4130 Rahn Rd B114 Use BLUE or BLACK Ink
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• For Office Use
City
Permit#of
Permit Fee: 1 D-D•. (4'i
3830 Pilot Knob Road
Eagan MN 55122 Date Received:
Phone: (651) 675-5675
Fax: (651) 675-5694 Staff:
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2017 COMMERCIAL BUILDING PE MIT APPLICATION
Date: ISV!? Site Address: 4 1 3 6 f.„.(i-In, ti, 6 1.1...--
Tenant Name: i7, C'v'
(Tenant is: New 1 X Existing) Suite#:
Former Tenant:
Name: `Gt eA 6-0Lieir-sS (.tet: Phone: 6 / 2( 61. 7 t e/ 1
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Property Owner / \ r l o S per„r l /�`�
Address/City/Zip: I. (� el5 � 1C`� �j � -- I-f16.
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t Applicant is: Owner Contractor
Type of Work
Description of work. i P t a-C 1 u(/. /)e L. k's 6 a v V t 5.1 6) Vt. , ct..(Gc:�:
Construction Cosf� / C'0a.Cm» „M
s Name: S—eut L-a.y SG X01 License#:
Contractor = ( / "rev v Lice:..)(,(-- t- I r ve City: tqlGc`OA�
Address: L� S � `qty” `si/1
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I State: l t(\iZip: 1`( 3 Phone: L,j� 5-4/6J
Contact: +"Q(�IC et' S'at,,;;at Email: v`) 1“ CIA• -j - C/c-1)4 ) L1-a c+: ('-'10
Name:
Registration#:
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Architect/Engineer Address: City:
i State: Zip: Phone:
IContact Person Email
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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
t___, 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.qopherstateonecall.orq
I hereby acknowledge that this information is complete and accurate; that the work will bei conformance with the ordinances and
codes of the City of Eagan; that I understand this is not a permit, but only an applica 'on fej 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 .r hi. r-• ires a review and approval of plans.
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Applicant's Printed Name p a t ignat re
P-se 1 of 3
DO NOT WRITE BELOW THIS LINE 141)"77?)-
SUB
TYPES I� ll �
Foundation Pu I'lc"Faclity ,, Exterior A atioiApartments
? Commercial/Industrial Accessory Building Exterior Alteration-Commercial
l" 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
K Replace 6 Water Damage Fire Repair Retaining Wall
Salon Owner Change *Demolition of entire building-give PCA handout to applicant
DESCRIPTION
Valuation ..•o Occupancy f it ) MCES System
Plan Review Code Edition t, +,.F n'1 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 CIO Inspection: Schedule Fire Marshal to be present: Yes No
Reviewed By: , Planning New Business to Eagan:
Reviewed By: , 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: 21(.9 (-)
Treatment Plant(Irrigation)
Park Dedication
Trail Dedication TOTAL: /I ( 'fes. 0
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