EA181526 - Plumbing - Commercial - Issued Date 03/03/2023 PERMIT
City of Eagan Permit Type: Plumbing
3830 Pilot Knob Rd ,��;,� ®.', Permit Number: EA181526
Eagan,MN 55122 •--- e'-� EAGAN
(651)675-5675 1111111111111111111111111111111111111111111111111
www.cityofeagan.com * E R 1 8 1 S Z 6 *
Date Issued: 3/3/2023
Site Address: 3400 Yankee Dr
Lot: 012 Block: 1 Addition: Comsery 1
PID:10-18200-01-012
Use: Blue Cross * 1 0 — 1 8 2 0 0 — 0 1 — 0 1 2
Description:
Sub Type: Commercial
Work Type: New
Description: Grease Trap
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:
Fee Summary: PL-Plumbing Commerical% $65.00 0801.4087
Valuation: 4,000.00 Surcharge-Based on Valuation $2.00 9001.2195
Total: $67.00
Contractor: - Applicant - Owner:
Schadegg Mechanical Inc Health Landlord(Mn)LLC
225 Bridgepoint Dr %Bcbsm Corporate Tax Dept M104
South St Paul MN 55075 PO Box 64560
(651)292-9933 Saint Paul MN 55164
This permit shall be null and void if work does not start within 180 days of issuance, or if work is suspended for 180 days or more after
started.
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Applicant/Permitee: Signature ZA-rssu B. : Signature
r----------------
IFor Office Use I
I
// Permit#: 181526
s/ ®/
I I
Permit Fee:
EAGANINECEIVEn
I
I Staff: I
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 1 I Payment Recvd: Yes No
(651)675-5675 1 FAX: (651)675-5694 I I
I I
Email: buiidinginspections cr.cityofeagan.com BY:__ I plans: Electronic _Paper I
---------- ---�
2023 COMMERCIAL PLUMBING PERMIT APPLICATION
❑ Please submit one set of electronic plans via email
Date: ,f K�� � Site Address: L V� /Z e{-t ✓r.L
Tenant: C .YW�a ,.� Suite #:
Property
Owner Name: Phone: E�✓"� �'� � �'
Name: {4i� ra�a�,�'..c/ License#: -� Y/ >r��
Contractor
Address: ,�r �%�'i::C>c+,/JniX/l City: State: Zi P�
r �
Phone: � r157 V� Email: c r}�t % c:. ; .�`� £ ��e <re.v—
New Construction d"_Addition Modify Space
Replacement Repair _Rebuild Work in Right-Of-Way
�'"� .�
Description of work: �� .-- y�- L X _ 1", c -F't
Type of Work Irrigation System L_yes/_no)(_RPZ/_PVB)
• Rain sensors required on irrigation systems
• Avg.GPM (2"turbo required unless smaller size allowed by Public Works)
Meter Required–Cali Utilities at(651)675-5646 to verity tests passed prior to picking up meter.
Domestic:Size&Type Fire: 1
Average GPM High demand devices?_Yes No Flushometers_Yes No
COMMERGIAL FEES ^`
Contract Value$ ���'��' _X.0115
$65.00 Permit Fee Minimum r 4 —
$65.00 PVB/RPZ Permit(includes State Surcharge) $ Permit Fee
Surcharge=Contract Value x$0.0005 $ cam' Surcharge
If the project valuation is over$1 million,please call City for Surcharge $ 45 1 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
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.cityofeagan.com/subscribe.
CALL BEFORE YOU DIG. Contact Gopher State One Call at(651)454-0002 or www.gopherstateonecall.org for protection against underground utility
damage. Contact Gopher State One Call 48 hours before you intend to dig to receive locates of underground utilities.
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.
Applicant's Printed Name Applicant's Signature
eel
4S