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C112 Use BLUE or BLACK Ink For Office Use `71, Permit*. / `/ City ofty f Permit Fee: ge)- 3830 Pilot Knob Road _ , Eagan MN 55122 Date Received: (( (2 Phone:(651)675-5675 buildinginsoections@citvofeagan.com Staff: AtuJ 2017 COMMERCIAL BUILDING PERMIT APPLICATION:. C 1,:1 Pit'Date: Site Address: / (�&sS�C l ®cec //2 U i3/1 / ,/ � Tenant Name: � Cl�t t/C Y' (Tenant is: /� New! Eidsting) Suite#: Former Tenant: / Name: /3r�/ k� C' V r Phone: 6/. —%'767-2‘/O 26/o Property Owner Address/City/Zip: /3 /IS /-L,., c=Serd, Applicant is: / Owner Contractor ✓ Type of Work Description of work: 4 vvo,,,,,t vn-T° �`� �'/ �a�i s r, e.<4:-4/ r-- Construction Cost: v Name: /7 J` ''t License it: Contractor Address: City; State: Zip: Phone: Contact: Email: Name: /V40 el <• Registration it: Architect/EngineerAddress: 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 are 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 y's website at www.citvofeaaan.comi subscribe. CALL BEFORE YOU DIG. Call Gopher State One Call at(651)45440002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.aooherstateonecall.orci 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 whic equires a review and approval of plans. x / </ '!� 1�f/' Applicant's Printed Name App cant's Signature Page 1 of 3 Sz_i C q 3s_ cl-- - c i 14117g1 DO NOT WRITE BELOW THIS LINE SUB TYPES Foundation — Public Facility _ Exterior Alteration-Apartments _Commercial/Industrial — Accessory Building _ Exterior Alteration-Commercial _ Apartments — Greenhouse/Tent — Exterior Alteration-Public Facility Miscellaneous Antennae — WORK TYPES New ✓ Interior Improvement — Siding _ Demolish Building* Addition _ Exterior Improvement Reroof _ Demolish Interior _ Alteration — Repair Windows _ Demolish Foundation — Replace — Water Damage _ Fire Repair _ Retaining Wall _ Salon Owner Change *Demolition of entire building-give PCA handout to applicant DESCRIPTION Valuation 5o O. a..pi Occupancy S. / MCES System AV* Plan Review Code Edition ZO 1 T P1IC.- SAC Units / (25%_100% ) — Zoning Pb City Water ✓ Census Code Stories / Booster Pump #of Units I Square Feet PRV #of Buildings ( Length Fire Sprinklers Type of Construction V'8. 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 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 _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:----7Yes No Reviewed By: ,Planning New Business to Eagan: Reviewed By: Chi e, , Building Inspector FEES / Water Quality Base Fee Y"O.5-0 Storm Sewer Trunk Surcharge /ill GLO Sewer Trunk Plan Review itlo VE 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: 4Trail Dedication TOTAL: Sid Page 2 of 3