4130 Rahn Rd B208 a
Use BLUE or BLACK Ink
For Office Use
Cityof Eaall Permit#: I 1 2.1n ,Permit Fee: 1
3830 Pilot Knob Road �'
Eagan MN 55122 Date Received:
Phone: (651) 675-5675
Fax: (651) 675-5694 Staff:
i
C9111U5
2017 COMMERCIAL BUILDING PERMIT APPLICATION (rl
Date: Clg7/7 C Site Address: Li I -3 c) (K.c.t.L A • •• ce),-,g.. 's` ) p),e;
Tenant Name: L L . J`I 1 060 (Tenant is: New/ Existing) Suite#:
Former Tenant:
I Name: /0v% CC .0 At'L�s LLL' � — 71 _ Il 774-iPhone:
Property Owner 6� S4. Lz t`sf ha. K*iry'Ir1,G'
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I Address/City/Zip: i�� IL-- ( �L 2 ( I r c�y1 e
Applicant is: Owner Contractor
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Type ofWork Description of work: 1 k-ct vt L/t'C t v 4- Til i s4-.c G i�'t i tCc ety
Construction Cost: (fa) U L a
Name: Si-e ,
L a\r'1"00 License#:
I
i 6t1.14(t V.
Contractor Address: L( c t 7 1- %s" �r CC: ce c‘ t +r city: ` �l
3 i State: Zip: �S� �t 3 7 Phone:
F
Contact: I/l C( Ct. .,e (4 5 ' 'I4- 4 3 ,,
_ I
_.. . S Email: C l / Gi �s'I
I
Name: Registration#:
Architect/Engineer Address: City: F
I
ii I State: Zip: Phone: t
Contact Person: Email:
E Licensed plumber installing new sewer/water service: Phone#:
NOTE:Plans and supporting documents that you submit are considered to be public information. Portions of
I the information may be classified as non-public if you provide specific reasons that would permit the City to S
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 applicatio for a ermit, 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 /'icr a uires a review and approval of plans.
x S*1-e La c-ce vi x 41
Applicant's Printed Name App lc.nt's Si 9naturre ______^
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DO NOT WRITE BELOW THIS LINE `I) J
SUB TYPES e
�.,�,
Foundation Public F ility Exterior Alteration—Apartments
'7C 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 OWL Water Damage Fire Repair Retaining Wall
Salon Owner Change *Demolition of entire building—give PCA handout to applicant
DESCRIPTION
Valuation Occupancy } .f,3 MCES System
Plan Review Code Edition t SAC Units
(25%_100% ) 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) Final/C.O. Required
Footings(Deck) Final/No C.O. Required
Footings(Addition) Other:
Foundation Foundation Before Backfill Pool:_Footings _Air/Gas Tests Final
Drain Tile Siding: Stucco Lath _Stone Lath _Brick EFIS
Roof:_Decking _Insulation _Ice&Water _Final _ Retaining Wall
Framing 30 Minutes 1 Hour Erosion Control
Fireplace: Rough In _Air Test Final Concrete Entrance Apron
Insulation Meter Size:
Sheetrock Electronic Plans Required
Windows
Final C/O Inspection: Schedule Fire Marshal to be present: Yes No
Reviewed By: , Planning New Business to Eagan:
Reviewed By: ' '7, , 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:
2104 (9k)
Treatment Plant(Irrigation)
Park Dedication
Trail Dedication TOTAL: , 0 V'D
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