4110 Rahn Rd A221 Use BLUE or BLACK Ink
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For Office Use �y
Cityof Eaaall Permit#:Permit Fee: a.(‘Qc/
3830 Pilot Knob Road
Eagan MN 55122 Date Received:
Phone: (651) 675-5675
Fax: (651) 675-5694 Staff:
I. 10
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2017 COMMERCIAL BUILDING PERMIT APPLICATION >9/i�
Date: 1 �r � Site Address: I R f('� Y) � D � '�/l 11 / J )-)_ i 1*
Tenant Name: k a( e I'/V\ A G e C I e v'-- (Tenant is: New/ A/Existing) Suite#:
(� Former Tenant:
aa.n Name.mtiI�a I� IY '\
�o �;��� Phone � ) ��o77d I
Property Owner ' Li/10 k �, fr\ R
I Address/City/Zip:
Applicant is: Owner A Contractor
Type of Work Description of worp t,..Ge 0-e6Kj,t1 a v C Jut S A- ..S 6 (A e c& lc o vi
) i
t Construction Cos?.. /
os I/ G 0 ,e U
IName: ►'"c (-6`.r--(6t1 License#: i
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Address: '(5-17 t r r�C e t,.-Odd Q�f i v'e City: I�/d Gl'0 f't^ i-°�
Contractor
I State: HN Zip: S S 1f/ 3 7 Phone: 1 /) C lG�
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Contact: S4t - L6- IS6 vt 1'56,"f) Email: 114 u Crki eh a 3- ) �'( / Gfc u cl, G u i^-,
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Name: Registration#: 1
Architect/Engineer Address: City:
State: Zip: Phone:
Contact Person: Email I
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 1
�:,.a ��.p_ `conclude that the are= trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.orq
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and
codes of the City of Eagan; that I understand this is not a permit, but only an applic.tion 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 wor�'w ich eq fres a review and approval of plans.
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Applicant's Printed Name App ic- Vs Sig atu
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DO NOT WRITE BELOW THIS LINE
SUB TYPES
Foundation Public Facility Exterior Alteration-Apartments
y( 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 QL Water Damage Fire Repair Retaining Wall
Salon Owner Change *Demolition of entire building—give PCA handout to applicant
DESCRIPTION
Valuation Occupancy MCES System
Plan Review Code Edition SAC Units
(25%_100% Y) Zoning City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Sprinklers
Type of Construction Width
REQUIRED INSPECTIONS
Footings_New Building_Deck_Addition Drain Tile
Foundation Foundation Before Backfill Retaining Wall
Vapor Barrier Erosion Control
Framing 30 Minutes 1 Hour Concrete Entrance Apron
Insulation Other:
Sheetrock Meter Size:
Roof: Decking _Insulation Ice&Water _Final
Siding: Stucco Lath _Stone Lath Brick EFIS Electronic As-Built Plans Required
Windows
Fireplace:_Rough In _Air Test Final Final/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: , Planning New Business to Eagan:
Reviewed By: T , Building Inspector
FEES Water Quality
Base Fee Storm Sewer Trunk
Surcharge Sewer Trunk
Plan Review Water Trunk
MCES SAC Street Lateral
City SAC Street
S&W Permit& Surcharge Water Lateral
Treatment Plant Other: 0 Icticielifdpia 1
Treatment Plant(Irrigation)
Park Dedication
Trail Dedication TOTAL:
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