =.?)r.t L D;2i J - Please return this form to Dale Schoepllner with your signed comments and the date of review. If you have any concerns with these plans, please so indicate on this form and notify and resolve these issues with the affected parties. If you are requesting that issuance of the building permit be held, please fill out the proper "hold" request form. Comments: Indicate any fees that are to be collected with the building permit: ? Yes ? No ? Yes ? No ? Yes ? No ? Yes ? No ? Yes -l* No ? Yes ? No Signature landscape security required water quality dedication park dedication trail dedication tree dedication ZONING? 2- Date CD/BLDG INSPUPLAN REVIEW MIKE 0 Ci,S3 - a? niU" v, y? '1 ' >, y h i b S4 ?7 nr i _ , M 1 lye t ?• MEMORA'NDTJ I - V w 0 { -- o, - TO- PAT GEAGAN, CHIEF OF POLICE JON HOHENSTEIN, ASSISTANT TO THE CITY ADMINISTRATOR DALE WEGLEITNER, FIRE MARSHAL ELECTRICAL INSPECTOR PUBLIC WORKS/ ENGINEERING DIVISION /UTILITIES/STREETS GENE VANOVERBEKE, FINANCE DIRECTOR RICH BRASCH, WATER RESOURCES COORDINATOR NIKE RIDLEY, SENIOR PLANNER ~ GREGG HOVE, SUPERVISOR OF FORESTRY FROM. MIKE BARCK, CONSTRUCTION INSPECTOR (BUILDING) DATE: preliminary construction plans for V e- The _ are in our plan review section for your review and comment. --:<> > G- Indicate any fees that are to be collected with the building permit: AMOUNT ? Yes ? No landscape security required ? Yes ? No water quality dedication ? Yes ? No park dedication ? Yes ? No trail dedication ? Yes ? No tree dedication ? Y,as ? No Signature ZONING? a $ Date CD/nLDG INSPE/PLAN REVIEW MIKE 8 Please return this form to Dale Schoeuuner with your signed comments and the date of review. If you have any concerns with these plans, please so indicate on this form and notify and resolve these issues with the affected parties. If you are requesting that issuance of the building permit be held, please fill out the proper "hold" request form. 4?- '4 .r ??,R?. f.l TO: PAT GEAGA:N, CHIEF OF POLICE JON HOHENSTEIN, ASSISTANT TO THE CITY ADMINISTRATOR DALE WEGLEITNER, FIRE NIARSHAL ELECTRICAL INSPECTOR PUBLIC WORKS/ ENGINEERING DIVISION /UTILITIES/STREETS GENE VANOVERBEKE, FINANCE DIRECTOR RICH BRASCH, WATER RESOURCES COORDINATOR G. MIKE RIDLEY, SENIOR PLANNER /-/ 3 C 'S 5 M GREGG HONE, SUPERVISOR OF FORESTRY =,4-:5 T' W. FROM: NUKE BARCK, CONSTRUCTION INSPECTOR (BUILDING) DATE: The -preliminary !construction plans for - ' It are in our plan review section for your review and comment. - Y - T? - % =- Please return this form to Dale Schoeppner with your signed comments and the date of review. If you have any concerns with these plans, please so indicate on this form and notify and resolve these issues with the affected parties. If you are requesting that issuance of the building permit be held, please fill out the proper "hold" request form. Ltw, .0961 A ;7 Comments- + &kA A 0. A C >4-' Indicate any fees that are to be collected with the building permit: ANIOUNT ? Yes R "'No landscape security require N I N G ? Yes EKNo water quality dedication ? ? Yes Ci` No park dedication ? Yes 19` No trail dedication ? Yes &"No tree dedication FD 3. 1- Date CDIa LDG INSPEIPLAN REVIEW MIKE 6 TO- PAT GEAGAIN, CHIEF OF POLICE JON HOHENSTEIN, ASSISTANT TO THE CITY ADMINISTRATOR DALE WEGLEITNER, FIRE MARSHAL ELECTRICAL INSPECTOR -:27., PCBLIC WORKS/ ENGINEERING DIVISION /UTILITIES/STREETS GENE VANOVERBEKE, FINANCE DIRECTOR RICH BRASCH, WATER RESOURCES COORDINATOR MIKE RIDLEY, SENIOR PLANNER GREGG HOVE, SUPERVISOR OF FORESTRY FROM: MIKE BARCK, CONSTRUCTION INSPECTOR (BUILDING) DATE: r 11 `'i / 1$ The -preliminary %'-construction plans for V c:-T4 La L 7 . c are in our plan review section for your review and comment. xK y ,?? -r c cA-I-rrt L r)12,, LI Please return this form to Dale Schoeppner with your signed comments and the date of review. If you have any concerns with these plans, please so indicate on this form and notify and resolve these issues with the affected parties. If you are requesting that issuance of the building permit be held, please fill out the proper "hold" request form. Indicate any fees that are to be collected with the building permit: AMOUNT ? Yes ? No landscape security required ? Yes ? No water quality dedication ? Yes ? No park dedication ? Yes ? No trail dedication ? Yes ? No tree dedication ? Yes ? No ZONING? „_t -3 -2 nature Date CD/BLDG INSPUPLAN REVIEW MIKE B Metropolitan Council Working for the Region, Planning for the Future Environmental Services February 20, 1998 Joe Voels Construction Analyst City of Eagan 3830 Pilot Knob Road Eagan, MN 55122 Dear Mr. Voels: The Metropolitan Council Environmental Services Division has determined SAC for the Delta Dental to be located within the City of Eagan. This project should be charged 17 SAC Units, as determined below. Charges: Office 35479 sq. ft. @ 2400 sq. ft./SAC Unit Conference 2752 sq. ft. @ 1650 sq. ft./SAC Unit Assembly/Printing 2956 sq: ft. @ 7000 sq. ft./SAC Unit If you have any questions, call me at 602-1113. Sincerely, Jodi I;. Edwards Staff Specialist Municipal Services Section JLE: 98022058 cc: S. Selby, MCES Carolyn Krech, Finance Department, Eagan NeQuisha Adams, McGough Construction Co. Inc. SAC Units 14.78 1.67 0.42 Total Charge: 16.87 or 17 230 Fast Fifth Street St. Paul, Minnesota 55101-1633 (612) 222-8423 Fax 229-2183 TDD/TTY 229-3760 An Eq=1 Oppo ztty Employer TO: PAT GEAGAN, CHIEF OF POLICE JON HOHENSTEIN, ASSISTANT TO THE CITY ADMINISTRATOR DALE WEGLEITNER, FIRE MARSHAL ELECTRICAL INSPECTOR - 7-PUBLIC WORKS/ ENGINEERING DIVISION /UTILITIES/STREETS :GENE VANOVERBEKE, FINANCE DIRECTOR RICH BRASCH, WATER RESOURCES COORDINATOR MIKE RIDLEY, SENIOR PLANNER GREGG HOVE, SUPERVISOR OF FORESTRY } yr ! pr ti FROM: MIKE BARCK, CONSTRUCTION INSPECTOR (BUILDING) DATE: -1/1 -1 /Z( ,P The -preliminary construction plans for b?r D v T r!= ??- t "17 are in our plan review section for your review and comment. xx u OcL -f a =^N't= >J.2+ c- Please return this form to Dale Schoeppner with your signed comments and the date of review. If you have any concerns with these plans, please so indicate on this form and notify and resolve these issues with the affected parties. If you are requesting that issuance of the building permit be held, please fill out the proper "hold" request form. Comments: CI-e_ OA 6e- _L dent 1fz'cd a -t, /tol ?? rah onr.?c?raRr?v • ?j o? 2"1 e e ?'/i9,. UcrlAI ? l`J`J(O ?'dfP?'. 7' c l11 d Gent 0C9 - Indicate any fees that are to be collected with the building pemutf.:a?-` , AMOUNT A ? Yes ? No landscape security required Z O N I N ? ? Yes ? No water quality dedication ? Yes ? No park dedication ? Yes ? No trail dedication ? Yes ? No tree dedication ? Yes ? No Sign to e 00 ?-4D - 4$ Date CD/BLDG INSPE/PLAN REVIEW MIKE B 612 332 9013 FROM (FRH 01. 09' 98 16:14/0T. 16: 13/N0. 3562181934 P I Ilanlrl}rpl Ortxm R AbraluiUaon, Inc. GA Nemkrnin byunmft rnu,:,jkmF 12011?smtoa Plsra M+mrep.W,Mi,unwu SSaTi.I'le5 (012)3371100 WU33N3niJ T R A N S M I T: '1 A L To:- Mike Dank Du ._- -9 Ian 1998 Smldiny, ins ctor - ?.r - _r"irrt _ Dmim Dental - - City afJav,.nn Cnmmissioa Number. 17yU.001.00 - 3830 Pilot Rnob Ruud - baa n, Ntinnesma 55122-1997 R'e fnrwarA tl?e fWlwrine' - Vla: - C1klb mview flopl Plates F?rat QW,s Mml - - - - - - Ovornighr rsymss - - - -. -. -. 3 Now Cuuner Hour r_nunu Ducct Crnrrirr - - - U...4d Ptvicel gnrvim. -_ - Fna: 681-4694 _8 - - - .- - - - - Pugac to fnllnw 3-11,111 Rcmarka Call wf Quc+rinns or CQrnrnents Cnlry forse tc: - - - - [,m.xultde - - - - - - Shop rvnw[M rle -_ -- - - - Copy emiccura rni - - - - - - Corrrspoodenw Fde F...m_ Cbrls Suhrnirr 612-337-14`n SLVy Dflwing Fdr - N W m N m 0 m 0 0 r7 ? 0 N rl) M N ti o w 4 - r F7L I}uaw £i,ps..n Itl rr4 taln.5 kklni 0.r ka?1 ®F/rVx oyd miry MY tltl uir ytie!•5 kN Ob n4q].r lalaY 1 r?u anb ori-Mr WWt[X Fr M'•I kkl rr1 W?IS Ma•F * kklM Wl ArN •}y5? tlf nI VIM ay,E . 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CJ w 4n m 0 M o - - 0 ti w y N f7 MI N iD CD 4 CD w kk1 eL [e br•i ttl JL ryIM • i kb ul[ rp Ir Mr= N' ww.n zr4y • us 6Y GYM tlr'a, =40 [Af M vn ron. = M' D:II ,a.. k.. nuM... E la.. I W ... s..m 8 D:I r^11 Open 711're m ' W -- f ' a 7 [II?rr1;. 1[[. Av rRr ? ?•• I N m ® \ _ to ` - / ? I m it S [mss. Er DI 9 6 g B _ _ r -IK ROOR PLM ¢o FrL ? C H : /n V/ S Ir/LI,N..r Exit corridors shall not be interrupted by intervening moms. EXCEPTION: Foyers, lohhies or reception roams constructed as required for corridors shall not he construed as mtervenmg rooms. Corridors which are located within an accessible route of travel shall also comply with Chapter 11. For Group I Occupancies see Section 1019 3 What are the hazards posed to the occupants exiting in a corridor system having intervening rooms? A ¦ The reasoning for not allowing corridors to be inter- . rupted by intervening rooms is that once an occu- pant has reached an area providing a certain level of safety, that level of safety should not be reduced as the occupant pro- gresses through the remainder of the exiting system. The code provides an exception in Section 1005.1 which allows foyers, lobbies or reception rooms not to be construed as intervening rooms if constructed as required for corridors. An intervening, room increases the fire hazard exposure potential to building occupants and could cause confusion in determining a safe path of travel to the exterior of the building. ^ ¦ We have noticed that the code does not contain a ?1( . definition for corridor. Please explain what consti- tutes a corridor. What is the difference between a corridor and an intervening room? A• As you have pointed out, the code does not contain a definition of a corridor and is silent regarding any distinction between a room and a corridor. Rooms which are relatively long compared to their width and which serve as part of an exit are generally considered to be corridors. The final de- cision as to whether or not such an area is to be classified as an intervening room or as a corridor is judgmental and must be de- termined by the building official. On numerous occasions, attempts have been made to devel- op language which would serve as a definition for a corridor. For every definition proposed, a layout could be developed which would render the definition unsuitable. The desire to maintain the code as a performance document has resulted in requiring the use of judgment as to the exiting scheme in each individual case. 1. A. May interoffice corridors serving an occupant load of less than 30 exit through adjoining areas (Figure 10-31)? B. What if the occupant load is more than 30? 2. May the corridor in Figure 10-32 be called part of the gen- eral office area and not a corridor? 3. A. If the corridor were 10 feet (3048 mm) wide, would it still be a corridor (Figure 10-33)? B. If one or more desks were set in this corridor, would it then become a room? A . Our answers are in the same order as your questions. 1. The answer to both portions A and B is no. The second paragraph of Section 1005.1 specifically prohibits exit- ing as suggested in your question. A corridor serving as an exit cannot discharge throw offices ace before reach- ing a ve means of exit. -- 2. Webster defines a corridor as a passageway, and it wou appear that Figure 10-32 shows that this is exactly the case for the corridor in question. Therefore, regardless of what an archi- tect or owner may wish to call it, it is still a corridor and should comply with the code as a corridor. 3. -33 etstothepointwhere'u quired. Our opinion is that event oug t e corridors shown are 10 feet (3048 mm) wide, they are still corridors and not part of the open office space. At some point, the width of the corridors would be such that they could reasonably be considered to be part of OFFICE A OFFICE ? . OFFICE OPEN OFFICE SPACE Q ¦ What is the intent of the statement in Section 1005.1, "Partitions ... not over 5 feet 9 inches (1753 mm) in height above the floor shall not be construed to form corridors"? A ¦ A corridor is a relatively narrow path of exit in a building. There is a degree of hazard to the occu- pants using a corridor because it restricts the occupants' exit path. The code requires that when the corridor serves a certain occupant load, the corridor must be of fire-resistive construc- tion with openings protected as addressed in Sections 1005.7 and 1005.8. Due to the height of partitions forming the corridor walls, it is not possible for the occupants using the corridor to be acutely aware of events on either side of the corridor as they progress toward the exterior of the building. However, if the partitions are limited to a given height, the occupants can be aware of events on both sides of the path of exit as they proceed to the exterior of the building. The code envisions this maxi- mum height to be 5 feet 9 Inches (1753 mm)- 0 • I need help in determining the exit schemes for these ¦ three drawings. All partitions are full height. FIGURE 1431 OFFICE OFFICE OFFICE OFFICE CORRIDOR OFFICE OFFICE S 8 O OFFICE OFFICE OPEN OFFICE SPACE FIGURE 10-32 88 OFFICE OFFICE OFFICE OFFICE 3 Y CO RRIDOR OFFICE g OFFICE gN OFFICE s OFFICE Ip'p OFFICE Ip P OFFICE OPEN OFFICE SPACE For SI: I inch = 25 4 mm, I foot = 304.8 mm. FIGURE 10.33 EXTERIOR ROOM B LOBBY Section 1005.4 1005.4 Projections. The required width of corridors shall be un- obstructed. EXCEPTION: Handrails and doors, when fully opened, shallnotre- duce the required width by more than 7 inches 0 78 mm) Doors in any position shall not reduce the required width by more than one half. Other nonstructural projections such as trim and similar decomlive features may project into the required width I1/2 inches (38 mm) on each side ANDIMe ROOM A RECEPTION Q ¦ We would like an interpretation of Section 1005.4 ¦ as it pertains to doors that extend across the full width of a corridor. Is this permitted? NOTE CORRIDOR SERVES 30 OR MORE OCCUPANTS EXTERIOR FIGURE 10-34-OFFICE FLOOR PLAN the open office space. Your judgment of this condition would be just as good as ours. If desks are placed in the corridors, they are still corridors and aisle space should be provided through there so that the required exit width would be maintained. Q ¦ Considering the exception to Section 1005.1, please ¦ refer to the attached illustration (Figure 10-34) and advise me whether reception room A would constitute a corri- dor, thereby allowing the glass in wall A to be nonwired glass. We maintain that wall A constitutes the corridor boundary and must, therefore, comply with corridor construction. A contrac- tor maintains that he has consistently received another interpre- tation elsewhere. He maintains that if the walls of reception room A are of one-hour construction, then the glass wal I is per- mitted. Lobby B would, in our opinion, be a perfect example of the intent of this section. 90' x 30'TENANT SPACE For SI: I foot = 304 8 mm. OFFICES RATED CORRIDOR 20MINUrE ASSEMBLY _COMPLYNG ONE-HOUR COI FIGURE 10-35 A0 If room A on the sketch you submitted is, in fact, a ¦ reception room, it is our opinion that the provisions of Section 1005.1 relating to lobbies, foyers and reception rooms would be applicable as long as the walls and ceiling of the reception room are constructed as required by Sections 1005.7 and 1005.8. Thus, the separation between the recep- tion room A and the corridor would not be required to be of fire-resistive construction or have a protected opening. Howev- er, depending on circumstances, the "glass wall" may require safety glazing in accordance with Section 2406. ¦ A The purpose of this section is not to prohibit doors . which, when closed, could extend across the full width of a corridor. Examples would be draft-stop and smoke-stop doors in hospital corridors. These doors can be per- mitted, provided the provisions of Section 1004 are satisfied and particular attention has been paid to swing requirements. The purpose of Section 1005.4 and the exception is to limit the projection of doors that open from a room into a corridor. If the door swings into the corridor through 180 degrees, then the maximum projection at the 90-degree point would be one half the required width of the corridor; the maximum projection at the 180-degree point (fully opened) would be 7 inches (178 mm) into the required width of the corridor. Section 1005.5 1005.5 AccesstoExits. When more than one exit is required, they shall be so arranged that it is possible to go in either direction from any point in a corridor to a separate exit, except for dead ends not exceeding 20 feet (6096 min) in length. Q ¦ In Figure 10-35, does the nonfire-rated corridor re- a quire exits at each end to prevent dead ends in ex- cess of 20 feet (6096 mm)? Also, does the exiting from room A through room B through the nonfire-rated corridor into the one-hour corridor provide complying exiting? 89 city of eagan THOMAS EGAN January 12, 1998 Mayor PATRICIA AWADA BEA BLOMQUIST SANDRA A. MASIN THEODORE WACHTER MR CHRISTOPHER SCHMITT Council Members HGA THOMAS HEDGES 1201 HARMEN PLACE City Administrator MINNEAPOLIS MN 55403-1985 E J VAN OVERBEKE City Clerk RE: DELTA DENTAL Dear Chris: This letter is in response to the preliminary plans displaying the exiting layout for the proposed Delta Dental building. Please be advised that we are unable to approve the design as submitted as the location of a coffee area and closet in corridor space conflicts with the corridor requirements as set forth by the 1994 Uniform Building Code, Section 1005. Additional corridor requirement information shown in the U.B.C. handbook further supports Section 1005. Additionally, the second floor corridor exiting to the north must be maintained continuously to the exterior exit. As shown, the corridor enters an intervening room before reaching the exit. You must also eliminate the exit signage from the open office space at that corridor entrance. Please make the necessary corrections and incorporate them into the design when submitting plans for a building permit. Thank you. If I can be of further assistance, please do not hesitate to contact me at 681-4679. Sincerely, Michael Barck Building Inspector MB/j s MUNICIPAL CENTER 3830 PILOT KNOB ROAD EAGAN MINNESOTA 55122-1897 PHONE, (612) 681 4600 FAX (612) 681-4612 TDD (612) 454-8535 THE LONE OAK TREE THE SYMBOL OF STRENGTH AND GROWTH IN OUR COMMUNITY Equal Opportunity/Affirmative Action Employer MAINTENANCE FACILITY 3501 COACHMAN POINT EAGAN. MINNESOTA 55122 PHONE (612) 681 43170 FAX (612) 681 4360 TDD (612) 454-8535 DELTA DENTAL CORPORATE HEADQUARTERS SECTION 01410 SPECIAL STRUCTURAL TESTING AND INSPECTION SPECIAL STRUCTURAL TESTING AND INSPECTION SCHEDULE Project Name: Delta Dental CoMorate Headquarters Project No. Location Eagan. Minnesota Permit No. Special Structural Testing and Inspection Specification Type of Report Assigned Section Article Description (2) Inspector 3) Frequency Firm (4 02200 Earthwork Technical Weekly 03300 Concrete Testing Technical Weekly 03100 Formwork Structural Weekly 03200 Concrete Reinforc. Structural Weekly 03000 Concrete Placement and Curing Structural Weekly 05120 Structural Steel Field Welds Technical Weekly 05120 High Strength Bolting Technical Weekly 05120 Shear Studs Technical Weekly 05120 Structural Steel Observation Structural Weekly 05210 Steel Joists Technical Weekly 05312 Steel Roof Decking Technical Weekly Notes: This schedule to be filled out and included in the project specification. Information unavailable at that time, to be filled out when applying for a building permit. (1) Permit No. to be provided by the Building Official. (2) Use descriptions per UBC Section 1701, as adopted by Minnesota State Building Code. (3) Special Inspector - Technical, Special Inspector - Structural. (4) Firm contracted to perform services. 1780.001 - DELTA DENTAL CORPORATE HEADQUARTERS Page 01410 - 1 ACKNOWLEDGMENTS Each appropriate representative shall sign below: Owner Fhm: Delta Dental per; Contractor. Firm: McGough Construction Date: Architect: Firm: HGA Date: SER: Firm: HGA Date: SIS: Firm: Date: Firm: Braun Intertec Date: SI- Firm: Date: TA: Firm: Date: ST-T: Firm: Date: F: Firm: Date: F. Firm: Date: -z - 3?24/48 S/?4(9S * The individual names of all prospective special inspectors and the work they intend to observe shall be identified. (Use reverse side of form if more room is needed.) Legend: SER - $tructueal Bngineer of Record TA - Testing Agency F = Fabricator SIT = Special Inspector - Technical SIS = Special Inspector - Structural Accepted for the Building Department By Date 1780.001- DELTA DENTAL CORPORATE HEADQUARTERS Page 01410 - 2 CODE ANALYSIS -Delta Dental p.1 HGA, Inc., 1201 Harmon Place, Minneapolis, MN 55403 - (612) 3374100 Project: Delta Dental Facility Code Review Comm. #: 1780.001.00 Location: Eagan, Minnesota Date Prepared: 24 November 1997 Prepared by: CNS ph: 612-337-4350 Reviewed by: DD ph: 612-337-4349 Applicable Codes: MSBC'95, UBC'94, CABO/ANSI 117.1. Disclaimer: The following analysis is part of an ongoing process of research and documentation of building code requirements as they relate to the above named structure. This analysis was prepared by HGA for planning purposes only, and should in no way be construed as a legally binding document. UBC Chapter 3 - Use or Occupancy [UBC, T-3A] Mixed - Group B office Group A Division 3 assembly' Group S Division 3 parking This building is a mixed occupancy Group B office, Group A, Division 3 assembly and Group S, Division 3 parking. The Group A and Group S will be entirely on the first floor of the building and as per UBC Table 3-B a one-hour occupancy separation will be required between all occupancies. This occupancy separation will be both vertical and horizontal An occupancy separation will be required between the mechanical boiler room and the rest of the project as per UBC Section 302.5 Special provisions of Group S, Division 3 shall include floor surfaces of non-combustible, non-absorbent materials and floors that drain to an approved oil separator or trap as per UBC Section 311.2.3.1 UBC Chapter 6 - Types of Construction The building will be Type II One-Hour Construction. This construction type gives us the allowable area (see general building limitations below) and allows for the most economical fire-resistive construction within the range of available possibilities. The Type II One-Hour Construction also allows for a four story building. [UBC, Table 6-A]: Type II - One-hour Construction Building Element 1. Bearing Walls - exterior 2. Bearing Walls - interior 3. Non-bearing Walls - ext. 4. Structural Frame 5. Permanent Partitions 6. Shaft Enclosures 7. Floors and Floor ceilings 8. Roofs and roof ceilings Tvpe II - One-hour Construction 1 hr 1 hr 1 hr 1 hr 1 hr 1 hr 1 hr 1 hr CODE ANALYSIS -Delta Dental ps HGA, Inc,, 1201 Hannon Place, Minneapolis, MN 55403 - (612) 337-4100 UBC Chapter 5 - General Building Limitations - see sheet A100 for additional information Section 503 - Location on Property The building sits well within the site property line with the closest property line approximately 135' from the building. The building will have access to public yards on all sides. As per UBC Table 5-A, B occupancies, A-3 occupancies and S-3 occupancies of Construction Type II One-Hour, when 40 feet or greater from a property line exterior non-bearing walls can be non-rated, non-combustible construction. Openings in exterior walls of this occupancy and construction type will not be permitted less than 5 feet from a property line and must be protected within 10 feet of the property line. Section 504 - Allowable Floor Areas 5042 Areas of Buildings Over One Story. The total combined floor area for multistory buildings may be twice that permitted by Table 5-B for one story buildings, and the floor area of any single story shall not exceed that permitted for a one-story building. 504.3 Allowable Floor Areas of Mixed Occupancies. When a building houses more than one occupancy, the area of the building shall be such that the sum of the ratios of the actual area for each separate occupancy shall not exceed one (See sheet A100) Exceptions: 2. Groups B, F, M and S and Group H, Division 5 Occupancies complying with the provisions of Section 505.2 may contain other occupancies provided that such occupancies do not occupy more than 10 percent of the area of any floor of a building, nor more than the basic area permitted in the occupancy by Table 5-B for such occupancy, and further provided that such occupancies are separated as specified in Section 302.4. Section 505 - Allowable Area Increases 505.1 General. The floor areas specified in Section 504 may be increased by employing one of the provisions of this section. 505.1.3 Separation on All Sides. Where public ways or yards more than 20 feet in width extend on all sides of a building and adjoin the entire perimeter, floor areas may be increased at a rate of 5 percent for each foot by which the minimum exceeds 20 feet. Such increases shall not exceed 100 percent...... Section 508 - Fire-Resistive Substitution When an approved automatic sprinkler system is not required throughout a building by other sections of this code, it may be used in a building of Type 11 One-hour,...... to substitute for the one-hour fire resistive construction. Such substitution shall not waive or reduce the required fire-resistive construction for: 1. Occupancy separations. 2. Exterior wall protection due to proximity of property lines. 3. Area separations. 4. Shaft enclosures. 5. Corridors. 6. Stair enclosures. 7. Exit passageways. 8. Type of construction separation. 9. Boiler, central heating plant or hot water supply boiler room enclosures. CODE ANALYSIS -Delta Dental p.3 HGA, Inc., 1201 Harmon Place, Minneapolis, MN 55403 - (612) 337-4100 [UBC Table 5-B] Type II - One Hour Construction / Group B Occupancy 18,000 sq. ft. allowable area x 2(UBC Section 504.2) = 36,000 sq. ft. x 2(UBC Section 505.1.3) = 72,000 sq. ft. allowable Type I) - One Hour Construction / Group A-3 Occupancy 13,500 sq. ff. allowable area x 2(UBC Section 505.1.3) = 27,000 sq. ft. allowable Type II - One Hour Construction / Group S-3 Occupancy 18,000 sq. ft. allowable area x 2(UBC Section 505.1.3) = 36,000 sq. ft. allowable Section 508 will apply. An approved automatic sprinkler system is not required by any other section of this code and is being provided throughout the building, therefore it will be used as a substitute for One-Hour fire-resistive construction. Chapter 9 - Fire Protection Systems As per Section 906 - Smoke and Heat Venting, smoke and heat venting will not be required. Smoke and heat venting is only required in single story buildings of Group B occupancies over 50,000 sq. ft of area. As per UBC Table 9-A - Standpipe Requirements, for a Group B occupancy, less than 4 stories in height but greater than 20,000 sq. ft per floor no standpipe is required when the building is fully sprinklered. There is also no hose requirement when the building is fully sprinklered. UBC Chapter 10 - Means of Egress - see sheet A100 for additional information Section 1002.1 Determination of Occupant Load 1002. 1.1 Areas to be included. In determining the occupant load, all portions of a building shall be presumed to be occupied at the same time. Exception: Accessory use areas which ordinarily are used only by persons who occupy the main areas of an occupancy shall be provided with exits as though they are completely occupied, but there occupant load need not be included in computing the total occupant load of the building. 1002.1.2 General. For areas without fixed seats, the occupant load shall not be less than the number determined by dividing the floor area assigned to that use by the occupant by the occupant load factor set forth in Table 10-A. For a building or portion thereof which has more than one use, the occupant load shall be determined by the use which gives the largest number of persons. The occupant load for buildings or areas containing two or more occupancies shall be determined by adding the occupant loads of the various use areas as computed in accordance with the applicable provisions of this section. Table 10-A Minimum Egress Requirements Use Minimum of two exits Occupant Load Factor arc required where number of occupants is at least Offices 30 100 Assembly 50 15 Garage, parking 30 200 CODE ANALYSIS -Delta Dental P.4 HGA, Inc., 1201 Hannon Place, Minneapolis, MN 55403 - (512) 337-4100 Office areas First floor 14,800 sq. ft. (Actual square footage) / 100 (Occupant Load Factor) = 148 (Occupant Load) Secondfloor 21,688 sq. ft. (Actual square footage) / 100 (Occupant Load Factor) = 217 (Occupant Load) Third floor 21,245 sq. ft. (Actual square footage) / 100 (Occupant Load Factor) = 212 (Occupant Load) Parking area - first floor 3200 sq. ft. (Actual square footage) 1200 (Occupant Load Factor) = 16 (Occupant Load) Assembly area - first floor 2560 sq. ft. (Actual square footage) / 15 (Occupant Load Factor) = 170 (Occupant Load) Accessibility All portions of the building shall meet the requirements of the American with Disabilities Act, The Uniform Building Code and the Minnesota State Building Code. UBC Section 1103.2.2 Accessible routes. When a building or portion of a building is required to be accessible, an accessible route shall be provided to all portions of the building, to accessible building entrances, connecting accessible pedestrian walkways and the public way. UBC Section 1103.2.3 Accessible entrances. Each building and structure, and each separate tenancy within a building or structure shall be provided with at least one entrance which complies with the accessible route provisions of CABO/ANSI At [7.1. At least 50 percent of all entrances shall be accessible. UBC Chapter 29 - Plumbing Fixtures Toilet Fixtures Required IUBC Ch. 29 TA-29-A1: Use 200 sq. ft. Per occupant as per Group B Table 29-A First Floor toilet fixtures - 21,504 sq ft - 3200 sq ft (parking area) = 18304 sq ft / 200 = 91.52 people. Assume 46 male and 46 female. Water Closets: Total 3-Men, 3-Women. Provide Handicap Accessible fixtures at each floor. Lavatories: Provide one per 2 water closets. Provided: 3-Men, 3 Women; two lavatories per toilet room; one shower per toilet room. Second Floor toilet fixtures - 21,688 sq ft / 200 = 108.44 people. Assume 54 male and 54 female. Water Closets: Total 4-Men, 4-Women. Provide Handicap Accessible fixtures at each floor. Lavatories: Provide one per 2 water closets. Provided: 4-Men, 4 Women; one lavatory per two water closets Third Floor toilet fixtures - 21,245 sq ft/ 200 = 106.23 people. Assume 53 male and 53 female. Water Closets required: Total 3-Men, 3-Women. Provide Handicap Accessible fixtures at each floor. Lavatories: Provide one per 2 water closets. Provided: 4-Men, 4 Women; one lavatory per two water closets 1997 BUILDING PERMIT APPLICATION (COM •? ?? ? CITY OF EAGAN 681-4675 -31W-9 rt The following are required with appropriate certification for all t1#A! construction: • 2 each: architectural plans; mech. & elec. plans; fire sprinkler plans; structural plans; site plans; landscaping plans; gre ,ng rainag ntrol plan; utility plan • 1 each: set of specifications: set of energy calculations; electrical power & lighting form; Special Inspections & Testing Schedule • Letter from MCNYS (phone #222.8423) indicating SAC determination • Code analysis indicating: codes used; occupancy classifications; setbacks; maximum allowable area as per Building and City Codes along with sq. ft. per floor; type of construction (synopsis of construction components) & any occupancy or area separation walls; occupancy loads; exit synopsis with a diagram indicating exiting loads from each room or area, travel paths & all rated corridors; plumbing fixtures; and parking. DATE: r e h ACA WORK TYPE: J( NEW REMODEL DESCRIPTION OF WORK: - IkAxi t t??/S CONSTRUCTION COST: iLOY 3, ?L TENANT NAME: I hk Dail Y-0- SITEADDRESS: S5(-0\)L6 (fie 141 p!r„e, mrcn mr LOT BLOCK / SUBD. _ ?ti9 GaSd r4t)) f, ? P.I.D. # Geo(vv., L? e Yi trr ??{,Y PROPERTY Name: ?el ?A C)? 63 J Phone #: ?a 9 - a3) lD OWNER .a RRST "10 Street Address: Jl L° -1 Lf "K L LA ("w"10 City: -No:-V- l* State: r^. n/ Zip: A4 IKF MCSa i( CONTRACTOR Company: L kPhone #: J Street Address: DI31 NE f-cA(v"ow five . City: '4'k- P >rw Zip: 1 Z ARCHITECT/ Company: a mph ??r???_ k fib! dwm 11. Phone #: X33 -7 - Ll-? It ENGINEER Name: ?av2 (\im?n d Registration #: Street Address: City: rr\r,1?, mn? State: /Yw Zip: 5S Sewer & water licensed plumber (only if installing sewer & water): I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: /? .uM GL ?G yvc? OFFICE USE ONLY _ ' LD G PERMIT P? u? 13- 04--Fourrdati=-" 18 CommAnd. WORK TYPE * 31 New ? 32 Addition GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Depth APPROVALS Planning ? 19 Comm./Ind. Misc. ? ? 20 Public Facility ? 33 Alterations ? 0 34 Repair ? ,I 1 rr2 Basement sq . ft. First Floor sq. ft. ? ?-3 A 3 2 nD sq. ft. p 3?o sq. ft. 3 sq. ft. X sq. ft. 11# Footprint sq. ft Building M3 2r, 2w` b/Z Engineering Variance Permit Fee Valuation: $ -7 +0 9'3, Ovo. Surcharge Plan Review MCNVSSAC l7,oUD,- (17 P 1,0L)0--) City SAC t wy,- ?,''(P Loo,-) Water Conn. (c?n.?? w? dev?lopna..t- ct S/W Permit ion. - S/W Surcharge . so Treatment Pl. -1,514% (piw 444) Road Unit 4?? Park Ded. -q-, w/ Oe?eluA Trails Ded. 'I Water Qual Other Copies Total: 21 Miscellaneous 35 Tenant Finish 37 Demolition MCNVS System City Water Fire Sprinklered vi=s Census Code 32- SAC Code 2j a Census Bldg. 01 Census Unit I % SAC SAC Units 17 Meter Size CITY USE ONLY L BL RECEIPT M 9q/ b SUBD. 6C&S M W&4-A RECEIPT DATE: 1997 MECHANICAL PERMIT (COMMERCIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Please complete for: ? all commercial/industrial buildings. mufti-family buildings when separate permits are not required for each dwelling unit. DATE: 7-e'5::96 CONTRACT PRIC . WORK TYPE: NEW CONSTRUCTION INTERIOR IMPROVEMENT DESCRIPTION OF WORK: FEES: ? $25.00 minimum fee or 1% of contract price, whichever is greater. ? Processed piping - $25.00 ? State surcharge of $.50 per $1,000 of eo Emit fee due on all permits. or. CONTRACT PRICE x 1% PROCESSED PIPING STATE SURCHARGE, TOTAL , SD 64V1.50 LIC3?i711 Q SITE ADDRESS: 2an? OWNER NAME: 1 2if??i2? TENANT NAME: (IMPROVEMENTS ONLY) INSTALLER: 1?019 TELEPHONE#: e?Vf 9-- Z3?? ADDRESS: S? C) 9-e' l CITY: L tiL? STATE: ZIP: r //7 PHONE #:7i? _?13 C? l`7 L5' V `? SO- SI URE: SIGNATU F PERMITTEE CI INSPECTOR w..,.` CITY USE ONLY G L ? BLRECEIPT tt: " - ,c/?06 65 SUBD. RECEIPT DATE: 5_111 1998 PLUMBING PERMIT (COMMERCIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Please complete for: all commercial/industrial buildings multi-family buildings when separate building permits are not required for each dwelling unit b79.6 flow preventer to be installed in commercial areas or residential boulevards Date: Z Work Type: X New Bldg. _ Add-on _ Repair _ U.G. Sprinkler Is Water Met r equ' ? 4 Yes No Water Flow GPM To inquire if Pressure Reducing Valve is required on new service, call 681-4646. FEES 1% of contract price or $25.00 minimum Contract Price: $ x 1% _ $ / 13 COMPLETE THIS AREA IF INSTALLING UNDERGROUND SPRINKLER SYSTEM Service: _ Existing (if coming off domestic line) OR _ New Backflower Preventer Permit Fee $ 25.00 Water Meter 1" @ $185.00 or 2" Turbo @ $846.00 $ If "new Service" add Water Permit $ 50.00 = WAC $ 780.00 = $ Water Treatment $ 420.00 = $ City Installed Tap $ 300.00 = $ Permit Fee $ '( 13 State surcharge is $.50 per $1,000 of permit fee or minimum of $.50 per permit State Surcharge $ qo t Total Fee $ ? 122 ?' I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable City of Eagan ordinances. It is the applicant's responsibility to notify the property owner that the City of Eagan assumes no liability for any damages caused by the City during its normal operational and maintenance activities to the facilities constructed under this permit within City property/right-of-way/easement.// f J SITE ADDRESS: 3 s b ,l9e l7 07 TENANT NAME: Deo ?g 't8.t NV`eG??jC-? 17V1G TELEPHONE #: 1 7-1406( INSTALLERNAME: DOOdq Inn STREET ADDRESS: ; ? / I C? dl t C7 ?e- CITY: ;1-, ego) STATE: A_ ZIP: 55- 7 OF PERMITTEE 317o r. CITY USE ONLY COMMERCIAL PLUMBING PERMIT -1998 METER SIZE Domestic Irrigation PRV Yes _ No UTILITY CONNECTION (APPLIES TO NEW SERVICE ONLY) REVIEWED BY: Building Inspector Date To determine meter size * See if it is indicated on back of Building Inspections card * Enter address in PIMS Screen 301 to obtain S&W permit # * Check PIMS Screens 110 (Remarks) * If gallons per minute are less than 25, a 1" meter will be required. If gallons per minute are more than 25, a 2" turbo with strainer will be required. This information is to be supplied by the designer of the system. Consult with Plumbing Inspector if Licensed Plumber does not know GPMs. Before selling meter * Check PIMS Screen 320 for Mproval of inspection results. No meter will be sold before all sewer and water inspections are complete on a new service. If new service lines are not required, one check may be written for meter and permit costs. Write meter type and size on receipt, code to 3716-9220 (meter portion only), and forward copy to Utility Billing Clerk. * Enter meter size, type, receipt #, date & amount paid on PIMS Screen 110. Copy of receipt should be given to Utility Billing Clerk. Miscellaneous Information * The installer is to contact Building Inspections at 68111675 for inspection of the inside water line and backflow preventer. The Central Maintenance Division may be reached at 681 A300 for water turn-on. * If meter is over 5/8", notify Central Maintenance so they can tell you if there is one in stock before plumber goes over there. JS/Formabld/plbg permit (comm) 1997 3/70 CITY USE ONLY 1 L ? BBL L7L .??luw?? RECEIPT #: SUBD. &S m C D AiL7 1 "' RECEIPT DATE: RECEIVED 1997 MECHANICAL PERMIT (COMMERCIAL) CITY OF EAGAN iUTAY 13 1993 3830 PILOT KNOB RD EAGAN, MN 55122 BY: ----- (612) 681-4675 Please complete for: ? all commercial/industrial buildings. multi-family buildings when separate permits are not required for each dwelling unit. DATE: 5-41 > CONTRACT PRICE: 0357-,)03 WORK TYPE: NEW CONSTRUCTION INTERIOR IMPROVEMENT DESCRIPTION OF WORK: Lv a*& r^ FEES: ? $25.00 minimum fee or 1% of contract price, whichever is greater. ? Processed piping - $25.00 ? State surcharge of $.50 per $1,000 of permit fee due on all permits CONTRACT PRICE x 1% 3? ZI -2-'5- PROCESSED PIPING STATE SURCHARGE TOTAL ,io7•?v SITE ADDRESS: 6 E7 OWNER NAME: ?r I+d f&7I TELEPHONE#: ?I?L1-SZSZ TENANT NAME: (IMPROVEMENTS ONLY) INSTALLER: ADDRESS: 62,0 FCi Op l T /Tae CITY: S?• V cyc,)/ STATE: _ ZIP: SS/1 PHONE* ?Ie 7 - ? ?? ? SIGNATURE: SIGNAT RE OF PERMITTEE CITY INSPECTOR I sUBD. B ReR'S rn APPROVED BY: CITY USE ONLY R.:o- RECEIPT #: RECEIPT DATE S - 1998 PLUMBING PERMIT (COMMERCIAL) CITY OF EAGAN 8850 PILOT KNOB RD EAGAN, MN 5512E (612) 681-4675 Please complete for: all commercial/industrial buildings multi-family buildings when separate building permits are not required for each dwelling unit backflow preventer to be installed in commercial areas or residential boulevards Date: Work Type: - New Bldg. _ Add-on Repair _ U.G. Sprinkler Description of Work: R P Z- Vb?d knelz°? vii O ey-jrL)y S? To inquire if Pressure Reducing Valve is required on new sere' e, call 681-4646. FEES i 1% of contract price or $25.00 minimum Contract Price: $ x I% RPZ COMPLETE THIS AREA ONLY IF INSTALLING UNDERGROUND SPRINKLER SYSTEM Service: Existing (if coming off domestic line) OR _ New Backflower Preventer Permit Fee»»»»»»»»»»»»»»»»»»»»»> $ 25.00 Water Flow GPM Water Meter V @ $189.00 or 2" Turbo @ $871.00 If "new service" add Water Permit $ 50.00 = State Surcharge $ .50 = WAC $ 807.00 = Water Treatment $ 444.00 = Permit Fee $ State surcharge is $.50 per $1,000 of ep rmit fee or minimum of $.50 per permit State Surcharge $ Total Fee $ v r " -5 I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable City of Eagan ordinances. It is the applicant's responsibility to notify the property owner that the City of Eagan assumes no liability for any damages caused by the City during its normal operational and maintenance activities to the facilities constructed under this permit within City property/right-of-way/easement. t I I SITE ADDRESS: TENANT NAME: INSTALLER NAME: STREET ADDRESS: CITY: hT - TELEPHONE #: ?19 / _MG f STATE: , ZIP: TURE OF PERMITTEE Z /? 9 /, &; 3, e a-- Contract No.: Project No.: CITY OF EAGAN Submittal Date: S- SEWER WA .R PERMIT RELEASE FO M PROJECT DESCRIPTION: O-Z 7- fl i L- Substantial Completion of Sewer & Water Date of Occurrence P I P : STE ERMISSION TO HOOK UP SANITARY SEWER WATER MAIN Lines Lamped and Acceptable Properly Chlorinated & Flushed Deflection Mandrel Test Passed Entire System Pressure Tested Manhole Structures Properly Entire System Conductivity Tested Constructed (Cstg. & Cover, Rings, Cone, All Valve Boxes Accessible, Straight 1 ft. Sections, Final Rim Setting, & & Keyed Build and Invert) All Valves Opened or Closed as Approp. Infiltration Test Bacteria Test Completed SERVICES All Wye Locations Confirmed All Curb Boxes Exposed, Set to Proper Grade & Marked with Fence Post Required Service Risers Televised COMMENTS: C/i Tz7 ?yYrri (J ?°J UT/L/T/ts, STEP II: FULL USE PERMIT (OCCUPANCY) STORM SEWER STREETS Lines Lamped & Acceptable Material Tests Checked & Passed CB Structures Properly Constructed (Conc. Compressive Strength & Air (Cstg & Cover, Rings, 1 ft. Section, Content, Bitum. Extract & Gradation, Invert, Final Cstg. Setting & Build, Gravel Base Gradation). DL-DR Correctly Set Rings & Cstg. Utility Structures & Lines Clear & Free Set in Full Bed of Mortar) of Debris & Gravel (Gate Valves Keyed) Aprons, Dissipaters & Rip Rap Properly Installed COMMENTS: RECOMMENDATION: I herein verify that the tests and inspections indicated above have been successfully completed. Any deviations or exceptions are described in my comments. With this considered, I recommend that permission to hook up or permission for occupancy be granted as appropriate to the above indications. Signed: t jectInspgc Confirmed by Public Works Department G: Forms&Lists/Sew& WatPermitRe[Fotm.doc 04Agk?-- November 24, 1998 Delta Dental 3560 Delta Dental Dr. Eagan, MN 633.5050 RE: Hydraulic Passenger - Elevator ID# Site: Delta Dental 3560 Delta Dental Dr. Eagan, 55122 Dear Sir/Madam Department of Administration 98-04838PT98-01 Minnesota Statutes Chapter 16B provides that the Department of Administration, Building Codes and Standards Division, Elevator Safety Section, inspect and approve elevators and manlifts (endless belt lifts) before they can be legally used in Minnesota. An Inspector from the Elevator Safety Section recently inspected your facility and determined it meets requirements of the Minnesota Elevator Safety Code. NOTE: Compliance with Minnesota Rules and the ANSI/ASME Al7.1, Safety Code for Elevators and Escalators does not necessarily assure compliance with the Americans With Disabilities Act of 1990. Sincerely, BUILDING CO ES AND STANDARDS V 'cj&-. John P. Roche State Elevator Inspector jr/rkr (CE-2) c: Reid, Douglas Michael, BO, City of Eagan Schindler Elevator Corp. McGough Construction ElFormCE2 Building Codes and Standards Division, 408 Metro Square Building, 121 7th Place Fast, St. Paul, MN 55101-2181 Voice: 651.296.4639, Fax: 651.297.1973; TTY: 1.800.627.3529 and ask for 296.9929 TO: PAT GEAGAN, CHIEF OF POLICE JON HOHENSTEIN, ASSISTANT TO THE CITY ADMINISTRATOR DALE WEGLEITNER, FIRE MARSHAL ELECTRICAL INSPECTOR Z._ PUBLIC WORKS/ ENGINEERING DIVISION /UTILITIES/STREETS -? GENE VANOVERBEKE, FINANCE DIRECTOR RICH BRASCH, WATER RESOURCES COORDINATOR MIKE RIDLEY, SENIOR PLANNER GREGG HOVE, SUPERVISOR OF FORESTRY FROM: MIKE BARCK, CONSTRUCTION INSPECTOR (BUILDING) DATE: /j ;q .P The _ preliminary construction plans for V--14 are in our plan review section for your review and comment. xd ?c ?rT .. .}r? - J 2 Please return this form to Dale Schoeppner with your signed comments and the date of review. If you have any concerns with these plans, please so indicate on this form and notify and resolve these issues with the affected parties. If you are requesting that issuance of the building permit be held, please fill out the proper "hold" request form. Comments: Indicate any fees that are to be collected with the building permit: ? Yes ? No ? Yes ? No ? Yes ? No ? Yes ? No ? Yes ? No ? Yes ? No landscape security required water quality dedication park dedication trail dedication tree dedication ZONING? Signature Date CD/BLDG INSPPJPLAN REVIEW MIKE B al?' MEMO city of eagan TO: DALE SCHOEPPNER, ASSISTANT BUILDING OFFICIAL DALE WEGLEITNER, FIRE MARSHAL PAUL OLSON, SUPERINTENDENT OF PARKS PUBLIC WORKS/ENGINEERING DEPARTMENT MIKE RIDLEY, SENIOR PLANNER DIANE DOWNS, UTILITY BILLING CLERK CHARLIE BORASH, UTILITIES FROM: BILL BRUESTLE, SENIOR INSPECTOR DATE: NOVEMBER 2,1998 SUBJECT: FINAL INSPECTION OF DELTA DENTAL LEGAL: L19 - B1, BCBSM EAST The Protective Inspections Division will be performing a final inspection of 3560 Delta Dental Drive on November 30, 1998. If you are requesting that the Certificate of Occupancy be held, please fill out the proper hold request form. Failure to return the hold request form will be considered your approval. The person, or department, requesting the hold is responsible for notifying and resolving any problems with the affected parties. /js CD/bldg insp//final insp - comm bldgs Ot-( PLUMBING (COMMERCIAL) Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 (p 3? Telephone # 651-675-5675 FAX # 651-675-5694 1110005 % 7: ? -O . U Date Site Address M/ao Q Unit # Tenant Name h614& ?)Z?aj Former Tenant Name Property Owner Telephone # ( ) C? S!W i Contractor f Address ' An My* Ave City _ P, L4 nI State I R f? Zip Telephone # (/ ,5j( ) 4 02 - f D ?i The Applicant is Owner ]rL Contractor Other Work Type _ New Bldg _ Add-on _ Repair RPZ _ PVB _ Irrigation system er size is 2" turbo unless smaller size permitted by Public Works • Jerry Wobschall to calculate fees. Required met (n? /J te Description of Work rt.f' K 215 To inquire if Pressure Reducing Valve is required on new service, call 651-675-5646 Meters - Call 651-675-5300 to verify that hydrostatic, conductivity, and bacteria tests passed prior to picking up meter Irrigation Size & Type Avg GPM Fire Size & Price 3/4" displacement $156.00 Domestic Size & Type Avg GPM Includes high demand devices? - Yes - No Flushometers - Yes _ No PRV Required _ Yes -No Permit Fee $50.50 minimum (includes State Surcharge) Contract Value $ x 1% _ $ Base Fee $ Meter(s) Required on all new buildings & boulevard irrigation systems $ Radio Meter Read If base £ee is $1,000 or less, surcharge is $.50 $ State Surcharge If base fee is over $1,000, surcharge is $s0 per $1,000 of the Base Fee ---------- -__- Following fees apply only when installing new irrigation system $ Water Permit Contact Jerry Wobschall at 651-675-5024 for required fee amounts $ Treatment Plant $ 4 Water Supply & Storage Stat i Surcharge ------------------------------------------------------------------------------------------------- ------- $ Total Fee I hereby apply for a Commercial Plumbing Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Plumbing Codes; that 1 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. p Applicant's Printed Name 1,0?ppli- ant's Signature r-, Cv ?'3 2006 FIRE SUPPRESSION SYSTEMS PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 Fax # 651-675-5694 Requirements: 2 complete sets of drawings and specifications cut sheets on materials and mmnnnentc to he ncPd Date _?? / / Q (p Site Address: 3'j6(1 bt° Lh' Ot/y? kl? 'fib (V L? Tenant/ Building Name:; The Applicant is: Owner_ Contractor Other PROPERTY OWNER Address: MAID I X99° Ciry: State: Zip: CONTRACTOR y/?LVI(( MN License #: -Q I j Address: 54 0 Na 1 VtL o- la n-c'' City: ?L( I m DLt {1 1 State: (}'? Zip: Phone #: I(03- 3(ol- 5000 ESTIMATED COMPLETION DATE: T ?3 ! FIRE PERMIT TYPE:j Sprinkler System (# of heads _ Fire Pump Standpipe Other: WORK TYPE: _ New Addition)) Alterations Remodel Other: ?Q KQ'Ioc f-' DESCRIPTION OF YORK: Commercial Residential _ Educational _ Other: 1?? 1, _Yj? l ?? 1 V(X Q ?lC? h? C?h A S l?sl_?Yl Q.D?Gi(t' Li)a ? /ar a«P? 3awl Gli?a S Please continue on reverse side PERMIT FEE: $50.50 Minimum Fee (includes State Surcharge) FU Contract Value $ Epp- x .01 = • If Permit Fee is $1,000 or less, add $.50 => If Permit Fee is over $1,000, add $.50 per $1.000 Permit Fee 3/4" Displacement Fire Meter - $167.00 TOTAL FEE: D? 6 Permit Fee So State Surcharge I hereby apply for a Fire Suppression System permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Minnesota Building/Fire Codes; 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 requir?ess a review and approval of plans. 01 1/li'Af4' T X?1 Atiti" 41 '?.? App1icnt's Printed Name Appliam's Signature v BELOW THIS 3 3560 Delta Dental Drive Eagan, MN 55122-3166 c DeCare T? 7 651.406.5994 Df Ill11A 600.371.6561 www.decare.com April 28, 2008 Mayor Mike Maguire City of Eagan 3830 Pilot Knob Road Eagan, MN 55122 Dear Mayor Maguire: I wanted to provide you advance notice of a public announcement our company is making tomorrow. DeCare International is selling its industry-leading dental benefits management company, DeCare Dental, LLC, to Anthem Holding Company, a division of WellPoint Blue Cross Blue Shield. DeCare Dental, LLC is the management company and administrator for Delta Dental of Minnesota and for Delta Dental companies in Nebraska, Wyoming and North Carolina; Blue Cross Blue Shield companies in Minnesota, Iowa and New York; and for Securian's national business. This is not a conversion of a non-profit company or a sale of Delta Dental of Minnesota. Rather, this transaction is a sale by DeCare International of the DeCare Dental management company. The result will be the one of the largest dental administrators in the country operated in Minnesota. Our current management team and employees will remain based at our 18-acre Eagan campus and our excellent customer service staff will remain on the Iron Range in Gilbert, Minnesota. As the integration moves forward, we expect to consolidate WellPoint's dental business here and to grow Minnesota jobs accordingly. The attached press release will go out to media tomorrow, so I ask that you hold this information confidential until April 29 at 2:00 pm. We have already made the internal employee announcement about the transaction. Please call me at 651-994-5129 if you have any questions. Very truly yours 1 "1 Joseph Lally Vice President, Strategic Planning cc Doug Johnson Bert McKasy c9DeCare Dental" FOR IMMEDIATE RELEASE Contacts: DeCare Dental Media: Peter Stathopoulos, (651) 994-5410 Heather Hofineister, (651) 994-5210 WellPoint, Inc. Media: James P. Kappel, (317) 488-6400 Investor Relations: Michael Kleinman, (317) 488-6713 DeCare Dental to Become Part of WellPoint DeCare remains in Eagan, continues serving Delta Dental of Minnesota, while creating greater opportunities to improve the health of consumers by providing innovative tools and health information. (Eagan, Minn.) April 29, 2008 - DeCare Dental, the administrator for Delta Dental of Minnesota and nine other dental brands worldwide, announced today that it has been acquired by WellPoint, Inc. (NYSE:WLP), the nation's largest health benefits provider. "DeCare is excited to join a company with a great reputation and opportunities," said Michael Walsh, President and CEO of DeCare Dental. "Our employees will be able to serve a much larger population of dental and medical members, executing on our mission to serve the oral health needs of our communities." DeCare will remain headquartered in Eagan, Minnesota. Its current management team and organization structure will remain intact, with Mike Walsh continuing to lead their operations. DeCare will continue to serve 4 million dental members in 22,000 employer groups through existing contracts and partnerships that include B1ueCross B1ueShield of Minnesota, Medica, Wellmark, Securian Financial Group and other leaders in the health care and insurance industry. These partners include WellPoint, whose New York dental business has been administered by DeCare Dental since 2000. "The expanded relationship with WellPoint is a natural continuation of several years of significant growth at DeCare, which increased revenue under management from $680 million in 2001 to more than $1 billion today," said Walsh. "This growth was necessary and intentional in a strategic model based on economies of scale in a low-margin, high-volume business. Delta Dental of Minnesota has benefited from this strategy - and will continue to benefit - due to the efficiencies generated by DeCare's ability to spread Minnesota's fixed costs across a global business platform." The acquisition of DeCare Dental enhances WellPoint's ability to offer dental products that balance affordability and access, drawing upon DeCare Dental's expertise in dental analytics and operations. "The acquisition of DeCare Dental builds upon a core focus of WellPoint which is to continually provide our members with innovative and industry-leading products," said Angela F. Braly, president and CEO of WellPoint. "DeCare Dental has clearly emerged as a leader in providing dental benefit management. Their state-of-the-art dental systems, analytical capabilities and exceptional management team will enhance WellPoint's ability to provide affordable, high- quality dental benefits to our members nationwide." "The research WellPoint has studied shows a linkage between poor oral health and serious medical conditions such as cardiovascular disease and diabetes," said Dennis Casey, President and CEO of WellPoint's UniCare and Specialty businesses. "An integrated health benefits plan that includes medical and dental coverage provides consumers with important preventative services that focus on overall well-being and good health." Upon completion of the acquisition, the combined organization will become one of the largest dental benefits administrators in the country with significant growth opportunities nationwide. DeCare will continue to service its current clients while integrating its team and services with WellPoint's current dental organization. The combination of WellPoint and DeCare Dental creates even greater opportunities to improve health by providing innovative tools and information. DeCare Dental currently serves 10 dental plans. DeCare Dental also operates DeCare Dental Systems Ireland (DSI), which offers custom enterprise software solutions, e-business applications and application performance tuning and is also the first American company to offer dental benefits in Ireland as Vhi DeCare Dental Dental. About WellPoint, Inc. WellPoint's mission is to improve the lives of the people it serves and the health of its communities. WellPoint, Inc. is the largest health benefits company in terms of commercial membership in the United States. Through its nationwide networks, the company delivers a number of leading health benefit solutions through a broad portfolio of integrated health care plans and related services, along with a wide range of specialty products such as life and disability insurance benefits, pharmacy benefit management, dental, vision, behavioral health benefit services, as well as long term care insurance and flexible spending accounts. Headquartered in Indianapolis, Indiana, WellPoint is an independent licensee of the Blue Cross and Blue Shield Association and serves its members as the Blue Cross licensee for California; the Blue Cross and Blue Shield licensee for Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri (excluding 30 counties in the Kansas City area), Nevada, New Hampshire, New York (as Blue Cross Blue Shield in 10 New York City metropolitan and surrounding counties and as Blue Cross or Blue Cross Blue Shield in selected upstate counties only), Ohio, Virginia (excluding the Northern Virginia suburbs of Washington, D.C.), Wisconsin; and through UniCare. Additional information about WellPoint is available at www.wellpoint.com. 2 About DeCare Dental With nearly 40 years of proven success, the DeCare Dental family of companies is a leading dental benefits management group that oversees more than $1 billion in managed revenues, serving 4 million individuals in 22,000 employer groups including Fortune 500 corporations, small businesses, non-profits and government entities in the United States and overseas. Through its affiliates and partners, DeCare is active in all major markets across the United States and also has operations in Europe. Focused on global leadership in dental benefits management, DeCare Dental sets the standard for innovation, quality, service and results. For more information on DeCare Dental, visit www.decare.com or call (toll-free) 800-371-6561. Delta Dental of Minnesota ("DDMN") is an authorized licensee of Delta Dental Plans Association, Chicago IL ("DDPA"). "Delta Dentalo " is a registered trademark of DDPA. DeCare International ("DeCare") is an authorized affiliate of DDMN. All other business entities and organizations named or identified in this document are not authorized licensees of DDPA. Nothing contained in this statement or set forth in this document is meant in any way to imply or suggest that any of the products or services of DeCare or any other business entity or organizations named or identified in this document and not licensed by DDPA are in any way sponsored, approved, endorsed or recommended by DDPA. SAFE HARBOR STATEMENT UNDER THE PRIVATE SECURITIES LITIGATION REFORM ACT OF 1995 This press release contains certain forward-looking information about WellPoint, Inc. ("WellPoint") that is intended to be covered by the safe harbor for "forward-looking statements" provided by the Private Securities Litigation Reform Act of 1995. Forward-looking statements are statements that are not historical facts. Words such as "expect(s)", "feel(s)", "believe(s)", "will", "may", "anticipate(s)" and similar expressions are intended to identify forward-looking statements. These statements include, but are not limited to, financial projections and estimates and their underlying assumptions; statements regarding plans, objectives and expectations with respect to future operations, products and services; and statements regarding future performance. Such statements are subject to certain risks and uncertainties, many of which are difficult to predict and generally beyond the control of WellPoint, that could cause actual results to differ materially from those expressed in, or implied or projected by, the forward-looking information and statements. These risks and uncertainties include: those discussed and identified in public filings with the U.S. Securities and Exchange Commission ("SEC") made by WellPoint; trends in health care costs and utilization rates; our ability to secure sufficient premium rate increases; competitor pricing below market trends of increasing costs; increased government regulation of health benefits, managed care and pharmacy benefit management operations; risks and uncertainties regarding the Medicare Part D Prescription Drug benefits program, including potential uncollectability of receivables resulting from processing and/or verifying enrollment (including facilitated enrollment), inadequacy of underwriting assumptions, inability to receive and process information, uncollectability of premium from members, increased pharmaceutical costs, and the underlying seasonality of the business; significant acquisitions or divestitures by major competitors; introduction and utilization of new prescription drugs and technology; a downgrade in our financial strength ratings; litigation and investigations targeted at health benefits companies and our ability to resolve litigation and investigations within estimates; our ability to contract with providers consistent with past practice; other potential uses of cash in the future that present attractive alternatives to share repurchases; our ability to achieve expected synergies and operating efficiencies in the WellChoice, Inc. acquisition within the expected time frames or at all, and to successfully integrate our operations; our ability to meet expectations regarding repurchases of shares of our common stock; future bio-terrorist activity or other potential public health epidemics; and general economic downturns. Readers are cautioned not to place undue reliance on these forward-looking statements that speak only as of the date hereof. WellPoint does not undertake any obligation to republish revised forward-looking statements to reflect events or circumstances after the date hereof or to reflect the occurrence of unanticipated events. Readers are also urged to carefully review and consider the various disclosures in WellPoint's various SEC reports, including but not limited to WellPoint's Annual Report on Form 10-K for the year ended December 31, 2006 and its Quarterly Reports on Form 10-Q for the reporting periods in 2007. 4 r----------------, ? I I I ? i I 77IFm 13 1 `?? I Data Received: ? Staff: 2008 MECHANICAL PERMIT APPLICATION Date: k Site Address: t-7'-Y`-lf? Y IcO. al l..l( ) Tenant: &9--, & ,, -d3j Suite #: RESIDENT/OWNER Name: Phone: Z-Ie Address/City/Zip: Z CONTRACTOR ?? Name: 114kr Zz- ?-i License Address: k>2? Aezt&tiv X®1 City: -? i State: AWL Zip: % Phone: g Contact Person: ;i an ),-.t-1 !u//1 S TYPE OF WORK = New. L Replacement -Additional -Alteration - Demolition Description of work: RESIDENTIAL COMMERCIAL PERMIT TYPE Furnace _ New Construction - Interior Improvement C ?/J v E Air Conditioner Install Piping -Processed n D D = Air Exchanger Gas Exterior HVAC Unit HVAC units must be screened r' i• 11 -Heat Pump _ Under/ Above ground Tank Install/ Remove) _ Other " When installing/removing tank(s), call for inspection by Fire Marshal and Plumbing Inspector RESIDENTIAL FEES: $50.50 Minimum Add-on or alteration to an existing unit (includes $.50 State Surcharge) $90.50 Fire repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) $ TOTALFEE COMMERCIAL FEES: $70.50 Underground tank installation/removal OR Contract Value $? X1% $50.50 Minimum (includes State Surcharge) $ Permit Fee - It Permit Fee is less than $1,000, surcharge Is $.50. - If Permit Fee is> $1,000, surcharge increases by $ 50 for each = $ <tTrj state Surcharge $1,000 Permit Fee (I.a a $1,001-$2,000 Pent Fee requires a $100 surcharge). 1 $ c:?--> TOTAL FEE 1 understand this is not a perm A, but only an application for a permit, andwork is not to start without a permit; that the work will be in accordance with the approved plan in the case of worts which requires a review and approval of plans, x) e.. t• Y o.l..e- e.. ?. ??e e:...t:.. - - - - - - - - - - - - - - - - - I For Office Use Ea~ ~ Permit I City of Ea u E I Permit Fee: ~r 3830 Pilot Knob Road i SEP 42 200 Eagan MN 55122 I Date Received: I Phone: (651) 675-5675 I Fax: (651) 675-5694 i Staff: `\114 L-----------------I 2009 COMMERCIAL BUILDING PERMIT APPLICATION Date: Site Address: L- C' ~ Tenant Name: V\_V, A (Tenant is: New / Existing) Suite Former Tenant: PROPERTY OWNER Name: V ~,_A Phone: Address / City / Zip: Applicant is: Owner Contractor TYPE OF WORK Description of work: C Construction Cost: , CONTRACTOR Name: License - 1 Address: ..2 1 :N_~ r i k r _ a City: ~yA State: i^`t Zip: s 1 1 Phone: Contact Person: ~~'''`~`t\ ARCHITECT / Name: Registration ENGINEER Address: City: State: Zip: Phone: Contact Person: Licensed plumber installing new sewer/water service: Phone - NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that the are trade secrets. 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 y' ~r"-c .w Cwt \e. x y Applicant's Printed Name Applicant's Signature Page 1 of 3 DO NOT WRITE BELOW THIS LINE SUB TYPES Foundation _ Public Facility _ Accessory Building _ Apartments Commercial / Industrial _ Exterior Alteration-Apartments _ Lodging Greenhouse / Tent _ Exterior Alteration-Commercial Miscellaneous Antennae Exterior Alteration-Public Facility WORK TYPES _ New _ Interior Improvement Siding Demolish Building* Addition Exterior Improvement Reroof Demolish Interior Alteration _ Repair Windows Demolish Foundation Replace _ Water Damage Fire Repair Salon Owner Change Retaining Wall *Demolition of entire building - give PCA handout to applicant DESCRIPTION Valuation Ap 3~6-zO Occupancy pj MCES System i Plan Review ~~le--5w Code Edition a0v7 AtAOC--SAC Units doa r.~ (25%_ 100%2LJ Zoning City Water yes Census Code Stories Booster Pump # of Units Square Feet PRV # of Buildings Length - Fire Sprinklers Type of Construction- Width -7-` REQUIRED INSPECTIONS Footings (New Building) Sheetrock Footings (Deck) Final / C.O. Required Footings (Addition) Final / No C.O. Required Foundation HVAC Drain Tile Other: Roof: -Decking -Insulation -Ice & Water -Final Pool: -Footings -Air/Gas Tests -Final Framing Siding: -Stucco Lath -Stone Lath -Brick Fireplace: -Rough In -Air Test -Final Windows Insulation Retaining Wall Meter Size: / Erosion Control Final C/O Inspection: Schedule Fire Marshal to be present: ✓ Yes No Reviewed By: 4&IL , Building Inspector Reviewed By:~ - , Planning COMMERCIAL FEES Base Fee 3t00 Water Quality Surcharge 4, .'5r-Z> Water Supply & Storage (WAC) Plan Review 40 Storm Sewer Trunk MCES SAC Sewer Trunk City SAC Water Trunk S&W Permit & Surcharge Street Lateral Treatment Plant Street Treatment Plant (Irrigation) Water Lateral Park Dedication Other: Trail Dedication Water Quality TOTAL f 39S: g o Page 2 of 3 Use BLUE or BLACK Ink For Office Use 7 I City of Ea ~ll j Permit ~ I o~ I Permit Fee: 3830 Pilot Knob Road I Eagan MN 55122 Date Received: f Phone: (651) 675-5675 Fax: (651) 675-5694 Staff: - - - - - - - - - - - - - - - - - J 2012 COMMERCIAL PLUMBING PERMIT APPLICATION ❑ Please submit two (2) sets of plans with all commercial applications. Date: a f Site Address: 356 0 DE L TA Z)k 9 ~ ~ 12 Tenant: ~J L u Suite PROPERTY OWNER Name: brt- i✓L Phone: Name: /~A)2)12i S M 6 C 14A N' I c /7(- License !12 91) R/c CONTRACTOR Address: gD 9 MOY7..1i h Clk City: ST, P4U L. StateM O Zip: a Phone: ~o✓r/' OoZ Email: P TR 4 08 (2- Ids M C C C 6 M TYPE OF -New _Replacement -Repair k Rebuild _ Modify Space _ Work in R.O.W. WORK Description of work: COMMERCIAL New Co Modify Space Irrigation System yes n ( ) RPZ / PVB) • Rain sensors required on irrigatio ems 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: t $60.00 Minimum (includes $5.00 State Surcharge) OR Contract Value $ &Zq J ~ x1% = $ Permit Fee Required on ALL new buildings and boulevard irrigation systems 4 $ Radio Meter Read $ Meter(s) *If the project valuation is over $1 million, please call for the State Surcharge $ 5.00 State Surcharge* 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 = $ D • 60 TOTAL FEE 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.goopherstateonecall.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 review and approval of plan 0,801 - x 1 /7 7 R A L) 6 x -4~2~z Applicant's Printed Name Applicant's Signature FOR OFFICE USE Approved By: Date:' Required Inspections:_ Under Ground Rough-In Air Test Gas Test Final PRV Required: _ Yes No Page 1 of 3 Use BLUE or BLACK Ink For Office Use Permit 1-1 ) j? j Ut ~ Eapn t1J ~ U J I V I 3830 Pilot Knob Road I Permit Fee: , 'IV, Eagan MN 55122 Date Received: v -1 Phone: (651) 675-5675 Fax: (651) 675-5694 Staff: - - - - - - - - - - - - - - - - - 9 2013 COMMERCIAL BUILDING PERMIT APPLICATION Date: 10/01/2013 Site Address: 3560 Delta Dental Drive Tenant Name: DeCare Dental (Tenant is: New / X Existing) Suite M Former Tenant: Name: WellPoint, Inc. Phone: Property Owner Address / City / zip: 120 Monument Circle, Indianapolis, IN 46204 Applicant is: Owner X Contractor Add 5 new W12x19 beams to underside of existing concrete deck to increase deck loa Type of Work Description of work: capacity_ Sandblast and paint underside of deck and beams Construction Cost: $29,000 Name: Outland Builders. Inc. License Contractor Address: 4029 W 125th Street city: Savage } State: MN zip: 55378 Phone: 651-242-6736 Contact: Donn Guiang Email: donn@outlandbuilders.com Name: Wenzel Enaineering Registration* 16175 ArchitectlEngineer ;Address: 10100 Morgan Ave South city: Bloomington i State: MN zip: 55431 Phone: 952-888-6516 _ Contact Person: Patty Cole Email: W n I rl m Licensed plumber installing new sewer/water service: Phone NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that they 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.gopherstateonecall.om 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 -Donn Guiang x Applicant's Printed Name App icant's Signature Page 1 of 3 f; DO NOT WRITE BELOW THIS LINE 1(j(061 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 21ioq?= - Occupancy S MCES System Plan Review ✓ Code Edition Ze17#WssG SAC Units (25%_ 100% Vf Zoning City Water Census Code Stories Booster Pump # of Units Square Feet PRV # of Buildings / Length Fire Sprinklers V Type of Construction zC - A Width REQUIRED INSPECTIONS Footings (New Building) Sheetrock Footings (Deck) Final / C.O. Required Footings (Addition) V 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 Reviewed By: 6w& , Building Inspector Reviewed By: .-,Planning COMMERCIAL FEES Base Fee QSG . oo Water Quality Surcharge • S"D Water Supply & Storage (WAC) Plan Review Z41iStorm Sewer Trunk MCES SAC Sewer Trunk City SAC Water Trunk S&W Permit & Surcharge Street Lateral Treatment Plant Street Treatment Plant (Irrigation) Water Lateral Park Dedication Other: Trail Dedication Water Quality TOTAL'l 764. ga Page 2 of 3 M ~n Special Structural Testing and Inspection Program Summary Schedule Project Name : Footbridge Repair/Maintainance Project No. Location 3360 Delta Dental Dr., Eagan, MN Permit No. Technical 2 Type of Specific Report Assigned Se73 Article Description (3) inspector (4) _Frequency (5) Firm (6) 1704Structural Steel Field .-%-T Upon Completion = Welding Note: This schedule shall be filled out and included in a Special Structural Testing and Inspection Program. (If not otherwise specified, assumed program will be'Gtildelines for Special Inspection & Testing' as contained In the State Building Code and as modified by the state adopted IBC.) (1) Permit No. to be provided by the Building Official (2) Referenced to the specific technical scope section in the program. (3) Use descriptions per IBC Chapter 17, as adopted by Minnesota State Building Code. (4) Special Inspector-Technical (SIT); Special Inspector - Structural (SIS) (5) Weekly, monthly, per test/inspection, per floor, etc. (6) Name of Firm contracted to perform services. ACKNOWLEDGEMENTS (Each appropriate representative shall sign below) PAC C Owner: M\ Firm s A:~ bQt{ ) tr a : Date: ) 0 t t 6 / t Contractor: " r I r `r Firm: _ 1 ; ''alt. oe / 5 Date: r % Architect: _ Firm: Date: a . Firm: Wenzel Engineering, Inc. Date: Oct. 16, 2013 SER• SI-S: Firm:. a,kV, ~.c Date: 10-4 `13 71 TA: _ Firm: Date: _ F: Firm: _ Date:? If requested by en veer/architect of record or building official, the individual names of all prospective special inspectors and the work they intend to observe shall be identified as an attachment. Legend: SER = Structural Engineer of Record SI-T = Special Inspector - Technical TA = Testing Agency SI-S = Special Inspector - Structural F = Fabricator d~lj f D/2/~ 3 Accepted for the Building Department By Date Issue Date: 2013/01/01 Rev No.: 0 Special Inspection Daily Report City of Eagan, MN. Page 1 of 1 Report No.: Structural Steel #1 Date of this Report: 10-29-13 Project Name: Delta Dental Project No.: BL -13-07102 Project Address: Client: Outland Builders Client Project No.: Weather: Partly Cloudy PM Dan Martin Temperature: 40 ° F Type of Inspection: ❑ Continuous ® Periodic Inspection Coverage: ❑ Masonry Welding & Bolting ❑ Piles & Piers ►5 ❑ Rebar Placement ❑ Foundations ❑ Concrete ❑ Fireproofing ❑ Tendon Placement ❑ Soils ❑ Special Cases: Did the architect or engineer authorize changes to City -approved plans? ❑ Yes (Listed Below) ❑ No Description and location of work completed: Visual weld observations were performed in accordance with AWS D1.1 Section 6 2010 criteria on the following: 1) New beam clip angle fillet welds to existing and new beam per DG Welding sheet 01 details 3/S1 and 4/S1 on connecting link floor to building from parking lot. Weld quality found acceptable. 2) Kwik bolts from clip angle to existing concrete south abutment at connecting link detail 2/S1 and 4/S1. Tightened per manufacturer recommendations. This will conclude steel observations for the project. SER: Wenzel Engineering Ms. Patty Cole List tests performed: Visual • Are there any discrepancies noted from this day's observations? Yes ❑ No El • Are there any outstanding discrepancies on this project? Yes ❑ No If yes, see attached Summary Sheet. Report given to Contractor: Yes ® No 0 To the best of our knowledge, work inspected was done in accordance with the approved plans, specifications, and applicable workmanship provisions of the current IBC, except as noted above. Signed: Graham, Dan Print Full Name: Daniel P. Graham Date: 10-29-13 I.D. No.: 1054095 S1&S2 • Providing engineering and environmental solutions since 1957 BRAUN INTERTEC Letter of Transmittal 1 Client: Outland Builders, Inc Braun Intertec Project No.: BL -13-07102 Date: November 06, 2013 To: Donn Guiang Outland Builders, Inc 4029 W 125th St. Savage, MN 55378 Re: Lieu Balk Bridge, 3560 Delta Braun Intertec Corporation 11001 Hampshire Ave. S. Minneapolis, MN, 55438 Phone: 651.242.6736 Fax: 888-675-5297 Email: donn@outlandbuilders.com Delivery Method: Email MN Documents Sent: !Comments: Structural Steel Steel #1 Dated 10-29-13 CC List: Documents Sent: Patricia Cole, Wenzel Engineering, Inc. Contact Information: Sent By: Tracy L Kosen Email: tkosen@braunintertec.com Phone: 952-995-2000 Rev 9/29/10 Structural Steel • Providing engineering and enviromental solutions since 1957. City of Eagan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 676-6694 4)11311.6U Use BLUE or BLACK Ink For Office Use Permit#: *I I%V`, Permit Fee: Date Received: Staff: •jti CIAL PLUMBING PERMIT APPLICATION ❑ Please s bmit two (2) sets of plans wi all comme cial applic tions. Date: '3 Siitte7,A�dddrress: p L(�f L Lt 1 I a�L. suite #c PtOpOwnererj/ . 1\L Carib .. al Owner = Name�1 Tenant: Phone: I �, License 6TG� o V , tycit Gf Pa..ij.I e[l►iv pS51O IStat Wo Is kg iphrnc.G . corn _ New _ Replacement Repair Rebuild _ Modify Space _ Work in R.O.W. Description of work: COMMERCIAL New Construction _ Modify Space _ Irrigation System ( yes / _ no) ( RPZ / _ PVB) • Rain sensors required on irrigation systems • 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 $55.00 Permit Fee Minimum *If contract value is LESS than $10,010, Surcharge = $5.00 **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 Following fees apply when installing a new lawn irrigation system Contact the City's Engineering Department, (651) 675-5646, for required fee amounts. Contract Value $ _$ =$ =$ x .01 00 O0 60,� Permit Fee Surcharge* TOTAL FEE $ Water Permit $ Treatment Plant $ Water Supply & Storage $ State Surcharge = $ TOTAL FEE CALL BEFORE YOU DIG. Call Gopher State One CaII 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.gopherstateonecall.orq I hereby acknowledge that this information is complete and accurate; that the work will be nformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a pe Land ork not to start without a pit; that the work will be in accordance with the approved plan in the case of work which requires a revie x t� o(sVx.. Applicants Printed Name FOR OFFICE USE Required Inspectio Under G _ Rough -In PRV R4 Page 1 of 3 PERMIT City of Eaga�l Permit Type: Sign 3830 Pilot Knob Rd �' Permit Number: EA133562 Eagan,MN 55122 , ' Date Issued: 10/27/2015 (651)675-5675 www.ci.eagan.mn.us � ' O t� tl� Site Address: 3560 Delta Dental Dr Lot: 1 Block: 1 Addition: BCBSM East PID: 10-13345-01-010 Use: Anthem Description: Sub Type: Monument Work Type: New Feet Inches Description: Aluminum PaneURouted Acrylic/Vinyl Graphics Length: 9 2 Height: 3 6 Sign Message: Width: 0 0 ANTHEM SqFt: 32.30 Location on Structure: Face Replacement Elevation: Q Electric: N Double: N Comments: Please call(651)675-5690 or(651)675-5687 for a Final Inspection. Fee Summary: Base Fee-$2.50 sq. ft. $80.78 0720.4089 Copies $1.25 0201.4230 Total: $82.03 Contractor: - Appl,�a„t - Owner: Lawrence Sign Delta Dental Plan of Mn 945 Pierce Butler Rt. 3560 Delta Dental Dr i St.Paul MN 55104 Eagan MN 55122 ', (651)488-6711 I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. ' ApplicantlPermitee: Signature Issued By: Signature 3 i �� Use B�UE or BLACK lnk 1 r-------�--^----'---' . f I For Office Use � ��UUl �� li� j Permit#: �.�3`�� I i � � i � 383U Pilot Knob Road � Permit Fee: �� Eagan MN 55122 � � Phone;{651)675-5690 � Date Received: � ; Fax;{651)675-5694 j Staff: I � _.��_�________�.�J i 20'i 5 SIGI�I PERMIT APPLICATION :• Submit one{1)application per building, pylon or monument sign. •:� Submit one(1)application per pylon or monument sign tenant panel replacement. ' •S Submit two(2)copies of drawing showing proposed sign and site plan or building elevation showing iocation on � property. ❖ 5ubmit one(9)separate sign plan or letter containing the landlord/building owner's�pproval of the sign. j •: Building Signs–Exposed electrical boxes or conduit shaN be shislded from view by painting to match the building or sign band area, or enciosing within the sign raceway. A11 raceways shall be constructed of materials or painted to match the building or sign band area. ❖ Pylon signs are a Conditional Use and subject to all conditions, regulations,and fees required for eondi#ional uses. *S Temporary Advertising Slgns–Please complete both sides of the application. •;• Applications submikfed via email are subject to an additional$025 per page printing charge which will be added to the permit fee. � d• If ar►y sign is placed,erected or installed without fiirst obtaining a sign permit, the permit fee shall be the amount equal to ; #wo times#he permif fee, per Se�tion 11.70 Subd.28.1.2 '� < . � � �:. � , £�� °. Sign Type, Dimen�aons ofySigln��5�9��I1�essa�ge �'� £ �� l � �� i `�`�� M��,� � � �.��.,� ,�� Feet lnches Feet Inches Feet Inches Awning Lengih � /� x Height �'� �_ x Depth Building , Canopy Tatal Square Feet: _�,�, ��i 3� Cons#ruct+on � ; Lease 5ign Message: � y Monument ��^�'��' ' ; Pylon Location on Structure: (t�.�,# Temporary Use Days � E Temporary Setback: Has Electricity ; f O#her Elevation: Is Double Faced 1 ; i Date: �1�1}� Applicant is: Ornmer i Tenant �5ign Company I Gontractor ' ', Address where sign is to be locatedc '°" i.�t"..�„� �.�--�"�? ��'"� � � Tenant or Business Name: � ,�� T E _��—' 1 �„'l�,-`�'-,r--�'' � Tenant Contact Name: � Tel�phone#: ' `'"1� Sign Company/Contractor: � �,;?�,�C'''..�'�''�., "� � Telephone#: �� 3�� , y Address: ��%".��+�t�ca � �� '�y State; �1'�°"� Zip: ; �-1—� ._.� I Property Owner: � �- ��j Telephone#:��4 `�' ^ �'" � t�� Address: �1► ty: State: Zip: ��J� �j�' � l /�C� Page 1 of 2 � . \ V �`� G��' ' �.� .03 �f � �,� � l� � / -�5�� Fee: $25.04 � #of 5igns� (maximum of 3) Sizes of the Sign{s); 1. 2, 3 ■ Total Sq.Ft.of all signs: (All 3 signs cannot exceed 25 sq.ft.) � W First Day of Placement: II ._.I � W �Q ■ Signs can be qlaced for�U days out of a 60-day period which cammences the first day a sign is � d X� placed. I N � Z W Sign PErmit Expiration flate: } � � Z . � ' � � • Sign permit(s)expires 60 days from first day of placement. ; � "�- m 10 Days Sign{s)Are To Be Placed: t 5 Q�' ,t�f Sign(s)wiil be attached to: building elev�tion pylon monurnent � '.J �r, � IL U I Q W, • Signs must be attaehed to#he building or to an existing monument owpylon sign. � �. � Sign(s)will be attached using#he follow�ng method: # W'p Signs must be placed securely and in a sound manner to ensure safety of the public&in accordance with � j:,, �- _ reasonable standards employed by sign makers. � Person responsible for placement/removai of sign: � � Telephone#; i Management Co. (if applicable) Telephone#: j Approval of the building Owner or Management Company may be required. Check your lease or call your ; Management Company for additional information. € CALL B�F(3RE YOU D1G. Call Gopher 5tate One Cali at(651)'45�-0002 for pro#ection agains#underground utility damage. � Call q8 hours before you intend to dig#o receive locates of underground utili#ies. www.4oAherstateonecall.ora I hereby acknowledge that I have read this application,state the appiica#ion is correct,and agree to comply with � Eagan,MN laws regulating construdion and placement. ; � � I X ��1^�� r� ', X Appiicant's Printed Marne Applican Signature ., FOR OFFICE USE .. ; 1Nork Tvpe: Descriqtion: Inspectlons' Fees _Change ExisUng �Aluminum pan G� _F.G.O.Aluminum _Footings $ , _CUP 1 Ftg.Ins, _Banner _Nalo-lit/Reverse Channel ,��inal $ V + { _Move _Board _LED/Electronic Copies$�,25/page � �, � _60 Days _Canister _Plastic cutout TOTAL $ �Z '� ' ,�New _CabinetlLogo _Plastic mofded _Channe!lit letters _Plastic Panel REViEWEQ BY: ` _Channel lit/raceway �Routed�CRyC.�G Planning i _Flex Face �Vinyl graphics Building Inspections � _ � � Page 2 0#2 � ' i €p 8 � � az-va^ ' x ''� A' �� `� '� "��'�' � ,�—� 2�� ,s� z � �,. ��.aP,�" m C.�'J wx� � b =i . m _, c � ... �t..� .. ,.: _Y , z �'�: �`�'� i , _ � �' �E�i -�, " -- m _....____.._._. � o�� ti� ''" m 5 », . .. f '7,h, . ' �'� A �` • � �� r � b ��, ir �� ` � � ';k�;� � � a `t�, �fT ". � v t =, ;. '''a ,. �`� x' j ��rv� r � ��`.'Y +' �w \ � a °�r � y�� § F � � . G�Y a.� v � z � � o '�t.'� °��",, -< � J a � {� .��. N 4r. � �� N o .� ` . � _ a O ,#• - e, . � ,, " '� � ,, i m r s°� � ' ' .t_ C/� � �s a I_�' �,. _ ._ . :� T '�""�'�Y,,�•- . . r, P �� `!� � � .. r��.'.. ��, .,Y�� . � � Y ��' '- �� f r � �€ � K � l .t r.F' " ..' ' �<� �., il t �i � r �, I . y�i4 � Y ` , �. � e a _ _ ._ _ a�� -�� a ��. � � „ �a .'� } =' m z .�j• � " i 2 axtn oO°a'z� amono � �A �'�)�"� j`� ( ��.l7 Z r vmi 3 v=� o m 1 .� ,��,a. �'�Rl"MT. .. �:T m a r C'l p�9 a�T Z � . ', . �C y�' sm uv san � � . ��°�`' �. m z s N y J y 3 m "['' �Ti n . �`� — ^� { ' a a a °pa a�a �c D +,� ��,K. a m z � W f T� y 3 �i T� � � ' a s� l� „�. !t:'� �''`i � z , � z m a rn t� .l3 � � =o � z m < = N o � �o = o � rn � y ,,, s c' 3 v � � � � `� m H� m 3 �K m� .o trt � � � � Zm � � � 3 K � O z f � _ � _ _ _ . ___ _ __.____._m (�,� �-' y o ' _ : . . m p � \ V �, _ ��3� "� �� w NN u�` m r*i a ;^o n a' _ I �. c I a� ]- � � � � °3�`° W 33 Ecpp I f � p � e a W . fl] ", a v �y � � � . �O v S _3 o R p '° C m �i 3 , z� C-_r_ � £ ,,s� " ` �- m m `-°��° � i a '', Z ',. i v � � �s � V i �,� =o� 3 vz � i � m �._ ; o w �.rD �J � � �,�Nv3 3 m : .. ( i C � . �� = 3 � � �� 3 F q *3 I . I � �' �` N^' � �G /}� },� �a..�_a�3 _o�m � � � o� lV �i� t c f 1 � fj�•L...�+ I � �� v � Page 1 of 3 �I��CUSHMAN 8i , F"��1��yc�'�y D Purchase order invalid wuhout accompanying terms and conditions r � A�\G GL /��. / TO: INVOICE TO: SHIP TO: NORDQUIST SIGN COMPANY EAGAN 945 PIERCE BUTLER ROUTE iJIVITED STATES 3560 DELTA DENTAL DRIVE ' ST.PAUL,MN,55104 EAGAN,MN,55122 LTNITED STATES LJNITED STATES 07-OCT-2015 07-OCT-2015 Replace exisring DeCare monument and building exterior signage with new'Anthem'wording.N01'E: , address on monument to show Blue Cross Road-not Delta Dental Drive.Total(including kvc)- $4,988.36 but that a 50%Deposit is requQed($2,494.18).Business UniUcost center#5571110000 ' obtained from Tracey Frampton I I Replace exterior signage 4,988.36 4,988.36 �I TOTAL 4,988.36 li 40730140 62090000 4,98836 TOTAL 4,988.36 THIS PURCHASE ORDER REQUIRES FURTHER APPROVAL APPROVALS Tom Kowaliczko 07-OCT-2015 Created By Property Manager Approval VENDOR ACCEPTANCE AND APPROVAL I HAVE READ AND AGREE TO THE ACCOMPANYING TERMS AND CONDITIONS NAME DATE SIGNATURE Printed on 7-Oc[-1S Page 2 of 3 ��AKEFI E�D Purchase order invalid without accompanying terms and conditions TERMS&CONDITIONS OF ORDER 1.DIRECT ALL PAYMENT INQUIRES TO THE RESPECTIVE BUILDING OFFICE. 2.Render your invoice with this order number indicated thereon.AVOID PARTIAL INVOICES. 3.All prices include F.O.B.delivery to building,applicable ta�ces and insurance,supervision,overhead and profit,unless specifically stated otherwise on this order. 4.PREPAY ALL FREIGHT SHIPMENTS. 5.No orders are to be accepted unless in writing or confirmed in writing. 6.The issuance of this order does not obligate the Purchaser to accept subsequent orders or any changes in the performance of the work.No claim for any extra work by the Vendor/Contractor will be allowed except upon complete compliance with a subsequent order. 7.The receipt of each order must be promptly acknowledged and delivery or performance date must be staYed in such acknowledgment.Orders not so acknowledged shall give Purchaser the right to cancel at its election. 8.Any order not accepted must be marked as such and returned to the Purchaser within three(3)days after issuance of it. 9.Purchaser may assign this Order without approval of VendodContractor, but Vendor/Contractor may not assign this Order or sub-contract any portion of the work without Purchaser's prior written approval. 10.The Purchaser reserves the right to cancel any and all orders not delivered according to the tenor of the obligation. 11.Contents of each package must be stated on a packing slip enclosed therein. 12.All material to be furnished or work to be performed shall be done in accordance with the plans,specifications and conditions at the building and must(regazdless of specifications)comply with all laws,ordinances,rules,regulations and requirements of Board of Underwriters,all Municipal and State Government authorities and Labor Unions having jurisdiction.Should there be any violations of the foregoing in any part of the materials or work to be furnished under this order,and the Vendor/Contractor on accepting this order does not call the attention of the Purchaser to this fact,then the Vendor/Contractor,at its own expense,will furnish all labor and materials to correct such violations. 13.If defective work or material is installed or fumished and allowed to remain,the Purchaser is to be allowed the difference in value between cost of work installed and cost of work specified. 14.The Vendor/Contractor will furnish all labor,materials,tools,scaffolding,rigging,hoisting,etc.,required to carry on the work in the best and most expeditious manor and protect its and other work,and will do all necessary cutting and patching and also remove and replace any interfering work,for the proper installation of its work. Vendor/Contractor agrees to perform work in a safe and proper manor and save Purchaser,its agents,employees,and pazent company,as well as the Owner(if other than Purchaser)of the building where the work is to be performed or materials used,hannless against any and all(i)claims and liability for injury to or death of any person and for damage to or loss of any property occurring in any manner whatsoever by reason of the work hereunder(except that resulting from the sole negligence of Purchaser)and(ii) penalties for,and wsts of labor and material to corcect the work as a result of,any breach of this Order or violation of any law or ordinance of rule or regulation of any governmental authority or any requirement of the Board of Undenvriters or Insurance Services Off"ice. 15.The Vendor/Contractor will procure and pay for all necessary permits in wnjunction with its work. 16.The Vendor/Contractor agrees to repair,replace or make good any damages,defects or faults resulting from defective work that may appear within one year after Purchaser's acceptance of the materials or work.Written guarantees if requested are to be furnished by the Vendor/Contractor. 17.The Vendor/Contractor sha11 commence and complete work and materials at such times as are required by the Purchaser.Time is of the essence of this agreement.Unless the Vendor/Contractor notifies the Purchaser(in writing),no delay shall be considered for an extension of time.If at any time,the Purchaser sha11 consider that proper progress is not being made,the Purchaser,upon three day's written notice by registered mail,shall have the right to employ proper and sufficient men and material to proceed with the work,and charge all costs incurred in this connection to the account of the Vendor/Contractor,in the meantime,stopping any further payments until the work is completed. I 18.Any material delivered or work done becomes the property of the Purchaser and may not be removed without consent of Purchaser. I 19.Prior to providing any labor or materials,VendodContractor will obtain the following insurance,naming Purchaser as a coinsured,and furnish Purchaser with original policies or duplicate original policies covering the period Vendor/Contractor is performing hereunder,to wit: (a)Workmen's Compensation insurance in accordance with law,and Employer's Liability insurance with limit of$100,000, (b)Comprehensive General Liability insurance including coverage for the"hold harmless"obligation assumed under paragraph 15 above,with the following limits of liability: Personal injury and property damage-$1,000,000 combined single limit, Printed on 7-Oct-15 �� r �� " Page3of3 ��w��j j1� Purchase order invalid w#hout aecompanying terms and conditions i � ,�... IE�.� I (c)Comprehensive Automobile Liability insurance(conceming owned vehicles,leased vehicles,and all other vehicles)with the following limits of liability: III Personal injury-$250;000 each person/$500,000 each occurrence. I�i Property damage-$100,000 each occurrence. '' All of the above insurance(i)shall provide that the same may not be cancelled or modified without 30 days prior written notice to Purchaser by certified mail and(ii)shall be II written with companies approved in writing in advance by Purchaser.In the event Vendor/Contractor fails to carry the inswance specified hereunder Purchaser may obtain such insurance and charge it to VendodContractor,who shall immediately reimburse Purchaser therefore.Vendor/Contractor agees that the provisions set forth in this paragraph shall be imposed upon,assumed and performed by each of its sub-vendors,sub-sub-vendors,sub-contractors and sub-sub-contractors. � 20.VendodContractor agrees:(a)to comply with all provisions of Executive Order 11246 of September 24,1965,and of the rules,regulations,and relevant orders of the Ilil Secretary of Labor,including but not limited to(i)not discriminating against any employee or applicant for employment because of race,color,religion,national origin,or sex, AND(ii)taking affirmative action to ensure that applicants are employed,and that employees are treated during employment,without regard to their race,color,religion, national origin,or sex,AND(iii)in all solicitations or advertisements for employees placed by or on behalf of VendodContractor,stating that all qualified applicants will receive consideration for employment without regazd to race,color,religion,national origin,or sex,AND(iv)sending to each labor union or representative of workers with which VendodContractor has a collective bargaining agreement or other contract or understanding,a notice to be provided by Purchaser advising the labor union or worker's representative of Vendor/Contractor's commitments under Section 202 of Executive Order 11246 of September 24,1965,and posting copies of the notice in conspicuous places available to employees and applicants for employment;and(b)to furnish all information and reports required by Executive Order 11246 of September 24,1965,and by the rules,regulations,and orders of the Secretary of Labor,or pursuant thereto,and to permit access to his books,records,and accounts by Purchaser and the Secretary of Labor for purposes of investigation to ascertain compliance with such rules,regulations,and ordera 2L Contractor shall maintain written records in accordance with generally accepted accounting procedures showing in detail all costs which it incurs and payments which it receives in the performance of this Agreement.Such records shall include,but shall not be limited to,payroll records,job cazds,attendance cards and job summaries and shall be subject to audit and inspection by Agent,Owner and their respective agents and representatives during the term of this Agreement and for seven(7)years after its expiration or eazlier termination,unless a longer period is required by law.Should the audit reveal errors in record keeping,Contractor shall immediately correct same and shall promptly inform Agent and Owner in writing of the action taken to correct such errors.Audits conducted by Agent or Owner,or their designees shall be an expense of Agent or Owner, provided,however,that if any such audit reveals that the aggregate expenses with respect to the Services are at least five percent(5%)less than indicated by the books and records maintained by Contractor,then Contractor sha11 promptly reimburse Agent and/or Owner for the cost of the audit.The right of Agent and/or Owner to audit the books and records maintained by Contractor shall survive the expiration or termination of this Agreement. Vendor/Contractor agrees that if work performed or materials ordered are for a building in which any o�ce of the United States of America as a Tenant is located,and this Order is for an amount exceeding$2500,Vendor/Contractor shall permit the Controller General of the United States or his duly authorized representative to have access to,and the right to examine any directly pertinent books,documents,papers and records pertaining to this Order until the expiration of three years after final payment of any monies has been made pursuant to the provision of this Order. 22.The Vendor/Contractor shall,at its own expense,defend any and all legal actions brought against the Owner and/or Purchaser in connection with this order and shall pay all attorneys'fees and all other expenses and promptly dischazge any judgments resulting there from. 23.Vendor/Contractor promises and agrees to pay the taxes measured by the wages of its employees required by the Federal Social Security Act and the contributions required by the New York Unemployment Insurance Law and hereby accepts the exclusive liability for said taaces and contributions and agrees to indemnify and hold harmless the Owner and Purchaser from any responsibility for same. 24.Workmen must report to the office of the building before starting and after completing work,or when leaving or returning to the job for any reason. 25.All goods delivered must be signed for by the superintendent of the building. 26.Performance by the VendodContractor of this order will not be accepted under terms and conditions other than those contained herein,unless specifically agreed to in writing by the Purchaser/Owner. 27.Where the word Owner is used,it refers to the Purchaser's principal,who is the Owner of Record of the building stated herein.The name of the Owner will be furnished on request. 28.Performance by the Vendor/Contractor of this order will not be accepted under terms and conditions other than those contained herein,unless specifically agreed to in writing by the Purchaser/Owner. Printed on 7-Oct-15 \�asp 1\Ofs\Ousersdefpaths\Cus}�mzn�cw�reports�nc_v7s_CI S_YRS_POPrint docx �.Y PERMIT City Of Eaga�l Permit Type: Sign 3830 Pilot Knob Rd Permit Number: EA133564 Eagan,MN 55122 , Date Issued: 10/27/2015 (651)675-5675 � O (� (�� www.ci.eagan.mn.us �� u Site Address: 3560 Delta Dental Dr Lot: 1 Block: 1 Addition: BCBSM East PID: 10-13345-01-010 Use: Anthem Description: Sub Type: Building Work Type: New Feet Inches Description: Aluminum Pan/Vinyl Graphics Length: 12 0 Height: 4 0 Sign Message: Width: 0 0 ANTHEM SqFt: 48.00 Location on Structure: Face Replacement Elevation: 0 Electric: N Double: N Comments: Please call(651)675-5690 or(651)675-5687 for a Final Inspection. Fee Summary' Base Fee-$2.50 sq.ft. $120,00 0�2o.4osa ' Copies $0.75 0201.4230 , Total: $120.75 � Contractor: - Appli�ant - Owner: Lawrence Sign Delta Dental Plan of Mn 945 Pierce Butler Rt. 3560 Delta Dental Dr St.Paul MN 55104 Eagan MN 55122 (651)488-6711 I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Applicant/Permitee: Signature Issued By: Signature � � � � �'�.��. � � , Use E3LUE or BLACK Ir�k � � r-�______....:..._.__--._,_�^�-i � �. I For Office tJse ' �l� U�U� Ull j Permit#: , ��l�' j �, � I I � 3830 Pilot Knqb Road � Permit Fee; ��r_ � � ' Eagan MN 55122 � Date Recsived. i � ' Phone.(651)675-5690 �; F'ax:(651)675-5694 I � � Staft: ( ��.�.��_.__.��.��.��J. il 2015 S1GN PERMlT APPLICATION � ' � �.• Submit one(1)application per building, pylon or monument sign. I ❖ Submit one{1)application per pylon or monument sign tenant panel replacement. � �i •: Submit two(2)copies of drawing showing proposed sigr�and site plan or building elevation showing iocation on ' property. i �.• Submit one{1)separate sign plan or lef#er containing the landlardlbuilding owner's approva�of#he sign. ` •;� Building Signs—Exposec�electrical boxes or conduit shall be shielde+�from view by painting to match the building or � sign band area, or enclosing within the sign raceway. All raceways shall be cons#�uc#ed of materials ar painted to ma#ch ; the building or sign band area: ; d• Py1on signs are a Conditional Use and subject to all conditions, regulations, ahd fees re�uired f�r condi#ional uses. � *:• Temparary Ad�er#ising Slgns—Please complete both sides of the applica#ion. ' •,• Applications submitted via email are subjec#to an additional$0.25 per page printing charge which wi11 be added#o the � permit fee. � •'r If any sign is placed, erected or installed without first obtaining a si�n permit,the permit fee shall be the amoun#equal to � twa times the permit fee, per Sectic�n 11 70 Subd 28 I 2 °� � � ,�� x� � �. �� ime��Y� r� "� i � �� . ��.M�..ri�� .�x��.. r,>�� °� � #u � � �# � �.x n�. Fee1 lnches Fee# Inches Feei Inches Awning L.ength _ �� 'x Heigh# �� - x Depth ' � Bui(ding �� f ' Canopy Tota!Square Feet: _�,,,�"-� ,, � ' Cons#ruction � Lease Sign Message: � � Monumen# ��`��' ; r Pylan Loeation on Struc#ure; .,..'��r+v �_�G�?.��1 Temporary Use Days ; Temporary Setback; Has Electricity � Other Elevation: Is Double Faced � I . Date: /�s�! � Applicant is: Owner Tenant �Sign CAmpany 1 Con#ractor —' � . g , , Address where sign is to be locatedc �;:��.„� ��,,T"��? ��•'�� '` � Tenant or Business Name. ��-,�---,, ! � � � Tenant Contact Name: " � Tefephane#; — ` � Sign Company/Gontrac#or: _��,��y�l�l��',�'"�" j�,, �� .�, Telephone#: �,�� .-��'� �'; � , Address. �' �-��t� � �-�-�'.") Zip: � - ----- _��'—�. �_�L". State: � ; Prop�rty Owners� � �-- �°`v Telephone#:��'�"}i��3�' .��} � Address: ��+' ty: - State: —�� Zip: �� l ��n n � � Page 1 oF 2 � l,�' ,�G)�� ` � ; ��°' � i�� Fee: $25.04 #of Signs: (ma�cimum of 3) � Sizes of the Sign(s}: 1. �, 3. ■ Total Sq. Ft.of aIl signs; {All 3 signs cannot exceed 25 sq.ft.) ~ � Firsf pay of Placement: � W J W �Q ■ Signs can be pJaced for 10 days out of a 60-�ay p�riod which eommences the first day a sign is a �� piaced. N Z W Sign Permit Expiration Date: C�.Z , : � � � Sign permit(s)expires 6fl days from first day Af placement. ; ':�w b ��... i }- pQ 90 Days Sign(s)Are To Be Placed: � J : � � Q_ Sign{s)will be attached to: building elevation pylon monument t W ■ Signs must be attached ta the building or#o an existing monument ar pylan sign. � �., `v Sign(s}wili be attached using the fiallowing method: � �, . W p`: Signs must be placed securely and in a soun�l manner to ensure safety of the public&in accordance with � �- reasonable standards employed by sign makers. ' - � Person responsibJe for placement/remo�al of sign; � `� �= Telephone#: � � ' Management Co, {if applicable) Telephone#: ; �_,� :.:;' Approval of#he building Owner or Management Company may be required. Check your lease or cal(your � ', � Management Gompany for additional information. CALL BEF'ORE YOU DIG. Call Gopher State One Cafl at(651)454-0002 for pro#ection against underground utility damage. � Call 48 hours before you intend to dig to receive loca#es of under round utilities. www. a hersta eonecall. r 9 0 q � t q ` I hereby acknowledge that i have read this application,state the appiic:ation is correct,and agree to comply with Eagan, MN laws regula#ing constructfon and placement. * : ; �.��,�,-► �i t`�1 ' x ' x : � Appli�cant's Printed Name Applican Signature � , _ FOR OFFICE USE r , Work Tvpe: Descriation: . ' Inspections "`` Fees � _Change Existing �Aluminum pan _F.G.O.Afuminum Footings ' $ _CUP`/Ftg.Ins, _Banner Hal,o-lit/Reverse Ghannel ��inal $ �.� . � � [ Move _8oard _,_,,,LED/Elec#ronic Copies$0:251page $ _60 Days _CanistQr _Plastic cu#out TOTAL $ �New _CabinetlLogo _Plas#ic molded ' I i I _Channel lit leiters Plastic Panel REVtEWED BY; � � _Channel lit 1�aceway _Routed PlannPng � t _Flex Face �Vinyl graphics BuPldin�Inspec#ions � ,-. , Page 2 of 2 � � . , � � 4,_0„ o � �_� ss sie � 0 X Z y � Q - � � � ; I � 4 i� �3 !N G t � �S I `k � '< � ti { I t.... � I a ,�"' a �f A � ��I O, , .�. .... .�. 0 ` F ¢ j i f� � � ; � qi , i .: c.�) ,'�. v � OF ` � � � O m { ii1 � � t � � $ � ss � D 31 s ' � D p �7 � € n rn < � � = o � m � � �� m D � {� { I � � Z m � C'� � � � ` O z f a O n � t`-t�i. rr7 � � � . � � , � i_ Z N � , � } � � � � � � n � j � � � _. a _ v \ i - � e __ a. � � o � , .:Z � � � � m y v c Z C� � Z (yj �O 4� S ym1 ¢o z"= '�— . , �.n s� N m a� � 1 �� '� :m a�iar Sc3C Z o ��43 3= � S ��.�^ �z v a m S x e 9 � a , �a — m O E � Z Z � � � e � 1 . . c� H �. � � � � m � -y � s � \ _ y i I a � � � W c c 3 z � c z 3 s .._.. ._... _..___ ._.... .. . . _ ..._._ _w .__ ___. ____.__. .__._ ..____. ____.�_.__...__.� __W_._.__ _.___._.._._ _._.. � o3aqTqA .�` _ �o � . " ' � C I y� �V o- p^a.9 y � �a H -yi ' O � � W m � ! ` yO ¢3 N �o��'o � O , 2 a� � N S � ,.:. � \ R\ ; B n g .3� � . b!� 'I n r, . J �/V ' m _ a �3"3 E"�n � � _ ?O 1 1 � F � � � �°S C z T . S .� ��\�r �� ^�� 3 Dq= f n �3 �z � . � � V \ ti � i y 2 O �� E Za ?�;� '`"o a .. � Za �� Gflq $3 < T N� , �' 3 n �� 0 3 rg r o T �_ _ ^ _m< �_o�a o�� , . . . � . � - � 0 8 � � ity o Eaaall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink t kil I For Office Use Permit #; e o� Permit Fee; I i Date Received: Staff: 2016 COMMERCIAL BUILDING PERMIT APPLICATION Date: 47/3/7-fige Site Address; 3Q-eo Pet -6 yet/(4i. •••• 'gar , M J 55(Z� Tenant Name: /" riA rt/te % (Tenant is: New / ✓Existing) Suite #: Former Tenant: Name: beVrri, rt"lim\ s ' `iYt:tnvt�!eATX Address / City / Zip: 5-00 Gt."cy„ts; AsJ Applicant is: 'Owner Contractor ceosc Description of work: 3C:::)r 1(.5C)1 +0/1-\)-P c�# -cOR. AAA, et.) 4( CA14017 PI,oC�ne:r 4t26 - X9 ,1 Construction Cost: Name: Achrec, Address: {122- ( 1 eA State: Mk) Zip: 57'1 34 Phone: l) /"K*C Email: .5 ,mei' s ttt ri . con". Name: Registration #: Address: City: Architect/Engini License #: City: t. ;A 33 1 State: Zip: Phone: Contact Person: Licensed plumber installing new sewer/water service: NOTE: Pia ns°and°supporting.documentsfhat the information may be Email: Phone #: yo submit' are considered to be public inforntadon. classified as non- public if you#provide specific reasons that would permit con udexthat they 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.uopherstateonemitorq 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 fo 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 wtt whic O` quires a review and approval of plans. x1 v'a c•e Ira was v.1 Applicant's Prin ed Name 1 Appli Page 1 of 3 'CIACA SUB TYPES. Foundation Commercial /Industrial _ Apartments Miscellaneous W9RK TYPES 4/ New Addition Alteration Replace Salon Owner Change DESCRIPTION Valuation Plan Review (25%_ 100%___) Census Code # of Units # of Buildings Type of Construction Dc ---7441 DO NOT WRITE BELOW THIS LINE Public Facility _ Accessory Building ✓ Greenhouse / Tent Antennae Interior Improvement Exterior Improvement Repair Water Damage F(x A $-E V� REQUIRED INSPECTIONS Footings (New Building) ; Footings (Deck) Footings (Addition) Occupancy Code Edition Zoning Stories Square Feet Length Width Foundation Drain Tile Roof: _Decking _Insulation Ice & Water Framing 30 Minutes 1 Hour Fireplace: _Rough In Air Test _Final Insulation Meter Size: /3-g./gO Exterior Alteration -Apartments Exterior Alteration -Commercial Exterior Alteration -Public Facility Siding Reroof Windows Fire Repair Final Final CIO Inspection: Schedule Fire Marshal to be present: Reviewed By:h7G , Building Inspector Demolish Building* _ Demolish Interior Demolish Foundation Retaining Wall *Demolition of entire building — give PCA handout to applicant u Zt IS,F1'il 3d a MCES System SAC Units City Water Booster Pump PRV Fire Sprinklers Sheetrock Final / C.O. Required Final / No C.O. Required Other: Pool: _Footings Air/Gas Tests _Final Siding: _Stucco Lath _Stone Lath _Brick Windows Retaining Wall Erosion Control Concrete Entrance Apron Yes No Reviewed By: / V IJ a Planning COMMERCIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC S&W Permit & Surcharge Treatment Plant Treatment Plant (Irrigation) Park Dedication Trail Dedication Water Quality 135', /,NGL Storm Sewer Trunk Sewer Trunk Water Trunk Street Lateral Street Water Lateral Other: TOTAL: Page 2 of 3 Use BLUE or BLACK Ink For Office Use itildi-2/02,14V'e----- 44111` City Of EafJL 2' 2017 Permit#:+ aun Permit Fee: 3830 Pilot Knob Road mA,:f T cED Eagan MN 55122 Date Received: Phone: (651)675-5675 buikilnoinsoections citvoteaeattcow Staff: ./�./ IQ 2017 COMMERCIAL BUILDING PERMIT APPLICATION 7 Date: 6aL/I Site Address: 35te0 fi 4AVA c>e(A.42a.t Dod4ity Tenant Name: iStiAtip,..AAA (Tenant is: New/ Existing) Suite#: Former Tenant: Name: eft to _ o tk,v Phone: Properly Owner Address/City/Zip: "l U—b cL4 t.r w S. -, 4).e420, t y• , ,i /5 Applicant is: %+` Owner Contractor (1?'cs-ej) Type of Work Description of work: '10 56 �e '` itep ko,L 1 SOC S Construction Cost: .0 J jaYZ&e Au IC) (, Name: J( fc) '[Gl✓ " V1ta10.1064.44_ License#: Contractor Address:4(04;6 t _(v ,U City f":44,A‘ trtL Stat Zip: 5.1--(.5n Phone: 1 5? — r 4? — 3 Contact: 514Svt. Oult,tiLe _Email: Y ' CC>r c so, iii • O Name: Registration II: Architect/Engineer Address: City: State: Zip: Phone: Contact Person: Email: Licensed plumber installing new sewer/water service: Phone#: NOTE:Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that they am trade secrets. You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvafeastan,comisubscribe. 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,00Dherstateonecall.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 o whi« ='*•r i. . review and approval of plans. x V t tQJ Applicant's Printed me !'p,IM `3�• / A�� eant'- Page 1 of 3 4-',' ,, ...\-- *-3,c(... K),,,u-,, .- ., d ,,- o 14 DO NOT WRITE BELOW THIS LINE 0 (02- SUB TYPES Foundation _ Public Facility _ Exterior Alteration-Apartments _ Commercial/Industrial /Accessory Building _ Exterior Alteration-Commercial Apartments /Greenhouse/Tent _ Exterior Alteration-Public Facility Miscellaneous Antennae W9RK 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 F t X17 PCS Occupancy Alt- MCES System t\1/A- Plan Review ✓ Code Edition 'SO IS-MPEG SAC Units (25%_100% 11( Zoning City Water Census Code Stories I Booster Pump #of Units Square Feet f So o C ►r) PRV #of Buildings I Length / Fire Sprinklers Type of Construction V I! Width Tr, REQUIRED INSPECTIONS Footings_New Building_Deck Addition Drain Tile Foundation Foundation Before Backfill Retaining Wall Vapor Barrier Erosion Control Framing 30 Minutes 1 Hour — Steel Reinforcement Insulation Concrete Entrance Apron Sheetrock Other: Roof:_Decking _Insulation _Ice&Water _Final Meter Size: Siding:_Stucco Lath _Stone Lath _Brick_EFIS Electronic As-Built Plans Required Windows Fireplace:_Rough In Air Test _Finalnal/C.O.Required Pool:_Footings Air/Gas Tests _Final Final/No C.O. Required Final CIO Inspection: Schedule Fire Marshal to be present: ✓Yes No Reviewed By: ilit?------ , Planning New Business to Eagan: Reviewed By: aArito ,Building Inspector FEES Water Quality Base Fee 13 r. ow Storm Sewer Trunk Surcharge /WCL.b Sewer Trunk Plan Review INGL4 Water Trunk MCES SAC Street Lateral City SAC Street S&W Permit&Surcharge Water Lateral Treatment Plant Stormwater Performance Security Treatment Plant(Irrigation) Landscape Security Park Dedication Other: c/ Trail Dedication TOTAL: `/ 3 r. Page 2 of 3 w -1 For Office Use Q� / /` * i P , Permit#: /5-4 q 71� / tlp tl d dd l� ®q ,� Nd r� (/IO V 0 „,,.a,, E AGA N Permit Fee: 7.". , w= Staff: 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 Payment Recvd: _Yes ,rNo (651)675-56751 TDD:(651)454-8535 I FAX:(651)675-5694 Email:buildinginspectionsAcityofeagan.corrt i Plans: Electronic Paper Plan Submittal:eplans aC�.citvofeagan.cont I ., 2019 COMMERCIAL PLUMBING PERMIT APPLICATION ❑ Please submit two(2)sets of paper plans with all commercial applications as well as an electronic set of the submittal, submitted via email,CD or flash drive Date: 11-13-19 site Address: 3560 Delta Dental Drive Tenant: Delta Dental Suite#: Property Owner Name: Delta Dental Phone; 651-406-5924 - Name: HARRISLicense#: PC642310 Contractor Address: 909 MONTREAL City: ST PAUL State: MN zip: 55102 Phone: 651-602-6539 Email: THAELTERMAN@HARRISCOMPANY.COM New Construction Addition Modify Space Replacement Repair Rebuild /� Work' lIn Right-Of-Way /, soz , i i L Description of work: E II C or W ft.--TS OOGI f..2. y ,A-1- /_73-c--3. 7g Type of Work Irrigation System(_,yes I_no)CL RPZ/_PVB) • Raln sensors required on irrigation systems • Avg.GPM (2°turbo required unless smaller size allowed by Public Works) Meter Required—Call Utilities at(651)675-5200 to verity tests passed prior to pickinrf up meter. Domestic:Size&Type Fire: 1 Average GPM High demand devices? Yes No Flushometers_Yes No COMMERCIAL FEES Contract Value$ x.015 $60.00 Permit Fee Minimum 60.00 $60.00 PVB/RPZ Permit(includes State Surcharge) $ Permit Fee Surcharge=Contract Value x$0.0005 $ Surcharge If the project valuation is over$1 million, please call City for Surcharge $ TOTAL FEE The following fees may apply when installing a new lawn irrigation system or $ Water Permit connecting a new water service. $ Treatment Plant Contact the City's Engineering Department,(651)675-5646,for required fee amounts. $ Meter Fee $ Radio Read $ State Surcharge $60.00 TOTAL FEE You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvoteanan.comisubscribg. CALL BEFORE YOU DIG. Call Gopher State One Call a1(661)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;t .t the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans, x TRACY HAELTERMAN �� blir MS.-%A.._ Applicant's Printed Name Appli ant's Sidfillure Page 1 of 4