EA188728 - Plumbing - Commercial - Issued Date 01/09/2024 PERMIT
City of Eagan ® , , Permit Type: Plumbing
3830 Pilot Knob Rd ��.;� °e Permit Number: EA188728
Eagan, MN 55122 EAGAN
(651)675-5675 * E A 1 8 8 7 2 8
www.cityofeagan.com
Date Issued: 1/9/2024
Site Address: 3500 Lexington Ave
Lot: 1 Block: 01 Addition: Parkside
PID:10-56775-01-010
Use: * 10 - 56775 - 0 1 - 0 10 *
Description:
Sub Type: Commercial
Work Type: Replace
Description: PVB
Meter Size Meter Tyne Manufacturer Serial Number Remote Number Line Size
Comments:
Fee Summary: PL-RPZ/PVB/Lawn Irrigation $64.00 0801.4087
Surcharge-Fixed $1.30 9001.2195
Total: $65.30
Contractor: - Applicant - Owner:
Interstate Testing LLC Monument Parkside LLC
PO Box 55 5200 Blue Lagoon Dr Ste 400
Anoka MN 55303 Miami FL 33126
(763)744-6149
This permit shall be null and void if work does not start within 180 days of issuance,or if work is suspended for 180 days or more after
started.
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Applicant/Permitee: Signature Issued By: Signature
------------------
For Office Use I
4 B � Permit#:
Permit Fee:EAGAN
J
I I
I
Staff: I
7__ ______________-
3830 PILOT KNOB ROAD i EAGAN, MN 55122-1810 1 Payment Recvd: _Yes No 1
(651)675-5675 1 FAX: (651)675-5694 1 I
Email: buildinginspectionsp_cityofeagan.com I I
I Plans: Electronic _Paper I
-------------------
2023
----------------J2023 COMMERCIAL PLUMBING PERMIT APPLICATION
❑ Please submit one set of electronic plans via email
Date: 6/23/23 site Address:3500 Lexington Ave.
Tenant: Suite M
tProperty l Parkside Apartments c/o Monument Real Estate
Owner l Name: p Phone: (651) 654-9118
Name: Interstate Testing, LLC PC751575
License#:
Contractor Address: P.O. Box 55 city, Anoka state: MN zip: 55303
I
Phone: (763) 744-6149 Email: interstatetesting@comcast.net
_ ..1 �
New Construction Addition Modify Space
✓ Replacement Repair Rebuild Work in Right-Of-Way
Description of work: Installed 1"Wilkins 720A Serial#: CAA73825
I Irrigation System(_yes I_no)(_RPZ/ PVB)
Type of Work I
I • Rain sensors required on irrigation systems
j • Avg.GPM (2"turbo required unless smaller size allowed by Public Works)
s
Meter Required—Call Utilities at(651)675-5646 to verity tests passed prior to picking up meter. I
Domestic:Size&Type Fire: 1
Y I
Average GPM High demand devices? Yes No Flushometers Yes No
COMMERCIAL FEES600
Contract Value$ x.015
$65.00 Permit Fee Minimum
$ 65.00 Permit Fee
$65.00 PVB/RPZ Permit(includes State Surcharge)
$ .30 Surcharge
I Surcharge= Contract Value x$0.0005
If the project valuation is over$1 million, please call City for Surcharge $ 65.30 TOTAL FEE
The following fees may apply when installing a new lawn irrigation system or $ Water Permit I
connecting a new water service. $
Treatment Plant
Contact the City's Engineering Department,(651)675-5646,for required fee amounts.
y $ Meter Fee I
I $ Radio Read I
----------------------------------------------------------- --------------- $ State Surcharge
_$65.30
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.
XDonn Miller X 4 'r /7 C
Applicant's Printed Name Applicant's Signature
Interstate Tic#n& LLC
P.O.Box SS Backilow Assembly Test Report
Anoka;,MN SS303 (RPZ, MAI PVB,SP'VB,)
(763)744-6149
49
tnteirstatetesting0camcast.stet Cit: Eagan
Property/Owner lnfomiatlon
Property Nagle, Parkside Apartments
Property Addr ew: Adds
3500 Lexin ton Ave.
city, Slane: xip.
Ea an MN 55123
Property Contact/phone#; starve: Phottr.
Jerry Ehr 651 354-9118
Property yrs Addrerst Address
3500 Lexington Ave. Eagan, MN 55123
City: state. xip-
Ea an MN 55123
Property Owner/Phose#: Name- phww
Monument Real Estate Management 651 354-9118
Type of Assembly/ ork Performed
APS PVB SPV8 DCVA
Test R Is 1W Test_,L Re s RB Test Ra Ria 'test,..,.,.Rtpalr,..,..,_RIB ...,_
Backflow Assembly information
Size: I4ake Model. !M=serviced..
1" Wilkins 720A CAA73825 Irrigation
Ly don of Arse;;;@ c Behi garage y sl
ewa jattachedto ui ding
Backflow Assembly Test Results
Type of Check Val"#1 Rhea Off valve#Z ReUef Vallve/ Check VsAve#2
Agg.*Ij Air Inlet Valve
RPS Open Closed— Open Closed— Opened at aid o closed—
Psessttre Did_._.-.. .pzid tlid not Oren
DcvA OP" C — open.. .... Closed�.� Open Closed
l'"ttre 01% pato pr+easre UM—psld
PV$f SP'VB opm— cta .,..X— Opened at .88 pso
re
Pre Dltlt�psid ' ...._ dosed..,.�-. Did am GPM
Comments.
PASS X FA1�
Tester's Information
Tester's Name. Tester's Signature; Cesdfication N, Date:
Donn Miller 8F065323 06-23-23
3
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