EA187149 - Plumbing - Commercial - Issued Date 09/28/2023 PERMIT
City of Eagan Permit Type: Plumbing
3830 Pilot Knob Rd '� � Permit Number: EA187149
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Eagan, MN 55122 EAGAN
(651)675-5675 1111111111111 IN 11111111111111111111111111111 IN
www.cityofeagan.com * E A 1 8 7 1 4 9 �K
Date Issued: 9/28/2023
Site Address: 1436 Lone Oak Rd
Lot: 1 Block: 1 Addition: STEM Magnet Elementary School
PID:10-72545-01-010 [9111111111111111111M EM
Use: Independent School District 197 * 1 0 — 7 2 5 4 5 — 0 1 — 0 1 0
Description:
Sub Type: Commercial
Work Type: New
Description: RPZ
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:
Fee Summary: PL-RPZ/PVB/Lawn Irrigation $64.00 0801.4087
Surcharge-Fixed $1.00 9001.2195
Total: $65.00
Contractor: - Applicant - Owner:
Commercial Plumbing&Heating Independent School Dist 197
24428 Greenway Ave 1897 Delaware Ave
Forest Lake MN 55025 Mendota Heights MN 55118
(651)464-2988
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 Issued By: Signature
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I For Office Use I
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Permit#:
Permit Fee:
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3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 r
Payment Recvd: Yes No
(651) 675-5675 1 FAX: (651)675-5694 I I
Email: buildinginspectionsCaD_cityofeagan.com I
l Plans: Electronic _Paper I
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2023 COMMERCIAL PLUMBING PERMIT APPLICATION
❑ Please submit one set of electronic plans via email
Date: 9/28/23 Site Address: 1436 Lone Oak Rd
Tenant.. Pilot Knob Elementary suite #:
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Property Independent School District 197 Phone:
Owner Name:
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Name: Commercial Plumbing & Heating, Inc. License#. PC643117
ContractorAddress: 24428 Greenway Ave city: Forest lake State: MN Zip: 55025
Phone: 651-464-2988 Email: mwisgerhof@cpandh.com
New Construction Addition Modify Space
Replacement Repair Rebuild Work in Right-Of-Way
Description of work: Add RPz for dishwasher
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Type of Work t Irrigation System(_yes/_no)(](RPZ/_PVB)
• Rain sensors required on irrigation systems
• Avg. GPM (2"turbo required unless smaller size allowed by Public Works)
Meter Required—Call Utilities at(651)675-5646 to verity tests passed prior to picking up meter.
Domestic:Size&Type Fire: 1
a
Average GPM High demand devices? Yes No Flushometers Yes No
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COMMERCIAL FEES
Contract Contract Value $ x.015 !
$65.00 Permit Fee Minimum 65.00
$65.00 PVB/RPZ Permit(includes State Surcharge) $ Permit Fee
$ Surcharge
r Surcharge=Contract Value x$0.0005
If the project valuation is over$1 million please call City for Surcharge $ 65.00, TOTAL FEE
The following fees may apply when installing a new lawn irrigation system or $ Water Permit
connecting a new water service.
x
Contact the City's Engineering Department, (651)675-5646, for required fee amounts. $ Treatment Plant
$ Meter Fee
$ Radio Read
$ State Surcharge
_$65.00 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.
x Derrek Skeie x Z;)"A4,161
Applicant's Printed Name Applicant's Signature