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3535 Blue Cross Rd 07/30/2012 09:34 FAX 6512929929 Schadegg Mechanical 100001/0001 Use BLUE or BLACK Ink - - - - - - - - - - - - - - - - For Office Use I City j Permit ~'7 'e'-) I of Eakan I a I Permit Fee: 3830 Pilot Knob Road Eagan MN 55122 I I Date Received: I Phone: (651) 675-5675 Fax: (651) 675-5694 Staff: I 2012 COMMERCIAL PLUMBING PERMIT APPLICATION r/Ca ~Pr ❑ Please submit two (2) sets of plans with all commercial applications. //6'/~ / Q Date: 740 Site Address: GCGfi.O Tenant: ~l~c e ~/223r Suite f1: PROPERTY ONWER Name: e001&/e/~ Phone: lazl Name: Jc ~C4o~esr ~F~/4 License CONTRACTOR Address: „S J f&-- ~ State:, ip: O&V QC~ /Y se /e+~ V Phone: Email: E+a~-~ JrC-"0L.. c~ .Cc TYPE OF -New _ Replacement _ Repair _Rebuild ✓Modify Space - Work in R.O.W. WORK Description of work: IA- COMMERCIAL _ New Construction Modify Space Irrigation System L- yes no) C_ RPZ PVB) • Rain sensors required on irrigation systems P;E.RMITTYPE . Avg. GPM (2' turbo required unless smaller size allowed by Public Works) Meters Call (651) 675-5646 to verity that tests passed prior to picking up meter. Domestic: Size & Type Fire: 1 Avg. GPM High demand devices? Yes No Flushometers -Yes No COMMERCIAL FEES: eac $60.00 Minimum (includes $5.00 State Surcharge) OR Contract Value $ 6Q6 - X1% Permit Fee Required on ALL new buildings and boulevard irrigation systems 4 $ Radio Meter Read - If the Permit fee is less than $10,010, the surcharge is $5.00 $ Meter(s) - If the Permit Fee is > $10,010, the surcharge increases by $.50 for each $1,000 Permit Fee i.e. a $10,010-$11,000 Permit Fee requires a $5.50 surcharge) $ State Surcharge Following fees apply when installing a new lawn irrigation system $ Water Permit Contact the City's Engineering Department, (651) 675-5646, for required fee amounts. $ Treatment Plant $ Water Supply & Storage $ State Surcharge c96' 960 0 TOTAL FEE 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.gopherstateonecall_oro I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and cedes 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 x Applicant's Printed Name Applicants Signature . FOR OFFICE-USE Approved By. Required. Inspections: -Under Ground Rough-In Air Test -Gas: Test Final. PRV Required: -Yes No - Cre~ Page 1 of 3 ~~i- dx From:Metropolitan Mechanical 19529419118 08/09/2011 13:35 #049 P.002/003 Use BLUE or BLACK ink . For I Office Use Permit I I City of Eqan I Permit Fee: 3830 Pilot Knob Road t Eagan MN 55122 i Date Received: I Phone: (651) 676.5675 I StaS. ~ Fax: t651 675-6694 L 2010 COMMERCIAL PLUMBING PERMIT APPLICATION Date: 12Q ~ Site Address: v ~ L7` 1 c t A:>.1 Qjoo),~ Tenant: E7`\~ U~J Q~ 1 ~1 Suite PROPERTY OWNER Name: k~~V . C %S~SS V ' SL-" ) QA. ) Phone: CONTRACTOR Name: Doody, Mechanical Inc License L098-06696 Address: 7450 Flying Cloud Dr City: Eden Prairie State: MN Zip: 55344 Phone: 952-941-7010 Email: rachel.i.nselman@dooahTech.us TYPE OF _ New _ Replacement Repair X Rebuild Modify Space Work in R.O.W. WORK Description of work: ~P 1 V t PERMIT TYPE COMMERCIAL New Construction Modify Space irrigation System yes / _ no) RPZ l PVB) v: Rain sensors required on irrigation systems Avg. GPM (2° turbo required unless smaller size allowed by Public Works) Meters Call (651) 675-5646 to verity that tests passed prior to nicking up mister. Domestic: Size & Type Fire: 1 Avg. GPM High demand devices? -Yes No Fiushometers `Yes No COMMERCIAL FEES: $55.00 Minimum (includes State Surcharge) OR Contract value $ x1% Permit Fee Required on ALL new buildings and boulevard irrigation Systems -a = $ Radio Meter Read If the Permit Fee is toss than $10,010, the surcharge is $5.00 $ Meter(s) - If the Permit Fee is > $10,010, the surcharge increases by $.50 for each $1,000 Permit Fee (i.e. a $10,010$11,000 Permit Fee requires a $5.50 surcharge) State Surcharge Following fees apply when installing a new lawn irrigation system. $ Water Permit Cali the City's Engineering Department, (651) 675-5646, for required fee amounts: $ Treatment Plant $ Water Supply & Storage $ State Surcharge TOTAL FEES i 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.gopherstateonecall.org I hereby accravdedge that this information is complete and accurate; that the woric 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 Pwork which requires a review and approval of plans. S(X\ x PaLKa-~- . . Appllcanrs Printed Name Ap licanrs Signature FOR OFFICE USE Approved By: Date: .._.i..- n.........+ n--L, I- A;. T-41 !_ne Tool cinol Dow Dewildresl• - Yrae w" JUL 2011 Use BLUE or BLACK Ink For Office Use j j Permit* 0 ® I City of Eajan 1 Permit Fee: 1 3830 Pilot Knob Road 1 I Eagan MN 55122 Date Received: j Phone: (651) 675-5675 I 1 Fax: (651) 675-5694 I Staff: I I ~r-- 2011 COMMERCIAL BUILDING PERMIT APPLICATION ~l Date: duly 13, 2011 Site Address: 3535 Blue Cross Road Tenant Name: Blue Cross Blue Shield (Tenantis: - New/ - Existing) Suite#:N/A Former Tenant: N/A PROPERTY OWNER Name: Blue Cross Blue Shield Phone: Address/City/Zip: 3535 Blue Cross Road Applicant is: Owner X Contractor TYPE OF WORK Description of work: Build 1 New Office Construction Cost: $8,000.00 CONTRACTOR Name: C.F. Haglin & Sons, _Inc. License N/A Address: 3939 I-lest 69th Street City: Edina State: MN zip: 55435 Phone:952-920-6123 Contact: Gary Gunderson Email: qqunderson@cfhaglin.com ARCHITECT / Name: Arch i tectural Alliance Registration 20915 ENGINEER Address:400 Clifton Ave. S. City:. Minneapolis State: MN Zip: 55403 Phone: 612-871-5703 Contact Person: Jon Stone Email: Licensed plumber installing new sewer/water service: N/A 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 the are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for pro ction again nd rgro d utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. herstateo II. r I hereby acknowledge that this information is complete and accurate; that the w k ill be in c rm n with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an ap n for a per t, a ork is not to start without a permit; that the work will be in accordance with the approved plan in the ca f ork hich req ' iew and a X GAry Gunderson X Applicant's Printed Name Ap ignature Page 1 of 3 i_ 6/cue cry a `3 53- 1&2(Al DO NOT WRITE BELOW THIS LINE SUB TYPES Foundation ,Public Facility _ Accessory Building Apartments _ Commercial / Industrial _ Exterior Alteration-Apartments _ Lodging _ Greenhouse / Tent _ Exterior Alteration-Commercial Miscellaneous _ Antennae _ Exterior Alteration-Public Facility WORK TYPES New _ Interior Improvement Siding _ Demolish Building* Addition _ Exterior Improvement Reroof _ Demolish Interior Alteration _ Repair Windows _ Demolish Foundation Replace _ Water Damage Fire Repair _ Salon Owner Change Retaining Wall *Demolition of entire building - give PCA handout to applicant DESCRIPTION Q 00 Valuation 'U Occupancy MCES System /C)Od Y ~c--5 A 9 Plan Review / Code Edition a 007 SAC Units (25%_ 100%Zoning City Water yes Census Code Stories Booster Pump # of Units Square Feet PRV # of Buildings Length Fire Sprinklers e,S Type of Construction Width REQUIRED INSPECTIONS Footings (New Building) Sheetrock Footings (Deck) Final / C.O. Required Footings (Addition) ✓Final / No C.O. Required Foundation Other: Drain Tile Pool: -Footings Air/Gas Tests -Final _/Roof: -Decking -Insulation -ice & Water -Final Siding: -Stucco Lath -Stone Lath -Brick V/ Framing Windows Fireplace: -Rough In Air Test -Final Retaining Wall Insulation Erosion Control Meter Size: Final C/O Inspection: Schedule Fire Marshal to be present: Yes ✓ No Reviewed By: A14 L Building Inspector Reviewed By: Planning COMMERCIAL FEES Base Fee . -25- Water Quality Surcharge ~4. 0~ Water Supply & Storage (WAC) Plan Review tQS, 9 ~ Storm Sewer Trunk MCES SAC Sewer Trunk City SAC Water Trunk S&W Permit & Surcharge Street Lateral Treatment Plant Street Treatment Plant (Irrigation) Water Lateral Park Dedication Other: Trail Dedication Water Quality TOTAL oZ 7~ .7 Page 2 of 3 ' Use BLUE or BLACK Ink For Office Use --------j - City of Et l~ I Permit I Permit Fee: ~ ' 6 j 3830 Pilot Knob Road Eagan MN 55122 Date Received: Phone: (651) 675-5675 Fax: (651) 675-5694 JUL 2 2011 I I Staff: 2011 FIRE SUPPRESSION SYSTEMS PERMIT APPLICATION* Date: 12-t Site Address: -~;536 l ~k~kk lL~ SS CX Tenant: ~ ~S ilk S~t~ SuiteM Name: T7kU-JP CVTSS'b(U-P U Phone: PROPERTY OWNER Address / City / Zip: S~(,~~ p (Lc,SS KC Applicant is: Owner 11, Contractor TYPE OF WORK Description of work: 11,1\S+A- :Pvc V1 i Construction Cost: tq Estimated Completion Date: o Z- ,o t - JJJ Name: y ~~(A o . RA IJ`r:-LA-- License CONTRACTOR Address:, SO~ ~ a A-y-e- City: c~ ?L State: ~Ao Zip: r55 [;S Q Phone: t 0 ' J Ci Z3 Contact: 6 t L" V1 S' Q Email: &mll m `1u v~~K FIRE PERMIT TYPE WORK TYPE Sprinkler System of heads) _ New , Addition Fire Pump _ Standpipe Alterations _ Remodel Other: Other: DESCRIPTION OF WORK: Commercial Residential Educational FEES $55.00 Minimum (includes State Surcharge) OR Contract Value $ Z~S' k rD x 1% - If the Permit Fee is less than $10,010, surcharge is $ 5.00 . $ 2 O Permit Fee - If the Permit Fee is > $10,010, surcharge increases by $.50 for each $1,000 Permit Fee (i.e. a $10,010411,010 Permit Fee requires a $ 5.50 surcharge) = $ c Surcharge 5-0 TOTAL FEE 3/4" Displacement Fire Meter - $204.00 ~V A Fire Meter = $ Z 41 - S d TOTAL FEE *Requirements: 2 complete sets of drawings and specifications, cut sheets on materials and components to be used I hereby apply for a Fire Suppression System permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Minnesota Building/Fire Codes; 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 L~d"1 l Cpl -4~ x Applicant's Pri ted Name App icant's Si nature . CALL BEFORE YOU DIG. Call Lph~ra~teonhll 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. a herstateonecall.or FOR OFFICE USE REQUIRED INSPECTIONS Hydrostatic Flow Alarm Drain Test Rough In Trip Pump Test Central Station Final ( Conditions of Issuance: Permit Reviewe Date: / / 1UL/15/2011/FRI 11;37 AM Doody Mechanical FAX No.651 487 2637 P,002/002. _ Use BLUE or BLACK Ink P or ~ Kor Office use I 0 1 Permit# P,(jy) ((j^y~y'tn' I : I c ~ r a IRIKLL ~L t t I 1 h' n' j Permit Fee: l ~1V ' 0 01 3830 Pilot Knob Road U l3 L I Eagan MN 55122 I Date Received: I I Phone: (659) 675-5675 1 I staff... I Fax: (651) 675-5694 1 2011 MECHANICAL PERMIT, APPLICATION Date: ! y l0 Site Address' 1 3 /J(~e G+j°SS Tenant: U • Suite 0: I = Name: BI w-e- C 1" 40t U f- Phone Address I City I Zip; / Name: License 4: -3pS:4 7-fit] Address: City: 1- State: I V Zip: Phone: Contact: 1 k u aEtltaif P /aG/~o4. ttia~po~Yl L~ New _ Replacement _ Additional Alteration Demolition Description of work: W-%,q Cfu 1G ,F- r c„( s►,`fs + Ora RESIDENTIAL COMMERCIAL Furnace Now Construction Interior Improvement Air Conditioner _ Install Piping _ Processed _ Air 1=xcnanger Gas Exterior HVAC Unit Heat Pump ^Under I Above ground Tank Install / Remove) Other - RESIDENTIAL FEEES: $55.00 MlnImum Add-on or alteration town existing unit (includes $5.00 state surcharge) $95.00 Fire repair (replace burned out appliances, ductwork, atc.) (includes $5.00 State Surcharge) TOTAL FEE COMMERCIAL FEES: $75.00 Underground tank instalfatfonlremoval OR Contract Value $ f Q. X I% $55.00 MMIE)IMum (includes State Surcharge) /,~CK-_ C1o Permit Fae - If the Permit Em is less than $10,010, surcharge Is $ 6.00 - If the Pemlf ftg Is > $10,010, surcharge increases by $.50 for each $1.000 Permit Fee - $ a Surcharge (i.e. a $10,010411,010 Permit Fee requires a $ 5.50 surcharge) $ liozlrJ-5-- TOTAL FEE CALL 13EFORE 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. 7e wm,-gonherstateonecall.orn 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 workk is not to start without a permit: that the work will be in accordance with the approved plan in the ease of work which requires a review and approval of plans. Applicanrs Printed Name~ Applicant's Signature Tom` ~ v 1UL/15/2011/FRI 11,37 AM Doody Mechanical FAX No.651 487 2637 P.001/002 ___U_s_e BLUE or BLACK Ink - - - - For Office Uss t I j Permit / / ` Clay o~ Eakan „ I Permit Fee: a' 0 0 1 3830 Pilot Knob Road J U G 1 5 201171 1 I Date Received: Eagan MN 55122 CL 1 I Phone: (651) 675-5675 I staff: I Fax: (651) 675-5694 2011 COMMERCIAL PLUMBING PERMIT APPLICATION Date:-J-/p" Site Address: ~~ccz.e-- /,.Sj f- -Tenant Suite P I Name: GCV (ASS Q/ k "S11 (t~- ham` Phone: ~ - Name: Doody, A,,<kt al + 6,4( Llcen6e KSOvd-y f 511, Stale: Ivu ZIP" Address: OJ l At Phone: 651- W 1 /0 0 Email: pp ! k ¢ /'i mot` u ~~p ve .✓f'I • ~ e° -New _Replacement _Repair Rebuild ,L Modify Spaces _ Work in R.O.W. Description of worts: des jC,.- sa pf,;- d W ` i n COMMERCIAL _ New Construction Y Modify Space irrigation System yes I X no) RPZ I _PVB) - • Rain sensors required on irrigation systems + Avg. GPM (2- turbo required unless smaller size allowed by Public Works) Meters Call (651) 675-5646 to verity that tests passed prior to picking up meter. Domestic: Size & Type Fire: 1 Avg. GPM High demand devices? Yes `No Flushometers _Yes No COMMERCIAL FEES: $55.00 Minimum (includes State Surcharge) OR Contract Value $ r~;, Dt7J• x 1% = $ Permit Fee Required on ALL new buildings and boulevard irrigation systems $ Radio Meter Read - If the Permi Fee is less than $10,010, the surcharge Is $5.00 $ Meter(s) - If the Permit Fee is > $10,010, the surcharge increases by $.50 for each $1.000 Permit l=ee $ c~ State: Surchar e i.e. a $10,0i0:-$11,000 Permit Fee re uires a $5.50 surcharge 9 Following fees apply when installing a new lawn Irrigation system $ Water Perm It Contact the City's Engineering Department, (651) 675-55646, for required fee amounts. $ Treatment Plant $ Water Supply & Storage $ State Surcharge - $cP S~ - - TOTAL FEE CALL BEFOI;E 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.dooherstateonecall.orv 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 Fagan; 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 9!p", X G 1fa $ x ~ Applicants Printed Name Applicants Signature - gig. Page 1 of 3 INSPECTION RECORD MY OF EAGAN PERMIT TYPE: # 14 38W Pilot Knob Road Permit Plumber: 0,- 4 1. Eagan; Minnesota 55123 Date Issued: 011 /1 t /44 (61 681-4675 SI'D'E ADDRESS: 1 fit of r _ # APPLICANT: 3:'A! t.CI€';.#i _ id r :1.i F311lf:1 t- I? V IC l PERMIT SUBTYPE: TYPE OF WORK: ~ "01 fill 1~141111'11 1014 DA 'PICV,4 TYPE F0.01'1NGS': i RAM 1146 h6 # hl F' 1_ [,i 4r r:~ t # x, 11 Pd 111,6 1` 1:NA1 P1 1t#t 1` 1 h1~1 1416 fINAU 71 o r Q a NSPEC ir ONR'' ECORP,,,~,.- "OO EA OA N PERT' TYPE ~,1 s s r Not F ob Road P®rXYii~ PJatrttt~ar ~ ~ ~ azx Mart sses 551 Date li§w4od~ 1.1 W'x.-4675 APPUCANT: l ti'1 .l it I. t.1c f.: /j ) 31. Ef tl'., if t.1 i^ 1"6f 11.f it II i tlpll,'1 (J) TYPE OFWORK: C 4WM , P Oft N F 1 t tit # RAM ! Ntj t r +>li~t'i11' y4_i~ ~ {r~1t,j'-. Itlttttrl'1 C ~ 1 1i VINAt r1~144 1 t RA I 1# F 3NA1 RVMAI'31('~3` i1111,AkAIf Illf IMI i fiRf'' 14011.1 1:f 0 4fW AN Y 1'1 4}b' HI N(a 41t V1 V 1R ICAt. Ul)1.4K, t Psr" No. P Nokler Doe TaMphons i S/W PLL"M a g HVAC ELECTR .fir,, °tr IQkpL ELECTIR t Dab &w. Commits f Foowsi Fourclation Frarning R Z YI 4rw Q Rough Ptbg. I Rough Htg. f _ t jt4-!4-~L Tsui. " a 1 o 191 101 Aj" Ftrepiace Fc~e Final Mg. Orsat Test Final Plbg. Plbg. Inspector - Notify Plumber Const. Meter Engr./Man Bldg. Final Dec* Ftg. Deck Final Well Pr. 134. PECTION RECORD I "NS #~TY OF EAGAN PERMIT TYPE:., c Pilot Knob Road Permit Number: 'Eagan,. Minnesota 55123 Date Issued: t to 94 (612) 681-4675 SITE ADDRESS: APPLICANT: I. if I 1 I1I fit t, : I tat0k, 4.I: f.) € 1i mi"(1041NII ::(trt'_yr (0 PERMIT SUBTYPE: TYPE OF WORK: DA T cap N I-, w : F 00 .1 H G F { PerffAt Om P t i HVAC ELECTRIC ELECTRIC tnlpewon Date blew conmwrft ,/f 14)AC Framing t Roofing i f Rough Pibg Rough Htg. fsul. i Fireplace Final Htg. Orsat Test Final Pibg. Pibg. Inspector - Notify Plumber Const. Meter EngrJPian Bldg. Final Deck Fig. Deck Final Well Pr. Disp. L F EAAN M PERMIT TYPE. k 3830 PHt Knob Road Permit Nuimber:+ EAgan, Minnesota 55122-1897 Date Issued: (612) 681-4175 SM ADDRESS: APPLICANT: LOT% I Ht.OC : 1. fi 3ta Otf)f CROSS RD "I'M CROSS 633-6060 ERWT SUBTYPE: TYPE OF WORK: CO*". /TNV. IMtTSC iw l l> A x> N INSULATION (>UQH IN Klee ROUGH IN "TO FINAL HT6 IlfAt i OEMARKSt P#.AM 1~?EVItWI,'O MY WAVM1~ MTt.LER. ARCHIT CTz MC,',O n" C;oWITRUCTTON i Permit Holder. Date Telephone III PLUMBING HVAC Inspection Date Insp. Comments FOOTINGS i FOUND FRAMING /10V ROOFING I ROUGH PLUMBING I, PLBG AIR TEST ROUGH 14EATING GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL 4 DOMESTIC METER IRRIGATION METER FLUSH MAINS CONDUCTIVITY TEST l HYDROSTATIC TEST 1 BSMT R.I. i BSMT FINAL DECK FTG DECK FINAL I ` M OF EAGAN INSPECTION RECORD" PERMIT TYPE. Pilot Knob Road Permit Nur►tber; , t Eagan, Minnesota 55122-1897 Date I ue&. X12! f~~,l ~ (612) 681:4 7 -AM ADDREW: i s 1 G C~ C l APPU CANT: 61,11F CROSS RD "43-' 680 T TYft, a TYPE OF WORK: s" 77 91- 'AT4 FINAL *ARkSr PLAN R Vi:C100 By f)At 3WHOEPPINIE'R< BL ids CROSS I THIF AF#C ltIY~C7 Mme ..mot`:-'- _ • _ ;fta+ Permit Holder Date Telephom I PLUMBING HVAC Ingpection Date IMP. Commerft FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST k INSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG f ORSAT TEST {g BLDG FINAL /Q p , off DOMESTIC h METER IRRIGATION METER FLUSH MAINS CONDUCTIVITY TEST HYDROSTATIC TEST BSMT R.I. BSMT FINAL DECK FTG i DECK FINAL r w 1 INSPECTIO MOIL MIT TYPE: "Pilot Ki*b Road > it tva►r,lber: Eagan, Minr)6SOta 55122-1897 f (612) 681-4675 MADDREss: ` ' • APPLICANT: f t. T MVIF CROSS SUBTYPE: TYPE OF WORK: 1~Ml. 1T#Cl a MEW c RIMAR`951 PLAN RFVFWF() 13Y DAU SC"OEPPOE f I Permit Holier Date Telephone # PLUMSING HVAC !Tpaction Date hup. Comments FOOTINGS POUND FRAMING ROOFING ROUGH f PLUMBING PLBG AIR TEST ` ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL DOMESTIC METER IRRIGATION METER FLUSH MAINS CONDUCTIVITY TEST HYDROSTATIC TEST BSMT R.I. BSMT FINAL DECK FTG i DECK FINAL s t `7 Jl1cHAJ1rrJ. Ji) ' CITY OF MI FSO Fill in numbered f TY/M ar Ni T~ E 1. 9~g 2. Installation Cost IF-0-4020 3. Job Address POAQ Lot Blk. T"w i 4. Owtw 8~ C~cw cis 5 f 1 ~K ~ t k=tom S, Ciontrattor A+4a S s4/ - &rc. C t* jpos" ON" 3 (o` 6. J Co (v A*lress 7, City 1~O L St~te Zip ng Type: Residential © Corrrmercial 0 Institutional 9. Work Description: New Cl AcleJ~ Alter © Repair 0 t~ ''J'. Describe Fuel Type I. gwiamml STU - M. Ea. No. Equip CF Forced Air z. Wig. Sollars mech. E Mfg- Unit J*ater Mfg. 4#ser ; rte. wt,~ j X- Air Cond. IW • Gay PlPhV Outlets f •a 12. } ttsttelsy certify that flee above inferrnaAon is true and correct, and I agm to Of sapr}r. pCrt y ar th 11 o trances and raq 4 r ng this type p 3 Sip"d .f - i. • rye" 4 ..Firms -7a Y y ~ Vi ~~yya'~[~``+fyl1 i~>~ 'FF/110M k CfTy Of Vat 30t CITY OF I&AGAK 3. MPWY TOL 2. I"Kirtion 3. JebAddress.~5-~3-5- 4. Owner 5: Contractor 6-t.-r C aL , 1~ Gc , Pht~+e fv 4/~` S. Address 7. city state X/xj z' 5 -w~ !t~ & Building Type: Residential 0 rrtrnereial rR lrrstitFaoomt. 9. watt Description: ' tow-"f I Add ~ Aft" CI " ft"ir Describe Fuel Type y BTU - M. No. ~ ~s, Cfm Forced Air x Air Hwmw;tw Mfg. Boilers Mfg. Unit Heater M%. O#W w Air Cond. Mfg. Gam, Piping Outlets, hen 6v certittr *St the abow intormwatfon is ttto and entreat, and I arm to oarnplV" with all OrdnWkM WW codes * type of we*. ..rrs awwad: b"poctiom: Ovis Insp. Dam If", 4 s is vo* wit wh at am a rmed. ; , P .O. i -Ift, E69W V FAR a6 _ hn PHONE' 4544100 Recraipt# ' ovedfor IA"M1 us M0*000 pate g 9 ~~8 a , 3535 ELM CROSS ROAD Erect ~ Occu{cy 01, del .__SectS twx CROSS Remo C3 Zoning - Lot st Parcel No. Repair d 'type of Const Addition No. Stories Name 1"R CROS&$ ! rtl8 SHIMD OF, ove Length Demolish Depth Addres$ SAM int. impr. Sq. Ft. city Phone a~ Install hlaMe ~ sR MSTRMTIAN CO Approval Foes + 2 X37 a{- rAIRVIEW AVE Assessment P nit ~t K Address city PT A~~ 633•-SOSO Water & Sew. Surcharge - 17 S RAI# ALLIANCE Police PAC ~ieu+ew ~~~ys A o 41 AVE So Fire s Eng. Water Conn. _ t _ Pt}ane 6"'03 Planner Water Mir Council Road Unit t heraby ack thatl have read this application and statethatthe Bldg. Off. T Tr. pI. information Is rrect and agree to comply with all applicable State of -APC Parma Minnesota Statutesand lty =gan-;40~ ces. Var. Date Signature of ~ I Iota l MCGOUCH A BuiWing Permit is issu*d *F to. l".+ +i it 'ICl~I Z on the express onn4400 ow . *111 work s Wt be dome in accordance with all applicab ' state of Min to Sta City of Eagan Ordinances. Widing Official , lino limiu m Dow r*"hww # ~ © o0 34 ~~S ~ !G/off //3~ csa rU,4c- 111-1-1 0 411/97o . ov Dab hop. commwft fo*Wp N FoundaVan W lRoafts_ pbl~ gzA Fqw PH* w~• - o v , 1-7 . au.p. ~I F _ PLUS PeRwT CITY OF EAGAN RECEIPT ~ ~^y 95 aO 8830 PILOT KNOB ROAD, EAGAN, MN $8121 DATE: / t - - CONTRACT PRICE: t Z, (V PHONE: 4644100 Sine Adds 1 C C f BLDG. TYPE WORK CR Lot Block SeclSu Res. New _ ? Name ro7 - Mutt Add-on~~ . m Address S 7r Comm. Repair c City$1 j?uu~ Phone Other dame V~- C C066. all 5,44 l NO. FIXTURES TOTAL I. C. C Yc~SS 2~ • Water Closet - $3.00 Addr s Bath Tubs - $3.00 p City h (A P Phone Lavatory - $3.00 Shower - $3.00 FEES Kitchen Sink - $3.00 ` COMMAND FEE - 1% OF CONTRACT FEE Urinal/Bidet -$3.00 MINIMUM - RESIDENTIAL FEE _$10.00 Laundry Tray - $3.00 MINIMUM COMM/IND FEE - 20.00 Floor Drains - $1.50 , STATE SURCHARGE PER PERMIT - Water Heater - $1.50 .50 Whirlpool - $3.00 (ADD $.50 SIC IF PERMIT PRICE GOES Gas Piping Outlets - $1.50 BEYOND $1,000.00) Softener - $5.00 q / Well - $10.00 bC . fI7~ Private Dlsp. - $10.00 Rough Openings - $1.50 r L12 SIGNATURE OF PERMITTEE FEE: T ~ STATE $!C: FORT CITY OF EAGAN . C tMIT # CHAN "L PE • MEC Of EAGJ M RECI T # (~p . Ll 3830 PILOT KNOB RQAt?,Alwl, MN 55121 DATE: CONTRACT PRICE: PHONE* 454-8100 " W, .5441 t: U.) BLDG. TYPE WORK D tt i Lot Block Sec/Sub Res. Now Name DMOV Mutt Add-on_ 0 Addr y(O_= Comm Repair c City ~-'i 00 1 Phone a? Other UC,Cr`0 Ue ledame . FEES Addy ' i U~ I RES. HVAC 0-100 M BTU .$24.00 p City Phone arw ADDITIONAL 50 M BTU - 6.00 ADD-ON AIR COND. 0-24 BTU - 12.00 TYPE OF WORK ADDITIONAL 6 M BTU - 6.00 GAS OUTLETS - 1511 EA. Forced Air M BTU COMM/IND FEE - 1% OF COWRACT-FEE a1' t3oiter M BTU MINIMUM - RESIDENTIAL FEE - 103 HORW M BTU 'MINIMUM - COMMAND FEE - .00 Air d. M BTU $ STATE SURCHARGE PER PERMIT 513 (ADD $.50 S/C IF PERMIT PRICE GOES Vim CFM BEYOND $1~*W.00) C3as Piping Outlets # i Y 1>fa i G T5___ apttLl R7 i~ FM- (Baum, eAk StC: p SIGNATURE OF PERMITTEE TOTAL: Ir .lt,r FOR: CITY OF EAGAN PERMIT i MECHANICAL PERMIT RECEIPT 60Y& ~90. CITY OF EAGAN CONTRACT PRICE: ~d• 3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE:'" PHONE: 4114-8100 $ite Address. BLDG. TYPE WORK DESC MPT1ON Lot 521--..- Block Sec/Su shept&wt 4 y Res. New Name -5 f Mult Add-on Address Comm. Repair City T. Pat-if Phone y"5 - Other Name 8/01e r O Z. 675e jZ17 FEES 3 Address 3S ` 61Q Q C OS^ Rd, RES. HVAC 0-100 M BTU -$24.00 p City 15 1 Phone- ADDITIONAL 50 M BTU - 6.00 ADD-ON AIR COND. 0-24 BTU - 12.00 r : TYPE OF WORK ADDITIONAL 6 M BTU - 6.00 GAS OUTLETS - 1.50 EA. Forced Air M BTU COMM/IND FEE - 1% OF CONTRACT FEE Boller M BTU MINIMUM - RESIDENTIAL FEE - 10.00 Unit Heater M BTU MINIMUM - COMWIND FEE - 20W Air Cond. M BTU STATE SURCHARGE PER PERMIT - .50 Vent CFM (ADD $50 S/C IF PERMIT PRICE GOES Gas Piping Outlets # BEYOND $1,000.00) ' Other rnocle t -yt FEE J SAC: S A RE OF PERMI E TOTAL: FOR: CITY OF EAGAN MECHANICAL tr ----r CI't`lf OF EA OKI . l F,11 in numperedspftw 1 ype or Print legibly Tat CI 1. Date 2. Installation Cost I Job Address ~~ot Blk. T C/t~--~ . 4. Owner ~ SS f ContractorllfUt~f'S loa ~ /Bone 6, Addre~~t >f 7r~ LJ/t% J 7, City af2L) state / zip 8. Building Type: Residential ❑ Commercials- Institutional Q g, Work Description: New Addk* After ❑ } Repair Q 10. Describe f l~'p"-' fC~~ry Fuel Type 11. NO. Equiumgm 8 TU - M. Ea. No, Et~uint CFAM Forced Air Air irt: Boilers Mech, E Unit Heater Wg• :fir Cond. ~ I IMS. . Piping Outlets 1Z 1 hereby r eify that eve information is true and comply +i * y #f ordfnanc rt gosrarning this type V 401-k. ~a~rt~l fat Fiat in Rovo Daft Pate Insp. This is Yaw permi~ n~ ec! and,p' ApPnDWd C1'g'Y #AGM ~'l , PW"dt IERW MECHANICAL Pr CITY OF EACA* ~ Fee r Type or Prim iwbiy Tea. 1. Elate 2. Installation Cost Job Addrew' ✓ ' ` a Blk. ~ ract 4. Owrw & Ccertractru 1' t f pkone f ~ Y 1 S. Address f `G r 9: ityi State -zip 70 v &-BWlcfing Type: Residential ❑ Commercial institutional Q 9. Work Description: New ❑ Add Alter ❑ Repair ❑ 10. Gibe Fuel Type - t ! 11 No. E%pijrment BTU - M. Fa. No. EauiortM CfM Forced Air Air Handling: Mfg. Bailers Mech. Exhaust Mfg. Unit Heater Mfg Kp ? • d r' Other Air Coed Mfg Gas, Piping Outlets Z f,.J} 12. 1 hereto Y rtify that Ow ab ro rnmtio true and correct, and 1 agree to cony with all or ces i~ des rning this type of work. Si9n~ Rough Final Inspections: Date , Insp. Date This is your permit when numbered and approved. Approved CITY OF EAGAN 854.8100 CITY OF EAGAN Remarks Addition7~ Blue Cross addn . Lot 3 Blk 1 Parcel10 14550111-30 91 Owner Street 3535 Blue Cross Rd. State Fa-gan,MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. 1971 5,198-90 519.89 10 Paid STREET RESTOR. GRADING SAN SEW TRUNK 1967 paid SEWER LATERAL WATERMAIN WATER LATERAL 1969 11 218.0 56o.92 10 Paid WATER AREA STORM SEW TRK 1983 36,432.00 2428.80 15 36 432.00 0007783 8-9-82 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. SAC PARK L VIL.U►GE OF EAGAN SEWER SERVICE 3795 Pilot Knob Road PERMIT NO.: S`T'ORM SEagan, MN 55122 DATE: 6/28/74 Zoning: Cl No. of Units: 1 Owner: Blue Cross Blue Shield of {MN Address: 1 Site Address: 3535 Blue Bross Road Plumber: Axel Newmann Plumbing & Heating t agree to comply with the Village of Eagan Connection Charge: Ordinances. Account Deposit: Permit Fee: 10.00 pd Surcharge: .50 pd By: Misc. Charges: Date of Insp.: Total: Insp.: Date Paid: a CITY OF EAGAN N2 18130 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 BUILDING PERMIT Receipt # -Le 44 - To be used for FTG/FOUNDATION Est. Value $325,000 Date JULY 10 , tg 90 Site Address 3535 BLUE CROSS ROAD Lot 1_ 2 _3 Bloc * Sec/Sub. Shur. OFFICE USE ONLY BLVE ROSS ADD Parcel No. C Occupancy FEES w Name BLUE CROSS/BLUE SHIELD Zoning $ 1,427.00 (Actual) Const Bldg. Permit o Address SAME (Allowable) - Surcharge 162.50 City Phone 456-8047 # of Stories 928.00 Length Plan Review a MCGOUGH CONST 900.00 R Name Depth SAC, City o~ Address 2737 NO FAIRVIEW AVE 55113 s.F.Total 5,400.00 SAC, MCWCC ~F City ROSEVILLE Phone 633-5050 S.F. Footprints - On Site Sewage Water Conn W W Name WTNSOR FART ^.Y JEFF WOLNI On Site Well - Water Meter vz Address 29 W 5TH ST MWCC System Acct. Deposit <z City ST PATTT, Phone 227-0659 City Water - PRY Required S/W Permit I hereby acknowlege that 1 have read this application and state that the Booster Pump S/W Surcharge information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Ea an 0 dinances. Treatment PI 2.268.00 Signature of Permite el APPROVALS Road Unit MCGOUGH 1-OiS~ Planner Park Dad. A Building Permit is is of to: on the express conditi that all work shall be done in accordance with all Council applicable State of Minnesota S tes and City o agan dinances. Bldg. Off. Copies Building Official Variance TOTAL $11,085.50 If 4..RA`F`m"'icvr ,CITY QF,SAdAN Permit Nos 8910 Date 7-23-87 3830 hot Knob Road Meter No: Size: - R.O. Box 21199 Reader No. Date: Eagan, MN 551,21 Owner city of Ea Site Address: Blue Cross /Blue Shield Paz 3590 Blue Cross Rd Piumber~BudL> Plumbing $ Sec. Conn. Chg: Zoning: PARR Acct. Dep: No. of Units: Permit Fee: FEE Surcharge: WAIVED I agree to comply with the City of Eagan Tr. Plant Ordinances. Meter. Misc.: By WATER SERVICE PERMIT CITY OF EAGAN N0 18308 3830• Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 BUILDING PERMIT Receipt # ADDITION & To be used for REMODELING Est. value $4,175,000 Date AUG 30 , 199-0.- Site Address 3535 BLUE CROSS RD Lot 1-3 Block 1 Sec/Sub. BLUE CROSS OFFICE USE ONLY Parcel No. Occupancy B-2 B_ FEES Zoning LB-- W Name BLUE CROSS /BLUE SHIELD (Actual) Const 6 Bldg. Permit 9,890.00 o Address 3535 BLUE CROSS RD (Allowable) I 1,417.5 0 City EAGAN Phone 456-8047 # of Stories 1 & BSMT Surcharge 0 Length 16$' Plan Review 6,428.0 =F Name MCGOUGH CONSTRU .TT N CO, INC Depth 162' SAC, City Address 9737 N FAIRVIEW AVE. S.F.Total 37,15-0 SAC, MCWCC City ROSEVILLE. Phone 633-5050 S.F. Footprints 18,fiZ5 (ffffittil SHE*) On Site Sewage Water Conn W W Name WINSOR FARICY On Site Well Water Meter Address 28 W FIFTH ST MWCC System 00 aW City ST PAUL Phone 227-0655 City Water Acct. Deposit PRV Required S/W Permit I hereby acknowlege that I have read this application and state that the Booster Pump SiW Surcharge information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Treatment PI Signature of Permitee Ct/ APPROVALS Road Unit A Building Permit is issu to: MCGOUGH CONS UCTION Planner Park Ded. on the express condition that all work shall be done in accordance with all Council applicable State of Minnesota Statutes and City of Eagan Ordinances. Bldg. Off. Copies Building Official noun .Q1 r._,~ f I i Variance - TOTAL 17, 735. 50 EAtr;AN SEWER SERVICE PERMIT 3830$1iot Knob Road 10064 P.O. Box 21199 PERMIT NO.: Eagan; MN 55121 DATE: a Zoning: A No. of Units. Owner: City of Eagan Address: Site Address: 41ult ;rosss/Blue Shield Park 3594 Blue Cr. Plumber. Budget Plumbing Ll Bl Sec. 17 I agree to comply with the City of Eagan Connection Charge: Ordinances. Account Deposit: FEE c Permit Fee: WAIVE Surcharge: By Misc. Charges: Date of Insp.: Total: Insp.: Date Paid: CITY OF EAGAN Remarks Addition Blue Cross Addn. Lot 2 Blk 1 Parcel-1 0 14550 020 01 Owner blitifl 05j 1CkU Street 3535 Blue Cross Rd. State Eagan,MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK 1967 Paid # SEWER LATERAL 1969 WATERMAIN # WATER LATERAL 1969 42,01.00. 29104-55 20 Paid WATER AREA STORM SEW TRK 1983 56, 918.00 3794.53 15 56 918.00 0007782 8-9-82 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. t SAC 28x570.00 210 & 118 2 -74 PARK CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121N 12246 PHONE: 454-8100 ttj SLrs', BUILDING PERMIT Receipt # To be used for INTERIOR RENW Ue $350,000 Date JULY 9 1 9Q_6 Site Address 3535 BLUE CROSS ROAD Erect ❑ Occupancy trot 02 Block 01 Sec/Sub. BLUE CROSS ADD Remodel ❑ Zoning Parcel No. Repair ❑ Type of Const. Addition ❑ No. Stories Name BLUE CROSS/BLUE SHIELD OF MNMove ❑ Length z Demolish ❑ Depth o Address SAME City Phone 456-8000 Int. Impr. Sq. Ft Install ❑ 0 Name MCGOUGH CONSTRUCTION CO Approvals Fees z b 00 Address 2737 N FAIRV I EW AVE Assessment Permit $1, 058. 00 City ST PAUlphone 6 3 3 - 5 0 5 0 Water & Sew. Surcharge 175.00 Q Police Plan Review 529.00 W Name ARCHITECTURAL ALLIANCE Fire SAC Address 400 CLIFTON AVE SO Eng. Water Conn. W W city MPLS Phone 871-5703 Planner Water Meter Council Road Unit I hereby acknowledge that 1 have read this application and state that the Bldg. Off. 7/2/86 Tr. PI. information is correct and agree to comply with all applicable State of Minnesota Statutes and City of ga es. APC Parks Signature of Permittee ''v"`**~ Var. Date Copies Total $1,762.00 A Building Permit is issued to. MCG H CONSTRUCTION IN on the express condition that all work shall be done in accordance with all app~~~licab tale of Minne ota Sta Ordinances. Building Official EAGAN TOWNSHIP BUILDING PERMIT N°• 1908 Owner . , Eagan Townshi r J p Address (present) J Town Hall Builder ..2:77 4e Address .t 3 t" C~-t, r z `1 y1.y'~ Date DESCRIPTION Stories To Be Used For Front Depth Height Est. Cost Permit Fee Remarks -e, '-c LOCATION Street, Road or other Description of Location I Lot Block Addition or Tract all( e ~ 1,7 This permit does not authorize the use of streets, roads, alleys or sidewalks nor does it give the owner or his agent the right to create any situation which is a nuisance or which presents a hazard to the health, safety, convenience and general welfare to anyone in the community. THIS PERMIT MUST BE KEPT ON THE PREMISE WHILE THE WORK IS IN PROGRESS. This is to certify, that.1:__ -~rz-__ has permission to erect a..... x_._.il ^ . ....................upon the above described premise subject to the provisions of the Building Ordinance for Eagan Townshili adopted April 11, 1955. 7 ,.y~ of T Per . l t Chair I = ,7 g~ nwn Board Building Inspector m t 115 N2 3425 CITY Of EAGAN BUILDING PERMIT Owner 3795 Pilot Knob Road ~p Eagan, Minnesota 55122 Address (present) 454-8100 c! Builder 10-Y-7 Date Address DESCRIPTION Stories To Be Used For Front Depth Height Est. Cost Permit Fee Remarks LOCATION v 97~ Street, Road or other Description of Location I Lot Block Addition or Tract This permit does not authorize the use of streets, roads, alleys or sidewalks nor does it give the owner or his agent the right to create any situation which is a nuisance or which presents a hazard to the health, safety, convenience and general welfare to anyone in the community. THIS PERMIT MUST BE~KEPT ON THE PREMIS~ WHILE THE WORK IS IN PROGRESS. This is to certify, that.136. !-~A.-. ..R ~`Phaspermission to erect a.... "1 ...._.._upon the above described premise subject to the provisions of all applicable Ordinances for the City of Eagan. ` V Per c_.a-.. a or Building Inspector ,t3 CITY OF EAGAN Remarks Addition- Blue Cross Addn. 1 1 Lot Blk- Parcel 10 1!i1.55O 010 01 Owner billf) /42"1-ity~a Street 353.5 TRlttP (.roSS Rd_ _ State Eagan, MN 55.122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK 196 Paid SEWER LATERAL WATERMAIN WATER LATERAL 1969 12 6 638.25 20 Paid WATER AREA STORM SEW TRK 1979 24 718.12 1647.87 15 4 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. SAC PARK CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 18308 PHONE: 454-8100 . , BUILDING PERMIT Receipt # To be used for REMODELING Est. Value S4,173,000 Date AUG 30 19 90 Site Address 3535 SLUE CROSS KO a Lot 1-3 Block 1 Sec/Sub. BLUE CROSS OFFICE USE ONLY FEES Parcel No. Occupancy B-2 B-1 Zoning LB w Name Bl"LtE CRt}$SPBLUE SHIELD (Actual) Const Bldg. Permit 9-189 *00 3 Address 3535 BLUE CROSS RD (Allowable) - 1,417.50 " e City EAGAN Phone 456-6047 # of Stories Ec &SI!iT Surcharge 428.00 Length Plan Review • o Name - MCWUGH CONSTRUCTION CO, INC I Depth ~7 SAC, City O ~ Address 2737 N FAIRVIEW AVE S.F. Total ~ o f City ROSEVILL E Phone 633-5050 S.F. Footprints 15,675 sac, Mcwcc Tnziira Culp On Site Sewage Water Conn WINSOR EARYCX LOUw Name= On Site Well Water Meter x Address 28 FIJI ST MWCC System a W City ST PAUL Phone 227-0655 City Acct. Deposit w Water PRV Required S/W Permit hereby acknowlege that t have read this application and state that the Booster Pump S/W Surcharge information is correct and agree to comply with all applicable State of Minnesota Statutes and City f Eagan Ordinances. Treatment PI Signature of Permitee APPROVALS Road Unit A Building Permit is issu o.~-MGOUGK CONSTRUCTION Planner Park Ded. on the express condition that all work shall be done in accordance with all Council applicable State of Minnesota Statutes and City of Eagan Ordinances. Bldg. Off. Copies 17,735.50 Building Official Variance TOTAL t 19 11,11 - 171-11i~) Permit No. Permit Holder Date Telephone # PLUMBING f H.V.A.C. ELECTRIC Inspection Date Insp. Comments Footings I Foundation Framing Roofing Rough Plbg. 01 p GY.t~/ U l~ s~ Rough Htg. I I Isul. i Fireplace I Final Htg. - S-g Final Plbg. Const. Meter Plbg. Inspector - Notify Plumber Engr./Plan Bldg. Final J 9 L!/~ 66) S Deck Fig. (J Deck Final ~Q- 7 -ix Well Pr. Disp. Tn7 r >w bar _ " .s. CITY OF EAGAN s s 18130 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 BUILDING PERMIT Receipt # "GIFIXIN"Ttow JULY to 90 To be used for Est. Value Date 19 i Site Aej."yess 30 3535 MOSS Jv- ;L OFFICE USE ONLY Lot 1,2*3 Block I- Sec/Sub. is A Parcel NO. Occupancy FEES Zoning - 1`427.00 Z Name (Actual) Const Bldg. Permit o Address (Allowable) Surcharge City Phone # of Stories* Length Plan Review - 9W zti Name 271? "0 IP?dRVIM An SS113 Depth SAC, City ~r Address S.F. Total c~i< SAC, MCWCC City Phone S.F. Footprints r ¢ On site sewage Water Conn late" VAX= F w Name On Site Well Water Meter In ST z MWCC System c=i~ Address Acct. Deposit M? City ST PAUL Phone City Water - PRV Required S/W Permit I hereby acknowlege that I have read this application and state that the Booster Pump S/W Surcharge information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Treatment PI Signature of Permitee APPROVALS Road Unit MCGOM CONST Planner A Building Permit is issued to: Park Ded. on the express condition that all work shall be done in accordance with all Council applicable State of Minnesota She-tutes and City of Eagan~Ordinances. Bldg. Off. Copies Variance TOTAL Building Official + iA 414 Permit No. Per it Holder ' Da Telephone # WATQQ d3 ~i 9/ O eo sEWaWf&,(: 64') 3 00, ~I /q/ P° PLUMBING Ovs S111,5119 0 eim-f 568 179/1W "AA tai / 79 do ELECTRIC J&~Q Inspection Date Insp. Comments Footings I Q!J ~O Q S k /o O Foundation Framing Roofing Rough Plbg. Rough Htg. Isul. ` Fireplace Final Htg. Final Plbg. Const. Meter Plbg. Inspector - Notify Plumber Engr./Plan Bldg. Final Deck Ftg. Deck Final Well Pr. Disp. PLUMBING PERMIT For Offlcg se Only CITY OF ElAGAN PERMIT # ~ CONTRACT 3830 PILOT KNOB ROAD, EAGAN, MN 55122 RECEIPT # PRICE „ V, PHONE 454.8100 DATE: Site Address u E i"`c 5S C BLDG. TYPE WORK DESCRIPTION Res. New Lot -3 Blogk .4 /Sub ' & Mult. Add-on Name ,90 t1? ~ 1l1 ~cf /i Comm. Repair Address4Z eDi7T" Other !h RES. $G. ONLY - COMPLETE THE FOLLOWING: !:t / Phon Z I NO. FIXTURES TOTAL /0 Water C t-$3.00 $ Batty=Tubs 00 Address Lavatory - $3.0 - - 0 city E G} 14 n! Phone Shewef - $3.00 0. Ali' _ 7' to . Ifttelaeft-ftk - $3.00 - Urinal/Bidet- $3.00 w c'G+ 0-0 FEES -7-Laundry Tray - $3.00 COMMAND. FEE - 1% OF CONTRACT FEE /0 Floor Drains - $1 APT. BLDGS. - COMM. RATE APPLIES Water Heate 1.50 F TOWNHOUSE & CONDO -RES. RATE APLLIES 3.00 S51M MINIMUM - RESIDENTIAL FEE $12.00 Gas mg Outlets - $1.50 4 MINIMUM - COMM.IND./FEE $20.00 ( INIMUM -1 PER PERMIT) STATE SURCHARGE PER,PERMIT .50 Softener - $5:00 (ADD $ ~0 S/C PER EAC~$1,000 OF PERMIT FEE) Well - $10.00 _ Private Disp. -$10.00 Rough Openings - $1.50 j ~t A $ U. G. Sprinkler System - $12.00 ste E ER EE PERMIT FEE: r fl 1 STATES S/C: ` FOR: CITY OF EAGAN fOS GRAND TOTAL: r:r :..-w - ..y v u~.. n,,..., v 4P-v. MECHANICAL PERMIT 'For City Use Only CITY OF EAGAN PERMIT# 3830 PILOT KNOB ROAD, EAGAN, MN 55122 RECEIPT # DATE G PHONE 454.8100 DATE: Site Address ; BLDG. TYPE WORK DESCRIPTION Lot Block Sec/Sub Res' New Canst. Mutt. Add-on Comm. Repair Name "c' Other - AddresoCQ C City,-LPhone' FEES RES. HVAC 0-100 M BTU - $24.00 Name ADDITIONAL 50 M BTU - 6.00 Address t (RES. HVAC INCLUDES A/C ON NEW CONSTRUCTION) City "kn > Z) Phone TOWNHOUSE & CONDOS - RES. RATE APPLIES MINIMUM RESIDENTIAL FEE - ALL ADD-ON & ' TYPE OF WORK REMODELS (INCLUDES GAS PIPING) - 12.00 r Forced Air M BTU $ GAS OUTLETS (MINIMUM -1 PER PERMIT- 50 NEW CONST.) EA. Boiler M BTU -COMMAND FEE -1% OF CONTRACT FEE Unit Heater M BTU $ APT. BLDGS. - COMM. RATE APPLIES - Air Cond. M BTU $ MINIMUM COMMERCIAL FEE - 20.00 Vent CFM $ STATE SURCHARGE PER PERMIT - .50 (ADD $ ~D SIC PER AGH $1000.00 OF PERMIT FEE) Gas Piping Outlets # $ - Other $ A Ile CommAnd. Contract Price x 1% $ OF-PSRMTTEE ',gyp PERMIT FEE: In ii t/ S/C: FOR: CITY OF EAGAN TOTAL: _ w~ "..;,r,„~; r,. _ ,c;.,. ...:.rr^: j;~u~.o.•-r,•r, yif"r ~ r.1 "<'.'~l?~+'a y""Y'~"SY~~Y:7F~7~f°"l"'~a+rnav.-..rc+-.• m Aw•. ",.a'R~v.se>,~4mv'~tas-++p~ MECHANICAL PERMIT For City Use Only CITY OF EAGAN PERMIT # 3830 PILOT KNOB ROAD, EAGAN, MN 55122 RECEIPT / DATE PHONE 454.8100 DATE: Site Address led BLDG. TYPE WORK DESCRIPTION Lot Blo Sec/Sub Res. New Const. Mult. Add-on Comm. Repair Name cat t!~-la r' C_44 -aOther Address C City, Oh i~ Phone FEES RES. HVAC 0-100 M BTU - $24.00 Name ADDITIONAL 50 M BTU - 6.00 (RES. HVAC INCLUDES A/C ON NEW of( < Addressr, a45 C.1 = CONSTRUCTION) City ~06T Phone TOWNHOUSE & CONDOS - RES. RATE APPLIES MINIMUM RESIDENTIAL FEE - ALL ADD-ON & TYPE OF WORK REMODELS (INCLUDES GAS PIPING) - 12.00 Forced Air M BTU $ GAS OUTLETS (MINIMUM - 1 PER PERMIT- 1.50 EA. NEW CONST.) Boiler - M BTU$ COMM/IN FEE -1% OF CONTRACT FEE Unit Heater M BTU $ APT. BLDGS. - COMM. RATE APPLIES Air Cond. M BTU $ MINIMUM COMMERCIAL FEE - 20.00 Vent CFM $ STATE SURCHARGE PER PERMIT - .50 (ADD S/C PER EACH41000.00 OF PERMIT FEE) Gas Piping Outlets # $ Other $ Comm./Ind. Contract PrICOW x 1% $ f J EE PERMIT FEE: S/C: FOR: CITY OF EAGAN ~ ~ TOTAL: 'r >,,K •r v lS? ` z . 'Tn: Y . vs '^rrK ~'w~,..~.~mFr; a;, 7, 1w, MECHANICAL PERMIT For City Use Only CITY OF EAGAN PERMIT # i (9 3830 PILOT KNOB ROAD, EAGAN, MN 55122 RECEIPT # DATE PHONE 454-8100 DATE: Site Address BLDG. TYPE WORK DESCRIPTION Lot Block Sec/Sub Res. New Const. / Mult. Add-on Name Comm. Repair Other Address ,-.r~& c City%`t L-~ 41!!) Phone " FEES RES. HVAC 0-100 M BTU - $24.00 Name ADDITIONAL 50 M BTU 6.00 c Address (RES. HVAC INCLUDES A/C ON NEW CONSTRUCTION) City Phone TOWNHOUSE & CONDOS - RES. RATE APPLIES MINIMUM RESIDENTIAL FEE - ALL ADD-ON & TYPE OF WORK REMODELS (INCLUDES GAS PIPING) - 12.00 Forced Air M BTU $ GAS OUTLETS (MINIMUM - 1 PER PERMIT- NEW CONST.) 1.50 EA. , Boiler _M-BTU $ COMM/IND FEE -1% OF CONTRACT FEE Unit Heater M BTU $ APT. BLDGS. - COMM. RATE APPLIES Air Cond. M BTU $ MINIMUM COMMERCIAL FEE - 20.00 Vent CFM $ STATE SURCHARGE PER PERMIT - .50 (ADD $.50 C PER EACH $1 0.00 OF PERMIT FEE) Gas Piping Outlets # $ Other $ - Comm./Ind. Contract Price' 1°!0 $ S~GNATJXRE O P R MITTEE JM4( ~Z PERMIT FEE: IV 0 S/C: FOR: CITY OF EAGAN i is ~1sl TOTAL: r ~ SITE ADDRESS I f13 Z y G 1--d Unit # Permit # L B Sect./Sub. INSPECTION INSPECTOR DATE COMMENTS X '12 y /3 aD o 0.61/a C:~7 ( - a 29 R a ll- -9 r~ INSPECTION INSPECTOR DATE COMMENTS cam. 7,;.7V- il 3= ut B -al -~rr~ ait*W tr. ; „ IO -fie «~p 2 e ~W «I eJgp 7e ~ ~1 /3 Dom( -T6 , i CITY OF EAGAN N°_ 1 10 81 L / 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 4548100 S6 /0 f BUILDING PERMIT Receipt # To be;wed for INT. REMODEL Est. Value 38,000 Date OCTOBER 4 , )9--a5 Site Address 3535 BLUE CROSS ROAD Erect ❑ Occupancy Lot 1 Block 1 SeclSub BLUE CROSS ADD1Wemodel V Zoning . Repair ❑ Type of Const. Parcel No. Addition ❑ No. Stories z Name BLUE CROSS/BLUE SHIELD Move Demolish C1 El Length Depth z Address 3535 BLUE CROSS ROAD Int.Impr. ❑ Sq. Ft. City EAGAN Phone Install ❑ Approvals Fees it Name C F 1JA(;LIN P. S*DN~ ut Address 4095 W 65TH-- Assessment Permit 229-00 City EDD1A Phone 990-6173 Water & Sew. Surcharge 19 _ 0 0 Police Plan Review 114- 50 bee Name 1-w Fire SAC Address Eng. Water Conn. <su City Phone Planner Water Meter Council Road Unit 1 hereby acknowledge that ve reo opplicotion and state that Bldg. Off. 9/12/8 5 Tr. PI. the information is correct agree comply with all applicable APC State of Minnesota Statute and Cit inances. Parks Var. Date Copies Signature of Perrr+ittee A Buildin Permit is issued C.F. HAGLIN & SONS Total 362 _ 50 g on the express condition tha+ all work shall be done in c th a applicoble State of Minnesota Statutes and City of Eagan Ordinances. Building Official ~zv "`-o~ne,{wi (--(-~41:t Par t>~ica Ilse ~l►: PERMIT # MECHANICAL. PERMIT,, CITY OF EAGAN RECEIPT # 3830 PILOT KNOB ROAD, EAGAN, MN 55122 CONTRACT PRICE: ?5?Q Co P14 454-8100 DATE: M (dregs M U G T KOL BLDG. TYPE WORK D WTIOM Lt>t ~S - 61~k_ Sec/Sub Res. "New Name Q t S e 11 e, Mutt Add-on Addr o oevvcl/ Comm Repair 0 ~ Phone Y-SqZ~ Other tlCity3~, _ PEES Name lue- rcr-s ue +t' ( RES. HVAC 0-100 M BTU $24.00 Addy 1 s)e°s ADDITIONAL 50 M BTU - 6.00 39 City_ _ Phone (RES. HVAC INCLUDES A/C ON NEW ! p CONSTRUCTION) I TYRE OF WORK GAS OUTLETS, (MINIMUM -1 PER PERMIT) - 1.50 s k. , COM"D FEE -1% OF CONTRACT FEE Forced Air M BTU APT. BLDG. = COMM. RATE APPLIES Boiler M BTU TOWNHOUSE & CONDOS - RES. RATE APPLIES Unit Heater M BTU MINIMUM RESIDENTIAL FEE ALL ADD-ON & . M BTU REMODELS - . t2-00- Air Cond MINIMUM COMMERCIAL FEE - 20.00 Vent CFM STATE SURCHARGE PER PERMIT - .50 Gas Piping Outlets # (ADD $.50 S/C PER EACH $1000.00 OF PERMIT FEE) Otl'ter PERMIT FEE: Jc.,~t C NATURE OF P ITTEE ; SIC: TOTAL: Z 5 FOR: CITY OF EAGA{V 4,i I1 _~5.~►0 ~ x i r. I _P.. i q Y CITY OF 1EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 551,29 ' PHONE: 454-8900 BUIL61N 3 PERMIT Receipt # r TO be "wed for Est. Value 38, Date 3 $Jte Address '4 5 3 5 BLUE C ROA. Wilt) Erect ❑ Occupancy Lot Block Sec/Sub. Bu~UE C'RO S A,, g6model 0 Zoning Y. Parcel No. Repair ❑ Type of Const. Addition ❑ No. Stories 5 Name 7•U' C'li0S5f13•°j i) Move ❑ Length Demolish ❑ Depth Address 3535 BLUE CROSS RQ D Int. Impr. ❑ Sq. Ft. City ry~ AN Phone Install CD 7 NOW* Approvals Rees Name t='. ll►~~-d~C`= i U Address r Assessment Permit .229L I City Xz t w4 'Phone Water & Sew. Surcharge 19_ 00 Police Plan Review 11,4,; 54D Name 9-z Fire SAC Address Eng. Water Conn. v <Z City Phone Planner Water Meter r. ! Council Road Unit ~ { hereby acknowledge that I h ~e read "',amply opplicotion and state that Bldg. Off. 9/12/ 5 Tr. PI. the infosmotion is correct ar~` agree tq~comply with all applicable State of Minnesota Statutes,, and Clty # -Eagorr-GRknonces. APC Park r Var. Date r ' trrri. _ Copies . Signature of Permittta¢ - C . F . HAi YI. 1~1 C S 4_ Total 362 = 5101, h Buildipg Permit Is issued te: on the expeess c tion that . all work shall be done in accordance, with all_~yppl oabte State of Minnesota Statutes and City of Eagan Ordinancow Pltutlding OfflPw 4 ......4 PWmk 14M hermit Holder Date Telephone # u"i" 51 2- -ey h~ ~l s a H.Y.A.C. '5 Yt) a a 2 Electric ((0 fo X96 t °~~~4 Cr't) Z a ~z --ellb 14a (e<- Inspection Date insp. Other Footings 1 Footings 11 Foundation Framing Roofing Rough Plbg. ZL Rough Htg. i Insul. I Fire lace r Final Htg. Final P@ng. 2- Final Corvocc. J Describe Location: Water well Sewer Pr: bhnP. ryu. i FOX `MECHANICAL PERMIT = E CITY OF EAGAN EC91PT # ti 3830 PILOT KNOB ROAD, EAGAN, MN,55122 DATE Coll **CT PRICE: 1 PHONE: 454-9100 Site Address r - BLDG. TYPE WORK DESGRWT** f,.• Bloc ec/Sub Res. New the Muit. Add-o CP[em. Repair . Address - , - Otter Cky Phone r 'IL FEES Name' RES. FiVAC, 0-100 M BTU - $2400 ' . Address ? ADDITIONAL 50 M BTU 6.00 . O City !-rte PC'A Phone " (RES. HVAC INCLUDES A/C ON NEB CONSTRUCTION) GAS OUTLETS (MINIMUM - 1 PER PERMIT) - 1.50 EA.-" TYPE OF WORK COMMAND FEE - 1% OF CONTRACT FEE Forced Air M BTU APT. BLDGS. COMM. RATE APPLIES TOWNHOUSE & CONDOS - RES. RATE APPLIES ,"Boiler M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON & ".Knit Heater M BTU REMODELS - 12DD n Ate CQn M BTU MINIMUM COMMERCIAL FEE - 20.00 STATE SURCHARGE PER PERMIT - '50 /C IF PERMIT PRICE GOES ~ < . 'i#~irx Outlets # BEYOND $1,000) - der ~ " - ~lQ FEE: S/C: Q St Arl E OF PEIiivYi7T f TOTAL.p FOR: CITY OF EAGAN , r--------- _ _ a k i i i w l 443 Lafayette Road N. MINNESOTA DEPARTMENT OF (651) 284-5005 St. Paul, Minnesota 55155 1-800-DIAL-DLI www.doli.state.mn.us LABOR & INDUSTRY TTY: (651) 297-4198 November 3, 2008 APPROVED FOR USE Blue Cross Blue Shield 3535 Blue Cross Rd Eagan MN 55121 RE: a ator - Elev r ID# -15335.02AL08-11 Sit Blue Cross Blue Shield Esc 1 (1-2 Up) 3535 Blue Cross Rd Eagan 55121 Dear Sir/Madam: Minnesota Statutes Chapter 16B provides that the Department of Labor and Industry, Construction Codes & Licensing Unit, Elevator Safety Section, inspect and approve elevators and manlifts (endless belt lifts) before they can be legally used in Minnesota. An Inspector from the Elevator Safety Section recently inspected your facility and determined it meets requirements of the Minnesota Elevator Safety Code. NOTE: Compliance with Minnesota Rules and the ANSI/ASME A17.1, Safety Code for Elevators and Escalators does not necessarily assure compliance with the Americans With Disabilities Act of 1990. THIS APPROVAL APPLIES TO THE INSTALLATION OF SKIRT BRUSHES, INDEX TEST & CLEAN nnwu ALL ELEVATOR RELATED EQUIPMENT IS SUBJECT TO ANNUAL RENEWAL OF THE OPERATING PERMIT: It is the owner's responsibility to maintain and keep current with all tests in accordance with the ASME A17.1 and the ASME A17.3. Frequencies for the required tests can be found in Chapter 1307 of the Minnesota State Building Code. Failure to maintain and perform the required tests may result in revocation of the annual operating permit. Operation of an elevator related device without a valid operating permit may result in an issuance of a "stop order" from the department and possible penalty of up to $10,000. For more information see our website at: http://www.doli.state.mn.us/bc_elevators.html I Sincerely, CONSTRUCDES & LICENSING ;p -x Tim D. Warren State Elevator Inspector nn tdw/rsg (CE-2) c: Schoeppner, Dale R., BO, City of Eagan NOV Q 4 2008 Otis Elevator Company t ElFormCE2 This information can be provided to you in alternative formats (Braille, large print or audio). An Equal Opportunity Employer 443 Lafayette Road N. MINNESOTA DEPARTMENT OF (651) 284-5005 ABOR & INDUSTRY -800-DIAL-DLI St. Paul, Minnesota 55155 xAlftlh, www.doli.state.mn.us TTY: (651) 297 297--4198 November 3, 2008 APPROVED FOR USE Blue Cross Blue Shield 3535 Blue Cross Rd Eagan MN 55121 RE: Escal - Elevator -15336.02AL08-11 Site: ue Cross Blue Shield Esc 2 (2-1 Dwn) 3535 Blue Cross Rd Eagan 55121 Dear Sir/Madam: Minnesota Statutes Chapter 16B provides that the Department of Labor and Industry, Construction Codes & Licensing Unit, Elevator Safety Section, inspect and approve elevators and manlifts (endless belt lifts) before they can be legally used in Minnesota. An Inspector from the Elevator Safety Section recently inspected your facility and determined it meets requirements of the Minnesota Elevator Safety Code. NOTE: Compliance with Minnesota Rules and the ANSI/ASME A17.1, Safety Code for Elevators and Escalators does not necessarily assure compliance with the Americans With Disabilities Act of 1990. THIS APPROVAL APPLIES TO THE INSTALLATION OF SKIRT BRUSHES, INDEX TEST & CLEAN nnwti ALL ELEVATOR RELATED EQUIPMENT IS SUBJECT TO ANNUAL RENEWAL OF THE OPERATING PERMIT: It is the owner's responsibility to maintain and keep current with all tests in accordance with the ASME A17.1 and the ASME A17.3. Frequencies for the required tests can be found in Chapter 1307 of the Minnesota State Building Code. Failure to maintain and perform the required tests may result in revocation of the annual operating permit. Operation of an elevator related device without a valid operating permit may result in an issuance of a "stop order" from the department and possible penalty of up to $10,000. For more information see our website at: http://www.doli.state.mn.us/bc-elevators.htmi Sincerely, CO UCTIO ODES & LICENSING 7D. Warren State Elevator Inspector tdw/rsg (CE-2) t; c: Schoeppner, Dale R., BO, City of Eagan NOV 0 4 200$ Otis Elevator Company ElFormCE2 This information can be provided to you in alternative formats (Braille, large print or audio). An Equal Opportunity Employer .t w 204COMMERCI4,L BUILDING PERIvHT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 , Telephone # 651-675-5675 Plans are considered public information unless you state they are trad s ret nd wh . Foundation Only New Building interior Improvement • Structural Plans (2) sets • Soils Report (1) • Architectural Plans (2) sets • Civil Plans (2) • Certificate of Survey (1) • Code Analysis 0) " • Certificate of Survey (1) • Structural Plans (2) • Project Specs 0) • Code Analysis (1) • Architectural Plans (2) sets • Key Plan (1) • Project Specs (1) 4.6 - HVAC units req'd. on bldg elev. / site plan • Master Exit Plan (1) • Spec insp & Testing Schedule (1) Civil Plans (2) • Energy Calculations (1) not always" • Soils Report (1) Landscaping Plans (2) • Elec. Power & Lighting Form (1) not always** • Meter size must be established • Code Analysis 0) • Meter size must be estabfishe" applicable 1 • Energy Calculations (1) J • Emergency Response Site Plan (1) l • Spec. Insp. & Testing Schedule (1) j • Electric Power & Lighting Form (1) ) 1 • Project Specs (1) ) • Master Exit Plan (1) J • SAC determination - call 651-602-1000 • SAC determination - call 651-602-1000 SAC determination -call 651-602-1000 • Fire Stopping Submittals • Fire Suppression/Alarm Form • Meter size must be established Call MN Dept of health at 651-2014500 for details regarding food & beverage or lodging facilities. Contact Building Inspections to we if it is required and for a sample. Permit for new building or da dition will not be processed without Emergency Response Site Plan. Date 3 / 6 / 2008 Construction cost. $ 80 000.00 Site Ades 3535 Blue Cross Road Unit/Ste # T e n a n t Name B 1 ue Cross B l u e Shield Former Tenant Name N/A Description of Work Restore Existing Exterior Stairs P r o p e r t y o w n e r Blue Cross B l u e Shield Telephone # ( ) Applicant is: _ Owner X - Contractor Contact (952 ) 920-6123 Gary Gunderson Contractor C.F. Hag 1 i n & Sons, Inc. Address 3939 West 69th Street City Edina State MN zip 55435 Telephone#( 952) 920-6123 Arch/Engr Architectural Alliance Registration # 16854 Address 400 Clifton Ave. S. city Minneapolis State MN Zip 55403 Telephone # ( 612) 871-5703 Licensed plumber installing new sewer/water service: Phone I hereby apply for a Commercial Building Permit and acknowledge that the inforMation is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of Statutes; eundqAtand this is not a permit, but only an application for a permit, and work is not to start without a permit; that am 1 be in acc ith the approved plan in the case of work which requires a review and approval of plans. ~ A-(2-:/ Gt t )i ~~~7 Applicart s Printed Name Xff cant's e ~ J DO NOT WRITE BELOW THIS LINE Sub Types ❑ 01 Foundation ❑ 26 Public Facility ❑ 30 Accessory Building ❑ 14 Apartments 0017 CommercialAndustrial ❑ 32 Ext Alt-Apartments ❑ 15 Lodging ❑ 28 Greenhouse e 34 Ext Alt-Commercial ❑ 25 Miscellaneous 1 29 Antennae ❑ 35 Ext Alt-Public Facility ❑ 37 Nail Salon Work Types ❑ 31 New ❑ 35 Int Improvement ❑ 38 Demolish (interior) ❑ 44 Siding ❑ 32 Addition ❑ 36 Move Bldg. ❑ 42 Demolish (Foundation) ❑ 45 Fire Repair ❑ 33 Alteration ❑ 37 Demolish (Bldg)" ❑ 43 Reroof ❑ 46 Windows/Doors V 34 Replacement *Demolition Building - Give PCA handout to applicant Valuation 90" Type of Const Width Plan Rev 100% - Occupancy - MCES System SAC Units Zoning City Water Nbr. of Units Stories Booster Pump Nbr. of Bldgs Sq. Ft PRV Fire Sprinklered Length Required Inspections Footings (new bldg) - Fireplace _ R.I. -Air Test -Final Footings (deck) - Insulation Footings (addition) _ Sheetrock _ Foundation Final/C.O. Drain Tile ✓ FhW No C.O. Driveway Apron _ Other Roof Ice Pr - Decking Insul _ Final _ Pool _ Ftgs - Air/Gas Tests -Final Framing Siding Stucco Lath Stone Lath _ Final Windows Final C/O Inspection: Schedule Fire Marshal to be present. _ Yes Approved By: t--~ Planning M i ~C e_. • Building Inspector Base Fee Surcharge 11/0.00 Plan Review _15-99. SAC-MCES SAC-City S/W Permit S/W Surcharge Treatment Plant Financial Guarantee Treatment Plant (irrigation) Storm SewerTrtmk Park Dedication Sewer Lateral Sewer Trunk Trail Dedication Street Water Quality Water Lateral Water Trunk Water Supply & Storage (WAC) Other Total f S • l For Office Use • I Permit City of Enn I Permit Fee: 3830 Pilot Knob Road s 1 Eagan MN 55122 I Date Received: Phone: (651) 675-5675 Fax: (651) 675-5694 i Staff: 2008 MECHANICAL PERMIT APPLICATION Date: Site Address: 35 35 }~1,, Cc-vSS Tenant: C <,a s L~L, 5k~~U- Suite RESIDENT / OWNER Name: C USS 9L.6IC fAllzz nG to Phone: Address / City / Zip: 353s kt, raw 4h 0,rJ2) -IT CONTRACTOR Name: Jcs t)A-) fz) i) Ce J 7a2liL S License 6.~ 3 3 7 Address: Z6G ~e rn ~r®d~l 4-,n2 /J, City: State: Zip: 55Yt/-7 Phone: \ J Contact Person: /nib o TYPE OF WORK New Replacement Additional /Alteration Demolition Description of work: 5e- !~l^ NOTE: Both roof mounted and ground mounted mechanical equipment is required to be screened by City Code. Please contact the Mechanical Inspector or one of the Planners for information on permitted screening methods. PERMIT TYPE RESIDENTIAL COMMERCIAL Furnace \ New Construction Interior Improvement Air Conditioner x Install Piping Processed Air Exchanger Gas _ Exterior HVAC Unit * HVAC units must be screened Heat Pump _ Under / Above ground Tank Install / _ Remove) Other When installing/removing tank(s), call for inspection by Fire Marshal and Plumbing Inspector RESIDENTIAL FEES: $50.50 Minimum Add-on or alteration to an existing unit (includes $.50 State Surcharge) $90.50 Fire repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) $ _TOTAL FEE COMMERCIAL FEES: j 6FU0. 06 x1% $70.50 Underground tank installation/removal OR Contract Value $ a<90 $50.50 Minimum (includes State Surcharge) _ $ z ?06- OD Permit Fee - If Permit Fee is less than $1,000, surcharge is $.50. If Permit Fee is > $1,000, surcharge increases by $.50 for each = $ l 0 a State Surcharge $1,000 Permit Fee (i.e. a $1,001-$2,000 Permit Fee requires a $1.00 surcharge). $ 021 KQ D D TOTAL FEE 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 ap6o plan in the case of work which requires a review and approval of plans. A,) x //ZA nl~ r-r-m A v 8 ldF Applicant's Printed Name App icant's Signature FOR OFFICE USE Reviewed By:. _ Date: - `A Required Inspections: Under Ground -Rough In _Air Test __Gas Service Test __In-floor'Heat _ al 2007 COMMERCIAL PLUMBING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 Do not combine inside and outside plumbing on the same application; separate applications and permits are required. Date M / '7 7 Site Address dad Unit # Tenant Name L~d f L(Q) L°1<31 Former Tenant Name Property Owner Telephone # ( ) Contractor O _ Address City = State n-1 )j Zip !5 / Telephone # (/p 5-J) 491-~ n l License # _ L6,9 Y - d 64.,2q 6 Expires: The Applicant is Owner Contractor Other Work Type _ New Bldg _ Modify Space -Irrigation System" _Yes -No Work in t / easement? X RPZ PVB: X New _ Repair/Rebuild _ Replace _ Re Rain sensors are required on irrigation system s li Description of Work ~P! Gt~ Q 16f'1 P P Z t_6 0 To inquire if Pressure Reducing Valve is req ed on new service, call 651-675-5646 Meters - Call 651-675-5646 to verify that hydrostatic, conductivity, and bacteria tests passed prior to picking u;size i ublic Wor s Irrigation Size & Type Avg GPM 2" turbo req'd unless smallllowed by P Fire Size & Price 3/4" meter $174.00 Domestic Size & Type Avg GPM Includes high demand devices? Yes - No Flushometers _ Yes - No PRV Required _ Yes -No Permit Fee $50.50 minimum (includes State Surcharge) Contract Value $ x 1% ~~O X50 Permit Fee $ Meter(s) Required on all new buildings & boulevard irrigation system s $ Radio Meter Read $ State Surcharge If pemrit fee is less than $1,000, surcharge is $.50 If permit fee is more than $1,000, surcharge is $.50 for each $1,000 owed. Following fees apply when installing new lawn irrigation system $ Water Permit Call the City's Engineering Department, 651-675-5646, for required fee amounts $ Treatment Plant $ Water Supply & Storage $ State Surcharge $ Total Fee I hereby apply for a Commercial Plumbing Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Plumbing Codes; that I understand this is t 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 w which requires a review and approval of plans. Applicant's Printed Name Applicant's Signatu e 7/, 5 - e 'F, ~ s 2006 COMMERCIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5694 Only New Building Interior Improvement • Structural Plans (2) sets • Architectural Plans (2) sets • Architectural Plans (2) sets • Civil Plans (2) • Structural Plans (2) • Code Analysis (1) • Certificate of Survey (1) • Civil Plans (2) Project Specs (1) • Code Analysis (1) • Landscaping Plans (2) • Key Plan (1) • Project Specs (1) • Code Analysis (1) • Master Exit Plan (1) • Spec. Insp. & Testing Schedule • Certificate of Survey (1) Energy Calculations (1) not always** • Soils Report (1) • Spec. Insp. & Testing Schedule (1) Elec. Power & Lighting Form (1) not always- • Meter size must be established • Meter size must be established • Meter size must be established-if applicable 1 • Project Specs (1) i • Energy Calculations (1) y 1 • Electric Power & Lighting Form (1) 1 1 • Master Exit Plan (1) 1 1 • Emergency Response Site Plan (1) 1 1 • Soils Report (1) 1 • SAC determination - call 651-602-1000 • SAC determination - call 651-602-1000 SAC determination -call 651-602-1000 • Fire Stopping Submittals • Fire Su ression/Alarm Plans Call MN Dept of Health at 651-201-4500 for details regarding food & beverage or lodging facilities. Contact Building Inspections for sample and if required Permit for new building or addition will not be processed without Emergency Response Site Plan. Date I l 7 Construction Cost AoAoy . . K)p Site Address 3S S-S' /3 JI& [ 4pS S 1202 0( I -te n 14l~ Unit/Ste # Tenant Name Former Tenant Name Description of Work my &,?kgb P 1✓y~.l S~'Ufr.~Lll~ & ,,x & raw- Property Owner l at ('[DDSs N a6 Sheld _ N,~4 Telephone #(6,51 ) G& Z IUl~S Applicant is: Owner _ Contractor Contact#: Z cDle~ Contractor d(,71 1! . isle V laic" TB t,~ a"! ' rnj; Address City State Zip Telephone # ( ) Arch/Engr Ar-6h i bf (Y re) AIjl~,l ee Registration # Address y00 City Mlr~n~r~0/r 5 ak, State Zip 5WO? 3ZKTelephone # ((,/Z) X71 S 703 Licensed plumber installing new sewer/water"Cervice: Phone I hereby apply for a Commercial Building Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; 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. / ' 4C51e sally Applicant's Printed Name Aj6licaii is Signature DO NOT WRITE BELOW THIS LINE Sub Types ❑ 01 Foundation ❑ 26 Public Facility ❑ 30 Accessory Building ❑ 14 Apartments ~ 27 Commercial/Industrial ❑ 32 Ext Alt-Apartments ❑ 15 Lodging ❑ 28 Greenhouse ❑ 34 Ext Alt-Commercial ❑ 25 Miscellaneous ❑ 29 Antennae ❑ 35 Ext Alt-Public Facility ❑ 37 Nail Salon Work Types ❑ 31 New ,0' 35 Int improvement ❑ 38 Demolish (Interior) ❑ 44 Siding ❑ 32 Addition ❑ 36 Move Bldg. ❑ 42 Demolish (Foundation) ❑ 45 Fire Repair ❑ 33 Alteration ❑ 37 Demolish (Bldg)* ❑ 43 Reroof ❑ 46 Windows/Doors ❑ 34 Replacement *Demolition (Entire Bldg only) - Give PCA handout to applicant Valuation a 00 0 0~- Type of Const' Width o o Plan Rev 100 /0 25 /o Occupancy MCES System SAC Units - Zoning City Water Nbr. of Units 6 Stories Booster Pump Nbr. of Bldgs 1 Sq. Ft. PRV Length Fire Sprinklered Required Inspections - Footings (new bldg) Fireplace - R.I. -Air Test Final - - Footings (deck) _ Insulation - Footings (addition) - Sheetrock _ Foundation _ Final/C.O. _ Drain Tile Final/No C.O. _ Driveway Apron _ Other Roof _ Ice Pr _ Decking Insul Final - Pool - Ftgs _ Air/Gas Tests Final V Framing - Siding _ Stucco Lath _ Stone Lath 'Final _ Windows Final C/O Inspection: Schedule Fire Marshal to be present. _ Yes V1 No Approved By: Planning Building Inspector - Base Fee Surcharge ! ° c Plan Review 7 . SAC-MCES SAC-City SMI Permit SM( Surcharge Treatment Plant Financial Guarantee Treatment Plant (Irrigation) Storm Sewer Trunk Park Dedication Sewer Lateral Sewer Trunk Trail Dedication Street Water Quality Water Lateral Water Trunk Water Supply & Storage (WAC) Other Total 2005 COMMERCIAL BUILDING PERMIT APPLICATIONC f r7/3 City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5694 a x 1D x x • Structural Plans (2) sets • Architectural Plans (2) sets • Architectural Plans (2) sets • Civil Plans (2) • Structural Plans (2) • Code Analysis (1) • Certificate of Survey (1) • Civil Plans (2) • Project Specs (1) • Code Analysis (1) " • Landscaping Plans (2) • Key Plan (1) • Project Specs (1) • Code Analysis (1) • Master Exit Plan (1) • Spec. Insp. & Testing Schedule • Certificate of Survey (1) • Energy Calculations (1) not always- • Soils Report (1) • Spec. Insp. & Testing Schedule (1) • Elec. Power & Lighting Form (1) not always** • Meter size must be established • Meter size must be established • Meter size must be established-if applicable 1 • Project Specs (1) 1 • Energy Calculations (1) 1 • Electric Power & Lighting Form (1) 1 1 • Master Exit Plan (1) 1 1 • Emergency Response Site Plan (1) 1 1 • Soils Report (1) • SAC determination - call 651-602-1000 • SAC determination - call 651-602-1000 • SAC determination -:call 651-602-1000 • Fire Stopping Submittals Call MN Dept of Health at 651-215-0700 for details regarding food & beverage or lodging facilities. Contact Building Inspections for sample and if required * Pernut for new building or addition will not be processed without Emergency Response Site Plan. Date 16 / Z.O 1 0 5 Construction Cost ~ Site Address 3535 13t_c~ CQ ag S t~~+~ Unit/Ste # Tenant Name &U f_ C_R& $S 1-6 f- SHZft.Z, Former Tenant Name Description of Work RQ~I:3:0,36 Srl:Ef_-rAAf-T-AL ~RfJt_4Gc Aeu- - Property Owner &JJ FG Ce0S-q Telephone !~v2 - ZS7`f4 Contractor ~t%T~ r.~ L~tZC7`a ZOOV;ZQ6, CrUS-T. J Ne- Address ~ f y to rS ST City _97% • PAU4 State J0 t~ Zip 5.STelephone # ( toy -MW -,S-630 ~°pN,gu~.a-AVT' Armor A10 E5 f,- 1-T- b . Registration Address 72-01 QfiaAS mug, City State Ai Al Zip .~S'f3g Telephone # `SZ) 83l /4 421, 153 Licensed plumber installing new sewer/water service: ✓V/ Phone ( i . I hereby apply for a Commercial Building Permit and acknowledge that the information is colot 1 ` d accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; 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. Appl'icant's Printed Name Applicant's Signature OFFICE USE ONLY Sub Types ❑ 01 Foundation ❑ 26 Public Facility ❑ 30 Accessory Building ❑ 14 Apartments 9,"27 Commercia ,4ndustrial ❑ 32 Ext Alt Apartments ❑ 15 Lodging ❑ 28 Greenhouse ❑ 34 Ext Alt-Commercial ❑ 25 Miscellaneous ❑ 29 Antennae ❑ 35 Ext Alt-Public Facility ❑ 37 Nail Salon Work Types ❑ 31 New ❑ 35 Int Improvement ❑ 38 Demolish (Interior) ❑ 44 Siding ❑ 32 Addition ❑ 36 Move Bldg. ❑ 42 Demolish (Foundation) ❑ 45 Fire Repair I!i ❑ 33 Alteration ❑ 37 Demolish (Bldg)* W43 Reroof ❑ 46 Windows/Doors ❑ 34 Replacement *Demolition (Entire Bldg only) - Give PCA handout to applicant y Valuation it/ D OS Type of Const Width Plan Rev 100% ✓ 25% Occupancy MCES System Census Code 7 Zoning City Water SAC Units Stories Booster Pump Nbr. of Units !m Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinkiered Required Inspections - Footings (new bldg) _ Fireplace - RI. - Air Test - Final Footings (deck) Insulation Footings (addition) - Final/C.O. _ Foundation _ FinaWo C.O. Drain Tile Other Driveway Apron - Poo) _ Ftgs - Air/Gas Tests - Final J Roof _ Ice Pr Decking we Insul `r' Fi Siding Stucco -Stone Framing Windows - - Approved By: Planning C-M%o~ Building Inspector Base Fee 2 813• 7s- . *,r o Surcharge 2-17, Plan Review SAC-MCES SAC-City Sm Penrrrit S/W Surcharge Treatment Plant Financial Guarantee Treatment Plant (Irrigation) Storm Sewer Trunk Park Dedication Sewer Lateral Sewer Trunk Trail Dedication Street Water Quality Water Lateral Water Trunk Water Supply & Storage (WAC) Other Total, Q 2 S ~01 ~-o 2005 COMMERCIAL PLUMBING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 Date 1// /0-S Site Address S 3 S h6 L,C.t `e C t°'aSS Unit # Tenant Name tti~ C P65 s Former Tenant Name NZA Property Owner 0/"e C ro. sg IRI u -c S h / t` t o Telephone # ( ) Contractor S W S o tv S r h Ck1Q.a~ ~e Address q 6 1 S City j3 (O® r7l I rk j State M/j Zip S ~ Telephone # O n .-;?.3 License # Expires: 1,-2-3 /--lt)5 The Applicant is Owner Contractor Other Work Type _ New Bldg Modify Tenant Space _ RPZ PVB _ New _ Repair/Rebuild _ Replace - Irrigation system Work within public right of-way/easement _ Yes _ No Rain sensors are required on irrigation systems L Description of Work Ihs7'all C_e a -S-t-e 4 U "t? Iz W O'T-R s/fU LA"--t I-(-- t- l e~Et°r- To inquire if Pressure Reducing Valve is required on new service, call 654-675-5646 f 2 /y2q Q P Meters - Call 651-675-5300 to verify that hydrostatic, conductivity, and bacteria tests passed prior to picking up meter. Irrigation Size & Type Avg GPM 2" turbo req'd unless smaller size allowed by Public Works Fire Size & Price 3/4" displacement $161.00 Domestic Size & Type Avg GPM Includes high demand devices? - Yes No Flushometers - Yes - No PRV Required _ Yes - No Permit Fee $50.50 minimum (includes State Surcharge) Contract Value $ & 000, CDC-") x 1% _ $ 0,10 Permit Fee $ Meter(s) Required on all new buildings & boulevard irrigation systems $ Radio Meter Read If permit fee is $1,000 or less, surcharge is $.50 $ SF7 State Surcharge If permit fee is over $1,000, surcharge is $.50 per $1,000 of the Permit Fee Following fees apply only when installing new irrigation system $ Water Permit Call Jerry Wobschall at 651-675-5024 for required fee amounts $ Treatment Plant $ Water Supply & Storage $ State Surcharge $ (e © , 50 Total Fee I hereby apply for a Commercial Plumbing Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Plumbing Codes; 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. e,QIAiJ _.57Lju rl S e If d Applicant's Printed Name Applicant's Signature CITY USE ONLY REQUIRED INSPECTIONS: U.G. Air Test Gas Test _ Rough In Final jz - I - o _5~ PLANS SUBMITTED APPROVED BY: , BUILDING INSPECTOR General Information • Radio Meter Read (required on all new buildings & boulevard irrigation systems- $141.00 • RPZ's must be tested every year and rebuilt every five years. Test results should be mailed to Paul Heuer at the City of Eagan. • A minimum fee permit per address is required for the following RPZ's: new, rebuild, repair, remove. • Water meters include copper hom/strainer, remote wire, and touch-pad meter. METERS REQUIRING 4-HOUR ADVANCE NOTICE PRIOR TO PICK UP GPM METERS USE PRICE GPM METERS USE PRICE 1-20 5/8" residential $125.00 4-120 1-1/2" irrigation syst $ 735.00 displacement sm commercial turbine" Public Works maximum must approve continuous meter size 10 2-30 3/4" lawn irrigation $161.00 4-160 2" turbine lg irrigation syst $ 931.00 maximum displacement residential & continuous sm commercial production lines 15 3-50 1" displacement very lg res $296.00 1/4 to 160 2" compound bldgs over $ 1,849.00 bldg to 24 units 65 units maximum sm commercial & continuous & lg comm bldgs 25 irrigation systems 5-100 1-1/2" bldgs 25-64 units $429.00 maximum displacement & continuous most Comm bldgs 50 METERS REQUIRING 30-DAY ADVANCE NOTICE PRIOR TO PICK UP GPM METERS USE PRICE GPM METERS USE PRICE 5-350 3" turbine very lg irrigation $1,182.00 6-500 4" compound +300 unit bldgs & $3,563.00 syst & production very lg comm bldgs lines 1/2-320 3" compound +200 unit bldgs $2,282.00 10-1000 6" compound +400 unit bldgs $6,076.00 very lg comm bldgs very Ig comm bldgs 15-1000 4" turbine very Ig irrigation $2,226.00 syst & production lines Comments • To schedule inspection of the inside water line and backflow preventer, call 651-675-5675. • To arrange for water turn-on, call 651-675-5300. cc: Maintenance Division Clerical Technician January 2005 00 .2005 COAPKERCULL MECHANICAL PERMffA?PTXAT-1W City Of Eagan 3 Not Knob Road, Eagan MN'55112 ~ Te4ephone # 651-67-5-5675 ' l eaY'ape ~ctr colt~iietci~Ui~xitri~ tx~il4iings multi-family buildings when se{wate permits are nnot required Waa& d r. } s Address " U+ t o C a livable) _ i-mot ~++.rtr.~ Previfts Teat* Nam Pt ty'Owner } S Adtlr Cti Ted ~dAS 11so.-AppheoW is cowactor Other Vvok F r~ Type Y Pi w Construction Un nd 'T'ank ~ tmtelt Rem * 4POW tit lr+tedoc Improvement Install Piping _ Pro sed was 4 ' 2tu* Of rkk: , f, ftSWMWnMDVhV undwground ink,. ce for Inspection by lire Uws" 4W ° A; :~t Fes: S78,Sf1 I.hidargrcntttd tank in~a11•etion/tBmo~~il" , ffi5[1.St► ~ (ixtcttxics 8tat~'3~rciLarg~} or _ I Value $ R - X 1% _ $ If P=9 foe is $1,000 Or less, add $.54 'Ile If ~ fee is over S1.M%, aced $.5Q for every $1,0W PVIL& fee T ably for a Cotnmeraal lviecha~tic Perch and acknotectg that the inforn'xiarton is arild t' ~!1 be in cpUf~arcna= with the ordinances and codes of the City of Eagan and with the A eha~i Cotes, I W n >t Pwnk tw only an application for a permit, and work is not to start without a eriwt; that tine work pill f *c amed plan m the case of work which requires a rev m and approval of plans. ~~S VP r . Sy: r A~ Daft: ~T~ ~ i h~ f3 w . a- 2005 CQ11 MERCIAL BUILDING PERMIT APPLICATION City Of Eaten 3830 Pikvt Knob Read, Eagan .tea 55122 Telq&oxte # 651-673-5675 FAX 651475-- *W Skwtwsi Planar PrAft + Art tech" Plans (2) soft • Ai6h " - • OW Plans C2) • Strt+cturW Plar«s (2) • Cod,eAn o (t7 - Ef of Survay (1) • Civil f IMS (2) • PMjW $Pacs • Ars*sis (1) . Landsca9ft Plans (2) • Key Finn (t) • $Poo$ (1) • Co" Arsa#ysis (1) . WSW FA Pigmy SpK. *W, & Testing Schedule • Corti caft of Survey (1) • EneW C4tcuktlom (1) not Bob • Raw (1) . SW_ insp. & Testing Sdva- ule (1) • Elec. Povw b L~bm' {f) r+at AvOyV" • tatter site must be established • Meter size must be established + MeW sire nest bo - Project Specs (1) Energy Catculations (1) l t • Electric Power 5 Lighting Form (1) 1 • Master Exit Plan (1) • Emcee may Response Site Plan (1) 1 1 * Soft ROW (1) STAG dot" hatiorl - cap 65ti 602- ODD . SAC determination - calf 531-602-1000 • ' SAC daternriragion -tug a*1 -1 i. . Fire 8uWnftt k Call ANN Dept of Health at 651-215-0700 for details regarding Mod & beveraS4 or ledgini t 4t~s. e * Contact Building Insr5tiow for saunple and if requircd Penult for pr^~ building or WW" will tot be proecssad without Ettxrgency Respomie Site Plan. Date 1 { 5 Construction Cast n w e lie Address o usiMe TO Nal" °Former Tenant Name laeriptiraet a1 Work 1 A.~ r`--` P t rz IE'~o'pera';y owmclr Tie # Stag f R1 Zip Tewpho # Addtveats 40- ej;r'T014 t! chY la State !1j Zip S 0 Teiopitou # { t fi_MA~ 3,12M Ummed plur?'tb ins'lh Wng sgbrt Wwaater servim: Pttooe - Ara apply for a Commercial Buil&ng Permit and acknowledge that the doa work will be in conformance with the ordinances and codes of the City o'er v~d thi l utes I understand this is not a permit, but only an application for a permit, a, irk is not to sW vriftut a pemit; that, the work will be in accordance with the approved plan in the cam of work wh mquir : a n~i~ Pd appro f fans. Appli Printed Name applicant's ig ihtm USE 01M © i ` Fou ttian : 0 26, Puhtio FaMk V ~Ir~y;B3ti 0 14 Apartments x'°"27 C Ct ~ 1 J~1~ld~i► O15 Dodging 0 28 Greenhouse U 34 tt A*~'oixi- n- 25 MiscellaztwUs a 29 Antomw 0 35 Ext Alt-PuM Facility 0 37 Nail Salmi Work Types fl 31 Now > 35 lr+t #tr+4t! Q 30' d 44 Siding tr3 32 Admen Q 30 Ma" bldg: 0 42 Oomokh (fob) (3 45 Tiro Rx"; 13 33 Attersd6n 37' 'DernOM (Oft)* Cl 43 Ro";a a 46 voldow Cl 34 Replac+ern t8 - (Mv* PCA hwKWO t* *MV4^* 33 er►oY mcr::B sy"Oft . Cett4tts Cc Zoning C4 Neater S _ SAC Unks . 0005W P" Nbr. of Urfts S4, Ft F Y% Nbr. of Bfts t Type ofConst Wkfth Rcquited Lna~peet~na _ ,:h Footing (new bit)Ida Footings (deck) >xin C.U. , Footings (addition) FitWfNo Cb. Fowxtadon otho Drain Tile 9 Roof _ Ice Pr Deckiag b sul _ Final " Pool lags _ Air/Gas Teats 1st Framing Siding Stecco „ Storrs Fireplace R.I. Air Test Final Windows Approved By: 1 r l uili irtg Bmw Fee o 9 s, Surcharge Pion Review 1t`lti Q MCES SAC City SAC Weer Supply 8 Storage MACS SAN Permit S/W SUS J _ Treatment Plant Park Dedk on Water QuaNty+ CO Water Trunk Sewer Trunk x Other Tc 3 , i City of Eap~ March 25, 2005 Pat Geagan MAYOR Peggy Carlson MARK COLBURN Cyndee Fields UNITED PROPERTIES Mike Maguire 3500 AMERICAN BLVD Meg Tilley MINNEAPOLIS MN 55431 COUNCIL MEMBERS RE: BV E CROSS BLUE SHIED 1sT AND 3RD FLOORS REMODEL Thomas Hedges 35 BLUE CROSS ROAD CITY ADMINISTRATOR Dear Mark: We have completed our review of the construction documents submitted in pursuit of obtaining a building permit for the above-referenced project. This review is not intended to be an exhaustive and comprehensive report. Unless otherwise noted, all references are to the 2000 I.B.C. It is our goal that this review will help you in complying with the MUNICIPAL CENTER applicable codes and we are, therefore, requesting that the following items be addressed. 3830 Pilot Knob Road Eagan, MN 55122-1810 1. Provide a fire extinguisher in the break room per City Fire Marshal. 651.675.5000 phone 2. Telephones in accessible phone booth to comply with MN Rules, Chapter .1341.0478 651.675.5012 fax and relative sections. 651.454.8535 TDD If you have any questions regarding these requirements, please call me at 651-675-5676. Thank you. MAINTENANCE FACILITY 3501 Coachman Point Sincerely, Eagan, MN 55122 Y 651.675.5300 phone ~t Gis-L~ 651.675.5360 fax Mike Lence 651.454.8535 TDD Senior Inspector ML/J' eh www.cityofeagan.com cc: Thomas DeAngelo, Architectural Alliance, 400 Clifton Ave. S., Minneapolis, N1N 55402 Keith Peters, Facilities Dept. Blue Cross Blue Shield, 1305 Corporate Center Dr., Eagan, MN 55121 Dale Schoeppner, Chief Building Official THE LONE OAK TREE The symbol of strength and growth in our community. A, N 1 city of eagan THOMAS EGAN Mayor August 23, 1996 SPATRICIA HAWN HUNTERA SANDRA A. MASIN THEODORE WACHTER SHARON ZAUHAR Council Members ASSISTANT VICE PRESIDENT OF ADMINISTRATIVE SERVICES THOMAS HEDGES BLUE CROSS BLUE SHIELD OF MINNESOTA City Administrator 3 53 5 BLUE CROSS ROAD E. J. VAN OVERBEKE EAGAN, MN 55164-0560 City Clerk Dear Sharon: I was recently informed of concerns expressed by the leadership of Blue Cross Blue Shield about the inclusion of the company property east of Blue Cross Road in the list of sites to be considered under the September 10 Park Bond Referendum. I would like to apologize for any concerns this has caused you and assure you that the Referendum Task Force and City Council have been advised that you are not interested in selling this property and that it should not be considered as a candidate site. I would like to provide you with some background on the site identification process to clarify that the appearance of the property on the referendum's preliminary list did not reflect any absence of communication by your representatives nor any ill intent by the City. For some time now, you and Chuck Hall have been working with our Community Development and Engineering staffs to outline and refine the future development of your property. Both of you have been very forthcoming with information about Blue Cross' plans for the area as noted in the attached correspondence. We appreciate the extraordinary effort you have made to work with the City to address issues with this property before the fact. I believe this typifies our long history and positive working relationship with both of you. Over the past two years, the City's Advisory Parks Recreation and Natural Resources Commission and a specially appointed Referendum Task Force have discussed the potential for a bond referendum to preserve additional open space within the community. This is an issue which has been the subject of referendums in other cities in recent years and increasingly it has become a topic of discussion as Eagan reaches a more mature stage of development. MUNICIPAL CENTER THE LONE OAK TREE MAINTENANCE FACILITY 3830 PLOT KNOB ROAD THE SYMBOL OF STRENGTH AND GROWTH IN OUR COMMUNITY 3501 COACHMAN POINT EAGAN, MINNESOTA 55122-1847 EAGAN, MINNESOTA 55122 PHONE: (612) 681-4600 PHONE: (612) 681-4300 FAX: (612) 681-4612 Equal Opportunity/Affirmative Action Employer FAX: (612) 681-4360 TDD: (612) 454-8535 TDD: (612) 454.8535 The Task Force's charge was to review currently undeveloped parcel's which might meet the future needs of the City for natural and open space preservation. The Task Force and City council determined that it would be in the best interests of the City, as a potential purchaser, to identify a potential list of a greater scope than could be acquired under the referendum. In that way, the City could investigate the plans of current property owners and gauge their willingness to sell while retaining a number of alternatives. If the referendum passes, it is important that our taxpayers receive the greatest return for their dollar. The Council believes that narrowing the list too much at the outset would cause the cost of the candidate sites to inflate and could diminish the value received by the community. The City is aware that some of the property owners will be willing sellers and some will not. Letters were forwarded to you and the other owners to begin the process of determining owner interest. We also realize that some owners' plans may change if a successful referendum offered them an alternative prospect for their property. Rather than narrow the list before this was known, the Task Force erred on the side of inclusion. We clearly understand that you do not wish your property to be considered further and we will respect that. We also hope that this explanation clarifies the City's intentions and methods in preparing this referendum. Eagan values and appreciates the part Blue Cross Blue Shield plays in this community and in its development. We look forward to the continued growth of the company within the community. If you or Mr. Hall have any questions, please call me at any time. Sincerely, Thomas L. Hedges City Administrator cc: Thomas Egan, Mayor Chuck Hall, C. Hall Co. Parks and Recreation Director Vraa Public Works Director Colbert Senior Planner Ridley C. HALL CO. Real Estate • Brokerage Counseling • Development Leasing • Management August 4, 1995 Mike Ridley Planner Planning Department City bf Eagan 3830 Pilot Knob Road Eagan, MN 551 22-1 897 Dear Mike: At the planning review session held July 27, 1995, a question was raised about the background and planning done before the request for the RiverPark Office Center approval process was started. It was indicated to the group that Blue Cross Blue Shield of Minnesota (BCBSM) has an internal long range plan for space growth and use. The plan is proprietary and it is preferred that portions be kept confidential because of the competitive nature of the present business climate. This letter is a synopsis of parts of the plan, and background of the information used in preparing it; as well as indications of the city personnel briefed and consulted, at various times during its formation. Blue. Cross Blue Shield of Minnesota has been a corporate citizen of Eagan since March of 1970, on completion of its original main building. The acquisition of the 180 acre site at 3535 Blue Cross Road preceded that date when the area was basically farm land. The original main building of about 200,000 square feet s'ts on a 55.3 acre site. The original building was almost doubled to 370,00 sq are feet in April of 1976, with extra space added in the early 90's, and in 1994 to a total of approximately 400,000 square feet of space. The planned de elopment of June of 1981 for the 55 acre site allows for two more 190,000 s uare foot expansions to be undertaken. On Blue Cross Road, acro s from the main building and to the east, Blue Cross Blue Shield of Minnesota awns 112.675 acres, which is the residual of the original 180 acre purchase, after park dedication. The city of Eagan has an ongoing discussion with BCBSM about this second site. BCBSM projects its needs on the site in the magnitude of 600,000 square feet of office space. The city will not know its requirements until Fall of 1995. BCBSM presently occupies between 800,000 and 900,000 square feet in Eagan, including the 400,000 at the main building, and at four locations, soon to be five. The long range plan calls for three locations in close proximity, with an undetermined amount of "swing" or short term use space available in the rental market again in close proximity on the so called "Yankee Doodle Corridor." 3862 BRIDGEWATER DRIVE • EAGAN, MINNESOTA 55123 • TELEPHONE (612) 454-3077 C. HALL CO. BCBSM has explored and is continually bombarded with proposals from other municipalities, including any number from out-state Minnesota. Most of these proposals include subsidies and enticements which as yet have not been sought by BCBSM from the city of Eagan, or offered by the city of Eagan. The long range plan calls for those opportunities to be shelved, to allow BCBSM to attempt to expand on its RiverPark site, as the first step in its planned use of the three sites at the Main Campus, the Blue Cross Road East Campus, and the RiverPark Campus. The sites would include about 2,000,000 feet of space, at approximately 800,000 - 600,000 - and 600,000 square feet respectively. The employee count could approach 6,000 people or about double the present employee count. Before acquiring the RiverPark site, BCBSM occupied the building as a tenant, ultimately leasing the whole building. During the tenancy, BCBSM had acquired an option on the adjacent land, and kept track of the various developments in the area, such as the upgrading of streets, proposed vacating of streets, etc., and'kept Mayor Tom Egan and City Manager Tom Hedges updated on the future of BCBSM interests. Before committing to exercise of the BCBSM purchase option on the land, and negotiation of the purchase of the RiverPark building, BCBSM directed C.Hall Co. to contact the city (Peggy Reichert and Tom Colbert) to discuss the plan to be submitted in a subsequent meeting, outlining five interconnected campus buildings, and seek their support, which was given. The attached letter, dated March 21, 1995 outlines the procedure. To reach the needs of BCBSM's space use, construction, and leasing plan, from 1995 to 2025, the three 50 to 60 acre sites (each) under consideration need maximum use of the land under the city codes, with as much help from the city as possible, wherever the city has latitude to help. The RiverPark P.D. process will set the tone for the following two developments, and will indicate whether the plan can succeed on three disconnected sites verses unified, larger, more expensive but subsidized sites with fixed plans and commitments. Yours truly, C.Hall Co. Charles F. Hall President 3862 BRIDGEWATER DRIVE • EAGAN, MINNESOTA 55123 • TELEPHONE (612) 454-3077 k , C. HALL CO. Real Estate - Brokerage Counseling - Development Leasing - Management March 21, 1995 Sharon Zauhar Assistant Vice President Administrative Services Blue Cross Blue Shield of Minnesota 3535 Blue Cross Road PO Box 64560 St. Paul, MN 55164-0560 Dear' Ms. Zauhar: This letter is to confirm and report on meetings held on behalf of Blue Cross Blue Shield of Minnesota with officials of the city of Eagan regarding the due diligence undertaken prior to the purchase of the RiverPark building. Initially, Charles Hall met with Tom Colbert, City Engineer, and Peggy Reichert, Director of Economic Development, on February 27, 1995, to ascertain the position of the city on the questions listed below regarding the proposed Blue Cross Blue Shield of Minnesota purchase of the RiverPark building. Ms. Reichert and Mr. Colbert indicated that they, and presently sitting city officials, could not commit to future actions by their offices or bodies, with out formal applications, and formal hearings and actions by the city. The information they gave us was of a guidance or public information nature. We discussed the following items: 1. Zoning. 2. Future of access westerly of Terminal Drive on Yankee Doodle Road. 3. Future of Kennebec Road right of way and access. 4. Potential very large special assessments now known. 5. Adequacy of parcel for parking in the event of expansion. 6. Green space requirements. 7. Adequacy of water and sewer availability in public,streets adjacent to parcel. 8. Their knowledge, if any, of the adequacy of natural gas and NSP electricity. 9. Access to State Highway 13. I O.Suggestions for procedures to be followed in development of the proposed expansion of the use of the site. 3862 BRIDGEWATER DRIVE - EAGAN, MINNESOTA 55123 - TELEPHONE (612) 454-3077 C. HALL CO. The general response to the verbal picture painted by C.Hall of BCBSM s intentions was positive, and the engineering department looked up the status of Kenebec Drive, and later indicated it had not been vacated. They knew of no new huge city projects in the area. Peggy Reichert suggested a planned unit development process as being the route to future development of the area. BCBSM then commissioned Winsor Faricy to do a preliminary density plan of the site, with a site plan, method of access, and proof of parking. Harry Olsen and C. Hail met with Peggy Reichert on March 9, 1995, and presented the plan attached for her suggestions and reaction. Ms. Reichert was generally positive and supportive of the plan, though she hoped as we do that the proof of parking area towards the river could be left green as long as possible, except for fire truck access. Based upon these meetings, and Winsor Faricy's and C.Hall Co.'s knowledge of the. Eagan codes, C.Hall Co. believes this property can be developed according to the plan presented, upon following all of the development procedures of the City of Eagan. Yours truly, C.Hall Co. Charles F. Hall President cc: Peggy Reichert City of Eagan Tom Colbert City of Eagan Wayne Winsor Winsor Faricy Harry Olsen Winsor Faricy x. John Healy Oppenheimer Wolff & Donnelly Jackie Jones Blue Cross Blue Shield of Minnesota 3862 BRIDGEWATER DRIVE • EAGAN, MINNESOTA 55123 • TELEPHONE (612) 454-3077 ! i Jj, it hNAL_1141 5 PaclhTilv(~ DUILDINC~ A" e NOT AREA (tn4o) t 64,r,3o roG. 1 PAFIVNb !411.(1:t5o) Je 10 4rAcE5 t'rton*ap &?P(Tiomev -4 aL64v kv,o004,F to bm44 AREA 400.000 6K )1Er A'iEA NWQ #W,000 5F pAWUNb po(I:too) 2133 OPA N I o TOTAL. PAa/clNb r<taurra -101 9ti'AGEfj Cglo Nb FPOW Lar EXPANDED (q'94LL$) I644 (529•) j / ,<j dY.F LOrS 1509 :t t / ` c,✓ t I Yl T6iAt 6"055 A.Db Aaa1: 59o,~B? S~ t u Z bwhNDED F(iDMf Lot OVL~I: i 'f a : W Ntr 5P. +Iog LOr WWI tTAL[fi) a I STML:27o NET ~iF. ~ Fu ♦I t / z 4 ~ ~ / II I ~r(I~l1'IN6 SLCV'. EMFL04Ef6:650 m:y I .278 NE'r 61r-. e ~ 2 2 1 ' X \ 52.5 ~Gtz~S 11.33 ~G¢ES 31.1'7 A~ ° KIT E P L A N - DON EP,, ' \ , 9o85M i - BAbhN NN J ~ • ~ a,.b•ae 1lt tto / S ~ 0 SO 110 !a0 " aka FIJ ~ • 22~ I l j y ~ Vy~ a f~. e r A~ 14 Ao( 14, 1- U IL RECEIVED AUG 2 9 2003 C O U N T Y EAGAN E~ "'-_PING DEPARTMEN Environmental Management August 25, 2003 EA 227 Barry C. Schade Lirector Dakota County Western Service Center Ms. Kristine Wingen 14955 GGalaxie Avenue American Engineering Testin Apple Apple Valley, , MN 55124 9 550 Cleveland Avenue North 952.891.7557 Saint Paul, MN 55114 Fax 952.891.7588 www.co.dakota.mn.us Re: BCBS Demolition Dump [Site 2048 (U-17)], Eagan Dear Ms. Wingen: A preliminary review was performed in response to your August 22, 2003, request for an enhanced environmental audit on the demolition dump located on the tax-forfeited property southeast of Yankee Doodle Road and Sibley Memorial Highway (TH 13). From your message, I am assuming that you are referring to the BCBS (Blue Cross-Blue Shield) Demolition Dump [Site 2048 (U-17)] located in Eag9an. I understand that you are out-of-the-office until Wednesday, August 27 and so I am sending you the site report and map of the latter disposal site. If I am incorrect, please don't hesitate to contact me immediately. The site report and map are attached for your information and are based on a limited file review (Attachment 1). If you discover any waste disposals or contaminant releases not reported here or uncover errors in this review, please contact me at telephone (952) 891-7542. Should you have additional questions or require further assistance, please contact me. Sincerely, Ronald C. S g Environmental Program Manager Site Assessment & Remedia(tion 1 ~t,r Leal s ~ ~ .1 i~ Attachment -Tom Cc: Tom Public Works Director, City of Eagan Printed «retydea Paw with 30% posacorrs-wage. AN EQUAL OPPORTUNMY EMPLOYER : SO Department of Administration +ieee• 0 C T 13 2004 October 12, 2004 By APPROVED FOR USE Blue Cross Blue Shield 3535 Blue Cross Rd. Eagan MN 55122 RE: Hydraulic Passenger - Elevator ID# -10434AL04-01 Site: Blue Cross Blue Shield 3535 Blue Cross Rd. Eagan 55122 Dear Sir/Madam: Minnesota Statutes Chapter 16B provides that the Department of Administration, Building Codes and Standards Division, Elevator Safety Section, inspect and approve elevators and manlifts (endless belt lifts) before they can be legally used in Minnesota. An Inspector from the Elevator Safety Section recently inspected your facility and determined it meets requirements of the Minnesota Elevator Safety Code. NOTE: Compliance with Minnesota Rules and the ANSI/ASME A17.1, Safety Code for Elevators and Escalators does not necessarily assure compliance with the Americans With Disabilities Act of 1990. Sincerely, BUILDING CODES AND STANDARDS Im Weaver State Elevator Inspector Pw/kad (CE-2) Schoeppner, Dale R., BO, City of Eagan Otis Elevator Company ElFormCE2 Building Codes and Standards Division, 408 Metro Square Building, 121 7th Place East, St. Paul, MN 55101-2181 Voice: 651.296.4639, Fax: 651.297.1973; TTY: 1.800.627.3529 and ask for 296.9929 COMMERCIAL n n~ l 2002 BUILDING PER &T APPLICATION r CITY OF EAGAN ` 1 `r! c) 651-681-4675 14, 1+ Foundation Only New Construction Interior Improvement • Structural Plans (2) sets . Architectural Plans (2) sets • Architectural Plans (2) sets • Civil Plans (2) . Structural Plans (2) • Code Analysis (1) • Certificate of Survey (1) . Civil Plans (2) • Project Specs (1) • Code Analysis (1) . Landscaping Plans (2) • Key Plan (1) • Project Specs (1) . Code Analysis (1) • Master E)at Plan (1) • Spec. Insp. & Testing Schedule . Certificate of Survey (1) • Energy Calculations (1) not always** • Soils Report (1) • Spec. Insp. & Testing Schedule (1) • Elec. Power & Lighting Form (1) not always** • Meter size must be established . Meter size must be established • Meter size must be established -if applicable Project Specs (1) 1 e Energy Calculations (1) 1 1 • Electric Power & Lighting Form (1) 1 1 • Master E)at Plan (1) 1 l • Fire Protection Plan (1) 1 d • Soils Report (1) 1 • MC/ES SAC determination letter • MC/ES SAC determination letter • MC/ES SAC determination letter call 651-602-1000 call 651-602-1000 call 651-602-1000 Contact Building Inspections for sample Food & beverage or lodging facilities - submit plan to MN Department of Health. Call 651-215-0700 for details. DATE: be ( , 19 r Q a" WORK TYPE: 0/- NEW REMODEL CONSTRUCTION COST: 2315 a Q SITE ADDRESS: 35 3 S G/ cw- Cr o SS TENANT NAME: Zoe (k SUITE FORMER TENANT NAME, IF APPLICABLE: DESCRIPTION OF WORK AeoJ So vr~ t o-p-m NX a^d Name: Phone (tom t ) (0 PROPERTY Last First OWNER Street Address: 3535 ~T 0 SS Ckoe, City: E-0, oy-, State: M d zip. 55! °Z °Z raj Company: AAn n of i- Phone (tA Sl )(033 S O 'CONTRACTOR Street Address: 31 11 f` Vice,/ i-iwt.-- City: State: tM Zi ARCHITECT/ . q ! 7. 2 20OZ ENGINEER Company: r4o r e- ( g'l ( i oyv e- Phone _ F~l Name: Registration B Street Address: 4-0 C ( t" "140.n f~ tri' sd City: ~V 1 S State: lJ Zip: Jr- 't a V Licensed plumber installing new sewer/water service: Phone I hereby acknowledge that I have read this application, state that the information is rest, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: Updated 1102 OFFICE USE ONLY SUBTYPE ❑ 01 Foundation ❑ 26 Public Facility ❑ 30 Accessory Bldg. ❑ 14 Apartments X 27 Commercial/Industrial ❑ 32 Ext Alt - Apts. ❑ 15 Lodging ❑ 28 Greenhouse ❑ 34 Ext Alt - Comm. ❑ 25 Miscellaneous ❑ 29 Antennae ❑ 35 Ext Alt - PF ❑ 37 Nail Salon WORK TYPE ❑ 31 New 35 Tenant Impr ❑ 42 Demolish (Foundation) ❑ 46 Windows/Doors ❑ 32 Addition ❑ 36 Move Bldg ❑ 43 Reroof ❑ 47 Repair ❑ 33 Alterations ❑ 37 Demolish (Bldg) ❑ 44 Siding ❑ 48 Authorization ❑ 34 Replacement ❑ 38 Demolish (Int) ❑ 45 Fire Repair GENERAL INFORMATION Census Code 45-7 Zoning sq. ft. SAC Code 30 # of Stories sq. ft. No. of Units Length sq. ft. No. of Bldgs. - Width sq. ft. Const. (Actual) LWK - Basement sq. ft. MC/ES System (Allowable) ' I hie. First Floor sq. ft. City Water UBC Occupancy_ sq. ft. Fire Sprinklered MISCELLANEOUS INSPECTIONS ❑ Gas Service Test ❑ Heating ❑ Insulation Plumbing ❑ Stucco/Stone APPROVALS Planning Building Engineering Variance aLob VALUATION $ Z Permit Fee 41 00 Surcharge Plan Review L r, MC/ES SAC % SAC City SAC SAC Units Water Supply & Storage Meter Size S/W Permit S/W Surcharge Treatment Plant Park Dedication Trails Dedication Water Quality Other Copies Total IEP-16-02 15:51 From:ICGOUGH WAREHOUSE +6516344608 T-230 P.05/06 Job-112 t f l 01- X .,J- - _ • 1 _ fl f v . .-._.~._.W I { too/toolt 33NVIIIIV 'IV2T=aLlHDKv 7Cv'd tO 8Y ~OtBi/60 BCBS Demolition Dump [Site 2048 (U-17)], Eagan BCBS DEMOLITION DUMP [Site 2048 (U-17)], Eagan Location. The BCBS (Blue Cross - Blue Shield of Minnesota) Demolition Dump is located southeast of the intersection of Yankee Doodle Road and Sibley Memorial Highway (Trunk Highway 13) in Eagan [PIN 10-14550-010-01; 14.37 acres; Public Land Survey: Northeast quarter of the northeast quarter of Section 17, T.27N., R.23W.]. The property is owned by the Minnesota Hospital Service Association (Blue Cross - Blue Shield of Minnesota), 3535 Blue Cross Road, Eagan, MN 55123. Description. Prior to the 1968-1969 construction of the Blue Cross - Blue Shield of Minnesota building, parking lots, and grounds, the area was farmed and likely hay-cropped if not offering livestock pasturage. The aerial photos reviewed did not indicate that the property was ever occupied. The April-May 1970 aerial photograph depicts the BCBS building, parking lots to the south of the parcel, and a north-trending linear trench in the center of the subject parcel. Access to the trench appears to be from both BCBS and Yankee Doodle Road on the north. Its purpose is unknown although it could have been excavated for utilities (e.g., storm sewer). Whatever its purpose, the trench and immediate area appears to have been backfilled with demolition and construction debris, as well as on-site or off-site soils, by the early 1970s. The volume of wastes appears to be small or moderate but is unknown as is the actual extent of the disposals. The site extent was mapped from the 1970 aerial photo. [Nota bene: It was once the common practice of some public works personnel and contractors to backfill excavations with demolition and construction debris, as well as "off-spec" soils (i.e., soils containing residual wastes and contaminant releases from off-site sources). It is not known if this site was related to a public works project.] In the mid-1980s and again in 1996, County staff observed scattered demolition debris at the surface in the area of the disposals. On 3 May 1996, staff observed small mounds on the hill slope, which were partially vegetated and had been landscaped at one time. Erosion had exposed concrete debris, and using a magnetic locator buried ferrous material was detected near some exposed concrete debris. Animal burrows were common in the area. The inspector noted that a fire hydrant and a marked natural gas pipeline were nearby and that perhaps their installation had resulted in the partial unearthing of the visible concrete debris. Presently, the property appears unencumbered by waste disposals. The parcel is vegetated, landscaped, and slopes downhill west of Blue Cross Road to Trunk Highway 13. A parking lot is present in the southernmost corner of the parcel, and its northwestern extent is very close to the estimated southern extent of the buried trench and disposals. Recommendations. The waste disposal site should be investigated to determine its origin and purpose, as well as the principal wastes and possible releases present. The Dakota County Environmental Management Department should be notified of any investigation, testing, and cleanup, and copies of all reports should be provided. Compliance with all applicable County Ordinances (e.g., Ordinance No. 110 - Solid Waste Regulation) is required. Contact Department staff for assistance at telephone (952) 891-7557. Caveat and Notes: The information provided is derived from a compilation of records and data gathered from a number of sources with variable reliability and accuracy. Therefore, it should be used with caution. Although reasonable and prudent care has been exercised, Dakota County and its employees are not responsible for any errors or omissions contained herein. If detailed investigations have not been conducted, the extent, boundaries, characteristics, and impacts of sites discussed may be incompletely known. The site inventory process is being continuously updated. Previously unknown sites are being reported, disclosed, and discovered, and new information on existing sites is being made available. Evaluations are based on reviews of and assumptions derived from only those records and data compiled. The maps and figures are not legally recorded surveys and should not be used as such. Should any discrepancies, inaccuracies, or inconsistencies be found, please contact the Dakota County Environmental Management Department immediately. This document may be copied, quoted, and otherwise disseminated provided that it is intact (all pages including maps and data), unaltered, and properly cited as to authority. RCS 11/1/01 Copyright © 2001 by Dakota County 2048.doc/pdf Dakota County Environmental Management Department - Site Assessment 1 Page 1 of 1 r Irv - r u - • ' _ 2196 ) 2014 1. •P ' X t a Jf i II'V rw } rl - J, i 3 All J I~ ' 'im- p , I~h ~:I ' r ~y try I e'" - F 1,Y 10 Gz { Ce r' M 2D690akelaCoun{i a r httn://s9R200.co.dakota.mn.us/outnut/emdatal GISWEB 1665590392.iug 8/25/03 cs -1 C-0 l COMMERCIAL 002 BUILDING PERMIT APPLICATION CITY OF RAGAN to 651-681-4675 -CJ Foundation Only New Construction Interior Improvement • Structural Plans (2) sets • Architectural Plans (2) sets • Architectural Plans (2) sets • Civil Plans (2) . Structural Plans (2) • Code Analysis (1) • Certificate of Survey (1) Civil Plans (2) • Project Specs (1) • Code Analysis (1) . Landscaping Plans (2) • Key Plan (1) • Project Specs (1) • Code Analysis (1) • Master Exit Plan (1) P • Spec. Insp. & Testing Schedule • Certificate of Survey (1) • Energy Calculations (1) not always** • Soils Report (1) . Spec. Insp. & Testing Schedule (1) • Elec. Power & Lighting Form (1) not always- 0 Meter size must be established . Meter size must be established • Meter size must be established - if applicable • Project Specs (1) 1 • Energy Calculations (1) 1 1 • Electric Power & Lighting Form (1) 1 1 • Master Exit Plan (1) ! d • Fire Protection Plan (1) 1 1 • Soils Report (1) 1 • MC/ES SAC determination letter MC/ES SAC determination letter MC/ES SAC determination letter call 651-602-1000 call 651-602-1000 call 651-602-1000 Contact Building Inspections for sample Food & beverage or lodging facilities - submit plan to MN Department of Health. Call 651-215-0700 for details. DATE: :~U.40 f 54 AO WORK TYPE: _ NEW ~ REMODEL CONSTRUCTION COST: SITE ADDRESS: 13 4 Y"ge dd t e ~ ~ ~~GC~dS TENANT NAME: ~ 3 5 B/up Grass ) t m~J SUITE FORMER TENANT NAME, IF APPLICABLE: DESCRIPTION OF WORK RS-b V! je , ~~6YO-VM :537 - 9_3 Name: 10 04t;k- ' Tv `4W At 5 Phone 1/ 1 2 PROPERTY Last First OWNER 1&Nk. C.U~ ye Street Address: Ll ~ ~ City: State: N Zip: 5:5 Z Company: ~c LLM 3~ Od Phone (ty ~ j ) && 2 - CONTRACTOR Street Address: '3536 tQ C, ypss P-"/ City: C,CP C~'i1// State: N Zip: 1 2 2 ARCHITECT/ ENGINEER Company: Phone ( } Name: Registration _ Street Address: JUN 1 1 200 p: City: State: J#:y Licensed plumber installing new sewerlwater service: PhoI hereby acknowledge that 1 have read this application, state that the information is c e , and a e to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: Updated 1/02 I Yankee Doodle Road Stage D H L m C G K 0 0 ❑ ccnn Pop Lemon- X O ade Ow O Q o B F J O F Kettle LL a Corn v 3 Info E I Booth Parking Lot ca* cr "y ~-o a- ~ l o c,~- l COMMERCIAL yVu~ .a C& SS 2002 BUILDING PERMIT APPLICATION CITY OF EAGAN 1 (a 651-681-4675 Foundation Only New Construction Interior Improvement • Structural Plans (2) sets • Architectural Plans (2) sets • Architectural Plans (2) sets • Civil Plans (2) • Structural Plans (2) • Code Analysis (1) • Certificate of Survey (1) . Civil Plans (2) • Project Specs (1) • Code Analysis (1) • Landscaping Plans (2) • Key Plan (1) • Project Specs (1) • Code Analysis (1) • Master Exit Plan (1) • Spec. Insp. & Testing Schedule • Certificate of Survey (1) • Energy Calculations (1) not always** • Soils Report (1) . Spec. Insp. & Testing Schedule (1) • Elec. Power & Lighting Form (1) not always"" • Meter size must be established • Meter size must be established • Meter size must be established - if applicable • Project Specs (1) 1 • Energy Calculations (1) 1 1 • Electric Power & Lighting Form (1) 1 1 • Master Exit Plan (1) 1 1 • Fire Protection Plan (1) 1 1 • Soils Report (1) 1 • MC/ES SAC determination letter • MC/ES SAC determination letter MC/ES SAC determination letter call 651-602-1000 call 651-602-1000 call 651-602-1000 Contact Building Inspections for sample Food & beverage or lodging facilities - submit plan to MN Department of Health. Call 651-215-0700 for details. DATE: y" ~ -Oa WORK TYPE: NEW _ X REMODEL CONSTRUCTION COST: -I S-0 SITE ADDRESS: -3 S -T F> 1 ~:e GroLc9 R~ 2C/~e 1148.eO TENANT NAME: R I WE- l rOS,S SUITE FORMER TENANT NAME, IF APPLICABLE: DESCRIPTION OF WORK o, wad k- (,ta area. y, SrA mP-S OL Cach Name: we- C~ 0 SS Phone PROPERTY Last First OWNER C►roSS j2d APR 0 3 2002 Street Address: City: 29-LL State: rn Zi R Company: G 60 u, 9~\ Phone CONTRACTOR ~ , Street Address: ~t ~ l 2 t,J AV r City: PAO, State: YY1 /V + Zip: .S-S ~l3 ARCHITECT/ yy~~ yy~~ ENGINEER Company: 9 11111ct,y, C'e Phone (ro a ) ?5 7 1 -.7 T) -1 Name: Registration Street Address: . City: ~Y\ Y L.S State: vv 1 Zip. Licensed plumber installing new sewer/water service: Phone (b 1 hereby acknowledge that I have read this application, state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: Updated 1/02 OFFICE USE ONLY SUBTYPE ❑ 01 Foundation ❑ 26 Public Facility ❑ 30 Accessory Bldg. ❑ 14 Apartments 27 Commercial/Industrial ❑ 32 Ext Alt - Apts. ❑ 15 Lodging ❑ 28 Greenhouse ❑ 34 Ext Alt - Comm. ❑ 25 Miscellaneous ❑ 29 Antennae ❑ 35 Ext Alt - PF ❑ 37 Nail Salon WORK TYPE ❑ 31 New 35 Tenant Impr ❑ 42 Demolish (Foundation) ❑ 46 Windows/Doors ❑ 32 Addition ❑ 36 Move Bldg ❑ 43 Reroof ❑ 47 Repair ❑ 33 Alterations ❑ 37 Demolish (Bldg) ❑ 44 Siding ❑ 48 Authorization ❑ 34 Replacement ❑ 38 Demolish (Int) ❑ 45 Fire Repair GENERAL INFORMATION Census Code 4317 - Zoning sq. ft. SAC Code 5c, # of Stories sq. ft. No. of Units Length sq. ft. No. of Bldgs. - Width sq. ft. Const. (Actual) 'jr-J~ Basement sq. ft. MC/ES System 11 (Allowable)1"7t First Floor sq. ft. City Water UBC Occupancy :a sq. ft. Fire Sprinklered MISCELLANEOUS INSPECTIONS ❑ Gas Service Test ❑ Heating ❑ Insulation Plumbing ❑ Stucco/Stone APPROVALS Planning Building Engineering Variance Permit Fee VALUATION $ ~ `-1 j 1 5- 3 a~ Surcharge QC~ / Plan Review 172- , - MC/ES SAC % SAC City SAC SAC Units Water Supply & Storage Meter Size S/W Permit S/W Surcharge Treatment Plant Park Dedication Trails Dedication Water Quality Other Copies Total c c~ CITY USE ONLY PERMIT O 1 - CJ RECEIPT DATE: APPROVED BY:T ~ 01 , INSPECTOR COMM CIAL MEMMICAL I'EI;14IIT APPLICATION ~ CITY OF EAem 3630 PILOT KNOB BD EAE N, MN 55122 651-661-4E675 Please complete for: all commercial/industrial buildings multi-family buildings when separate permits are not required for each dwelling unit I DATE: I - Z& - 0 SITE ADDRESS: 383 ,Q 8 LdE C2d SS F-J. CC trl MAI. rr/Z.Z OWNER NAME: 131 o e, C 20 Ss PHONE (AREA CODE) TENANT NAME (IMPROVE$vIENTS ONLY): WAS THERE A PREVIOUS TENANT IN THIS SPACE? _ Y N. NAME: INSTALLER: _UNI"TCO ADDRESS: fiL44 A ✓C . /V . PHONE joSl - 4F-0. 9/3 0 (AREA CODE) CITY: Sj, STATE: -/V%1/ . ZIP: 0 //7 WORK TYPE: New construction Install U.G. Tank _ Interior Improvement Remove U.G. Tank Processed Piping Specify Nature of Work: jJV,5LtU A, 9XHl4cl~i T/Crw +L f/[.L~~t. v ~ t U'~2 X// A/ Jlnlg When installing/removing underground tank, call 651-681-4675 for inspection by Fire Marshal and Plumbing Inspector. Fees: I% of contract price OR $50.00 minimum fee, whichever is greater. " I i ,3 Underground tank removal/installation = minimum fee Contract price: $ Z 00 ~ 1% = $ j 2(' (Base Fee) State surcharge calculate at $.50 for. each $1,00013 age Fee TOTAL $ Z , f_0 I SIGNATURE OTUPERMITTEE I _ Updated 1/01 I { CITY USE ONLY PERMIT ^C'-l L4 RECEIPT DATE: © 3 _ d -4 APPROVED BY: INSPECTOR COMMERM L MECE"CAL PF M1T AfTLICATION CUYOFEAGM 3630 PILOT KNOB RD EAGM, MN 55188 651-661-4675 Please complete for: all commercial/industrial buildings multi-family buildings when separate permits are not required for each dwelling unit DATE: S" SITE ADDRESS: 36- 0J- ;d1a e- C~r•ss Da-ct' OWNER NAME: alte 6i0ssS PHONE - r1 r3 rL--, i r~ r (AREA CODE) ~F U Ii~ TENANT NAME (IMPROVEMENTS ONLY): 1 i WAS THERE A PREVIOUS TENANT IN THIS SPACE? Y N. NAME: Li j INSTALLER: G /t_S yw ~nic~ By ADDRESS: ~i3D ~fs~ PHONE (AREA, CODE) CITY: STATE: / I/t~ ZIPS WORK TYPE: New construction Install U.G. Tank Interior Improvement Remove U:G. Tank Processed Piping Specify Nature ofWork! 1"t0 Pli &A_- 7, 6AK RF_: r>GAAT"a_ Co,,.sPv A 2:,a&r r G UAl!% When installing/removing underground tank, call 651-681-4675 for inspection by Fire Marshal and Plumbing (inspector. Fees: 1% of contract price OR $50.00 minimum fee, whichever is greater. Underground tank removal/installation = minimum fee Contract price: $ x 1 % _ $ '6 'V v (Base Fee) State surcharge 'S' 17 t/ calculate at $.50 for each $1,000 Base Fee TOTAL $ C) zll~ L SIGNA RE.OF PERMITTEE Updated 1101 j CITY USE ONLY - LL v jj PERMIT `T (a RECEIPT DATE: I LI t COMMEgCIAL pLUM$IN6j P MIT APPLICATION CITY OF RAG" 3830 PILOT KNOB RD Ia' &U, MN 55182 651-s$1-48'l5 INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED Date: "UST 2.0 0 1 WORK TYPE _ New Bldg _ Add-on Repair _ RPZ _ PVB * Irrigation system * Must complete reverse side of application also. Required meter size is 2" turbo unless smaller size permitted by Public Works DESCRIPTION OF WORK K E P L A C6 6 A T H LO O M (1 X1 u- k. S I Q LOO t L (t W& C H t 6 pt of s To inquire if Pressure Reducing Valve is required on new service, call 651-681-4646 METERS - Call 651-681-4300 to verify that hydrostatic, conductivity, and bacteria tests passed prior to picking up meter Irrigation Size & Type Avg GPM Fire Size & Price 3/4" displacement $149.00 Domestic Size & Type Avg GPM Does this include high demand devices? _ Yes No FLUSHOMETERS _ Yes K No PRV REQUIRED ! Yes X No Site Address: 3 5 3 5 B L U C N-o 5 S ~ O A j) Tenant Name: 5L i ~f Um /6tW S ; E 0 Telephone (Area Code) Was there a previous tenant in this space? _ Y X N. If Yes, Name: Installer Name: ~ E1 R U P t) L~ 1 rJ M u N 41s L A L Telephone 5 Z - Q 10 n (Area Code) Installer Address: 13 Q O 4 P S N; jt 6 -(0 Q A u~. SO, City: E D E i l P-k 1 a.! L, State: M Q Zip code 55 3 q FEES Contract price $ 10 6 G d x 1% ($50.00 minimum) Contract Fee $ 10&0- 00 Meter(s) $ Required on all new buildings & boulevard irrigation systems (Acct # 9220-4509) Radio Meter Read $ Surcharge: $.50 Minimum. If contr fce-exceeds $1,000,-calculate at State Surcharge $ 6 50 cents per $1,000 contract fee. Total Frorn keverse New Service $ AUG 1 p [001 Total $ 10("L 00 I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable City of Eagan ordinances. It is the applicant's responsibility to notify theproperty ownerthat the City of Eagan assumes no liability for any damages caused by the City during its normal operational and maintenance activities to the facilities constructed under this permit within City property/right-of-wayleasement. SIGNATU)KE OF PERMITTEE Ati r a bPLAN0 CITY USE ONLY REQUIRED INSPECTIONS: _ U.G. Air Test r Gas Test ^ Rough In Final PLANS SUBMITTED APPROVED BY: BUILDING INSPECTOR I dt%) of czar9an PATRICIA E. AWADA Mayor September 11, 2000 PAUL BAKKEN BEA BLOMQUIST PEGGY A. CARLSON SANDRA A. MASIN Council Members Mr. Joel Springer Ellerbe Becket THOMAS HEDGES 800 LaSalle Ave City Administrator Minneapolis MN 55402 Re: Blue Cross Blue Shield Interior Remodeling 3535 Blue Cross Rd Lot 1 Block 1 Blue Cross Dear Mr. Springer: As per your request, the City of Eagan has reviewed the preliminary construction plans dated July 31, 2000 for the above referenced project. We will approve the distribution of accessible restrooms as proposed if the project commences with the current adopted codes. Upon reviewing the scope of the project, it appears that a healthy distribution of accessible facilities has been achieved. This review was performed on concept only and a complete plan review will be performed upon receiving a permit application and necessary documents. If you have any questions or concerns, do not hesitate to contact me at 651-681-4699. Sincerely, bale Dale Schoeppner Assistant Building Official cc Doug Reid, Building Official Craig Novaczyk, Building Inspector DS/hm MUNICIPAL CENTER THE LONE OAK TREE MAINTENANCE FACILITY 3830 PILOT KNOB ROAD THE SYMBOL OF STRENGTH AND GROWTH IN OUR COMMUNITY 3501 COACHMAN POINT EAGAN, MINNESOTA 55122-1897 EAGAN. MINNESOTA 55122 PHONE: (651) 6814600 PHONE: (651) 681-4300 FAX: (651) 681-4612 Equal Opportunity Employer FAX: (651) 681-4360 TDD: (651) 454-8535 www.cityofeagan.com TDD: (651) 454-8535 CITY USE ONLY L BL PERMIT W Qv SUED: C~ t V~ e (~S RECEIPT#:' APPROVED BY: u , INSPECTOR RECEIPT DATE: l -dv 8000 MECHANICAL PERMIT (COMMERCIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55188 651-681-4675 Please complete for: all commercial/industrial buildings multi-family buildings when separate permits are not required for each dwelling unit DATE: ~oZ /~D d WORK TYPE: New construction Install U.G. Tank ?4C Interior Improvement Remove U.G. Tank Processed Piping When installing/removing underground tank, call 651-681-4675 for inspection by fire marshal and plumbing inspector. r( Description of work: Tom/' 4e&; Fees: 1% of contract price OR $30.00 minimum fee, whichever is greater. Underground tank removal/installation = minimum fee Contract price: ~ x 1% = $ 0 5-OD (Base Fee) State surcharge -SC calculate at $.50 for each $1,909 Base Fee 3 --1 5 © TOTAL $ SITE ADDRESS: OWNER NAME: ~?/iceCro s~5 Olu e , ~~~C~ PHONE - (AREA CODE) TENANT NAME (IMPROVEMENTS ONLY): WAS THERE A PREVIOUS TENANT IN THIS SPACE? Y ~dN. NAME: INSTALLER: (~'GJ~HS ~D~i`t 3 T / ADDRESS: 47 PHONE D a (AREA ODE) CITY: 9 v.„-, A STATE: At ZIP- L/ SIGNATURE OF P RMITTEE 0 -0 0 -7 2000 BUILDING PERMIT APPLICATION (COMMERCIAL) C651-681-4675 Foundation Only New Construction Interior Improvement • Structural Plans (2 sets) . Architectural Plans (2 sets) • Architectural Plans (2 sets) • Civil Plans (2 sets) . Structural Plans (2 sets) • Code Analysis (1) " • Certificate of Survey (1) • Civil Plans (2 sets) • Project Specs (1 set) • Code Analysis (1) . Landscaping Plans (2 sets) . Key Plan (1) • Project Specs (1) . Code Analysis (1) " . Master Exit Plan (1) • Spec. Insp. & Testing Schedule " • Certificate of Survey (1) . Energy Calculations (1) not always" • Soils Report (1) . Spec. Insp. & Testing Schedule (1) " . Elec. Power & Lighting Form (1)notalways" • Meter size must be established • Meter size must be established . Meter size must be established - if applicable • Project Specs (1) 1 • Energy Calculations (1) 1 1 • Electric Power & Lighting Form (1) 1 • Master Exit Plan (1) 1 1 • Fire Protection Plan (1) 1 1 • Soils Report (1) 1 • MC/ES SAC determination letter . MC/ES SAC determination letter MC/ES SAC determination letter call 651-602-1000 call 651-602-1000 call 651-602-1000 Contact Building Inspections for sample Food & beverage or lodging facilities: Plan must be submitted to Minnes Department of Health - call 651-215-0700 for details. DATE: M I I~ WORK TYPE: _ NEW REMODEL CONSTRUCTION COST: DESCRIPTION OF WORK: _6'i1 yA .N- TENANT NAME: SUITE M FORMER TENANT NAME: ii n n SITE ADDRESS: T)53'J l~L ~vSJ VIr rtZ~ ll _ LOT , BLOCK SUBD U,`--~ Name: L a ~-Qa~~L rPhone#: ( PROPERTY Last First OWNER /J Street Address: _~y'j~ k~~U cr" Y I- city 'F-rap'4/`' State: IAA A~ Zip: I a 2 Company: yUT~ r~UC11~ l:gU~ N Jf3~ Phone #:---1 CONTRACTOR _ Street Address: ~hcr V «~>e- City 71-- tQi,J~ State: VA ~ Zip: ARCHITECT/ i ENGINEER Company: &tAA,~e, 3 t Ak\ ~&^g- Phone -)03 Name: ~1 Registration Street Address: q~ N A-ti e-- 5 City tv P~ k State: IMty Zip: Licensed plumber Installing sewer/water: Phone Meter Size: I hereby acknowledge that I have read this application, state that the information is correct, and a e to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances- Signature of Applicant: f OFFICE USE ONLY BUILDING PERMIT SUBTYPE ❑ 01 Foundation ❑ 26 Public Facility ❑ 30 Accessory Bldg. ❑ 14 Apartments 27 Commercial/Industrial ❑ 32 Ext Alt - Apts. ❑ 15 Lodging -9 28 Greenhouse ❑ 34 Ext Alt - Comm. ❑ 25 Miscellaneous ❑ 29 Antennae ❑ 35 Ext Alt - PF WORK TYPE ❑ 31 New ❑ 34 Repair ❑ 37 Demolish Bldg. ❑ 43 Reroof. ❑ 32 Addition ❑ 35 Tenant Impr ❑ 38 Demolish (Interior) ❑ 44 Siding 33 Alterations ❑ 36 Move Bldg. ❑ 42 Demolish (Found) ❑ 45 Fire Repair ❑ 46 Windows/Doors GENERAL INFORMATION - Census Code zoning> sq. ft. SAC Code # of Stories sq. ft. No. of Units Length sq. ft. No. of Bldgs. ! Width sq. ft. Const. (Actual) Basement sq. ft. MC/ES System (Allowable) First Floor sq. ft. City Water UBC Occupancy- sq. ft. Fire Sprinklered MISCELLANEOUS INSPECTIONS ❑ Gas Service Test *-JC Heating ❑ Insulation ❑ Plumbing ❑ Stucco/Stone APPROVALS /V (~,50 - Planning Building ,12,~ Engineering Variance - VALUATION:$ Permit Fee Surcharge 35 n L Plan Review IS U" i . 4 L } MC/ES SAC % SAC City SAC SAC Units Water Supply & Storage Meter Size S/W Permit S/W Surcharge Treatment Plant Park Dedication Trails Dedication Water Quality Other Copies Total ` j COMMERCIAL BUILDING PERMIT APPLICATION C1 - I ( CITY OF EAGAN 651-681-4675 - -CS Foundation Only New Construction Interior Improvement • Structural Plans (2) sets . Architectural Plans (2) sets • Architectural Plans (2) sets • Civil Plans (2) . Structural Plans (2) • Code Analysis (1) • Certificate of Survey (1) . Civil Plans (2) • Project Specs (1) • Code Analysis (1) . Landscaping Plans (2) • Key Plan (1) • Project Specs (1) . Code Analysis (1) • Master Exit Plan (1) • Spec. Insp. & Testing Schedule . Certificate of Survey (1) • Energy Calculations (1) not always" • Soils Report (1) • Spec. Insp. & Testing Schedule (1) • Elec. Power & Lighting Form (1) not always" • Meter size must be established . Meter size must be established • Meter size must be established - if applicable • Project Specs (1) 1 • Energy Calculations (1) " l 1 . Electric Power & Lighting Form (1) 1 1 • Master Exit Plan (1) 1 1 • Fire Protection Plan (1) 1 1 • Soils Report (1) 1 • MC/ES SAC determination letter • MC/ES SAC determination letter MC/ES SAC determination letter call 651-602-1000 call 651-602-1000 call 651-602-1000 Contact Building Inspections for sample Food & beverage or lodging facilities: Plan must be submitted to Minnesota Department of Health - call 651-215-0700 for details. DATE 4/9/01 WORK TYPE NEW X REMODEL CONSTRUCTION COST 32,500 SITE ADDRESS 3535 Blue Cross Road TENANT NAME Blue Cross Blue Shield SUI FORMER TENANT NAME D APR 10 2001 DESCRIPTION OF WORK Demo & 3 new offices - 1 new wall rm -1 By Name: DeNucci Ben Phone#: 6( 51 ) 662-9012 PROPERTY Last First OWNER Street Address 3535 Blue Cross Road City Eagan State MN Zip 55122 Company McGough Construction Phone# ( 6 5 1 } 633-5050 CONTRACTOR Street Address: 2737 Fairview Avenue City St Paul State MN Zip 55113 ARCHITECT/ ENGINEER Company Ellerbe Becket Phone # ( 612 } 376-2000 Name Registration # Street Address 800 LaSalle Avenue City Minneapolis State MN Zip 55402 Licensed plumber installing new sewer/water service: Phone ( I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. i Signature of Applicant: Updated 1/01 ~ - a Ll 5-/0 PA ~ t 7- 2F A 6 1,E I OFFICE USE ONLY SUBTYPE ❑ 01 Foundation ❑ 26 Public Facility ❑ 30 Accessory Bldg. ❑ 14 Apartments A~ 27 Commercial/Industrial ❑ 32 Ext Alt - Apts. ❑ 15 Lodging ❑ 28 Greenhouse ❑ 34 Ext Alt -Comm. ❑ 25 Miscellaneous ❑ 29 Antennae ❑ 35 Ext Alt - PF ❑ 37 Nail Salon WORK TYPE ❑ 31 New ❑ 35 Tenant Impr ❑ 42 Demolish (Found) ❑ 46 Windows/Doors ❑ 32 Addition ❑ 36 Move Bldg ❑ 43 Reroof ❑ 47 Rep X 33 Alterations ❑ 37 Demolish (Bldg) ❑ 44 Siding ❑ 48 Authorization ❑ 34 Replacement ❑ 38 Demolish (Int) ❑ 45 Fire Repair GENERAL INFORMATION Census Code Zoning F12 sq. ft. SAC Code 50 # of Stories sq. ft. No. of Units d Length sq. ft. No. of Bldgs. I Width sq. ft. Const. (Actual) Basement sq. ft. MC/ES System (Allowable) First Floor sq. ft. City Water UBC Occupancy sq. ft. Fire Sprinklered MISCELLANEOUS INSPECTIONS ❑ Gas Service Test ❑ Heating ❑ Insulation ❑ Plumbing ❑ Stucco/Stone APPROVALS Planning Building UW Engineering Variance ' VALUATION $ , Permit Fee 1-4 -4 - Surcharge ) . Plan Review y~ I MC/ES SAC % SAC City SAC SAC Units Water Supply & Storage Meter Size S/W Permit S/W Surcharge Treatment Plant Park Dedication Trails Dedication Water Quality li Other Copies ~I Total ~l i © ek_. I COMMERCIAL BUILDING PERMIT APPLICATION 0 CITY OF EAGAN 14 (,1-4 p 0 651-681-4675 CL„AMt-& Foundation Only New Construction Interior Improvement • Structural Plans (2) sets • Architectural Plans (2) sets • Architectural Plans (2) sets • Civil Plans (2) • Structural Plans (2) • Code Analysis (1) • Certificate of Survey (1) • Civil Plans (2) • Project Specs (1) • Code Analysis (1) • Landscaping Plans (2) • Key Plan (1) • Project Specs (1) • Code Analysis (1) • Master Exit Plan (1) • Spec. Insp. & Testing Schedule • Certificate of Survey (1) • Energy Calculations (1) not always** • Soils Report (1) • Spec. Insp. & Testing Schedule (1) • Elec. Power & Lighting Form (1) not always- • Meter size must be established • Meter size must be established • Meter size must be established - if applicable • Project Specs (1) 1 • Energy Calculations (1) 1 1 • Electric Power & Lighting Form (1) 1 1 • Master Exit Plan (1) 1 1 • Fire Protection Plan (1) 1 1 • Soils Report (1) 1 • MC/ES SAC determination letter • MC/ES SAC determination letter • MC/ES SAC determination letter call 651-602-1000 call 651-602-1000 call 651-602-1000 Contact Building Inspections for sample Food & beverage or lodging facilities: Plan must be submitted to Minnesota Department of Health - call 651-215-0700 for details. DATE / "O13-DI WORK TYPE _ NEW -A REMODEL CONSTRUCTION COST / SITE ADDRESS A, a U44 3.6 TENANT NAME SUITE # FORMER TENANT NAME DESCRIPTION OF WORK Name:-Lt Q tJ~9 c~1.1/ Phone#: PROPERTY Last First OWNER Street Address 2 ~)>%G(,t fK}YJ,tL L~C.(~l City State zip 0 ,57 Company y Phone ) I -8875 CONTRACTOR ~r~ ft Street Address: 6500 `h W J City StateZip 553 I FV11 I -"F ARCHITECT/ ENGINEER Company Phone U Name fr 1 Registration # ado y Street Address f~ City ~M~Apb~ - State Zip `-t za Licensed plumber installing new sewer/water service: Phone I hereby acknowledge that I have read this application, state that the information is correct, and r e to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Sign oture of Applicant: Updated 1101 OFFICE USE ONLY I SUBTYPE ❑ 01 Foundation ❑ 26 Public Facility ❑ 30 Accessory Bldg. ❑ 14 Apartments X 27 Commercial/Industrial ❑ 32 Ext Alt - Apts. ❑ 15 Lodging ❑ 28 Greenhouse ❑ 34 Ext Alt - Comm. ❑ 25 Miscellaneous ❑ 29 Antennae ❑ 35 Ext Alt - PF ❑ 37 Nail Salon WORK TYPE ❑ 31 New X 35 Tenant Impr ❑ 42 Demolish (Found) ❑ 46 Windows/Doors ❑ 32 Addition ❑ 36 Move Bldg ❑ 43 Reroof ❑ 47 Repair ❑ 33 Alterations ❑ 37 Demolish (Bldg) ❑ 44 Siding ❑ 48 Authorization ❑ 34 Replacement lr 38 Demolish (Int) ❑ 45 Fire Repair GENERAL INFORMATION Census Code 151 Zoning sq. ft. SAC Code to # of Stories sq. ft. No. of Units 4 Length sq. ft. No. of Bldgs. ( Width sq. ft. Const. (Actual) 11 1 Basement sq. ft. MC/ES System (Allowable) First Floor sq. ft. City Water UBC Occupancy sq. ft. Fire Sprinklered MISCELLANEOUS INSPECTIONS ❑ Gas Service Test ❑ Heating ❑ Insulation ❑ Plumbing ❑ Stucco/Stone APPROVALS Planning Building C04k:, Engineering Variance VALUATION $ Permit Fee 1-i o es%:~ , ~~o Surcharge 3 Co -5D Plan Review 2- ~3 - C) ~l MC/ES SAC % SAC City SAC SAC Units Water Supply & Storage Meter Size S/W Permit S/W Surcharge Treatment Plant Park Dedication Trails Dedication Water Quality Other Copies Total C V O J~ COMMERCIAL BUILDING PERMIT APPLICATION CITY OF EAGAN _C11 "f 651-681-4675 l Foundation Only New Construction Interior Im rovem ,t • Structural Plans (2) sets • Architectural Plans (2) sets • Architectural Plans (2) sets • Civil Plans (2) • Structural Plans (2) • Code Analysis " (1) " • Certificate of Survey (1) • Civil Plans (2) • Project Specs (1) • Code Analysis (1) " • Landscaping Plans (2) • Key Plan (1) • Project Specs (1) • Code Analysis (1) " • Master Exit Plan (1) • Spec. Insp. & Testing Schedule " • Certificate of Survey (1) • Energy Calculations (1) not always" • Soils Report (1) • Spec. Insp. & Testing Schedule (1) " • Elec. Power & Lighting Form (1) not always- • Meter size must be established • Meter size must be established • Meter size must be established - if applicable • Project Specs (1) 1 • Energy Calculations (1) " 4 1 • Electric Power & Lighting Form (1) 1 • Master Exit Plan (1) 1 1 • Fire Protection Plan (1) l • Soils Report (1) 1 • MC/ES SAC determination letter MC/ES SAC determination letter MGES SAC determination letter call 651-602-1000 call 651-602-1000 call 651-602-1000 Contact Building Inspections for sample M Food & beverage or lodging facilities: Plan must be submitted to Minnesota Department of Health - call 651-215-0700 for details. DATE b rc~ b- WORK TYPE NEW REMODEL CONSTRUCTION COST L 7 SITEADDRESS ? n itnC TENANT NAME C V `Q SS SUITE # FORMER TENANT NAME DESCRIPTION OF WORK f t r j` ~r~ r Name:- ekLkc c fa S~ Phon k iL~.. PROPERTY Last First U OWNER Street Address 3 S l k C - ~G City f, Q w State mi - Zip Company 0 u 01 tom' - Phone # (~S~ ) l9 b I q P)i C (0 CONTRACTOR Street Address: F:~V%~1r-- UCe(^J A f A City State / Zip S'S` /r3 ARCHITECT/ 1nf ( ) ENGINEER Company... y1 c,1u Phone # Name Registration # Street Address 6,1( kA) AI e- S - City State zip Licensed plumber Installing new sewer/water service: Phone I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: Updated 1/C Poo" I -T j2,Q&P r OFFICE USE ONLY SUBTYPE ❑ 01 Foundation ❑ 26 Public Facility ❑ 30 Accessory Bldg. ❑ 14 Apartments ~7 Commercial/Industrial ❑ 32 Ext Alt - Apts. ❑ 15 Lodging ❑ 28 Greenhouse ❑ 34 Ext Alt - Comm. ❑ 25 Miscellaneous ❑ 29 Antennae ❑ 35 Ext Alt - PF ❑ 37 Nail Salon WORK TYPE ❑ 31 New ❑ 35 Tenant Impr ❑ 42 Demolish (Found) ❑ 46 Windows/Doors ❑ 32 Addition ❑ 36 Move Bldg ❑ 43 Reroof u 47 Repair X33 Alterations ❑ 37 Demolish (Bldg) ❑ 44 Siding ❑ 48 Authorization ❑ 34 Replacement ❑ 38 Demolish (Int) ❑ 45 Fire Repair GENERAL INFORMATION Census Code Z43 7 Zoning PC sq. ft. SAC Code so # of Stories sq. ft. No. of Units G Length sq. ft. No. of Bldgs. I Width sq. ft. Const. (Actual) JTA/ Basement sq. ft. MC/ES System (Allowable) fin/ First Floor sq. ft. City water UBC Occupancy _ i _ sq. ft. Fire Sprinklered MISCELLANEOUS INSPECTIONS ❑ Gas Service Test ❑ Heating ❑ Insulation ❑ Plumbing ❑ Stucco/Stone APPROVALS Planning Building 19ti Engineering Variance VALUATION $ YLS~rnad . D0 Permit Fee Surcharge s-0 Plan Review . MC/ES SAC % SAC City SAC SAC Units Water Supply & Storage Meter Size S/W Permit S/W Surcharge Treatment Plant Park Dedication Trails Dedication Water Quality Other Copies Total 1_~ . ~I L 6+$, 6 '(-)CL I COMMERCM1 15I1k2 ("S BUILDING PERMIT APPLICATION O CITY OF EAGAN -C> 651-681-4675 ~ 16d 9'/3 Foundation Only New Construction Interior Improvement • Structural Plans (2) sets • Architectural Plans (2) sets . Architectural Plans (2) sets • Civil Plans (2) . Structural Plans (2) • Code Analysis (1) • Certificate of Survey (1) • Civil Plans (2) • Project Specs (1) • Code Analysis (1) • Landscaping Plans (2) • Key Plan (1) • Project Specs (1) • Code Analysis (1) • Master Exit Plan (1) • Spec. Insp. & Testing Schedule . Certificate of Survey (1) . Energy Calculations (1)notalways*" • Soils Report (1) • Spec. Insp. & Testing Schedule (1) . Elec. Power & Lighting Form (1) not always" • Meter size must be established . Meter size must be established • Meter size must be established - if applicable • Project Specs (1) 1 • Energy Calculations (1) 1 1 • Electric Power & Lighting Form (1) 1 1 . Master Exit Plan (1) 1 1 • Fire Protection Plan (1) 1 1 • Soils Report (1) 1 • MC/ES SAC determination letter . MC/ES SAC determination letter MC/ES SAC determination letter call 651-602-1000 call 651-602-1000 call 651-602-1000 Contact Building Inspections for sample Food & beverage or lodging facilities: Plan must be submitted to Minnesota Department of Health - call 651-215-ONO for details. DATE K TYPE _ NEW _ REMODEL C TRUCTION COST G 0 SITE ADDRESS C v O TENANT NAME 6 J1 v!t- , (IL SUITE S'k el' FORMER TENANT NAME ll / 4-j , DESCRIPTION OF WORK Cu atr, A 3 S Ig0CoU Name: Ub C Phone#: F PROPERTY Last First OWNER ~I Street Address S o t ~ City 'Sq (Iq"J State Zip Y - r -4t, Company Phone # ( CONTRACTOR Street Address:_ City State Zip `~D -531 ARCHITECT/ ENGINEER Company. 1 1 t~ C 1~ f ' C LA~ All" C ~ Phone # (&I Name ~(Y I Registration # Street Address UU C 'I 0-i Ao'f- City l" L P 1 f State IV V" Zip 7' 5 ~-f 0 7 Licensed plumber Installinst new sewerlwater service: Phone O I hereby acknowledge that I have read this application, state that the information is c rrect, grid re to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: 1 ` - Updated 1101 A OFFICE USE ONLY SUBTYPE ❑ 01 Foundation ❑ 26 Public Facility ❑ 30 Accessory Bldg. ❑ 14 Apartments '0- 27 Commercial/Industrial ❑ 32 Ext Alt - Apts. ❑ 15 Lodging ❑ 28 Greenhouse ❑ 34 Ext Alt - Comm. ❑ 25 Miscellaneous ❑ 29 Antennae ❑ 35 Ext Alt - PF ❑ 37 Nail Salon WORK TYPE ❑ 31 New 35 Tenant Impr ❑ 42 Demolish (Found) ❑ 46 Windows/Doors ❑ 32 Addition ❑ 36 Move Bldg ❑ 43 Reroof ❑ 47 Repair ❑ 33 Alterations ❑ 37 Demolish (Bldg) ❑ 44 Siding ❑ 48 Authorization ❑ 34 Replacement ❑ 38 Demolish (Int) ❑ 45 Fire Repair GENERAL INFORMATION Census Code 4/3'7 Zoning D sq. ft. SAC Code :50 # of Stories sq. ft. No. of Units o Length sq. ft. No. of Bldgs. I Width sq. ft. Const. (Actual) V7 -AJ Basement sq. ft. MC/ES System (Allowable) First Floor sq. ft. City Water UBC Occupancy sq. ft. Fire Sprinklered MISCELLANEOUS INSPECTIONS ❑ Gas Service Test ❑ Heating ❑ Insulation ❑ Plumbing ❑ Stucco/Stone APPROVALS Planning Building 02~~ Engineering Variance VALUATION $ Permit Fee Surcharge Plan Review MC/ES SAC % SAC City SAC SAC Units Water Supply & Storage Meter Size S/W Permit S/W Surcharge Treatment Plant Park Dedication Trails Dedication Water Quality Other Copies Total COMMERCIAL BUILDING PERMIT APPLICATION 470-00 P7 -3 ( CITY OF EAGAN 651-681-4675 Foundation Only New Construction Interior Improvement • Structural Plans (2) sets • Architectural Plans (2) sets • Architectural Plans (2) sets • Civil Plans (2) • Structural Plans (2) • Code Analysis (1) • Certificate of Survey (1) • Civil Plans (2) . Project Specs (1) • Code Analysis (1) • Landscaping Plans (2) • Key Plan (1) • Project Specs (1) • Code Analysis (1) • Master Exit Plan (1) • Spec. Insp. & Testing Schedule • Certificate of Survey (1) • Energy Calculations (1) not always- • Soils Report (1) • Spec. Insp. & Testing Schedule (1) • Elec. Power & Lighting Form (1) not always" • Meter size must be established • Meter size must be established • Meter size must be established - if applicable • Project Specs (1) 1 • Energy Calculations (1) 1 1 • Electric Power & Lighting Form (1) 1 1 • Master Exit Plan (1) 1 1 • Fire Protection Plan (1) 1 1 Soils Report (1) 1 • MC/ES SAC determination letter MC/ES SAC determination letter MC/ES SAC determination letter call 651-602-1000 call 651-602-1000 call 651-602-1000 Contact Building Inspections for sample Food &beverage or lodging facilities: Plan must be submitted to Minnesota Department of Health - call 651-215-0700 for details. DATE Q 1 " a ' d ( WORK TYPE _ NEW REMODEL CONSTRUCTION COST L~ 6-7, ©d SITE ADDRESS 3 3 S I k~ 6Y-0 SS u TENANT NAME SUITE # FORMER TENANT NAME DESCRIPTION OF WORK ~ern C) Q'.!~ ~N 1St' 4- aid Name: S ►Q r"- e Phone#: ( PROPERTY Last First OWNER Street Address City State zip TV'O'J~ Coo Company Y\/\ C GO Lk~ Phone # ((Q~ ~ , a Ll g - a 5- I o gel CONTRACTOR Street Address: a-1 3 City gT 1 iAt^\ State zip r 1 ARCHITECT/ G~ 1 11 ` (a ~ a- ENGINEER Company t ~A C'- Phone # ((a/c- ) 97 Name Cad e y re r\('d(a (~n Registration # Street Address Li0 0 e t 't-1 C J~ A U e- City A of (J d t t S State zip Licensed plumber installing new sewer/water service: Phone I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: O\L( Updated 1/01 OFFICE USE ONLY SUBTYPE ❑ 01 Foundation ❑ 26 Public Facility ❑ 30 Accessory Bldg. ❑ 14 Apartments ❑ 27 Commercial/Industrial ❑ 32 Ext Alt - Apts. ❑ 15 Lodging ❑ 28 Greenhouse ❑ 34 Ext Alt - Comm. ❑ 25 Miscellaneous ❑ 29 Antennae ❑ 35 Ext Alt - PF ❑ 37 Nail Salon WORK TYPE ❑ 31 New ❑ 35 Tenant Impr ❑ 42 Demolish (Found) ❑ 46 Windows/Doors ❑ 32 Addition ❑ 36 Move Bldg ❑ 43 Reroof ❑ 47 Repair ❑ 33 Alterations ❑ 37 Demolish (Bldg) ❑ 44 Siding ❑ 48 Authorization ❑ 34 Replacement ❑ 38 Demolish (Int) ❑ 45 Fire Repair GENERAL INFORMATI N Census Code fo Zoning l~ sq. ft. SAC Code 36 # of Stories sq. ft. No. of Units Length sq. ft. No. of Bldgs. Width sq. ft. Const. (Actual) _ • .mil Basement sq. ft. MC/ES System ✓ (Allowable) ?t • r./ First Floor sq. ft. City Water UBC Occupancy sq. ft. Fire Sprinklered MISCELLANEOUS INSPECTIONS ❑ Gas Service Test ❑ Heating ❑ Insulation ❑ Plumbing ❑ Stucco/Stone APPROVALS Planning Building aA* Engineering Variance VALUATION $ Permit Fee Surcharge Plan Review MC/ES SAC % SAC City SAC SAC Units Water Supply & Storage Meter Size S/W Permit S/W Surcharge Treatment Plant Park Dedication Trails Dedication Water Quality Other Copies Total 16 J_ COMMERCIAL BUILDING PERMIT APPLICATION CITY OF EAGAN ~-~C l ` 651-681-4675 Foundation Only New Construction gY • Structural Plans (2) sets • Architectural Plans (2) sets • Architectural Plans (2) sets • Civil Plans (2) • Structural Plans (2) • Code Analysis " (1) • Certificate of Survey (1) • Civil Plans (2) • Project Specs (1) • Code Analysis (1) " • Landscaping Plans (2) • Key Plan (1) • Project Specs (1) • Code Analysis (1) • Master Exit Plan (1) • Spec. Insp. & Testing Schedule " . Certificate of Survey (1) • Energy Calculations (7) not always-- • Soils Report (1) • Spec. Insp. & Testing Schedule (1) " • Elec. Power & Lighting Form (1) not always- • Meter size must be established • Meter size must be established • Meter size must be established - if applicable • Project Specs (1) 1 • Energy Calculations (1) 1 1 • Electric Power & Lighting Form (1) 1 1 • Master Exit Plan (1) l 1 • Fire Protection Plan (1) " l 1 • Soils Report (1) 1 • MC/ES SAC determination letter MC/ES SAC determination letter MC/ES SAC determination letter call 651-602-1000 call 651-602-1000 call 651-602-1000 Contact Building Inspections for sample Food & beverage or lodging facilities: Plan must be submitted to Minnesota Department of Health - call 651-215-07000 for details. DATE WORK TYPE NEW X REMODEL CONSTRUCTION COST Xy6 7, ©d d SITE ADDRESS J`~ ~3~C(e (_-f"~S~> fQc~~cl SUITE # TENANT NAME fMle ~5 ` 4:l / r! c e ~O 2 hlm FORMER TENANT NAME AI(A DESCRIPTION OF WORK 3e<Wr de S~ w ZG~fx 1COrf p Cv L 4ef'- 0j'14 Name: NL/P_ Cy'V5 ~3~Gt J`L1 l~ Phone#: ( S< ) o? - a S~/~ PROPERTY Last First (~v /2 Al C_ /6f / Ve, OWNER ~ Street Address 606; Rae C, llnss City rG1L~0/7 State zip 55-6~d I Company PC ~-7©G(9 C00.57 7-a- aC 6 ©i'1 "Phone # ( 32 -,,570,5-n CONTRACTOR Street Address: ~ ~7 / 2 7 P/ Ir V/ C~GU Ale /4/U City a I State zip J~~~J7 ARCHITECT/ ENGINEER Company Phone # (G /a ) 57/' 7c;7 le;2 Namef^e Registration # Street Address 4D0 C/9/1 17 / U~'/'~ G/P l LG City /'V/'rJ~c~aray~/ ~s State /7;7/U zip J` 5"G103 Licensed plumber installing new sewerlwater service: Phone I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: I~~'lL CL~ Updated V OFFICE USE ONLY SUBTYPE ❑ 01 Foundation ❑ 26 Public Facility ❑ 30 Accessory Bldg. ❑ 14 Apartments X 27 Commercial/Industrial ❑ 32 Ext Alt - Apts. ❑ 15 Lodging ❑ 28 Greenhouse ❑ 34 Ext Alt - Comm. ❑ 25 Miscellaneous ❑ 29 Antennae ❑ 35 Ext Alt - PF ❑ 37 Nail Salon WORK TYPE ❑ 31 New 35 Tenant Impr ❑ 42 Demolish (Found) ❑ 46 Windows/Doors ❑ 32 Addition 36 Move Bldg ❑ 43 Reroof u 47 Repair ❑ 33 Alterations ❑ 37 Demolish (Bldg) ❑ 44 Siding ❑ 48 Authorization ❑ 34 Replacement ❑ 38 Demolish (Int) ❑ 45 Fire Repair GENERAL INFORMATION Census Code 432 Zoning p' sq. ft. SAC Code _ -30 # of Stories sq. ft. No. of Units Length sq. ft. No. of Bldgs. i Width sq. ft. Const. (Actual) Basement sq. ft. MC/ES System (Allowable) t4 First Floor sq. ft. City Water UBC Occupancy _1 sq. ft. Fire Sprinklered MISCELLANEOUS INSPECTIONS ❑ Gas Service Test ❑ Heating ❑ Insulation ❑ Plumbing ❑ Stucco/Stone APPROVALS Plann ing Building cf&~ Engineering Variance Permit Fee 3p VALUATION $ 1( 607j 600 Surcharge 'a-3"~ Plan Review 9 F5- I , g MC/ES SAC % SAC City SAC SAC Units Water Supply & Storage Meter Size S/W Permit S/W Surcharge Treatment Plant Park Dedication Trails Dedication Water Quality Other Copies Totals 1 AIL a PHONE 454-5242 EAGAN TOWNSHIP 3793 PILOT KNOB ROAD ST. PAUL, MINNESOTA 581 11 June 14, 1.972 Minnesota Hospital Service Assn. 3535 Blue Cross Road Ot.Paul, l'2i 55122 Attention: Merlin R. Bretzman Dear 1 X. Bretzman: This letter is in reply to your request for information in regards to your asses:,ments on Blue Cross Addition and that portion of the un- platted property this is now assessed: 'LUi• (,i?r`5S ~~D~ITION of 1 Block 1 Sewer & water lats & water area Original amount assessed $12,765.00 Unpaid balance $10,212.00 Lot 2 Block 1, Sewer & water lats & water area Original amount assessed $42,081.00 Unpaid balance $33,672.80 Lot nick}` Sewer & water lats & water area riginaT amount assessed $11,218.50 Unpaid balance $ 8,974.82 Outlot A, Should now be posted to Parcel 3231-A and NOT to your tax statement which shows up in the amount of $579.00 JD O/10D D/d 77 SECTION 17 Parcel 3232-A, Sewer & water lats & water area Original amount assessed $13,900.50 Unpaid balance $11,120.42 IU 01700 616 n~ The above mentioned unpaid balances are payab e until the 15th day of November of 1972 without any additional interest rate. The assessments were spread over a 20 year period with an annual interest rate of 8% per year on the unpaid balance. The cut off date for payment of any unpaid assessment is the _.5th day of November of the year in question. These assessments were assessed n 19"9. If additional information is needed in this matter call me. Sincerely, Ann Goers Assessment clerk PHONE 454.5242 EAGAN TOWNSHIP 8798 PILOT KNOB ROAD ST. PAUL, MINNESOTA Basil June 14, 1972 Minnesota Hospital Service Assn. 3535 Blue Cross Road St-Paul, MN 55122 Attention: Merlin R. Bretfman Dear Mr. Bretsman: This letter is in reply to your request for information in regards to your assessments on Blue Cross Addition and that portion of the un- ' platted property that is now assessed: LUE CROS a DTTTIIOIA Lot 1 Block 1, Sewer & water lats & water area Original amount assessed $12,765.00 Unpaid balance $109212.00 Lot 2 Block 1, Sewer & water lats & water area Original amount assessed $42,091.00 7i,,.paid balance $33,672.80 D ` Block_ 1, Sewer & Water fats & water area riri nal`amount assessed $11,218.50 Unpaid balance $ 8,974.82 Outlot A, should now be posted to Parcel 3231-A and not to your tax statement which shows up in-the amount of $579.00 W SECTION 17 Parcel 3232-A, Sewer & water lats & water area Original amount assessed $13,900.50 Unpaid balance $11,120.42 Gm'!! The above mentioned unpaid balances are payable until the 15th day of November of 1972 without any additional interest. The assessments were spread over a 20 year period with an annual interest rate of 8% per year on the unpaid b unpaid balance. The cut off date for payment of any unpaid assessment is the 15th day of November of the year in question. If additional information is need in this matter please call me. Sincerely, Ann Goers Assessment Clerk `3~t"JJ~f j 9 r a i Winsor/FaricyArchitects, Inc. Suite 375, 28 West Fifth Street Architects Saint Paul, Minnesota 55102 Interior Designers 612. 227. 0655 Planners 17 May 1990 Mr. Joe Merchak City of Eagan 3830 Pilot Knob Road P.O. Box 21199 Eagan, Minnesota 55121 RE: Blue Cross Blue Shield Computer Center W/F Project No. 8709-8802 Dear Joe: Enclosed is the information I promised to send you at our last meeting, as well as a copy of our interofficre memo of that meeting. Included are a plan of each level showing the new addition, the 2 hour area separation wall we will be maintaining between the original building and the 1974 addition, and calculations of areas for both the 1st level (basement level) and the 2nd level (1st story). Also included is an overall layout of each floor showing all of the existing building plus our new addition at a smaller scale. If you have any questions, or if the information shown regarding allowable areas or construction type is not as you had understood our conclusions to be, please call me at once. We are still planning on having some plans to you for a preliminary review by the 1 st week of June - with final documents for final review and building permit application the first part of July. Sincerely, 444LJ;~- John Rohrman, AIA JR/jmd Enclosures MEETING REPORT PRESENT: Joe Merchak - Construction Analyst, City of Eagan Dave Engleson - Winsor/Faricy Architects, Inc. John Rohrman - Winsor/Faricy Architects, Inc. RE: Blue Cross / Blue Shield of Minnesota Corporate Service Center Addition W/F Project No. 8709-9001 DATE: 26 April 1990 FROM: John Rohrman - Winsor/Faricy Architects, Inc. We met at the City of Eagan offices to review the proposed addition and verify the building classifications and area limitations. The existing building received a building permit in 1969, before Eagan adopted the UBC, therefore, the original structure doesn't meet current codes regarding maximum areas for exposed steel structure and sprinklers. When the 1974 addition was built, a 2 hour area separation wall was defined between new and existing, and we will maintain that barrier and rate our new addition type I I -1 hour construction. The lower level can be classified as basement, since more than 50% of this level is below grade, as well as is more than 50% of the rest of the existing building at this level. The area limitation foL B-2 office building of type II -1 hour construction is 18,000 s.f. + 100% increased for separation ogL!17 sides'+ 10096 increase for sprinklers = 72,000 s.f. per floor. Since our 2nd level (our 1 st story) is approximately 20,000 s.f. in area, we are under the maximum. f~. I will forward Joe drawings of each level showing the location of the 2-hour area separation wall, and ( forward him area calculations of the new combined with the existing areas on our side of the 2-hour area separation wail. OTE: If we use the computer room as the 2nd exit for the office area, the doors must not be locked. It can be posted that an alarm will sound if opened, but not locked. ` o 3i c~ v'k o Q1 its- I ' \ mot. i 151 0 .0% k"M ' - ( ~ ' r VVk Yff u ~ ~ R k a !11~ 1 ~ Ala I ? ~''tio Y.k•a- ~ _ _ - 7 ~ • ~ :ilk n ~ y~. ~ fo' _,...r id a~ it'd •d ~ All ~ rl ;G - r. I ~ • , f I ! 1 ~ ~~`'u +s~sa ~ V A 1 1 ~ ~ ~LL'cRy 1 ' ock" ate. i s ! a 1 157: 1©. q 3 5. f . dl~O• ~ ! t40Y•fY ` ii ~ ~ ~ g; i : .Peru' t ' ! f -0• { i'ce' UPS r:- r_ ~ I / / I R9 =5 14 J % CORPORATE SERvic CENTER ADDITION i ITION - ITT LWfL 1 BUILDING COD- ?UIRII3I'S • Code Reference - UBC Table 5-A 1) Occupancy Table ~/aj& - O iu 163 gs 2 L 2) Fire Zone (Info. fran ) UBC Chapter 16 3) Building Type allowed in Fire Zone SBC 103 4) Existing Building, Code Compliance 5) Construction Type: Existing Bldg. -{rte it- I AR f(1~ New Bldg. 6) Actual Area (Ea. Fl. & Total) (vo ~Kts-t ( ~o¢ I 7) Allowable Area : occupancy Type- ( - 2. a Construction Type' UBC Table 5-C Basic Allowable Area ~T S.F. UBC 505 (a) +33-1/3% in Fire Zone 3 S.F. UBC 506 (a) + 1VD % for separation on ,C sides ~gl bDv S. F, UBC 506 (b) & (c) + IUD % for Fire Sprinklers , UP S.F.' ' Total Allowable area per floor for a 1 or 2 story building 72~, S.F. UBC 505 (b) Total Allowable Area for Buildings over two stories = 'f 2 x Allowable Area per Fl. ^ - -S.F. = S.F. } UBC 420 8) Lowest level Classifies as a story * i45V_mW0 r' EMC 505 (c) Basement '65 Basements and Cellars need not be included in Tota Allowable Area. 5121 /CfC! I Y f e~ Metropolitan Waste Control Commission Mears Park Centre, 230 East Fifth Street, St. Paul, Minnesota 55101 612 222-8423 July 6, 1990 Mr. Joe Merchak Construction Analyst City of Eagan 3830 Pilot Knob Road Eagan, MN 55122 Dear Mr. Merchak: The Metropolitan Waste Control Commission determined SAC for the Corporate Service Center Addition for Blue Cross and Blue Shield located within the City of Eagan. This project should be charged 9 SAC Units, as determined below. SAC Units Charges: Office Space 21984 sq.ft. @ 2400 sq.ft. per SAC Unit 9.16 or 9 If you have any questions, call Roger Janzig at 229-2119. Si cerely, Donald S. Bluhm Staff Engineer DSB:RWJ:jle 90070557 cc: Carolyn Krech, Finance Department, Eagan S. Selby, MWCC John A. Shea, McGough Construction Co., Inc. Equal Opportunity/Affirmative Action Employer O city of eagan 3830 PILOT KNOB ROAD THOMAS ELAN EAGAN, MINNESOTA 55122-1897 Mayor PHONE: (612) 454-8100 DAVID K GUSTAFSON FAX: (612) 454-8363 PAMELA McCREA TIM PAWLENTY THEODORE WACHTER Council Members August 10, 1990 THOMAS HEDGES City Administrator EUGENE VAN OVERBEKE City Clerk JOHN ROHRMAN, A.IA WINSOR(FARICY ARCHITECTS, INC 28 W FIFTH ST, SUITE 375 ST PAUL, MN 55102 Re: Blue Cross Blue Shield Corporate Service Center Addition Dear Mr. Rohrman: I have reviewed for code compliance the construction documents for the above-referenced project. As discussed in our telephone conversation this morning, the following items should be addressed: • Verify that the new showers being installed in rooms 265 and 268 comply with the handicap accessible requirements of MSBC 1340.0500, Subpart 5. • Verify that the tackboards proposed for room 236 comply with the provisions of UBC Section 4204. • Toilet paper dispensers should be located such that they do not obstruct use of the toilet stall grab bars. • Door number 102 shall be a 20-minute assembly complying with UBC 3305(h). • Provide approved barriers in stairways "D" and "F" as required by UBC 3306(h). • Verify that the placement and location of exit signage comply with UBC 3314. • The omission of an elevator lobby is premised upon the supposition that openings between two adjacent floors need not be protected provided these levels do not freely communicate with additional levels. Verify the integrity of opening protection for corridor complex comprised of areas numbered 103, 104, 105, 106, 203, 204, 207, 219, 220, 222, 224, and 225, particularly where it extends into the existing building. THE LONE OAK TREE ...THE SYMBOL OF STRENGTH AND GROWTH IN OUR COMMUNITY Equal Opportunity/Affirmative Action Employer JOHN ROHRMAN AUGUST 10, 1990 PAGE TWO • A review of the construction documents submitted does not confirm the existence of a complying two-hour area separation wall between the original building and the 1974 addition. Thus, please submit an alternative method for meeting the allowable area requirements of UBC 505. (Perhaps upgrading the addition to meet the requirements of Type I construction would suffice.) Additionally, piping must be re-routed to avoid the proposed substation and switch gear areas (rooms 117 and 118) in order to comply with the electrical code. Sincerely, 0 V Joe Merchak, Construction Analyst Protective Inspections JM/mg PERMIT i CITY OF EAGAN 3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G Fagan,. Minnesota 55122-1897 Permit Number: 0 3 2 2 6 9 (612) 681-4675 Date Issued: 06/17/98 SITE ADDRESS: 3535 BLUE CROSS RD LOT: 1 BLOCK: 1 BLUE CROSS P.I.N.: 10-14550-010--01 DESCRIPTION: NEW TENTS&CANOPIES Building Permit Type COMM./IND. Building 'Work Type NEW REMARKS: PLAN REVIEWED BY DALE SCHOEPPNER FEE SUMMARY: VALUATION $500 Base Fee $21.00 Surcharge Total Fee $21.50 i I CONTRACTOR: - Applicant - OWNER: YANKEE DOODLE FESTIVAL 24324233 BLUE CROSS & BLUE SHIELD 1565 CLIFF RD 3--269 3535 BLUE CROSS RD EAGAN MN 55122 EAGAN MN 55122 (1612) 432-4233 (612)456-8000 I hereby acknowledge that I have reed this application and state that the information is correct and agree to comply with all applicable State of Mn. Statutes and City of Eagan Ordinances. I A-A4~" APPLICANT/PERMITEE SIGNATURE SSUED BY: SI N RE lo2. 2 IM 1998 BUILDING PERMIT APPLICATION (COMMERCIAL). i CITY OF EAGAN 681-46?5 Submit following to obtain necessary permit Foundation Only New Construction Interior Improvement structural plans (2 sets) architectural plans (2 sets) architectural plans (2 sets) civil plans (2 sets) structural plans (2 sets) code analysis (1) * code analysis (1) civil plans (2 sets) project specs (1 set) soils report (1) landscaping plans (2 sets) Key Plan project specs (1) code analysis (1) " energy calculations (1) not always " Special Inspections & Testing Schedule " soils report (1) Electric Power & Lighting Form (1) not always " SAC determination letter from MC/WS - SAC determination letter from MCNVS - SAC determination letter from MC/WS - call 602-1000 call 602-1000 call 602-1000 Special Inspections & Testing Schedule (1) project specs (1) energy calculations (1) " Electric Power & Lighting Form 1 Contact Building Inspections for sample Food & Beverage or Lodging facilities: Plan must be submitted to Minnesota Department of Health. Cali 215-0700 for details. DATE: WORK TYPE: NEW REMODEL DESCRIPTION OF WORK: li9hkL--z 10(Dc//&- A?X rl CeaY~lh 7-s 7-2V1,14- /C`)-?73' CONSTRUCTION COST: TENANT NAME: SITE ADDRESS: S, S l3 ~u ~ Coe o sS o ,%,;",,g xn i4 SUITE -LOT BLOCK SUBD, f~a CIA W P.I.D. # Name: why e Cross ILE /e/ Phone PROPERTY Last First OWNER Street Address: .~•5 St. C,-v.c.s ~'oa City State: q-7 Zip: `4~,> nY Sc/roeAC~s/~7(095~ Company: hiez o 4;--i l710ai1 Phone ^11.etc z~od~Q Lc o~~~2 g ty .?-i/~3~ CONTRACTOR n Street Address: /Zi S oast' -3-2 6 9 License # City EI9 G /a h State: J -",k) Zip: ,S3%2 5y ARCxr / E ER Company:.ES7-V ter 7-i5' L Phone -f-E>7 n Name: `-7-2~>7 .i.7--7, , Registration A IN F-~ o A. Street Address: City State: Zip: Sewer & water licensed plumber (only if installing sewer & water): I hereby acknowledge that I have read this application and state that the in is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. ~hec~ 6p), e f ye), 7T - Ie'2h v d>+ ~j Signature of Appii o~~t PERMIT 6 CITY OF EAGAN 3830 Pilot Knob Road PERMIT TYPE: BUILDING Eagan, Minnesota 55123 Permit Number: 024351 (612) 681-4675 Date Issued: 08/11/94 SITE ADDRESS: 3535 BLUE CROSS RD LOT: 1 BLOCKa 1 BLUE CROSS P.I.N.: 10-14550-010-01 DESCRIPTION: (ROOFING) Building Permit Type COMM./IND. MISC. Building Work Type REPAIR REMARKS: FEE SUMMARY: VALUATION $38,000 Base Fee $336.50 Surcharge 19.00 Total Fee $355.50 CONTRACTOR: - Applicant - OWNER: CONSOLIDATED BLDG SERVICES 24406447 BLUE CROSS BLUE SHIELD 8530 VRLtf.Y VIEW CT 3535 BLUE CROSS RD PRIOR LAKE MN 55372 EAGAN MN (612) 440-6447 I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable Mate of Mn. Statutes and City of Eagan Ordinances. f APPLICANT/PERMITEE SIGNATURE ISSUED SIG T R - PERMIT ~s Cl""Y OF EAGAN 3838 Pilot Knob Road PERMIT TYPE: BUILDING Eagan, Minnesota 55123 Permit Number: 0 2 4 0 9 8 (612) 681-4675 Date Issued: 07/19/94 SITE ADDRESS: 3535 BLUE CROSS RD LOT: 1 BLOCK: 1 BLUE CROSS P.I.N.: 10-14550-010-01 DESCRIPTION: (ENERGY CENTER) Building Permit Type COMM./IND. Building Work Type NEW UBC Occupancy B-4 Construction Type II-N Zoning PD Building Length 124 Building Width 60 Building stories 1 Square Feet 7,936 REMARKS: SEPARATE PERMITS ARE REQUIRED FOR ANY PLUMBING OR ELECTRICAL WORK FEE SUMMARY: VALUATION $377,000 Base Fee $1,609.00 Plan Review $1,045.85 Surcharge 188.50 Total Fee $2,843.35 CONTRACTOR: - Applicant - OWNER: MCGOUGH CONST CO 26335050 BLUE CROSS/SHIELD OF MN 2737 N FAIRVIEW AVE 3535 BLUE CROSS RD ST PAUL MN 55113 EAGAN MN (612) 633-5050 (612)456-8047 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 Mn. L Statutes and City of Eagan Ordinances. APPLICANT/PERMITEE SIGNATURE ISCb~ . GNATURE r [F PERMIT CITY GF EAGAN 3830 Pilot Knob Road PERMIT TYPE: BUILDING Eagan, Minnesota 55123 Permit Number: 0 2 3 8 8 8 (612) 681-4675 Date Issued: 06/15/94 SITE ADDRESS: 3535 BLUE CROSS RD LOT: 1 BLOCK: 1 BLUE CROSS P.I.N.: 10-14550-010-01 DESCRIPTION: building Permit Type FOUNDATION Building Work Type NEW UBC Occupancy 8--4 Construction Type II N Zoning PD Building Length 124 Building Width 59 Building stories 1 Square Feet 7,936 REMARKS: ~~BUILDING TO HOUSE GENERATOR FEE SUMMARY: VALUATION $100,000 Base Fee $639.50 CITY SAC $100.00 Plan Review $415.68 S & W PERMIT $100.00 e unr rque f Surcharge $50.00 S & W SURCHARGE $.50J 1pd91~y' SAC $800.00 TREATMENT PLANT 348.00 SAC 100 Total Fee $2,453.68 SAC Units 1 Subtotal $1,905.18 CONTRACTOR: - Applicant - OWNER: MCGOUGH CONST CO 26335050 BLUE CROSS/BLUE SHETLD 2737 N FAIRVIEW AVE 3535 BLUE CROSS RD ST PAUL MN 55113 EAGAN MN (612) 633-5050 (612)456-8047 I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all app,11cable State of Mn. StZsLICAINIPPERMITEE-SIGNAI'llif and City of Eagan Ordinances. j I( ISSUED 9YIS]GkATURE PERMIT CITY (JIF EAGAN PERMIT TYPE, BUILDING I 3830 Pilot Knob Road Permit Number: 032991 Eagan, Minnesota 55122-1897 Date Issued: 08/26/98 (612) 681-4675 SITE ADDRESS: 3535 BLUE CROSS RD LOT: 1 BLOCK: BLUE CROSS P.I.N.: 10-14550-010--01 i DESCRIPTION: Building Permit Type COMM./IND. MISC. Building Work Type ALTERATION Census Code 437 ALT. NONRES. REM# .REVIEWED BY DALE SCHOEPPNER. BLUE CROSS IS THE ARCHITECT. I FEE SUMMARY: VALUATION $8,000 Base Fee $137.25 Surcharge 4.00, Total Fee $141.25 I RTIES Pp 28937580 BLUE CROSS 35010 80TY STREET W 3535 BLUE CROSS RD BLOOMINGTON MN 55431 EAGAN MN 55164 (612) 893-7580 (651)405-7627 1 hereby acknowledge that I have- read this application and state that the information is correct and agree to comply with all applicable State of Mn. Statutes and City of Eagan Ordinances. -L4- ICA /PERMITEE SIGNATURE ISSUED BY: SIG ATU 1998 BUILDING PERMIT APPLICATION (COMMERCIAL) CITY OF EAGAN 681-4675 y 5 Submit following to obtain necessary permit Foundation Only New Construction Interior Improvement structural plans (2 sets) architectural plans (2 sets) architectural plans- (2 sets) civil plans (2 sets) structural plans (2 sets) code analysis (1) " code analysis (1) " civil plans (2 sets) project specs 0 set) soils report (1) landscaping plans (2 sets) Key Plan project specs (1) code analysis (1) " energy calculations (1) not always Special Inspections & Testing Schedule " soils report (1) Electric Power & Lighting Form (1) not always - SAC determination letter from MC/WS - SAC determination letter from MC/WS - SAC determination letter from MCMIS - call 602-1000 call 602-1000 call 602-1000 Special Inspections & Testing Schedule (1) project specs (1) energy calculations (1) " Electric Power & Lighting Form (1 Contact Building inspections for sample food & Beverage or Lodging facilities: Plan must be submitted to Minnesota Department of Health. Call 215-0700 for details. DATE: I R WORK TYPE: NEW ,REMODEL DESCRIPTION OF WORK: 'f s CONSTRUCT COST: zq/ o0 ~ 7C7 T NAME: SITE A DRESS: SUITE LOT BLOCK SUBD. P.I.D. # Name: Phone (t) PROPERTY Last First OWNER (36 3 Street Address: City State: Zip: Company: Phone / V CONTRACTOR Street Addres : iJ C-) License # City State: A2 GA-- Zip: ARCHITECT/ ENGINEER Company: Phone Name: Registration Street Address: City State: Zip: Sewer & water licensed plumber (only if installing sewer & water): I hereby acknowledge that t have read this application and state that the information is ct and agree to comp w' applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: ~ PERMIT ~J CITU OF -EAGAN 3830 Pilot Knob Road PERMIT TYPE: BUILDING Eagan, Minnesota 55122-1897 Permit Number: 0 3 3 6 3 6 (612) 681-4675 Date Issued: 10/16/98 SITE ADDRESS: 3535 BLUE CROSS RD LOT: 1 BLOCK: 1 BLUE CROSS P.I.N.: 10-14550-010--01 DESCRIPTION: COM. CLOSET PU l tnc.q Permit Type COMM./IND. MISC. uui1dinn Work Type ALTERATION t 4nsus Code 437 ALT. NONRES. REMARKS: PLAN REVIEWED BY WAYNE MILLER. ARCHITECT: MCGOUGH CONSTRUCTION 2737 NORTH FAIRVIEW AVENUE FEE SUMMARY: VALUATION $80,000 Base Fee $394.75 Plan Review $256.59 Surcharge X15.400 ...I Total Fee $666.34 I CONTRACTOR: Applicant - OWNER: MCGOUGH CONST CO 26335050 BLUE CROSS/BLUE SHIELD 3737 N FAIRVIEW AVE 3555 BLUE CROSS Rid ST PAUL MN 55113 EAGAN MN 55122 (612) 633--5050 (651) t hereby 6cknowledge that Z have reod this application and estate that the information is correct and aprep two comply wi_Lh all applicable State of Mn.. Statutes and City col, Eaoan Ordinances, APPLICANT/PERMIT E I ATURE Q)SUED BY: SIGNA UR 1998 BUILDING PERM IT APPLICATIQaOMMERCIAL) 3 CITY OF EAGAN 681-4675 Submit followin to obtain necessary permit b - I a _CK Foundation Only New Construction Interior Improvement structural plans (2 sets) architectural plans (2 sets) architectural plans (2 sets) civil plans (2 sets) structural plans (2 sets) code analysis (1) code analysis (1) " civil plans (2 sets) projed specs 0 set) soils report (1) landscaping plans (2 sets) Key Plan- project specs (1) code analysis (1) " energy calculations (1)notaiways ' Special Inspections & Testing Schedule " soils report (1) Electric Power & Lighting Form (1) not mays SAC determination letter from MCNVS - SAC determination letter from MC/WS - SAC determination letter from MCMIS - call 602-1000 call 602-1000 tail 602-1000 Special Inspections & Testing Schedule (1) project specs (1) energy calculations (1) Electric Power & Lighting Form 1) Contact Building Inspections for sample Food & Beverage or lodging facilities: Plan must be submitted to Minnesota Department of Health. Call 215-0700 for details. DATE: WORK TYPE: NEW X REMODEL DESCRIPTION OF WORK: Ark Je4y"_ CONSTRUCTION COST: TENANT NAME: „~gj SITE ADDRESS: 3632S ] 1 ~ Cc _ _ _ 2cI SUITE LOT BLOCK L SUBD. QA P.I.D. # Name: U4 is)-\i c CA Phone PROPERTY Last T First OWNER Street Address: City _ e-\, S ~~CC State: Zip: f rc`c l CA-1 2 'tic- 3 Company: hf\t~ a.~t Phone BPS! -to - 57(3 SO CONTRACTOR Street Address: License # City J t State: ft vv' zip: ARCHITECT/ ENGINEER Company: Al(- Lcz t `~Yvc , Phone (RS 1:J C' Name: h9ar'k-01 tri" 1 Vf j Registration Street Address: c1'S`l I'VU L) I t'sa.1t- City P6{, State: mN Zip: S3 / ? RECEI Sewer & water licensed plumber (only if installing sewer & water): O C T i hereby acknowledge that I have read this application and state that the info t with all applicable State Minnesota Statutes and City of Eagan Ordinances.- ~t - Signature of Applicant: 'r of mss, OFFICE USE ONLY BUILDING PERMIT TYPE ❑ 1 Foundation ❑ 19 Comm./Ind. Misc. ❑ 21 Miscellaneous N 18 Comm.And. ❑ 20 Public Facility WORK TYPE ❑ 31 New ❑ 33 Alterations ~e35 Tenant Finish ❑ 32 Addition ❑ 34 Repair ❑ 37 Demolition GENERAL INFORMATION Const. (Actual) Basement sq. ft. MCMS System (Allowable) 4First Floor sq. ft. City Water UBC Occupancy sq. ft. Fire Sprinklered Zoning sq. ft. Census Code G13 7 # of Stories sq. ft. SAC Code Length sq. ft. Census Bldg. Depth Footprint sq. ft. Census Unit APPROVALS Planning Building Engineering Variance Permit Fee Valuation: $ 30, O Surcharge -8- Fes,7 Plan Review ~6 SCo 5 MCMS SAC City SAC Water Conn. S!W Permit SMt Surcharge Treatment Pl. Park Ded. Trails Ded. Water Qual. Other Copies Total: % SAC SAC Units Meter Size I 1990 BUILDING PERMIT APPLICATION CITY OF EAGAN SINGLE FAMILY DWELLINGS MMLTIPLE DWELLINGS COMMERCIAL 2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL 3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PLANS I SET OF ENERGY CALCULATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS 1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS # OF RENTAL UNITS # OF FOR SALE UNITS PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY OF MONTH IN WHICH REQUEST IS MADE. LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED. NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH, ADDRESS IS DESIRED, NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED. PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED. PERMIT MUST SHOW A LICENSED PLUMBER. O1+~L. . ~a To Be Used For: Valuation: 2.,5 00 Date: ~o 74 1) U Site Address OFFICE USE ONLY Lot / Block FEES C{'O^jO Occupancy _ Zoning y2 . Da Parcel/Sub Actual Const Bldg. Permit Allowable Surcharge 74z, sp Owner # of stories Plan Review ?A0 Length SAC, City 00.00 Address 3535,Qcec,~ Depth SAC, MWCC L~,fyO S.F. Total Water Conn City/Zip Code 0 Footprint S.F. Water Meter Acct. Deposit Phone 4p 5 -7 On site sewage- S/W Permit On site well S/W Surcharge Contractor 1 MWCC System _ Treatment Pl.,QGb City water Road Unit Address .2 73 q Z& ~ac~ +rtecNJ PRV - Park Ded. Booster Pump Copies " City/Zip Code SSi/ SUBTOTAL -T APPROVALS Penalty Phone S'0 W°~Y'\ Planner TOTAL / UBS.Sv Council Arch /Engr. Bldg, Off. Variance j Address City/Zip Code I to w Phone # 2 Z 10 3Z 5r vvJ vA~~~ RE* T- S-T 2 2 5 X3,b"'~ ,5~d 3~5,oa~? K,aa~S-~ t6Z►~~ I -L7 y d, S ss 9 ~ )o q © v ~twu ~x60 r S~fo® Ft A COMMERCIAL ~ ~BUILDING PERMIT APPLICATION 1~-'-~p's 55 CITY OF EAGAN 651-681-4675 i Foundation Only New Construction Interior Improvement • Structural Plans (2) sets • Architectural Plans (2) sets • Architectural Plans (2) sets • Civil Plans (2) • Structural Plans (2) • Code Analysis " {1) • Certificate of Survey (1) • Civil Plans (2) • Project Specs (1) • Code Analysis (1) • Landscaping Plans (2) • Key Plan (1) • Project Specs (1) • Code Analysis (1) " • Master Exit Plan (1) • Spec. Insp. & Testing Schedule • Certificate of Survey (1) • Energy Calculations (1) not always" • Soils Report (1) • Spec. Insp. & Testing Schedule (1) " • Elec. Power & Lighting Form (1) not always- • Meter size must be established • Meter size must be established • Meter size must be established - if applicable • Project Specs (1) 1 • Energy Calculations (1) " 1 1 • Electric Power & Lighting Form (1) 1 • Master Exit Plan (1) 1 1 • Fire Protection Plan (1) l 1 • Soils Report (1) 1 • MVES SAC determination letter • MVES SAC determination letter MGES SAC determination letter call 651-602-1000 call 651-602-1000 call 651-602-1000 Contact Building Inspections for sample Food & beverage or lodging facilities: Plan must be submitted to Minnesota Department of Health - call 651-215-0709 for details. DATE DO WORK TYPE NEW RE ODEL ONSTRUCTION COST allD SIT ADDRESS TENANT NAME SUITE # FORMER TENAN ?NAME DESCRIPTION OF WORK Name: hone#: PROPERTY Last First OWNER Street Address City State Zip Compan Z.Oorf one # ( N CONTRACTOR Street Address: City State ip ARCHITECT/ ENGINEER Company Phone # ( ) Name Registration # Street Address City State Zip Licensed plumber installing new sewer/water service: Phone I hereby acknowledge that 1 have read this application, state that the information is co nd agre omply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: Updated 1/C I OFFICE USE ONLY • r'1 SUBTYPE ❑ 01 Foundation ❑ 26 Public Facility ❑ 30 Accessory Bldg. ❑ 14 Apartments ❑ 27 Commercial/Industrial ❑ 32 Ext Alt - Apts. ❑ 15 Lodging ❑ 28 Greenhouse ❑ 34 Ext Alt - Comm. 25 Miscellaneous ❑ 29 Antennae ❑ 35 Ext Alt - PF WORK TYPE TeN-r -ig G *'NJ a P!K _("AP, ❑ 37 Nail Salon ❑ 31 New ❑ 35 Tenant Impr ❑ 42 Demol' h (Found) ❑ 46 Windows/Doors ❑ 32 Addition ❑ 36 Move Bldg ❑ 43 Reroof u 47 Repair ❑ 33 Alterations ❑ 37 Demolish (Bldg) ❑ 44 Siding ❑ 48 Authorization ❑ 34 Replacement ❑ 38 Demolish (Int) ❑ 45 Fire Repair GENERAL INFORMATION Census Code &2 l Zoning sq. ft. SAC Code # of Stories sq. ft. No. of Units Length sq. ft. No. of Bldgs. Width sq. ft. Const. (Actual) Basement sq. ft. MC/ES System (Allowable) First Floor sq. ft. City Water UBC Occupancy sq. ft. Fire Sprinklered MISCELLANEOUS INSPECTIONS ❑ Gas Service Test ❑ Heating ❑ Insulation ❑ Plumbing ❑ Stucco/Stone APPROVALS Planning Building C"(0-) Engineering Variance VALUATION $ =0 Permit Fee Surcharge Plan Review MC/ES SAC % SAC City SAC SAC Units Water Supply & Storage Meter Size S/W Permit S/W Surcharge Treatment Plant Park Dedication Trails Dedication Water Quality Other Copies Total b CITY OF EAGAN 14341 1994 BUILDING PERMIT APPLICATION' , 681-4675 SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy calcs. COMMERCIAL 2 sets of architectural & structural plans, I set of specifications, I copy of energy calcs. Penalty applies: 1) when permit is typed, but not picked up by last working day of month in which request is made, 2) address is changed or 3) lot change is requested once permit is issued. Date / l / Valuation of work _ A Site Address: L I~G67 L-7 STREET SUITE # i' Tenant Name: (commercial only)~17SS' -ce- LOT BLOCK SUBD. yJ P.I.D. # Descri tion of work: The applicant is: ❑ Owner Contractor ❑ Other (Describe) Nam <~'3 Phone Property 'LAST -T FIRST Owner Address STREET STE # City State Zip Company r Phone Contractor Address License # Exp. City _-°'YLI A-1 State zip Architect/ Company Phone Engineer Name Registration # Address City State Zip Sewer & water licensed plumber Processing time for sewer & water permits is two days once area has been approved. I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with 11 applicable ate of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY BUILDING PERMIT TYPE ❑ 01 Foundation ❑ 06 Duplex ❑ 11 Apt./Lodging ❑ 16 Basement Finish ❑ 02 SF Dwg. ❑ 07 4-Plex ❑ 12 Multi. Misc. ❑ 17 Swim Pool D 03 SF Addition ❑ 08 8-Plex ❑ 13 Garage/Accessory ❑ 18 Comm./Ind. ❑ 04 SF Porch ❑ 09 12-Plex ❑ 14 Fireplace ❑ 19 Comm./Ind. Misc. ❑ 05 SF Misc. ❑ 10 Multi. Add'l. ❑ 15 Deck ❑ 20 Public Facility ❑ 21 Miscellaneous WORK TYPE ❑ 31 New ❑ 33 Alterations ❑ 35 Tenant Finish ❑ 37 Demolish ❑ 32 Addition ❑ 34 Repair ❑ 36 Move GENERAL INFORMATION Const. (Actual) Basement sq. ft. MWCC System (Allowable) 1st Fl. sq. ft. City Water UBC Occupancy 2nd F1. sq. ft. PRV Required Zoning Sq. Ft. total Booster Pump # of Stories Footprint Sq. ft. Fire Sprinkler Length On-site well Census Code Depth On-site sewage SAC Code Census Bldg APPROVALS Census Unit Planning Building Assessments Engineering Variance REQUIRED INSPECTIONS ❑ .Site ❑ Footing ❑ Framing ❑ Insulation ❑ Wallboard ❑ Final ❑ Draintile ❑ Fireplace Permit Fee 3 - Sb vatuation: Surcharge Plan Review License MWCC SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment Pl. Road Unit Park Ded. Trails Ded. Copies Other LAC : nits CITY OF EAGAN~ . 1994 BUILDING PERMIT APPLICATION, OQ4 681-4675 SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 co y of energy calcs. R;d COMMERCIAL 2 sets of architectural & str &ttwa4_plar~,,_j_se of specifications, 1 copy of energy ca cs. Penalty applies: 1) when permit is typed, but not picked up by last working day of month in which request is made, 2) address is changed or 3) lot change is requested once permit is issued. Date Valuation of work Site Address: ,3536- STREET SUITE # Tenant Name: (commercial only) LOT BLOCK SUBD. P . I . D . # Description of work: Al A The applicant is: ❑ Owner 14 ontractor ❑ Other (Describe) Named Phone Property LAST FIRST Owner Address G_3. STREET STE # City State Zip Company Phones- Contractor Address License # Exp. City" State 4:~2 jj Zip __S5713_ Company f Phone 2-27 - 04 R Architect/ Engineer Name Registration # Address City State Zip O~ Sewer & water licensed plumber Processing time for sewer & water permits is two days once area has been approved. I hereby acknowledge that I have read this application and state that the information is correct and agree to co ly wi 11 applicable State of Minnesota Statutes and City of Eagan Ordinances. /f Signature of Applicant: i OFFICE USE ONLY BUILDING PERMIT TYPE '4X ❑ 01 Foundation ❑ 06 Duplex ❑ 11 Apt./Lodging ❑ 16 Basement Finish ❑ 02 SF Dwg. ❑ 07 4-Plex ❑ 12 Multi. Misc. ❑ 17 Swim Pool ❑ 03 SF Addition ❑ 08 8-Plex ❑ 13 Garage/Accessory ❑ 18 Comm./Ind. ❑ 04 SF Porch ❑ 09 12-Plex ❑ 14 Fireplace Q 19 Comm./Ind. Misc. ❑ 05 SF Misc. 13 10 Multi. Add11. ❑ 15 Deck ❑ 20 Public Facility ❑ 21 Miscellaneous WORK TYPE 31 New ❑ 33 Alterations ❑ 35 Tenant Finish ❑ 37 Demolish 32 Addition ❑ 34 Repair ❑ 36 Move GENERAL INFORMATION Const. (Actual) 71~/ Basement sq. ft. MWCC System (Allowable) 1st F1. sq. ft. City Water UBC Occupancy a-y 2nd Fl. sq. ft. PRV Required Zoning Sq. Ft. total Booster Pump # of Stories Footprint Sq. ft. )3~ Fire Sprinkler Length On-site well Census Code Depth D G On-site sewage SAC Code APPROVALS Census Unit Planning Building Assessments Engineering Variance REQUIRED INSPECTIONS ❑ Site ❑ Footing "Framing ❑ Insulation ❑ Wallboard ® Final ❑ Draintile ❑ Fireplace Permit Fee vatuat;on: $ 3 ? a Surcharge Plan Review License MWCC SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment Pl. Road Unit Park Ded. Trails Ded. Copies Other Total: SAC % SAC Units CITY OF EAGAN 1994 BUILDING PERMIT APPLICATION. 681-4675 "Awl SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered siLsnur=ve ys, 1 energy cal cs . 11 A~ 2 1~ COMMERCIAL 2 sets of architectural & struct jans,` I set o specifications, I copy of energy - Penalty applies: I) when permit is typed, but not picked up by last working day of month in which request is made, 2) address is changed or 3) lot change is requested once permit is issued. Date Lq '74- Val uati on of work .4 o o a Site Address:_ 3 S3 6LU6-Coe-bSS CA 6 ~~1 r~ ,~S►/opt` STREET SUITE # Tenant Name: (commercial only) QLU~, C2oss6L*j ►9:4-.D ac /-•J rJ LOT BLOCK SUBD. P.I.D. # - Cam. Description of work: Si^je-iE 5T-o2 001 L.6, J&- o 1-40u;tC GSW CI O The applicant is: ❑ Owner Ems. Contractor ❑ Other (Describe) Name _ 6C6 S M C-mot, M )fit .oG 6- Phone-4-SG --80±fl Property LAST FIRST Owner Address 3 ~ .3 S ~ ~6 fired ss :KoA.p STREET STE # City C.A'j State >M rJ Zip ss l Company M(2600,944 COrJ5TKAyCT[o&) Ce'. ''Jc Phone b3 3 - So So Jeff Contractor Address a1 3? r~ Ave-, License # Exp. City r 70A,) z~ State _ /11 j _ Zip s 1 13 Company 0, r4 sc',S j F",42t C`x- i2e 0 r-6c o s , We Phone -OGS~ ArChiteCt/ TZ~~~F~(Lfl Engineer Name Registration # DI Address 4.d- 1 i•~) A3 w S-r,e tw-r doa-,-► City -S"-\. State ✓rl rJ Zip SS I o Sewer & water licensed plumber Processing time for sewer & water permits is two days once area has been approved. X/ I I hereby acknowledge that I have re lication nd state that the information is correct and agree to comp4y-*14A a] a Stat Minnesota Statutes and City of Eagan Ordinances. - Si nature of Applicant: 9 .2 OFFICE USE ONLY BUILDING PERMIT TYPE E] 01 Foundation ❑ 06 Duplex ❑ 11 Apt./Lodging ❑ 16 Basement Finish ❑ 02 SF Dwg. ❑ 07 4-Plex ❑ 12 Multi. Misc. ❑ 17 Swim Pool ❑ 03 SF Addition ❑ 08 8-Plex ❑ 13 Garage/Accessory ❑ 18 Conan./Ind. ❑ 04 SF Porch ❑ 09 12-flex ❑ 14 Fireplace ❑ 19 Comm./Ind. Misc. ❑ 05 SF Misc. ❑ 10 Multi. Add'l. ❑ 15 Deck ❑ 20 Public Facility ❑ 21 Miscellaneous WORK TYPE P 31 New ❑ 33 Alterations ❑ 35 Tenant Finish ❑ 37 Demolish ❑ 32 Addition ❑ 34 Repair ❑ 36 Move GENERAL INFORiv ATI+ON Const. (Actual) Basement sq. ft. MWCC System (Allowable) 1st F1. sq. ft. City Water UBC Occupancy 2nd F1, sq. ft. PRV Required Zoning Sq. Ft. total Booster Pump # of Stories / Footprint Sq. ft. ;u 4^ Fire Sprinkler Length On-site well Census Code 3 27) Depth On-site sewage SAC Code 30 APPROVALS Census Unit T Planning Building Assessments Engineering Variance REQUIRED INSPECTIONS ❑ .Site ICJ Footing El Framing I3 Insulation ❑ Wallboard El Final ❑ Draintile ❑ Fireplace Permit Fee v$iuat,«,: $^/SCI ,C'>ta Surcharge ! Plan Review License MWCC SAC , City SAC Water Conn. Water Meter Acct. Deposit S/W Permit i:? S/W Surcharge Treatment Pl. 21 Road Unit Park Ded. Trails Ded. Copies Other Total. SAC % SAC Units V PLUMMING PERMT (GOI4+MUMC AL CITY OF EAGAN 383 `PIS O$ EAGAN blN- 53I . "1-675 PLEASE C N[PLETP. FOR ALL C069MRCIA,L MDUSMIAL BUU?INGS. ALSO FOR MULTI' FAMILY BUILDINGS W"EN SEPARATE P'ER1 rr ARE NOT, REQUIRED ' FOR EACH ,DWELLING UNIT. N CONMUMON ADD ON ROAM WORK DESCRIPTION: ~D Af . O. Ae_ /mar. c/y' ~ $ i CONTRACT PRICE x 1% $ y-- STATE SURCHARGE TMAL ~ l ',r 6a .~GG/ ff'pi+r¢- SJw ADDRESS: TENANT NAMEz , r OWNER NAME- C-s J' INSTALLER: 4 /'Z~cQl RRSS: vim -l PHONE FOR: CITY OF EAGAN a~ CAL. . 52 Avery St Pain, MN 55117 29 4 PLUMING PERMIT (RLSIDF TIAL) CITY OF EAGAN 38M PHAT KNOB RD RAGAN MN 33222 . (412) 6824678 PLEASE CON[PLETE FOR SINGLE FAMILY DWELLING . ALSO, FOR T M44H AND CONDOS, WHEN PERMI'TS► ARE REQUIRED FOR EACH UNIT. SHO'W'ER 3.00 WATER CLOSET 3.00 BATH TUB 3.00 LAVATORY 3.00 KrIX3iEN SINK 3,00 LAUNDRY TRAY 3.00 HOT TUB/SPA 3.00 rte? WATER HEATER 3.00 ' FLOOR DRAIN 3.00 GAS PIPING OUTLET • own= - : 3.00 ROUGH OPENINGS 1.50 WATER SOFTENER 00 PRIVATE DISP. • n,~.cxy. 2100 U.G. SPRINKLER - 3.00 ALTERATIONS • to cgluft 20.00 WATER TURN AROUND 20.00 STATE SURCHARGE .50 TOTAL: SITE ADDP!"ESS: k OWNER NAME: INSTALLER: ADDRESS. CITY;,,,_, STATE: CODE: PHONE ( ) SIGNA'T'URE UP PERIV nTEE 1990 BUILDING PERMIT APPLICATION.= CITY OF EAGAN SII4GLE FAMILY DWELLINGS- MULTIPLE DWEI~LNG9 ! COMMERCIAL 2 SETS OF PLANS- 2 SETS OF PLANS 2, SETS OF. ARCHITECTURAL 3 REGISTERED. SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PLANS 1 SET OF ENERGY CALCULATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS 1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS # OF RENTAL UNITS # OF FOR SALE UNITS . PENALTY APPLIES WHEN: TYPING OF PERMIT'IS REQUESTED BUT NOT PICKED UP BY LAST WORKING DAY - OF MONTH IN WHICH REQUEST IS MADE: LOT CHANGE IS REQUESTED ONCE PERMIT IS I-SSUED.. NOTE: ADDRESSES FOR CORNER TATS, CONTRACTOR/HOMEOWNER-MUST DESIGNATE WHICH ADDRESS,IS ' DESIRED-. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS -ISSUED. PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE'A PERMIT'HAS BEEN'COMPLETEA; ' PERMIT MUST SHOW A LICENSED PLUMBER. commek6Al. AD,c),-no&3 AMID R~-ynop t,/N(r a To. Be Used For: i Valuation: 'i, /7 Odd Date: Site Address ._,s3'' Us 16A1_Q1_ a&,+" {kv_,. OFFICE USE ONLY Lot Bloch FEEES ~ A Occupancy Zoning B Parcel/Sub. Actual Const Bldg. Permit 04 Allowable Surcharge, 0 Owner # of stories , rc .~a~ £ ~SM1T• Plan-Review Cg~ Z oo Length 16g` SAC, City Address j _51 ~ _15" ~ LA~ Depth SAC, NIWCC S.F."Total' 3 r7 350 Water Conn City/Zip Code , Footprint S. F. J 67,E Water Mete Acct- Deposit Phone On site sewage_ VW Permit On'site well S/W"Surcharge Contractor CC System Treatment Pl. City, water Road Unit Address 3 PRV Park Ded. Booster Pump Copies' City/Zip de s p_s SUBTOTAL APPROVALS Penalty , Phon( 0 Planner TOTAL Council Arch./Engr.~ :Bldg. Off. $ / ~i p~Variance Address 2.8 OY,e.21 ~'.ll~C _ City/Zip Code t Phone r~ 35 s 8~t, Sb AIM ~5 / y i r7i SCE PLAN' REV I Cw d " rf39U-tiij+ - 4 1 . '7 L7 _r Fl t*~%~UU* +11 ,Yy amity of aagan 3830 PILOT KNOB ROAD THOMAS ELAN EAGAN, MINNESOTA 55122-1897 Mayor PHONE: (612) 454-8100 DAVID K. GUSTAFSON FAX: (612) 454-8363 PAMELA McCREA TIM PAWLENTY THEODORE WACHTER Council Members August 10, 1990 THOMAS HEDGES City Administrator EUGENE VAN OVERBEKE City clerk JOHN ROHRMAN, AIA WINSOR/FARICY ARCHITECTS, INC 28 W FIFTH ST, SUITE 375 ST PAUL, MN 55102 Re: Blue Cross Blue Shield Corporate Service Center Addition Dear Mr. Rohrman: I have reviewed for code compliance the construction documents for the above-referenced project. As discussed in our telephone conversation this morning, the following items should be addressed: • Verify that the new showers being installed in rooms 265 and 268 comply with the handicap accessible requirements of MSBC 1340.0500, Subpart 5. • Verify that the tackboards proposed for room 236 comply with the provisions of UBC Section 4204. • Toilet paper dispensers should be located such that they do not obstruct use of the toilet stall grab bars, • Door number 102 shall be a 20-minute assembly complying with UBC 3305(h). • Provide approved barriers in stairways "D" and "F" as required by UBC 3306(h). • Verify that the placement and location of exit signage comply with UBC 3314. • The omission of an elevator lobby is premised upon the supposition that openings between two adjacent floors need not be protected provided these levels do not freely communicate with additional levels. Verify the integrity of opening protection for corridor complex comprised of areas numbered 103, 104, 105, 106, 203, 204, 207, 219, 220, 222, 224, and 225, particularly where it extends into the existing building. THE LONE OAK TREE...THE SYMBOL OF STRENGTH AGWH OUOMMIY Equal Opportunity/Affirmative Action Employer w ! w JOHN ROHRMAN AUGUST 10, 1990 PAGE TWO • A review of the construction documents submitted does not confirm the existence of a complying two-hour area separation wall between the original building and the 1974 addition. Thus, please submit an alternative method for meeting the allowable area requirements of UBC 505. (Perhaps upgrading the addition to meet the requirements of Type I construction would suffice.) Additionally, piping must be re-routed to avoid the proposed substation and switch gear areas (rooms 117 and 118) in order to comply with the electrical code. Sincerely, ~ M~ 0 U Joe Merchak, Construction Analyst Protective Inspections JM/mg ..f.... •r;:a :•::•:::sr: 1 1993 PLUMBING PERMIT (COMMERCIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN MN 55122 (612) 6814675 PLEASE COMPLETE FOR ALL COMMERCL IANDUSTRIAL BUILDINGS. ALSO FOR MULTI- FAMILY BUR.•DINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING L • ~T. NEW CONSTRUCTION _ ADD ON REPAIR WORK DESCRIPTION: /~/_o b"< 6~~/~irfls /~/7PCitlYAe.~ C2ssin /rr rly(,7 m< CONTRACT PRICE: $ r~ oy FEE: 1% OF CONTRACT FEE. STATE SURCHARGE: $.50 FOR EACH $1,000 OF R1►I' FEE. MINIMUM FEE: S 25.00 CONTRACT PRICE X 1% $ STATE SURCHARGE $ TOTAL $ O1 5. 5 v SITE ADDRESS: -?5,3 5 ~:~f'y S S K c~ TENANT NAME: STE. # OWNER NAME: INSTALLER: I e x;~ ADDRESS: s- -CITY: i STATE: ZIP CODE: PHONE FOR: ate. -_q~ CITY OF EAGAN APPLICA-W 61-7 I NL r:::•rorn:::.::.:::.6, ~~a~...;rr:;:r.r•:.r:;,tt:::::>r.::;ti'•....,. D. _ :.......................................................................:.:.:...::::.::::.:::.:..::::...:..................::::r::..::::. 1993 PLUMBING PER UT (RESIDENI74L) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN MN SS122 (612) 681-4675 PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. NO. FI=ES EACH 1 SHOWER 3.00 WATER CLOSET 3.00 BATH TUB 3.00 LAVATORY 3.00 KITCHEN SINK 3.00 LAUNDRY TRAY 3.00 HOT TUB/SPA 3.00 WATER HEATER 3.00 FLOOR DRAIN 3.00 GAS PIPING OUTLET • minimum -1 3.00 ROUGH OPENINGS 1.50 WATER SOFTENER 5.00 PRIVATE DISP. • DalXty, lic. 15.00 U.G. SPRINKLER • dome under coast. 3.00 ALTERATIONS • to existing 15.00 WATER TURN AROUND 15.00 STATE SURCHARGE .50 TOTAL: SITE ADDRESS: OWNER NAME:'-- INSTALLER: ADDRESS: 5-3 tJi2v,•✓~ CITY: Yr" loxi,Z STATE: ZIP CODE: ,F/-2, PHONE (6,,4 t1k 7 - SIGNATURE OF PERMITTEE CITY OF EAGAN FOR CITY USE ONLY 3830 PILOT KNOB ROAD EAGAN, MN 55122 PERMIT # 91? 9 PHONE: (612) 454-8100 RECEIPT # C / 7Q& p9oo m DATE : / PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS & TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. WORK DESCRIPTION FEES NEW CONST ADD-ON MINIMUM $15.00 ADD ON HVAC 0-100 M BTU 24.00 REPAIR ADDITIONAL 50 M BTU 6.00 GAS OUTLETS - MINIMUM 3.00 OF 1 PER PERMIT OWNER NAME: SUBTOTAL: $ SITE ADDRESS: STATE SURCHARGE: .50 LOT: BLOCK SUBD. TOTAL: $ INSTALLER: ADDRESS: SIGNATURE OF PERMITTEE CITY: ZIP: PHONE 1It1I4"M PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS, APARTMENT BUILDINGS, AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. PRICE: e d - FEES OWNER NAME : C_/o S , • Q~ 1% OF CONTRACT FEE. p" (I STATE SURCHARGE - $.50 FOR SITE ADDRESS: ~ e ~J''-SS ~ccld EACH $1,000 OF PERMIT FEE. PROCESSED PIPING - $25.00 LOT : 3 BLOCK SUBD. 2;X~'_ 0/y! $25.00 MINIMUM FEE. INSTALLER: =cl. ~NeA S~ CONTRACT PRICE x 1% $ 49,00 ADDRESS : `33 Fc, I j v~C.t,J STATE SURCHARGE $ 0 S O CITY: ZIP.: ~c~14 ~ :go PHONE TOTAL: J 1~7' ' (SIGNATURE) FOR: CITY OF EAGAN r G O/N n C' ck }A ii Lw 1(" '1)~, r1i C~ a,-, u C~ J W flp 41 Li "'n 4er- el a~ 4 N' , C.~ tz`T P~ r n `1 \e ne w ce~S V. in le C ) L 3 r,,\ ,er J 16 ; 1 r✓0 :.:v::•:::::i::.. --i2is }i ::.:::...i :::.::::::::..::::...~::::i f... ~(F }.v: iiii;'.;:jiY:::'<:::i i~i:i;;.Si;:i;%'':!j.i}i ;;ti ;ti:'>:i• ):?:;~:iv:':': j:' (;:.:.::ii ~v;:?•: i: ;:?;vi.::::::iiiii:'?i.`::~ii:':::::'.:j:'r,:::,:,i:::iii:.: {:..!'•~.:.:::v.•Y.L. i}:i:Y:::'ii;iii{;>:j:.>:•: . ::i\ii'•Si:. +i:o:i}• ::ii::::;•fiii i::::: iiii i)iii:r.:'::ii:::2::;:<:;:i:~: .}}}}}:;iYiS:iii;;}:J:::;}Y}:~......: }:::::::•.:::::::c:..:{::;:;::::;? Li j • • n. i't~'~~~~~. ~•~.•~'.'•..:;.y..:.,.,y ..•`.•i_••:,}...::i:.:.ii.':`:iriii?iii[';id''.iii pup ..................................................•.......:.:..............,.....v.v: x.v::::::::::::::::::::::: ;•:)::x:::::::::::,..v,..xronroT<+rr:::::.r •.v::.v:,..:;.+}::. :::~.:.•..r .+•}v r: . w:. 1993 PLUMBING PERMIT (COMMERCIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN MN 55122 (612) 681-4675 PLEASE COMPLETE FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS. ALSO FOR MULTI- FAMILY BUE :SINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING U N-:'T. NEW CONSTRUCTION ADD ON REPAIR WORK DESCRIPTION: I CONTRACT PRICE: $UO~ O'er FEE. 1% OF CONTRACT FEE. STATE SURCHARGE: $.50 FOR EACH $1,000 OF PtiI' FEE. MINIMUM FEE: $ 25.00 CONTRACT PRICE X 1% $ STATE SURCHARGE TOTAL $ Q?rj SO SITE ADDRESS:-?535 hu i'O 5 S 1Cot. TENANT NAME: STE. # OWNER NAME: INSTALLER: ADDRESS: .fs` r~ct+i; CITY:r C STATE: ZIP CODE: ~5,11 T PHONE FOR: CITY OF EAGAN APPL Sa_ :..:::::.:;.:..:;::'::ass. :as:•.'.::.^;.;•s;.... 'oss:.;. ..~aasas::•::::::::;.:; :•:;.::»::.:a?s::;?u::;ssss;a,•:::.~.~a.~::::::::::::: ~:.:sf•3. _ :..................:.:,::•::::._:....:,.........?:•::•:::::::•:::o-::::::::,:•:::»::•::::::•::.:::::::•:::•:::.>:.;:-.mss;,; s••;•ssssa:::::.::. •.?.:\h... ...:.....:r::..::.:::},:•::.pn•:vi::•i •iiiiiri::•; ;?.iii::?.}i: ii:. •::.a.,.ti:Y.•Yi:4}'•}$;:":i:-:a:•::;+?:ti:+i: ii^-is-.:::. a::• . 1993 PLUMBING PERMIT (RESIDE) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN MN 55122 (612) 6SIA67S PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. - NO. FIXTURES EACH SAL SHOWER 3.00 WATER CLOSET 3.00 BATH TUB 3.00 LAVATORY 3.00 KITCHEN SINK 3.00 LAUNDRY TRAY 3,00 HOT TUB/SPA 3.00 WATER HEATER 3.00 FLOOR DRAIN 3.00 GAS PIPING OUTLET • minimum -1 3.00 ROUGH OPENINGS 1.50 WATER SOFTENER 5.00 PRIVATE DISP. • DalXty. ric. 15.00 U.G. SPRINKLER • home under cont. 3.00 ALTERATIONS • to existing 15.00 WATER TURN AROUND 15.00 STATE SURCHARGE •50 TOTAL: SITE ADDRESS: OWNER NAME: INSTALLER:- ADDRESS: CITY: S~r- STATE: ZIP CODE:/ PHONE 7 - 1,~)&' / SIGNATURE OF PERMITTEE : PAYMRIU' OF FEE AT TIME OF CITY OF E A G A myrm APPLICATION DOES NOT CX, TTUlE * APPROVAL OF PERMIT. APPLICATION FOR PERMIT • INSPECTION OF SEWER AND/CR XWER rNSTALLATIONS WILL NOT BE SCHED- SE WER AND/OR WATER CONNECTION Ulm UNTIL PERMIT HAS BEEN . ~ APPROVED. x• P ease Print) 1) PROPERTY ADDRESS: LEGAL DESCRIPTION: 4UO Lot.B ck Sub i.vision or Tax Parcel ID IF EXISTING STRUCMME, DATE OF ORIGINAL .BUILDING PERMIT ISSUANCE: I~ PRESENT ZONING/PROPOSED LSE:. (Month/Year). CONPMCIAL/RETAIL/OFFICE R-1 SINGLE FAMILY Q INDUSTRIAL, ( R-2 DUPLEX (Two Units) n INSTITUTIONAL/GOVERMEW R-3 TOWNHOUSE (Three + units) ( Units) R-4 APARnE=/CONDOMINIUM ( Units) 2) NAME ~l~L ADDRESS:- 2 k e!; CITY, STATE, zIP: PHONE:. d 3) GJ`~~ For Czty Use NAME:~~ Plumbers License: ADDRESS:4 f `L ie~ Active CITY, STATE, ZIP: Expired Not recorded PHONE: 9 MASTER LICENSE# Staff EXtial NAME: ADDRESS: CITY, STATE, ZIP:~j~:6~,~ PHONE: Sl,~t~""tG~ O •5) a• • : a • of CONNECTION TO CITY SEWER CONNECTION TO CITY WATER OTHER 6) _y • iQ PLEASE HOLD APPROVED PERMIT FOR PICK-UP BY ONE OF ABOVE PLEASE MAIL APPROVED PERMIT TO 1, 3, 4, ABOVE (C cle one) Oak- yf y' • • ! i ~i• ~4• f Di • ! ! tl~l i 1 1 91 f ,7i' ~ .r- ...-FOR ,CITY USE ONLY PERMIT # ISSUED Pd w/Bld„g. Permit FEES: $ 0(o 4r?' SEWER PERMIT (INCLUDE SURCHARGE) WATER PERMIT (INCLUDE SURCHARGE) $ $ WATER METER/COPPERHORN/OUTSIDE READER $ $ WATER TAP (INCLUDE CORPORATION STOP) $ C SEWER -TAP $ $ ACCOUNT DEPOSIT - SEWER $ $ ACCOUNT DEPOSIT - WATER $ WAC $ SAC $ $ TRUNK WATER ASSESSMENT $ $ TRUNK SEWER ASSESSMENT $ $ LATERAL BENEFIT/TRUNK SEWER $ $ LATERAL BENEFIT/TRUNK WATER $ $ WATER TREATMENT PLANT SURCHARGE $ $ OTHER: $ $ TOTAL RECEIPT RECEIPT DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? YES 'IF YES, THEN A "PERMIT FOR WORK WITHIN PUBLIC ROADWAY" MUST BE ISSUED BY THE ENGINEERING NO DIVISION. LIST AS A CONDITION. SUBJECT TO THE FOLLOWING CONDITIONS: APPROVED BY: TITLE: DATE : aa~ 3210` 03 I Now I . MECRANICAL PERMTr (COK"RCUL) CIW OF IEAGAN PIIAT KNOB RD EAGAN MN $5122 (612) "14675 PLEASE C OMPIZIM FOR .ALL COMI4ERCIAL/INDUSTRIAL BU&DINOS. A aO ODMI ` 4M FOR APARTMENT BUILDINGS OR O'T'HER MULTI-FAMILY DUI MINGS WHEN SEPAMT'E PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. DATE: CONTRACT PRICE: do ' ° NEW BUILDING 4C INTETt,IOR.IMPROVENIENT, WORK D'"F CRIPTIC3N: a►. F FEES, 1% OF FEE PROCESSED PIPING. $25.00 MINIMUM FEE: 525.00 STATE SURCHARGE $.50 FOR EACH $1,000 OF I~ FEE. TOTAL 45 STT E ADDRESS- OWNER NAME: TELEPHONE TENANT NAME: (EMPROVEMEM ONLY) : INSTALLER: " :t_ A; 1--chl.-a L-Isiz AD Us r crrY: STATE: ZTP E. ";I LEPHONE 00. S GNATURE OF PERMrrTEE CITY INSPECTOR Pq 10 2000 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF RAGAN 3830 PILOT KNOB RD - 55122 651-661-4675 X301$ Now QQ095100 Reauffernwils CA 9 3 registered $ite surveys showutg 3q.1 of lot. Sq. I of house U ~ 2 copies Of Plan and 9k roofed areas Q% MOCIMUM lot 2MMO i set of *new c olculaftu for heated additions q 2 copies of pions (show beam & window sues: poured bad design; etc.) t site a my for extedor additions & decks > 1 set of energy calculation > 3 copies of hrw preservaflon pion if lot pkdted attar 7/1M3 DATE: CONSTRUCTION COST: DESCRIPTION Of W STREET ADDRESS: LOT: BLOCK: SUBD./P.I.D. C aos u2 i Name' C~6 Phone C PROPERTY Last First OWNER Sheet Addtess• City State' zip: compcmy:~ CSZ~ i 6- hone : l '32 - ~-E'~-3 (area code) CONTRACTOR ~o ~2_ License # Exp. Sheet Address: City State: n Zip: ARCHITECT/ ENGINEER Company: Name: Telephone C ( ) Sheet Address: Registration C try State: Zip. Sewer/water licensed umber (if Installing amr/water Phone#: 1 hereby acknowledge that I have read this application. state that the Womnation is correct, and agree to comply wNh a8 applicable State of Minnewto Statutes and City of Eagan Ordinances. Signature of App t: OFFICE USE ON MAY Q 3 Certificates of Survey Received Yes No Tree Preservation Plan Received Yes No Not Required REST ROOM N : 5L6 ,x yo Q K 'S T TE T P2 Food Be age Booth M 00 P 1 F D T Food R Booth t.. HOSPITALITY TENT A ' x `tv Information 20V- X REST ROOM REST ROOM PARKING LOT 1999 BUILDING PERMIT APPLICATION (COMMERCIAL) CITY OF EAGAN 651 681-4675 Requirements to building permit Foundation Only New Construction Interior Improvement • Structural Plans (2 sets) • Architectural Plans (2 sets) • Architectural Plans (2 sets) • Civil Plans (2 sets) • Structural Plans (2 sets) • Code Analysis (1) • Code Analysis (1) • Civil Plans (2 sets) • Project Specs (1 set) • Project Specs (1) • Landscaping Plans (2 sets) • Key Plan • Spec. Insp. & Testing Schedule " • Code Analysis (1) • Master Exit Plan • SAC determination letter from MC/ES - • SAC determination letter from MC/ES - call • SAC determination letter from MC/ES - call call 651-602-1000 651-602-1000 651-602-1000 • Spec. Insp. & Testing Schedule (1) • Energy Calculations (1) not always " • Project Specs (1) • Elec. Power & Lighting Form (1) not always • Energy Calculations (1) • Electric Power & Lighting Form (1) • Master Exit Plan • Soils Report 1 Contact Building Inspections for sample Food & beverage or lodging facilities: Plan must be submitted to Minnesota Department of Health. Call 65~1-215-0700 for details. DATE: 62-11-1 WORK TYPE: NEW REMODEL DESCRIPTION OF WORK: ~x f Cry S 7-,1/a.Q -7-4" ~7- JUn t 0~2-0 CONSTRUCTION COST: TENANT NAME: -~ooc C r SITE ADDRESS: 4 IrgC! -f 8 SUITE LOT BLOCK- SUED. ~k L P.I.D. # rz ~,val / f~C yy~ J c "Name: N- /roe c~!/4_ /9 Z y Phone PROPEJV,Tf Last First 32- _ Lr Z ER / Street Address. 970 6)(`" %!`-C&L City State: /97 Zip: V Company: Phone CONTRACTOR Street Address: City State: Zip: ARCHITECT/ ENGINEER Company: Phone Name: Registration Street Address: City State: Zip: Sewer & water licensed plumber (only if installing sewer & water): I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Appli OFFICE USE ONLY BUILDING PERMIT TYPE 01 Foundation ❑ 26 Public Facility ❑ 28 Greenhouse 25 Miscellaneous ❑ 27 Commercial/Industrial ❑ 29 Antennae WORK TYPE r S 31 New ❑ 34 Repairs ❑ 37 Demolish Bldg. ❑ 43 Siding/Soffits/Facia SCI 32 Addition ❑ 35 Tenant Impr ❑ 38 Demolish (Interior) ❑ 44 Windows/Doors ❑ 33 Alterations ❑ 36 Move Bldg. ❑ 42 Reroof ❑ 45 Fire Repair GENERAL INFORMATION Const. (Actual) Basement sq. ft. Census Code :~4D (Allowable) First Floor sq. ft. SAC Code 3 UBC Occupancy sq. ft. No. of Units i Zoning sq. ft. No. of Bldgs. d , # of Stories sq. ft. MC/ES System Length sq. ft. City Water Width Footprint sq. ft. Fire Sprinklered APPROVALS Planning Building Engineering Variance VALUATION: $ 046 Permit Fee ~ • a Surcharge Plan Review MC/ES SAC % SAC City SAC SAC Units Water Supply & Storage Meter Size S/W Permit S/W Surcharge Treatment Plant Park Dedication Trails Dedication Water Quality Other Copies ~-f Total 612 432 4233 r FROM YANKEE DOODLE FESTIVAL PHONE NO. : 612 432 4233 Jun. 15 1999 08:03PM P1 Yankee Dooille'Arts & Crafts Festival .bb /~dX AA 3 Eagan, MN 55122 r 612-432-3694 w~ r To: F From: Patsy Schroeder and Ji11 Andersen Date' rl pp Festival Directors Total Number of Pages: CP S-/- &k/ e1-69 y~ Phone: 612-432-4233 Fax: (same) Remarks: _ add-- --7-.LcS l-/e_. p T ~ ~liS1 ~ Tri' h 74- j ~ A;7 >40 612 432 4233 FROM YANKEE DOODLE FESTIVAL PHONE NO. : 612 432 4233 Jun. 15 1999 08:03PM P2 19,98 BUILDING PERMIT APPLICATION (COMMERCIAL) x CITY OF EAGAN 681.4675 Submit following to obtain necessary ermit Foundation -Only New Construction Interior Improvement structural plans (2 sets) architectural plans (2 sets) architectural plans (2 sets) Civil plans (2 sets) structural plans (2 sets) code analysis (1) . code analysis (1) civil plans (2 sets) project specs 1 soils report ( set) (1) landscaping plans (2 sets) Key Plan project specs (1) Code analysis (1) energy calculations (1)notalways Special Inspections & Testing Schedule soils report (1) Electric Power & Lighting Form (1) not always SAC determination letter from MCNvS - SAC determination letter from MCNVS - SAC determination letter from MC/WS - call 602-1000 call 602-1000 call 602-1000 Special inspections & Testing Schedule (1) project specs (1) energy calculations (1) Electric Power & Lighting Form AIL_ I Contact Building Inspections for sample Food & Beverage or Lodging facilities. Plan must be submitted to Minnesota Department of Health. Call 215-0700 for details. DATE' 4p Y /5 ~ J~ WORK TYPE: NEW REMODEL DESCRIPTION OF WORK: Ceaw'y4 707x 7 1730 my SctlY~i}s~~L`'~Z CONSTRUCTION COST: TENANT NAME: 2 /1 ~-1e .scl" y~'~ 1- 41'4~ e"eo s'.r SITE ADDRESS: 4f x 0 sS ~0 c e f~.-0 PC'ex X,"EJ SUITE LOT BLOCK SUED. P.E.D. # Name: mf t ~'ress ~1 .S li~ //'/•~s, Phone PROPERTY Last First OWNER Street Address: 3 t C,eex_~ 77 c. J City State: Zip: S S%' 2- Company' I s 4 a L fJhal:o ^'a1 Cr 5~3 ~3 k 1 Phone CONTRACTOR Street Address: / - S te , e ~ tiSc„ 3 2 6 9 License # - City "e G Stater Zip: J 3 l.z ARCHI / , E ER Company:Z!iZ1zR 6-L r ; t1 % ~I L phone Nike: Registration Street Address: City State: Zip: Sewer & water licen9ed plumber (only if installing sewer & water): I hereby acknowledge that I have read this application and state that the informatio "s correct and agree to comply with all applicable State a Minnesota Statutes and City of Eagan Ordinances. -y--r 'c. 4, a e),- J Signature of Appfi a °7"fru rs alca~ (p~i' cv: /f ~a /f lrrry 7~ ti P RESM ROO yC Q D H L KID'S ART TENT P 2 S7 C Food G K M Beverage Booth $ Booth p 1 FOOD B F Food J COURT R Booth pc)X(oo I aox HOSPITALITY TENT A I E L4 o x L4 v Information 20'X-bCD x REST REST ROOM ROOM PARKING LOT H E H O R A N D U H TO: JIM STURM, CITY PLANNER PAT GEAGAN, POLICE CHIEF JON HOHENSTEIN, ASSISTANT TO THE CITY ADMINISTRATOR DALE WEGLEITNER, FIRE MARSHAL BILL AKINS,.ELECTRICAL INSPECTOR PUBLIC WORKS/ENGINEERING/UTILITIES/STREETS 4 WE VAMVER4tEE, i!NANCE DIR R RICH BRASCH, WATER RESOURCES COORDINATOR FROM: DOUG REID, CHIEF BUILDING OFFICIAL DATE : RE: PLAN REVIEW The preliminary X construction plans for [✓Iue- Cross QIvL SAid - Cner9v Ce"fer -3535' 61VL crois RQ. are in our plan review secti6n for your review and comment. Please return this form to Dale Schoeppner withv your Ysigned comments and the date of review. 'aro;euiiS f01 1W t If you have any objections to approval of these plans, it is your responsibility to notify this department and resolve any problems with the affected parties. If you are requesting that the issuance of the building permit be held, please fill out the proper hold request form. Thank-you. COMMENTS: Z ~f s 2 Signature Date Metropolitan Waste Control Commission Mears Park Centre, 230 East Fifth Street, St. Paul, Minnesota 55101-1633 612 222-8423 June 13, 1994 Mr. Dale Schoeppner Construction Analyst City of Eagan 3830 Pilot Knob Road Eagan, MN 55122 Dear Mr. Schoeppner: The Metropolitan Waste Control Commission determined SAC for the Blue Cross Blue Shield Energy Center to be located at 3535 Blue Cross Road within the City of Eagan. This project should be charged 1 SAC Unit, as determined below. SAC Units Charges: Fixture Units 20 f.u. @ 17 f.u./SAC Unit 1.18 or 1 If you have any questions, call Jodi Edwards at 229-2113. Sincerely, Roger W. Janzig Planner RWJ:JLE 94061358 cc: S. Selby, MWCC Carolyn Krech, Finance Department, Eagan Rhonda Smieja, McGough Construction Equal Opportunity/Affirmative Action Employer 4ft SPECIAL INSPECTION AND TESTING SCHEDULE (To be used in accordance with the "Guidelines for Special Inspection and Testing") PROJECT NAME BCBS/M Generator Building PROJECT NO. LOCATION Eagan, MN (1) PERMIT NO. SPECIAL INSPECTION SCHEDULE Svec gation, Type of Report Assigned Section c Description 2 Firm, 3 e enc Firm 4 03300 3 Concrete-Placement TA Ea. pour AET 03300 3 Concrete-Reinf. Placement TA Ea. pour AE1 04200 3 Masonr -Reinf. Placement TA Periodic AET 05120 3 Structural Steel-Confi urati n SER Periodic Dunham 02200 3 Earthwork-Sample & Test TA Periodic AET TESTING SCHEDULE 03300 3 Concrete-Sample & Test TA Ea. our AET 04200 3 Masonry - Sample & Test TA Periodic AET 05120 3 Structural Steel - Welds TA Periodic AET 05120 3 Structural Steel - Bolts TA Periodic AET 05220 3 Steel Joists - Welds TA Periodic AET 05310 3 Steel Deck - Welds TA Periodic AET Notes: This schedule to be filled out and included in the project specification. Information unavailable at that time to be filled out when applying for a building permit. (1) Permit No. to be provided by the Building Official. (2) Use descriptions per U.B.C. Section 306. (3) Special Inspector, Testing Agent or Fabricator. (4) Firm contracted to perform services. ACRNOWLEDGrMENTS Each appropriate representative must sign below: Owner: Lt' 4 Firm: Date: 14~ ~f9 4 Contractors Firm. A c6-p-,) ~*t(r&Ny-CA,ate: ~t~-- Architect: Date: Firm: eEL , 4AW1 CS/' --z SER: t ory P. C~ Firm: Date: * SI: tE Firm: Date: r ~i¢ l9~ *SI: Firm: Date: TA: Firm: Date: TA: Firm: Date: F: Firm: Date: F: Firm: Date: * The individual names of all prospective special inspectors and the work they intend to observe must be identified on the reverse side of this form. Legend: SER Structural Engineer of Record SI = Special Inspector TA Testing Agent F Fabricator Accepted for the Building Department By Date: CLAIII VOUCHER - REtUND REQUTST CITY OF EAGAlf R i CL.AI!lANT MCGOUGH CONST CO ADDRESS 2737 N FAIRVIEW AVE ST PAUL MN 55113 s Location .3535 BLUE CROSS RD LOT 1, BLK 1, BLUE CROSS Receirt Ho.IDate 27824/JUN 15, 1994 Reason for Refund NEW BUILDING TO HOUSE GENERATOR WILL GET SEWER WATER FROM EXISTING LINES; NOT ANEW SERVICE Tyre of Refund Electrical rermit 01-3211 S rlumbing remit 01-3212 $ Ilechanical. reTmit 01-3213 S Surcharge 01-2155 $ .50 Water Connortion reTmit 20-3713 $ 50.00 Sewer Connretion reTmit 20-3743 S 50.00 Account Deposit 20-2252 $ - Utility Account Over-royment 20-2250 $ Other: 'TOTAL $ 100.50. l declarp under the rpnaltieg of law that this account. claim or demand is just and that no part of it has been raid. •10/28/94 ~'Si-, sture ~,Q_3/ 9 Date ~ ~ L ,end /S a` e- , Radwei 4ad e4tia ~S 4d4aard", low. OTTO G. BONESTROO ROBERT W. ROSENE v V~ JOSEPH C. ANDERLIK nl Paid, /~(I~ BRADFORD A.LEMBERG e7`. &M. 55f0& ROBERT D. FRIGAARD RICHARD E. TURNER - PHONE: 646^4886 J A M E S C . O L S O N December 5, 1969 ~l A Mr. A. C. Godward t Consulting Engineer 4924 France Ave. So. Minneapolis, Minnesota 55410 Re: Blue Cross Addition Eagan, Minnesota File No. 6049 Dear Sir: Enclosed herewith is one copy of your proposed Blue Cross Addition plat marked to show our suggested changes' relative to Blackhawk Road and also showing the requested easement for sanitary sewer in Lot 1, Block, 1. By carbon copy of this letter we are also sending one copy of proposed plat to your surveyors, Egan, Field & Nowak. As you know, the Town Board has gone through the hearing which officially vacates old Blackhawk Road. This should enable you to show the new road dedication without referring to itas an outlot. We have located the trunk sanitary sewer easement in accordance with our discussion with you sometime ago and in accordance with your development site plan. If there are any questions, please call. We will appreciate receiving further information on the subdivision of the balance of the Blue Cross property if it is available. It is anticipated that the Township will desire to extend this trunk sani- tary sewer through that property during 1970. Please keep us advised. Yours very truly, BONESTROO, ROSENE, ANDERLIK & ASSOCS., INC. Robert W. Rosene RWR:li cc: John Klein Alyce Bolkek____ Paul Hauge, Atty. Egan, Field & Nowak `9 MEETING REPORT PRESENT: Jackie Jones - Blue Cross Blue Shield of Minnesota Sharon Zauhar - Blue Cross Blue Shield of Minnesota Jim Sturm - City of Eagan Mike Ridley - City of Eagan John Rohrman - Winsor/Faricy Architects, Inc. John Barbour - Winsor/Faricy Architects, Inc. RE Blue Cross Blue Shield of Mi A W fE''Project No. 8709-9001 DATE: 22 June 1990 FROM: John Barbour - Winsor/Faricy Architects, Inc. We met at Eagan City offices to discuss parking requirements for BCBSM as related to the new addition. The following was discussed: 1. The present building population is approximately 1,450 people. The new addition will not change the building population. 2. The existing parking lot has about 1,250 spaces not including a new unpaved lot at the south end of the parking lot. When paved and striped, there will be about 140 additional parking spaces. 3. On a typical day, there are usually about 200 open parking spaces. 4. Per the zoning ordinance, using an 80% net-to-gross ratio, 1,970 parking spaces would be required for the existing building, plus 195 spaces for the new addition, for a total of 2,165 parking spaces. 5. The Site Plan was reviewed. Jim Sturm noted that adequate proof of parking does exist. 6. BCBSM will not need to request a zoning variance but will need to submit a letter to the City stating a committment to finish the south lot including paving, striping and curb and gutter. Other Discussion: 7. Minnesota Public Radio has presented a proposal to the City to construct an array of 450' tall radio towers somewhere between BCBSM and the river. Their proposal is on the agenda for the Planning Commission Meeting on 22 July. BCBSM may be interested in attending. c: All Present Dick Gunderson - McGough Construction Company, Inc. Wayne Winsor - Winsor/Faricy Architects, Inc. l Blue Cross and b Blue Shield of Minnesota P.O. Box 64560 • St. Paul, Minnesota 55164 June 25, 1990 Jim Sturm City Planner, City of Eagan 3830 Pilot Knob Road Eagan, Minnesota 55122 RE: Additional Parking Requirement at 3535 Blue Cross Road Dear Jim: This letter serves as confirmation that Blue Cross and Blue Shield of Minnesota agrees to surface and curb the 140 space parking lot on the southeast corner of the main facility site at 3535 Blue Cross Road to comply with the additional parking required for the building addition currently under design. We agree to complete the surfacing and curbing prior to the occupancy date of the addition. The lot meets the twenty foot set-back requirement. Thank you for your prompt attention to this issue. Sincerely, Sharon Zauhar Director, Human Resources and Corporate Services 456-8361 MINNESOTA DEPARTMENT OF HEALTH Division of Environmental Health REPORT OF PLANS Plans and specifications on Plumbing for Blue Cross and Blue Shield Remodeling Location Eagan, Minnesota Date Examined September 13, 1955 Prepared and submitted by APchitectural Alliance, 400 Clifton Avenue South, Minneapolis, Minnesota 55403 Date Received August 7, 1985 Ownership - Blue Cross and Blue Shield of Minnesota, 3535 Blue Cross Road, P.O. Box 43560, St. Paul, Minnesota 55111 Scope - This examination is limited to the design of this particular project only insofar as the provisions of the Minnesota Plumbing Code, as amended, apply, and does not cover the water supply or sewerage system to which this plumbing system is connected. The examina- tion of plans is based upon the supposition that the data on which the design is based are correct, and that necessary legal authority has been obtained to construct the project. The responsibility for the design of structural features and the efficiency of equipment must be taken by the project designer. Approval is contingent upon satisfactory disposition of any requirements included with this report. Inspections - Special care should be taken to insure that the material and installation of the plumbing system are in accordance with the provisions of the Minnesota Plumbing Code. It is necessary that the State Health Department make roughing-in and final inspections of the plumbing system to determine whether it complies with the Code. Provisions should be made for applying an air test at the time of the roughing-in inspection as outlined in Minn. Rules p. 4715.2820 of the Code. In order to facilitate this work, there is attached a self-addressed card which should be returned, indicating the name of the plumbing contractor so that arrangements can be made for the State Health Department to be notified by him as to the time that the installation will be ready for test and inspections. No acceptance of the plumbing installation can be given until inspection and test of the roughing-in work (Minn. Rules p. 4715.2820, subp. 2), finished plumbing (Minn. Rules p. 4715.2820, subp. 3), and inspection of the completed installation by a representative of the State Health Department indicates compliance with the provisions of the Code. Requirements - (OVER) Authorization for construction in accordance with the approved plans may be withdrawn if construction is not undertaken within a period of two years. The fact that plans have been approved does not necessarily mean that recommendations or requirements for change will not be made at some later time when changed conditions, additional information or advanced knowledge make improvements necessary. Approved: Vatt- /,Z/" P i)A14 Milton R. Bellin, P.E. Patrick M. Simpkins Public Health Engineer Engineering Aide Section of Water Supply Section of Water Supply and Engineering and Engineering I` 4 Requirements: 1. The soak sink shall be trapped and vented. 2. Verify the hand sink is trapped and vented according to the Minnesota Plumbing Code. 3. Dishwashing Machines - Every dishwasher in a building for public use shall discharge to the drainage system through an air gap. If a floor drain constructed without a backwater valve is installed on the horizontal dishwasher branch, the dishwasher may be connected directly to the drainage system. The water supply to any dishwasher in which the supply opening is located below the spill line of the machine should be protected with a vacuum breaker (see Minn. Rules p. 4715.1250). 4. Verify a temperature and pressure relief valve for the water heater. 5. Use of 50-50 solder or flux containing lead is now prohibited by State law on potable water distribution systems. Solder containing less than .2 percent lead must be used (Section 326.371). 6. The water piping system shall be disinfected in accordance with Minn. Rules p. 4715.2250. 7. The plumbing system shall be tested in accordance with Minn. Rules p. 4715.2820. ~I r J ► See instructions for completing this form on back of yellow copy. E 7 8 6 9 8 X" Below Work Covered by This Request 7 New Add Rep. Type of Building AppiiancesWired Equipment Wired Home Range Temporary service Duplex Water Heater Electric Heating Apt. Building Dryer Other (Specify) Comm /Industrial Furnace Farm Air Conditioner Other (specify) I Contractor's Remarks: * 42.- 3.,,r+ r 9 _ A Compute Inspection Fee Below. A7, yC . 3E72wer 7AOxq 3 - 3/- # Other Fee # Service Entrance Size Fee # Circuit seders Fee Swimming Pool 0 to 200 Amps 0 to 100 Amps 0v Transformers Above 200 Amps Above t00 Amps p.-90 Signs Inspector's Use Only: TOTAL Irrigation Booms AW/ Special Inspection Alarm/Communication Other Fee I, the Electrical Inspector, hereby Rough-in Date certify that the above inspection has Final Date been made. OFFICE USE ONLY This request void 18 months from E 786_98//_,3A/' Request Date Fire No. Rough-In Inspection 3/ ~I„~ Required? ❑ Ready Now ❑ Will Notify Inspector /I/J ❑ Yes ❑ No When Ready? A licensed contractor ❑ owner hereby request inspection of above electrical work at: Job Address (Street, Bo;;; x Roo.) City 3535 61ass 1.0 4.6 &,4K7,4 Section No. Township Name or No. Range No. County L, 74 Occupant (PRINT) Phone No. Power Su liar Address r'y 4&Z- Electrical Contractor (Company Name) Conhactors rise No. E7JQG ~/~,4r! ~,yvT~A~'7a2S - U~ 2-'2._ Mailing Address (Contractor or Owner Making Installation) //ff 277 E. /G4 tu4),~'(` ~Q(jL XtLe 5~/a Aut 'zed S' nature (con tredo er Making Installaion) Phone Number 27!I-Z MINNESOTA STATE BOARD OF E RICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. - Room S-1 BE ACCEPTED BY THE STATE BOARD 1821 University Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (612) 642-0800 ENCLOSED. k / C7~ {V~" 1986 BUILDING PERMIT APPLICATION - CITY OF EAGAN NOTE: ALL CONTRACTORS MUST BE LICENSED WITH THE CITY OF EAGAN SINGLE FAMILY DWELLINGS INCLUDE 2 SETS OF PLANS, .2 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS MULTIPLE DWELLINGS - RESIDENTIAL RENTAL UNITS FOR SALE UNITS INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECK WITH BLDG. DEPT., 1 SET OF ENERGY CALCULATIONS COMMERCIAL INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS, $2,000 LANDSCAPE BOND To Be Used For: Office Space Valuation: $350,000.00 Date: 6-27-86 Site Address 3535 Blue Cross Road OFFICE USE ONLY Lot Block Erect Occupancy ? 114 t4So 0 2 Q --D Remodel Zoning Parcel/Sub Repair Type of Const Addition # of Stories Owner Blue Cross Blue Shield of MN Move Length Demolish Depth Address 3535 Blue Cross Road Int.Impr. ✓ Sq Ft Install City/Zip Code Eagan, MN 55164 Phone 456 8000 Earl Milbridge APPROVALS FEES ContractojMc Gough Construction Co., Inc-Assessments Permit Water/Sewer Surcharge l 1 Address 2737 N. Fairview Ave. Police /Plan Review Fire SAC City/Zip Code5t. Paul, MN 55113 Engr Water Conn Planner Water Meter Phone 633 5050 Jeff Wolnik Council Road Unit Bldg Off _X- - Treatment PI Arch./Engr. Architectural Alliance APC Parks Address 400 Clifton Ave. So. Variance Copies TOTAL City/Zip Code Minneapolis, MN 55403 Phone # 871 5703 Mark Merrill NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED. 4' 1 l~,ocao c~.~2 2soIDOo Z-"~D X2S = ~Z lost I t i 1985 BUILDING PERMIT APPLICATION - CITY OF EAGAN NOTE: ALL CONTRACTORS MUST BE LICENSED WITH THE CITY OF EAGAN COMMERCIAL SINGLE FAMILY DWELLINGS INCLUDE 2 SETS OF ARCHITECTURAL INCLUDE 2 SETS OF PLANS & STRUCTURAL PLANS, 1 SET OF 3 CERTIFICATES OF SURVEY SPECIFICATIONS AND 1~SET OF 1 SET OF ENERGY CALCULATIONS ENERGY CALCULATIONS $2,000 LANDSCAPE BOND To Be Used For : .~-pAyaluation : =,r~ Date : Site Address '35 5 'V-0 Ovo S OFFICE USE ONLY Lot Block l Erect Occupancy RemodelC Zoning Parcel/Sub 7~~e GwS S, Repair Type of Const Addition # of Stories Owner" Move Length Demolish Depth Address Int.Impr. Sq Ft Install City/Zip Code Phone APPROVALS FEES Contractor c-'. Assessments Permit Water/Sewer ~ Surcharge Address 4'='~L--' Police Plan Review Fire SAC City/Zip Code =IIJ 5:5 35 Engr WA ter Conn Planner ater Meter Phone '~y• Council ////Road Unit g ALL Bldg Off Treatment Pl Arch./En r. APC Parks Variance Copies Address TOTAL City/Zip Code Phone # I R 4253 70 s = 4 fn/1 m m 0 m O a0 O n n Z N rn r. r z 0 <n M m n D M H -n Z m-5 D m m D 0 c oo 000 v O- Z W m M n - mx n-1 n > Z r Onm 0 n _ Z-1 , -4m ZM 3 cm;f M C y~ W 7F ox C-1 0= ---I CC: i p 'n 70 v= S M Z m 0,Z m m 0 m O m O N ZM OO C) -n G3 a c -i -1 O Zm n~ °Z m c7 y m W TEMPORARY CONSTRUCTION EASEMENT IN CONNECTION WITH EAGAN CITY PROJECT NO. 709R THIS EASEMENT, made this lxork day of !A4 y , 2000, between BCBSM, INC., a Minnesota corporation, hereinafter referred to as "Landowner" and the CITY OF EAGAN, a municipal corporation, organized under the laws of the State of Minnesota (hereinafter referred to as the "City"). WITNESSETH: That the Landowner, in consideration of the sum of One Dollar ($1.00) and other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, does hereby grant and convey unto the City, its successors and assigns, a temporary construction easement, over, under and across the following described premises, situated within Dakota County, Minnesota, to-wit: A temporary easement for construction purposes over, under, across and through that part of Lot 2, Block 1, BLUE CROSS ADDITION, Dakota County, Minnesota described as follows: Commencing at the most westerly corner of said Lot 2; thence northeasterly along the northwest line of said Lot 2 a distance of 100.0 feet to the point of beginning of said a temporary easement; thence southeasterly deflecting to the right 90 degrees 00 TnJuila'`es 00 M seconds 40.0 feet; thence northeasterly deflecting to the left 90 degrees 00 minutes h 00 seconds a distance of 180.0 feet; thence northwesterly deflecting to the left 90 degrees 00 minutes 00 seconds a distance of 40.0 feet to the northwest line of said Lot 2; thence southwesterly along said northwest line to the point of beginning. Said temporary easement to expire July 15, 2002. See also the graphic attached hereto as Exhibit "A". The grant of the foregoing temporary construction easement for site grading purposes includes the right of the City, its contractors, agents and servants to enter upon the premises at all reasonable times to construct, reconstruct and inspect site grading and the further right to remove trees, brush, f undergrowth and other obstructions. After completion of such construction, maintenance, repair or removal, the City shall restore the premises to the condition in which it was found prior to the commencement of such actions, save only for the necessary removal of trees, brush, undergrowth and other obstructions, subject only to grading alterations. And the Landowner, its successors and assigns, does covenant with the City, its successors and assigns, that it is the Landowner of the premises aforesaid and has good right to grant and convey the easement herein to the City. IN TESTIMONY WHEREOF, the Landowner has caused this easement to be executed as of the day and year first above written. BCBSM, C., a Minn ota corporation B U EN y y' - Its: Vice 'PVr _eA1_- STATE OF MINNESOTA) ) ss. COUNTY OF DAKOTA ) On this ?,161 day of 2000, before me a Notary Public within and for said County, personally appeared o: 14t %,p to me personally known, who being by me duly sworn, did say that he she is the - K4w of BCBSM, INC., the corporation named in the foregoing instrument, and that said instrument was signed on behalf of said corporation by authority of its Board of Trustees and said I~li,✓ac acknowledged said instrument to be the free act and deed of the corporation.' Notary Pdblic SCOTT D. JOHNSTON 4 NOTARY PUBLIC-MINNESOTA MY COMMISSION EXPIRES 1.31.2005 2 SaScr~~ car, : ~3 ;L u ° SS Z e 117 3 S ,Q L c. G ASS I? c~ Adler, inc;l:Acles% new gl`c.l p,,,,S O,J Jt`~cc,- er an tnA, C-J slier L 4o r,ooed a2lo4a,44- 6,; ar ller C,I~~I yes minnesota department of health 717 s.e. delaware st. p.o. box 9441 minneapolis 55440 0 (612) 623-5000 September 20, 1"5, 31100 CMOs ?llue, Shield of,MIxaftota 35 35 Blue Cives so" P.O. Box 43560 St. Paul, Min otai 55111 t3eritle~aenlTaadi+~ Subject: Plumbin : for SUN, 2M! MM ue 3er3,d 1410 do ra i ze'e We are enclosing a cep Of our report covering ern' exeexdn%tioA of plane Specifications on the above-designated project. A set of the Identified Plane and 4W1ficatia= is also being return to you. IT Is THE PST OwIM's mmsi I rTy Aix THr PIANS AT THE PROJECT LOCATION. Your attention is directed to the Statement pertaining to it~peectic~n of the plumbing. It is important that use receive the informtion ; Indicated in order that the necesesaryy 1=pection =ky, be wee. If You be►ve any questions in reasrd to plumbing inspection, ple",& contact Donald Gt 1cy at 612!623-5328. thi~ have +2' qustlons in regard to the information contained in epor, please eammicatet Frith Patrieek gi. A$ at 612/623--535'T. Sinctreay yours, Petry L: Fng1, P. L, . Chief Section of 'dater SuMI and ngineerizeg GLFslsgh tic Zeaeure~s cc: Mr. IWilliam Adam, Plumbing Inspector Archite et al, All1 e, an equal opportunity employer APPROVED AS TO FORM: City Attorney's Office Dated: `712--. f V I APPROVED AS TO CONTENT: Pa he Works Department Dated: I - -22 ob THIS INSTRUMENT WAS DRAFTED BY: SEVERSON, SHELDON, DOUGHERTY & MOLENDA, P.A. 7300 West 147th Street, Suite 600 Apple Valley MN 55124 (612) 432-3136 Easement No. 765 (RBB/wkt #206-13891) 3 v.~ 1..~• 1~r-r-.~.•v r~. ~".'1-r-yam 1 ti-1, to i w r 1 rT . O l1 ~ 1~ 1 CIA ti . Jl ; 111` trD - r-l il._. _ l~ - _ - Az- ~C I _ ~ ` , vim. w . ATH 13 - = - - co CID o CONSTRUCT ION - 0 LIMITS cv r EASEMENT AREA N1 [ - 7 r SCALE: I"=100' CITY OF EAGAN 7UR PRO). NO. 7098 , TH 13 RECONSTRUCTION 11. .SCreap,bw- PARCEL R TEMPORARY EASEMENT •~~x+ ~uac rr.. x1v.:lr1 r•~ . ~ 1 ~ cn 4 T A PHONE 454.5242 EAGAN TOWNSHIP 8798 PILOT KNOB ROAD ST. PAUL, MINNESOTA ssttt I June 14, 1972 Minnesota Hospital Service Assn. 3535 Blue Cross Road St.Paul, MN 55122 Attention: Merlin R. Bret,§man Dear Mr. Bretzman: This letter is in reply to your request for information in regards to your assessments on Blue Cross Addition and that portion of the un- ' platted property that is now assessed: x CROS S ADDITION ~LR4!!.IR+Iml16m.01Y11 Lot 1 Block 1, Sewer 4 water fats & water area Original amount assessed $12,765.00 Unpaid balance $10,212.00 %Lot 2 Bloc' Sewer & water lats & water area Original amount assessed $42,091.00 Unpaid balance $33,672.80 Lot 3 Block 1, Sewer & Water bats & water area Original amount assessed $11,218.50 Unpaid balance $ 8,974.82 Outlot A, should now be posted to Parcel 3231-A and not to your tax statement which shows up in the amount of $579.00 /C GI ~L L' C /C SECTION 17 Parcel 3232-A, Sewer & water lats & water area Original amount assessed $13,900.50 Unpaid balance $11,120.42 /C 61M111 D/61 Gill The above mentioned unpaid balances are payable until the 15th day of November of 1972 without any additional interest. The assessments were spread over a 20 year period with an annual interest rate of 8% per year on the unpaid b unpaid balance. The cut off date for payment of any unpaid assessment is the 15th day of November of the year in question. If additional information is need in this matter-please call me. Sincerely, Ann Goers Assessment Clerk PHONE 454.5242 EAGAN TOWNSHIP 3798 PILOT KNOB ROAD ST. PAUL. MINNESOTA aa9 June 14, 1.972 I~;innesota Hospital Service Assn. 3. »"5 Blue Cross Road ".Paul, Yjll 55122 Attention: Merlin R. Bretzman ?`ear Er. Bretzman: This letter is in reply to your request for information in regards to your asses..ments on Blue Cross Addition and that portion of the un- platted property this is now assessed: SS ADDITION Lot 1 block 1 Sewer & water lats & water area Original amount assessed $12,765.00 Unpaid balance $10,212.00 Lot 2 L1ock l Sewer & water lats & water area g.L a` a[,ioiin. assessed $42,081.00 Unpaid balance $33,672.80 Lot 3 Block 1, Sewer & water lats & water area Original amount assessed $11,218.50 Unpaid balance $ 8,974.82 Outlot A, Should now be posted to Parcel 3231-A and NOT to your tax atatement which shows up in the amount of $579.00 /U 0/ ~'O O D16 7 SECTION 17 Parcel 3232-A, Sewer & water lats & water area Original amount assessed $13,900.50 Unpaid balance $11,120.42 The above mentioned uri aid balances area a p payable until the 15th day of November of 1972 without any additional interest rate. The assessments were spread over a 20 year period with an annual interest rate of 6% per year on the unpaid balance. The cut off date for payment of any unpaid assessment is the 15th day of November of the year in question. These assessments were assessed in 1969. If additional information is needed in this matter call me. Sincerely, Ann Goers Assessment clerk . no's - ~5 'gU YA~.U~Crd~1 ; A ~►O o~OO . od ~I~CT'. ~ M~~~'~'EME~CT~ ~1 ► 7Z 0 r - ~ ~ ~ IA[G ~ Y t~~5rj SEA BLOMQUIST MAYOR THOMAS HEDGES Q `I CITY ADMINISTRATOR CITY- OF EAGAN EUGENE V CLERK BEKE JAMES ATHOMAS. SMIEGANTH t/ C CITY CLERK JERRY THOMAS THEODORE WACHTER '-3795 PILOT KNOB ROAD - COUNCIL MEMBERS _ "P.O. BOX 21199 EAGAN, MINNESOTA 55122 PHONE 454-8100 Y \;KE:. t1hrch 5, 1982 X-- Mr. Daryl_ Jenson ,krervisor, Building Fngineering 3535 Flue Cross Pnad, P.O. Pox 43560, St. Pahl, MN 55164 Dear 11r. Jenson : 'Ihi.s letter is in regard to our inspection on Janwry 29, 19,92 and my submission of conies of the Aerco Ilelitherm I-Teat Exchanger and the Balti- more Aircoil Company Ener-Changer to the Minnesota Departrrnt of Health. I am enclosing a copy of their findings. ';he City of Fagan will enforce back flow xrreve ti.ons on this aquitxlxnt . Please notify me within thirty clays to re-inspect this equinnnt. Sincerely, Bill Adams Inspector fr(r Enc. E. M/bar i THE LONE OAK TREE THE SYMBOL OF STRENGTH AND GROWTH IN OUR COMMUNITY. minnesota department of health 0 717 s.e. delaware st. p.o, box 9441 minneapolis 55440 (612) 296-5221 March 1, 1982 Mr. Bill Adams Inspector City of Eagan . 3795 Pilot Knob-Road Eagan, Minnesota 55122 Dear Mr. Adams: This is in response to your letter of February 5, 1982 to Mr. Don Stanley .of this Department which. transmitted enclosures pertaining to the Aerco Helitherm Heat Exchanger and the-Baltimore Aircoil Company Ener-Changer. Both types of heat exchangers would be used to heat domestic water. As you know, the State Plumbing Code requi.res that the domestic water system be protected against possible contamination by non-potable liquids or gases. Since neither of these two units provides a positive separation-between the heating medium and the potable water, they should be used only in applications where the heating medium can be classified as potable.. Such a medium would.be unconditioned water or steam, or that which has been treated with a food grade treatment substance.as approved by FDA or EPA. An example of a heat exchanger which is designed to provide a positive separation between the potable water and the heat transfer medium would be one which has a heat transfer surface consisting of two separate fixed walls with a vented space between. I hope thi.s clarifies the Department's position with respect to heat exchangers used for heating potable water. Sincerely yours, Milton R..Bellin, P.E. Public Health Engineer Section of Water Supply and General Engineering cc: Don Stanley MRB:tme an equal opportunity employer CITY USE ONLY PERMIT LA to Q \-i RECEIPT DATE: " L U ' CJ APPROVED INSPECTOR COMMERCUL MECHMICAL PUMff "PLICATION CITY OF EMM 3630 PILOT KNOB RD AGM, MN 55185 651-661-4675 Please complete for: all commercial/industrial buildings multi-family buildings when separate permits are not required for each dwelling unit DATE: 716-101 _ SITE ADDRESS: 3 ZJ, AU6 GMU jtJo 910 . .S•SZ Z Z OWNER NAME: 11..616 ~4m I& C 'MW PHONE - (AREA CODE) TENANT NAME (IMPROVEMENTS ONLY): WAS THERE A PREVIOUS TENANT IN THIS SPACE? Y _I N. NAME: INSTALLER: ©(/l&A ' MP~QAl1 ADDRESS: 930 C'. F0? PHONE Z - 9'5Y 269 (AR CODE) CITY: 1 ~JCt -m J STATE: 4_ ZIP: WORK TYPE: New construction Install U.G. Tank _7X_ Interior Improvement Remove U.G. Tank Processed Piping Specify Nature ofWork:A j-oJT7Au ,iX.ttitw( Q ~A CAIt-l't t When installing/removing underground tank, call 651-681-4675 for inspection by Fir Plumbing (inspector. 0 _ , q 8 W Fees: I% of contract price OR $50.00 minimum fee, whichever is greater. ` ut 9 2001 Underground tank removal/installation = minimum fee Contract rice: $ S By p x 1°l0 = $ ZJ~6. 00 (Base Fee) State surcharge • SU calculate at $.50 for each $1,000 Base Fee TOTAL $.~r•C}•~d _ SI ATURE OF PERMITTEE ~gaicD .K1KtrCt~ Updated 1/01 i QOYM 2. CITY USE ONLY PERMIT RECEIPT DATE: f APPROVED BY s, NSPECTOR COM+I ACIAL MECH"CAL, I'H"IT "Pl ICATION CITY OF KAem 8$30 PILOT KNOB $D EAGM, MN 5518E 651-6$1-4E675 Please complete for: all commercial/industrial buildings multi-family buildings when separate permits are not required for each dwelling unit DATE: 2-q,, 2.mo/ SITE ADDRESS: OWNER NAME: PHONE - (AREA COD-7E) TENANT NAME (IMPROVEMENTS ONLY): if Zh WAS THERE A PREVIOUS TENANT IN THIS SPACE? Yi' NAME: INSTALLER: /✓~eeo~l,,, /✓~,o ion i ca l~G~ ,7~r°ai i^ ADDRESS: ~'.3 ~/a L✓c~t liy,g ~n /Qre __r PHONE YYZ-- 70~/ b (AREA CODE) CITY: STATE: 1YJ ZIP: y WORK TYPE: New construction Install U.G. Tank Interior Improvement Remove U.G. Tank Processed Piping Specify Nature of Work: V el el 40 ~er n~vq~... .ax/v~ Floc i► ~ ~e„c.I When installing/removing underground to ,call 651-681-4675 for inspection by Fire Marshal and Plumbing (inspector. Fees: I% of contract price OR $50.00 minimum fee, whichever is greater. Underground tank removal/installation = minimum fee Contract price: x 1°l0 = $ SZ9, vo (Base Fee) n r State surcharge calculate at $.50 for eac Q F ! <<t, C A D C ~ TOTAL $ MM _!9_V 5 J UL SIGNATURE 20 1 ~ ITTEE ~3~.~ w ~►.ers~.~» Updated 1/01 yRnkec, t)nod (c, -tO2.(d REST ROOM STAGE ~0 N o ~6X~ d k 1A Q D H L HOSPITALITY O TENT 2 C Food T G Booth M FOOD Beverage COURT Booth 1 B F ood J Booth KID' AIX ART TENT Infor E a on REST REST ROOM ROOM PARKING LOT M,p o`F ac~~~.r LJ 0A ~ILAC cross HANDICAP PARKING BLUE CROSS ROAD b Cyrour~nS O 0 C~ C:::) C= . ~ tr ® 1~1 Aih"G- aocK g 0 o ca o 0 0 0 0 SERVICE r i 40- CITY USE ONLY PERMIT RECEIPT DATE: C I APPROVED BY: INSPECTOR CObI14MM MCHAMCAL Mff APPLICATION CITY OF Fu6m 3830 P LOT KNOB ~tD KA8E11FN, MN 55122 651-681-4675 Please complete for: all commercial/industrial buildings multi-family buildings when separate permits are not required for each dwelling unit DATE: ~.us 44 Z t3c9 SITE ADDRESS: OWNER NAME: PHONE - EA CODE) TENANT NAME (IMPROVEMENTS ONLY): 'S WAS THERE A PREVIOUS TENANT IN THIS SPACE? Y 0'--N. NAME: INSTALLER: ADDRESS: 73a,~..~G .✓/rx/ PHONE #:~,t~: ~~1--701 n (AREA CODE) CITY: STATE: lnr/ _ ZIP: ,S53'Yy WORK TYPE: New construction Install U.G. Tank Interior Improvement Remove U.G. Tank Processed Piping Specify Nature ofWork:e' d'i✓ Zy ~i~Tib~o~n~j /~~2_2•!~-1 When installing/removing underground tank, call 651-681-4675 for inspection by Fire Marshal and Plumbing (inspector. n Fees: 1% of contract price OR $50.00 minimum fee, whichever is greater. Underground tank removal/installation = minimum fee A U G 6 L i Contract price: $ 'G Wa x 1% = $ Z410 (Base Fee) By State surcharge 00-3-0 calculate at $.50 for each $1,000 Base Fee_ TOTAL $ f YOB Sb SIGNATURE OF PERMITTEE Updated 1/01 EAGAN TOWNSHIP 3795 Pilot Knob Road St. Paul, Minnesota 55111 Telephone 454.5242 PERMIT FOR SEWER SERVICE CONNECTION DATE: May 29, 1969 NUMBER 445 . D4. OWNER:MINN. HOSP. ASSwN. Address Yankee Doodle Rd. & Hwy. #13 PLUMBERJ. & T. Contracting, Inc. TYPE OF PIPE Heavy Cast Iron DESCRIPTION OF BUILDING Industrial Commercial Residential Multiple Dwelling No. of units Location of Connections: Connection Charge Permit Fee 7.50 Street Repairs Total Inspected by: Date Remarks: By Chief Inspector In consideration of the issue and delivery to me of the above permit, I hereby agree to do the proposed work in accordance with the rules and regulations of Eagan Township, Dakota-County, Minnesota By 0 4 A J. & T. Contracting, Inc. 655 w. County Rd. E St. Paul, nn. 55112 Please notify when ready for inspection and connection and before any portion of the work is covered. EAGAN TOWNSHIP 3795 Pilot Knob Road St. Paul, Minnesota 55111 Telephone 454-5242 PERMIT FOR WATER SERVICE CONNECTION Date: May 29. 1 L69 Number: 27= - .~~e- Z Billing Name: MINN. HOSP. ASSIN. Site Address: Yankee Doodle Rd. & Hwy. X13 Owner: MINN. HOSP. ASSN. Billing Address Plumber: J. & T. Contracting, Inc. Location of Connection Meter Size Connection Chg. Meter No. Permit Fee 7.50 Meter Reading Meter Dep. Meter Sealed: Yes Add'1 Chg. NO Total Chg. Inspected by Date Building is a: Remarks: Residence Multiple No. Units Commercial-._. - Industrial By: Other Chief Inspector i In consideration of the issue and delivery to me of the above permit, I hereby agree to do the proposed work in accordance with the rules and regulations of Eagan Township, Dakota County, Minnesota. By: r J. & T. Contracting, Inc. 655 W. County Rd. E, St. Paul 55112 Please notify the above office when ready for inspection and connection. I l i _ PHONE 454.5242 EAGAN TOWNSHIP 3793 PILOT KNOB ROAD ST. PAUL. MINNESOTA 58111 June 14, 1.972 Minnesota Hospital Service Assn. 3535 Blue Cross Road St.Paul, YIN 55122 Attention: Merlin R. Bretzman Dear Mr. Bretzman: This letter is in reply to your request for information in regards to your assessments on Blue Cross Addition and that portion of the un- platted property this is now assessed: :-BLUE CROSS - ADDITION il- Lot 1 Block 1'~Sewer & water Tats & water area 0-rigind,l-"amount assessed $12,765.00 Unpaid balance $10,212.00 Lot 2 Block 1, Sewer & water lats & water area Original amount assessed $42,081.00 Unpaid balance $33,672.80 Lot 3 Block 1, Sewer & water lats & water area Original amount assessed $11,218.50 Unpaid balance $ 8,974.82 Outlot A, Should now be posted to Parcel 3231-A and NOT to your tax statement which shows up in the amount of $579.00 /D 0266 D/tJ 77 SECTION 17 Parcel 3232-A, Sewer & water lats & water area Original amount assessed $13,900.50 Unpaid balance $11,120.42 6066 616 n) The above mentioned unpaid balances are payable until the 15th day of November of 1972 without any additional interest rate. The assessments were spread over a 20 year period with an annual interest rate of 8% per year on the unpaid balance. The cut off date for payment of any unpaid assessment is the 15th day of November of the year in question. These assessments were assessed in 1969. If additional information is needed in this matter call me. Sincerely, Ann Goers Assessment clerk i~ Blue Cross Addn. Minn. Hospital Assn. Blue Cross Addn. M".Yln. Hospital Assn. Lot 1 Blk 1 3535 Blue Cross Rd. Lot 2, kk 1 3535 Blue Cross Rd. c-3769 75211 a-3770 55111 Date No. Yrs. Total Annual Date No. Yrs. Total Annual Street Surfacing Street Surfacing Paving, Bituminous ' Paving, Bituminous Paving, Bituminous Paving, Bituminous Grading & Gravel Grading 8, Gravel ' Curb and Gutter Curb and Gutter Storm Server, Outfall r Storm Sewer, Outfall ° - Storm Sewar, Outfoll Storm Sewer, Outfall ° - Storm Sewer, Trunk Storm Sewer, Trunk r,._. Storm Server, Lateral - Storm Sewer, Lateral _ r LZ Sanitary Sewer, Main /""'I 7 Sanitary Sewer, Main t ` Sanitary Sewer, Main Sanitary Sewer, Main - !:69saoltary Sewer, Lateral ° - Sanitary Sewer, Lateral Water, Main Water, Main ° -!OWater, Lateral & area. 20 42, 091.00 2104.55 Water, Lateral &a.rea 20 12,765.00 638.25 Remarks3 Remarks: a a1 N c CO Q~ . c . s ,-i \0 cd U-N 4-3 W RI O r-) O 4 w N r-i a> u^ti 00 ~ o CD OD a} ur ►0 01\ N .{a H 4 W tc\ 111111111}lllllll rn z a ,awe ° o a 0 a )o a ; 0) c c o p O 0 0 4 4 a ~ ~ p p p 4 ri a? (7 q p p p q~ ~p p C ja ad ro s>< $ t•}~ Y]f., 471 rA .ac O Lp ~i y 01 C N N y N L 1r .r 0 41 'O a O O U 1-- O O CC C .C a O ►~1 C - i/l ~,0.~ a L~ ` V Vf N 41{{ bf{{ af;~S 4i tf! j 3 l 7W /D o 4C94 a t • MASTER CAtD t LOCATION ..7 . V P r~~j d OWNER ~.!3S Bl W Cress le . STRUCTURE AND j G. LAND USED AS Issued To Permit No. Issued Contractor Owner BUILDING 440 a~f P' L ULWNG C (1' 2 J PO AkC4V$,d^ ex ✓m c CESSPOOL - SEPTIC TANK WELL ELECTRICAL HEATING GAS INSTALLING SANITARY SEWER OTHER OTHER Approved Items (Initial) Date Remarks Distance From Well FOOTING SEPTIC FOUNDATION CESSPOOL FRAMING TILE FIELD FT. FINAL ELECTRICAL DEPTH HEATING OF WELL GAS INSTALLATION SEPTIC TANK CESSPOOL DRAINFIELD PLUMBING WELL SANITARY SEWER Violations Noted on Back COMMENTS: ~L low. 1~ ~t e~j 79' 21 e n,, 7,5 9'"d ll'K C Y e. "ems ~ja /vim 1. G7 751 i ~i t o of ~~~t s 7~rjeyl ~/?rah v~/~d 1yrPrtYtLf 4S ~ 36 - ~-~n - ~d ~ C~ lam! rr red `is /o•~? ,2 - ' s - J~ ,~Z ~ n QyP QA d FO Y-W ~ 19 y \r~~" J 7 7S- t^ - (9 7 5` - it ~d~-7~ ~,~►1j~ v dress 1 C'f~ d~'3 a t~ 3 0 5'_4•~~-' 2nd R•~f T, a• ktt • CAI ~r1T /p0~ 7l o/l lreff. ,~or~~rooY• C)'7.- Igo 0 16 10-1-75- ~ -ems P /0-1/f- 7.5 i nrer,, e e// liner ' hg~ c~ enema 'c 760 i l REUBEN L. ANDERSON -CHER.NE, INC. MECHANICAL CONTRACTORS R.L.ANDERSON 5060 EXCELSIOR BOULEVARD • MINNEAPOLIS, MINNESOTA 55416 CHAIRMAN OF THE BOARD A. L. CH ERNE - - - - PRESIDENT - TELEPHONE 926-2784 - - 0. C. ENGDAHL - SECRETARY - - L. H. KELLEY - VICE PRESIDENT - - - A.R. B ECKSTROM - - VICE PRESIDENT BEN WESER - - _ VICE PRESIDENT March 17, 1975 MAR 1$ 1975 Dunham Associates, Inc. 6800 France Avenue South Minneapolis, Minnesota 55435 Attention: Mr. Cliff Anderson SUBJECT BLUE CROSS SAND TRAP VENTS Gentlemen: On drawing #M-5, near grids A-26 and AD, the 3" vent lines from the two sand traps are shown as rising separately up shaft #5 and out k through the roof (see drawing #M-ll and #M-14 also). We propose to combine these two 3" risers into one 4" riser up through the shaft and out through the roof. This revision has been discussed with and received the verbal approval of Mr. Dale Peterson of the. City of Eagan and Mr. Paul Panekas of the State of Minnesota. Yours truly, I L. H. Kelley cc.: Mr. Dale Peterson Mr. Dick Lembke Mr. Tom Daulton i I L_ , r ~ t CONTRACTOR'S MATERIAL & TEST CERTIFICATE 6 PART "A" GENERAL "'PROCEDURE - - - - UPON COMPLETION OF WORK. INSPECTION AND TESTS SHALL BE MADE BY THE CONTRACTOR'S REPRESENTATIVE AND WITNESSED BY AN OWNERS REPRESENTATIVE, ALL DEFECTS SHALL BE CORRECTED AND SYSTEM LEFT IN SERVICE BEFORE CONTRACTORS MEN FINALLY LEAVE THE JOB. A CERTIFICATE SHALL BE FILLED OUT AND SIGNED BY BOTH REPRESENTATIVES. COPIES SHALL BF. PREPARED FOR APPROVING AUTHORITIES. OWNERS AND CONTRAC- TOR. IT IS UNDERSTOOD THE OWNER'S REPRESENTATIVE'S SIGNATURE IN NO WAY PREJUDICES ANY CLAIM AGAINST CONTRACTOR FOR FAULTY MATERIAL. POOR WORKMANSHIP. OR FAILURE TO COMPLY WITH APPROVING AUTHORITY'S REQUIREMENTS OR LOCAL ORDINANCES. PROPERTY NAME DATE PROPERS eza ACCEPTED BY APPROVING AUT ORITY('S) NAMES A DRESS PLANS Lo INSTALLATION CONFORMS TO CCEPTED PLANS yts NO ❑ EQUIPMENT USED IS APPROVED Y NO IF NO. STATE DEVIATIONS HAS PERSON IN CHARGE OF FIRE EQUIPMENT BEEN INSTRUCTED AS TO LOCATION OF CONTROL VALVES AND CARE OF THIS NEW EQUIPMENT? YE5 (~M NO ❑ INSTRUC IF NO. EXPLAIN - - TIONS HA$ A COPY OF INSTRUCTION AND MAINTENANCE CHART BEEN LEFTAT PLANT? YES NiNO C] IF NO. EXPLAIN - FIA1 SHINU: flow the iepuired rate until water fs clear aN Indicated by no collection of foreign material in burlap bags at outlets such as h3' rRnts an blow-offs. !''lush at flows not less than 750 (wm fm' 6-Inch pipe and smaller, 1000 ;iPINI for 8-Inch pipe, 1500 GPM for 10-inch pipe, and 2000 GP\I for 12- inch pipe. When supply cannot produce stipulated flow rates, obtain maximum available. 'T'ES'T' HYDROSTATIC: Hydrostatic tests shall be made at not leas than 200 PSI for two hours or 50PSI above static pressure in excess of 150 PSI. Differential dr)-pipe valve clappers shall be left open during test to prevent damage All aboveground piping leakage shall be stopped. DESCRIP- I-sAAA(;F,: New pipe laid with rubber gasketed Joints shall, it the worknaan.ship is, sa Uslaclory, have little or no leakage at the Joints. The Amount of leakage at the Joints shall not exceed 2 quarts per hour per 100 joints Irrespectively of pipe diameter. The leakage shall be dis- tributed over AN Joints. If such leakage occurs at a few Joints the mstallatlon shall be considered unsatisfactory and ne-ssary repairs TION - niRde. New pipe iRid with caulked lend or lead-substitute Joints shall, if the workmanship is eRtisfactory, have little or no leakage at the joints. Any Joint having. leakage or more then a "slight drip' or "weeping" shall be repaired. Leakage shall not exceed l ~-z. ili(jaid races ure) per hour per Inch of pipe diameter - per joint. The leakage shall tae distributed over all Joints. If such leakage occurs almost vo- tirely at a few Joints, the Installation shall be considered unsatisfactory and necessary repairs made. I'SlIU IATIC: Fstablish 40 PSI air pressure and measure drop which shall not exceed I% PSI in 21 hours. Test pressure tanks at normal water level and air pressure and measure air pressure drop which shall not exceed 1~j 1181 in 24 hours. PART "B" - UNDERGROUND PIPING - - FEEDS BLDGS.~ LOCATION t s '1--r PIPE TYPES AND CLASS - TYPE JOINT UNDER- GROUND CONFORMS TO STANDARD YES ❑ NO ❑ IF NO. EXPLAIN PIPES AND JOINTS NEEDING ANCHORAGE CLAMPED. STRAPPED. OR BACKED IN yLS ❑ No ❑ ACCORDANCE WITH STANDARD JOINTS IF NO. EXPLAIN TESTS FLUSHING HYDROSTATIC LEAKAGE REQUIRED _ NEW UNDERGROUND PIPING FLUSHED ACCORDING TO STANDARD YES ❑ BY (COMPANY) HOW FLUSHING FLOW WAS OBTAINED: PUBLIC WATER ❑ TANK OR RESERVOIR ❑ FIRE PUMP ❑ THROUGH WHAT TYPE OPENING: FLUSHING HYB. BUTT. ❑ OPEN PIPE ❑ LEAD-INS FLUSHED ACCORDING TO STANDARD YES 0 TESTS BY. (COMPANY) HOW FLUSHING FLOW WAS OBTAINED: PUBLIC WATER ❑ TANK OR RESERVOIR ❑ FIRE PUMP ❑ THROUGH WHAT TYPE OPENING: Y CONN. TO FLANGE a SPIGOT ❑ OPEN PIPE ❑ For. No. 85 Rev. M.Y. 1973 - Printed in U.S.A. HYDROSTATIC ALL NEW UNDERGROUND PIPING HYDROSTATICALLY TESTED AT TEST PSI FOR HOURS --~~TOTAL AMOUNT OF LEAKAGE MEASURED LEAKAGE I GALS HOURS TEST L OWABLE LEAKAGE--------- - - - " _ GALS HOURS • j NUMBER INSTALLED TYPF HYDRANTS ALL OPERATE SATISPACTORILI' _ YES :..1 NO ❑ r'~WATER CONT ROL VALVES LEFT WIDE OPEN: CONTROL ! IF NO. STATE REASON YES ❑ NO ❑ VALVES HOSE THREADS OF FIRE DEPARTMENT CONNECTIONS AND i HYDRANTS INTERCHANGFABLF WITH THOSE OF FIRE DEPARTMENT ANSWERI,r A'-ARMl - yes ❑ • No ❑ - DATE LEFT 1N SERVICL REMARKS - - - - PARTS A & B j NAME OF SPRINKLER CONTRACTOR FOR PRc PF P'Y OWNER ISIGNFD! TITLE SPRINKLER CONTRA(:TOP iSRGNED) SIGNATURES Dj TESTS WITNESSED BY TITLE DATE - PART "C - SPRINKLER do WATER SPRAY ABOVEGROUND PIPING (FILL OUT SEPARATE PART "C" FOR EACH RISER) LOCATION SEav£s B Dds - - - TESTS HYDROSTATIC: ALL PIPING. REQUIRED PNEUMATIC: DRY PIPING. DRAIN: EQUIPMENT OPERATION: ALL. MAKE MODEL SIZE QUANTITY TEMPERATURE SPRtKLEIFT -r - - - --RATING -Sr CC'4 - - - - - - - _ MATERIAL AND KIND CONFORMS TO - PIPE AND STANDARD FITTINGS IF NONE. EXPLAIN - A L A R M D E V I C E MAXIMUM TIME TO OPERATE THROUGH TEST PIPE 4- ALARM VALVE OR FLOW TYPE MAKE MODEL - MIN._ - SFC. INDICATOR OPERATING TEST RESULTS: OK2 DRY MAKE MODEL SER. TIME TO TRIP TRIP TIME THROUGH TEST PIPE WATER AIR POINT WATER ALARM NO. WITHOUT WITH PRESS. PRESS. Ala REACHED OPERATED PIPE I Q O. D. Q. O. D. PRESS. TEST PROPERLY OUTLET MIN. SEC. MIN. SEC. P.S.I. P.S.I. P S.1. MIN. SEC. YES NO VALVES IF NO, E PLAIN - OPERATION: 1•NEUtitATlt _ ❑ ELEf.TEIC. n HYDRALLIC ❑ PIPING SUPERVISED: YEs ❑ NO ❑ DETECTING MEDIA SUPERVISED YES ❑ NO ❑ DELUGE DOES VALVE OPERATE FROM THE MANUAL TRIP AND/OR REMOTE CONTROL STATIONS? YES ❑ NO ❑ &1 Sl THERE AN ACCESSIBLE PACILITY IF NO, EXPLAIN IN EACH CIRCUIT FOR TESTING? YES ❑ No ❑ PREAC TION EACH CIRCUIT OPERATE DOES EACH CIRCUIT OPERATE MAXIMUM TIME TO VAVES I Eli SION LOSS ALARM? VALVE RELEASE? - OPERATE RELEASE: MAKE MODEL ERVI 1 YES _ NO YES NO MIN, SEC. ALL PIPING HYDROSTATICALLY TESTED AT PSI FOR HOURS DRY PIPING PNEUMATICALLY TESTED: YES NO ❑ TESTS EQUIPMENT OPERATES PROPERLY: Yes ❑ No ❑ IF NO. STATE REASON DRAIN TEST: READING OF GAGE LOCATED NEAR WATER SUPPLY TEST PIPE - RESIDUAL PRESSURE WITH VALVE IN TEST PIPE OPEN WIVE STATIC PRESSURE PSI _ PSI j NUMBER USED LOCATIONS NUMBER REMOVED BLANK TESTING WET.DED OR BRAZED PIPING YES i IF YES, DO YOU CERTIFY AS THE SPRINKLER CONTRACTOR THAT THE. WEI.DEHS OR GRAZERS ARE QUALIFIED FOR No 0 WEILD- GASKETS ING OR BRAZING IN ACCORDANCE WITH THE REQUIREMENTS OF ASME BOILER AND PRESSURE VESSEL CODE, ,4FCT10\ IA. QUAI.IFICATION STANDARD FOR WELDING AND BRAZING PROCEDURES, WELDERS, GRAZERS, AND WELDING AND BRAZING OPF.RATORS-1969 EDITION, YES ❑ NO ❑ REMARKS DATE LE IN 1 E WITH ALL CONTROL VALVES OPEN. s' S NA E OF SPRINKLER CONTRACTOR FOR P QPERTY OWNER (SIGNED TITLE PART „C" I SIGNATURES FOR SPRINKLER CONTRA R 1G ED) TESTS WITNESSED 0 TITLE DATE CONTRACTOR'S MATERIAL & TEST CERTIFICATE i PART "A" GENERAL PROCEDURE - UPON COMPLETION OF WORK. INSPECTION AND TESTS SHALL BE MADE BY THE CONTRACTOR REPRESENTATIVE AND WITNESSED BY AN OWNER'S REPRESENTATIVE. ALL DEFECTS SHALL BE CORRECTED AND SYSTEM LEFT IN SERVICE BEFORE CONTRACTORS MEN PINALLY LEAVE THE FOB. A CERTIFICATE SHALL BE FILLED OUT AND SIGNED BY BOTH REPRESENTATIVES. COPIES SHALL as PREPARED FOR APPROVING AUTHORITIES. OWNERS AND CONTRAC- TOR. IT IS UNDERSTOOD THE OWNER'S REPRESENTATIVE'S SIGNATURE IN NO WAY PREJUDICE;; ANN' CLAIM AGAINST CONTRACTOR FOR FAULTY MATERIAL. POOR WORKMANSHIP. OR FAILURE TO COMPLY WITH APPROVING AUTHORITY'S REQUIREMENTS GR LOCAL ORDINANCES. PROPERTY NAME J- - - - DATE E__ t?LLI r= C-f-'-0 n,,:-S NID D nm - PROPERTY ADDRESS ACCEPTED BY APPROVING AUTHO ITY('S) NAMES ADDRESS 4in,__ - y _ PLANS Zz 2_9 7' INSTALLATION CONFORMS TO ACCEPTED PLANS yt;s NO ❑ EQUIPMENT USED IS APPROVED rE5 NO ❑ IF NO. STATE DEVIATIONS 1 HAS PERSON IN CHARGE OP FIRE EQUIPMENT BEEN INSTRUCTED AS TO LOCATION j OF CONTROL VALVES AND CARE OF THIS NEW EQUIPMENT? YES NO ❑ IF NO. EXPLAIN i INSTRUC- TIONS HAS A COPY OFINSTRUCTION AND MAINTENANCE CHART BEEN LEFT AT PLANT? TES, No ❑ IF NO. EXPLAIN - i FLUSHiNC: Flow the required rate until water 1s clear as indicated by no collection of foreign material in burlap bags at outlets such al 05-rants an blow-offs. Flush at flows not less than 756 011M for 8-inch pipe and smaller, 1000 :;P\f for ii-inch pipe, 1500 GPM for 10-Inch pipe, and 2000 Gl'INI for 12 im•h pipe. When sul+ply cannot produce stipulated now rates, obtNin maximum avallable. TEST HYDROSTATIC: Hydrostatic tests shall be made at not less than 200 PSI for two hours or SOPSI above static pressure in excess of 150 PSI Differential dry-pipe valve clappers shall be left open during text to prevent damage. All aboveground piping leakage shall be stopped. DESCRIP- 1.FA3t At,F: New pipe laid with rubber gasketed joints shall, if the workmanship is satisfactory, have little or no leakage at the joints. Th, amount of leakage at the Joints shall not exceed 2 quarts per hour Per 106 joints Irrespectively of pipe diameter. The leakage shall be dig j tributed i-er all joints. It such leakage occurs at A few joints the installation shall be considered unsatisfactory and necessary it-piol i TION made, New pipe laid with caulked lead or lead-substitute joints shall, if the workmanship is satisfactory, have little or no leakage at th, joints. Any Joint having leakage or more th(tn a "slight drill" or "weeping' shall be repaired. Leakage shall not exceed 1 ..z. Okitlid u,es ure) per hour per Inch of pipe diameter per joint. The leakage shall be distributed over all joints. If such leakage --cur. ahmoxt cn tireiy at A few joints, the Installation shall be considered unsatlNfeictory and necessary repairs made. PNEUMATIC: FNtablish 90 PSI air pressure and measure drop which shall not exceed 1!/t PSI In 24 hours. Test pressure tanks at norms water level and air pressure and measure air pressure drop which shall not exceed 1M PSI in 24 hours. PART "B" - UNDERGROUND PIPING FEEDS BLDGS. J LOCATION j PIPE TYPES AND CLASS TYPE JOINT t UNDER- GROUND CONFORMS TO STANDARD YES ❑ NO ❑ IF NO. EXPLAIN PIPES AND JOINTS NEEDING ANCHORAGE CLAMPED. STRAPPED. OR BACKED IN YLS ❑ - N0 ❑ ACCORDANCE WITH STANDARD IF NO. EXPLAIN JOINTS 4 TESTS FLUSHING HYDROSTATIC LEAKAGE REQUIRED _ NEW UNDERGROUND PIPING FLUSHED ACCORDING TO STANDARD YES ❑ BY (COMPANY) HOW FLUSHING FLOW WAS OBTAINED: PUBLIC WATER ❑ TANK OR RESERVOIR ❑ FIRE PUMP ❑ THROUGH WHAT TYPE OPENING: FLUSHING Itro, OUTT. ❑ OPEN PIPE ❑ LEAD-INS FLUSHED ACCORDING TO STANDARD YES ❑ TESTS BY (COMPANY) HOW FLUSHING FLOW WAS OBTAINED: PUBLIC WATER ❑ TANK OR RESERVOIR ❑ FIRE. PUMP ❑ THROUGH WHAT TYPE OPENING: Y CONN. TO PLANGE A, SPICOT ❑ OPEN PIPE ❑ Forte Ns. 65 Rev. Msy. 1973 - Print<d is U.S.A. HYDROSTATIC ALL NEW UNDERGROUND PIPING HYDROSTATICALLY TESTED AT TEST PSI FOR HOURS J TOTAL AMOUNT OF LEAKAGE MEASURED LEAKAGE i CALS HOURS TEST If ALLOWAOLE LEAKAGE " - GALS. HOURS U ER INSTALLED TYPE AND MAKE HYDRANTS ALL OPERATE SATISFACTORILY YES ❑ NO ❑ A ER OTEROL VALVES LEFT WIDE OPEN: YES ❑ No ❑ CONTROL W IF NO, REASON VALVES HOSE THREADS OF FIRE DEPARTMENT CONNECTIONS AND HYDRANTS INTERCHANGEABLE WITH THOSE OF FIRE DEPARTMENT ANSWERING ALARM? YES ❑ No ❑ FATE LEFT IN SERVICE REMARKS PARTS A & B~ji NAME OF SPRINKLER CONTRACTOR FOR PROPERTY OWNER ISIGNEDI TITLE I FOR SPRINKLER CONTRACTOR (SIGNED) DATE SIGNATURES TESTS WITNESSED BY TITLE DATE PART "C" - SPRINKLER & WATER SPRAY ABOVEGROUND PIPING (FILL OUT SEPARATE PART •'C•' FOR EACH RISERI LOCATION - SERVES BLDGS.; Pek 1' N ar-0 tf 112 &n-) c TESTS HYDROSTATIC: ALL PIPING. REQUIRED PNEUMATIC: DRY PIPING. DRAIN: j EQUIPMENT OPERATION: ALL. 1 MAKE MODEL SIZE QUANTITY TEMPERATURE r RATING SPRINKLERS OR II it C~~'1 R, SPRAY NOZZLES PIPE AND MATERIAL AND KIND CONFORMS TO STANDARD FITTINGS IF NONE. EXPLAIN ALARM DEVICE MAXIMUM TIME TO OPERATE THROUGH TEST PIPE ALARM VALVE OR FLOW TYPE MAKE MODEL MIN. - SEC. INDICATOR WA-4 R-0 /j OPERATING TEST RESULTS: DRY MAKE MODEL SER. T ROUGH TEST PIPE WATER AIR TRIP TIME ALARM POINT WATER NO. WITHOUT WITH PRESS. PRESS. AIR REACHED OPERATED PROPERLY TEST TLET Q. O. D. Q. O. D. PRESS. OU PIPE MIN. SEC. MIN, SEC P.S.I. P.S.I. P.S.I. MIN. SEC. YES NO VALVES IF NO. E LAIN OPERATION: PNEUMATIC ❑ KLECTEIC ❑ HY9EAULIC ❑ PIPING SUPERVISED: YES ❑ 140 0 DETECTING MEDIA SUPERVISED: YES ❑ NO ❑ DELUGE DOES VALVE OPERATE FROM THE MANUAL TRIP AND/OR REMOTE CONTROL STATIONS? YES ❑ No ❑ jI IS THERE AN ACCESSIBLE FACILITY IN EACH CIRCUIT FOR TESTING? YES ❑ No ❑ IF NO. EXPLAIN PREACTION VALVES DOES EACH CIRCUIT OPERATE DOES EACH CIRCUIT OPERATE MAXIMUM TIME TO MAKE MODEL SUPERVISION LOSS ALARM? VALVE RELEASE? OPERATE RELEASE: i YES NO YES NO MIN. SEC. ALL PIPING HYDROSTATICALLY TESTED AT PSI FOR HOURS DRY PIPING PNEUMATICALLY TESTED; YEmj~r) NO ❑ TESTS EQUIPMENT OPERATES PROPERLY: rs No ❑ IF NO. STATE REASON DRAIN TEST: READING OF GAGE LOCATED NEAR WATER SUPPLY TEST PIPE RESIDUAL PRESSURE WITH VALVE IN TEST PIPE OPEN WIDE STATIC PRESSURE PSI PSI NUMBER USED LOCATIONS - ,NUMBER REMOVED BLANK TESTING WELDED OR BRAZED PIPING YES ❑ NO ❑ IF YES, DO YOU CERTIFY AS THE SPRINKLER CONTRACTOR THAT THE WELDERS OR GRAZERS ARE QUALIFIED FOR WELD- GASKETS ING OR BRAZING IN ACCORDANCE WITH THE REQUIREMENTS OF ASME BOILER AVD PRESSURE VESSEL CODE„ SECTION IX. QUALIFICATION STANDARD FOR WELDING AND BRAZING PROCEDURES, WELDERS, BRAZERS, AND WELDING AND BRAZING OPERATORS-4968 EDITION. YES ❑ No ❑ DATE LEFT IN S ICE WITH ALL CONTROL VALVES OPEN. REMARKS 3 NA E OF SPRINKLER CONTRACTOR FOR PR E TY OWNER (SIGNED) I TITLE PART "C" SIGNATURES FOR SPRINK R CO R LSIGNED) i° TITLE DATE TESTS WITNESSED 8 Y f. LETTER Of TRANSMITTAL VIKING AUTOMATIC SPRINKLER CO. 2366 ROSE PLACE DATE JOB NO. 74.2 _-50 ST. PAUL, MINNESOTA 55113 `TI ,9L,5- 7 I L~° ATTENTION 612 - 6364680 RE: 40 TO 74~~ 702--jAJ k - 5 W/ P 7 . GENTLEMEN: WE ARE SENDING YOU. tached........ ❑Under separate cover via the following items: ❑ Shop drawings ❑ Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of letter ❑ Change order ❑ COPIES DATE NO. DESCRIPTION 1 THESE ARE TRANSMITTED as checked below: ❑ For approval ❑ Approved as submitted ❑ Resubmit copies for approval ]ia For your use ❑ Approved as noted ❑ Submit copies for distribution As requested ❑ Returned for corrections ❑ Return corrected prints ❑ For review and comment ❑ ❑ FOR BIDS DUE 19 PRINTS RETURNED AFTER LOAN TO US REMARKS: COPY TO f L ) FORM LT-352 SIGNED: IF ENCLOSURES ARE NOT AS NOTED, KINDLY NOTIFY US AT O E! f Inc oC a 4 1 al-V I ttt/// f. _ I RECEIVED SEVERSON, SHELDON, JUL a 1 2003 DOUGHERTY & MOLENDA, P.A. EAGAN ENGINEERING DEPARTMENT SUITE 600 7300 WEST 147TH STREET APPLE VALLEY, MINNESOTA 55124-7580 (952) 432-3136 TELEFAX NUMBER (952) 432-3780 E-MAIL bauerr@sevmonsheldon.com TO: Tom Colbert, Director of Public Works FROM: Robert B. Bauer, City Attorney Y DATE: June 30, 2003 RE: BCBSM, Inc./City of Eagan Our File No. 206-20093 Tom, Enclosed please find two original Right-of-Way, Drainage and Utility and Temporary Construction and Slope Easements in connection with the above-referenced matter. Please have the easements signed as to content and return the same to me via interoffice mail. prr ~D - aU - iv/ 1- 3 6 EASEMENT RIGHT-OF-WAY, DRAINAGE AND UTILITY AND TEMPORARY CONSTRUCTION AND SLOPE EASEMENTS THIS EASEMENT, made this a 1, '-k day of Jr~, n -e~- , 2003, between BCBSM, INC., a Minnesota corporation (hereinafter referred to as "Landowner"), and the CITY OF EAGAN, a municipal corporation, organized under the laws of the State of Minnesota (hereinafter referred to as the "City"). WITNESSETH: That the Landowner, in consideration of the sum of One Dollar ($1.00) and other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, does hereby grant and convey unto the City, its successors and assigns, a permanent right of way, drainage and utility easement, over, across and under that part of the Northwest Quarter of the Northwest Quarter of Section 16, Township 27, Range 23, Dakota County, Minnesota, to-wit: Commencing at the northwest corner of said Section 16; thence on an assumed bearing of South 89 degrees 44 minutes 16 seconds East along the north line of said Northwest Quarter of the Northwest Quarter 1309.95 feet to the northeast corner of said Northwest Quarter of the Northwest Quarter; thence South 00 degrees 27 minutes 30 seconds East along the east line of said Northwest Quarter of the Northwest Quarter 375.03 feet to the point of beginning of the easement to be described; thence North 89 degrees 44 minutes 16 seconds West parallel to said north line of the Northwest Quarter of the Northwest Quarter 170.01 feet; thence South 00 degrees 27 minutes 30 seconds East parallel to said east line of the Northwest Quarter of the Northwest Quarter 60.00 feet; thence South 89 degrees 44 minutes 16 seconds East parallel to said north line of the. Northwest Quarter of the Northwest Quarter 170.01 feet to said east line of the Northwest Quarter of the Northwest Quarter; thence North 00 degrees 27 minutes 30 seconds West along said east line of the Northwest Quarter of the Northwest Quarter 60.00 feet to the point of beginning. hereinafter "Right of Way, Drainage and Utility Easement". AND A temporary construction easement over, under, and across that part of the Northwest Quarter of the Northwest Quarter of Section 16, Township 27, Range 23, Dakota County, Minnesota, described as follows: Commencing at the northwest corner of said Section 16; thence on an assumed bearing of South 89 degrees 44 minutes 16 seconds East along the north line of said Northwest Quarter of the Northwest Quarter 1309.95 feet to the northeast corner of said Northwest Quarter of the Northwest Quarter; thence South 00 degrees 27 minutes 30 seconds East along the east line of said Northwest Quarter of the Northwest Quarter 320.03 feet to the point of beginning of the easement to be described; thence continuing South 00 I degrees 27 minutes 30 seconds East along said east line of the Northwest Quarter of the Northwest Quarter 55.00 feet; thence North 89 degrees 44 minutes 16 seconds West parallel to said north line of the Northwest Quarter of the Northwest Quarter 170.01 feet; thence South 00 degrees 27 minutes 30 seconds East parallel to the east line of said Northwest Quarter of the Northwest Quarter 80.00 feet; thence North 89 degrees 44 minutes 16 seconds West parallel to said north line of the Northwest Quarter of the Northwest Quarter 30.00 feet; thence North 00 degrees 27 minutes 30 seconds West parallel to said east line of the Northwest Quarter of the Northwest Quarter 100.00 feet; thence South 89 degrees 44 minutes 16 seconds East parallel to said north line of the Northwest Quarter of the Northwest Quarter 30.00 feet; thence North 78 degrees 35 minutes 49 seconds East 173.15 feet to the point of beginning. hereinafter "Temporary Construction Easement". Said Temporary Construction Easement will expire on June 1, 2005. The Right of Way, Drainage and Utility Easement and Temporary Construction Easement are depicted on Exhibit "A" attached hereto and incorporated herein. The grant of the foregoing Right of Way, Drainage and Utility Easement includes: (1) the right of the City, its contractors, agents and servants to construct, reconstruct, inspect, repair and maintain a roadway, and erect and maintain signs in conjunction with the public's use of said roadway and appurtenances; and (2) the right of the City, its contractors, agents and servants to enter upon the Right of Way, Drainage and Utility Easement at all reasonable times to construct, reconstruct, inspect, repair and maintain pipes, conduits and mains; and (3) the right to remove trees, brush, undergrowth and other obstructions within the Right of Way, Drainage and Utility Easement. The grant of the foregoing Temporary Construction Easement includes the right of the City, its contractors, agents and servants to enter upon the Temporary Construction Easement at all reasonable times (1) as necessary to construct the improvements within the Right of Way, Drainage and Utility Easement; and (2) the right to remove trees, brush, undergrowth and other obstructions located within the Temporary Construction Easement as needed for such construction. After completion of the construction of the improvements within the Right of Way, Drainage and Utility Easement, the City shall restore the Temporary Construction Easement to the condition in which it was found prior to the commencement of such actions, except that the City shall not be responsible to replace trees, brush, or undergrowth which were removed as a necessary part of the construction for the improvements located in the Right of Way, Drainage and Utility Easement. Landowner, its successors and assigns, does covenant with the City, its successors and assigns, that it is the title owner of record of the land underlying the Right of Way, Drainage and Utility Easement and the Temporary Construction Easement and has good right to grant and convey the easement herein to the City. [THE REMAINDER OF THIS PAGE HAS BEEN INTENTIONALLY LEFT BLANK] L IN TESTIMONY WHEREOF, Landowner has caused this easement to be executed as of the day and year first above written, LANDOWNER: BCBSM, INC, a inneso corporation By: Roger K1 pp Its: Vic -P side STATE OF MINNESOTA ) )ss. COUNTY OF A oTA ) The foregoing instrument was acknowledged before me this 3 P, day of 2003, by Roger Kleppe, the Vice-President of BCBSM, INC., a Minnesota corporation, on behalf of the corporation. Notary Public s ■ LORI J. CUMMINGS NOTARY PUBLIC-MINNESOTA My Commission Expires Jan. 31, 2005 t AAAAAAAAAAAAAAAANVA&AAAAAAAMAN xr APPROVED AS TO FORM: 1Z~ - / _ City Attorney's Office Dated: fo/ 3 6 w-5 APPROVE AS TO CONTENT: Public Works Department Dated: 4Z Z &.3 THIS INSTRUMENT WAS DRAFTED BY: SEVERSON, SHELDON, DOUGHERTY & MOLENDA, P.A. 7300 West 147th Street, Suite 600 Apple Valley MN 55124 (952) 432-3136 (RBB: 206-20093) I CUM1 RCL4,L BU IDING Permit, Application City Of Eagan 3830 Pilot Knob Road, F pu Ma 55122 Telephone # 651-675-5675 )FAX # £51-679-%94 77 -77 -z 7 * sarv4s (2) ` svu un PhM (2) • Cf Ana Vie, {4; 0340 A"atysis t) " Land in0tana . (2) ~ PI M 8pece (1} r CodeAaWysia • 1UlN i'E4Phirt t SOW- } . & Tasting Schedule " " • Certificate of Survey (1,} • &Vww +t+i (i) riot • So" (i) $per- Inap. & Testing Seheduie (f) * Eioo, Power6 fq►rtt (i; ratmildl - . • tsar 91xd rnustbe ~ • Mater stm nlrat be estab#ished . rr t if qr NOW Sp*m ! ErwwW Ca1cu4tionV r. 1 Ete Wc,Power & L g"rig f=orm 1 • Masten E)dt . En"r9eeitey Response Site inn (i) d ~ 3oitsRe's~+tut (i) • - 65i-80Z1• _SAO ft*m*)a calf 654-89 =i SAC rleterritlr - t 791 7 ` tali MN D"% of Health at 651-215-0700 for dulls rt g fend & b" " s or to :Ud#dK • Contoot ft Ak ing Inspections for sswrp4e and ifmquimd molten-it states "not always ~ s Pern* for a& building of I#JWM will not be ptocessed without En-wgeney Respo= Sit- PI* ite 7 a~n Coat 'Tiaint i+T t Fvfatr Tft# N ` b' . '7 . rye ai~11A .,...w StMft, /1iM✓~= zip 'I`sepbaft tt ;/a) T .1 ,A 'r ! Iie~iatr~ttiaa. AAtr Staete - j: U0ef ! ptttrrtOr#tt"Rna # MANN{ aeni}*: t!©t#r; Jzoxrv~ r apply for a Commercial Building Permit and acknowledge that the WID at if, the work will be in 0onformance with the ordinate m and codes of the City of ti~* and A WSW Stab"; I Mend this is not a permit, but only an tappli Lien" for az pmt, std w o& to at that the work, will be in accordax with the approved in the £ark "bich ~uravai! ate, _Wmval of plans. Appli s PrAted Name AppliraiWs OFFICE USE OHLY Dad 0Typos 1 Fotnutatijik D 26:, t!ub1iC Faeiliq L ' 3~ . ~ ~ . r y Y, f ❑ 14, A.paz a 27 Conu ercislll u l ❑ 32 ~t Alt 15 miZing~. D 28 Greenhouse 0 34 ~1 ' A - 0 25 Misoelll9 A ntenuae _ ❑ 35 0 37 Nail Sa«tct WoTk Types 0 31 New C] -35 int-moment D 39: Varn (h*srl+ar) © 44 rq © 32 Addftfon 3$ M01" Bldg. t l +42 Donn fish (Fda!! ) © 45 Flre R "of C3 33 Alteration Cl 41 D 0191" ` 43 fterouf © 46 WkW*v at` S . C] 34 R"Wwne st *I~win iiliklcs► { E *W - GN9 POA twWo rt to appNe wd Cww.m Code If --!1j Zoning -r CRY water - SAC Units Bwster Pump W. Of Units Sq. Ft. _ PRV N#x. of tkdgs t tmVth Fite Sp**Iersd 'type of Const REQUMD ItSIFECTlfltNS r... ; Footings (new bldg) FiaalIC.Q. Footings (deck) Final/No C.O. Footings (additivu) Plumbing , Facubda# t HVAG Drain Ti? f Other t u Roof r~ Ice & Water Final Pool Ftgs AAirl6u Tests Fi#~l Frartftg- Siding Stuccoes Slane _ Fireplace :ILL Air T stt Final Windows (Wwhepuoemem) 7ut Retaining Watt Approved ay: ; Planning t iuism- Approved 8Y Ami, 6ui W Base Fee 1 0 $ 3 ..w Surcharge l Ut© C Flan Review MC/Es SAC City SAC Water SqW& Storage S!W Permit S/W Surcharge Treatment Plant Park Dedication Traits Ded n Water QUaitiy 0*jeS Tatar 1 s 290 RCLAL PLUMBMG Mrlffr APPLICATION CITY OF EAGAhi 83t~ PILOT KNOB ROAD, SAGAN 35122 ~k-673675 . out*. i! Atdrm ut snant Name Fenftv Tenant Nam G ~tD>R'~~►1" 1 Area~r. x Clay is Tokome # (io ID. Amt, oar Work Type Add-on Repair RPZ PV9 ~ Irr i[t ~y x 4i ftbschstl to esieulate fees. R uired ter size is tMrf#ti esaa!!e tgi~ee ta#c ~rc~ ids` r a rnqurec if Frcing t~va is requi~d.o~ servl,ee, Call bS155'~3-.5646... CaH 651=675 S to. verify rain h tie, con&tciivity, and b - a tlmn pu"d Iftft"JUn fi tion Siizyt& & Prim Ty Avg OPM Tin Doran c size & Tye Avg GPM rncludts Wo demo# d!evivo3 ~ Yep Yes Yes No ftvWt Fee $50-50 mtsi Srl Vain x, 1% Bl" Foe ' l Requirod crosit bufldWp & ItM& If base fft is MAN or No% s v t me Is S..50 $ State Sub 'b" If bares fee is ac ~ $1,840, sere,b"$R is per $I,000 of the Base Fee F , ft` *leg fees m4ft only Wb i ~ in* f k Systm C emy w 7 $ wam P r I JUL 4.22004 ow stor* lteeaby apply for e t orrmiercial Plum ing Permit W4 WJMOWIedge this a iaxfortxrxrioa is ti F e +en zft conkmmee with the ordimm~ end codes of die City of Eiapn and with the Plumbing Cows; dot I wAmur4 d)is is vw ft, 1 oply aft potion for a ppmk and rvtxk is not to steer without a pM_r~i; that the work wilt be in woxthmm w* she tie a+ df woeie wt" requires a reek w and approrvaall of plat is Printed N=* Applimfs Signasim s I , . --NORTH LINE OF NW1/4 16_27-23 T ! '1 A O DAKOTA,,, r-,liolN l ~A I l R li I -v l i°l i ---1309.95 S89'44'16"E- _ un - 00.04 5 S89°44r1611E- - - Lo O - o COUNTY ROAD NO. 28 (YANKEE DOODLE ROAD) NW CORNER ! o 16-27-23 Ln o -EXISTING R/W o ! - o I I - i _ I i 1 --470.04 S89'44'16"E~- -j 30 30 GRAPHIC SCALE cv N 60 0 0 ( 1 ! o w Ao qa O O N V I Z O LL ( IM FEET f`~ e \ W O \ O WATER ELEVATION = 827.4 \ ! z ` AS OF 9196102 (NA VD 1929 OA TUM) ' cv 30.00.....,,, ( O O N PROPOSED- O TEMPORARY Ln w I c CONSTRUCTION N~83549 E rr] `rt Q ° o EASEMENT l\(- 0 w ~ 9~ -t l W - [170.01 N8944'16'W_ ( Z r~ I T I oMl o'~ 1 PROPOSED P ° I t- °,1 1', - ROADWAY--/ ° 3 I °oi ON EASEMENT ~ Cl I I z) 170.01 589'44'16"E 20.00 30.00 S00'27'30"E N 89'4 4' 16'• W P.F Ar I Mr,YY w.~M 1MN Ki r.y, dMd, 4„r~1rn, w ® Slplf FWOTi KIgMCIfIfN MC 1007. MY r1 v ,r~,r,. Yr rw° w wdw wY A..1 wIiN.4, crtoct tc s w °o+x or Mrc nrryor.c .w° Iwc i uN I .....dr u,wr i... c.r..,.. ,.w. u. ENTRAP MAINTENANCE AD0111 c°.®°n°wc awralx° ua° ascrlpwnlrc w,° N u° ,I,M N °Irw„N. CITY OF EAGAN, .FAu'wu"wu® 'S.OQ N/A Lk. y„ca„ mcs ■vloui nR txlrta atnt° calsrlr ar Aoamwu PROPOSED TEMPORARY Q YM. I! Mp1A aA 601 MMl M07 tF .CtgIAA4C .a ++r uu.wnroA® uu a t[ute a 11F tow.. MINNESOTA PERMANENT EASEMENTS uuuU M0. Av Ml[ RM90NA rMAN W. OI ti3llONt MgQgqF t0f RAF O.Mr•Qt p 1K /ri,W 14n,1 O.la O.ro1/dJ 2005 COMMERCIAL BUILDING PERMIT APPLICATION - City Of Eagan ` 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5694 lail3 - 111 t Q s x ffi s. « x x SEEN= Structural Plans (2) sets • Architectural Plans (2) sets . Architectural Plans (2) sets . Civil Plans (2) • Structural Plans (2) . Code Analysis (1) Certificate of Survey (1) . Civil Plans (2) . Project Specs (1) Code Analysis (1) " • Landscaping Plans (2) . Key Plan (1) Project Specs (1) • Code Analysis (1) " • Master Exit Plan (1) . Spec. Insp. & Testing Schedule • Certificate of Survey (1) . Energy Calculations (1) not always" . Solis Report (1) • ..Spec. Insp. & Testing Schedule (1) " . Elec. Power & Lighting Form (1) not always:". • Meter size must be established • Meter size must be established a Meter size must be established--if applicable 1 Project Specs (1) 1 . Energy Calculations (1) 1 . Electric Power & Lighting Form (1) " l I . Master Exit Plan (1) 1 1 . Emergency Response Site Plan (1) b I . Solis Report (1) 1 . SAC determination -call 651-602-1000 . SAC determination - call 651-602-1000 SAC determination - call 651-602 9000 • Fire Stopping Submittals _ Call Mid Dept of Health at 651-215-0700 for details regarding food & beverage or lodging facilities. Contact Building Inspections for sample and if required Permit for new building or addition will not be processed without Fmergency Response Site Plan. Date Ia.! Construction Cosh t Site Address &Q-__ Cm j As o unitlSte # Tenant Name (N,'{1~~ f~sa. +..ci Former Tenant Name Description of Work ~t~ 6e1~- C2il~Qy~~i 4•.~ a~~~~ i'G`~~ a Property Owner 0~k%kvt Telephone # (161 ) 6L 7 ;lr' 4Z- Contractor Address t 7 lr 44✓y,cw It. City State zip l { Telephone # { (p~j~) VSV ArchlEngr k4bg~~ Registration # Address City State Zip Telephone # { _ITT Licensed plumber installing new sewerlwater service: " Phone # '~S I hereby apply for a Commercial Building Permit and acknowledge that the information mplete and a rate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; 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 ork will be in accordance with the approved plan in the case of work which requires a review and approval *Plan vlica rinted Name Applicant's Signature OFFICE USE ONLY Sub Types " . - A \ ❑ 01 Foundation D 26 Public Facility ❑ 30 Accessory Building ❑ 14 Apartments 9'27 Commercial/Industrial ❑ 32 Ext Alt Apartments ❑ 15 Lodging - ❑ 28 Greenhouse ❑ 34 Ext Alt-Commercial ❑ 25 Miscellaneous ❑ 29 Antennae ❑ 35 Ext Alt-Public Facility ❑ 37 Nail Salon Work Types ❑ 31 New ❑ 35 Int Improvement ❑ 38 Demolish (Interior) ❑ 44 Siding ❑ 32 Addition ❑ 36 Move Bldg. ❑ 42 Demolish (Foundation) ❑ 45 Fire Repair 0' 33 Alteration ❑ 37 Demolish (Bldg)* ❑ 43 Reroof ❑ 46 Windows/Doors ❑ 34 Replacement 'Demolition (Entire Bldg only) - Give PCA handout to applicant Valuation Type of Const 11 Width Plan Rev 100% ✓ 25% Occupancy MCES System Census Code Zoning City Water SAC Units Stories Booster Pump Nbr. of Units Sq. R. PRV Nbr. of Bldgs Length Fire Sprinklered Required Inspections Footings (new bldg) _ Fireplace RI. _ Air Test _ Final Footings (deck) _ Insulation Footings (addition) _ Final/C.O. Foundation FinaWo C.O.. Drain Tile _ Other Driveway Apron _ Pool _ Ftgs Air/Gas Tests Final Roof _ Ice Pr - Decking Insid _ Final _ Siding Stucco Stone ✓ Framing Windows - - Approved By: I - Planning Building Inspector Base Fee 3 fo 3. 2.5' Surcharge 11 .50 Plan Review o'? 36o, 1 SAC-MCES ^ SAC-City S1W Permit " SM Surcharge Treatment Plant Financial Guarantee Treatment Plant (Irrigation) - Storm Sewer Trunk ~y Park Dedication Sewer Lateral Sewer Trunk 4 Trail Dedication Street L" Water Quality Water Lateral Water Trunk Water Supply & Storage (WAC) Other Total l D. Sb McGough Construction 2737 Fairview Avenue St. Paul, Minnesota 55113 (651) 633-5050 Fax (651) 633-5673 LETTER OF TRANSMITTAL TO City of Eagan DATE: December 6, 2005 3830 Pilot Knob Rd. RE: Blue Cross Blue Shield Eagan, MN 55122 Inspections Department McGough Job #5500299-014 WE ARE SENDING YOU X Attached X Under separate cover via MSG. the following items: Shop drawings Pricing Plans Samples Specifications Copy of letter Change order COPIES DATE NO. DESCRIPTION 1 Signed Building Permit Application 2 Project Drawings THESE ARE TRANSMITTED as checked below: For approval Approved as submitted Resubmit copies for approval X For your use Approved as noted Submit copies for distribution As requested Make Corrections Noted Return corrected prints REMARKS Pl e 1 4 1a M r may. i ` ve an questions. Thank you. cc: File Copy Yours very truly, i` McGough Construction John Wawack/lmb 7 s r ' 75~O *,6_'~7 2006 COMMERCIAL BUILDING PERMIT APPLICATION City Of Eagan Z L 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5694 Foundation Only New Building Interior Improvement • Structural Plans (2) sets . Architectural Plans (2) sets • Architectural Plans (2) sets • Civil Plans (2) • Structural Plans (2) • Code Analysis (1) • Certificate of Survey (1) . Civil Plans (2) • Project Specs (1) • Code Analysis (1) . Landscaping Plans (2) • Key Plan (1) Project Specs (1) . Code Analysis (1) • Master Exit Plan (1) • Spec. Insp. & Testing Schedule • Certificate of Survey (1) • Energy Calculations (1) not always- Soils Report (1} • Spec. Insp. & Testing Schedule (1) • Elec. Power& Lighting Form (1) not always- Meter size must be established . Meter size must be established • Meter size must be established-if applicable . Project Specs (1) • Energy Calculations (1) • Electric Power & Lighting Form (1) ) • Master Exit Plan (1) ) • Emergency Response Site Plan (1) • Soils Report (1) • SAC determination - call 651-602-1000 . SAC determination - call 651-602-1000 SAC determination -call 651-602-1000 • Fire Stopping Submittals . Fire Su ression/Alarm Plans Call MN Dept of Health at 651-215-0700 for details regarding food & beverage or lodging facilities. * * Contact Building Inspections for sample and if required Permit for new building or addition will not he processed without Emergency Response Site Plan. Date / / Construction Cost $975,000.00 Site Address 3535 Blue Cross Road, Eagan, MIV 55122 Unit/Ste # Tenant Name -BlueCross BlueShield of M(J Former Tenant Name Description of Work Tear- ff existing roof and roof insulation dawn to deck. Install new SFB6* asphalt nEmbrane. Insulate to code. Property Owner B1ueCross BlueShield of ICI Telephone # ( 651) 662-8000 Applicant is: _ Owner X Contractor Contact ( 651 )488-5630 Contractor Peterson Bros. Roofing and Construction, Inc. Address 481 Burgess Street City St. Paul State MN Zip 55117 Telephone # ( 651 ) 488-5630 Arch/Engr Registration # Address C* State Zip Tele e ) 6 2006 Licensed plumber installing new sewerlwater service: Phone I hereby apply for a Commercial Building Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; 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. Michael J. Finken, President Applicant's Printed Name Applicant's Signature ! t DO NOT WRITE BELOW THIS LINE Sub Types ❑ 01 Foundation ❑ 26 Public Facility ❑ 30 Accessory Building ❑ 14 Apartments X 27 Commercial/Industrial ❑ 32 Ext Alt Apartments ❑ 15 Lodging ❑ 28 Greenhouse ❑ 34 Ext Alt-Commercial ❑ 25 Miscellaneous ❑ 29 Antennae ❑ 35 Ext Alt-Public Facility ❑ 37 Nail Salon Work Types ❑ 31 New ❑ 35 Int Improvement ❑ 38 Demolish (Interior) ❑ 44 Siding ❑ 32 Addition ❑ 36 Move Bldg. ❑ 42 Demolish (Foundation) ❑ 45 Fire Repair ❑ 33 Alteration ❑ 37 Demolish (Bldg)* El' 43 Reroof ❑ 46 Windows/Doors ❑ 34 Replacement "Demolition (Entire Bldg only) - Give PCA handout to applicant Valuation 1757, 000 Type of Const Width 42lnR Re:: 100% 25% Occupancy MCES System SAC Units Zoning City Water Nbr. of Units Stories Booster Pump Nbr. of Bldgs Sq. Ft. PRV Length Fire Sprinklered Required Inspections Footings (new bldg) _ Fireplace _ RI. -Air Test -Final - Footings (deck) _ Insulation Footings (addition) _ Sheetrock _ Foundation Final/C.O. Drain Tile Final/No C.O. Driveway'Apron T Other Roof Ice Pr _ Decking V/Insu) Final _ Pool _ Ftgs _ Air/Gas Tests _ Final Framing _ Siding _ Stucco Lath - Stone Lath _ Final _ Windows Final C/O Inspection: Schedule Fire Marshal to be present. _ Yes 'No Approved By: Planning r,kl6 Building Inspector Fee ---~G : Base Surcharge _ /jq & 0 Plan Review SAC-MCES SAC-City S/W Permit SM Surcharge Treatment Plant Financial Guarantee Treatment Plant (Irrigation) Storm Sewer Trunk Paris Dedication Sewer Lateral Sewer Trunk Trail Dedication Street Water Quality Water Lateral Water Trunk Water Supply & Storage (WAC) Other Total 1!' S Cf 77 . S'~ g~3 ~'S o s 0 2006 FIRE SUPPRESSION SYSTEMS PERMIT APPLICA D O City Of Eagan D 3830 Pilot Knob Road, Eagan Mn 55122 OCT 7 2~Q6 Telephone # 651-675-5675 Fax # 651-675-5694 Requirements: 2 complete sets of drawings and specifications cut sheets on materials and components to be used Date / /2 Site Address: 54,1 C-- c (2'&' ~ Tenant / Building Name: 61-le C f cS 5 011.4e 5hJ 4j The Applicant is: Owner Contractor Other PROPERTY OWNER Address: City: State: Zip: CONTRACTOR p1 N CcJN Q Ffpl€ MN License (S C1C cf ~ Address: 2V W City: State:Zip: j Phone cif ~~515`~ ESTIMATED COMPLETION DATE: / cploo FIRE PERMIT TYPE: Sprinkler System of heads Fire Pump _ Standpipe _Z Other: C602 WORK TYPE: _X New Addition Alterations - Remodel Other: DESCRIPTION OF WORK: Commercial Residential Educational X Other: &4z,? 5C4&E- Please continue on reverse side PERMIT FEE: ~e trz rr k ee (inch4tt 914te gtsl Contract Value $ L/ x .01 = $ Permit Fee • If Permit Fee is $1,000 or less, add $.50 $ State Surcharge If Permit Fee is over $1,000, add $.50 per $1,000 Permit Fee 3/4" Displacement Fire Meter - $167.00 $ TOTAL FEE: $ I hereby apply for a Fire Suppression System permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Minnesota Building/Fire Codes; 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 DO NOT WRITE BELOW THIS LINE 1ZEQUIRED INSPECTIONS I k clrostatir Flow Alarm Drain lest Rough In Trig PumpTes`t Central station i-inal Conditions oflssuancc: I) L) Permit Aphru~cd atc: 1- 2007 COMMERCLAL BULDMG PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 ` Plans are considered public information unless you state they are trade secret and why. Foundabon Only New Building Interior Improvement • Structural Plans (2) sets • Soils Report (1) • Architectural Plans (2) sets • Civil Plans (2) • Certificate of Survey (1) • Code Analysis (1) • Certificate of Survey (1) • Structural Plans (2) • Project Specs (1) • Code Analysis (1) • Architectural Plans (2) sets • Key Plan (1) • Project Specs (1) 401 HVAC units req'd. on bldg elev. / site plan • Master Exit Plan (1) • Spec Insp & Testing Schedule (1) . Civil Plans (2) • Energy Calculations (1) not always- • Soils Report (1) • Landscaping Plans (2) • Elec. Power & Lighting Form (1) not always** • Meter size must be established • Code Analysis (1) • Meter size must be established-if applicable J • Energy Calculations (1) J Emergency Response Site Plan (1) J J • Spec. Insp. & Testing Schedule (1) J J • Electric Power & Lighting Form (1) J J Project Specs (1) J J • Master Exit Plan (1) J • SAC determination - call 651-602-1000 • SAC determination - call 651-602-1000 • SAC determination - call 651-602-1000 • Fire Stopping Submittals • Fire Suppression/Alarm Form • Meter size must be established Call MN Dept of Health at 651-2014500 for details regarding food & beverage or lodging facilities. Contact Building Inspections to see if it is required and for a sample. Permit for new building or addition will not be processed without Emergency Response Site Plan. Date 6 I 26 1 2007 Construction Cost $ 51 pd Site Address 3535 Blue Cross Road unit/Ste # Tenant Name Blue Cross B l u e Shield Former Tenant Name N / A Description of Work Entrance Renovation Property Owner Blue Cross Blue Shield Telephone#(651 ) 662-2542 Applicant is: _ Owner X Contractor Contact ( 952 ) 920-6123 Contractor C.F. Hag 1 i n & Sons, Inc. P NI C~Q,LtiJ GuNa £a*--sail/ Address 3939 West 69th Street cityEdina state Minnesota Telephone#(952) 920-6123 ArchMugr Architectural Alliance Registration# 16854 Address 400 Clifton Ave. S. U city Minneapolis State Minnesota zip 55403 Telephone#(612)871-5703 Licensed plumber installing new sewer/water service: Phone ( I hereby apply for a Commercial Building Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of Statutes; I rstand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the k ! 'll be in cor ce with the approved plan in the case of work which requires a review and approval of plans. i Gary Gunderson Applicant's Printed Name is §iwattd e DO NOT WRI'T'E BELOW THIS LINE Sub Types ❑ 01 Foundation ❑ 26 Public Facility ❑ 30 Accessory Building ❑ 14 Apartments a' 27 Commercial/Industrial ❑ 32 Ext Alt-Apartments ❑ 15 Lodging ❑ 28 Greenhouse ❑ 34 Ext Alt-Commercial ❑ 25 Miscellaneous ❑ 29 Antennae ❑ 35 Ext Alt-Public Facility ❑ 37 Nail Salon Work Types ❑ 31 New ❑ 35 Int Improvement ❑ 38 Demolish (Interior) ❑ 44 Siding ❑ 32 Addition ❑ 36 Move Bldg. ❑ 42 Demolish (Foundation) ❑ 45 Fire Repair ,)~33 Alteration ❑ 37 Demolish (Bldgr ❑ 43 Reroof ❑ 46 Windows/Doors ❑ 34 Replacement `Demolition Building - Give PCA handout to applicant Valuation 000 Type of Const Width Plan Rev 100% ✓ 25% Occupancy MCES System SAC Units _0 Zoning City Water Nbr. of Units Stories Booster Pump Nbr. of Bldgs Sq. Ft PRV Fire Sprinklered Length Required Inspections Footings (new bldg) _ Fireplace r R.I. -Air Test -Final Footings (deck) _ Insulation Footings (addition) _ Sheetrock Foundation Final/C.O. _ Drain Tile _ Final/No C.O. Driveway Apron _ Other Roof _ Ice Pr _ Decking Insul T Final Pool _ Ftgs _ Air/Gas Tests _ Final Framing _ Siding _ Stucco Lath _ Stone Lath _ Final _ windows Final C/O Inspection: Schedule Fire Marshal to be present. _Yes ✓ No Approved By: Planning Building Inspector Base Fee % ' 7S r Surcharge • ~-D Plan Review 2 SAC-MCES SAC-City S/W Permit SNV Surcharge Treatment Plant Financial Guarantee Treatment Plant (tnigation) Storm Sewer Trunk Park Dedication Sewer Lateral Sewer Trunk Trail Dedication Street Water Quality Water Lateral Water Trunk Water Supply & Storage (WAC) Other Total l 443 Lafayette Road N. MINNESOTA DEPARTMENT OF (651) 284-5005 St. Paul, Minnesota 55155 LABOR & INDUSTRY 1.800-DIAL4198 www.doli.state.mn.us TTY: (651) 297-4198 April 24, 2008 APPROVED FOR USE Blue Cross Blue Shield 3535 Blue Cross Rd. Eagan MN 55121 RE: Escalator - Elevator ID# -15339AL08-11 Site Blue Cross-Btae--Shield, #5 (3-4 Up) 3535 Blue Cross Eagan 55121 Dear Sir/Madam: Minnesota Statutes Chapter 16B provides that the Department of Labor and Industry, Construction Codes & Licensing Unit, Elevator Safety Section, inspect and approve elevators and manlifts (endless belt lifts) before they can be legally used in Minnesota. An Inspector from the Elevator Safety Section recently inspected your facility and determined it meets requirements of the Minnesota Elevator Safety Code. NOTE: Compliance with Minnesota Rules and the ANSI/ASME A17.1, Safety Code for Elevators and Escalators does not necessarily assure compliance with the Americans With Disabilities Act of 1990. THIS APPROVAL APPLIES TO THE JOG CIRCUIT. Sincerely, CONSTRUCTION CODES LIC NSING SWO-C 14 4.el~ Bruce Borgschatz State Elevator Inspector bhb/rsg (CE-2) c. Schoeppner, Dale R., BO, City of Eagan Otis Elevator Company FTANR 2 8 2008 By ElFormCE2 This information can be provided to you in alternative formats (Braille, large print or audiotape). An Equal Opportunity Employer 443 Lafayette Road N. MINNESOTA DEPARTMENT OF (651) 284-5005 St. Paul, Minnesota 55155 LABOR & INDUSTRY 1-800-DIAL4198 www.doli.state.mn.us TTY: (651) 297-4198 April 24, 2008 APPROVED FOR USE Blue Cross Blue Shield 3535 Blue Cross Rd. Eagan MN 55121 RE: Escalator - Elevator ID# -15338AL08-11 Site: Blue Cross Blue Shield, #4 (3-2 Dwn) 3535 Blue Cross Rd. Eagan 55121 Dear Sir/Madam: Minnesota Statutes Chapter 16B provides that the Department of Labor and Industry, Construction Codes & Licensing Unit, Elevator Safety Section, inspect and approve elevators and manlifts (endless belt lifts) before they can be legally used in Minnesota. An Inspector from the. Elevator Safety Section recently inspected your facility and determined it meets requirements of the Minnesota Elevator Safety Code. NOTE: Compliance with Minnesota Rules and the ANSI/ASME A17.1, Safety Code for Elevators and Escalators does not necessarily assure compliance with the Americans With Disabilities Act of 1990. THIS APPROVAL APPLIES TO THE JOG CIRCUIT. Sincerely, CONSTRUCTION CODES LICENSING Bruce Borgschatz State Elevator Inspector bhb/rsg (CE-2) c. Schoeppner, Dale R., BO, City of Eagan Otis Elevator Company nn M-- APP 2 8 2008 By ElFormCE2 This information can be provided to you in alternative formats (Braille, large print or audiotape). An Equal Opportunity Employer 443 Lafayette Road N. MINNESOTA DEPARTMENT OF (651) 284-5005 St. Paul, Minnesota 55155 LABOR & INDUSTRY 1-800-DIALzDLI www.doli.state.mn.us TTY: (651) 297-4198 April 24, 2008 APPROVED FOR USE Blue Cross Blue Shield 3535 Blue Cross Rd. Eagan MN 55121 RE: Escalator - Elevator ID# -15336AL08-11 Site:r.---- -Blue. Cross Blue_S_ hield, #2 (2-1 Dwn) 3535 Blue Cross Rd. Dear Sir/Madam: Minnesota Statutes Chapter 16B provides that the Department of Labor and Industry, Construction Codes & Licensing Unit, Elevator Safety Section, inspect and approve elevators and manlifts (endless belt lifts) before they can be legally used in Minnesota. An Inspector from the Elevator Safety Section recently inspected your facility and determined it meets requirements of the Minnesota Elevator Safety Code. NOTE: Compliance with Minnesota Rules and the ANSI/ASME A17.1, Safety Code for Elevators and Escalators does not necessarily assure compliance with the Americans With Disabilities Act of 1990. THIS APPROVAL APPLIES TO THE JOG CIRCUIT. Sincerely, CONSTRUCTION CODES & LICENSING S.""14 'V Bruce Borgschatz State Elevator Inspector bhb/rsg (CE-2) c. Schoeppner, Dale R., BO, City of Eagan Otis Elevator Company {7 APR 2,o08 jBy . . ElFormCE2 This information can be provided to you in alternative formats (Braille, large print or audiotape). An Equal Opportunity Employer 443 Lafayette Road N. MINNESOTA DEPARTMENT OF (651) 284-5005 St. Paul, Minnesota 55155 LABOR & INDUSTRY 1-800-DIAL-DLI www.doli.state.mn.us TTY: (651) 297-4198 April 24, 2008 APPROVED FOR USE Blue Cross Blue Shield 3535 Blue Cross Rd. Eagan MN 55121 RE: Escalator - Elevator ID# -15335AL08-11 Site: Blue.Cress-f #1 (1-2 Up) 535 Blue Cross Rd. ag Dear Sir/Madam: Minnesota Statutes Chapter 16B provides that the Department of Labor and Industry, Construction Codes & Licensing Unit, Elevator Safety Section, inspect and approve elevators and manlifts (endless belt lifts) before they can be legally used in Minnesota. An Inspector from the Elevator Safety Section recently inspected your facility and determined it meets requirements of the Minnesota Elevator Safety Code. NOTE: Compliance with Minnesota Rules and the ANSI/ASME A17.1, Safety Code for Elevators and Escalators does not necessarily assure compliance with the Americans With Disabilities Act of 1990. THIS APPROVAL APPLIES TO THE JOG CIRCUIT. Sincerely, CONSTRUCTION CODES IC SING Bruce Borgschatz State Elevator Inspector bhb/rsg (CE-2) c. Schoeppner, Dale R., BO, City of Eagan Otis Elevator Company ~ VV) a 8 aP~ ~ ~ zoo ElFormCE2 This information can be provided to you in alternative formats (Braille, large print or audiotape). An Equal Opportunity Employer 443 Lafayette Road N. MINNESOTA DEPARTMENT OF (651) 284-5005 St. Paul, te.mna 85155BOF~ & INDUSTRY TTy:1(651)297-4 98 April 24, 2008 APPROVED FOR USE Blue Cross Blue Shield 3535 Blue Cross Rd. Eagan MN 55121 RE: Escalator - Elevator ID# -15337AL08-11 Site: Blue Cross Blue Shield, #3 (2-3 Up) C 35 Blue Cross R c agan Dear Sir/Madam: Minnesota Statutes Chapter 16B provides that the Department of Labor and Industry, Construction Codes & Licensing Unit, Elevator Safety Section, inspect and approve elevators and manlifts (endless belt lifts) before they can be legally used in Minnesota. An Inspector from the Elevator Safety Section recently inspected your facility and determined it meets requirements of the Minnesota Elevator Safety Code. NOTE: Compliance with Minnesota Rules and the ANSI/ASME A17.1, Safety Code for Elevators and Escalators does not necessarily assure compliance with the Americans With Disabilities Act of 1990. THIS APPROVAL APPLIES TO THE JOG CIRCUIT. Sincerely, CONSTRUCTION CODE LIC NSING SA44e 14 6, Bruce Borgschatz State Elevator Inspector bhb/rsg (CE-2) c: Schoeppner, Dale R., BO, City of Eagan Otis Elevator Company D rr;~ APR 2 8 2008 By ElFormCE2 This information can be provided to you in alternative formats (Braille, large print or audiotape). An Equal Opportunity Employer 443 Lafayette Road N. MINNESOTA DEPARTMENT OF (651) 284-5005 1'800-DIAL-DLI St. Paul, Minnesota 55155 LABOR & INDUSTRY www.dolistate.mn.us TTY: (651) 297-4198 April 24, 2008 APPROVED FOR USE Blue Cross Blue Shield 3535 Blue Cross Rd. Eagan MN 55121 RE: Escalator - Elevator ID# -15340AL08-11 -1I ghield~., Site: Blu #6 (4-3 Dwn) 3535 Blue Cross Rd. . Dear Sir/Madam: Minnesota Statutes Chapter 16B provides that the Department of Labor and Industry, Construction Codes & Licensing Unit, Elevator Safety Section, inspect and approve elevators and manlifts (endless belt lifts) before they can be legally used in Minnesota. An Inspector from the Elevator Safety Section recently inspected your facility and determined it meets requirements of the Minnesota Elevator Safety Code. NOTE: Compliance with Minnesota Rules and the ANSI/ASME A17.1, Safety Code for Elevators and Escalators does not necessarily assure compliance with the Americans With Disabilities Act of 1990. THIS APPROVAL APPLIES TO THE JOG CIRCUIT. Sincerely, CONSTRUCTION CODES LICENSING /Luck, Bruce Borgschatz State Elevator Inspector bhb/rsg (CE-2) c. Schoeppner, Dale R., BO, City of Eagan Otis Elevator Company ElFornI This information can be provided to you in alternative formats (Braille, large print or audiotape). An Equal Opportunity Employer L hu+t..r~rah ~~'PitiNINC~_ PT1n- oVibolNb riNV Aw-mi"Of tt. - ---..Urrom t'WN - O MNI.-- h'(o~ I ~lafg-M b. ra►oeir UrVIVK ril tl. ,gyn. - r+toN~-ecui~:• Nnr PO 9, ~ ~ riJD. MatA. SECOND-LEVELPLRN-_. 'C4 ~A? N f N z{t'IS _ _ • - G0 BCBSM Corporate Service Crenter. .Feasibility Study 10 April 1990 FIRST (:EVEC N- S C h e m e lb 1~ s ~ ~ ~ _,,i li k ~ ~ ~ III' ~ ~ f I' ~ ~ GLYCOL. COOt~~~°~ IviDUNT>wq ~ ~ a ~ ~ ~ ~~n~l ~ea~ci~aG~ Mrn, ~ _Vy' _ ~ 'rVr~l_L ~~rJ~~IGLE t_~ ~ ~P~~ CbrdCR~re PNL~ ">3~F~r'~ ~ ~ I ~0 zo ~ ~ ~ on! 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F~ FI El'G-t ~ `Z ~ r~, ~ JACY.. i 8 ~ RS.. j ~ PIPII~ ~lJi~~~~ ~Ii~~~CAS~ IN~UL,, I I ~ ~ ~ ~ ~ y~ I ~ ~I~L~ C~I~Y ~~c~" Lac, aF I ~ _ ~.~p~C55U~~ GFtL1Cn~ NffaN PG11~JT SYSTkM. E~f~sTII~G~ Fp ~ ~ SUPPI.`{ •~IP~ xis E T ~~NC: U tJ~, _ I I~' ~ _ DiSC~{. PL~hlIJM - ~ ~ _ _ - ~ I ~7hJ ~.IRC~N FPuAM~ -}r _ ~ s ~ - I 1`M~RMtalrl~ oG %2 ~S PAM ~I~ - _ l _ a _ I i - _ - ~ _ I i ~ _ ~ Nl ~KI~TIIUC~ DLIC.T~r1p~,p~ ~ ~ _ ST~Ln l1fP~"J FD,"""'~ i~, i ~ i ~ _ - p~ ~fY~iPJ Ul4LV~. ~ , sL( URJlerru ~~P>, i, F1JP~NI~1-l ~ INSTRL~. PI.~X . CaNPJ. _ I ,-.L _ _ l=~ _ ~ ~i~ ~ i ~e a~ ~ . I ~ 12~t AT PlPihl~.~ CpN~~C.T4~N~a f~, ~ ! -i' ~ i~ i ~ ~ry ~,h~, t,~Nl'~ ~ GI.YC~~, C.~:I.~R,~ 1 5'A ! f U~!a; A~OQE;. 3 ~i i ~ t ~ u~ ~ C ' REMOVE ~XISF, 11r~ sL~ i III ~ a?E C-~YCQL. P1PlNG 4 ~ f ~~i ~ Triie{~ Flncrj~L~ss : K~a ~~W RI1 r ti?P UUCTS - a~GJ>ti~L-- DAf~ ~ ~ l ~ ~ fiW ~ - ~ I~ X 10 ~CJUS`( h~Uf~h~iSt-i ~ ~1;1S~~1Ll. H~44ti`.~ ~'f~1~~1: ~~G'°~ ~ I ~ ~ ° rr'~ ~ c~ j i ~ 7a W~ Gf= M i ka'^1~~,C~~.f~dG°Y RFcral~ qt`y' 11~1~'9 V~~1trL i ' rr ili~S7AL' 'f'I~;il;EC~EI~ 1 ~ MOUh1T~D VJ~SPHIt`f ~-lC:~~a ~T~,Y-C~nG~ ~ ~ ' ib~ ~i _ ~ ~ _t~o~. s~~_N ~ i ~ i'' yll~~~~E, C~~CGI~ ~~~,~~a~ Co~f~~~~~~iir~~ I i ~ ~ ~a; y @ f~ a ~~~`e,. ~~UIC.~, E, VJf~L( f~~IJ~~J°~~1~,~ k~C~iACY~~°1" ~ ~ ~ I s~ I j VC-,~th"`'( Ex,~;C,`f u'~dIT1-I C'?V~lhJ~ ~ ~ ~ Pa , ~d rr a._ 4 j' ~ , , ~ es~~ ,.~e IC`i6T~l~l~ R1k1v a,>'ti ~ _ _ \ ~u h w. I i ~ ~ ~ ~7 / - i t r1i::k~ StF:~. f'li%{~~ ~ ~ j ~ n f' i~ y ~L ~ _ _ ST (f,'fl` J E'Xri. rA~I ~mrlc ' ~ o r~a~ j - ~ ~ss- _~..r.~ ~ ~m . .3 F/j0A1 ST(jUG (Ulf '1 .a ~~Uf £ff ISL. ~ 4~l i u, , r_ i d q r__ - _ _ _ _ _ { bpd I!p ~ w I, _ , - ~11f NAhlClftd6 fl~1T VE(~I k ~ i-ftd6 fl~1T ~VE(~IFY ~ ~ ~ ~ ~ i ;`~;~cr~ f~~•,° v~/~zr,} Rat .e!/cic_r? ~rcc~a ~ ~ ~ I~ i C 'fnxltn L,~71JVI„,1~ '~nl~1~Cj~Drtil$FY TU PdPIi1~G DIAC-~,~tYl f~t~NrP~~tE~2~LELF~~uC.t~ rC~4, SP~CI~rCATz<<fY; roR 512F.P Pt~~NUM: Qi~c,r~al~s;E PAD"` t0~d'kt GAT~i i~sTC fu~.~v ~P,~aW~L~. y~i7'~i G~~~`TIIW%~ ~ C~'~ T,^''; I , hiECHA1~IGAL ~CZFICA~.~~.,„ 1. Exhaust Fan ~ L ~ :Furnish and install a Peerless electric forward curve belt drive utilit _ e, Y ~Le . 1,~0 ' blower as noted on the drawin s. Byo~,~er shall be com letel assembled 9 p y and tested with electric motor, adjusta'a1e Iriatar base, adjustable V-belt drive be rid bearin s heav au e steel Pd f 'r ' ~ Yo 9 9 Y g 9 haus~ng weld_ or a1 tight carlstruction. 61ower wheel sha11 be forward curved with constantly risinr7 rs _ _ horsepower characteristics. .Unit to be Model 8Ag 7 1/2" wheel diameter, 1 6 HP 400 CFM 1400 outlet velocit 1 4" SP 208-1 918 RPM. Nan( / 9 9 Y9 / g N9 7 unit from structure above with vibration isolators as re aired, Electrical Q - contractor to rovide start r and dis o n - Provide aluminum wheel and p e c n eai,. sparkproof motor. 2, Air Conditioning Unit Air conditionin s stem sha11 be manufactured b °i ke -Rice and shall g Y YLs Y include the followin com orients: 9 p a. U -flow conditionin unit with su 1 air discharoe lenum< p 9 Pp Y ~ p b. Glycol circuit with package for economizer cycle, c. Electric reheat with control acka e. p 9 d. Gl co1 cooler with control acka e. Y p 9 ' e. Ex ansion/sur e tank. p 9 f. G1 col um with controls. Y p p g. 40% Dow Chemical Dowtherm SRwI ]ycol solution. 9 h. Condensate pump packaoe. J i. Hot as b ass for-each com ressor circuit. 9 YP P Unit shall be Model ~tumber UG-18 at 7~?:' DBg 60° G16, 192 mbh total 9 179.1 mbh sensible 24.9 K6~J reheat 9,~J00 cfm at 0.5" SP 460 3 60. 5 g g / Cooler Model DFC-276, 60 gpm at 23° head, wi°~h 3 HP pump package. ti:'- I W 11E,~011 i AUG 1 7 2009 I For. Office Use . • ' I Permit cc let C City of ~ I Permit Fee: / I 3830 Pilot Knob Road I G~ I Eagan MN 55122 r I ~ I Date Received: Phone: (651) 675-5675 7 ? Fax: 675-5694 (651) , staff: I t-----------------I 00 FIRE SUPPRESSION SYSTEMS PERMIT APPLICATION* Date: Site Address: -356 B`o--A( OSC `5 Tenant: U CIV tlt Suite PROPERTY OWNER Name:'P~1111 uuss 9I (it c~ f L ACk _ Phone: c Address/ City/ Zip: I V C Applicant is: Owner Contractor I SiOYV ~IG~e+~ ~~iL I l ( i~~ _ ~U C`1'I( TYPE OF WORK Description of work: b~„n 1 G • ~ c~ Construction Cost: 2C b~ f)~ Estimated Completion Date: CONTRACTOR Name: i Kt o AL, I wq C r/0(- (/License Address: City: t State: 1'" Yy Zip: 5 ✓t/ Phone: Contact Person: EmL" FIrERMIT TYPE WORK TYPE Sprinkler System of heads _ New _ Fire Pump Addition Standpipe _Iterations _ Remodel Other: Other. DESCRIPTION OF WORK: Commercial Residential Educational FEES $50.50 Minimum (includes State Surcharge) OR Contract value $ 7 y~ x 1% • Uy Permit Fee Q - If Permit Fee is less than $1,000, surcharge is $.50. - If Permit Fee is > $1,000, surcharge increases by $.50 for each State Surcharge $1,000 Permit Fee (i.e. a $1,00142,000 Permit Fee requires a $1.00 surcharge).~D $ TOTAL FEE 3/4" Displacement Fire Meter - $183.00 $ Fire Meter $ TOTAL FEE *Requirements: 2 complete sets of drawings and specifications, cut sheets on materials and components to be used I hereby apply for a Fire Suppression System permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Minnesota Building/Fire Codes; 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 equires a review and approval of plans. x x NVYI& M1A1K Applicant's Printed a e Applicant's Signature FOR OFFICE USE REQUIRED INSPECTIONS Hydrostatic Flow Alarm Drain Test Rough In Trip Pump Test Central Station / Final Conditions of Issuance: ' Permit Reviewed by: Date: / Use BLUE or BLACK Ink For Office Use q/ 5-7 7 1 City of E a aIl ~LE Permit l Permit Fee:. 3830 Pilot Knob Road {l Eagan MN 55122 OCT Q 8 2009 I / I Date Received: ~ Phone: (651) 675-5675 Fax: (651) 675-5694 Staff_ - - - ---------J 2009 MECHANICAL PERMIT APPLICATION Date: Or Site Address: ~~J`' c3 3a~ Tenant: '0 _ ~~c vS Suite RESIDENT / OWNER Name: Phone: lo-J% Address / City / Zip: rc fib ;s _x4 CONTRACTOR Name: License Address: City: State: A Zip: r3~~ Phone: foL~aV Contact Person: TYPE OF WORK New Replacement P /Additional Alteration Demolition Description of work: Zf'/`' 040 ais NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened by City Code. Please contact: the Mechanical Inspector for information on permitted screening methods, PERMIT TYPE RESIDENTIAL COMMERCIAL _ Furnace New Construction Interior Improvement Air Conditioner P "Install Piping Processed Air Exchanger Gas Exterior HVAC Unit _ Heat Pump _ Under / Above ground Tank C_ Install / _ Remove) When installing/removing tank(s), call for inspection by Fire Other Marshal and Plumbing Inspector RESIDENTIAL FEES: $50.50 Minimum Add-on or alteration to an existing unit (includes $.50 State Surcharge) $90.50 Fire repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) $ TOTAL FEE COMMERCIAL FEES: $70.50 Underground tank installation/removal OR Contract Value $ W, GAO x 1 % $50.50 Minimum (includes State Surcharge) &e, fd Permit Fee - If Permit Fee is less than $1,000, surcharge is $.50. 6X as - If Permit Fee is > $1,000, surcharge increases by $.50 for each = $ Surcharge $1,000 Permit Fee (i.e. a $1,001-$2,000 Permit Fee requires a $1.00 surcharge). -'7h~j / 06 = $TOTAL FEE 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.aopherstateonecall.ora 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 niinntthe case of work which requires a review and approval of plans. ~j x_1fl~i-A42 x Applicant's Printed Name Applicant's Signature FOR OFFICE USE Reviewed By: Date:r_ Required Inspections: Under Ground , Bough In -Air Test -Gas Service Test _In-floor Neat inaI Exterior HVAC Screening Inspection 1-----------------1 t Eap ~1of I Permit 3830 Pilot Knob Road j Permit Fee: Eagan MN 55122 I I Phone: (651) 675-5675 Date Received: -r-;2 Fax: (651) 675-5694 Staff: 2009 COMMERCIAL PLUMBING PERMIT APPLICATION Date: Site Address: C Tenant: Suite PROPERTY Name: OWNER Phone: CONTRACTOR Name: J License Address: City: _ PQt State ' V Zip: Phone: [r1 L" 9 e2 -"YContact Person: -Qz), n ► C? Q. TYPE OF New - Replacement - Repair Rebuild Modify Space Work in R.O.W. WORK - - - Description of work: PERMIT TYPE COMMERCIAL New Construction _ Modify Space - Irrigation System yes / _ no) (URPZ PVB) • Rain sensors required on irrigation systems • Avg. GPM (2" turbo required unless smaller size allowed by Public Works) - Meters Call (651) 675-5646 to verity that tests passed prior to nicking up meter. Domestic: Size & Type Fire: Size & Price 3/4" meter 203.00 Avg. GPM High demand devices? _Yes No Flushometers Yes No COMMERCIAL FEES: $50.50 Minimum (includes State Surcharge) OR Contract value $ x1% = $ Permit Fee Required on ALL new buildings and boulevard irrigation systems 4 = $ Radio Meter Read - If Permit Fee is less than $1,000, surcharge is $.50 = $ Meter(s) - If Permi Fee is > $1,000, surcharge increases by $.50 for each $1,000 $1,000 Permit Fee (i.e. a $1,001-$2,000 Permit Fee requires a $1.00 surcharge). = $ State Surcharge Following fees apply when installing a new lawn irrigation system. $ Water Permit Call the City's Engineering Department, (651) 675-5646, for required fee amounts. $ Treatment Plant $ Water Supply & Storage $ State Surcharge TOTAL FEES $ d I hereby acknowledge that this information is complete and accurate; that the work will be in confo ce 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 withou permit; that the work will be in accordance with the approved plan in t case of work which requires a review and approval of plans. bi d l 1 ~i( t-C x 416~ Applicant's Printed Name Applicant's Signature FOR OFFICE USE Approved By: Date: Required Inspections: , ___`.Under Ground -Rough-In Air Test Gas Test, -Final PRV Required: Yes No Page 1 of 3 Fc, ( )ffice„Usb Permit fill C h c I I City of EaRd I Permit Fee: ~ D 3830 Pilot Knob Road I Date Received: - --Eagan-MN-55122 - ( U al( I I Phone: (651) 675-5675 I I Fax: (651) 675-5694 I Staff-------------- I 2009 MECHANICAL PERMIT APPLICATION Date: 01 9 Site Address: MA 03 O A,40S ~ ~ S 3esG) a V A 4D Tenant: WgeM&I22 or- 1 Suite RESIDENT / OWNER Name: Phone: Address/ City / Zip: 3 ~ '5LJ>J.CJW4-'~- F-V mo CONTRACTOR Name:~) ' License Address: 22r t21W04*IF0 ^_T_ Pbl;r_ City: I.- pha_ State: ynn~ Zip: Phone: WZ- rja-' qql~ Contact Person: TYPE OF WORK New _ Replacement _ Additional Alteration Demolition Description of work: > ' °Z" AZ~ NOTE: Both. rootmounted. and,ground. mounted mechanical equipment is required to `be screened by City Code. Please contact; the Mechanical Inspector or one of the Planners, for information on ermitted screening methods. RESIDENTIAL COMMERCIAL PERMIT TYPE P --New Construction _ Interior Improvement _ Furnace Install Piping _ Processed 'Air Conditioner Gas Exterior HVAC Unit _ Air Exchanger Heat Pump - Under / Above ground Tank Install Remove) " When installing/removing tank(s), call for inspection by Fire Other Marshal and Plumbing Inspector RESIDENTIAL FEES: $50.50 Minimum Add-on or alteration to an existing unit (includes $.50 State Surcharge) $90.50 Fire repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) $ TOTAL FEE COMMERCIAL FEES: $70.50 Underground tank installation/removal OR Contract Value $ x1% - iJ $50.50 Minimum (includes State Surcharge) J Permit Fee - If Permit Fee is less than $1,000, surcharge is $.50. If Permit Fee is > $1,000, surcharge increases by $.50 for each = $ State Surcharge $1,000 Permit Fee (i.e. a $1,001-$2,000 Permit Fee requires a $1.00 surcharge). t~ $ , TOTAL FEE 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 wit out a permit; that the work ill be in accordance with the approved plan in the case of work which requires a review and approval of plans. xv►1ES ~~L x ` Applicant's Printed Name Ap icant's Signature FOR OFFICE USE eviewed By: Date: Vzn:~, Required Inspections: -Under Ground Rough In -Air Test -Gas Service Test _In floor Heat Final Exterior HVAC Screening Inspection Use BLUE or BLACK Ink x a I For Office Use I Permit / I City of Eajan JUL L 9 RECI Permit Fee: ld 3830 Pilot Knob Road q4z Eagan MN 55122 Date Received: ~I Phone: (651) 675-5675 I I Fax: (651) 675-5694 I Staff: I t 2010 COMMERCIAL BUILDING PERMIT APPLICATION C 7/2.9/10~(~ Date: Site Address: 3535 Blue Cross Road Eagan HPJ Tenant Name: Blue Cross Blue Shield (Tenant is: New/ X Existing) Suite NZA Former Tenant: N/A PROPERTY OWNER Name-Blue Cross Blue Shield Phone: 651-662-2542 Address/City/Zip: 3535 Blue Cross Road, Eagan, MN Applicant is: _ Owner X Contractor TYPE OF WORK Description of work: Build 2 Conference Rooms Construction Cost: $44,000.00 CONTRACTOR Name: C . F . Hagl i n & Sons, Inc. License#: N/A Address: 3939 West 69th Street City: Edina State: MN Zip: 55435 Phone: 952-920-6123 Contact: Gary Gunderson Email: ggunderson@cfhaglin.com ARCHITECT / Name: Architectural Al l i 1 once Registration 20915 ENGINEER Address: 400 Clifton Avenue S. City: Minneapolis State: MN Zip: 55403 Phone: 612-871-5703 Contact Person: Jon Stone Email: jstone@archalliance.com 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 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. herstat n all.or I hereby acknowledge that this information is complete and accurate; that the wo k ill be i o ormance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an appli ' n for a er it, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case rk hich r quir s a review and approval of plans. X Gary Gunderson X Applicant's Printed Name A',pli is Sign ure Page 1 of 3 DO NOT WRITE BELOW THIS LINE l SUB TYPES _ Foundation Public Facility _ Accessory Building _ Apartments V/ Commercial / Industrial _ Exterior Alteration-Apartments _ Lodging _ Greenhouse/ Tent _ Exterior Alteration-Commercial Miscellaneous _ Antennae _ Exterior Alteration-Public Facility WORK TYPES / New v Interior Improvement Siding _ Demolish Building* _ Addition _ Exterior Improvement Reroof _ Demolish Interior Alteration _ Repair Windows _ Demolish Foundation Replace _ Water Damage Fire Repair _ Salon Owner Change Retaining Wall *Demolition of entire building - give PCA handout to applicant DESCRIPTION ` Valuation 4 ma Occupancy MCES System ✓ Plan Review / Code Edition It l fy-) SAC Units OlN® e#4.vGE of vs-6 O• fL a cc . L n (25%_ 100% Zoning City Water Census Code Stories Booster Pump # of Units d Square Feet PRV # of Buildings Length Fire Sprinklers Type of Construction' Width REQUIRED INSPECTIONS Footings (New Building) Sheetrock Footings (Deck) Final / C.O. Required Footings (Addition) ✓ Final / No C.O. Required Foundation Other: Drain Tile Pool: -Footings Air/Gas Tests -Final Roof: -Decking -Insulation -Ice & Water -Final Siding: -Stucco Lath -Stone Lath -Brick V/ Framing Windows Fireplace: -Rough In -Air Test -Final Retaining Wall Insulation Erosion Control Meter Size: Final C/O Inspection: Schedule Fire Marshal to be present: Yes ✓ No Reviewed By: L6 , Building Inspector Reviewed By: Planning COMMERCIAL FEES W7.7- Base Fee S Water Quality Surcharge Water Supply & Storage (WAC) Plan Review f V 1 '74 Storm Sewer Trunk MCES SAC Sewer Trunk City SAC Water Trunk S&W Permit & Surcharge Street Lateral Treatment Plant Street Treatment Plant (Irrigation) Water Lateral Park Dedication Other: Trail Dedication Water Quality TOTAL Page 2 of 3 ;A® Metropolitan Council Environmental Services August 12, 2010 Dale Schoeppner Building Official City of Eagan 3830 Pilot Knob Road Eagan, MN 55122 Dear Mr. Schoeppner: The Metropolitan Council Environmental Services (MCES) Division has determined SAC for the Blue Cross Blue Shield remodel to be located at 3535 Blue Cross Road within the City of Eagan. This project should be charged no additional SAC Units, as determined below. SAC Units Charges: Meeting Room 592 sq. ft. @ 1650 sq. ft./SAC Unit 0.36 Credits: Office (Look-Back Period) 592 sq. ft. @ 2400 sq. ft./SAC. Unit 0.25 Net Charge: 0.11 or 0 The business information was provided to MCES by the applicant at this time. It is the City's responsibility to substantiate the business use and size at the time of the final inspection. If there is a change in use or size, a redetermination will need to be made. If you have any questions, call me at 651- 602-1118 or email karon:cappaert@metc.state.mn.us. Sincere., Karon Cappaert SAC Technician Environmental Services Division KC:kb: 100812A4 Determination expiration: August 12, 2012 . cc: J. Nye, MCES Peggy Fleck, Eagan Gary Gunderson, CF Haglin (email) www.metrocouncil.org 390 Robert Street North • St. Paul, MN 55101-1805 + (651) 602-1005 Fax (651) 602-1477 TTY (651) 291-0904 An Equal Opportunity Employer Use BLUE or BLACK Ink For Office Use -7 Cam. City of Ea in I Permit a 3830 Pilot Knob Road Permit Fee: I Eagan MN 55122 Date Received: Phone: (651) 675-5675 I Fax: (651) 675-5694 1, Staff_ , JAN - - - - - - - - - - - - - J 2010 MECHANICAL PERMIT APPLICATION Date: ! 19L 20 1 Site Address: 3 ~''S5 aLJ1r~IZ S Tenant: ILIA-1 Suite RESIDENT / OWNER Name: $LJ~s LJ _ Phone: Address / City / Zip: CONTRACTOR Name: 50Yj yvttG2'13t~AL. License Address: -,PZX! T5)34Wj~ hel, T bIW Ito City: . f P7)0 State: ^X^) Zip: Phone: Los/ 4P4o;~- Contact:-Ti Email:. *-X70A TYPE OF WORK New Replacement Additional Alteration Demolition Description of work: • NOTE: Roof mounted and ground mounted mechanical equipment is required to be Kreened by City Code. Please contact the Mechanical Inspector for information on permitted screening methods. RESIDENTIAL COMMERCIAL PERMIT TYPE Furnace New Construction interior improvement Air Conditioner Install Piping Processed _ Air Exchanger Gas Exterior HVAC Unit _ Heat Pump Under / Above ground Tank L_ Install / _ Remove) " When installing/removing tank(s), call for inspection by Fire Other Marshal and Plumbing Inspector RESIDENTIAL FEES: $55.00 Minimum Add-on or alteration to an existing unit (includes $5.00 State Surcharge) $95.00 Fire repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) $ TOTAL FEE COMMERCIAL FEES:~ $75.00 Underground tank installation/removal OR Contract Value x1% $55.00 Minimum (includes State Surcharge) q'1 Llf~ Permit Fee - If the Permit Fee is less than $10,010, surcharge is $ 5.00 - If the Permit Fee is > $10,010, surcharge increases by $.50 for each $1,000 Permit Fee _ $ Surcharge (i.e. a $10,010-$11,010 Permit Fee requires a $ 5.50 surcharge) Cc- _ TOTAL FEE 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.gopherstateonecall.org 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 wor is not to start without 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 07 L, 6 Yr aA✓ x k, Applicant's Printed Name A plicant's Signa ure FOR OFFICE USE 4viewed By: Date: ( L O f Required Inspections: Under Ground ough In -Air Test Gas Service Test In-floor Heat final - Exterior HVAC Screening Inspection JAN-25-2011 TUE 12:12 PM schadegg mechanical FAX NO. 6512929929 P. 02 Use BLUE or BLACK Ink For Office Use I j Permit I non City of Ea I ~ a~; C~ I Permit Fee: 3830 Pilot Knob Road I Eagan MN 55122 I Pate Received: l Phone., (651) 675-5675 I I I Staff: Fax: (651) 675-5694 2010 COMMERCIAL PLUMBING PERMIT APPLICATION Date: r~ u?"T I Site Address: Tenant: Suite PROPERTY / OWNER Name: isjoe cj(oss e skp*elGr,yt" nr Phone: CONTRACTOR Name: ,e k.4de~ I3'1e~1~ : tw I License Address: Ar, city: State: 10^1 Zip: S 7.~ r Phone: All ~ 2.`22- 133 Email: eldOU a .Stl.ad~' ~--M,-Ch rIDI-" pair Rebuild f Modify Space _ W.W. TYPE OF _ New - Replacement _ Re ork in R O I WORK Lil ' Description of work. COMME'RCIAI. PERMIT TYPE i~MOdlf _ New Construction y 5paoe Irrigation system L._ yes I _ no) RPZ I PVB) • Rain sensors required on irrigation systems • Avg, GPM (2" turbo required unless smaller size allowed by Public Works) _ Meters Call (651) 675-5646 to verity that tests passed prior to picking up meter. Domestic: Size & Type Fire: 1 Avg. GPM _ High demand devices? Yes No Flushometers -Yes _No COMMERCIAL FEES: $55.00 Minimum (includes State Surcharge) OR Contract Value $ X1% ~0 Permit Fee Required on ALL new buildings and boulevard irrigation systems a = $ Radio Mater Read - If the P= ee is less than $10,010, the surcharge is $5,00 = $ Meter(s) - If the Permit Fee is > $10,D113, the surcharge increases by $.50 for each $1,000 hermit Fee (i.e. a $10,010411,000 Permit Fee requires a $5.50 surcharge) = $ 5, d State surcharge Following fees apply when installing a new lawn irrigation system. $ Water Permit Call the City's Engineering Department, (651) 675-5646, for required fee amounts. $ Treatment Plant $ Water Supply & Storage $ State Surcharge TOTAL FEES $ 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. o herstateonecall.or I hereby acknowledge that this information Is complete and accurate; that the worts 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 perrnit; tha a work will be in accordance with the approved plan in the care of work which r ulres a review and approval of plans, JJ A Applicant s Printed Narhb Applicant's Signatu r '11 3 FOR OFFICE USE Approved By: Date: Required Inspections: -Under Ground Rough-In AIr Test Gas Test Final PRV Required: _ Yes No Page 1 of 3 Use BLUE or BLACK Ink ---------i For Office Use I I I I Permit j City of Eajan I Pewit Fee. 3830 Pilot Knob Road I Eagan MN 55122 ? ` Date Received: Phone: (651) 675-5675 Fax: (651) 675-5694 staff: I 2011 COMMERCIAL BUILDING PERMIT APPLICATION C nl tq~' . Date: 5/17/11 Site Address: 3535 BlueCross Road, Eagan, MN 55122 62-0-11 Tenant Name: BlueCross BlueShield of Minnesota (Tenant is: New/ X Existing) Suite M Former Tenant: PROPERTY OWNER Name: BlueCross BlueShield Phone: (651) 662-8000 Address / City / zip: 3535 Blue Cross Road, Eagan, MN Applicant is: Owner X Contractor TYPE OF WORK Description of work: Installation of new data center backup power. Renovation of existing data center back up power. Construction Cost: $1,595,000 CONTRACTOR Name.' Mortenson Construction License Address: 700 Meadow Lane North City: Minneapolis State: MN Zip: 55422 Phone: 763-287-5968 Contact: Justin Berdan Email: Justin.Berdan@mortenson.com ARCHITECT / Name: Dunham Associates. Inc. Registration ENGINEER Address: 50 South 6th Street, Suite 1100 City: Minneapolis State: MN Zip: 55402 Phone: 612-465-7551 Contact Person: Lee Offerdahl Email: Lee.Offerdahl@dunhameng.com Licensed plumber installing new sewer/water service: Doody Mechanical Phone 651-487-1061 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 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.ctopherstateonecall.org 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 r quires a r view and approval of plans. x x Justin Berdan Applicant's Printed :Name Ap cant's Signature Page 1 of 3 C P- 0 DO NOT WRITE BELOW THIS LINE SUB TYPES _ Foundation Public Facility _ Accessory Building _ Apartments Commercial / Industrial _ Exterior Alteration-Apartments _ Lodging _ Greenhouse/ Tent _ Exterior Alteration-Commercial Miscellaneous Antennae Exterior Alteration-Public Facility WORK TYPES / New V Interior Improvement Siding _ Demolish Building" _ Addition _ Exterior Improvement Reroof _ Demolish Interior Alteration _ Repair Windows _ Demolish Foundation Replace _ Water Damage Fire Repair _ Salon Owner Change Retaining Wall "Demolition of entire building - give PCA handout to applicant DESCRIPTION *Lp ✓ Valuation Occupancy MCES System Plan Review Code Edition SAC Units O (25%_ 100% -~6 Zoning City Water ✓ Census Code Stories Booster Pump # of Units y Square Feet PRV # of Buildings 1 Length Fire Sprinklers f~illrLr"~AType of Construction Width REQUIRED INSPECTIONS Footings (New Building) Sheetrock Footings (Deck) Final / C.O. Required Footings (Addition) Final / No C.O. Required Foundation Other: Drain Tile Pool: -Footings -Air/Gas Tests -Final Roof: -Decking -Insulation -Ice & Water -Final Siding: Stucco Lath -Stone Lath -Brick Framing Windows Fireplace: -Rough In -Air Test -Final Retaining Wall Insulation Erosion Control Meter Size: / Final C/O Inspection: Schedule Fire Marshal to be present: V Yes No Reviewed By: , Building Inspector Reviewed By: , Planning COMMERCIAL FEES Base Fee B 334. 7S" Water Quality Surcharge 1,3 OD Water Supply & Storage (WAC) Plan Review 3 pj . Bq Storm Sewer Trunk MCES SAC Sewer Trunk City SAC Water Trunk S&W Permit & Surcharge Street Lateral Treatment Plant Street Treatment Plant (Irrigation) Water Lateral Park Dedication Other: Trail Dedication Water Quality TOTAL ! L Page 2 of 3 d Metropolitan Council Environmental Services May 27, 2011 Dale Schoeppner Building Official .City of Eagan 3830 Pilot Knob Road Eagan, MN 55122 Dear Mr. Schoeppner: The Metropolitan Council Environmental Services (MCES) Division has determined SAC on behalf of the City for the Blue Cross Blue Shield remodel to be located at 3535 Blue Cross Road within the City of Eagan. A determination was not necessary. It is the Council's understanding there will be no change in use or size; therefore, no additional SAC is due. The business information was provided to MCES by the applicant at this time. It is the City's responsibility to substantiate the business use and size at the time of the final inspection. If there is a change in use or size, a redetermination will need to be made. If you have any questions, call me at 651-602-1118 or email karon.cappaert@metc.state.mn.us. Sincerely, 2wL r aron Cappaert SAC Technician Environmental Services Division KC:kb: 110527A5 Determination expiration: May 27, 2013 cc: J. Nye, MCES Peggy Fleck, Eagan (email) Justin Berdan, Mortenson (email) www.metrocouncil.org 390 Robert Street North • St. Paul, MN 55101-1805 • (651) 602-1005 • Fax (651) 602-1477 • TTY (651) 291-0904 An Equal Opportunity Employer Use BLUE or BLACK Ink For Dfi~ce U j I 'f 96 -7 City of Eajan I Permit I I Permit Fee: ILI 3830 Pilot Knob Road I I Eagan MN 55122 Date Received: j Phone: (651) 675-5675 I I Fax: (651) 675-5694 I Staff: I .~------.----((///y----- J 2011 COMMERCIAL BUILDING PERMIT APPLICATION LI ~C Date: 4/14/2011 Site Address: 3535 Blue Cross Road Tenant Name: Blue Cross B l u e Shield (Tenant is: New / Existing) Suite#: N/A Former Tenant: N/A PROPERTY OWNER Name: Blue Cross Blue Shield Phone: 651-662-7950 Address / City / Zip: 3535 Blue Cross Road Applicant is: Owner X_ Contractor TYPE OF WORK Description of work: Exterior Stoop Installation (1 Construction Cost: $88, 000.00 CONTRACTOR Name: C.F. Haglin & Sons, Inc. License#: N/A Address: 3939 West 69th Street city: Edi na state: MN Zip: 55435 Phone: 952-920-6123 Contact: Gary Gunderson Email: ggunderson@cfhaglin.com ARCHITECT / Name: Nokomi s Registration 14685 ENGINEER Address: 1004 E. 51st Street City: Minneapolis State: MN Zip: 55417 Phone: 612-532-1112 Contact Person: Keith Peters 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 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. herstateon Il.or I hereby acknowledge that this information is complete and accurate; that the Vwol be co rmance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an a for per t, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case f re a review and approval of plans. x Gary Gunderson x Applicant's Printed Name Ap is nature Page 1 of 3 DO NOT WRITE BELOW THIS LINE SUB TYPES Foundation Public Facility Accessory Building Apartments Commercial / Industrial _ Exterior Alteration-Apartments _ Lodging _ Greenhouse/ Tent _ Exterior Alteration-Commercial Miscellaneous Antennae _ Exterior Alteration-Public Facility WORK TYPES _ New Interior Improvement Siding Demolish Building* Addition Exterior Improvement Reroof _ Demolish Interior Alteration _ Repair Windows _ Demolish Foundation Replace Water Damage Fire Repair _ Salon Owner Change Retaining Wall *Demolition of entire building - give PCA handout to applicant DESCRIPTION o>~ Valuation ~8~000 Occupancy 1R MCES System Plan Review ✓ Code Edition 2D0'7 Se SAC Units ar ~X'. 104P (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) Sheetrock Footings (Deck) Final / C.O. Required Footings (Addition) -Z7 Final / No C.O. Required Foundation Other: Drain Tile Pool: -Footings -Air/Gas Tests -Final Roof: -Decking -Insulation -ice & Water -Final Siding: -Stucco Lath -Stone Lath -Brick Framing Windows Fireplace: -Rough In -Air Test -Final Retaining Wall Insulation Erosion Control Meter Size: . / Final C/O Inspection: Schedule Fire Marshal to be present: Yes v No Reviewed By: (~6 . Building Inspector Reviewed By: . Planning COMMERCIAL FEES Base Fee Water Quality Surcharge 4A . a-<, Water Supply & Storage (WAC) Plan Review Storm Sewer Trunk MCES SAC Sewer Trunk City SAC Water Trunk S&W Permit & Surcharge Street Lateral Treatment Plant - Street Treatment Plant (Irrigation) Water Lateral Park Dedication Other: Trail Dedication Water Quality TOTAL L3~ . Page 2 of 3 Use BLUE or BLACK Ink ~7 L( I, For Office Use j . r 2 7 1 Permit q 1. _ I City of Eap ~J l 1 _64, 3830 Pilot Knob Road Permit Fee: rFIVED j j Eagan MN 55122 Date Received: Phone: (651) 675-5675 2Q1~ I I Fax: 651) 675-5694 I I I Staff. I 2011 COMMERCIAL FIRE ALARM PERMIT APPLICATION* Date: 03/0 I ! 11 Site Address: 3S 3 S Tenant: _ 3L-Lkb)_ / ,KL.t. _ 5k4-" Suite M~ 496""Vo PROPERTY OWNER Name: (34(-4, C 1't 5jt4: Q, S Phone: Address / City / Zip: Applicant is: Owner 2<Contractor TYPE OF WORK Description of work: d C.-QE-2l ' Construction Cost: _990c,00 Estima ed Completion Date: O q t' (1 t CONTRACTOR Name: "6 uo V [ t9~ ¢Q C6yollbi"Qz °ense I S ©0 3 7S Address ')_0 CX-) 7(p '5t city: State:Zip: G-EL !S Phone: 5 la ^ A ( 1~ C~ Contact: Email: It ~e Y~ Q YC 1 /U C •CO New Remodel WORK TYPE , Addition _ Other: Alterations DESCRIPTION OF WORK: ?L Commercial _ Residential _ Educational FEES $55.00 Minimum (includes State Surcharge) OR Contract Value $ s q 0 00 x1% 49 n J~ Permit Fee - If the Permit Fee is less than $10,010, surcharge is $ 5.00 _ 2 - If the Permit Fee is > $10,010, surcharge increases by $.50 for each $1,000 Permit Fee - 9'' Surcharge (i.e. a $10,010411,010 Permit Fee requires a $ 5.50 surcharge) TOTAL FEE *Requirements: 2 complete sets of drawings and specifications, cut sheets on materials and components to be used I hereby apply for a Fine Alarm permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Minnesota Building/Fire Codes; 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- C N e-ra ICL l~ e pi-Q x Applicant's cant's Printed Name A lican ' at [VI FOR OFFICE USE Reviewed By, Date. Required Inspections: Rough-In Final Fire Alarm Test Use BLUE or BLACK Ink I qe. !x I Permit#: f U ~1 Eajan 1 I I Permit Fee: 3830 Pilot Knob Road i I Eagan MN 55122 Date Received: Phone: (651) 675-5675 I j Fax: (651) 675-5694 Staff: 2011 FIRE SUPPRESSION SYSTEMS PERMIT APPLICATION* Date: 2-14 Site Address: 363 &-Zv. RMW Tenant: o? Suite M PROPERTY OWNER Name: BIup. Cross 8100- ahola Phone: 661- lolo~ ~g~ ~ Address / City / Zip: 35,35 Btu e,&oSS twd Applicant is: Owner Contractor TYPE OF WORK Description of work: QQeI A~ F/r d.rd mi%ldr ~a -1/1 n?vi~j~.us ~D ar4F1&V`. Construction' Cost: 90 Estimated Completion Dater April 1 2011 CONTRACTOR NameAmnmi A F rime- Rrely4, ohc License C-075 Address: 575 M,nntl»A2 Ave, V. City: 64.JJLU~ State: Zip: 55103 Phone: Contact: Mdrk R9. Email: 4ekle 5vmmit~;rf, _GOlr1 FIR PERMIT TYPE WORK TYPE V Sprinkler System of heads' _ Newdition _ Fire Pump _ Standpipe _ Alterations V Remodel Other: Other: DESCRIPTION OF WORK: Commercial Residential Educational FEES $55.00 Minimum (includes State Surcharge) OR Contract Value $ 902 x1% _ $ 903. ~oc. Permit Fee If the Permit Fee is less than $10,010, surcharge is $ 5.00 - If the Permit Fee is > $10,010, surcharge increases by $.50 for each $1,000 Permit Fee 6-00=$ Surcharge (i.e. a $10,010-$11,010 Permit Fee requires a $ 5.50 surcharge) $ Qr 7 TOTAL FEE 3/4" Displacement Fire Meter'-,$203.00 $ ===MA= Fire Meter TOTAL FEE *Requirements: 2 complete sets of drawings and specifications, cut sheets on materials and components to be used I hereby apply for a Fire Suppressiorr System permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Minnesota Building/Fire Codes; that I understand this is not apermit, 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 /zrk F~~~al Applicants Printed Name- a Applicant's nature CALLSEFORE 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.aopherstateonecall.org FOR OFFICE USE A REQUIRED INSPECTIONS Hydrostatic Flow Alarrrj Drain Test Rough In Trip t Pump Test C.ent-at Statics Final Conditions of Issuance: r,. Permit Reviewed Date: r Use BLUE or BLACK Ink ------------i For Office Use I I Permit 7,S/ I I City of Eajan C I l1 3830 Pilot Knob Road i Permit Fee. Eagan MN 55122 Date Received: Phone: (651) 675-5675 RECEIVED ~ Fax: (651) 675-5694 i Staff: 71 JAN 0 5 2011 ----------C~f iES 2011 COMMERCIAL BUILDING PERMIT APPLICATION Date: 1-3-11 Site Address: 353 5' Q IA C" S S "OrD Tenant Name: R w ct /1 I s eLuwa FiLA (Tenant Is: New 14 Existing) Suite Former Tenant: PROPERTY OWNER Name: LUF, CIZO yS B~.J~S~1~fiL-O ©F M-/4 Phone: Address/City/Zip: 21-2y &JLCAOSS 90A-0 37, f4ac-0 ^AJ fS'/Gy-d Applicant is: Owner Contractor TYPE OF WORK Description of work: TCAIA-d T Construction Cost: f?- SK2 29 CONTRACTOR Name: (LJi~'t C'oA1ST,t,yc~'I6IJ License#: Address: 72W3 L IC-5-1- 1-496, 57',_t 15I5,C406 City: f1 4edyf r?*" State: MAI - Zip: - '5412 Phone: qX12 Contact: DF gA~-1ckan/ Email: ~l ac~. ~a.rtc%q s,► ¢ r~IV1 r;~J~J~/S►L9".,~ ARCHITECT / Name: AaChl 1 ff, G9'✓A-A2. G L-1 AA _ Registration ENGINEER Address:/ ) GLtFrdAl AIC- S. City: .41Amalfpdu,' State: N/ Zip:-'tld 2, Phone: 012 - 971 1916 Contact Person: JOn MA/tr 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 0 the information may be classifi as non-publics f you provide speck reasons t t would per it the City to conclude th t the are trade se ts. 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.aoaherstateonecall.om 1 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 requires a review and approval of plans. x ~2Jk11 she-( C ~cM,A-~✓ ~ Applicant's Printed Name Applicant's Signatu Page 1 of 3 M S pia DO NOT WRITE BELOW THIS LINE ~Lt SUB TYPES _ Foundation Public Facility _ Accessory Building _ Apartments v/ Commercial / Industrial _ Exterior Alteration-Apartments Lodging _ Greenhouse/ Tent _ Exterior Alteration-Commercial Miscellaneous _ Antennae _ Exterior Alteration-Public Facility WORK TYPES - New /interior Improvement Siding _ Demolish Building* - Addition _ Exterior Improvement Reroof _ Demolish Interior _ Alteration _ Repair Windows _ Demolish Foundation Replace _ Water Damage Fire Repair _ Salon Owner Change Retaining Wall *Demolition of entire building - give PCA handout to applicant DESCRIPTION Valuation Z 5 (03 00'r Occupancy B0 A -3~ Z MCES System Plan Review / Code Edition S.OVI f4-5 SAC Units . A0 GH-MUdb N v4E or- 0ce , t_0 . (250/q_ 1000/, Zoning r b City Water Census Code Stories Z Booster Pump # of Units O Square Feet PRV # of Buildings I Length Fire Sprinklers V -fAX4-1f Type of Construction •P, Width / REQUIRED INSPECTIONS Footings (New Building) Sheetrock Footings (Deck) ~coal / C.O. Required Footings (Addition) Final / No C.O. Required Foundation Other: Drain Tile Pool: -Footings -Air/Gas Tests -Final Roof: -Decking -Insulation -Ice& Water -Final Siding: -Stucco Lath -Stone Lath -Brick VI/ Framing Windows Fireplace: -Rough In -Air Test -Final Retaining Wall Insulation Erosion Control Meter Size: Final C/O Inspection: Schedule Fire Marshal to be present: Yes No Reviewed By:' , Building Inspector Reviewed By: Planning COMMERCIAL FEES Base Fee 17-1 208.7 Water Quality Surcharge l , OG8.10 Water Supply & Storage (WAC) Plan Review 7 , q 3 t. W1 Storm Sewer Trunk MCES SAC Sewer Trunk City SAC Water Trunk S&W Permit & Surcharge Street Lateral Treatment Plant Street Treatment Plant (Irrigation) Water Lateral Park Dedication Other: Trail Dedication Water Quality TOTAL O'2 1,) 2 13.3 Page 2 of 3 Use BLUE or BLACK Ink -i For Office Use/ C I Permit SI City of Eajan Permit Fee: 3830 Pilot Knob Road I I Eagan MN 55122 Date Received: Phone: (651) 675-5675 I I Fax: (651) 675-5694 I Staff: I 2010 COMMERCIAL BUILDING PERMIT APPLICATION Date: 10/29/10 Site Address: 3535 Blue Cross Road Tenant Name: N / a (Tenant is: New / Existing) Suite Former Tenant: PROPERTY OWNER Name: Blue Cross Blue Shield Phone: 651-662-2542 Address/City/zip: 3535 Blue Cross Rd Applicant is: Owner X Contractor TYPE OF WORK Description of work: Interior Demolition - 2nd Floor Ceilings & Floors_ Construction Cost: CONTRACTOR Name: C.F. Hagl i n & Sons, Inc. License Address: 3939 West 69th Street city: Edina State: MN zip: 55435 Phone: 952-920-6123 Contact: Gary Gunderson Email: ggunderson@cfhag]in.com ARCHITECT / Name: Architectural Alliance Registration ENGINEER Address:400 Clifton Ave. S. City: MinneaPolis State: MN zip: 55403 Phone:612-871-7212 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 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.aopherstateonecall.org 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 Gary Gunderson X Applicant's Printed Name Applicant's Signature Page 1 of 3 Use BLUE or BLACK Ink _ '1D Pi W Fl fob For Office Us I --7 'l Permit City of Eagan AU G 3 0 ®1 0 J , ! I Permit Fee: 3830 Pilot Knob Road! 1 G S I I Eagan MN 55122 Date Received: I Phone: (651) 675-5675 c Fax: (651) 675-5694 I Staff: 2010 MECHANICAL PERMIT APPLICATION Date: / ~1 aDCD Site Address: Tenant: 1_• Suite RESIDENT / OWNER Name: a6apioe;'-' L1y ~U> Phone: Address/ City /Zip: 145-0 8-n b1CONTRACTOR Name: e, /t1 VkW_4 W I LA License Address: IZ4 z i t ~ Irk N>W y l City: , State: _W R) Zip: S So7~;_ Phone: Contact~>41 4;V% VA) TYPE OF WORK New Replacement Additional Alteration Demolition Description of work:"%o 166 °jc)n A) 1:*2 11AJ zy-Ak6 &4,9-A)bt~ &V)~ NOTE: Roof mounted and ground mounted mechanical' equipment is required to be screened by City Code. Please contact the Mechanical Inspector for information on permitted screening methods. RESIDENTIAL COMMERCIAL PERMIT TYPE Furnace New Construction Interior Improvement Air Conditioner Install Piping Processed _ Air Exchanger Gas Exterior HVAC Unit _ Heat Pump Under / Above ground Tank Install / _ Remove) When installing/removing tank(s), call for inspection by Fire Other Marshal and Plumbing Inspector RESIDENTIAL FEES $55.00 Minimum Add-on or alteration to an existing unit (includes $5.00 State Surcharge) $95.00 Fire repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) $ TOTAL FEE COMMERCIAL FEES: $75.00 Underground tank installation/removal OR Contract Value $ "7y 4140 x1% $55.00 Minimum (includes State Surcharge) _ $ !20 Permit Fee - If the Permit Fee is less than $10,010, surcharge is $ 5.00 - If the Permit Fee is > $10,010, surcharge increases by $.50 for each $1,000 Permit Fee = $ 'J Surcharge (i.e. a $10,016411,010 Permit Fee requires a $ 5.50 surcharge) r~ _ $ 6 fJ TOTAL FEE 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.ciopherstateonecall.org 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 of to start without a permit; th he work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. xb~y r t CA) x tn2 ki Applicant's Printed Name App cant's Signature FOR OFFICE USE R iewed By: -7-,49 Date: q / 6 Required Inspections: -Under Ground _Rough In -Air Test Gas Service Test -in-floor Heat KFinal Exterior HVAC Screening Inspection Use BLUE or BLACK Ink For Office Use I Permit City of E w Permit Fee: 3830 Pilot Knob Road Eagan MN 55122 Date Received: ; Phone: (651) 675-5675 Fax: (651) 675-5694 - o rl Ll 3 j Staff: I I 2010 COMMERCIAL FIRE ALARM PERMIT APPLICATION* Date: 7/2 2/D Site Addres(s:: 3S 3 S e6tp Q(y Tenant: )334--e S Coy Suite 4~ 4 PROPERTY OWNER Name: )3,&L-C CA-6-4-~ 6A s ® Phone: Address / City / Zip: Applicant is: Owner Contractor a ti -o "a ~P TYPE OF WORK Des escrip on of work: Construction Cost: Woo •00 Estimated Completion Date: 13 010 CONTRACTOR Name: i f0 t) 11&&0L (b-j, lCLC&, License ~S O 7 SJ -Lk Address: q ioo LLB 7(11 Sf City: J State: "-W'4 Zip: ~S Lt 3 S Phone: q S~' 3S - 4 (n 0 0 Contact:-601&" J~at--2 Email: &1) LL L b (1) LVCINC• CD W%,- X New Remodel WORK TYPE Addition Other: Alterations DESCRIPTION OF WORK: X Commercial _ Residential _ Educational FEES ~o $55.00 Minimum (includes State Surcharge) OR Contract Value $ Z 00 - x1% p $ 7 ( • n Permit Fee - If Permit Fee is less than $1,000, surcharge is $ 5.00. _ If Permit Fee is > $1,000. surcharge increases by S 50 for each $ 1,000 Permit Fee 5,6 State Surcharge (i_e. a $1.001-S2,000 Penriit Fee requires a $5.50 surcharge). $ .04N ©0 TOTAL FEE *Requirements: 2 complete sets of drawings and specifications, cut sheets on materials and components to be used I hereby apply for a Fire Alarm permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Minnesota Building/Fire Codes; 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 6,A J- JUL 2 3 Eml x Applicant's Printed Name Ap ican s Sign tur FOR OFFICE USE Reviewed B o Date: 7 Required Inspections: Rough-In Final Fire Alarm Test Contractor's Material and Test Certificate for Aboveground Piping NFPA 13 PROCEDURE Upon completion of work, inspection and tests shall be made by the contractor's representative and witnessed by an owner's representative. All defects shall be corrected and system left in service before contractor's personnel finally leave the job. A certificate shall be filled out and signed by both representatives. Copies shall be prepared for approving authorities, owners and contractor. It is understood the owner's representative's signature in no way prejudices any claim against contractor for faulty material, poor workmanship, or failure to comply with approving authority's requirements or local ordinances. PROPERTY NAME BLUE CRO55 BLUE ,SHIELD DATE 3/24/11 PROPERTY ADDRESS 3535 BLUE CROSS ROAD EAGAN, MN 55121 ACCEPTED BY APPROVING AUTHORITIES (NAMES) CITY OF EAGAN FIRE DEPARTMENT ADDRESS 3795 PILOT KNOB ROAD PLANS EAGAN, MN 55122 INSTALLATION CONFORMS TO ACCEPTED PLANS ® YES ❑ NO EQUIPMENT USED IS APPROVED ® YES ❑ NO IF NO, EXPLAIN DEVIATIONS HAS PERSON IN CHARGE OF FIRE EQUIPMENT BEEN ISTRUCTED AS TO ® YES ❑ NO LOCATION OF CONTROL VALVES AND CARE AND MAINTENANCE OF THIS NEW EQUIPMENT? IF NO, EXPLAIN? INSTRUCTIONS HAVE COPIES OF THE FOLLOWING BEEN LEFT ON THE PREMISES? 1. SYSTEM COMPONENTS INSTRUCTIONS ® YES ❑ NO 2. CARE AND MAINTENANCE INSTRUCTIONS ® YES ❑ NO 3. NFPA 25 ® YES ❑ NO LOCATION OF SUPPLIES BUILDING(S): 2n' FLOOR (1974 BUILDING) SYSTEM YEAR OF ORIFICE TEMPERATURE MAKE MODEL MANUFACTURE SIZE QUANTITY RATING REL F1FR56 2011 1/2" 10 155 0 F SPRINKLERS REL G4A 2011 1/2" 116 165 ° F REL G4 XLO 2011 17/32" 255 165 0 F REL FlFR56 QREC 2011 1/12 175 ° F OF PIPE AND TYPE OF PIPE: PER NFPA 13 FITTINGS TYPE OF FITTINGS: PER NFPA 13 MAXIMUM TIME TO OPERATE ALARM VALVE ALARM DEVICE THROUGH TEST CONNECTION OR FLOW TYPE MAKE MODEL MINUTES SECONDS INDICATOR DRY VALVE O.O.D. MAKE MODEL SERIAL NO. MAKE MODEL SERIAL NO. TIME TO TRIP TRIP TIME WATER ALARM OPERATED THROUGH TEST WATER AIR POINT REACHED PROPERLY DRY PIPE CONNECTION ' PRESSURE PRESSURE AIR TEST OUTLET' OPERATING PRESSURE TEST MINUTES SECONDS PSI PSI PSI MINUTES SECONDS YES NO WITHOUT ❑ ❑ O.D. WITH ❑ ❑ .O.D. IF NO, EXPLAIN OPERATION ❑ PNEUMATIC ❑ ELECTRIC ❑ HYDRAULICS PIPING SUPERVISED ❑ YES ❑ NO DETECTING MEDIA SUPERVISED YES ❑ NO DOES VALVE OPERATE FROM THE MANUAL TRIP, REMOTE, OR BOTH ❑ YES ❑ NO CONTROL STATIONS? DELUGE AND IS THERE AN ACCESSIBLE FACILITY IN EACH CIRCUIT IF NO, EXPLAIN FOR TESTING. PREAATION ❑ YES ❑ NO VALVES DOES EACH CIRCUIT OERATE DOES EACH CIRCUIT OPERATE MAXIMUM TIME TO SUPERVISION LOSS ALARM? VALVE RELEASE? OPERATE RELEASE MAKE MODEL YES NO YES NO MINUTES SECONDS ❑ ❑ ❑ ❑ I MEASURED FROM TIME INSPECTOR'S TEST CONNECTION OPENED LOCATION MAKE AND SETTING STATIC PRESSURE RESIDUAL PRESSURE FLOW RATE PRESSURE AND FLOOR MODEL FLOWING REDUCING INLET PSI OUTLET PSI INLET PSI OUTLET PSI FLOW GPM VALVE TEST HYDROSTATIC: HYDROSTATIC TESTS SHALL BE MADE AT NOT LESS THAN 200 PSI FOR TWO HOURS OR 50 PSI ABOVE STATIC PRESSURE IN EXCESS OF 150 PSI FOR TWO HOURS. DIFFERENTIAL DRY-PIPE VALVE CLAPPERS SHALL BE LEFT OPEN DURING TEST TO PREVENT DAMAGE. ALL ABOVEGROUND PIPING LEAKAGE SHALL BE STOPPED. TEST DESCRIPTION PNEUMATIC: ESTABLISH 40 PSI AIR PRESSURE AND MEASURE DROP, WHICH SHALL NOT EXCEED Ilk PSI IN 24 HOURS. TEST PRESSURE TANKS AT NORMAL WATER LEVEL AND AIR PRESSURE AND MEASURE AIR PRESSURE DROP, WHICH SHALL NOT EXCEED 11/z PSI IN 24 HOURS. ALL PIPING HYDROSTATICALLY TESTED AT 200 PSI FOR 2 HOURS. IF NO, STATE REASON DRY PIPING PNEUMATICALLY TESTED ❑ YES ❑ NO EQUIPMENT OPERATES PROPERLY ® YES ❑ NO DO YOU CERTIFY AS THE SPRINKLER CONTRACTOR THAT ADDITIVES AND CORROSIVE CHEMICALS, SODIUM SILICATE OR DERIVATIVES OF SODIUM SILICATE, BRINE, OR OTHER CORROSIVE CHEMICALS WERE NOT USED FOR TESTING SYSTEMS OR STOPPING LEAKS? TESTS ® YES ❑ NO DRAIN READING OF GAUGE LOCATED NEAR WATER SUPPLY TEST RESIDUAL PRESSURE WITH VALVE IN TEST TEST CONNECTION: PSI CONNECTION OPEN WIDE PSI UNDERGROUND MAINS AND LEAD IN CONNECTIONS TO SYSTEM OTHER: EXPLAIN RISERS FLUSHED BEFORE CONNECTION MADE TO SPRINKLER PIPING. VERIFIED BY COPY OF THE U FORM NO. 85B ❑ YES ® NO FLUSHED BY INSTALLER OF UNDERGROUND SPRINKLER PIPING ® YES ❑ NO BLANK TESTING NUMBER USED LOCATIONS NUMBER REMOVED GASKETS WELDED PIPING ❑ YES ® NO IF YES... DO YOU CERTIFY AS THE SPRINKLER CONTRACTOR THAT WELDING PROCEDURES COMPLY WITH THE REQUIREMENTS OF AT LEAST AWS 62.1? ❑ YES ❑ NO DO YOU CERTIFY THAT WELDING WAS CARRIED OUT IN COMPLIANCE WITH A DOCUMENTED WELDING QUALITY CONTROL PROCEDURE TO INSURE THAT ALL DISCS ARE RETRIEVED, THAT OPENINGS IN PIPING ARE SMOOTH, THAT SLAG AND OTHER WELDING RESIDUE ARE REMOVED, AND THAT THE INTERNAL DIAMETERS OF PIPING ARE NOT PENETRATED? ❑ YES ❑ NO DO YOU CERTIFY THAT THE WELDING WAS PERFORMED BY WELDERS QUALIFIED IN COMPLIANCE WITH THE REQUIREMENTS OF AT LEAST AWS B2.1? ❑ YES ❑ NO CUTOUTS DO YOU CERTIFY THAT YOU HAVE A CONTROL FEATURE TO INSURE THAT ALL CUTOUTS I (DISCS) (DISCS) ARE RETRIEVED? ® YES ❑ NO HYDRAULIC DATA NAMEPLATE PROVIDED ® YES ❑ NO IF NO, EXPLAIN NAMEPLATE REMARKS DATE LEFT IN SERVICE WITH ALL CONTROL VALVES OPEN: NAME OF SPRINKLER CONTRACTOR: SUMMIT FIRE PROTECTION SIGNATURES ADDRESS: 575 MINNEHAHA AVE. W., ST. PAUL MN 55103 PHONE: 651 251-1880 FOR PROPERTY OWNER (SIGNED) TITLE DATE 9 FOR SPRINKLER CONTRACTOR (SIGNED) TITLE DATE UMM1T F4RC PROTEGTION ADDITIONAL HYDROSTATIC TEST & ROUGH-IN INSPECTION CONDUCTED ON 3/24/11 (GRID #1 - #15) )"z INITIALS EXPLANATION HYDROSTATIC TEST & ROUGH-IN INSPECTION CONDUCTED ON _J_Jii (SOUTH OF GRID #15) INITIALS AND NOTES I I Use BLUE or BLACK Ink JGk~ I i For Office Use ! I City Permit of Eajan SEP 2 M1 I I I Permit Fee. 3830 Pilot Knob Road I I Eagan MN 55122 ~ Date Received: I Phone: (6 1) 675-5675 A-11100 I I Fax: (651) 675-5694 1 Staff: 1 I 20 1 COMMERCIAL FIRE ALARM PERMIT APPLICATION* Date: Site Address: 'i r;,i g R1 up Crc), Rnar9 Tenant: B1 e Cross Blue Shield SuiteM UPS/Battery rms Blue Cross Blue Shield of MN Name: Phone: PROPERTY OWNER Address /City /Zip: Applicant is: Owner Contractor Install preaction sprinkler sys control panel, detection devices TYPE OF WORK Description of work: a ~ au io visua notification in a ery rooms. - Construction Cost: 3519.50 Estimated Completion Date: 10/07/2011 Name: Low Voltage Contractors License M TS 00375 4200 W 76th St Minneapolis CONTRACTOR Address: City: State: MN Zip: 55435 Phone: 952-835-4600 Jacob Behm jbehm@lvcinc.com Contact: Email: -New X Remodel WORK TYPE i x Addition Other: Alterations , DESCRIPTION O WORK: X Commercial Residential Educational FEES $55.00 Minimum (includes State Surcharge) OR Contract Value $ 3519.50 x1% - If the Permit Fee is le s than $10,010, surcharge is $ 5.00 50.00 Permit Fee If the Permit fee is > 10,010, surcharge increases by $.50 for each $1,000 Permit Fee - (i.e. a $10,010-$11,01 Permit Fee requires a $ 5.50 surcharge) 5.00 Surcharge 55.00 TOTAL FEE *Requirements: 2 complete sets of drawings and specifications, cut sheets on materials and components to be used I hereby apply for a Fire larm permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Minnesota Building/Fire Codes; that I and nd th' 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 a o ed in t case of work which requires a review and approval of plans. x Jacob Behm X_ Applicant's Printed Name App 's Si a re FOR OFFICE USE Reviewed By: Date: r` V . Required Inspections: Rough-In Final Fire Alarm Test i OS/16/2012 16:24 FAX 7634257755 190002/0003 Use BLUE or BLACK Ink _ :-For Office Use e~ I I I 110 Zo'm 4~- City of Ea ® 1 Perm! t I Permit Fee: 3830 Pilot Knob Road,c~ G-`~ I r Eagan MN 55122 6 ~D~1 Date Received. 12- Phone: (651) 675-5675 M~~ I I Fax: (651) 675-5694 I Staff: X535 ~lu.~G~ss 12d~ 2012 FIRE SUPPRESSION SYSTEMS PERMIT APPLICATION* Date: Site Address: Rl ;z RR kAtl1f Tenant: ~JC CM-5.5 Not %Ad Suite Name: Phone: OP.ERTY'O ;Address /City /Zip: Applicant is: Owner Contractor TYPE OFV1fQF~KI Description of work: Ua~ C~) VPJ)lJlW1~ 5®l~4 t~~~ets st Construction Cost: da Estimated Completion. Date: /VI R- ~~o`"Ztl <Z Name: SlWiNe_ aoitc~ton License C- ooFS CONTACTOR Address: jOgOn Mc Avg.. A, City: 1 ~r~lt'e 1 State~~: I ~►1V _ Zip: 5530 Phone: -7 (o-3-12,5 4-4 +1 'F Contact ~ -M W nAok Email: P. S k lf (1C' i . Cairn L FIRE PERMIT TYPE WORK TYPE X Sprinkler System of heads-z ) New Addition _ Fire Pump _ Standpipe Alterations _ Remodel Other: Other. DESCRIPTION OF WORK: Commercial Residential Educational FEES $60.00 Minimum (includes State Surcharge) OR Contract Value $ 5570 x1% If the Permit Fee is less than $10,010, surcharge is $ 5.00 = $ GO Permit Fee If the Permit Fee is > $10,010, surcharge increases by $.50 for each $1,000 Permit Fee (i.e. a $10,010-$11,010 Permit Fee requires a $ 5.50 surcharge) _ $ 1 ndoW Surcharge _ $ TOTAL FEE 3/4" Displacement Fire Meter - $231.00 Fire Meter $~®©~e TOTAL FEE *Requirements: 2 complete sets of drawings and specifications, cut sheets on materials and components to be used I hereby apply for a Fire Suppression System permit and acknowledge Dial Die information is complete and accurate; that the work Wil be In conformance with the ordinances and codes of the City of Eagan and with the Minnesota Building/Fire Codes; 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 Mcodance with th approved plan in the case of work which requires a review and approval of plans. x JAL4155 x Applicant's Printed Name Appl is Signature fr3/16/2012 16:24 FAX 7634257755 100003/0003 CALL BEFORE YOU DIG. Call Gopher State One Cali 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,gopherstateonecall.org s , FQR't FP)CE-t1SE a ! r.r RE601RED INSPECTIONS = z Hyoe6statid z. Flow Alarm Drain Test Rough In Final P Central Station Condlt Trlp ump Test , !M8soflssuance; ; 1: P 1: rte Reirmit "Reviewed py' Date / l Use BLUE or BLACK Ink ID 1-----------------i ~w I For Office Use 1 QR 13 ~0~~ i Permit City of Eajan 1 1 Permit Fee: 7 3830 Pilot Knob Road Z Eagan MN 55122 Date Received: Phone: (651) 675-5675 1 I Fax: (651) 675-5694 i staff: 2011 COMMERCIAL BUILDING PERMIT *PPLICATION ~ou~ Date: 4/13/12 SiteAddress: 3535 Blue Cross Road L_ Tenant Name: Blue Cross Blue Shield (Tenant is: New / Existing) Suite Former Tenant: PROPERTY OWNER Name: Blue Cross Blue Shield Phone: 651-662-2542 Address /city/zip: 3535 Blue Cross Road Applicant is: Owner X Contractor TYPE OF WORK Description of work: Interior Remodeling Construction Cost: $ 28,000.00 CONTRACTOR Name: C.F. Haglin & Sons, Inc. LicenseN/A Address: 3939 West 69th Street c17 Edina State: MN zip: 5534t"Phone: 952-920-6123 Contact: Gary Gunderson Email: ggundeeson@cfhaglin.com ARCHITECT / Name: Architectural Alliance Registration 20915 ENGINEER Address:400 Clifton Ave. S. City: Minneapolis State: MN zip: 55403 Phone: 612-871-5703 Contact Person: Jon; Stone Email: Jstone@archalliance.com 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 the are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection again t underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www. o herstateon call.or I hereby acknowledge that this information is complete and accurate; that the wq)rk ill be n c ormance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an appl' on for it, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of w rk hic requir re.vigtrc3Vfiplans. x Gary Gunderson X Applicant's Printed Name App 'c 's Signature Page 1 of 3 A9 C126 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 v 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 2$/ DM ~ Occupancy B MCES System Plan Review ✓ Code Edition 2W7M5P6 SAC Units $/i✓o e~Gt DA USE OX 0ez.4b. (25%_ 100%_) Zoning City Water ✓ Census Code Stories Booster Pump # of Units V Square Feet PRV # of Buildings Length Fire Sprinklers Type of Construction A Width REQUIRED INSPECTIONS Footings (New Building) Sheetrock Footings (Deck) Final / C.O. Required Footings (Addition) ✓ Final / No C.O. Required Foundation Other: Drain Tile Pool: -Footings -Air/Gas Tests -Final Roof: -Decking -Insulation -Ice & Water -Final Siding: -Stucco Lath -Stone Lath -Brick Framing Windows Fireplace: -Rough In -Air Test -Final Retaining Wall Insulation Erosion Control Meter Size: / Final C/O Inspection: Schedule Fire Marshal to be present: Yes v No Reviewed BY: Uem& ~ Building Inspector Reviewed By: , Planning COMMERCIAL FEES Base Fee 7 7 S • Z Water Quality Surcharge / • dO Water Supply & Storage (WAC) Plan Review 2 Storm Sewer Trunk MCES SAC Sewer Trunk City SAC Water Trunk S&W Permit & Surcharge Street Lateral Treatment Plant Street Treatment Plant (irrigation) Water Lateral Park Dedication Other: Trail Dedication Water Quality TOTAL 77 ~6 Page 2 of 3 Use BLUE or BLACK Ink I For Office Use I + of I Permit#: Ob1ty of Eajan I Permit Fee: (U C~ o 3830 Pilot Knob Road j Eagan MN 55122 I Date Received: Phone: (651) 675-5675 Staff: j Fax: (651') 675-5694 2012 COMMERCIAL PLUMBING PERMIT APPLICATION Date: VJ~~ 12- Site Address: nn Cam, n 0 _ Tenant: Suite PROPERTY J t r Phone: OWNER Name: Name: Metropolitan Mechanical Contr License#: L098-06734 CONTRACTOR Address: 7450 Flying Cloud Dr City: Eden Prairie State: MN Zip: 55344 Phone: 952-941-7010 Email: rachel.nelson@metromech.com TYPE OF , New _ Replacement _ Repair ) Rebuild _ Modify Space -Work in R.O.W. WORK Description of work: VDU I COMMERCIAL New Construction Modify Space Irrigation System yes I _ no) (.)C RPZ / PVB) • Rain sensors required on irrigation systems PERMIT TYPE • Avg. GPM (2" turbo required unless smaller size allowed by Public Works) Meters Call (651) 675-5646 to verity that tests passed prior to picking up meter. Domestic: Size & Type Fire: 1 Avg. GPM High demand devices? _Yes No Flushometers Yes No COMMERCIAL FEES: $60.00 Minimum (includes $5.00 State Surcharge) OR Contract Value $ x1% Co C-) `no Permit Fee Required on ALL new buildings and boulevard irrigation systems ~ $ Radio Meter Read - If the Permit Fee is less than $10,010, the surcharge is $5.00 $ Meter(s) - If the Permit fee is > $10,010, the surcharge increases by $.50 for each $1,000 Permit Fee i.e. a $10,010-$11,000 Permit Fee requires a $5.50 surcharge) $ State Surcharge Following fees apply when installing a new lawn irrigation system $ Water Permit Contact the City's Engineering Department, (651) 675-5646, for required fee amounts. $ Treatment Plant $ Water Supply & Storage $ State Surcharge CoO. TOTAL FEE 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.gopherstateonecall.org 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 approv of plans. bkV x Rachel Nelson x Applicant's Printed Name Applicant's Signature FOR OFFICE USE Approved By: Date: Required Inspections: Under Ground Rough-In Air Test Gas Test Final PRV Required: _ Yes No Page 1 of 3 aoLI 0 L4 Doi ~ c( 50 G Use BLUE or BLACK Ink 'A S J I For Office Use I City of Eajan I Permit I vv 3830 Pilot Knob Road Permit Fee: j Eagan MN 55122 Phone: (651) 675-5675 1 Date Received: Fax: (651) 675-5694 7 I Staff: - - - - - - - - - - - - - - - - - J 2012 MECHANICAL PORMIT APPLICATION ❑ Please submit two (2) sets of plans with all commercial applications. Date: 7/12/12 Site Address: 3535 Blue Cross Road Eagan, MN 55122 Tenant: Blue Cross Blue Shield Suite Name: Randy Blaha Phone: (651) 662-2542 RESIDENT / OWNER Address / City / Zip: PO Box 64560, Route N 194 Name: Metropolitan Mechanical Contractors, Inc. License 20-0832303 CONTRACTOR Address: 7450 Flying Cloud Drive City: Eden Prairie State: MN Zip: 55344 Phone: (952) 941-7010 Contact: Erin Chapman Email: erin.chapman@metromech.com New Replacement Additional X Alteration Demolition TYPE OF WORK Description of work: NOTE: Roof mounted and ground mount mechanical equipment is required to be screened by City Code. Please contact the Mechanical Inspector for information on permitted screening methods. RESIDENTIAL COMMERCIAL Furnace t New Construction _ Interior Improvement PERMIT TYPE -Air Conditioner Install Piping Processed Air Exchanger Gas Exterior HVAC Unit Heat Pump Under / Above ground Tank Install Remove) Other RESIDENTIAL FEES: $60.00 Minimum Add-on or alteration to an existing unit (includes $5.00 State Surcharge) $100.00 Fire repair (replace burned out appliances, ductwork, etc.) (includes $5. PO State Surcharge) = $ TOTAL FEE COMMERCIAL FEES: $75.00 Underground tank installation/removal (includes $5.00 State Surcharge) OR Contract Value $ $220,000.00 x j% $60.00 Minimum (includes State Surcharge) _ $ $2,200.00 Permit Fee - If the Permit Fee is less than $10,010, surcharge is $ 5.00 $5.00 Surcharge - If the Permit Fee is > $10,010, surcharge increases by $.50 for each $1,000 Permit Fee (i.e. a$10,010-$11,010 Permit Fee requires a $ 5.50 surcharge) _ $ $2205.00 TOTAL FEE 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.gogherstiteonecall.org 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 o plans. / x Ey° vi irta,pVVIc x Applicant's Prin ed Name Applicant's Sig ature FOR OFFICE USE Required InspectioX"Rough Reviewed By: Date? z~l L 9 Underground In Air Test Gas Service T st In-floor Heat Final HVAC Screening Use BLUE or BLACK Ink For Office Use j I Permit I City of EaEdn a I Permit Fee. o I 3830 Pilot Knob Road Eagan MN 55122 Date Received: Phone: (651) 675-5675 Fax: (651) 675-5694 Staff: 2011 COMMERCIAL BUILDING PERMIT APPLICATION Date: 7/31/2012 Site Address: 3535 Blue Cross Road f t l Tenant Name: n/a (Tenant is: New / Existing) Suite M Former Tenant: PROPERTY OWNER Name: Blue Cross Blue Shield Phone: Address/ City/ Zip: 3535 Blue Cross Road Applicant is: Owner X Contractor TYPE OF WORK Description of work: Parking Garage Repair Construction Cost: $50,000.00 CONTRACTOR Name: C . F . Hagl i n & Sons, Inc. License i Address: 3939 West 69th Street City: Edina State: MN Zip: 55435 Phone: 952-920-6123 Contact: Gary Gunderson Email: ggunderson@cfhaglin.com ARCHITECT / Name: Meyer Borgman Johnson Registration 18328 ENGINEER Address: 125 Sixth Street City: Mi nneapol i s State: MN Zip: 55402 Phone: 612-338-0713 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 the are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for prote 'on against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www. o 'erstateonecall. r I hereby acknowledge that this information is complete and accurate; that the wore wj a in confor ce with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an appl' n f r a pe it, a work is not to start without a permit; that the work will be in accordance with the approved plan in the case of wor (jgw and approval of plans. x _Gary Gunderson X Applicant's Printed Name Apoli ant' ignature Page 1 of 3 / 3S-~ &e- (f-ro-s5 0 DO NOT WRITE BELOW THIS LINE l0(0 7 / SUB TYPES _ Foundation /Public Facility _ Accessory Building Apartments -;/Commercial / Industrial _ Exterior Alteration-Apartments Lodging _ Greenhouse / Tent _ Exterior Alteration-Commercial Miscellaneous _ Antennae _ Exterior Alteration-Public Facility WORK TYPES New _ Interior Improvement Siding _ Demolish Building* Addition /Exterior Improvement Reroof _ Demolish Interior Alteration Repair Windows _ Demolish Foundation Replace _ Water Damage Fire Repair _ Salon Owner Change _ Retaining Wall *Demolition of entire building - give PCA handout to applicant DESCRIPTION Valuation SolCGO o~ Occupancy MCES System Plan Review ✓ ✓ Code Edition 24G71gS&C- SAC Units (25%100% Zoning City Water Census Code Stories Booster Pump # of Units y Square Feet PRV # of Buildings / Length Fire Sprinklers Type of Construction .-A- Width REQUIRED INSPECTIONS Footings (New Building) Sheetrock Footings (Deck) Final / C.O. Required Footings (Addition) Final / No C.O. Required Foundation Other: Drain Tile Pool: -Footings -Air/Gas Tests -Final Roof: -Decking -Insulation -Ice & Water -Final Siding: -Stucco Lath -Stone Lath -Brick Framing Windows Fireplace: -Rough In Air Test -Final Retaining Wall Insulation Erosion Control Meter Size: Final C/O Inspection: Schedule Fire Marshal to be present: Yes No Reviewed By: . Building Inspector Reviewed By: Planning COMMERCIAL FEES Base Fee G 7S~ Water Quality Surcharge ZS• e-a Water Supply & Storage (WAC) Plan Review 5 . Storm Sewer Trunk MCES SAC Sewer Trunk City SAC Water Trunk S&W Permit & Surcharge Street Lateral Treatment Plant Street Treatment Plant (Irrigation) Water Lateral Park Dedication Other: Trail Dedication c~ Water Quality TOTAL- Page 2 of 3 's N ' Use BLUE or BLACK Ink For Office Use j "Tor C ity of EaR df I Permit I I I, ; j Permit Fee: 3830 Pilot Knob Road I ; Eagan MN 55122 Date Received: ~a_- 1 Phone: (651) 675-5675, Fax: (651) 675-5694 R I I I Staff: I n r4 2012 COMMERCIAL BUILDING PERMIT APPLICATION J Date: 8/27/12 SiteAddress: 3535 Blue Cross Road Tenant Name: Blue Cross Blue Shield of MN (Tenant is: New / V/ Existing) Suite Former Tenant: Name: Blue Cross Blue Shield of MN Phone: 651-662-8000 PROPERTY OWNER Address / City / Zip: 3535 Blue Cross Road Applicant is: Owner Contractor Description of work: Interior Office Renovation TYPE OF WORK t Construction Cost: $1,157,866.00 4 Name: Mortenson Construction License Address: 700 Meadow Lane North city: Minneapolis CONTRACTOR State: MN Zip. 55422 Phone: 612-490-0280 contact: Justin Berdan Email: Justin.Berdan@Mortenson.com Name: Architectural Alliance Registration 20915 ARCHITECT/ Address: 400 Clifton Ave South City: Minneapolis ENGINEER state: MN zip: 55403 Phone: Architectural Alliance Contact Person: Jon Stone Email: jstone@archalliance.com License d~pIumber installing new sewer/water service: Phone NOTE: Plans and supporting documents that you submit are considered to be public..infor'm...a,.tion. 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. 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.gopherstateonecall.org 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 Justin Berdan x Applicant's Printed Name ~Pplicant's Signature Page 1 of 3 DO NOT WRITE BELOW THIS LINE 106797 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 000 a~ Occupancy 16 MCES System -r- Plan Review ✓ Code Edition 2-M7msoc SAC Units 0 L~l ~ (25%_ 100%~ Zoning J~ City Water Census Code Stories Booster Pump # of Units 0 Square Feet PRV # of Buildings Length Fire Sprinklers Type of Construction• B Width REQUIRED INSPECTIONS Footings (New Building) Sheetrock Footings (Deck) -Final / C.O. Required Footings (Addition) ✓ Final / No C.O. Required Foundation Other: Drain Tile Pool: -Footings -Air/Gas Tests -Final Roof: -Decking -Insulation -ice & Water -Final Siding: -Stucco Lath -Stone Lath -Brick Framing Windows Fireplace: -Rough In Air Test -Final Retaining Wall Insulation Erosion Control Meter Size: Final C/O Inspection: Schedule Fire Marshal to be present: /Yes No Reviewed By: CwG , Building Inspector Reviewed By: Planning COMMERCIAL FEES Base Fee 4, 510Water Quality Surcharge 565.24 Water Supply & Storage (WAC) Plan Review y~ $ Z. to y Storm Sewer Trunk MCES SAC Sewer Trunk City SAC Water Trunk S&W Permit & Surcharge Street Lateral Treatment Plant Street Treatment Plant (Irrigation) Water Lateral ! Park Dedication Other: Trail Dedication Water Quality TOTAL 43 G Page 2 of 3 Metropolitan Council 7 Environmental Services September 11, 2012 Dale Schoeppner Building Official City of Eagan 3830 Pilot Knob Road Eagan, MN 55-122 Dear Mr. Schoeppner: The Metropolitan Council Environmental Services (MCES) Division has determined the SAC to be charged for the wastewater capacity demand for the Blue Cross Blue Shield 4th Floor remodel to be located at 3535 Blue Cross Road within the City of Eagan. A determination was not necessary. It is the Council's understanding this project entails remodeling existing office to office. There will no change in use; therefore, no additional SAC would be due. The business information was provided to MCES by the applicant at this time. It is the City's responsibility to substantiate the business use and size at the time of the final inspection. If there is a change in use or size, a redetermination will need to be made. If you have any questions, call me at 651-602-1118 or email karon.cappaert@metc.state.mn.us. Since ly, 1 on Cappaert SAC Program Technical Specialist Environmental Services Division KC:kb: 120911A9 Determination expiration: September 11, 2014 cc: J. Nye, MCES Peggy Fleck, Eagan (email) Justin Berdan, Mortenson (email) www.metrocouncil.org 390 Robert Street North,* St. Paul, MN 55101-1805 • (651) 602-1005 • Pais (651) 602-1477 • TTY (651) 291-0904 An Equal Opportunity Employer W Use BLUE or BLACK Ink For Office Use I I 1 I Permit I 3830 Pilot Knob Road Permit Fee: `S Eagan MN 55122 Phone: (651) 675-5675 I Date Received: Fax: (651) 675-5694 1 1 14 I Staff: VIq ----------J 2012 MECHANICAL PERMIT APPLICATION ❑ Please submit two (2) sets of plans with all commercial applications. Date: 9/20/12 Site Address: 3535 Blue Cross Road, Eagan MN Tenant: Blue Cross Blue Shield Suite Name: Blue Cross Blue Shield, Attn Randy Blaha Phone: 651-662-2542 RESIDENT /OWNER Address / City / Zip: 3535 Blue Cross Road, Eagan MN Name: Metropolitan Mechanical Contractors, Inc. License 20-0832303 CONTRACTOR Address: 7450 Flying Cloud Drive City: Eden Prairie State: MN Zip: 55344 Phone: 612-269-2559 Contact: Erin Chapman Email: erin.chapman@metromech.com New Replacement Additional X Alteration Demolition TYPE OF WORK Description of work: Replace existing VAV boxes, ductwork, and plumbing fixtures with new. NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened by City Code. Please contact the Mechanical Inspector for information on permitted screening methods. RESIDENTIAL COMMERCIAL Furnace New Construction Interior Improvement 4 - PERMIT TYPE -Air Conditioner X Install Piping Processed Air Exchanger Gas Exterior HVAC Unit Heat Pump Under / Above ground Tank Install Remove) Other RESIDENTIAL FEES: $60.00 Minimum Add-on or alteration to an existing unit (includes $5.00 State Surcharge) $100.00 Fire repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) _ $ TOTAL FEE COMMERCIAL FEES: 1-70,000 $75.00 Underground tank installation/removal (includes $5.00 State Surcharge) OR Contract Value $ 299,888A@ x1% $60.00 Minimum (includes State Surcharge) = $ Permit Fee "If the project valuation is over $1 million, please call for Surcharge 5.00 Surcharge* 2,005.00 TOTAL FEE 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.gopherstateonecall.org 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 Erin Chapman x 0111 Applicant's Printed Name Applicant's Signature FOR OFFICE USE y / Required Inspections: Reviewed By: Gate F Underground Rough In Air Test Gas Service Test In-floor Heat Final HVAC Screening ___Us_e_B_LUE or BLACK Ink -ForOff- ~ I l~ l -71 Permit Ui Ealan I Permit Fee: city 3830 Pilot Knob Road I ( I Eagan MN 55122 Date Received: ~0 z I Phone: (651) 675.5675 I Fax: (651) 675-5694 I Staff I 2012 COMMERCIAL PLUMBING PERMIT APPLICATION Please submit two (2) sets of plans with all commercial applications. Q~~ 91 ej - Site Address: 1 61 S le X-4 Date: Tenant &I( s Blue- t Suite # ..a._.>..a~a. r.• s.~vs"1~..tiey~~r.~aawd+w.lxV~YF~ss4~"-~~•w.+u,u.•._•srs~-~..a~~.. _.w.~.ew.~+rs.r"- ..^~ww'eYY.+d~~.+~_~sa.s~+ PROPERTY OWNER Name: EAo 0 S `JQW° _Phone: Name: -Mmb tinC-- License # - f~ 7- - ~ 6 ~ t CONTRACTOR Address: - ~~.t LlXit City: 9rffm e- State: ml~ Zip: ~ t d 1~,,_~_ -f.- A Phone Email. f yJy TYPE OF New ~ Replaceme it` -Repair _Rebuild - Modify Space Work m R.O.W. WORK ' - . Description of work: Pcwpat ` COMMERCIAL _ New Construction Modify Space j _ Irrigation System yes no) RPZ / _ PVB) • Rain sensors required on Irrigation systems PERMIT TYPE . Avg. GPM (Y turbo required unless smaller size allowed by Public Works) _ Meters Call (651) 675-5646 to verity that tests passed prior to nicking up meter. Domestic. Size & Type d 0 Fire: 1 I Avg. GPM High demand 414~=Znss ,KNo Flushometers _,Yes _No , j COMMERCIAL FEES: 99250 1 $60.00 Minimum (includes $5.00 State Surcharge) OR Contract Value $ x 16/e Permit Fee Required on ALL new buildings and boulevard Irrigation systems 4 $ Radio Meter Read $ Meter(s) If the project valuation is over $1 million, please call for the State Surcharge $ 5.00 State Surcharge' Fallowing fees apply when installing a new lawn irrigation system $ Water Permit Contact the City's Engineering Department, (651) 675-5646, for required fee amounts. $ Treatment Plant $ Water Supply & Storage $ State Surcharge $ TOTAL FEE 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.aopherstateonecall.org 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,1 x Applicant's Printe Name Applicant's Slgnatu e FOR OFFICE USE Approved By: Date: I Z- Required Inspections: -Under Ground ~ough4n "r Test Gas Test Final PRV Required: - Yes No Page 1 of 3 Use BLUE or BLACK Ink For Office Use j EaRdfl 1 Permit I City of 1 ~ Permit Fee: 3830 Pilot Knob Road I 1 Eagan MN 55122 Date Received: Phone: (651) 675-5675 Fax: (651) 675-5694 Staff: 2012 COMMERCIAL BUILDING PERMIT APPLICATION Date: 912/12 Site Address: 3535 Blue Cross Road Tenant Name: Blue Cross Blue Shield of MN (Tenant is: New Existing) Suite Former Tenant: Name: Blue Cross Blue Shield of MN Phone: 651-662-8000 PROPERTY OWNER Address / City / Zip: 3535 Blue Cross Road s Applicant is: Owner Contractor t Description of work: Roof Replacement TYPE OF WORK r Construction Cost: $335,000.00 Mortenson Construction Name: License I Address: 700 Meadow Lane North city. Minneapolis CONTRACTOR i i state: MN Zip: 55422 Phone: 612-490-0280 Contact: Justin Berdan Email: Justin.Berdan@Mortenson.com Name: Architectural Alliance Registration 20915 ARCHITECT/ Address: 400 Clifton Ave South City: Minneapolis ENGINEER 3 state: MN Zip: 55403 Phone: Architectural Alliance Contact Person: Jon Stone Email: jstone@archalliance.com 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. 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.aopherstateonecall.org 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 Justin Berdan x Applicant's Printed Name A nt's Signature Page 1 of 3 oe- DO NOT WRITE BELOW THIS LINE SUB TYPES Foundation _ Public Facility _ Exterior Alteration-Apartments V Commercial / Industrial _ Accessory Building _ Exterior Alteration-Commercial _ Apartments T 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 ~35,0C~ 0 Occupancy ~j MCES System 1CT~Lde~~ Plan Review 6 Code Edition 2007 Ms pf, SAC Units Zoning City Water Census Code Stories Booster Pump # of Units Square Feet PRV # of Buildings Length Fire Sprinklers Type of Construction A. Width REQUIRED INSPECTIONS Footings (New Building) Sheetrock Footings (Deck) Final / C.O. Required Footings (Addition) Final / No C.O. Required Foundation Other: Drain Tile Pool: Footings _Air/Gas Tests -Final Roof: -Decking V /Insulation -Ice & Water Final Siding: -Stucco Lath -Stone Lath -Brick Framing Windows Fireplace: -Rough In _Air Test -Final Retaining Wall Insulation Erosion Control Meter Size: Final C/O Inspection: Schedule Fire Marshal to be present: Yes No Reviewed By: 60W6 , Building Inspector Reviewed By: , Planning COMMERCIAL FEES Base Fee 7-466. 1Sr Water Quality Surcharge &7.516 Water Supply & Storage (WAC) Plan Review D." Storm Sewer Trunk MCES SAC Sewer Trunk City SAC Water Trunk S&W Permit & Surcharge Street Lateral Treatment Plant Street Treatment Plant (Irrigation) Water Lateral Park Dedication Other: Trail Dedication Water Quality TOTAL Z (3 Page 2 of 3 t Use BLUE or BLACK Ink For Office Use I 1 Permit ~ 6 I City of Eajan 1 Permit Fee -3 0 . I 3830 Pilot Knob Road i I Eagan MN 55122 Date Received: i Phone: (651) 675-5675 I j Fax: (651) 675-5694 I staff: j 2012 COMMERCIAL BUILDING PERMIT APPLICATION ft„s~11 Date: 10/10/12 SiteAddress: 3535 Blue Cross Road Tenant Name: Blue Cross Blue Shield of MN (Tenant is: New / ~Z Existing) Suite Former Tenant: Name: Blue Cross Blue Shield of MN Phone: 651-662-8000 PROPERTY OWNER Address / City / Zip: 3535 Blue Cross Road - Applicant is: Owner Contractor Exterior Facade Restoration (Tuckpointing, Flashing Revisions) TYPE OF WORK i Description of work: Construction Cost: $289,500.00 Name: Mortenson Construction License Address: 700 Meadow Lane North city. Minneapolis CONTRACTOR state: MN Zip: 55422 Phone: 612-490-0280 Contact: Justin Berdan Email: Justin. Berdan@Mortenson.com i Name: Architectural Alliance Registration 20915 i ARCHITECT/ Address: 400 Clifton Ave South City: Minneapolis ENGINEER state: MN zip: 55403 Phone: Architectural Alliance contact Person: Jon Stone Email: jstone@archalliance.com I 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 theV 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. wwwyopherstateonecall.org 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 Justin Berdan x Applicant's Printed Name icant's Signature Page 1 of 3 DO NOT WRITE BELOW THIS LINE /07 S6~ 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 Jnterior 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 do Valuation Z~D~I~D Occupancy MCES System Plan Review ✓ Code Edition 2l07M1 bc_ 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 %T Width REQUIRED INSPECTIONS Footings (New Building) Sheetrock Footings (Deck) Final / C.O. Required Footings (Addition) Final / No C.O. Required Foundation Other: Drain Tile Pool: -Footings -Air/Gas Tests -Final Roof: -Decking -Insulation -Ice & Water -Final ✓ Siding: -Stucco Lath -Stone Lath -Brick Framing Windows Fireplace: _Rough In Air Test -Final Retaining Wall Insulation Erosion Control Meter Size: Final C/O Inspection: Schedule Fire Marshal to be present: Yes No Reviewed By: -eG , Building Inspector Reviewed By: , Planning COMMERCIAL FEES Base Fee 2 / f G . T i~ Water Quality Surcharge / °t~ Water Supply & Storage (WAC) Plan Review Z Stone Sewer Trunk MCES SAC Sewer Trunk City SAC Water Trunk S&W Permit & Surcharge Street Lateral Treatment Plant Street Treatment Plant (Irrigation) Water Lateral Park Dedication Other: Trail Dedication Water Quality TOTAL 37& 4e Page 2 of 3 . s L G ~ Use BLUE or BLACK Ink a rv , For Office Use I Permit I City of Eajan-~ 3830 Pilot Knob Road i Permit Fee: Eagan MN 55122 Date Received: Phone: (651) 675-5675 Fax: (651) 675-5694 I Staff: +~l I A-11331 r 2012 COMMERCIAL FIRE ALARM PERMIT APPLICATION* Date: ~I10al12- Site Address: 3535 61i,(e Cross Raad Ea cW1 MN 55122 Tenant: SIML emss BIUt SVIkAd Suite Name: 6IML Cms<, Nut ShitAd Phone: PROPERTY OWNER Address / City / Zip: ' 535 Blue. Gross Roadf EaaAA MN 55122 Applicant is: Owner X Contractor TYPE OF WORK Description ofworK:a Antis #&4 .A4 o f* Old Aredem suskm wft it mm N hAer Atom pa ,n Inl+ia n 6WAnofiPi14 on us as s"imiftA m Litiua(11t95, Construction Cost: Estimated Completion Date: Namelow %l _ CoMmoliorS, Inc. License 7-SOM97-S CONTRACTOR Address: 42 O (hies{ '70* swat City: Ed s M. State: N zip: 55545 Phone: 952-1971-17-919 Contact: Jl toh ettim Email: ( New Remodel WORK TYPE -Addition -Other: -Alterations DESCRIPTION OF WORK: X Commercial Residential Educational FEES $60.00 Minimum (includes State Surcharge) OR Contract Value $J'53$AM.Q) x1% - If the Permit Fee is less than $10,010, surcharge is $ 5.00 = $ Permit Fee - If the Permit Fee is > $10,010, surcharge increases by $.50 for each $1,000 Permit Fee (i.e. a $10,010-$11,010 Permit Fee requires a $ 5.50 surcharge) . $ 5.00 Surcharge _ $ (I SS5 •OO TOTAL FEE .Requirements: 2 complete sets of drawings and specifications, cut sheets on materials and components to be used I hereby apply for a Fire Alarm permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Minnesota Building/Fire Codes; 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 appr v of plans. x x Ap icant's Printed NW-m App i nt's Signature FOR OFFICE USE Reviewed By: Date: Required Inspections: Rough-In V Final Fire Alarm Test r r1 S t~~'i 1/ Vl C' For Use BLUE or BLACK Ink I Office Use I CCI) Permit City of EaEd ; Permit Fee: 3830 Pilot Knob Road Eagan MN 55122 Date Received: Phone: (651) 675-5675 l~ Fax: (651) 675-5694 I Staff: I_________________J 2012 FIRE SUPPRESSION SYSTEMS PERMIT APPLICATION* Date: ( 2 l Z Site Address: 153-7 BlLtC. 6655 R00.1 Tenant: Suite Name: gRki Phone: I PROPERTY OWNER Address /City /Zip: 353'5 gl-.e,. C,nyss YCo,k Applicant is: Owner Contractor TYPE OF WORK Description of work: rote eaL W. ►s - 4o Construction Cosi Estimated Completion Date- 12 I t I t Z Name: License LAOS CONTRACTOR Address yep City: 1 State: N Zip: SS 130 Phone: 66 I - 2S 3 2? I Contact: 5Lv* '&%l Email: FIRE PERMIT TYPE WORK TYPE ~C Sprinkler System of heads t2$ New _ Addition Fire Pump _ Standpipe Alterations - Remodel Other: Other: DESCRIPTION OF WORK: Commercial Residential Educational FEES $60.00 Minimum (includes State Surcharge) OR Contract Value $ 311 7--7 z 1% - If the Permit Fee is less than $10,010, surcharge is $ 5.00 = $ 3 2~ Permit Fee - If the Permit Fee is > $10,010, surcharge increases by $.50 for each $1,000 Permit Fee (i.e. a $10,010-$11,010 Permit Fee requires a $ 5.50 surcharge) _ $ 5.0o Surcharge _ $ L 1 TOTAL FEE 3/4" Displacement Fire Meter - $231.00 = $ Fire Meter _ $ ® TOTAL FEE *Requirements: 2 complete sets of drawings and specifications, cut sheets on materials and components to be used I hereby apply for a Fire Suppression System permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Minnesota Building/Fire Codes; 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 Ste- gam; k&n, x Applicant's Printed N me Applicant's Signature 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.4ooherstateonecall.om FOR OFFICE USE REQUIRED INSPECTIONS Hydrostatic Flow Alarm Drain Test Rough In Trip Pump Test Central Station Final Conditions of Issuance: Permit Reviewed by ~~G Date: / / CityofEaaail 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Piukutd 3 Acio folo-44 chiGC.tor tisl." Use BLUE or BLACK Ink For Office Use I cc61W7 Permit #: Permit Fee: - � 7 Date Received: Staff: f> 2012 FIRE SUPPRESSION SYSTEMS PERMIT APPLICATION* Date: 1// 12 Site Address: 3535- 13i -1J i_CIw55 941 Tenant: Bz-v E_ C4 -05S SS Suite #: 0 k' I�f J t PROPERTY OWNER Name: p1 -L) C J2- 5 S VL- U E JN 1 >_LrlQ/� Phone: Address/city/zip: 3535" 84-4 s� � e-itoS. 44t) M N 551 z 2 - Applicant Applicant is: Owner >4. Contractor TYPE OF lllORK . , x Description of work: p 4 c,t�l ML: �,�iL f"� � 5YS�' p t` -�YI'1 /-LCL -S l �/�i. j Construction Cost: _yZ to.12/ 3//)Z � � Estimated Completion Date: x ...... xxsx CONTRACTOR Name: \AKIN; KING Arra n6T"iC gl N4G 6 License #: Address: .3Di YOg4 4($s = City: -N • P401- 4ULState: State:nil) Zip: -r-51 Phone: 559 3 r Contact: !i, -t HcALL15TE1!- Email:' rh . feNeallzdered V;ki,, j pr;•ilil-•0S FIRE PERMIT TYPE A Sprinkler System (# of heads*,) Standpipe WORK TYPE New Addition Fire Pump _ _ )4 Alterations _ Remodel Other: Other: DESCRIPTION OF WORK: Commercial _ Residential — Educational FEES $60.00 Minimum (includes State Surcharge) OR $10,010, surcharge is $ 5.00 surcharge increases by $.50 for each $1,000 Permit Fee requires a $ 5.50 surcharge) Contract Value $ V2970, CO x 1% - If the Permit Fee is less than = $ '/29, 76 Permit Fee - If the Permit Fee is > $10,010, Fee = $ 2%,5b Surcharge (i.e. a $10,010-$11,010 Permit = $ I/54 TOTAL FEE 3/4" Displacement Fire Meter - $231.00 = $ Fire Meter = $ TOTAL FEE *Requirements: 2 complete sets of drawings and specifications, cut sheets on materials and components to be used 1 hereby apply for a Fire Suppression System permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Minnesota Building/Fire Codes; 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 accopSlance with the approved plan in the case of work which requires a review and approval of plans. x /et .l'4C,Q LLc9 reit_ Applicant's Printed Name x 7i'I Applicant's Signature CALL BEFORE YOU DIG. Call Gopher State One CaII 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.00pherstateonecall.org FOR OFFICE USE REQUIRED INSPECTIONS 1,DIHydrostatic Trip Conditions of Issuance: Drain Test Central Station Permit Reviewed by. 41`. City of Earn 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use Permit #: EA I b8 61.v?- Permit Fee: 57i lag Date Received: Staff: 7 2012 COMMERCIAL BUILDING PERMIT APPLICATION Date: 11/5/12 Site Address: 3535 Blue Cross Road J Tenant Name: Blue Cross Blue Shield of MN PROPERTY OWNER (Tenant is: New / ✓ Existing) Suite #: Former Tenant: Blue Cross Blue Shield of MN Name: Address / City / Zip: 3535 Blue Cross Road TYPE OF WORK CONTRACTOR Applicant is: Owner Contractor Phone: 651-662-8000 Description of work: Data Center Renovation Construction Cost: $5,000,000.00 Name: Mortenson Construction Address: 700 Meadow Lane North State: MN Zip: 55422 Contact: Justin Berdan Phone: License #: city: Minneapolis 612-490-0280 Email: Justin.Berdan@Mortenson.com Name: Dunham Associates, Inc. Registration #: 23434 ARCHITECT/ 50 South 6th Street, Suite 1100 Minneapolis Address: City: (� ENGINEER State: MN zip: 55402 Phone: 612-465-7550 Contact Person: Lee Offerdahl Email: lee.offerdahl@dunhameng.com 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 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.gopherstateonecall.orq 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 which requires a review and approval of plans. x Justin Berdan Applicant's Printed Name nt's Signature Page 1 of 3 DO NOT WRITE BELOW THIS LINE /O g -3(oR SUB TYPES Foundation V Commercial / Industrial Apartments Miscellaneous WORK TYPES New Addition Alteration Replace Salon Owner Change DESCRIPTION Valuation Plan Review (25%_ 100% Census Code # of Units # of Buildings Type of Construction _ Public Facility _ Accessory Building _ Greenhouse / Tent Antennae Interior Improvement _ Exterior Improvement Repair _ Water Damage 51 AV, too 0 Z • A REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) Foundation Drain Tile as, Occupancy Code Edition Zoning Stories Square Feet Length Width <Roof: _Decking _Insulation _Ice & Water _Final ✓ Framing Fireplace: _Rough In _Air Test _Final Insulation Meter Size: Final C/O Inspection: Schedule Fire Marshal to be present: /Yes Reviewed By: C'4/ C" , Building Inspector _ Exterior Alteration—Apartments _ Exterior Alteration—Commercial Exterior Alteration—Public Facility Siding Reroof Windows Fire Repair Demolish Building* Demolish Interior Demolish Foundation Retaining Wall *Demolition of entire building - give PCA handout to applicant 24907 Hoe • ✓S�}I eetrock Final / C.O. Required Final / No C.O. Required t/ Other: F/2& STD/,,PM/✓L Pool: _Footings Air/Gas Tests _Final Siding: _Stucco Lath _Stone Lath _Brick Windows Retaining Wall Erosion Control MCES System SAC Units ©//fl'eeli1H/G6/N £1Q OA a'G..GD. City Water ✓ Booster Pump PRV Fire Sprinklers ✓ LE+��— DNS No Reviewed By: Planning COMMERCIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC S&W Permit & Surcharge Treatment Plant Treatment Plant (Irrigation) Park Dedication Trail Dedication Water Quality 2/, f5-4..75-- / 5- 56.7S/5- 00. ae I `Ii 2-7/ . 19 Water Quality Water Supply & Storage (WAC) Storm Sewer Trunk Sewer Trunk Water Trunk Street Lateral Street Water Lateral Other: TOTAL37,72$.&f Page 2 of 3 44111/1' City of Eaaau 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 ‘111. Use BLUE or BLACK Ink For Office Use Permit Fee: O l ice, Permit #: Date Received: 1 2> ' 1 Staff: 2012 MECHANICAL PERMIT APPLICATION ❑ Please submit two (2) sets of plans with all commercial applications. Date: 12/4/12 Site Address: 3535 Blue Cross Road, Eagan MN Tenant: Blue Cross Blue Shield Suite #: J RESIDENT / OWNER Name: Blue Cross Blue Shield, Attn Randy Blaha Phone: 651-662-2542 Address / City / Zip: 3535 Blue Cross Road, Eagan MN CONTRACTOR Name: Metropolitan Mechanical Contractors, Inc. License #: 20-0832303 Address: 7450 Flying Cloud Drive City: Eden Prairie State: MN Zip: 55344 Phone: 612-269-2559 Contact: Erin Chapman Email: erin.chapman@metromech.com TYPE OF WORK X New Replacement Additional Alteration X Demolition Description of work: Add new cooling and condensing units to the existing data center. NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened by City Code. Please contact the Mechanical Inspector for information on permitted screening methods. PERMIT TYPE RESIDENTIAL Furnace COMMERCIAL New Construction Interior Improvement Air Conditioner X Install Piping Processed Air Exchanger Gas Exterior HVAC Unit Heat Pump Under / Above ground Tank ( Install / Remove) Other RESIDENTIAL FEES: $60.00 Minimum Add-on or alteration to an existing unit (includes $5.00 State bumed out appliances, ductwork, etc.) (includes Surcharge) $5.00 State Surcharge) = $ TOTAL FEE $100.00 Fire repair (replace COMMERCIAL FEES: $75.00 Underground tank installation/removal $60.00 Minimum (includes State (includes $5.00 State Surcharge) Surcharge) $1 million, please call for Surcharge OR Contract Value $ 3,200,000.00 x 1% = $ 32,000.00 Permit Fee *If the project valuation is over = $ 16.000 Surcharge* = $ 32,016.00 TOTAL FEE 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.gopherstateonecall.orq 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 Erin Chapman Applicant's Printed Name A plicant's Signet re FOR OFFICE USE (3 Required Inspections:/ Reviewed By: , `e. Date: t i U r2 --- Underground Y Rough In (Air Test Gas Service Test In -floor Heat d Final HVAC Screening Sarah Brandel From: Scott Peterson Sent: Monday, April 01, 2013 12:01 PM To: Sarah Brandel Subject: FW: BCBS Data Center Upgrades Scan please From: Erin Chapman[mailto:erin.chapman©METROMECH.COM] Sent: Tuesday, March 19, 2013 9:35 AM To: Scott Peterson Cc: Brett Christensen; Matt McGovern Subject: BCBS Data Center Upgrades Good Morning Scott, MMC has been working with mechanical permit EA108493 at BCBS for their Data Center Upgrades. The original permit was for (8) DX CRAC units. I wanted to let you know the owner has requested through an addendum the addition of one more 12 ton unit for their test lab. We will be calling for inspection of this unit in the next couple of weeks. Thank you, Erin Chapman erin.chapman@METROMECH.com Project Manager (612) 269-2559 cell METROPOLITAN MECHANICAL CONTRACTORS, INC. 7450 Flying Cloud Drive • Eden Prairie • Minnesota 55344-3723 Phone • (952) 941.7010 Fax • (952) 941.9118 • www.metromech.com 1 City of Eagan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 PUtilco"� Use BLUE or BLACK Ink For Office Use Permit #: Permit Fee: Date Received: Staff: 110307 2013 FIRE SUPPRESSION SYSTEMS PERMIT APPLICATION* Date: 5/1/2013 Site Address: 3535 Blue Cross Road Tenant: Blue Cross Blue Shield Suite #: *Requirements: 2 complete sets of drawings and specifications, cut sheets on materials and components to be used I hereby apply for a Fire Suppression System permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Minnesota Building/Fire Codes; 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 Appli 's Signature Name: Phone: illhlq rope ownerii. Address / City / Zip: — 1 Applicant is: Owner Contractor Iii Description of work: 11 III Ungoms, = Construction Cost: $11, 6 0 0 . 0 0 Estimated Completion Date: eti`���'il� Vii' = Name: JN Johnson Fire and Safety License#: TS0000324 t iiuii iiii I�Id ,11 ry �r Address: 4200 West 76th Street City: Minneapolis on rac 1 p� State: MN Zip: 55435 Phone: 952-835-4700 �iii il!t RandyAlee t` � Contact: Email: rcallee@jn-johnson.com FIRE PERMIT TYPE Sprinkler System (# of heads _) Fire Pump _ Standpipe_ X Other: L.'--fG— ka WORK TYPE X New Addition Alterations _ Remodel _ Other: DESCRIPTION OF WORK: X Commercial Residential Educational FEES $55.00 Minimum Contract Value $ 11, 600 .0 0 x 1 % *If the project valuation is over $1 million, please call for Surcharge = $ 116. 00 Permit Fee = $ 5.00 Surcharge* _ $ 121.0 0 TOTAL FEE 3/4" Displacement Fire Meter - $245.00 .$ Fire Meter =. $ TOTAL FEE *Requirements: 2 complete sets of drawings and specifications, cut sheets on materials and components to be used I hereby apply for a Fire Suppression System permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Minnesota Building/Fire Codes; 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 Appli 's Signature ~pPL 10795" Use BLUE or BLACK Ink For Office Use I 1 V I {FM1~ I Permit City of \J-1 I 3830 Pilot Knob Road Permit Fee: Eagan MN 55122 t , I Phone: (651) 675-5675 MAY 1~ u l_Qil I Date Received: I I Fax: (661)675-5694 I I Staff: 2012 MECHANICAL PERMIT APPLICATION ❑ Please submit two (2) sets of plans with all commercial applications.. Date: Mill`' i4 1K Site Address: 353 XPA& Tenant: &-of- Cwvoves, rwl> &W, Suite RESIDENT / OWNER Name: *P561~5 ®r- 1;V--j Phone: Address /City /Zip:1sS~j~✓~/r+yli 5 V.I9jtP Name: n«I~ ml;c* l b'V License MQ) z ~77-,q CONTRACTOR Address: s yymi~&Aqtwr 1;~nlai- City: i~zv, ~51, h~L State: ~J Zip: !5S075 Phone: 4, 62!l2" 2 2 Contacta~W1,*XX-/A/✓ Email:11_7 _ New - Replacement 4- Additional _ Alter tion Demolition TYPE OF WORK Description of work: YIADl~tl~1 DJ17 -Z 70C 9,b 4 PINT- R CW, Iow'N NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened by City Code., Please contactthe Mechanical Inspector for information on permitted screening methods. RESIDENTIAL COMMERCIAL Furnace New Construction _ Interior Improvement PERMIT TYPE -Air Conditioner Install Piping -Processed Air Exchanger Gas Exterior HVAC Unit - Heat Pump Under / Above ground Tank L_ Install Remove) Other 1XXXVW:rD 7;J0 ©A 146111V1 RESIDENTIAL FEES: $60.00 Minimum Add-on or alteration to an existing unit (includes $5.00 State Surcharge) $100.00 Fire repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) = $ TOTAL FEE COMMERCIAL FEES: $75.00 Underground tank installation/removal (includes $5.00 State Surcharge) OR Contract Value $ _ x1% $60.00 Minimum (includes State Surcharge) fpw Permit Fee - If the Permit Fee is less than $10,010, surcharge is $ 5.00 Surcharge - If the Permit Fee is > $10,010, surcharge increases by $.50 for each $1,000 Permit Fee (i.e. a $10,010-$11,010 Permit Fee requires a $ 5.50 surcharge) (,dg S~ TOTAL FEE 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.gopherstateonecall.or_q I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordin ces and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work i not to start without a permit; t t he work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. x dA) x Applicant's Printed Name Ap licant's Signature FOR OFFICE USE Required Inspection s~:~ viewed By: Date:-5/w// Underground : Rough In Air Test Gas Service Te t In-floor Heat Final HVAC Screening R 48 Use BLUE or BLACK Ink For Office Use Permit#: p I I PO ! I Eajan City of t I I Permit Fee: I 3830 Pilot Knob Road 1.° Eagan MN 55122 ' J 4 LJ1 I I Date Received: 5 Phone: (651) 675-5675 I I Fax: (651) 675-5694 I Staff: I f 2013 COMMERCIAL BUILDING PERMIT APPLICATION Date: Site Address: S ~ 131(,"e L- v°j S S l2caTenant Name: ✓;1 it C Cyo S S f~G~~ C~ r e'-1c; (Tenant is: New/ X Existing) Suite M Former Tenant: s~> r. _ Name: f5lG ytr s S w~ 5~L~,r W-P Phone: Property Owner Address / City / Zip: S ~;IVLe- S / l Applicant is: Owner Contractor h~ lGr✓E &~t c" / i f> (a irc°X ~G~ G~/1 e~ i Type of Work Description of work: ~1 , / Construction Cost: r Name: License a _ Address: 5 ZS" TfCi/f// S/ S6)Z->r64city: /')I /'L''~'/t Contractor pState: Zip: t) Phone: r 2- J 3 Z? S 5 / Contact: f~l A 12-46- Y L4 t LA-Z . /t Email rWi ele- mrX ' t 19`e It Name: V G.c Ad 1 Registration ei Architect/Engineer € Address: City: / ~ ~ e ei/t-i State: Zip: S 3 Phone: Gt 'rte G/Y►t O &2 r It " I y Contact Person Email: : O /0afC' 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. 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.aor)herstateonecall.ora 1 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 1 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 require r )ew and approval of plans. x W~~t C Applicant's Printed Name Applic nt's Signature Page 1 of 3 3535 131uk Gvo ss DO NOT WRITE BELOW THIS LINE //0 SUB TYPES _ Foundation _ Public Facility _ Exterior Alteration-Apartments d 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 JAA- Valuation DD Occupancy B MCES System Plan Review - Code Edition o7 M5A-e SAC Units /(/p LA iIrG~ /,r/v5E do OGG.. G+D . (25%_ 100%V Zoning City Water t/ Census Code Stories ft oog- Booster Pump # of Units Square Feet 33~ PRV # of Buildings Length Fire Sprinklers Type of Construction ~t • [7 Width REQUIRED INSPECTIONS Footings (New Building) VSheetrock Footings (Deck) 7 Final / C.O. Required Footings (Addition) ✓ Final / No C.O. Required Foundation Other: Drain Tile Pool: -Footings -Air/Gas Tests -Final Roof: -Decking -Insulation -Ice& Water -Final Siding: -Stucco Lath -Stone Lath -Brick Framing Windows Fireplace: -Rough In -Air Test -Final Retaining Wall Insulation Erosion Control Meter Size: t~ Final C/O Inspection: Schedule Fire Marshal to be present: V Yes No Reviewed By: L.Y.1f"v , Building Inspector Reviewed By: , Planning COMMERCIAL FEES Base Fee D . 7Sr Water Quality Surcharge S Z • rU Water Supply & Storage (WAC) Plan Review 7 D G • 3' Storm Sewer Trunk 49 MCES SAC Sewer Trunk City SAC Water Trunk S&W Permit & Surcharge Street Lateral Treatment Plant Street Treatment Plant (Irrigation) Water Lateral Park Dedication Other: Trail Dedication / Water Quality TOTAL ~B Y S• G'~` Page 2 of 3 CityofEaaafl 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use Permit #: 3 St t Permit Fee: W V • Date Received: LO ' C 3 Staff: 2013 COMMERCIAL FIRE ALARM PERMIT APPLICATION* Date: (p - 20 - 13 Site Address: SS 35- eh), C cess eo 41\ Tenant: QJurs 00,054 eh/ .S{,ie-k Name: 210E C¢0$5 L3Wuc1 Sh14 Phone: Suite #: Address / City / Zip: Applicant is: Owner x. Contractor Description of work: 40014+0r-.) 01 A Pee- - c+ow 5),c41,, i'o CNtisliss.,F.2& 4141 ft � Construction Cost: -1 , 3 (a 9 Estimated Completion Date: Name: Y)'i,NA) solo,. 0.00 w As/ License #: TS a 00 7 q 9 Address: '57.3 h'hwJ►b(r%srJia /4uc. W City: PaidI State: MA) Zip: ST/ 0 3 Phone: '57 - $8 - 07 7 1 Contact: 511 i$)t eoc.��-r Email: oL ,w e- nrrUCOwwa y. Loh, New X( Addition Alterations Remodel Other: DESCRIPTION OF WORK: X( Commercial Residential Educational FEES $55.00 Minimum *If the project valuation is over $1 million, please call for Surcharge Contract Value $ y, 3c, 9 x 1% _ $ SS . UCS Permit Fee = $ 5.00 Surcharge* _ $ 600. OO TOTAL FEE *Requirements: 2 complete sets of drawings and specifications, cut sheets on materials and components to be used I hereby apply for a Fire Alarm permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Minnesota Building/Fire Codes; 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 5 / bltr COG �� (4 Applicant's Printed Name plicant's Signature *City of Etan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use (� Permit #: 11 t i 1 i Permit Fee: j r7. ° a Date Received: -71 (1 13 Staff: 2013 FIRE SUPPRESSION SYSTEMS PERMIT APPLICATION* Date: 6-67-113 Site Address: 'S3S 311)C.-caS ka t 54n 01A 5_5I)a, Tenant: g (1-6 Cass ,3 it) c511Teti Suite #: J Property / OWt er Name: L I c-CrcSS ,eluc 6/1ie( Phone: Address / Applicant is: City / Zip: 3535 3 ( de, cr-c)S3 I2r0,J, L=c�4 n /11 r\ 5s1)....)...... Owner A Contractor Ty 0 Description Construction of work: 4 ; Pia Si7,s }rrn 4113 fa /ma- i cl3- EX Is --1 i rt y r Cost: Estimated Completion Date: V I 4 D7" Name: _ ik it i 1 A . � License #: 6-015 Address: 59 lA.AtL JA k 3 City: .I.-. 1 State: W Zip: 5,510.5 Phone: (oS/ ASA IITO Contact: an -5 f S\1 ra 1 In Email: sl,wa(11, n Suva r►i) 4 P m . cor-t FIRE PERMIT TYPE X Sprinkler System (# of heads SIO) WORK TYPE New Addition Fire Pump — Standpipe _ _ XAlterations _Remodel _ Other: Other: DESCRIPTION OF WORK: )(Commercial Residential Educational _ _ FEES $55.00 Minimum $1 million, please call for Surcharge Contract Value $ ‘/;18;1)-°‘) x 1% *If the project valuation is over = $ 2ira10 Permit Fee _ $ 5.00 Surcharge* = $ ,..e..7.00 TOTAL FEE 3/4" Displacement Fire Meter - $245.00 = $ Fire Meter _ $ ,e.7. 06 TOTAL FEE . 2 complete sets of drawings and specifications, cut sheets on materials and components to be used I hereby apply for a Fire Suppression System permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Minnesota Building/Fire Codes; 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 InS 0(511t,fietli Applicant's Printed Name Applicant's Sig ature FOR OFFICE USE REQUIRED INSPECTIONS �a •boss i' Trip Conditions of Issuance: Flow Alarm CA- A Use BLUE or BLACK Ink n ( ~ I For Office Use Lily O1 Eapn Permit ll v I 3830 Pilot Knob Road I Permit Fee: Zi> I I Eagan MN 55122 Date Received: Phone: (651) 675-5675 Fax: (651) 675-5694 Staff: ! 2013 COMMERCIAL PLUMBING PERMIT APPLICATION Please submit two (2) sets of plans with all commercial applications. Date:(/ /Z~L'YY Site Address: V+7~~ ~~~9~ Tenant: _ Gam//fib Suite Properly Owner Name: Phone: Name: License Contractor i Address: City: S(f~ StaterZip: ~J"Os`w i= Phone: Email: Type-Of Work - New _Replacement -Repair _Rebuild Modify Space - Work in R.O.W. Description of work: COMMERCIAL _ New Construction P' Modify Space _ Irrigation System C_ yes / _ no) RPZ / _ PVB) • Rain sensors required on irrigation systems Permit Type . Avg. GPM (2" turbo required unless smaller size allowed by Public Works) - Meters Call (651) 675-5646 to verity that tests passed prior to nicking up meter. Domestic: Size & Type Fire: 1 Avg. GPM High demand devices? Yes No Flushometers Yes No COMMERCIAL FEES Contract Value ©©O X.01 $55.00 Permit Fee Minimum _ $ 46 Permit Fee *If contract value is LESS than $10,010, Surcharge = $5.00 = $ L~ O Surcharge* **If contract value is GREATER than $10,010, Surcharge = Contract Value x $0.0005 we ***If the project valuation is over $1 million, please call for Surcharge = $ - TOTAL FEE Following fees apply when installing a new lawn irrigation system $ Water Permit Contact the City's Engineering Department, (651) 675-5646, for required fee amounts. $ Treatment Plant $ Water Supply & Storage $ State Surcharge TOTAL FEE 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.aonherstateonecall.oro 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 Applicant's Printed Name Applicant's Signature FOR OFFICE USE Approved By: Dater tf Required Inspections: 1(1-"Under Ground ough4n it Test Gas Test Final PRV Required: _ Yes Page 1 of 3 Use BLUE or BLACK Ink For Office Use I I < I City of Ea an i Permit J s E I Permit Fee: r 3830 Pilot Knob Road Eagan MN 55122 i I I I Date Received: I Phone: (651) 675-5675 I I Fax: (651) 675-5694 Staff: 2013 COMMERCIAL BUILDING PERMIT APPLICATION , Date: 09/06/2013 Site Address: 3535 Blue Cross Road Tenant Name: (Tenant is: New / Existing) Suite M Former Tenant: Name:Blue Cross Blue Shield of Minnesota Phone: Property Owner Address/City/zip: 3535 Blue Cross Road N Applicant is: Owner X Contractor Type of Work Description of work: Remodel Fitness Center Construction Cost: $487,700. Name:C. F. Haglin & Sons, Inc. License Contractor Address: 3939 West 69th Street city: Edina State: MN zip: _ 55435 Phone: 952-920-6123 Contact: Gary Gunderson Email: ggunderson@cfhaglin.com Name: Architectural Alliance Registration 20915 Address: 400 Clifton Ave So City: Minneapolis Architect/Engineer State: MN Zip: 55403-5703 Phone: Jon Stone 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 the are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for prote on against nderground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www. o rstateone l.or I hereby acknowledge that this information is complete and accurate; that the worVin icore ance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an d work is not to start without a per t; hat e work will be in accordance th the approved plan in the cas of wo iew and approval of plans. x x Applicant' Printed Name Ap ican Page 1 of 3 4 ► DO NOT WRITE BELOW THIS LINE (S 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 no Valuation 13¢ g~ Occupancy $ MCES System Plan Review ✓ Code Edition 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) Sheetrock Footings (Deck) Final i C.O. Required Footings (Addition) Final / No C.O. Required Foundation Other: Drain Tile Pool: -Footings -Air/Gas Tests -Final Roof: -Decking -Insulation -Ice & Water -Final Siding: -Stucco Lath -Stone Lath -Brick ✓ Framing Windows Fireplace: -Rough In -Air Test -Final Retaining Wall Insulation Erosion Control Meter Size: Final C/O Inspection: Schedule Fire Marshal to be present: Yes No Reviewed By: 6ek14 , Building Inspector Reviewed By: , Planning COMMERCIAL FEES Base Fee Water Quality Surcharge Water Supply & Storage (WAC) Plan Review ° 7 Storm Sewer Trunk MCES SAC >3?b • r•-t. Sewer Trunk City SAC 26e • Water Trunk S&W Permit & Surcharge Street Lateral Treatment Plant GD2 - wv Street Treatment Plant (Irrigation) Water Lateral Park Dedication Other: Trail Dedication Water Quality TOTAL 12~ .5• Page 2 of 3 Dale Schoeppner September 16, 2013 Chief Building Official City of Eagan 3830 Pilot Knob Road Eagan, MN 55122-1810 Dear Mr. Schoeppner: The Metropolitan Council Environmental Services (MCES) Division has determined the SAC to be charged for the wastewater capacity demand for Blue Cross Blue Shield of Minnesota fitness center to be located at 3535 Blue Cross Road within the City of Eagan. The City will be charged 2 SAC Units for this project, as determined below. SAC Units Charges: Lockers 40 lockers @ 14 lockers/SAC 2.06 Credits: Office (SAC paid 10/74) 2931 sq. ft. @ 2400 sq. ft. /SAC 1.22 Net Charge: 1.64 or 2 The business information was provided to MCES by the applicant at this time. It is the City's responsibility to substantiate the business use and size at the time of the final inspection. If there is a change in use or size, a redetermination will need to be made. If you have any questions, email me at Jessica.Nye@metc.state.mn.us. Sincerely, )Ab~l Jessie Nye Supervisor, ES Revenue (SAC) JN:kg: 130916A2 Determination expiration: 09/16/2015 cc: Amy Griffin, Eagan (email) Gary Gunderson, C.F. Haglin & Sons (email) File, MCES I Popp- • • - Street North St. Paul, MN 55101-1805 Equal Opportunity Employer c 0 U N C I L Use BLUE or BLACK Ink For Office Use n j I Permit City of Eaad s~ 3830 Pilot Knob Road Permit Fee: Eagan MN 55122 I Date Received: I Phone: (651) 675-5675 Fax: (651) 675-5694 I Staff: - - - - - - - - - - - - - - - - J 2013 COMMERCIAL BUILDING PERMIT APPLICATION Date: 09/08/2013 Site Address: 3535 Blue Cross Road Tenant Name: N/A (Tenant is: New / Existing) Suite M Former Tenant: Name: Blue Cross Blue Shield of Minnesota Phone: 651-662-2542 Property Owner Address/City/Zip: 3535 Blue Cross Road, Eagan, MN 55122 Applicant is: Owner X Contractor Description of work: Provide New Handicap Access & Stairs At Employee Type of Work Entrance $40,000.00 Construction Cost: Name: C. F. Haglin & Sons, Inc. License Address: 3939 West 69th Street City: Edina Contractor State: MN Zip: 55435 Phone: 952-920-6123 Contact: Gary Gunderson Email: ggunderson@cfhaglin.com Name: Architectural Alliance Registration 20915 Architect/Engineer Address: 400 Clifton Avenue South City: Minneapolis State: MN Zip: 55403 Phone: Contact Person: Jon Stone 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 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. herstateonecall.or I hereby acknowledge that this information is complete and accurate; that the work ill be in c ormance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an appli t n for it, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case hich es a review and approval of plans. x e?A7_'~ GUI'sb';cy~~rz x Applicants Printed Name A lic f s Si ure Page 1 of 3 1 /533 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 V 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 / A ,ice Valuation Occupancy ~ MCES System A/ euDat-- *LT Plan Review r` Code Edition 2x7M5&- SAC Units (25%_ 100%_.!:~ Zoning City Water Census Code Stories Booster Pump # of Units G" Square Feet PRV # of Buildings Length Fire Sprinklers Type of Construction 6~ A- Width REQUIRED INSPECTIONS Footings (New Building) Sheetrock Footings (Deck) Final / C.O. Required Footings (Addition) 7' Final / No C.O. Required Foundation Other: Drain Tile Pool: -Footings -Air/Gas Tests -Final Roof: -Decking -Insulation -Ice & Water -Final Siding: -Stucco Lath -Stone Lath -Brick Framing Windows Fireplace: -Rough In -Air Test -Final Retaining Wall Insulation Erosion Control Meter Size: Final C/O Inspection: Schedule Fire Marshal to be present: Yes No Reviewed By: Building Inspector Reviewed By: , Planning COMMERCIAL FEES Base Fee S 7 . 2 5- Water Quality Surcharge 2-0 • e"U Water Supply & Storage (WAC) Plan Review 3.73 • Z L Storm Sewer Trunk MCES SAC Sewer Trunk City SAC Water Trunk S&W Permit & Surcharge Street Lateral Treatment Plant Street Treatment Plant (Irrigation) Water Lateral Park Dedication Other: Trail Dedication Water Quality TOTAL 9fi7• Page 2 of 3 Ar- 1,9 5.74 Use BLUE or BLACK Ink `p n For Office Use Permit#: I , C*ty of Evan 3830 Pilot Knob Road gO~eJ I Permit Fee: Eagan MN 55122 1 l~ Phone: (651) 675-5675 oC~4 i Date Received: Q 7 ~3 Fax: (651) 675-5694 Staff; j - 2012 MECHANICAL PERMIT APPLICATION ❑ Please submit two (2) sets of plans with all commercial applications. Date:-~_Y o'XeAV)?)Site Address: 3534' libLJtr 4A4*6 A&" Tenant: Suite RESIDENT / OWNER Name: ULJ Cbp!~6 V_,,t.JE -%40.-&t0 Phone: Address / City / Zip: 353 )SLOC ah0611 UP" Name: 41 oll((4 y31 13'h~JLAt+ License MQ') CONTRACTOR Address: ~S RR.tbG6-~01J;Jr j>n.►Vt' City: 0 State: M Al Zip: J ~D7 Phone: ~isl " 6 Q 3 3 Contact:~_~_U#IvA 1DIJ Email:cl$EX.TIJ & !5&"&2jCA --Aq "Gds- ~o _ New Replacement .Additional _ Alteration Demolition TYPE OF WORK Description of work: , 1z P `10W IrLLZ 00i `nr) NOTE: Roof mounted andground mounted-mechanical equipment is required to be screened by-City Code. Please contact`:the Mechanical Inspector for information on permitted screening methods. RESIDENTIAL COMMERCIAL Furnace New Construction 001'n'~erior Improvement PERMIT TYPE -Air Conditioner -Install Piping -Processed Air Exchanger Gas - Exterior HVAC Unit - Heat Pump Under / Above ground Tank L_ Install Remove) Other RESIDENTIAL FEES: $60.00 Minimum Add-on or alteration to an existing unit (includes $5.00 State Surcharge) $100.00 Fire repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) = $ TOTAL FEE COMMERCIAL FEES: $75.00 Underground tank installation/removal (includes $5.00 State Surcharge) OR Contract Value $ x1% $60.00 Minimum (includes State Surcharge) Qn Permit Fee - If the Permit Fee is less than $10,010, surcharge is $ 5.00 e4P/ Surcharge If the Permit Fee is > $10,010, surcharge increases by $.50 for each $1,000 Permit Fee (i.e. a $10,010-$11,010 Permit Fee requires a$ 5.50 surcharge) = $ d TOTAL FEE 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.aopherstateonecall.org I hereby acknowledge that this information is complete and accurate; that the work will be i 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 t to start without a permit; that th ork will be in accordance with the approved plan in the case of work which requires a review and approval of plans. x.rA-K 5 L. x Applicant's Printed Name A licant's Signature FOR OFFICE USE Required Inspections: ! Reviewed By: Date: Underground Rough In Air Test Gas Service Test In-floor Heat Final HVAC Screening Y E-C_l evec1 Use BLUE or BLACK Ink reG 1~r~ For Office Use I City of Ea (in I J01. I Permit Fee: I 3830 Pilot Knob Road I I Eagan MN 55122 Q ~~1~ I I Phone: (651) 675-5675 Date Received: IQ I % I Fax: (651) 675-5694 I I ~ Staff: ~ 2013 FIRE SUPPRESSION SYSTEMS PERMIT APPLICATION* Date: {r ~13 Site Address: 3535 ':W(, a- ~ xc',~ _ Tenant: Suite Name: Phone: pry O.Wil.er. Address /City / Zip:_ Applicant is: Owner /Contractor Description of work: t? rype~( Construction Cost: zoo Estimated Completion Date: tea _ ~13 r.. R Name: License 0 ~xfi+w Address: City: r~ State: Zip: Phone: ids/' j k YyYy~ . Contact vim-- Email FIRE PERMIT TYPE WORK TYPE Sprinkler System of heads 4) - New - Addition Fire Pump Standpipe 'Alterations Remodel Other: Other: DESCRIPTION OF WORK: Commercial _ Residential _ Educational FEES $55.00 Minimum Contract Value $ 62-00 x 1%u *If the project valuation is over $1 million, please call for Surcharge = $--p a- Permit Fee = $ 5.00 Surcharge* = $ Lo -7 - TOTAL FEE 3/4" Displacement Fire Meter - $245.00 Fire Meter TOTAL FEE *Requirements: 2 complete sets of drawings and specifications, cut sheets on materials and components to be used I hereby apply for a Fire Suppression System permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Minnesota Buildi Fire Codes; that I understand this is not a permit, but a re only an application for a permit, and work is not to start without a permit; that the work will be ' 12 ap oved plan in the case of work with the JU which requires a review and approval of plans. _a A X x ~AA.P4 Applicant's Printed Name Applicant's Signature OFFICE USEM REQUIRED INSPECTIONS Hydrostatic Flow Alarm Drain Test Rou Trip Pump Test Permit Reviewed by: '" ;Date: 443 Lafayette Road N. MINNESOTA DEPARTMENT OF (651) 284-5005 St. Paul, Minnesota 55155 1-800-DIAL-DLI www.dii.mn.gov LABOR III DUSTRY' TTY: (651) 297-4198 AMk 10/8/2013 OCT Q 9 1013 APPROVED FOR USE Blue Cross Blue Shield of Mn PO Box 64560 St Paul, MN 55164 RE: TRACTION PASSENGER Elevator ID# ELV-1002705 Site: BLUE CROSS BLUE SHIELD NORTH CAR 3535 Blue Cross Rd EAGAN, MN 55122 Dear Sir/Madam: Minnesota Statutes Chapter 326B provides that the Department of Labor and Industry, Construction Codes 8: Licensing Unit, Elevator Safety Section, inspect and approve elevators and maniifts (endless belt lifts) before they can be legally used in Minnesota. An Inspector from the Elevator Safety Section recently inspected your facility and determined it meets requirements of the Minnesota Elevator Safety Code. NOTE: Compliance with Minnesota Rules and the ANSI/ASME A17.1, Safety Code for Elevators and Escalators does not necessarily assure compliance with the Americans With Disabilities Act of 1990. NOTE: THIS APPROVAL APPLIES TO WORK PERFORMED BY OTIS ELEVATOR. ALL ELEVATOR RELATED EQUIPMENT IS SUBJECT TO ANNUAL RENEWAL OF THE OPERATING PERMIT: It is the owner's responsibility to maintain and keep current with all tests in accordance with the ASME A17.1 and the ASME A17.3. Frequencies for the required tests can be found in Chapter 1307 of the Minnesota State Building Code. Failure to maintain and perform the required tests may result in revocation of the annual operating permit. Operation of an elevator related device without a valid operating permit may result in an issuance of a "stop order" from the department and possible penalty of up to $10,000. For more information see our website at: http://www.dIi.mn.gov/CCLD/Elevator.asp Sincerely, N TRUCTION CODES & LICENSING - Donna Hix State Elevator Inspector c: OTIS ELEVATOR COMPANY Dale Schoeppner, City of Eagan Building Official ElFormCE2 This information can be provided to you in alternative formats (Braille, large print or audio). An Equal Opportunity Employer 443 Lafayette Road N. MINNESOTA DEPARTMENT OF (651) 284-5005 St. Paul, Minnesota 55155 1-800-DIAL-DLI www.dli.mn.gov LABOR I DUST Y TTY: (651) 297-4198 10/30/2013 APPROVED FOR USE Blue Cross Blue Shield of Mn PO Box 64560 St Paul, MN S 4-- - RE- TRACTION PASSENGER ator ID# ELV-1002704 e: BLUE CROSS BLUE SHIELD TOWER CAR 3535 Blue Cass Rd MEAGAN, N 55122 De Minnesota Statutes Chapter 3268 provides that the Department of Labor and Industry, Construction Codes & Licensing Unit, Elevator Safety Section, inspect and approve elevators and manlifts (endless belt lifts) before they can be legally used in Minnesota. An Inspector from the Elevator Safety Section recently inspected your facility and determined it meets requirements of the Minnesota Elevator Safety Code. NOTE: Compliance with Minnesota Rules and the ANSI/ASME A17.1, Safety Code for Elevators and Escalators does not necessarily assure compliance with the Americans With Disabilities Act of 1990. NOTE: THIS APPROVAL APPLIES TO CODE COMPLIANCE ISSUES. ALL ELEVATOR RELATED EQUIPMENT IS SUBJECT TO ANNUAL RENEWAL OF THE OPERATING PERMIT: It is the owner's responsibility to maintain and keep current with all tests in accordance with the ASME A17.1 and the ASME A17.3. Frequencies for the required tests can be found in Chapter 1307 of the Minnesota State Building Code. Failure to maintain and perform the required tests may result in revocation of the annual operating permit Operation of an elevator related device without a valid operating permit may result in an issuance of a "stop order" from the department and possible penalty of up to $10,000. For more information see our website at: http://www.dli.mn.gov/CCLD/Elevator.asp Sincerely, CONSTRUCTION CODES & LICENSING Tim Warren State Elevator Inspector c: OTIS ELEVATOR COMPANY Dale Schoeppner, City of Eagan Building Official ElFormCE2 This information can be provided to you in alternative formats (Braille, large print or audio). An Equal Opportunity Employer 443 Lafayette Road N. I ES,OTA DEPARTMENT OF (651) 284-5005 St. Paul, Minnesota 55155 1-800-DIAL-DLI www.dli.mn.gov LABOR INDUSTRY TTY: (651) 297-4198 10/30/2013 APPROVED FOR USE Blue Cross Blue Shield of Mn PO Box 64560 St Paul, MN 55164 RE: CTION PASSENGER E levator ID# ELV-1002704 Site: BLUE CROSS BLUE SHIELD TOWER CAR 3535 Blue Cross Rd ALAN, MN 55122 Dear Sir/Madam: Minnesota Statutes Chapter 326B provides that the Department of Labor and Industry, Construction Codes & Licensing Unit, Elevator Safety Section, inspect and approve elevators and manlifts (endless belt lifts) before they can be legally used in Minnesota. An Inspector from the Elevator Safety Section recently-inspected your facility and determined it meets requirements of the Minnesota Elevator Safety Code. NOTE: Compliance with Minnesota Rules and the ANSI/ASME A17.1, Safety Code for Elevators and Escalators does not necessarily assure compliance with the Americans With Disabilities Act of 1990. NOTE: THIS APPROVAL APPLIES TO THE FIRE SERVICE OVERLAY. ALL ELEVATOR RELATED EQUIPMENT IS SUBJECT TO ANNUAL RENEWAL OF THE OPERATING PERMIT: It is the owner's responsibility to maintain and keep current with all tests in accordance with the ASME A1.7.1 and the ASME A17.3. Frequencies for the required tests can be found in Chapter 1307 of the Minnesota State Building Code. Failure to maintain and perform the required tests may result in revocation of the annual operating permit. Operation of an elevator related device withouta valid operating permit may result in an issuance of a "stop order" from the department and possible penalty of up to $10,000. For more information see our website at: http://www.dli.mn.gov/CCLD/Elevator.asp Sincerely, CONSTRUCTION CODES & LICENSING Tim Warren State Elevator Inspector c: OTIS ELEVATOR COMPANY Dale Schoeppner, City of Eagan Building Official ElFormCE2 This information can be provided to you in alternative formats (Braille, large print or audio). An Equal Opportunity Employer 443 Lafayette Road N. St, Paul, Minnesota 55155 www.dli.mn.gov 11/27/2013 LABOR Blue Cross Blue. Shield of Mn PO Box 64560 St Paul, MN 55164 RE: HY Site: 0 IC PASSENGER lue Cross Blue Shield Main Car 3535 blue Cross rid EAGAN, MN 55122 Dear Sir/Madam: ffiw 6 r 9 ivii B. c 1 OF IT.. (651) 2845005 1 -800 -DIAL -DLI TTY: (651) 297-4198 APPROVED FOR USE Elevator ID# ELV-10434 Minnesota Statutes Chapter 326B provides that the Department of Labor and Industry, Construction Codes & Licensing Unit, Elevator Safety Section, inspect and approve elevators and manlifts (endless belt lifts) before they can be legally used in Minnesota. An Inspector from the Elevator Safety Section recently inspected your facility and determined it meets requirements of the Minnesota Elevator Safety Code. NOTE: Compliance with Minnesota Rules and the ANSI/ASME A17.1, Safety Code for Elevators and Escalators does not necessarily assure compliance with the Americans With Disabilities Act of 1990. NOTE: THIS APPROVAL APPLIES TO THE FIRE SERVICE UPGRADE. ALL ELEVATOR RELATED EQUIPMENT IS SUBJECT TO ANNUAL RENEWAL OF THE OPERATING PERMIT: It is the owner's responsibility to maintain and keep current with all tests in accordance with the ASME A17.1 and the ASME A17.3. Frequencies for the required tests can be found in Chapter 1307 of the Minnesota State Building Code. Failure to maintain and perform the required tests may result in revocation of the annual operating permit. Operation of an elevator related device without a valid operating permit may result in an issuance of a "stop order" from the department and possible penalty of up to $10,000. For more information see our website at: http://www.dli.mn.gov/CCLD/Elevator.asp incerely, CTIOMODE LICENSING Donna Hix State Elevator Inspector c: OTIS ELEVATOR COMPANY Dale Schoeppner, City of Eagan Building Official ElFormCE2 This information can be provided to you in alternative formats (Braille, large print or audio). An Equal Opportunity Employer Dec. 26. 2013 12:26PM LVC JNJ 4,11' City of Eqpt 3830 Pilot Knob Road Eagan MN 65122 Phone: (661) 676-5676 Fax: (651) 6765694 No. 0659 P 2 Use BLUE or BLACK Ink For Office Use Penult #: Pemttt Fee: Dale Received: Staff: 2013 COMMERCIAL FIRE ALARM PERMIT APPLICATION* Date: 12.11.-1P11. Site Address: 53S 1 u.e, i rnss korai , get �a i M.1S1 S S 17,2, • t Property Owner. Name: ?Auk. Cross Blue Sh IP/1.CI Phone: Address lCity /Zip: Applicant Is: 3535 EW -L C,roSS It mei ,9 &..vt A41\1SS12..2 Owner X Contractor J Type of Work Description of work: Construction Cost: T5fall Are, LitGtYio i#ltuI0.3 In 11L,W ii'+ Pu. sS Caller 41,0(0 i On Estimated Completion bate: IZ I Z3I i 3 Contractor Name: Low V014 -age COr l rS 'inc. License #: TS 00375 Address: 1-I200 Whht 7104" StYtL* City: Eat AA State; AAN Zip: Ss1-135 Phone: el 52 Z. el 2' 721 Contact: Sa.cob 13ehvn Email: ' bc.h ryi gIkiCAl1L.(,0{vl Work Type, - _ New Addition )( Alterations _ Remodel Other. DESCRIPTION OF WORK: X Commercial _ Residential Educational FEES 155.00 Permit Fee Minimum Contract Value $ I, 0 (r. 00 x .01 = $ 55.00 Permit Fee 'If contract value is LESS than $10,010, Surcharge "If contract value is GREATER than $10,010, 'If the project valuation Is over $1 million, please = $5.00 Surcharge ; Contract Value x $0.0005 = $ S. 0 0 Surcharge* call for Surcharge = $ 50 -0 0 TOTAL FEE 'Requirements: 2 complete sets of drawings and specifications, cut sheets on materials and components to be used 1 hereby apply for a Fire Alarm permit and acknowledge That the Information Is complete and accurate; that the work will be In conformance with the ordinances and codes of the City of Eegan end with the Minnesole BuildinglFire Codes: that I understand this Is not a permit, but only on application for a permll, 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 Sfit.o b $ewvin Applicant's Printed Name FOR OFFICE USE Required Inspections: Reviewed By icant's Signature Rough -In f=inal • Fire Alarm Test Date: h2 —30'13 443 Lafayette Road N. MINNESOTA DEPARTMENT OF (651) 284-5005 St. Paul, Minnesota 55155 7 1 -800 -DIAL -DU www.dli.mn.gov LABOR 8c INDUSTRY TTY: (651) 297-4198 1/2/2014 Blue Cross Blue Shield of Mn PO Box 64560 St Paul, M 164 RE: YDRAULIC FREIGHT Site Blue Cross Blue Shield Frt Car 3535 Blue Cross Rd GAN MN 55122 Dear Sir/Madam: JAN 062014 APPROVED FOR USE Elevator ID# ELV-16264 Minnesota Statutes Chapter 326B provides that the Department of Labor and Industry, Construction Codes & Licensing Unit, Elevator Safety Section, inspect and approve elevators and manlifts (endless belt lifts) before they can be legally used in Minnesota. An Inspector from the Elevator Safety Section recently inspected your facility and determined it meets requirements of the Minnesota Elevator Safety Code. NOTE: Compliance with Minnesota Rules and the ANSI/ASME A17.1, Safety Code for Elevators and Escalators does not necessarily assure compliance with the Americans With Disabilities Act of 1990. NOTE: THIS APPROVAL APPLIES TO WORK PERFORMED BY OTIS ELEVATOR. ALL ELEVATOR RELATED EQUIPMENT IS SUBJECT TO ANNUAL RENEWAL OF THE OPERATING PERMIT: It is the owner's responsibility to maintain and keep current with all tests in accordance with the ASME A17.1 and the ASME A17.3. Frequencies for the required tests can be found in Chapter 1307 of the Minnesota State Building Code. Failure to maintain and perform the required tests may result in revocationof the annual operating permit. Operation of an elevator related device without a valid operating permit may result in an issuance of a "stop order" from the department and possible penalty of up to $10,000. For more information see our website at: http://www.dli.mn.gov/CCLD/Elevator.asp Sincerely, CONSTRUCTION CODES & LICENSING Tim Warren State Elevator Inspector c: OTIS ELEVATOR COMPANY Dale Schoeppner, City of Eagan Building Official ElFormCE2 This information can be provided to you in alternative formats (Braille, Targe print or audio). An Equal Opportunity Employer 443 Lafayette Road N. MINNESOTA DEPARTMENT OF (651) 2845005 St. Paul, Minnesota 55155. LABOR & iND i 1-800-342-5354.. www.dli.mn.gov I ND 1 2/12/2014 APPROVED FOR USE FF11 1014 Blue Cross Blue Shield of Mn PO Box 64560 St Paul, MN 55164 RE: ESCALATOR Elevator ID# ELV-15336 Site: ross Blue Shie sc 2 (2-1 Dwn) 3535 Blue Cross Rd . EAGAN, MN 55122 Dear Sir/Madam: Minnesota Statutes Chapter 326B provides that the Department of Labor and Industry, Construction Codes & Licensing Unit, Elevator Safety Section, inspect and approve elevators and manlifts (endless belt lifts) before they can be legally used in Minnesota. An Inspector from the Elevator Safety Section recently inspected your facility and determined it meets requirements of the Minnesota Elevator Safety Code. NOTE: Compliance with Minnesota Rules and the ANSI/ASME A17.1, Safety Code for Elevators and Escalators does not necessarily assure compliance with the Americans With Disabilities Act of 1990. NOTE: THIS APPROVAL APPLIES TO WORK PERFORMED BY OTIS ELEVATOR. ALL ELEVATOR RELATED EQUIPMENT IS SUBJECT TO ANNUAL RENEWAL OF THE OPERATING PERMIT: It is the owner's responsibility to maintain and keep current with all tests in accordance with the ASME A17.1 and the ASME A17.3. Frequencies for the required tests can be found in Chapter 1307 of the Minnesota State Building Code. Failure to maintain and perform the required tests may result in revocation of the annual operating permit. Operation of an elevator related device without a valid operating permit may result in an issuance of a "stop order" from the department and possible penalty of up to $10,000. For more information see our website at: http://www.dii.mn.gov/CCLD/Elevator.asp Sincer CO TR TION CODES & LICENSING Brad Underdahl State Elevator Inspector c: OTIS ELEVATOR COMPANY Dale Schoeppner, City of Eagan Building Official ElFormCE2 This information can be provided to you in alternative formats (Braille, large print or audio). An Equal Opportunity Employer 443 Lafayette Road N. MINNESOTA DEPARTMENT OF (651) 284-5005 St. Paul, Minnesota 55155 LABOR & INDUSTRY ~-$0.0.342-5354 - www.dli.mn.gov 2/12/2014 APPROVED FOR USE Blue Cross Blue Shield of Mn PO Box 64560 1Q14 St Paul, MN 55164 RE: ESCALATOR Elevator ID# ELV-15335 Site: B ross Blue Id Esc 1 (1-2 Up) 3535 Blue Cross Rd EAGAN, MN 55122 Dear Sir/Madam: Minnesota Statutes Chapter 326B provides that the Department of Labor and Industry, Construction Codes & Licensing Unit, Elevator Safety Section, inspect and approve elevators and manlifts (endless belt lifts) before they can be legally used in Minnesota. An Inspector from the Elevator Safety Section recently inspected your facility and determined it meets requirements of the Minnesota Elevator Safety Code NOTE: Compliance with Minnesota Rules and the ANSI/ASME A17.1, Safety Code for Elevators and Escalators does not necessarily assure compliance with the Americans With Disabilities Act of 1990. NOTE: THIS APPROVAL APPLIES TO WORK PERFORMED BY OTIS ELEVATOR. ALL ELEVATOR RELATED EQUIPMENT IS SUBJECT TO ANNUAL RENEWAL OF THE OPERATING PERMIT: It is the owner's responsibility to maintain and keep current with all tests in accordance with the ASME A17.1 and the ASME A17.3. Frequencies for the required tests can be found in Chapter 1307 of the Minnesota State Building Code. Failure to maintain and perform the required tests may result in revocation of the annual operating permit. Operation of an elevator related device without a valid operating permit may result in an issuance of a "stop order" from the department and possible penalty of up to $10,000. For more information see our website at: http://www.dli.mn.gov/CCLD/Elevator.asp Sincer C T CTION CODES & LICENSING Bra n rdahI State Elevator Inspector c: OTIS ELEVATOR COMPANY Dale Schoeppner, City of Eagan Building Official ElFormCE2 This information can be provided to you in alternative formats (Braille, large print or audio). An Equal Opportunity Employer 443 Lafayette Road N. St. Paul, Minnesota 55155 www.dli.mn.gov 3/6/2014 MINNESOTA DEPARTMENT OF LABOR & INDUSTRY Blue Cross Blue Shield of Mn PO Box 64560 St Paul, MN 55164 - RE: ESCALATOR Sit- Blue Cross Blue Shield Esc 5 (3-4 Up) 3535 Blue Cross Rd EAGAN, MN 55122 Dear Sir/Madam: (651) 284-5005 1-800-342-5354 APPROVED FOR USE Elevator ID# ELV-15339 Minnesota Statutes Chapter 326B provides that the Department of Labor and Industry, Construction Codes & Licensing Unit, Elevator Safety Section, inspect and approve elevators and manlifts (endless belt lifts) before they can be legally used in Minnesota. An Inspector from the Elevator Safety Section recently inspected your facility and determined it meets requirements of the Minnesota Elevator Safety Code. NOTE: Compliance with Minnesota Rules and the ANSI/ASME A17.1, Safety Code for Elevators and Escalators does not necessarily assure compliance with the Americans With Disabilities Act of 1990. NOTE: THIS APPROVAL APPLIES TQ WORK PERFORMED BY OTIS ELEVATOR. ALL ELEVATOR RELATED EQUIPMENT IS SUBJECT TO ANNUAL RENEWAL OF THE OPERATING PERMIT: It is the owner's responsibility to maintain and keep current with all tests in accordance with the ASME A17.1 and the ASME A17.3. Frequencies for the required tests can be found in Chapter 1307 of the Minnesota State Building Code. Failure to maintain and perform the required tests may result in revocation of the annual operating permit. Operation of an elevator related device without a valid operating per mit may result in an issuance of a "stop order" from the department and possible penalty of up to $10,000. For more information see our website at: http://www.dli.mn.gov/CCLD/Elevator.asp Sincer CO TION CODES &LICENSING L {" Brad Underdahl State Elevator lnspector c: OTIS ELEVATOR COMPANY Dale Schoeppner, City of Eagan Building Official ElFormCE2 This information can be provided to you in alternative formats (Braille, large print or audio). An Equal Opportunity Employer 443 Lafayette Road N. St. Paul, Minnesota 55155 www.dli.mn.gov 3/6/2014 i MINNESOTA DEPARTMENT OF LABOR & INDUSTRY Blue Cross Blue Shield of Mn PO Box 64560 St Paul, MN 551 RE: Si Dear ESCALATOR Blue Cross Blue Shield Esc 6 (4-3 Dwn) 3535 Blue Cross Rd EAGAN, MN 55122 (651) 284-5005 1-800-342-5354 APPROVED FOR USE Elevator ID# ELV-15340 Minnesota Statutes Chapter 326B provides that the Department of Labor and Industry, Construction Codes & Licensing Unit, Elevator Safety Section, inspect and approve elevators and manlifts (endless belt lifts) before they can be legally used in Minnesota. An Inspector from the Elevator Safety Section recently inspected your facility and determined it meets requirements of the Minnesota Elevator Safety Code. NOTE: Compliance with Minnesota Rules and the ANSI/ASME A17.1, Safety Code for Elevators and Escalators does not necessarily assure compliance with the Americans With Disabilities Act of 1990. NOTE: THIS APPROVAL APPLIES TO WORK PERFORMED BY OTIS ELEVATOR. ALL ELEVATOR RELATED EQUIPMENT IS SUBJECT TO ANNUAL RENEWAL OF THE OPERATING PERMIT: It is the owner's responsibility to maintain and keep current with all tests in accordance with the ASME A17.1 and the ASME A17.3. Frequencies for the required tests can be found in Chapter 1307 of the Minnesota State Building Code. Failure to maintain and perform the required tests may result in revocation of the annual operating permit. Operation of an elevator related device without a valid operating permit may result in an issuance of a "stop order" from the department and possible penalty of up to $10,000. For more information see our website at: http://www.dli.mn.gov/CCLD/Elevator.asp Sincerely, CO CTION CODES & LICENSING State Elevator Inspector c: OTIS ELEVATOR COMPANY Dale Schoeppner, City of Eagan Building Official ElFormCE2 This information can be provided to you in alternative formats (Braille, large print or audio). An Equal Opportunity Employer 443 Lafayette Road N. St. Paul, Minnesota 55155 www.dli.mn.gov 2/28/2014 MINNESOTA DEPARTMENT OF LABOR. & INDtJSTICY Blue Cross Blue Shield of Mn PO Box 64560 St Paul, RE: Si Dea 5164 ESCALATOR Blue Cross Blue Shield Esc 3 (2-3 Up) 3535 Blue Cross Rd EAGAN, MN 55122 Sir/Madam: (651) 284-5005 1.800-342-5354 APPROVED FOR USE Elevator ID# ELV-15337 Minnesota u es Chapter 3266 provides that the Department of Labor and Industry, Construction Codes & Licensing Unit, Elevator Safety Section, inspect and approve elevators and manlifts (endless belt lifts) before they can be legally used in Minnesota. An Inspector from the Elevator Safety Section recently inspected your facility and determined it meets requirements of the Minnesota Elevator Safety Code. NOTE: Compliance with Minnesota Rules and the ANSI/ASME A17.1, Safety Code for Elevators and Escalators does not necessarily assure compliance with the Americans With Disabilities Act of 1990. NOTE: THIS APPROVAL APPLIES TO WORK PERFORMED BY OTIS ELEVATOR. ALL ELEVATOR RELATED EQUIPMENT IS SUBJECT TO ANNUAL RENEWAL OF THE OPERATING PERMIT: It is the owner's responsibility to maintain and keep current with all tests in accordance with the ASME A17.1 and the ASME A17.3. Frequencies for the required tests can be found in Chapter 1307 of the Minnesota State Building Code. Failure to maintain and perform the required tests may result in revocation of the annual operating permit. Operation of an elevator related device without a valid operating permit may result in an issuance of a "stop order" from the department and possible penalty of up to $10,000. For more information see our website at: http://www.dli.mn.gov/CCLD/Elevator.asp Sinc UCTION CODES & LICENSING Bra• nd-rdahl State Elevator lnspector c: OTIS ELEVATOR COMPANY Dale Schoeppner, City of Eagan Building Official ElFormCE2 This information can be provided to you in alternative formats (Braille, large print or audio). An Equal Opportunity Employer 443 Lafayette Road N. St. Paul, Minnesota 55155 www.dli.mn.gov 2/28/2014 Blue Cross Blue PO Box 645 St Paul, RE: Site: 55164 liMINNESOTA DEPARTMENT OF LABOR & INDUSTRY RECEr 1� taR 03 2014 ESCALATOR Blue Cross Blue Shield Esc 4 (3-2 Dwn) 3535 Blue Cross Rd EAGAN, MN 55122 Dear Sir ' adam: (651) 284-5005 1.800-342-5354 APPROVED FOR USE Elevator ID# ELV-15338 Minnesota Statutes Chapter 326B provides that the Department of Labor and Industry, Construction Codes & Licensing Unit, Elevator Safety Section, inspect and approve elevators and manlifts (endless belt lifts) before they can be legally used in Minnesota. An Inspector from the Elevator Safety Section recently inspected your facility and determined it meets requirements of the Minnesota Elevator Safety Code. NOTE: Compliance with Minnesota Rules and the ANSI/ASME A17.1, Safety Code for Elevators and Escalators does not necessarily assure compliance with the Americans With Disabilities Act of 1990. NOTE: THIS APPROVAL APPLIES TO WORK PERFORMED BY OTIS ELEVATOR. ALL ELEVATOR RELATED EQUIPMENT IS SUBJECT TO ANNUAL RENEWAL OF THE OPERATING PERMIT: It is the owner's responsibility to maintain and keep current with all tests in accordance with the ASME A17.1 and the ASME A17.3. Frequencies for the required tests can be found in Chapter 1307 of the Minnesota State Building Code. Failure to maintain and perform the required tests may result in revocation of the annual operating permit. Operation of an elevator related device without a valid operating permit may result in an issuance of a "stop order" from the department and possible penalty of up to $10,000. For more information see our website at: http://www.dli.mn.gov/CCLD/Elevator.asp Sincere COCENSING - TION CODES & LI 411) fi Bra. • nder. ahhlle,adtt' State Elevator Inspector c: OTIS ELEVATOR COMPANY Dale Schoeppner, City of Eagan Building Official ElFormCE2 This information can be provided to you in alternative formats (Braille, Targe print or audio). An Equal Opportunity Employer VY114 T-12 cc, ?0 Use BLUE or BLACK Ink I I For Office Use I o04? & 5 ~ Permit City ~ 1 Olf Ealan I J 3830 Pilot Knob Road Permit Fee: 0~f O. 00 Eagan MN 55122 RECEIVED I I Phone: (651) 675-5675 I Date Received: cJ Fax: (651) 675-5694 MAY 13 7014 Staff: 2014 MECHANICAL PERMIT APPLICATION ❑ Please submit two (2) sets of plans with all commercial applications. Date: 1 Site Address: F--)J R1 ~Lc_ L'Vyl: Gs Mi J G ( 2- -Tenant: ~~t~ ~ U W,lylrlesof~ Suite Resident/Owner Name: 13tUe G ss Ice Sl~tt~(( s Phone: ~~5 1 ccu - 2SLI 2- Address/ City/Zip: ~ 5 l V cvr,' Name: License Contractor Address: i hok City: Cd w I atk Vri e., State: M N Zip: Ca Phone: q 5 Z- ` t4 i I N U Contact: FV i 6J'1 Email: , 0 C; L lu a h co, mew w vwlt i New Replacement Additional Alteration Demolition Type of Work Description of work: Mryt'_ i y1eJ ocak ~1-(c -n h G~i,4(~1~11U`l _ NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened by City Code. Please contact the Mechanical Inspector for information on permitted screening methods. RESIDENTIAL COMMERCIAL Furnace New Construction Interior Improvement Permit Type -Air Conditioner Install Piping Processed Air Exchanger Gas Exterior HVAC Unit Heat Pump Under/Above ground Tank Install Remove) Other RESIDENTIAL FEES $60.00 Minimum Add or alteration to an existing unit (includes $5.00 State Surcharge) $100.00 Residential New (includes $5.00 State Surcharge) = $ K/A TOTAL FEE COMMERCIAL FEES Contract Value $-,201000 x .01 $55.00 Permit Fee Minimum $70.00 Underground tank installation/removal 2- b - CO Permit Fee *If contract value is LESS than $10,010, Surcharge = $5.00 !0-00 Surcharge* **If contract value is GREATER than $10,010, Surcharge = Contract Value x $0.0005 ***If the project valuation is over $1 million, please call for Surcharge = $ 2-1(7) . oo TOTAL FEE 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 nota 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 ~VI V1 Ctv 4YV o v-\ x ~W Applicant's Print 6d Name Applicant's Signatur FOR OFFICE USE Required Inspections: Reviewed By:~ Date: Underground Rough in Air Test Gas Service Test In-floor Heat Final HVAC Screening Use BLUE or BLACK Ink r I For Office Use I 11 I Permit l~ ~1t1 ` City 0 ~1 I - 3830 Pilot Knob Road Permit Fee:, 1 Eagan MN 55122 A 1 ZUNI I I Phone: (651) 675-5675 MAY Z 1 Date Received: Fax: (651) 675-5694 1 I I Staff: 2014 MECHANICAL PERMIT APPLICATION Please submit two (2) sets of plans with all commercial applications. Date: I,{ 14 Site Address: Ss ( u (vuSS V~oad Tenant: Bloe CIIV~ B W J iiifJd ( 1' 411 Q Hr- ~;U fT--' Suite Resident/Owner Name:_B(E>S (,pr- (VII VlV1f'SOO Phone: 61 Z51f2-- Address/ City/ Zip: (l~~ GVt SS 00(A W Z N 2- N fiVU 0 d 41f al (,l.(1l I (ta- License ZG 6 52 Contractor ~ Address: ~ City: State: -KA N Zip: 'J• Phone: 1 2 Cl~ I - C) Contact: eo VA 'l 6L~A Email: , Cpl ~ `VC- TV New Replacement Additional Alteration Demolition Type of Work Description of work: NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened by City Code. Please contact the Mechanical Inspector for information on permitted screening methods. RESIDENTIAL COMMERCIAL Furnace New Construction Interior Improvement Permit Type -Air Conditioner Install Piping Processed Air Exchanger Gas Exterior HVAC Unit Heat Pump Under/Above ground Tank Install / _Remove) Other RESIDENTIAL FEES $60.00 Minimum Add or alteration to an existing unit (includes $5.00 State Surcharge) ,i $100.00 Residential New (includes $5.00 State Surcharge) = $ /4?1GM•Q) TOTAL FEE COMMERCIAL FEES Contract Value $ X.01 $55.00 Permit Fee Minimum $70.00 Underground tank installation/removal = $ Ci~ Q Permit Fee *If contract value is LESS than $10,010, Surcharge = $5.00 = $ 2-' f• 001 Surcharge* **If contract value is GREATER than $10,010, Surcharge = Contract Value x $0.0005 ***If the project valuation is over $1 million, please call for Surcharge = $ 50 i C LPL TOTAL FEE 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- E✓) V,\ Ck"w cu x Applicant's Printed N me Applicant's Signature FOR OFFICE USE Required Inspections: Reviewed By: Date: Z Under mind P.ouc;h in Air Test Gas Service Test In-floor He~it Final HVAC Screening ~d MAY 2 1 2014 YVI 4 2914 cc, 600 � , Use BLUE or BLACK Ink �-----------------i � For Office Use � � . R������Q � 23� � � �� �� �� � Permit#: � � 1 I �//� � I � Mp,y � � �a14 j Permit Fee: � l Cl/.. I 3830 Pilot Knob Road � I Eagan MN 55122 � Date Received: � Phone: (651)675-5675 � I Fax: (651)675-5694 � Staff: � � I . `_______________�J 2014 COMMERCIAL BUILDING PERMIT APPLICATION Date: �•�b'�� Site Address: �� ��+4� �JroSS �.DrA.� � +�`S�Z'�" Tenant Name: (Tenant is: New/�Existing) Suite#: �r'1R. �.�iW'KN �!�}�i��1lr1. � Former Tenant: Name: �WL. ��_'�wGs�`wLl� Phone: ���������� Address/City/Zip: �S3S '$t�►GC�cs �'.e����,�m� �'�'�Z � �� �� :;_��. .','� Applicant is: Owner Contractor ��� `�w� � Description of work:'�y}�t n`'D�I �1M.d1rDV t�A�.cw�� ��t,�,�y�'l�..l �r��s_ � `��p�bf 1?Vt�l'k ��. Construction Cost: �����Z�� � � , ��:� x Name:�.+� ��Y,�ut S A d� �.�s � License#: '�t0����Z. % =;-- ���;. �c�ntractor ��� Aaaress: "��0 N�t,L�1auJ �LNL�� N� c�ty: M.�v�►i.t�m. t:S � , State:�Zip: � a Z.�o�►- Phone: ��P J• 2 0�`«�Q� ` 4� �`�,�`� � � ` �� � � `` ' Contact: L �t� �� EmaiL �� • ' • �.� �� ; r� Name: �u.t►��N.M. f�s.�iyuCt�nl�ut Registration#: � � , � Address SV � ti0'M'� �Y�LL.rli' �`��Ot� City: µ�rltA�C 0(:S ,�"��'1��.`�IEtl��i�?�'C�� ry r�,� ` "`� ���° � State:�Zip: ����� Phone: ��Z'�4'� "�5S 0 �.„�,-�.�. � � ��� ��� �� �: �� Contact Person: ��t (�C✓0�11,1�,� EmaiL �t� . r d�.h,1 f� W1 •L rb� Licensed plumber installing new sewer/water service: Phone#: � ,, � �. �� �u ., �� lU�4?"E #�C�rr�a��srr�+n������ �,�c�+���r�r��t�r� ���d a��+e������,� `� l� r�`crr�,�� � � d ".,�. .,� c//////d s i/r - �``...\� '""k�`\ " / \a..�..\".-.°-.� `".-... � � /i/ �.. ��jf�(� fy +��`j,�r�'� �"y.,.. j�/� j 3ry `� {G�� t/� f �i� ig� {jy {� /y "'\��r/���N�rti"R!/�X�SE��3�"i'X/����w���+l��l��i S7'1���f����f�M`/�i���� � � ���������� RT���'.�M��I�������i4 Cn���� ,: � � � , / ; ii�0/i �,�, � „/ ,� �.. /:� �%; ,� !. �/ //�/%/ p . /� �: �,,,� � '� ' .�� ...,.���.. : ;: r/ '" 0„ „'" �/� ;�;�/, : �i// ....`\� '-��` ,,,,.., ,, :.. ..; ��t � ,,,z, s ;, „+�lt�`�'�!'d�E%��t`�`t8 ��t�t4►s„� * � „ ' ,,, 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 wiil 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 pian in the case of work which requires a review and approval of plans. x i�J�►{ ��D �iY X .. � ApplicanYs Printed a e A ' an s Signature Page 1 of 3 • " i � - �'=53� �J�< C,��sS �'� ' DO NOT WRITE BELOW THIS LINE 1 Z���I SUB TYPES ' Foundation _ Public Facility _ Exterior Alteration-Apartments �I ✓Commercial/Industrial Accessory Building Exterior Alteration-Commercial Apartments Greenhouse!Tent Exterior Alteration-Public Facility Miscellaneous Antennae WORK TYPES _ New _ Interior Improvement _ Siding _ Demolish Building" �ddition _ 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 e�' Valuation )��� Occupancy � MCES System __t�__c-� � Plan Review � �AC�'f Code Edition o?Q4�'7 ,/��5�.-� SAC Units Q '¢L��` (25%_100% ✓) Zoning �� City Water t,i.-�i Census Code Stories Booster Pump �-` #of Units Square Feet PRV '-"' #of Buildings Length Fire Sprinklers y�if Type of Construction �..T Width � REQUIRED INSPECTIONS Footings(New Building) Sheetrock Footings(Deck) Final/C.O.Required Footings(Addition) �/ Final/No C.O.Required Foundation Other: Drain Tile Pool:_Footings _Air/Gas Tests _Final Roof:_Decking _Insulation _Ice&Water _Final Siding:_Stucco Lath _Stone Lath _Brick �/ Framing Windows Fireplace:_Rough In _Air Test _Final Retaining Wall Insulation Erosion Control Meter Size: �--'°'_-� Final C/O Inspection: Schedule Fire Marshal to be present: Yes No ,/ � / C-. ,� Reviewed By: � (�' , Building Inspector Reviewed By: ` , Planning COMMERCIAL FEES Base Fee �3�� 'jS Water Quality Surcharge � `7��d� Water Sampling Fee Plan Review 3 �$g�✓9 Water Supply&Storage(WAC) MCES SAC Storm Sewer Trunk City SAC Sewer Trunk S8�W Permit 8�Surcharge Water Trunk Treatment Plant Street Lateral Treatment Plant(Irrigation) Street Park Dedication Water Lateral Trail Dedication Other: WaterQuality TOTAL�q,a�lo. f� Page 2 of 3 ,. , - Page 1 of 1 Y . 12 �,���/ FW: SAC Determination-BCBS project ` SACProgram vu %f �� to: ' 'Dale Schoeppner' OS/19/2014 07:41 AM Cc: "'Amy Griffin"', "'Leslie.Seppamaki@Mortenson.com"' Hide Details From: SACProgram<SACProgram@metastate.mn.us> To: "'Dale Schoeppner"' <DSchoeppner@cityofeagan.com>, Cc: "'Amy Griffin"' <agriffin@cityofeagan.com>, "'Leslie.Seppamaki@Mortenson.com'" <Leslie.Seppamaki@Mortenson.com> 3 Attachments ��"'��'; '��'"�: '��"�`' � � � BCBS SAC Transmittal-A-2014.pdf a101.pdf M101 1 ST FLOOR PIPING PLANS.pdf Based c�n the inforrnation belo�nr�nd t1�e a#tac�er� docurnen#s, i#is the CounciPs untlers#anding that this proje�entails#he relocation flf Chilied 1/Vater piping and rnodification to the elect�ical. There is nt� change of use ta the spa�e_ Theref�re, no determination is required and no SAC would be due based on this in#ormation. Jessie IVye Supervisor,ES Revenue(SAC) Please visit our SAC website by clicking;SAC Proaram .�.,,_.�.. ...�. . .e�.._.. _.�._.,_,.w�. ...... .. .�rv.. . __..__.._„ . From: Leslie.Seppamaki@Mortenson.com [ma�Ito:Lesl�e SepQamaki@Mortenson.+com1 Sent: Friday, May 16, 2014 10:53 AM To: SACProgram Subject: SAC Determination - BCBS project I will be submitting plans for permit to the City of Eagan and they require a SAC determination letter. The interior remodel however does not have any changes to the sewer and waste. Only changes are to relocate some Chilled Water piping. The majority of work is electrical upgrades. I was wondering if you still would send a letter stating no SAC changes are part of the project. Please see attached form and drawings for a interior remodel of BlueCross BlueShield in Eagan. Please review and let us know if any additional information is needed. Thank you, Leslie �� ? Leslie Seppamaki,LEED�AP Project Manager Mj,�r"t��sj�� Mortenson Construction;Building vvi�at's next �+ = phone 763.287.5933 cell 651.503.2008 fax 763.287.3526 www.mortenson.com �Please consider your responsibility to the environment before printing this e-mail. file:///C:/LJsers/lseppama/AppData/Local/Temp/8/notes72D2EF/�web7040.htm 5/19/2014 . e.. . v �� . . . . r ��'`���"" ' � 1� B✓ �� Use BLUE or BLACK Ink � �,.. � �-----------------� � F o r O ff c e U s e „ � , I � (�g � ��� �� �t� �� REC�IVED � Pe�,�t#:�---------- ; (''� �� , � j Permit Fee:__�lJ-�� _ I 3830 Pilot Knob Road ��N 19 2014� I �j� I Eagan MN 55122 I ��`T��' � � Date Received:� — I Phone:(651)675-5675 � - � Fax:(651)675-5694 � Staff: _� � . `_�____ ________�J 2014 FIRE SUPPRESSION SYSTEMS PERMIT APPLICATION* Date: 06/17/14 Site Address: 3535 Blue Cross Rd. Tenant:�lue Cross Blue Shield Data Center Stabilization Ph2 _______su�te#:__________�____ � _ �� ,`, �,�,�aiFr4 r'°�`� - � ��� ���� ��;;'� t , Name: --------------Phone: ---------- --------------------- ° �E��� ���� �r,r�� � � a��w � d� �,�ti � � � � � � � Address l City/Zip:-----�------------------�----����------------------ �� ����������, � � � � �4 ���E '� ��'�'�.����'e��u' �; �; , q" Ap�J�ICclllt l8: � OWII@I' X COlitl'BCtOf � ---- ---- -a;�r3'���� d� .:� � r� � `. � � � . � . .� . K ����� `� � '� �` '������� D�scri tion of work: RELOCATE 6 HEADS FOR NEW EQUIPMENT LAYOUT � p �------------------------------------- �����,w � � �-��,� � � � ��� r� �� �� ����� ��� � ��'� ����, Construction Cost: ECOLAB Estimated Completion Date: 07/07/14 ___� � ���� , ���� � - -------- ---- � "�`� `'t�� ESCAPE FIRE PROTECTION � C-086 � � , —,�� ,�'������� Name:-----------------------------License#:�------ ---- � � �:�� ���������-�-�`"�� �f� ���� 3020 CENTERVI � ��� _ Address:______________LLE RD. ________________Y City: LITTLE CANADA �_�__�_ __ �"����__ _ ������i�� ` - ������� � .,� ��" ���`'�� ��� MN 55117 651-771-8874 � � , � " � 9�,�� 5tate:-------Z�p�------------ Phone:--------- �;�1 �� � ��� � _ � -------------- - �aa� . � � '„�� ��� ��� Contact: BRIAN WEBER � BR1AN ESCAPEFIRE.COM �� �- >� ,� �� -----------Email:--- � FIRE PERMIT TYPE WORK TYPE X_Sprinkler System(#of heads_6_) ___New ___Addition _Fire Pump _�Standpipe X Alterations ___Remodel ---Other:---------- - --Other:--------------- DESCRIPTION OF WORK: X Commercial Residentiai Educational FEES Contract Value$900_00 _�v_x A1 $55.00 Permit Fee Minimum _ 55.00 ____v_permit Fee *If contract value is LESS than$10,010,Surcharge=$5.00 -�----- ----- "If contract value is GREATER than$10,010,Surcharge=Contract Value x$0.0005 =$_________5.00Y____Surcharge" **`If the project valuation is over$1 million, please call for Surcharge -$__�_____60_00___TOTAL FEE 3/4"Displacement Fire Meter-$260.00 =$________N�A___Fire Meter =$_______60.00__ TOTAL FEE *Requirements:2 complete sets of drawings and specifications,cut sheets on materials and componen#s to be used I hereby apply for a Fire Suppression System permit and acknowledge that the information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Minnesota Building/Fire Codes;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�equires a review and approval of pians. BRIAN WEBER � X------------ - - --------------------- X- — ApplicanYs Printed Name App cant's Signa#ure � ���� �Y I V4 `it w s� � Use BLUE or BLACK Ink �-------- ---------i � For Office Use � � ' 1����� ' �lt 0� �a aIl I Permit#: I � � � � 3830 Pilot Knob Road � j Permit Fee: �� I ��� i RECEI JED � � Eagan MN 55122 � i i A�G 1 ���1� � Date Received: � Phone: (651) 675-5675 i i Fax: (651)675-5694 � Staff: � � ------------- � ����j�``f 2014 COMMERCIAL BUILDING PERMIT APPLICATION � � Date: ���17 G��� �1'°Site Address: 3535 B1 ue Cross Road Tenant Name: B1 Ue Ct^oss B1 ue Shi el d Of Mi nnesota (Tenant is: New/ Existing) Suite#: Former Tenant: Name: Blue Cross Blue Shield of Minnesota Phone: Property Owner Adaress i city i zip: 3535 B1 ue Cross Road Applicant is: Owner X Contractor Type of Work �escription otwork: I nteri or Remodel i ng Construction Cost: $275,000. Name: C. F. Haglin & Sons, InC. License#: � Canfiractor�� Address: �939 West 65th Street ��ty: Edi na, State: MN Z�p: 55435 Phone: 952-920-6123 Contact: Gary Gunderson Email: ggunderson@cfhagl i n.com Name: ArChi teCturdl Al l i ance Registration#: 20915 Architect/Engineer Address: 400 Cl i fton Avenue South City: Mi nneapol i s State: MN Zip: 55403 Phone: ���"��,�-5703 Contact Person: �on Ston2 Email: Licensed plumber installing new sewer/water service: Phone#: NOTE.Plans and supporting docv»i�i��#�atyau=s�br►r��t,t��c���1+��''l�� .; ����',.� �� ,t�� ' � ; the ir►formatian may be c/assified;as.n��c��t��c i�,ye�rp�o��afe��i�'�re���;���tr�����,� ° " �Cty, �onc�'ude#�r�t�� �a�t�de�r�#s.;� : �7.= 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.qoqherstateonecalJ�.org I hereby acknowledge that this i�formation is complete and accurate; that the work wjll e in confo nce with the ordinances and codes of the City of Eagan; that i ;araerstand this is not a permit, but only an appli o r a per t, d work is not to start without a permit;that the work will be in accordance with the approved plan in the case of wo w ch requ' review and approval of plans. X Gary Gunderson X ' Applicant's Printed Name A�plican ' natur � Page 1 of 3 . � � � � c��s ��� l�e s Y� j �� � � 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 Z??.��ooa , � Occupancy ,$, �'3 MCES System ✓ Plan Review ✓` Code Edition 2D07 M�/513G SAC Units/Vo dN�rta�/� /N t�,E e�t mu„t„p, (25%_100%!''j� Zoning �'� City Water Census Code Stories Booster Pump #of Units d Square Feet l�l'Sg PRV r #of Buildings �— Length Fire Sprinklers ✓ Type of Construction ,� ',� Width REQUIRED INSPECTIONS Footings(New Building) Sheetrock Footings(Deck) Final/C.O. Required Footings(Addition) � Final/No C.O. Required Foundation Other: Drain Tile Pool:_Footings _Air/Gas Tests _Final Roof: Decking _Insulation _Ice&Water _Final Siding:_Stucco Lath _Stone Lath _Brick � Framing Windows Fireplace:_Rough In _Air Test _Final Retaining Wall Insulation Erosion Control Meter Size: Final C/O Inspection: Schedule Fire Marshal to be present: �Yes No ��. Reviewed By: ��'�L' , Building Inspector Reviewed By: " , Planning COMMERCIAL FEES Base Fee Z��L -rf Water Quality Surcharge �37• so Water Sampling Fee Plan Review 13 b���°� Water Supply&Storage(WAC) MCES SAC Storm Sewer Trunk City SAC Sewer Trunk S&W Permit 8�Surcharge Water Trunk Treatment Plant Street Lateral Treatment Plant(Irrigatioro) Street Park Dedication Water Lateral Trail Dedication Other: Water Quality TOTAL ���3 • �� Page 2 of 3 s R �' l� r � • . Use BLUE or BLACK Ink --------- i � For Office Use � �• � � I �,� I �� O� �� U� I Permit#: � � I � � RECEIVED � Permit Fee: I���� �r j 3830 Pilot Knob Road Eagan MN 55122 ��� j � �"�I� i 8', � �l� i � Date Received: � Phone: (651�675-5675 s � Fax: (651)675-5694 � Staff: � �________����___�J r• 2014 COMMERCIAL BUILDING PERMIT APPLICATION ��((� Date: SiteAddress: 3535 Blue Cross Road Tenant Name: B1 Ue Cross and B1 ue Shi el d of Mi nne�e�nt is: Newi Existin9) suite#: Former Tenant: N/A i Name: B1 ue Cross and B1 ue Shi el d of Mi nnes�,�one: ����������� ��' ,address i ciry i zip: 3535 B1 ue Cross Road = Applicant is: Owner X Contractor � ' ��� � �escription of work: �I nteri or Remodel i ng , ����I� _ � Construction Cost: $65,000. �`� Name: C. F. Haglin & Sons, Inc. �icense#:� ��� Aadress: 3939 West 69th Street city: Edi na �� state: M� zip: 55435 phone: 952-920-6123 � contact: Gary J. Gunderson Emaii: 99underson@cfhagl i n.com rvame: Archi tectural Al 1 i ance Registration#: 20915 ����,,� � Address: 400� C1 i fton Avenue �;ty: Mi nneapol�i s � � MN 55043 612-871-5703 State: Zip: Phone: Contact Person: Email: Licensed plumber installing new seweNwater service: Phone#: ��i�a��� �� �`!� �� �. ,�� � � � � �{ '� "'�' l, � � �_� � �._ � � . �` r,' ' � r ° � • � ; � �; , - 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. o herstateonecall.orq I hereby acknowledge that this information is complete and accurate; that the work i I-be in �onformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an appli t for rmit, and work is not to start without a permit;that the work will be in accordance with the approved plan in the case of ' #t~ ires a review and approval of plans. x L1ti�Z.� �i3������� x Applican s Printed Name A 's Si n ure Page 1 of 3 _ t �53, ��� �,�,�a �' . . .� /��1�� r � • � 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 ✓ ln�erior Improvement _ Siding _ Demolish Building* _ Addition _ cxterior Improvement _ Reroof _ Demolish Interior _ Alteration _ �e�s�i� _ Windows , Demolish Foundation _ Replace _ �later Damage _ Fire Repair _ Retaining WaU Salon Owner Change *Demolition of entire building-give PCA handout to applicant DESCRIPTION ..v ✓ Valuation L!J�ODO�" Occupancy B MCES System Plan Review ✓ Code Edition Zdd7 M�58G SAC Units ?>/,�p��/,�USE OL Ol�,LD. (25%_100%� Zoning `�� City Water t/ Census Code Stories � Booster Pump #of Units � Square Feet 41g PRV � #of Buildings I Length Fire Sprinklers Type of Construction �Fj Width REQUIREQ INSPECTION� Footings(New Building) Sheetrock Footings(Deck) Final/C.O. Required Footings(Addition) �Final/No C.O. Required Foundation Other: Drain Tile PooL•_Footings AiNGas Tests _Final Roof: Decking _Ins4�iat:on _Ice&Water _Final Siding:_Stucco Lath _Stone Lath _Brick � Framing Windows Fireplace:_Rough In _A'sr Test _Final Retaining Wall Insutation Erosion Control Meter Size: Final G/O Inspection: Schea�f� Fire Marshal to be present: " Yes No �� Reviewed B � y: �/p�ro , Building Inspector Reviewed By: � , Planning COMMERCIAL FEES Base Fee �T�t'� Water Quality Surcharge 32-S o Water Sampling Fee Plan Review Sl �• ZG Water Supply 8�Storage(WAC) MCES SAC Storm Sewer Trunk City SAC Sewer Trunk S&W Permit&Surcharge Water Trunk Treatment �'lant Street Lateral Treatment Plant(Irrigatior�� Street Park Dedication Water Lateral Trail Dedication Other: Water Quality TOTAL� �3�3 .o / Page 2 of 3 Use �C�EJ�or BLACK Ink � For Office Use � � 1� �.�I%�� 'L!�, 1j�Q J�� I Q I �V � �IT !ov (0 � Permit#: U�� � Clt of �� �� � �r� ����� �� � `'''� � � �VG)�i � �7 ` �"°��°`'� �''' � � Permit Fee: � 3830 Pilot Knob Road � � Eagan MN 55122 S�P I I 1 � 2014 Date Received: Phone:(651)675-5675 � � Fax:(651)675-5694 " �,t,� " :' I I `'`i� � � Staff: � `����������������J 2014 FIRE SUPPRESSION SYSTEMS PERMIT APPLICATION* Date: �t'�'"�� Site Address:_.!�� ��L.t� I'"b �r Tenant:y ` l ��„�,�.�� o Q N/`,, �"e� .....-� . ��.�..�.,�,.,�.� Suite# - ..,.�,.,.�«.�.�„_.. K� �...:.,.�.�,..�,..��,e... _.r.,.�..�.a..,,,..�.,..�..�,...�. .,._.. ' Name:��.��3$�-�.��5�� ��� Phone: ,. .g i. �.1�.�� � Property Owner Address/City/Zip: , � � Applicant is: Owner Contractor � � .._. .��u._F.._.�...n.o-w�.�,�.�__�� . . ,-���- --._ ._ r�. .. x - .. . , �� � Description of work: � �� ��� � � � � Type of Work or , � r � � '� Construction Cost �S� Estimated Completion Date.J�'1/Ui� ta ��......�..,.���» �_��, _ � � ra . N.,.,.,, .� ,._�-n.. ,:- -. _e... - � - . � � § _.. - . �._ .....,,��.._..�..�.Fw.,,�„�..�..� .�;_��.,r € � ` G� ` Name:���i t I''t'p��r'l�Trc�r°�ti. License#: �' d�...) � � � 5`1� 1'��ron��1.� �,��LA � at �'� .�Z I � Contractor Address � y. � � ; t � � State:�_Zip: J'rjf�-?� Phone: [�SLS�- ���(- /�'(�j � 'E � � �� Contact EmaiL• ; ��.u..., a.-., ...__.� ..� . :-r., �,��..�., ,,-..�.A NR,�>,. .. ��_- . , � . ___ ...�,,,�,,,,..,T��M�..F. .,,�....��..�.�{-�.� _..� � FIRE PERMIT TYPE WORK TYPE � a �� �Sprinkler System(#of heads E� ) New Addition � � _Fire Pump _Standpipe � c�Alterations _Remodel Other: � — Other: DESCRIPTION OF WORK: �C Commerciai _Residential _Educational . � µ ..,�.,�,..�.�,�,�_F .,..�..,�.�.� ..�.,�..F�.R..,...�,�Y�,�....�,,,-�„ FEES � � -- Contract Value$ x.01 � $55.m0 P�rmit F��MinErnum .� "If contract value is LESS than$10,010,Surcharge=$5.00 -$ Permit Fee ' '"If contract value is GREATER than$10,010, Surcharge=Contract Value x$0.0005 -$ �� ` Surcharge* ""*If the pro�ect valuation is over$1 million, please call for Surcharge _$ ��C•� � TOTAL FEE 3!4"Displacement Fire Meter-$260.00 =$ Fire Meter _$ TOTAL FEE �.Y,.:.:> �s�:_,_ _,a.�=�_F.:s�..,,�.���.�n-_.�,.. ��,�..� �_x:.,,�. ,,,�.��r �.�-�,.�,.m�n....,.�.��,�.�.�..�,�. , �__. ��,,,� .,.,_: *Requirements.2 complete sets of drawings and specifications,cut sheets on materials and components to be used I hereby apply for a Fire Suppression System permit and acknowledge that the information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Minnesota Building/Fire Codes;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 b ccordance with the approved plan in the case of work which requires a review and approval of plans. X�,��o�� \.��,�eMd.� ApplicanYs Printed ame Applicant's Signature f ����� z-- ; FOR OF�I�E USE " REQtlIRED INSPECTlONS Hydrostatic F1ow Alarm Drain Test Rough ln 'frip Pump Test Central Station :��Final Gonditions of Issuance: # / / Permit Reviewed by: , -;2-�` �'��� Da#e: � l J��l � .�: � Use �LUE or BLACK Ink �v� ���-1 �<<� I��'��� �-----------------i � For Office Use � r �� I Permit#: ����� I Cit of �� �� �r � ����� ; `^��, ; � � °'� Permit Fee: �(f v 3830 Pilot Knob Road "�� 5�� 1 1 2014 I I Eagan MN 55122 ' � Date Received: � Phone:(651)675-5675 � i I , �a Fax:(651)675-5694 � ---- � Staff: � `__�_��____�____�J 2014 FIRE SUPPRESSION SYSTEMS PERMIT APPLICATION* Date: " -►� Site Address:������j,(��11'O� �� Tenant: �1�1 (�1(�„�ly�/ky\, � �G�i; ►�Q,� Suite#: � QG�" � ,...�.�.: 't r Name:'�y��,��j���.�A�����-Phone: � � Property Owner ;' Address/City/Zip: Applicant is: Owner �Contractor i Type of Work } Description of work:�t tl � � r Construction Cost:�(��j Estimated Completion Date: Name:�c LLMM j t 1''ig��r'n�"r �r License#: l_..° � /S Contractor �ddress:�� �,nn 1�•��-_ �� City: ��� ,��{ State:�iL�Zip: �`�j��_ Phone: LSZS�- ����- /�r � Contact�� ` Email: FIRE PERMIT TYPE WORK TYPE �Sprinkler System(#of heads�) New _Addition _Fire Pump _Standpipe �Alterations _Remodel Other: Other: DESCRIPTION OF WORK: �C Commercial _Residential _Educational FEES Contract Value$ �� x.01 $55.0� Fermit Fee Minimum -$ SS i Permit Fee . '`If contract value is LESS than$10,010,Surcharge=$5.00 ""If contract value is GREATER than$10,010, Surcharge=Contract Value x$0.0005 -$ s � Surcharge` '`**if the project valuation is over$1 million, please call for Surcharge � _$ �OO " TOTAL FEE 3/4"Displacement Fire Meter-$260.00 =$ Fire Meter. ; �.,.,. �-w..,.�M,.��,,r.���..,,�.. - ����.:.. .. _$ TOTAL FEE ' *Requirements:2 complete sets of drawings and specificetions,cut sheets on materials and components to be used I hereby apply for a Fire Suppression System permit and acknowledge that the information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Minnesota Building/Fire Codes;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�'��c�.u.�t.�..� ��nr 1�' • X Applicant's Printed Name ApplicanYs Signature ���.�.�.��� - - ���L���" �FOR OFFiCE USE � REQUIRED INSPECTIONS Hydrostatic Flow Alarm Drain Test Rough 7n Trip Pump Test Central Station ��inai I Conditions of issuance: I i i , � � � � � � � �� Permit Reviewed by - �r'`f�-� _Y�---�- C' Date: � / �� / � ��� ����� Use BLUE or BLACK Ink �'����1� �Do9�7 �-Fo�o��e�se---------� �1��' 0�����11 ������.� � � Pe�,�t#:1 ���'�� � 3830 Pilot Knob Road � � � Permit Fee:�S, �� � Eagan MN 55722 S�P � � 2��4 � � � I Phone:(651)675-5675 � Fax:(651)675-5694 /���� I Date Received: � � �_ �, I I �Y:______,_��"__ ____ ._.._ � Staff: � -------- -- ������J 2014 MECHANICAL PERMIT APPLICATION ❑ Please submit two(2)sets of pians with all commercial applications. Date��'}'j l� �p/Q�- Site Address:��5 ��;, ��l�i,�, ; �ra� �5��� Tenant i..�i� �� � �j,�}� � �� Suite#• R�il,�@I�fIOWI��I' � Name:�L�►: ������� �J�.-`U� Phone: �< � `�� r Address/City/Zip:�5�5 �"�,�� �J��� �Ly��� � _ , r ` :� r Name:��►���7 �'`��/Lr�-(� License#: � N�a11�f�CfOC :� = Address:�� ��2.1 ��ll�) �y�G City:�J!,�"jj, ���� � � � �� State:�Zip:�Sfi�� Phone:_�o��� ��� q�� l� � Contact:�it�����'i/� EmaiL.��GJC�l��� � � �L-..��-19d�+ri;L'D�► ; � New Replacement �Additional Alteration Demolition z � ; �. 7ype of Work � Description of work:��,�hr���y� /�.�a���� �� �� �,�, ���,��� � NOTE Roof mounted and grpund mounted me,chan�cat equ�pment�s�eyu�red ta!�e��r+eened;b � Code .:Please c�onfa�t the Nlechan�cal'Inspector for�nformafion on pemu�fted`scree�ing����s� �z �. y _�... > � . . , � � �� � �� � ;. .� . RES/DENT/AL COMMERC/AL c: _Fumace _New Construction ,_Interior Improvement �g���`�� '_ _Air Conditioner _Install Pi in � P 9 Processed _Air Exchanger _Gas X Exterior HVAC Unit _Heat Pump _UndeNAbove ground Tank �Install/ Remove) _Other — RES/DENT/AL FEES $60.00 Minimum Add or alteration to an existing unit(includes$5.00 State Surcharge) $100.00 Residential New(includes$5.00 State Surcharge) -$----- TOTAL FEE COMMERCIAL FEES $55.00 Permit Fee Minimum Contract Value$ i��S� x.01 $70.00 Underground tank installation/removal =$ ��� �� Permit Fee *If contract value is LESS than$10,010,Surcharge=$5.00 ""If contract value is GREATER than$10,010,Surcharge=Contract Value x$0.0005 -$ � `� Surcharge• ***If the project valuation is over$1 million, please call for Surcharge -$ 1 3�� � TOTAL FEE 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 permi ,that the work wili be in accordance with the approved plan in the case of work which requires a review and approval of plans. x= l����j �., ' G.sA.) Applicant's Printed Name X i Ap icant s Signature FOR OFFtCE USE Required Inspections: �� ` /� / �/� ' R viewed By: ` Date.l / � 7 Underground Rough In Air Test Gas Senrice Tes# 1n-floor Heat Final HVAC Screening ( �' .��� )t��f� Use BLUE or BLACK Ink �-----------------, � For Office Use I C"""" �, �--. . � ��(L-!(C/� � �1�� U 1 ����11 ��'��.;m��"��.d�� ' I Permit#:�� � � � UJ I 3830 Pilot Knob Road S�P � � ZO�4 � Permit Fee: i Eagan MN 55122 � I Phone:(651)675-5675 i Date Received: 7 � Fax:(651)675-5694 ��;_..� � � __._.d__ � Staff: � �������� ��������J 2014 MECHANICAL PERMIT APPLICATION ❑ Please submit two(2)sets of plans with all commercial applications. Date:��� t1 �1'`�° Site Address: ��✓3� ��-C� ��� �G�� Tenant: �'l�� ��"�` � �ti��% ���'�"��=� Suite#: ~1��S1d�[1tlOW�'i@r' '; Name: 1?i'�.L� �.h�'`� A�:17 �Lv't: �/ti� Phone: ' �:: Address/City/Zip: �'�3`� ���i �-n-L"GS� ��J�� � � � ` � � Name: �����`���j !'11���%�l��Z-- License#: ; � � 3 �O�f�Cfflr � ��; Address: ��'�'J1yiF�Gy,t�-��r►''j ,�1���L City: ��� ��� �l`�UL� �� State: 1�Y1�1 Zip: � 'J�Q����� Phone: �D��'�vZ��� 1��3 Contact:�v'`� `�a,.�x e�' Email:..��'�E���'(���:�tb��n����1#f �d�I � New Replacement _Additional �Alteration Demolition ` � � ' Description of work: p'�'►-Cu'��l^� '7�'� �'a✓i�N E� ��J1-�� �OG��S �[`ype of Work Y � NOTE Roof:mounted and ground mounted mechamca�equ��meirt�s rsequ�rr�d ta,:he�creened 4y Gity ; �F �, ; � „ ,..,. ... s � �, ;' vCode ;Please,contact"tlie Mechani,cal,tnspector for�nformatloni-�n perr�r�ft.�c�scr�nln9 methoda RES/DENTIAL COMMERC/AL f i�,. _Fumace _New Construction �interior Improvement ' Air Conditioner install Piping Processed Q�f'llll�'T�/p� — — — Air Exchanger Gas _Exterior HVAC Unit _Heat Pump Under/Above ground Tank �Install/ Remove) Other RES/DENTIAL FEES $60.00 Minimum Add or alteration to an existing unit(includes$5.00 State Surcharge) $100.00 Residential New(includes$5.00 State Surcharge) _$ TOTAL FEE COMMERCIAL FEES Contract Va(ue$�,-��j D(,`�f? x.01 $55.00 Permit Fee Minimum $70.00 Underground tank installation/removal =$ ���_�� Permit Fee "If contract value is LESS than$10,010,Surcharge=$5.00 =$ j Q"�� Surcharge" **If contract value is GREATER than$10,010,Surcharge=Contract Value x$0.0005 A *"'If the project valuation is over$1 million, please call for Surcharge _$ ��.'t"'rQ�7 TOTAL FEE I hereby acknowledge that this information is complete and accurate; that the work will be in confortnance 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 i 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 , �-a�X ct�,�. x ,� . � . Applicant's Printed Name Appli nt's Signature FOR OFFtCE USE � Required Inspections�: Revi ed By: � `� Date:� � Underground 1 Rough In Air Test Gas Service Test In-floor Heat final HVAC Screening � Use BLUE or BLACK Ink r----------------^ I For Office Use � � � Permit#: �1 ��� I Clt of �� �� � .�, � Y � � Permit Fee: u�� I 3830 Pilot Knob Road � � Eagan MN 55122 < I �f,12,�`/ I Phone: (651) 675-5675 �z i Date Received: / i Fax: (651) 675-5694 j Staff: � j �-----------------� ���� �� 2014 COMMERCIAL BUILDING PERMIT APPLICATION ����i� Date: ����_Site Address: ��� � C�U� � . � �v! S� j Z Z � Tenant Name: ��ti,Q Lt�ISSS ���hF�S�1�;�-1� (Tenant is: New/�Existing) Suite#: Former Tenant: Name: ��;�y�Q_�XV��S �l ��`�i.� Phone: �05�- 1P�2�2-�$`(Z Property Owner Address/Cit i Zi �S �� l u2.�C.�r�c� �Z�� , �,c� Y P�_ � -,. - � �C sI Z2, Applicant is: � Owner Contractor f -Ph��,�5k- � 3, T e Of WOt'k Description of work:__ �-�Q�.{,�,-t.,�.�� (� `� �r,,,, �h�.,,,.� � �- C�1-1 k C� } Yp Construction Cost: � yZr ��S•° ° ' Name: �8./.-�(,in,��,��,�'1�,,���� License#: —�—� Contractor Address: �(�t� V�•�-C.�d,�--,,�1 (�(M-e ) / ,. City: V�,�V�-eo►.�v L ;S State:�IJ Zip:�"S�22.,, Phone: �S !' ,�U3° Z�� Contact: 1 UC. S Ci�.�,� Email: i 7 e�,�G;; ✓Vt, }�y� , Dv� Name: ��,.t,n�1 Gtitn.� �S ii(�1 ��'1,C r Registration#: Architect/Engineer Address: S U �5����'1,� �";����, �- city: �lY�h��,h1�C State:�t�Zip: C�'-1 ��2'l-_�"�/� Phone: �0 l 1.�4 � �--�jp►-� � ` Contact Person:�r�V N�l�, EmaiL �'1� . C'1 v {�, .Q c � �� Licensed plumber installing new sewer/water service: Phone#: NOTE:Plans and supporting documents that you submif 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 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.org 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 L�L�l C�C ��� G�V1n.G1,�.G �, x � � ApplicanYs Printed Name Ap lic Signature Page 1 of 3 �s�3s t31 �.� �,��ss �-� � ����73 . 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 � � 8 s' � MCES S stem Valuation � 0 0o Occupancy � y Plan Review ✓ Code Edition �oa7 ��G SAC Units o/�✓o ey�r��s �N(is�o�. oCG.L4. (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) Sheetrock Footings(Deck) Final/C.O. Required Footings (Addition) ✓ Final/No C.O. Required Foundation Other: Drain Tile Pool:_Footings _Air/Gas Tests _Final Roof:_Decking _Insulation Ice&Water Final Siding:_Stucco Lath Stone Lath Brick � Framing Windows Fireplace:_Rough In _Air Test _Final Retaining Wall Insulation Erosion Control Meter Size: Final C/O Inspection: Schedule Fire Marshal to be present: � Yes No � Reviewed By: ��G , Building Inspector Reviewed By: , Planning COMMERCIAL FEES Base Fee l00�. l� Water Quality Surcharge �G . S� Water Sampling Fee Plan Review (v Sz. 7(i Water Supply & Storage (WAC) MCES SAC Storm Sewer Trunk City SAC Sewer Trunk S&W Permit& Surcharge Water Trunk Treatment Plant Street Lateral Treatment Plant(Irrigation) Street Park Dedication Water Lateral Trail Dedication Other: Water Quality TOTAL ��i 703' S� Page 2 of 3 � Use BLUE or BLACK ink r————————————————^ I For Office Use � � � Permit#:_��`�'� � Clt of �� a� �� � � � a���Z�� � Permit Fee: 3830 Pilot Knob Road I I Eagan MN 55122 � �, � Phone: (651) 675-5675 i DateReceived: l �Z"� ' j Fax: (651) 675-5694 i �,� � � Staff: �-----------------� C�lt�� 2014 COMMERCIAL BUILDING PERMIT APPLICATION �� �y,�� Date: t��1 ) 1�' Site Address: ��� )t,t,��� "j ,,� �lG,Ztit� A1�;� .S�/ZZ � r7 Tenant Name: ��+�1�Q (,��� �jl�t�' ��`�;{,l G� (Tenant is: New/�Existing) Suite#: Former Tenant: Name: `��u,i' ��� �� �n� �,��Z �� Phone: � S�-��O f�Z`��`i'(-7 PCOpeI"ty OWtler Address/City/Zip: �S � 1 Vl�. C S� �Sr�Z� r- -`�`` �� Applicant is: Owner i�-Contractor � � ����5� la.v� Type Of Work Description ofwork: �1�n S���,� �� ,��,,� ;p �' .�� �����/ �,,,�1 / Construction Cost: � ���i Name: ��.r.-}���,-�,� (_�,. - .t-,�,.� License#: Contractor Address: � v�.�(,,�3 � ic;�.� 0� city: �Ll,ti�,,�no.�- ,�1 ,e State: I'Ybr�/' Zip:_ ,��Z"L Phone: I,QS (—�(U S-��-, Contact: ' ` Email: eS��� � S� i�,; �, ,� e Name: ��,nV1rn,►.�� �1ic �v1 c , Registration#: Architect/Engineer Address: � ����srt,` S';�c�,.� ca-�e-�. city: 1�.t.:.—r,�,,�r�;�� State: ltil N _Zip: ;S� t-�v"?.-�S"�t v°` Phone: �p I�,-`'j (v,� -�� t.�� Contact Person: '7L�7 EmaiL �,J S� D (,�,�, ? G Licensed plumber installing new sewer/water service: Phone#: NOTE:Plans and supporting documents fhat you submif are considered'to be public information. Portions of the information may be cl,assified as non-public if you provide specific reasons that would permit'the City to conc/ude 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.org 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 l�.U��� ����l,�Ct.IG�, �` '` ApplicanYs Printed Name pp " t s Signature Page 1 of 3 ��3 5� (�1 vc C��� ►�:� , DO NOT WRITE BELOW THIS LINE �-��O{� 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 �1 q�DOD . °=� Occupancy � MCES System 1�.� � �EGtJR�tl�(UpGeA#� � Plan Review Code Edition � MS�G SAC Units (25%_100%� Zoning City Water Census Code Stories Booster Pump #of Units C7 Square Feet --� PRV #of Buildings � Length '—' Fire Sprinklers Type of Construction �'.� Width - — REQUIRED INSPECTIONS Footings(New Building) Sheetrock Footings(Deck) Final/C.O. Required Footings(Addition) � Final/No C.O. Required Foundation Other: Drain Tile Pool:_Footings _Air/Gas Tests _Final Roof:_Decking _Insulation _Ice&Water _Final Siding:_Stucco Lath _Stone Lath _Brick ✓ Framing Windows Fireplace:_Rough In _Air Test _Final Retaining Wall Insulation Erosion Control Meter Size: Final C/O Inspection: Schedule Fire Marshal to be present: � Yes No Reviewed By: ��(i , Building Inspector Reviewed By: `� , Planning COMMERCIAL FEES Base Fee �r530.7� Water Quality Surcharge Bq•�o WaterSampling Fee Plan Review yq� •�1�1 Water Supply & Storage (WAC) MCES SAC Storm Sewer Trunk City SAC Sewer Trunk S&W Permit& Surcharge Water Trunk Treatment Plant Street Lateral Treatment Plant(Irrigation) Street Park Dedication Water Lateral Trail Dedication Other: Water Quality TOTAL ��Z� /S� �� Page 2 of 3 Use BLUE or BLACK Ink --, �U� � Fo�OfficeUse ------- � . g t�p � p � {Jl�� U��Q�Qll �,r� �1 i Permit#: C�o�� � 383(' Pilot Knob Road � f0,� � Permit Fee: 1 ��� j Ea�an MN 55122 � ` I � � Phone:(651)675-5675 � Date Received: � � Fax:�651)675-5694 � �� I + � Staff: -----------------� 2014 MECHANICAL PERMIT APPLICATION l��� 'Ms�f ❑ Please submit two(2)sets of plans with all commercial applications. �,��10� � 1 Date: 11/25/2014 Site Address: 3535 BlueCross BlueShield Road �",-� Tenant: BlueCross BlueShield of Minnesota Suite#:Main Campus � � � ' ��� Name:BlueCross BlueShield of Minnesota Phone: R��fi�lentlOw��r f ;��' � � ;� Address/City/Zip: 3535 BlueCross BlueShield Road/Eagan/55122 �; � Name:Metropolitan Mechanical Contractors License#: t�`" 7450 Flying Cloud Drive � ; Address: City: Eden Prairie �� Contractor .. ��$ State:MN Zip. 55344 Phone: �952)941-7010 `�� ��� ames.lam recht metromech.com �~ �>`= Contact:�ames Lamprecht Email: � p @ New Replacement Additional X Alteration Demolition .� �,���Ty�3@4�'f`�/pP�C�' ��� Description of work: Main Generator Room Update � � �y � ' U;� °xNOTE:Roof;mounY����nd:grountl mqu� c�teehan9caJ�qufpm�'�it�is`���iu'�t�to be sc,reeni�d�b`y City,�,,, Y�.. , ��?de Please cQr��ct the,N�ecl��rticaM�s�ecta��; t�� _rt�tlal�;on�p�fi�iitted screening rnethods. ` ` ' RES/DENTIAL COMMERCIAL ,� � v. _Furnace New Construction x Interior Improvement �4 — — pe�i��pg � _; —Air Conditioner X Install Piping � _Processed _Air Exchanger Gas Exterior HVAC Unit _Heat Pump Under/Above ground Tank �Install/_Remove) Other RES/DENTIAL FEES $60.00 Minimum Add or alteration to an existing unit(includes$5.00 State Surcharge) $100.00 Residential New(includes$5.00 State Surcharge) _$ TOTAL FEE COMMERCIAL FEES Contract Value$ 16,650 x.01 $55.00 Permit Fee Minimum $70.00 Underground tank installation/removal =$ 166.50 Permit Fee 'If contract value is LESS than$10,010,Surcharge=$5.00 _$ 8.33 Surcharge"` *"If contract value is GREATER than$10,010, Surcharge=Contract Value x$0.0005 ""`If the project valuation is over$1 million, please call for Surcharge =$ 174.83 TOTAL FEE 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. �� g V!a��l�� �i4��/�G�'_ X ��/��==��•,+�,, A licant's Printed Name � pp pp' ant's Sign��'[i ,.,-{" '. ._,_ _ FOR OFFICE US� � � ��`� ` � Reqw�g�i;lnspe�tions �` '� '� �u���e�tl B ���� , �� � � � R�'��+ Y �: � �� Date: �,.� � ": Uritlergr�ound,, `�R,augh fn.; AitfTesrt -`:: Gas S`�rYice Test�`s��'1n=floor Hea�, �Fin'�I`, �iV,�G Screeriing, _ .�o�-� ��� Use BLUE or BLACK ink ����s �-- '/ ----------------, ��C� ��C��U� � For Office Use 1 �l 0��� � ; P��„��: / ����5�' � �� � N�5 '1015 � Permit Fee: 1 �O -�C.� i 3830 P�lot Knob oad ,� i Eagan MN s5122 � Phone:(651 j 675-5675 E Date Rec�ived: �-1 �'l � i Fax:(651jfi75-5694 j � 3 � Staff: ����������i������J 2014 MECHANICAL PERMiT APPLICATI4N � Ptease submit two(2)sets of plans with a!1 commercial app6cations. Date:r:Tvh9� � �L��SiteAddress: �J�S� �I..a�� G�7 �1��' Tenant• ���JGi Suite#- �@SIC��CI#IQVII[1@�' Name:���'���7 /�'1V� ���� Phone: _��� � �-� Address/C'�y/Zip: �5'�5� 1'�V�Ll� �� :° Name:��G�� ��C�'�� License#: I Address:���31»��1�'r �I1-t�� City: �, )� f�� 'I ,Cor�trac�Or x q '_= State:�Zip:'.'���'J d�`J� Phone: �Gr7'�— a���'' q !�"3� Contact:�� �s�x�� Emaii: ��a�CTb���'Mb���—M1tsLl4-• Gn x� New Repiacement Additionai �Atteration • Demolition T Ofi�NOI"IC Descri tion ofwork: 1J�� �lr���l'1-i��"T��DIt� �1�l��' �IC�- YP� p _ , ,NQTE:Roofwmqu_,nbed and ground mourrted mechanical ec�Wpme�rt is;�equ�red ta be scr+eened by City. ; Code.`.Please coMacttt�s M�ahankat tr�spectorfor,informatian�,pem�tttied screeniny methods. RES/DENT/AL GOMMERCIAL Fumace _New Construction ,�,Interior lmprovement �p����.�E� �" _Air Conditioner _Install Piping _Processed � Air F�cchanger Gas _Exterior NVAC Unit Heat Pump UnderiAbave ground Tank (_{nstail!_R�nove) Other RES/DENTlAL FEES $60.00 Minimum Add or alteration to an existir�g unit(inciudes$5.00 State Surcharge} $100.OQ Residential 1Jew(includes$5.00 State Surcharge) _$ TOTAL FEE COMMERCIAL FEES Contract Value$ {'7�BAD x.01 $55.00 Permit Fee Minimum $70.00 Underground tank instaliation/removai =� (�b� Permit Fee *If contract value is LESS than$10,010,Surcharge=$5.OQ =$ � a� Surcharge' **If corttract value is GREATER than$10,010,Surcharge=Contract Value x$0.0005 '�'*if the project vatuation is over$1 million,piease calt for Surcharge =� (,'�,�, Sj� TOTAL FEE I hereby acknowledge that this information is complete and aCcurate;that the wo�1c wilt be in conformance with the oalinances and codes of the Gity of Eagan;that I understar�d this is not a permit,but only an application for a permit,and work is not to start without a pertn'•that the work will be in accordance with tF�approved plan in the case of work which requires a review and approval ot plans x ��� �—,Gi t�� x � Applicant's Printed Name Ap �can s Signature FOR OFFIEE tJSB (� � Reetu�red Inspcetiens: yiewed By: �V D'd�:_^,�_t_' Underground Rough In Air Test Gas Service Test In floor Heat F�nai HVAC Screernng � ����`� � Use BLUE or BLACK Ink �� ���- -----------------� ��•� y�E-� � For Office Use I j_ � I Cl6O! L� �lt ���� � � [Q35 I Permit#: UJ I � �` � U�'�' i ���-. � � I Permit Fee: 3830 Pilot Knob Road ���< <�«�Ul I I,, I I Eagan MN 55122 �/� f��C��� � Date Received:tS�� �� � l � Phone:(651)675-5675 I Fax:(651)675-5694 � Staff:S� � �������������_���J 2015 COMMERCIAL PLUMBING PERMIT APPLICATIO� �� ,�/��-J` «ci-e ��.w s:L � � ❑ Please submit two(2)sets of plans with all commercial applications. ��� �p�`�,� Date: �v ��% � Site Address: ���� ��� �y�`�-�.�C�"'� Tenant: �i4.°E' C�OS,J Suite#: PI'���"��/ ('��n�� Name: Phone: �l�ms: c c�i4�@5's //��'�•c.0� License#: ��n���� Address:���°'���i1os:L�/"'"�City: cJ. JT ��� State:��Zip:���� Phone:���i���ra�'��� Email: •✓ v.� J'c,��� � .,. �,c �e�a� „�.������,� _New �eplacement _Repair _Rebuild _Modify Space _Work in R.O.W. Description ofwork: u- � C� �ik.� ��¢i�y i COMMERCIAL _New Construction .✓ Modify Space _Irrigation System�yes/_no)�RPZ/_PVB) • Rain sensors required on irrigation systems ��'!#CtEt Tj(�. ; • Avg.GPM (2"turbo required unless smaller size allowed by Public Works) Meters Call(651)675-5646 to verity that tests passed qrior to picking up meter. ` Domestic:Size&Type Fire: 1 Avg.GPM High demand devices? Yes No Flushometers_Yes No . oG COMMERCIAL FEES Contract Value$t.�B� �� x.01 $55.00 Permit Fee Minimum � _$ �� � Permit Fee �� �If contract value is LESS than$10,010, Surcharge=$5.00 =$ � � Surcharge* '*if contract value is GREATER than$10,010, Surcharge=Contract Value x$0.0005 0�,=....-- "�'If the project valuation is over$1 million, please call for Surcharge -$ �o TOTAL FEE Following fees apply when installing a new lawn irrigation system $ Water Permit Contact the City's Engineering Department,(651)675-5646,for required fee amounts. $ Treatment Plant $ Water Supply&Storage $ State Surcharge _$ TOTAL FEE CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. \ 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 �'//��,/C C-���•�— x ��� ApplicanYs Printed Name ApplicanYs Signature �Q�t'.4��I�E l���° Appr�r�d By. ' ° ��� �'�' ' � �uir.�s�.�ns���: �nd$t�i'ound �i�augh-Ir� �:.,y,Air'C�est G�s.T�,���„E��a� �'1��/ ti��n.�,;..�.���.F�4 �e��a'R��a�ed�r�s: '.I��tB�`�fze ` ��c#i�F��ad �tl�r�crr���r' �#a�f Page 1 of 3 Use BLUE or BLACK Ink � , ' r---------------- I For Office Use . ^�/� � � ,�� �' �/ ` � Permit#: � _ � _ Clt of �a0a� , /� � �> ,s � b I Permit Fee: �E/�� � 3830 Pilot Knob Road � ,�°� ��� Eagan MN 55122 � �V��� � I Date Received: I Phone: (651)675-5675 i i Fax: (651) 675-5694 ��������`-� j Staff: I MAY 2 S 1Qi� �-----------------� 2015 COMMERCIAL BUILDING PERMIT APPLICATION A ,- Q ' Date: 5 �Z` ` �� Site Address: 3�3� `7��^�L��'/ � ' , Tenant Name: ��G� ��li S���N'�'N (Tenant is: New/ l� Existing) Suite#: Former Tenant: � Name: ��D�'1 �'f� W1� Phone: � � � � � �rv�ert���flwr�r � � 35,� l��`�° c� 1�il�C ,�1.���� � z x �, Address/City/Zip: � ;�� �� �� � :; Applicant is: Owner � Contractor � �R � � e �� ��� �` ` Description of work: ���� �rd'�'°��''�'� �'! ��' ��� ��� ' �����°�1��.� �: � � � �q� ��r�„ . � � � i Construction Cost: �� � � r =' Name: � ��� ���`��EN �O�'►�rl/ �^�'� ' License-#: � � �� Address: 3�� � �� � � � City: ���^��' �ontr�c�c�r � State: (!�N Zip: '� �ZOp� Phone: t�� ��20��Q�� �j' � ���"� �� /�l C� Dt",r'//t LA c���t l,,v� , Contact: D� Email: �"'� � � ; Name: �`��1 � "'r� Registration#: �� ` �S b�; 2 /' �,cl�i#�ct�n o Address: �4L' �I�-��v'� ���' � City: N�1��S . S��! : � r� � D °� ����� State: M^� Zip: �J�� Phone: ��2- —������ � e�; ..., `�� Contact Person: � ,j br- Email: Licensed plumber installing new sewedwater senrice: Phone#: l4�O�'�, Pl "�.��an�t s� orl�rn��t������,�� ����er�����#� ����'�r�i � "�f, � � � �d,r�s n�', � ���prc�'� 3�. ,�^�c�r'e�� ,�`��roi���!'iri�t�fie G�#�y tv #he r�►forr��tic�n�n,��+�c1a�s,�� r�i # � � � � s : � � . y ,... �> � +� }� �^ — t. ..' r�. ,- � :.�.. �,. � �..� �� .'�,: ..Q��r�i���„�^F�i !.A'G-3.i.' 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.gopherstateonecall.orq 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 eview and approval of plans. �p t X�6�`^�- �t��E a`"ir�; X P �t�2+� �. Applicant's Printed Name ApplicanYs Signature Page 1 of 3 s S 3 � ��c�-E �/�5s �c-f � � . DO NOT WRITE BELOW THIS LINE � ��7 � Y SUB TYPES �oundation _ Public Facility _ Exterior Alteration-Apartments Commercial/Industrial Accessory Building Exterior Alteration-Commercial _ Apartments Greenhouse/Tent _ Exterior Alteration-Public Facility , _ Miscellaneous _ Antennae I, WORK TYPES _ New _ Interior Improvement _ Siding _ Demolish Building* , Addition _ Exterior Improvement _ Reroof _ Demolish Interior I �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 -� I� Valuation 1�'� ��� s Occupancy � MCES System �J�.S ,�+'i����� Plan Review + e.._S Code Edition �0%5�`/Y�5lg(� SAC Units �� �(.1�e,,� (25% . 100%� Zoning ��� CityWater � ����fi�,� Census Code Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Sprinklers Type of Construction -� Width REQUIRED INSPECTIONS Footings(New Building) Sheetrock Footings(Deck) �F'nal/C.O. Required Footings(Addition) ✓ Final/No C.O. Required Foundation Other: Drain Tile Pool:_Footings _Air/Gas Tests _Final Roof:_Decking _Insulation _Ice&Water _Final Siding:_Stucco Lath _Stone Lath _Brick � Framing Windows Fireplace:_Rough In Air Test _Final Retaining Wall Insulation Erosion Control Meter Size: Concre Entrance Apron Final C/O Inspection: Schedule Fire Marshal to be present: Yes No ' • ''"r���r- Reviewed By: �I�t..- L. , Building Inspector Reviewed By: � , Planning COMMERCIAL FEES Base Fee .'`��(�� 7J� Water Quality Surcharge ��� � Water Sampling Fee Plan Review ��a `(rJ� �` Water Supply&Storage(WAC) MCES SAC Storm Sewer Trunk City SAC Sewer Trunk S8�W Permit&Surcharge Water Trunk Treatment Plant Street Lateral Treatment Plant(Irrigation) Street Park Dedication Water Lateral Trail Dedication Other: Water Quality TOTAL � � �( 5��+ �,/,� Page2of3 ( Use BLUE or BLACK Ink C;��.�' � ,-----------------, �' /a'/7S � For O�ce Use � C�6Ol L� �11 C�`����(� i Permit#: '����"� i � � � jPermit Fee: j 3830 Pitot Knob Road � � � Eagan MN 55122 � Date Received:�'o��"'�l � Phone:(651)675-5675 I I Fax:(651)675-5694 C � / � JU�. 2 o LD�J � Staff<fG7 � . ��__��__���__�__�J 2015 FIRE SUPPRESSION SYSTEMS PERMIT APPLICATION* Date:_,� � Site Address: ,�e 3� ,��� �r� �� Tenant:_ \���Ue- �sS �,� ,Sf°D i��� Suite#: J�}R�6 t� F6'rrr�— Name:_ .���.,� Phone: PrOperty OW1t@F: Address/City/Zip: Applicant is: Owner Contractor Type of Work Descriptionofwork: �d� ����a� �+'" /1tU �C►�,l-.a ���io��'S" � o _ _ _ -- - ___ Construction Cost: �.� Estimated Completion Date: �d,���IS' Name: l `e License#: �' d75 Contractor Address: � CV•o�i� City: �„� State:�Zip: .3.x0� Phone: l0 5�� dS�! '�� Contact: ��} r'�� Email: �wcr��+ StJ �'►'i►'�ca�/S� FIRE PERMIT TYPE WORK TYPE �prinkler System(#of heads�) New Addition _Fire Pump _Standpipe Alterations �emodel Other. Other: DESCRIPTION OF WORK: _Commercial _Residentia! _Educationa! FEES $55.00 Permit Fee Minimum Contract Value$ .�.� x.01 �If contract value is LESS than$10,010,Surcharge=$5.00 "`If contract value is GREATER than$10,010,Surcharge=Contract Value x$0.0005 =$ �'�'S UU Permit Fee '**If the project valuation is over$1 million, please call for Surcharge =$ s.(J� Surcharge* $100.00 Residential New(includes$5.00 State Surcharge) _$ '���U(� TQTf;�FEE 3/4"Displacement Fire Meter-$270.00 =$ Fire Meter _$ TOTAL FEE *Requirements:2 complete sets of drawings and specifications,cut sheets on materials and components to be used I hereby apply for a Fire Suppression System permit and acknowledge that the information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Minnesota Building/Fire Codes;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 �'�,r�s � kU�r�k X � Applica�t's Printed Name Applicant's Signature 1�.� vo5 S 13 1 FOR OFFICE USE REQUIRED IN,SPECTIONS Hydrostatic FlowAlarm Drain Test �' Rough In Trip' : Pump Test Gentral S3ation �! ,Final = Conditioris of Issuance: " '� `�� �� _ +s.�'�L�" Date� / � / ,'�� P.,ermit�Reviewed•;b > . , , �.�, -, { -� G� � `\' `�(; dC� _ _ Use BLUE or BLACK ink n5 \�'' �� 4 � For Office Use I � ,.���tY�,�k.�?�'�� Q��` i Pennit#: ���� i � city of Ea��� � � �.;� ��. � � g�� a.s � 3830 Pilot Knob Road r` � Permit Fee: � � � I Eagan MN 55122 ���-_' I ��'�i�� � Phone:(651) 675-5675 ��",� ;. ��;. t.��'� � Date Received: I Fax: (651)675-5694 '� � �' I � � Staff: � I 2015 (VIEC�-I�f�11�,�L PERMlT APPLICATION � Please submit two (2) sets of pians with ali commercial applications. Date: '�'�-1 -� � SiteAddress: J �3� ��UI.LrC�SS Tenant: �JG� � Suite#: , �-__..... ---_.__-__.�___:. �._.� ,..u.�. .. _....._.�.. .-..�_.v....._.�_.��_.�.._.�.__.._�� ..__ .......�..�....:,��u.__.. �._.m..�.�,..._w._e_�....__�_...�...�.�.__�._..__w__� fi �� ? i Name: Phone: 6 Resident/awr�er $ : Address/City/Zip: ? ._�...�,w .. .._.���.�_....... _.�. �... _ .u...._ . _._._....._.�..�.�_.�,_..._.____.._�._._..�.___�,�,�w _..�...__..�.._.�.., , .�.��.�._ __..M.y.�� ..�.._ ...._�._. � /'� , A �_" � , ? Name. �.19d���(Zril,'� �"l LC.Y�;I.'VLI�R.�icense#: N/(� n� ��3�{ E � , , 6 � Address: SII y �"�1���I'�U�'U /�T!/'C- City: ��e� �/OrO� � � Contractor � f� D � � � State: /VZip: SS��(J Phone: (��o�" c�. �O�( "' �2D� � g t ' R � � Contact ��v� , „�.,...�_.�. .* � f,bY4POJ`G�.�t 1Ms�)J�'j.�JI��C�',c,•�C1'�- `plQ�' Email �� f.�, . a, ����_� �..... _�.M�,....�.�.��,.��.w. .�-.. �......� �..�_.,,���..,���,.� .Nu...��. .,�.�.w,�,�� ,, q � , New �Replacement _Additional �Alteration Demolition � � ; � . § � � � UU � Type of Work �. Descript�on of work � (e �Y' Fj� � v� dlS l,/�D���� � �..:4.�...� .�.�w��..�F.�.�.�..,.,.Y.�.�..�,.�,���.�. �.���.���..�...�.� -....��.w,�,.n..�,.�...,�.,�.m.� , . ..�.� ' � NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened by City,;t Y t � : Code. Please contact the Mechanical inspector for information on permitted screening.methods. � , ..Mu...:�_��..,�,.�_..��.��.�..4.�. ......,.µ__,....... ,�,.....�.��.,w..�,...�_..�.w..,,�,o:..�..�.�.�,,, � ..,f.�w�,.,,�,�......_.��.N...�.�....�,w.�...._..,......�,....,...,�.�.�,.�...�.��.c_„�..��..._,.,,_..�, � �.._�� � � � RESIDENTIAL � COMMERCIAL E � ; _Fumace � ,New Construction _Interior Improvement g � �2Ci111t Typ@' i —Air Conditioner � �fnstall Piping _Processed � � i ' � ., _Air Exchanger � _Gas _E�erior I-IVAC Unit � � � ; _Heat Pump � _UnderlAbove ground Tank (_Install/_Remove) � � � ' Other � ` �..�,�.�.., :.. ..�_.:,.�..� .�.,...:�._,.z.........�.�<-_,,.�.��.�...,..��. � ..���.z,�....,� ,..�,�___v.,_t.y�.�_..w......... .......�._.�..�.�..,..,_.a.�.�.�.,��........,�:_...�r,....�..<.�.,�..�.�.�....,�.���,..�..�.....�,.4 # i RESIDENTlAL FEES i ; $60.00 Minimum Add or alteration to an existing unit(includes $5.00 State Surcharge) f � $10Q.00 Residential New(includes $5.00 State Surcharge) _ $ TOTAL FEE i �_.. W...__. .�,.._�._ .._ ._..., . ._ �.�. _ .�_� . .v.�u. �.,..._, � ...a..�.M �,,.A..,..._ . x . M� ....�.�_. _._....� _ .___ . ,_ _,... �.�_�..a. .... ._.v. ,.. �'i � COMMERCIAL FEES Contract Value $ 4 , �� x.01 � ; $55.00 Permit Fee Minimum � �`� ; � � $70.00 Underground tank ii�stallation/removai =$ � �`� � a Permit Fee q _ ; *If contract value is LESS than $10,010, Surcharge= $5.00 =� �e� +a� Surcharge* � *"If contract value is GREATER than $10,010, Surcharge=Contract Vaiue x$0.0005 � ' ***If the project valuation is over$1 million, please call for Surcharge =� �g�� �� TOTAL FEE � � ,m._.... . _.�._...u. ..... ... .. ....�u.�.. ..._... �. .,..,_._. . .�,. .�_..�_....,.��w....w.,..__...�... .�._...__ w. ...__._�.. . �.�._...,_�.., � ..._..� .._.�__ ...,.. ..,,.�...,,�. I hereby acknowledge that this information is complete and accurate; thai the work will be in conformance with the ordinances and codes of ihe City of Eagan; that I understand this is not a permii,but only an application for a pennit,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. I � 1 x , \ �f x ApplicanYs Printed Name ApplicanYs ignature FOR OFFICE USE �� �� � Required Inspec±:ons; Reviewed By: Date: � Underground ough In iC Air Test Gas Service Test _In-floor Heat �nal HVAC Screening 41' City ef Eaall 3830 Pilot Knob Road Eagan MN 55122 = ,� „„ 1 �, Phone: (651) 675-5675 t ' -) QLD Fax: (651) 675-5694 DEL 282015 Use BLUE or BLACK Ink For Office Use —7 Permit #: J 3q Permit Fee: ,.3g(. v" -/ Date Received: Staff: 2015 COMMERCIAL BUILDING PERMIT APPLICATION Date: 12.28.15 Site Address: Tenant Name: BlueCross BlueShield 3535 Blue Cross Road Eagan, MN 55122 (Tenant is: New / X Existing) Suite #: Former Tenant: Health Landloard (MN) LLC - ( Randy Blaha with Blue Cross, Name: Phone: 651.662.2542 Address / City / Zip: PO Box 64560, Saint Paul MN 55164 Applicant is: Owner Description of work: Cooling Tower Replacement Construction Cost: $444,890.00 ( Does not include Electrical and Mechanical - Separate Permits.) Name: Mortenson Construction License #: AM008193 iuu iweaaow pane i� City: Minneapolis Phone: 612.916.4605 Email: Sam.Kaler@Mortenson.com Name: Dunham Associates, Inc. Registration #. 40436 Address: 50 South Sixth Street Suite 1100 City: Minneapolis State: MN Zip: 55402 Phone: 612.465.7690 Contact Person: Darren Regan Email: Darren.Regan@dunhameng.com Licensed plumber installing new sewer/water service: Phone #: 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 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 1< / e Applicant's Printed Name x Applicant's Signature Page 1 of 3 �?sS r � 4i,t.,E DO NOT WRITE BELOW THIS LINE SUB TYPES Foundation Public Facility Accessory Building Greenhouse / Tent Miscellaneous Antennae v' Commercial / Industrial Apartments WORK TYPES New Addition Interior Improvement ✓ Exterior Improvement Alteration Repair Replace Water Damage Salon Owner Change DESCRIPTION Valuation Plan Review (25% 100% ✓S Census Code # of Units # of Buildings Type of Construction II VS; 6'00— Occupancy *% Code Edition Zoning Stories 0 Square Feet / Length Width REQUIRED INSPECTIONS V Footings (New Building) Footings (Deck) Footings (Addition) V Foundation Drain Tile Roof: _Decking Insulation Ice & Water Final ,/ Framing Fireplace: Rough In Air Test Final Insulation Meter Size: Final CIO Inspection: Schedule Fire Marshal to be present: Reviewed By: , Building Inspector Exterior Alteration -Apartments Exterior Alteration -Commercial Exterior Alteration -Public Facility Siding Reroof Windows Fire Repair Demolish Building* Demolish Interior Demolish Foundation Retaining Wall *Demolition of entire building - give PCA handout to applicant 13/u ZDt SIBG r> MCES System SAC Units City Water Booster Pump PRV Fire Sprinklers Sheetrock Final / C.O. Required ✓ Final / No C.O. Required Other: Pool: _Footings Air/Gas Tests _Final Siding: _Stucco Lath Stone Lath Brick Windows Retaining Wall Erosion Control Concrete Entrance Apron Yes No Reviewed By: , Planning COMMERCIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC S&W Permit & Surcharge Treatment Plant Treatment Plant (Irrigation) Park Dedication Trail Dedication Water Quality 3/zc, .7S' 277.56 26 32. .3� Water Quality Water Sampling Fee Storm Sewer Trunk Sewer Trunk Water Trunk Street Lateral Street Water Lateral Other: TOTAL 53 _/ • tO V Page 2 of 3 City ef aeau 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 mg3 q (L oc A x'03 CA4 cg- IA -14 .Kcid jwCEIVE() QEc292015 Use BLUE or BLACK Ink For Office Use Permit #: / — / / 3 5i Permit Fee: /Of b r Date Received: Staff: 2015 MECHANICAL PERMIT APPLICATION 121 Please submit two (2) sets of plans with all commercial applications. Date: 12/28/15 Site Address: 3535 Blue Cross Road, Eagan MN 55122 Tenant: Blue Cross Blue Shield of Minnesota Suite #: J Res, etlt/OWiler� Name: Blue Cross Blue Shield of Minnesota Phone: Address / City / Zip: 3535 Blue Cross Road, Eagan MN 55122 Contractors yn r a Name: Metropolitan Mechanical Contractors, Inc. License #: 20-0832303 Address: 7450 Flying Cloud Drive City: Eden Prairie State: MN Zip: 55344 Phone: 952-941-7010 Chapman a man e.ca man Contact: P Email: rinhmetromech.us p @ Type of Work Perrnit Type n New Replacement Additional Alteration Demolition Description of work: NOTE Roof mounted and ground mounted Code Please1contact the Mechanical RESIDENTIAL Furnace mechanical equipmen isrec a red t. • Yscreened y Cita Inspector for inform on on permitted screening methods COMMERCIAL New Construction iC Interior Improvement Air Conditioner i, Install Piping Processed Air Exchanger Gas Exterior HVAC Unit Heat Pump Under/Above ground Tank ( Install / Remove) Other kraA) t OD 11%1 �� ��G��LG em.Nev K. oka-- RESIDENTIAL FEES $60.00 Minimum Add or alteration to an existing unit, includes State includes State Surcharge Jam' ta4K, Surcharge , = $ N/A- TOTAL FEE $100.00 Residential New, COMMERCIAL FEES $60.00 Permit Fee Minimum Contract Value #40 (ifl (00.0-0 x .01 = $ 151-11-(00 Permit Fee $70.00 Underground tank installation/removal Surcharge = Contract Value x $0.0005 If the project valuation is over $1 million, please call for Surcharge _ $ 5O7.?O Surcharge = s fO(7X , 3a TOTAL FEE 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. Erin Chapman Applicant's Printed Name x Applicant's Sign i ure City of Eakail 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 CitedL et- cIc 9103rin- RL t.:EIVED DEC 2 9 2015 Use BLUE or BLACK Ink For Office Use Permit #: Permit Fee: .-9c7 Date Received: Staff: 2015 COMMERCIAL PLUMBING PERMIT APPLICATION I-1 Please submit two (2) sets of plans with all commercial applications. Date: 12/28/15 Site Address: 3535 Blue Cross Road, Eagan MN 55122 Tenant: Blue Cross Blue Shield of Minnesota Property Owner Contractor Name: Blue Cross Blue Shield of Minnesota Phone: Suite : Name: Metropolitan Mechanical Contractors, Inc.20-0832303 License #: Address: 7450 Flying Cloud Drive City: Eden Praire Phone: 952-941-7010 Email: Erin CrlaPnlan State: MN Zip: 55344 erin.thapnlan@rnetrornech.us Type of Work Permit Type New Replacement Repair Rebuild X Modify Space Work in R.O.W. fkilodify CW domestic water, add new softner skid, install-FiW emergency eye Description of work: wash and mixing valve. COMMERCIAL New Construction X Modify Space irrigation System ( yes / no) ( RPZ PVB) • Rain sensors required on irrigation systems • Avg. GPM (2" turbo required unless smaller size allowed by Public Works) Meters Call (651) 675-5646 to verity that tests passed prior to picking up meter. Domestic: Size & Type Fire: 1 Avg. GPM High demand devices? Yes _No Flushometers Yes' No COMMERCIAL FEES $60.00 Permit Fee Minimum $60.00 PVB/RPZ Permit (includes State Surcharge) Surcharge = Contract Value x $0.0005 If the project valuation is over $1 million, please call for Surcharge Following fees apply when installing a new lawn irrigation system Contact the City's Engineering Department, (651) 675-5646, for required fee amounts. Contract Value $ 85,000.00 x .01 $ 850.00 42,50 892.50 $ 892.50 Permit Fee Surcharge TOTAL FEE Water Permit Treatment Plant Water Supply & Storage State Surcharge TOTAL FEE CALL BEFORE YOU DIG. Call 'Gopher State One Call at (651) 454-0002 for protection against underground utility damage. \ 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. Erin Chapman Applicant's Printed Name Applicant's Signet 4 re 1111(r Page 1 of 4 C!ty of Ekon 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 RECEIVED JUL 2 9 2016 Use BLUE or BLACK Ink For Office Use y� Permit #: /J / / (� 3 7 Permit Fee: /e0 Date Received: -7-44 Staff: 2016 COMMERCIAL PLUMBING PERMIT APPLICATION ❑ Please submit two (2) sets of plans with all commercial applications. Date: 07/25/2016 Site Address: 3535 Blue Cross Road Eagan, MN. 55121 Tenant: Blue Cross Suite #: Property Owner Name: Blue Cross Phone: Contractor Name: Schadegg Mechanical License #: PC Cott'( L Z 1 (s+.rIc 40 Address: 225 Bridgepoint Drive City: South St. Paul State: MN Zip: 55075 Phone: 651-292-9933 Email: Type of Work — New Replacement Repair 0/Rebuild Modify Space Work in R.O.W. _ — Description of work: Test six (6) RPZs rebuild one (1) RPZ Permit Type COMMERCIAL New Construction Modify Space Irrigation System (_ yes / no) ( RPZ / PVB) • Rain sensors required on irrigation systems • Avg. GPM (2" turbo required unless smaller size allowed by Public Works) Meters Call (651) 675-5646 to verity that tests passed prior to picking up meter. Domestic: Size & Type Fire: 1 Avg. GPM High demand devices? Yes _No Flushometers _Yes _No COMMERCIAL FEES $60.00 Permit Fee Contract Value $2000.00 x .01 Minimum 60.00 $60.00 PVB/RPZ Permit Surcharge = Contract If the project valuation _ $ Permit Fee (includes State Surcharge) _ $ NA Surcharge Value x $0.0005 60.00 is over $1 million, please call for Surcharge = $ TOTAL FEE Following fees apply Contact the City's Engineering when installing a new lawn irrigation system $ Water Permit Department, (651) 675-5646, for required fee amounts. $ Treatment Plant $ Water Supply & Storage $ State Surcharge = $ TOTAL FEE CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. \ 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 STi19B>M Applicant's Printed Name x Applicant's ature FOR OFFICE USE Approved By: Date: Required Inspections: _Under Ground _Rough -In _Air Test _Gas Test _Final PRV Required: _ Yes No Meter Related Items: Meter Size Radio Read Manometer Staff: Page 1 of 3 Dale Schoeppner From: Bjorklund, Gary (DLI) <Gary.Bjorklund@state.mn.us> Sent: Friday, August 26, 2016 2:32 PM To: 'peggie.splittstoser@otis.com'; 'peggie.splittstoser@otis.com'; Dale Schoeppner; DU.Elevator.ETrakit Final Approval for Permit Work at 3535 Blue Cross Rd, EAGAN Subject: OTIS ELEVATOR COMPANY: The ELV REPAIR permit work has been completed and approved for the following project: Permit Number. .-€tV1.G08-O0232— Project e: Blue Cross Blue Shield Main Car Site Lo ation: 3535 Blue Cross Rd, EAGAN The Department of Labor and Industry is required to inspect and provide approvals on elevator related devices prior to allowing them to be placed into service. An Inspector from the Elevator Safety Section recently performed an inspection of the work performed under the permit listed at the site above. The repairs are in compliance with the Department rules for elevators. CONSTRUCTION CODES & LICENSING DIVISION Elevator Section 1 IA Lti-liiy CL Use BLUE or BLACK Ink ch6_6K- of, For Office Use D 2-8 Permit#: 4111' City of Eaaali (//cfri s 6 .c 3830 Pilot Knob Road Permit Fee: Eagan MN 55122 Phone: (651)675-5675 Date Received:—'f Fax: (651)675-5694 0 .0 Staff: r!� J 2016 MECHANICAL PERMIT APPLICATION ® Please submit two (2) sets of plans with all commercial applications. Date: 11/30/16 Site Address: 3535 Blue Cross Road,Eagan MN Tenant: BCBS of Minnesota Suite#: Name: Blue Cross Blue Shield of Minnesota Phone: 651-662-8000 Resident/Owner Address/City/Zip: 3535 Blue Cross Road,Eagan MN 55122 2. Name: Metropolitan Mechanical Contractors,Inc License#: 20-0832303 i3 gt Address: 7450 Flying Cloud Drive City: Eden Prairie `ontr1{to �* State: MN Zip: 55344 Phone: 612-269-2559 ,_< - Contact: Erin Chapman Email: erin.chapman@metromech.us 1-':'m., , E i New Replacement Additional X Alteration Demolition : « « $ Description of work: Remove existing boiler and install(4)new condensing boilers e`- 1' " NOTE Roof mounted andground mounted mechanical eq u� ment is required to be screenedby cit ' - Code :Please'.contacttheMechanical ins ,ectorforinformation`on erns :� .. Y � �, q p ,.- - p„ p at#ed screening methods a> RESIDENTIAL COMMERCIAL , Furnace New Construction Interior Improvement '- Air WM Conditioner X Install Piping Processed Air Exchanger X Gas Exterior HVAC Unit Heat Pump Under/Above ground Tank ( Install/ Remove) Other RESIDENTIAL FEES $60.00 Minimum Add or alteration to an existing unit, includes State Surcharge $100.00 Residential New, includes State Surcharge =$ TOTAL FEE COMMERCIAL FEES Contract Value$ 605,691.00 x.01 $60.00 Permit Fee Minimum $75.00 Underground tank installation/removal, includes State Surcharge =$ 6056.91 Permit Fee =$ 302.85 Surcharge Surcharge=Contract Value x$0.0005 If the project valuation is over$1 million, please call for Surcharge =$ 6,359.76 TOTAL FEE 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 fora permit,and work is not to start without a permit;thaat the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. x Erin Chapman x Applicant's Printed Name Applicant'sSig ture FOR O_ lC ij E {. : Require` #l'® '-4,- Reviewe«..B ®. -41��� u"e `�� -�- "�.z�' � �` x 1 �- = <-�- -�.•ate � e;� Undergrounds .e R©igh In -- ,Ai Test .-4,4?---: 4'4.',-1,GasrService= est In floor eat . 1 « Use BLUE or BLACK Ink For Office Use �/// ) -7 / 14 of Eapft Permit#: ! -/ _ / / (� *C Permit Fee: I&- F 3830 Pilot Knob Road Eagan MN 55122 RECEIVED Date Received: Phone:(651)675-5675 Fax:(651)675-5694 JUL 4 2017 Staff: J 2017 COMMERCIAL PLUMBING PERMIT APPLICATION ❑ Please submit two (2)sets of plans with all commercial applications. Date: 6/30/17 Site Address: 3535 BLUE CROSS ROAD Tenant: BLUE CROSS BLUE SHIELD Suite#: kt ! SAME AS ABOVE (MIKE BRULES) 612-369-3520 ,k Name: Phone: Q° METROPOLITAN MECHANICAL CONTRACTORS z � �` Name: License#: P C 6 4 2 8 3 3 a ra' .'. Address: 7450 FLYING CLOUD DR City: EDEN PRAIRIE State: MN Zip: 55344 Phone: 952-941-7010 Email: Shawn.berger@metromech.us \`,a-4 X New Replacement Repair _Rebuild Modify Space Work in R.O.W. 44 Description of work: RPZ INSTALL `* i5 ' COMMERCIAL New Construction Modify Space ` '` X Irrigation System( yes/_no)( X RPZ/_PVB) i £;6 Rain sensors required •on irrigation systems • � ermT( • Avg.GPM (2"turbo required unless smaller size allowed by Public Works) • 4„ z _Meters Call(651)675-5646 to verity that tests passed prior to picking u.o meter. i Domestic:Size&Type Fire: 1 ,,,( , iift. Avg.GPM High demand devices? Yes_No Flushometers_Yes_No COMMERCIAL FEES Contract Value$ x.01 $60.00 Permit Fee Minimum 60 . 00 $60.00 PVB/RPZ Permit(includes State Surcharge) _$ Permit Fee $ 0 Surcharge Surcharge=Contract Value x$0.0005 60 . 00 If the project valuation is over$1 million,please call for Surcharge =$ TOTAL FEE Following fees apply when installing a new lawn irrigation system $ Water Permit Contact the City's Engineering Department,(651)675-5646,for required fee amounts. $ Treatment Plant $ Water Supply&Storage $ State Surcharge -$ TOTAL FEE CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. 1 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 o 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 SHAWN BERGER x, 11A,P _ `!. 4 � -Zy' ` ' - Applicant's Signature /Applicant's Printed Name ps a �� g! t � rz' \ I::C , � sk2¢ Y mo3w^ thR$ r. N,-;,V;:,-4,";',.!W \ iY9 " r u y RViRq Ye, � � ud i h- Aika T7lh® . s� ons C, .. v... ,rw,. Page 1 of 3 DocuSign Envelope ID:EE5B866B-9E30-4079-8C79-DFO7BFC4CB25 AUG• 1 2017 Usece oBLACK Ink i 1 0.0 101V G E 4cr . of li PermitPermit#:For OffiFee:Ui3C- BsLeUE City 3830 Pilot Knob Road Eagan MN 55122 Date Received: 48'.21`1 jilt Phone: (651)675-5675 buildinginspections(acitvofeacian.com Staff: J 2017 COMMERCIAL BUILDING PERMIT APPLICATION Date:9/7/18 Site Address: 3535 Blue Cross Road, Eagan, MN 55122(Main Building) Tenant Name: Blue Cross and Blue Shield of Minnesota (Tenant is: New/_X_Existing) Suite#: Former Tenant: s <4 Name: Blue Cross and Blue Shield of Minnesota Phone:651-662-8997 pe Owner Address/City/Zip: 3535 Blue Cross Road, Eagan, MN 55122 (' Iii Applicant is: X_Owner Contractor phi • Description of work: Putting up a 40'x 100' for an employee picnic 4000 Sr -. pao>ti e - � Construction Cost: Eft1EA'f III' Qa 01 — 1 . Name: Ultimate Events--Tim Smith License#: 2 Cont Address: 13405 15th Ave. North City: Plymouth .% State:MN Zip: 55441 Phone:763-559-6206 ..," Contact:Tim Smith Email: tsmith@ue-mn.com Name: Registration#: 4' ArciYitect/E Address: City: State: Zip: Phone: �� ale. Contact Person: Email: Licensed plumber installing new sewer/water service: Phone#: s } s ns a ° ta/n g! #ys u".. fi =rt.del' ® o ®e.o ,...,:c; ..dnfe atlon ortions in i'1317 e ion maybe c! e o >, lc you provides rc re t would% e t �r #o conclude h e ar rade sp r 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. 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.gopherstateonecall.orq 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. p—DocuSigned by: Ki rsti a Foster �` fosk.r x x Applicant's Printed Name Applii ta ure Page 1 of 3 i-J $ iIi' DocuSign Envelope ID:EE5B866B-9E30-4079-8C79-DFO7BFC4CB25 J�r7��, DO NOT WRITE BELOW THIS LINE z-lt v\ SUB TYPES –3S-3' U (,,c ( LS IU Foundation _ Public Facility Exterior Alteration–Apartments _ Commercial/Industrial _ Accessory Building _ Exterior Alteration–Commercial Apartments Greenhouse/Tent _ Exterior Alteration–Public Facility •Miscellaneous Antennae WORK TYPES V 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 fife*. f� `Occupancy 4 MCES System NA' Plan Review Code Edition ZO IS 1141) . SAC Units (25% 100%_) ---- Zoning City Water Census Code Stories Booster Pump #of Units Square Feet if teob PRV #of Buildings Length 100 ` Fire Sprinklers Type of Construction Width tip 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: ✓ Yes No Reviewed By: , I , Planning New Business to Eagan: Reviewed By: ` "� , Building Inspector FEES Water Quality Base Fee 1.35.6'''6 Storm Sewer Trunk r Surcharge /AttL$ Sewer Trunk Plan Review /NGL4 Water Trunk MCES SAC Street Lateral City SAC Street SSW Permit&Surcharge Water Lateral Treatment Plant Stormwater Performance Security Treatment Plant(Irrigation) Landscape Security Park Dedication Other: Trail Dedication TOTAL: ''#/.35-' 610 Page 2 of 3 z< ° NIs' m o�8 :x .4- to a m a 0 7 yrs. #111144 , t Y .may & .t' 0 esf.t), v I V4 :., 'J wet o,.'tn`,,,,,'N'. ',,t. 4 ,, .., ,„,4 ,,,,:e,..„. g . .„ , i..,,...0, / ... 3, . ,„ I . .6., ,,, ,,,,, ,, . .,„.., .. ,, , i_ _•, -,..„„,,, .,.. / ,.,r 1,,irr,...!i. it* ', 6 to r, r rJ' "a f� .- �'R .i ' 'II y� .,..:i„ritAlz.,. . it Vz �: :A Y *yf it �F cn WE:. 61) Eczz Lf.) s A� ,,R,•.'+d -'e''Qyy ,, �:5 $'Ar. �C± (• 75 CO in °' CO Q J N to IS i • N I¢ !! I =� } 1 "•" , bi4. + * yxa • °,- N ' ;Pi; II - .ti' ,"% ' ' 3 Ln Ri CD to CI2. ) p p s c4.4 Ca-' O (?� C �O 'O tn +' '� g'a ,,, °°net N O o o Q _ . p a, 0 > t O N N uo +0' J E 4O " ate' C •i U +' 8A 'O U N v v- (O N ._ i� VI C N C E ci O2f N >,(13 Q H +, n < O NI Q- c o o O — rn E +' 8 L Q u o +� v > Q f 6 U ,‘i,' C V Ea' o 'al g < .v 2 ' - vim-. c ° .0 NO o c `° n •Q c' 8 N c C U Q. C L T p O X ® C w° ,o ci-z too +.. c U O +•J g � aJ U u. -' n w o a; ca •N o a l0 A n v a) a' •E _p , _ ° o u z ata a, Yn o u, «' a tea, v ° m v N o 2 O •.° .a• L - v 2.3 ,21 a c• on 0 aj •v c �, oA N O ._ Q. a) U N v a?S v cu O a 'p -a -a o2S 'x4-1 • '� E• cu +� U u i s a.° ;,_ n o o a, 'n-.., r 3 E O ° c Q) LL Oc C N co +p' O z a1 c z O� •X N• c C " 4, • 0 +' `.° o C .aov‘11 vi ° o �47-. tA co c `� 4- :g c � o 'co CE. '� N N o '� u O_ i E E 00) (.9 aJ U ate-+ E N v ® u O O O Eo L C C +O, a•' +' 6 0 O ? O .® F— L2 '— v c.) t� cn V) U v g O io L 0 coo Use BLUE or BLACK Ink r I For Office Us -`� Permit#: /LS ` City of Eaall G G} 3830 Pilot Knob Road n5 (- Permit Fee: / / / Eagan MN 55122 �" fh3 ("l I Phone:(651)675-5675 Date Received: i L Staff: /' J 2017 MECHANICAL PERMIT APPLICATION ❑ Please submit two(2)sets of plans with all commercial applications. Date: Site Address: 3535 Bluecross Road Eagan, MN 55122 Tenant: Mike Bruels Suite#: ter\ v Name: Blue Cross Blue Sheild Phone: 651-662-8000 3535 Bluecross Road Eagan, MN 55122 2, Address/City •/Zip: g f' '' Name: Metropolitan Mechanical Contractors License#: to Address:7450 Flying Could Drive City: Eagan Tam. `' State: MN Zip: 55344 Phone: 952-941-7010 Contact: Erin Chapman Email: Erin.Chapman@metromech.us ti w NeReplacement Additional Alteration Demolition ; o Wor Description of work: Replacing two Air Handling Units OL-': _ off and ground .Ion C e+ han ul t t I re ired to be screened by City Cw.•.e Please,.. ° the Mechanical 11114)ctor WitittprOatiPit on,permitted ening,»methods.. 4 RESIDENTIAL COMMERCIAL y 4:Nk : Furnace New Construction Interior Improvement Noe \ � _Air Conditioner X Install Piping Processed Air Exchanger Gas Exterior HVAC Unit \ Heat Pump _Under/Above ground Tank ( Install/_Remove) Other RESIDENTIAL FEES $60.00 Minimum Add or alteration to an existing unit,includes State Surcharge $100.00 Residential New,includes State Surcharge =$ TOTAL FEE COMMERCIAL FEES 298,988 Contract Value$ x.01 $60.00 Permit Fee Minimum $75.00 Underground tank installation/removal,includes State Surcharge =$ 2,989.88 Permit Fee _$ 149.50 Surcharge Surcharge=Contract Value x$0.0005 If the project valuation is over$1 million,please call for Surcharge =$ 3,139.38 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.citvofeagan.com/subscribe. 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' (to r0) 5A', illi f ii:zxt1 Applicant's Printed Name Ap licant's Sig t re FCR OFFICE USE z`N Oa gr-if ,,y, Inspection i, t611 Reviewed n rou . .,124,iough In „. . as Service Test..- In--ii.t#tat . ,: .F ..01l ;.HVAC c ening .. Use BLUE or BLACK Ink r i For Office Use � City of Eaiall Permit#: 4" 7 P {``F 3830 Pilot Knob Road Permit Fee: /2 b v 0 Eagan MN 55122 ...1, U,ot Date Received: 0 31'1 (651)675-5675 ' 'A'fl S`0-6 L Staff: 67 J buildinoinspectionsOcitvofeadan.com 2017 COMMERCIAL PLUMBING PERMIT APPLICATION ❑ Please submit two(2)sets of plans with all commercial applications. Date: Site Address: 3535 Bluecross Road Eagan, MN 55122 Tenant: Mike Bruels Suite#: Fr• _1 9 ' 9e74, Name.• Blue Cross Blue Sheild Phone: 651-662-8000 etro olitan Mechanical Contractors :" Metropolitan P License#: Cotltrac ' Address: 7450 Flying Cloud Drive City: Eden Prairie State: MN Zip: 55344 " ' 952-941-7010 Email:ilErin.Chapman@metromech.us Phone: B Of '? _New ✓ Replacement Repair _Rebuild Modify Space _Work in R.O.W. mss,. Description of work: r C tLC7 r 1.., ( A ,v '� t 1. i - , ,, , COMMERCIAL New Construction x Modify Space Irrigation System(_yes/V no)(_RPZ/_PVB) '�> "' € ' • Rain sensors required on irrigation systems '' it Type • Avg.GPM (2"turbo required unless smaller size allowed by Public Works) ,k,-,b ,, , . Meters Call(651)675-5646 to verity that tests passed prior to picking up meter. Domestic:Size&Type"la Fire: 1 r A. = 1 GPM High demand devices?_Yes_No Flushometers_Yes_No COMMERCIAL FEES Contract Value$12,101 x.01 $60.00 Permit Fee Minimum 122.00 $60.00 PVB/RPZ Permit:(includes State Surcharge) =$ Permit Fee _$ 6.00 Surcharge Surcharge=Contract Value x$0.0005 If the project valuation is over$1 million,please call for Surcharge =$ 128.00 TOTAL FEE Following fees apply when installing a new lawn irrigation system $ Water Permit Contact the City's Engineering Department,(651)675-5646,for required fee amounts. $ Treatment Plant $ Water Supply&Storage $ 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.citvofeagan.com/subscribe. CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. I hereby acknowledge that this information is complete and accurate;that the work will be in confo ..-• e 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 wit,.ut r-rmit;that the work will be in accordanc with the approved plan in the case of work which requires a review and approval of plans. x [ M4,L, -j r Ff1 x `f1 t )61//1/1/1 Applicant's Printed Name App a is Signature Folt s, IC Sf r � " : 'prs, water iRetgttt In ctit .�,-,-t ; /9rounctttiaugltairs ,Q�� Ttttir Final ��t0I0t ;01ftre4iYes' ,‘',' ,,,,,Nd Meteagefited I : ; /leter Sim,.. . .. `�..t ar)ome er 'staff; z. ;,:. 4 Page 1 of 3 Use BLUE or BLACK Ink O For Office Use -7 CityU Eagii Permit#: / 4 U3630 Pilot Knob Ro Eagan MN 55122 i- 'V 4 Date Received: d '' 7 (651)675-5675 buildinninsgectionsacitvofeadan.cornStaf St.= 2. `S 2017 .g 2017 COMMERCIAL PLUMBING PERMIT APPLICATION ❑ Please submit two(2)sets of plans with all commercial applications. p, Date: -3k- (� Site Address: 3E3 t �ti� Cr- R 0 el\GA0.----7 1Z Tenant: - Suite#: Property Owner Name: Blue Cross Phone: Name: Schadegg Mechanical License#: PC644629 contractor Address: 225 Bridgepoint Drive City: South St.Paul State: MN Zip: 55075 Phone: 651-292-9933 Email: e of Work -New 1,17';- -cement Repair 'S/ Rebuild —Modify Space Work in R.O.W. Description of work: COMMERCIAL _„•New Construction Modify Space irrigation System(__..yes!_no)(___RPZ/_PVB) • Rain sensors required on irrigation systems Permit type • Avg.GPM (2"turbo required unless smaller size allowed by Public Works) Meters Call(651)675-5646 to verity that tests passed prior to picking to meter. Domestic:Size&Type Fire: 1 Avg,GPM High demand devices?Yes No Flushometers_Yes_No COMMERCIAL FEES Contract Value$ 21,5-00 •°'° x.01 $60.00 Permit Fee Minimum =$ (a b , Permit Fee $60.00 PVB/RPZ Permit(includes State Surcharge) =$ 0 I Surcharge Surcharge=Contract Value x$0.0005 If the project valuation is over$1 million,please call for Surcharge =$ 'V 00 •(.o TOTAL FEE Following fees apply when installing a new lawn irrigation system $ Water Permit Contact the City's Engineering Department,(651)675-5646,for required fee amounts. $ Treatment Plant $ Water Supply&Storage $ 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.citvofeasran.com/subscribe. CAU,BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage; 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 pe it;that the work will be in accordance with the approved plan ithe n x 1 se of work which requires a review and approval of plans. n lMa - ::.x Applicant's Print ame Applicant's gnature FOR OFFICE USE Approved By Date; Required inspections Under Ground ;,Rough-in Air Test Gas Test Final , PRYRequired�—Yes_'No Meter Related tternin Meter,Size- Radio ReadManometer— Staff: . Page 1 of 3 t f (Gd A{s r For Office Use as , , fi,.....i,, ! l 0�i}�C I:, ® &c/d ::::eeo yL ..L�.. � 3--- 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 Date Received: / 1 (651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 I Email: buildinginspections(c�cityofeagan.com CIE l Staff: I Commercial Plan Submittal: eplans(acityofeagan.com J APR s 3 7018 2018 MECHANICAL PERMIT APPLICATION ❑ Please submit two (2)sets of paper plans with all commercial applications as well as an electronic set of the submittal, submitted via email, CD or flash drive Date: 4/12/18 Site Address: 3535 Blue Cross Road Tenant: Blue Cross Blue Shield of Minnesota Suite#: Blue Cross Blue Shield of Minnesota 800-382-2000 - fResldetlliOwtler>;.. Name: Phone: �� ' same as above , � 44 ,. � Address/City/Zip: 20-0832303 Name: Metropolitan Mechanical Contractors License#: // /r , 7450 FlyingCloud Drive Eden Prairie �69' q40,- > Address: City: dP/c2-CO , Or State: MN Zi P 55311 Phone: 952-941-7010 9 ,-qL 7._ "s 5 Erin Chapman erin.chapman@metromech.us Contact: Email: NewpI Re Demolition lacement Additional Alteration s Remodel existing cafeteria including AHU's that serve cafeteria Type-Of Vvork, Description of work: NOTE Roof mounte-Thd/ vv'Cigrou rmountedmechanicaleq ipmen 'u red to scr City --= Code Pease ntact the Mech acal spectorA or i r o is r tper tied ree�I a ods - . RESIDENTIAL COMMERCIAL Furnace New Construction ✓ Interior Improvement X' `k,41-i _' Air Conditioner If Install Piping Processed Permit Types Air Exchanger 9 Gas Exterior HVAC Unit VI's, - Heat Pump Under/Above ground Tank (ti Install/If Remove) ,,, _i �„ Other RESIDENTIAL FEES $60.00 Minimum Add or alteration to an existing unit, includes State Surcharge $100.00 Residential New, includes State Surcharge =$ TOTAL FEE COMMERCIAL FEES "7,65MO .� Contract Value$76 0.00 x.01 $60.00 Permit Fee Minimum $75.00 Underground tank installation/removal, includes State Surcharge =$ 60 76--(-°- ov Permit Fee _$ 382.50 Surcharge Surcharge=Contract Value x$0.0005 If the project valuation is over$1 million, please call for Surcharge =$ 8092.50 Y60.6/v SIJ 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.citvofeaqan.com/subscribe. 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 Erin Chapman x Applicant's Printed Name Applicant's Signature FOR OFFICE USE;,4 , .4_4,'' =' , tt ,_ Required Inspections > ev!e edgy ate: ' Underground: y. '-Rough Ind Air Test Gates S rvice,Tes Intfl o Hea Find A Sr e iii. ... two . ... .,6.�._ • ...., � G,/-/ /�s WV-,„, is to,llt wygt (`O r['t!(D r 47,7-e—ecifigli S ��` For Office Use 4 + � t t , , E AGA N Id �4' 7 %,c.y r`,�j, ",63cId �� Q �,,e_ J ` (�� Permit Fee: `-� g l•—/ Date Received: ItI 3830 PILOT KNOB ROAD EAGAN, MN 55122-1810 � 3''A (651)675-5675 I TDD: (651)454-8535 ( FAX: (651)675-5694 Staff: Plan Submittal:eplans(a�cityofeagan.com AP ' 7Q� 2018 COMMERCIAL PLUMBING PERMIT APPLICATION ❑ Please submit two(2)sets of paper plans with all commercial applications as well as an electronic set of the submittal, submitted via email, CD or flash drive Date: 4/9/18 Site Address: 3535 Blue Cross Road,Eagan MN 55122 Tenant: Blue Cross Blue Shield Suite#: Proper Owner, 4�` Name: Blue Cross Blue Shield Phone: 1-800-382-2000 a;- Metropolitan Mechanical Contractors,Inc 20-0832303 Name: License#: Con aC P. Address: 7450 Flying Cloud Drive City: Eden Prairie irState: MN Zip: 55344 952-941-7010 VII-- erin.chapman@metromech.us (612)269-2559 Phone: Z 64 Z-�'S�Email: P '1: Oz. _New _Replacement Repair Rebuild ✓ Modify Space Work in R.O.W. ' t + Description of work: Remodel existing Cafeteria including AHU that serve cafeteria # r T- COMMERCIAL New Construction x Modify Space �' Irrigation System(_yes/✓ no)(_RPZ/ PVB) 4 ,, • Rain sensors required on irrigation systems PermiTyp ` . Avg.GPM (2”turbo required unless smaller size allowed by Public Works) Meters Call(651)675-5646 to verity that tests passed prior to picking up meter. Domestic:Size&Type 3° `°PPB' Fire: 1 Avg.GPM High demand devices? Yes�No Flushometers_Yes�No 0 COMMERCIAL FEES Contract Value$600.00 x.01 $60.00 Permit Fee Minimum 60.00 $60.00 PVB/RPZ Permit(includes State Surcharge) =$ Permit Fee _$ 30.00 Surcharge Surcharge=Contract Value x$0.0005 ob If the project valuation is over$1 million, please call for Surcharge =$ 690.00 167 (��, TOTAL FEE Following fees apply when installing a new lawn irrigation system $N/A Water Permit Contact the City's Engineering Department,(651)675-5646,for required fee amounts. $N/A Treatment Plant $N/A Water Supply&Storage $N/A State Surcharge =$690.00 _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.citvofeagan.com/subscribe. CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. 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 Erin Chapman x 5 2e Applicant's Printed Name Applicant's Sig ature , FO OFC S . . o edar .. Asa , - -® lima lapectlon Ude . rob fl ®' est _G x ,Reece ire() '' eter Relate Items . . a er Si ' Radio 'ea• ,. Manometer _ . Page 1 of 3 e1(0 For Office Use 1 ; Permit#: 1-19 E AGA N Permit Fee: Date Received: 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651)675-5675 I TDD:(651)454-8535 I FAX: (651)675-5694 f.(t Staff: buildinginspections(&cityofeagan.com L MAR 302018 2018 COMMERCIAL BUILDING PERMIT APPLICATION Date: 3/30/18 Site Address: 3535 Blue Cross Road Tenant Name: Blue Cross Blue Shield (Tenant is: New/X Existing) Suite#: Former Tenant: Name: Blue Cross Blue Shield Phone: 651 .662.2542 Property Owner 1750 Yankee Doodle Road, Edina, MN 55121 Address/City/Zip: Applicant is: Owner X Contractor Type of Work Description of work: Remodel of cafeteria Construction Cost: 2,500,000.00 Name: Carlson-LaVine, Inc. License#: Contractor Address: 2965 Partridge Road City: Roseville State: MN Zip: 55113 Phone: 651.303.8612 Email: brads@carlsonlavine.com contact: Brad Shamp Name: KOMA, Inc. Registration#: 50117 6115 Cahill Ave Inver Grove Heights Address: City: hitect/Engineer Arc /s f. Phone: 651.451.4605 413 State: MN Zip: 55076 Contact Person: Jon LeNoble Email:jlenoble@komainc.com Licensed plumber installing new sewer/water service: Phone#: NOTE:Plans and supporting documents that you submit are considered to be public information. Portes of the information may be classified as non-public if you provide spcific-reasons that wuld permit the City to conclude that they are trade-sem" 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.cityofeacian.com/subscribe. 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.aopherstateonecall.orq 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. Brad Shamp Applicant's Printed Name Applicant's Signature 0 DO NOT WRITE BELOW THIS LINE /Lig �6 7 SUB TYPES S.‹ igIu..E C PSS . 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 v 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 Zi , dG- °```'_ Occupancy 4- ?- $ MCES System V'F Plan Review ✓ Code Edition 'A/C sfoe SAC Units C Lei __ (25% 100%A)" Zoning F City Water V Census Code Stories f Booster Pump #of Units t Square Feet PRV #of Buildings I Length Fire Sprinklers V Type of Construction I•tis Width REQUIRED INSPECTIONS Footings_New Building_Deck_Addition Drain Tile Foundation Foundation Before Backfill Retaining Wall Vapor Barrier Erosion Control .Framing 30 Minutes 4 1 Hour Steel Reinforcement V Insulation Street/Curb Cut Inspection V Sheetrock Other: Roof:_Decking _Insulation _Ice&Water Final Meter Size: Siding: Stucco Lath Stone Lath Brick_EFIS V Electronic Set of Final Revised Plans Windows Fireplace: Rough In Air Test Final Final/C.O.Required Pool: Footings _Air/Gas Tests _Final L Final/No C.O.Required Final CIO Inspec - -. ---•ule Fire Marshal to be present: >`` Yes No Reviewed By: , Planning New Business to Eagan: ile. Reviewed By: im , Building Inspector FEES Water Quality Base Fee 11d /CC •7 Storm Sewer Trunk Surcharge 1, ! S"0• ' Sewer Trunk Plan Review 7/ 17 f • R'7 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: ilci Trail Dedication TOTAL:` Gam- `j 1? -• 4' � Page 2 of 3 MCES USft letter Reference: 180418A5 Address ID:4862 Payment ID:410889 1L-7947-7 • Date of Determination: 04/18/18 Determination Expiration: 04/18/20 Greetings! Please see the determination below. Project Name: Blue Cross Blue Shield -Cafeteria Project Address: 3535 Blue Cross Road Suite U/Campus: N/A City Name: Eagan Applicant: Jon LeNoble, KOMA Special Notes: None Charge Calculation: Cafeteria: 561 meals x 3 gallons/meal @ 274 gallons/SAC= 6.14 Total Charge: 6.14 Credit Calculation: Blue Cross & Blue Shield (SAC 10/74) Office: 15,730 sq. ft. @ 2400 sq. ft./SAC= 6.55 Total Credit: 6.55 Net SAC: -0.41 —or— 0 SAC Due The business information was provided to MCES by the applicant at this time. It is the City's responsibility to substantiate the business use and size at the time of the final inspection. If there is a change in use or size, a redetermination will need to be made. If you have any questions email me at: toni.janzig@metc.state.mnus. Thank you, Toni Janzig SAC Technician Please visit our SAC website by going to: http://www.metrocouncil.org/SACprogram 390 Robert Street North I St. Paul, MN 35191-1805 Phone 651.602.1000 I Fax 661,602.1.,:-:,0 I MY 0tr,i.X91.01:10 l metr<,._.��unci.c>r METROPOLITAN �c al�a,:, ;it n�t1 Fear,icy(~ C Q U N C I L Jo • ` 7• ` Z 7 ARCHITECTS I DESIGNERS I ENGINEERS Inspection Department Eagan Municipal Center 3830 Pilot Knob Rd. Eagan, MN 55122 Re: BCBS Main Cafeteria Remodel Project No.: 17033 Building Permit Narrative, March 27, 2018 To whom it may concern: Enclosed are the documents corresponding to the application for commercial building permit for the BCBS Main Cafeteria Remodel project located at 3535 Blue Cross Road. The proposed project involves the remodel of the existing cafeteria in the main building of Blue Cross Blue Shield of MN (BCBS) including the seating areas, food service areas (servery), and parts of the kitchen. The work will consist of architectural modifications and interior finishes, conversion of HVAC systems from constant to variable air volume, improvements to ventilation and exhaust, updates to plumbing, upgrades to lighting and new food service equipment. The building is currently occupied and BCBS plans to occupy adjacent portions of the existing building during construction. The cafeteria currently serves an employee population of approximately 1,115 individuals during normal business hours and the cafeteria serves, on average, 561 meals a day, 227 breakfasts and 334 lunches. Please let me know if there are any questions or if additional material will facilitate the review of the permit documents. Sincerely, ct1 Jo/LeNoble, AIA KS A ik t r For Office Use isbel ,, � + � r rr l./Y�'-�= `.'�'�-GAN .[ZiC�a r-, :::: L: ,._..,, MAY 2 3 2018 - ! X Date Received: 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 Staff: buildinginspectionsC cityofeagan.com 2018 COMMERCIAL FIRE ALARM PERMIT APPLICATION Date: 5-18-18 Site Address: 3535 Blue Cross Rd, Eagan, MN 55122 Tenant: Blue Cross Blue Shield Suite#: ❑ Requirements: 2 complete sets of drawings and specifications, cut sheets on materials and components � ,t } Name: BCBS of Minnesota Phone: roperty Owner Address/City/Zip: t* ',� Applicant is: Owner X Contractor ' " it-. -' Description of work: Remove, retain and relocate fire alarm devices for cafeteria remodel. ' 'p ' Work .{ $7,830.00 9-14-18 F Construction Cost: Estimated Completion Date: # ' ECSI TS002284 a . ` ' Name: License#: 7900 Chicago Ave S Bloomington ��OD ��rE� y � Address: City: fr M N 55420 612-816-3411 r State. Zip: Phone: 14--1.- Nathan Mullenbach nmullenbach@ecsillc.com Contact: Email: New ✓ Remodel s Yp Addition Other: �t:szg: ✓ Alterations DESCRIPTION OF WORK: ✓ Commercial Residential Educational FEES 12 800.00 Contract Value$ x.01 $60.00 Permit Fee Minimum 128.00 =$ Permit Fee Surcharge= Contract Value x$0.0005 =$ 6.40 Surcharge* If the project valuation is over$1 million, please call for Surcharge 1$4.40 =$ 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.citvofeagan.com/subscribe. I hereby apply for a Fire Alarm permit and acknowledge that the information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Minnesota Building/Fire Codes;that I understand this is not a permit,but only an application for ao 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. 006 _iodir .iZ x Nathan Mullenbach x a Applicant's Printed Name Applicant's Signature e� evlewed 8y :#a file: aired In a `ons # % oug k n , yYA}la ,,,,,,,N,--1, # � H ��' "� ��� trey Al ! e��R� € r' f,'n:' :; x±t m r r rt — .iED For Office Us d ,41i i i y 0lb, (� ry Q Permit#: q"C=7, '-7 ..... .�,d t,..e 9,,,,,,, E AG A isi Permit Fee: Staff: 3830 PILOT KNOB ROAD 1 EAGAN, MN 55122-1810 Payment Recvd: Yes-33{ No , (651)675-56751 TDD:(651)454-8535 I FAX:(651)675-5694 I Email:buildinginsoections ancityofeagan.com Plan Submittal:eplans@citvofeagan.com I Plans: Electronic Paper 2018 COMMERCIAL MECHANICAL PERMIT APPLICATION ❑ Please submit two(2)sets of paper plans with all commercial applications as well as an electronic set of the submittal,submitted via email, CD or flash drive Date: 10/10/18 Site Address: 3535 Blue Cross Rd Tenant: Blue Cross Blue Shield Suite#: 1 Name. Blue Cross Blue Shield �'� � Phone: /.. .44 Address/City/Zip: 3535 Blue Cross Rd,Eagan,MN 55122 1q'ta foes Name: Custom Refrigeration License#: MB003502 ts114 Address: 640 Mendelssohn Ave N City: Golden Valley 57 ! ; ., `` ''# ,, State MN Zip:_55427 Phone: 763-544-4499 �� t 'i,4,. . , Contact: Daniel Bailey Email: daniei@customrefrigeration.com a � x`Y x New Replacement Additional Alteration Demolition ,3=°° � 1tfl, Installation of 2 refrigeration systems serving a single walk in cooler. Condensing n ,;.i9 : 0,1 y , Description of work: units to be located in a mechanical room directly below the walk in box. --i-;„ ,M� „ #"& j '''',v. 7 �'r } �';# 11$Y . , >r. } 1. sig ° - " V ;,f, t 5 5�t� a " n,• L a� � 4 ,1 ,1 ,, q,, COMMERCIAL ,14.11,1,:,-,' ',.s,. ;• '. . . . .. .°�".."- ' f 4 ti : ,71;i: �,� K New Construction Interior Improvement X Refrigeration �`f A4 : fb � Install Piping Processed , , �r co',.. � Gas Exterior HVAC Unit ,,,'„ —Under/Above ground Tank (_,_Install I Remove) COMMERCIAL FEES Contract Value 9500.00 $60.00 Permit Fee Minimum $ x.01 $75.00 Underground tank installation/removal,includes State Surcharge =$ 95 Permit Fee Surcharge=Contract Value x$0.0005 =$ 4.75 Surcharge If the project valuation is over$1 million,please call for Surcharge =$ 99.75 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.citvofeagan.com/subscribe. 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 Daniel Bailey . Applicant's Printed Name Applicant's Signature iiii:‘, 0,,;,,,f,-,-,,,,,,7` ,t5'7.„ ic,-7.— 77 -: 4-7::-t-lAk.,-64141,toji,,,7, - , ;,..,:' ,-7,r -7.7 .:,7-7417,-iI. :4,,,... 1 / 4574 � 5 h - mar s� Yk �` �.. J� „i fill.4'-- i p',: lgr l4' 94 +� ..,,-.3,., ; Hi d SPa.' �...i, 2 "„.m-,3,7-,74,,,,,, F' a 0 F er i4, � I 0,/V",J &e, , J, -0 -i A, 0 EAGAN 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651) 675-5675 1 TDD: (651) 454-8535 1 FAX: (651) 675-5694 buiIdingins pections@cityofeagan.corn ----------, I For Office Use 1 jPermit #: I I I Permit Fee: I I 1 Date Received: ��=�-LJ— I I NOV 2 6 2018 1 Staff: 2018 FIRE SUPPRESSION SYSTEMS PERMIT APPLICATION Date: 07/05/18 site Address: 3535 Blue Cross Road Tenant: Blue Cross Blue Shield Suite #: ❑ Requirements: 2 complete sets of drawings and specifications, cut sheets on materials and components 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.citvofeagan.com/subscribe. I hereby apply for a Fire Suppression System permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Minnesota Building/Fire Codes; 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. Digitally signed by Scott Baillargeon DN C=US. x Scott Baillargeon x Scott Baillargeon E=scott.baillargeon@vikingsprinkler.us, CN=Scott Baillargeon --Date.: Applicant's Printed Name Applicant's Signature blo BCBS Name: Phone: Property Owner 3535 Blue Cross Road Address / City / Zip: X A plicant is: Owner Contractor Relocating heads throughout cafeteria remod I due new ceilings. Type of Work Description of work: 09/10/18 Construction Cost. t t' Estimated Completion n Date: Viking Automatic Sprinkler Co C0005 Name: License #: 301 York Ave St. Pau Contractor Address: City. MN 55130 651-558-325 C& State: Zip: Phone: Scott Baillargeon SCott.baillargeong ingsprink .us Contact: Email: FIRE PERMIT TYPE WORK TYPE ✓ Sprinkler System (# of heads ih, New Addition Fire Pump Standpipe Alterations ✓ Remodel Other: Other: DESCRIPTION OF WORK: ✓ Commercial Residential Educational FEES 42000 Contract Value $ X.01 $60.00 Permit Fee Minimum _ $ 420.00 Permit Fee Surcharge = Contract Value x $0.0005 If the project valuation is over $1 million, please call for Surcharge = $ 21.00 Surcharge $100.00 Residential New (includes State Surcharge) = $ 441.00 TOTAL FEE 3/4" Fire Meter - $290.00 =$ 0 Fire Meter =$ 441.00 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.citvofeagan.com/subscribe. I hereby apply for a Fire Suppression System permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Minnesota Building/Fire Codes; 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. Digitally signed by Scott Baillargeon DN C=US. x Scott Baillargeon x Scott Baillargeon E=scott.baillargeon@vikingsprinkler.us, CN=Scott Baillargeon --Date.: Applicant's Printed Name Applicant's Signature blo FOR OFFICE USET _ REQUIRED INSPECTIONS Hydrostatic Trip Conditions of Issuance: Flow Alarm Drain Test ,R,.o-u�gh In Pump Test Central Station 1/ Final Permit Reviewed by:�� z� Date: / / / C2 5/ 1 010 '19 EAGAN 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 AUG 2 9 2018 (651) 675-5675 1 TDD: (651) 454-8535 1 FAX (651) 675-5694 buildinainspectionse.cityofeagan.com ---------------- For Office Use I I j Permit #: I 1 I I I I Permit Fee: I Ij � Date Received: I I I I Staff. L------------- --� 2018 FIRE SUPPRESSION SYSTEMS PERMIT APPLICATI Date:.'O Site Address: _'V12 Ict ` Tenant:��- L 11 �--'�- Suite #: 0 Reauirements: 2 complete sets of drawings and specifications, cut sheets on materials and components `h { G; .a� Name: Phone: A r al. 4Prope O In y s > i Address /City /Zip: Applicant is: Owner Contractor 4 C ri4 Description of work: Construction Cost: c3 Estimated Completion Date: k a Name 001 License #: V LI S PCA LA Con actor ., Address: 1�.. �i State; �" Zip: Phone: LIS City: I V �Ai wt. 19 Y` i �S h�YYLi{�C Glrs Contact:►'i FIRE PERMIT TYPE WORK TYPE New Addition Sprinkler System (# of heads Fire Pump Standpipe Alterations Remodel _ Other:12 r--- c> L^,— I Other: DESCRIPTION OF WORK: Commercial Residential Educational FEES , Contract Value $ C1 X.01 $60.00 Permit Fee Minimum Le -D _ $ Permit Fee Surcharge =Contract Value x $0.0005 • C" If the project valuation is over $1 million, please call for Surcharge = $ . Surcharge —t $100.00 Residential New (includes State Surcharge) = $ TOTAL FEE 3/4" Fire Meter - $290.00 = $ Fire Meter Radio Read (required with Fire Meters) - $190 _ $ TOTAL FEE You may subscribe to receive an electronic notification from the City of propos d website at www.ciinfeanan.com/subscribe. I hereby apply for a Fire Suppression System permit and acknowledge that the inforrnati conformance with the ordinances and codes of the City of Eagan and with the Minnesota only an application for a permit, and work is not to start without a permit; that ther�V4 ich requires review and approval of plans. a��4� x ( � x ordinances by !!Or up for an email update on the City's is co lite and acc te; that the work will be in N'r�/Flre Cod I understand this is not a permit, but nce ith the approved plan in the case of work t Applicant's Printed Na a Applicant's Signature 7C For Office Use I Permit#: /-gam • , • . ,• • ,,, E AGA Permit Fee: �7/' ` /D • • ° "C EIVED I _� 1 '� •< 3 Staff: I �1 MAY0 2019 Payment Recvd: Yes No I 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 1 (651) (651) (651) 675-5675 TDD: 454-8535 FAX: 675-5694 I I I buildinginspections@cityofeagan.com L Plans: Electronic • Paper 2019 FIRE SUPPRESSION SYSTEMS PERMIT APPLICATION Date: 9 170 Site Address: 3 5 3 flobwetbre)55 IZ,GfJ Ct si. (N\1'1 IS 12? Tenant: CJ`w`e- CrGSS 6(4L S F1,1 'e-t A, - CJ`ev1. or Li Suite#: 0 Requirements: 2 complete sets of drawings and specifications, cut sheets on materials and components volt-kctss ►40lk� (,5I- 67- sf3 z_ �� � Name: S�}ue+ Phone: PCOPeI /Owner ; Address/City/Zip: J S3 S 'bLLt,G t ro5 5 124 — P Rre 11,1 1 o9 ", , , °; Applicant is: Owner y Contractor i-o 'T a ofWork . .i Description of work: 4't, d 1.A.9 1 Y4.t 0..02c Lc/ z ,Sip,-cs s ,a Sel YP0149 ems►�►--a,E4-! i;,atm-„' Construction Cost: 4 f Q 0 0 Estimated Completion Date: Name: Si.k,wt vv‘,• t- 0-0 w�►n� License#: Contracto Address: .*7 S m 11.1. `G L rrJ,4 Ake..-14.) City: 'Qct t'w''�1 CS k3 .— O(4 L -� , State: ow) Zip: DPhone: — - t Contact: 5 'a Cif& 'II:I Id Email: 434 Ki) c SU'*1't f d- do Ll5 • eG144 FIRE PERMIT TYPE WORK TYPE Sprinkler System (#of heads_) _New _Addition Fire Pump _Standpipe Alterations _Remodel C O'`' VOther: (, at 8-U(l)5rc4& (/other: 1 DESCRIPTION OF WORK: Commercial Residential _Educational FEES Contract Value$ t)�09 x.01 $60.00 Permit Fee Minimum _$ 1p ' Permit Fee Surcharge=Contract Value x$0.0005 If the project valuation is over$1 million, please call for Surcharge =$ 3 Surcharge $100.00 Residential New(includes State Surcharge) =$ TOTAL FEE 3/4"Fire Meter-$290.00 =$ N Fire Meter Radio Read(required with Fire Meters)-$190 =$ / OTAL 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.citvofeacian.com/subscribe. I hereby apply for a Fire Suppression System permit and acknowledge that the information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Minnesota Building/Fire Codes;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 re iew and approval of plans. X 1'\A4 1,L)7%, - -C,.-J tkf x / /• i—sait Applicant's Printed Name 0 Apphcan s Signature A .--d-?-40 I-1/ oo'D-C) /__ -.SC,c)( FOR OFFICE USE REQUIRED INSPECTIONS Hydrostatic Flow Alarm Drain Test Rough In Trip Pump Test Central Station Final' Conditions of Issuance: rt Permit Reviewed by Date: / 1 ___d. For Office Use Permit#: l Sei4' 1 Permit Fee: E AGA N Staff: yam ma aa= ammm; Payment Recvd: Yes _No I 3830 PILOT KNOB ROAD I EAGAN,MN 55122-1810 (651)675-5675 I TDD:(651)454-8535 I FAX:(651)675-5694 Plans: Electronic Paper Plan Submittal:eolansAcitvofeaaan.com L 2019 COMMERCIAL BUILDING PERMIT APPLICATION Date: Sit/7 6 2017 Slte Address: 3 635 B 1 me, o..rosl 72.041 coU A I T� Tenant Name: 2i i�(L 0 toss dnd ?3k , of (Tenant is: New/ Existing) Suite#: Former Tenant: Name: c/aMM —pcl.VL't, Phone: 65/-- 44a-7g5d Property Owner Address/City/Zip: 3535 131UL C1rOSc l?.oad, ea 5SIXD. Apr senib trve, lot,/‘ Applicant is: . Ownertp Contractor Type of Work Description of work: Afro,,i g ��Q►/i l!�k `l�(1(;P, �0 X s ah cop toyer !'den oft *he. 'dr Construction Cost: '5,v0 c 1 / Name: //I i 0� W e St F/�(�- License#: (�OO q 139 r' A Contractor Address: 5 3 i) 11 &part- A i t CitySe. St �POIO State: /M t 1 A. Zip: 65 015 Phone: (o S I" List- aaaD__ Contact: 7'0�.� Rel1fnrS Email: 7'O tiortkQJ PI Id LLrtfenw -col CDM Name: Al A Registration#: Architect/En gineer Address: City: State: Zip: Phone: Contact Person: Email: Licensed plumber installing an 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 website at www.citvofeaaan.com/subscribe. CALL BEFORE YOU DIG. Call Gopher State One Call at(851)454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.aooherstateonecail.orq 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 V QTt�, lneis (del' Applicant's Printed Name Axpplic n s Signature DO NOT WRITE BELOW THIS LINE /5- .0 )z-7 SUB TYPES 3535 Oai= CcQoc s Rd. _ 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 dt...- Valuation S O a a Occupancy tA, MCES System Plan Review -/ Code Edition 2e1S* kW- 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 1(24 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 C/O Inspection: S.%v.ule Fire Marshal to be present: Yes \K. No Reviewed By: _ , Building Inspector Reviewed By: , Planning COMMERCIAL FEESJP Water Quality Base Fee I18 Storm Sewer Trunk — Surcharge 2 2' Sewer Trunk — Plan Review * 7C. 2'2- Water Trunk -- MCES SAC -' Street Lateral —• City SAC Street '" S&W Permit&Surcharge Water Lateral Treatment Plant Other: -� Treatment Plant(Irrigation) Park Dedication Trail Dedication TOTAL: /9 Page 2 of 3 0 (", K For Office Use • • ii : r 0 ` Permit#: t_..?•.a ,,or �f `� tom... ..,,,, E AG A N Permit Fee: ,), 3�" RECEIVER Staff:E ..,..=, 3830 PILOT KNOB ROAD I EAGAN, MN 22-1810 rPa (651) 675-5675 I TDD: (651)454-8535 J FAX (68. 7 - 694i19 yment Recvd: Yes No Email: buildinginspections ,citvofeagan.com • Plan Submittal: eplans( citvofeagan.com • Plans: Electronic aper J (sjA nal 2019 COMMERCIAL PLU ING PERMIT APPLICATION \‘\ E Please submit two(2)sets of paper plans with all commercial applications as well as an electronic set of the submittal, 01/ submitted via email,CD or flash drive iy,-‘ Date: c1•12.•l'\ Site Address: 3 CS Sr Q(txt.Cro SS RcJ- Tenant: A_L1O S fit)-t- SkQ,l6.. Suite#: 15-1.-0,441 :::0. ^5 {' c,J,,.` _,a.''u_.n Name: bkt�.t� S � SAS kft6 Phone: (D S7. (o!o 2•Boco '.';,-..„'4;71: i7'1I''•• Name: t act' License#: Ylt 1n1 .''y t y-,' �ra. .,. " , Address: c1/'-( ff�/id -A - JJ. City: IJP.4U State: /VIM-Zip: 51-4/2-6 ( L1k_ . Phone: x{03•s3 3-3� c Email: /1-06e.Q (or-p ie 4?-ecillAilr(e4, 0,1A- � � New Construction Addition Modify Space ,;4f1E M=+ X Replacement Repair Rebuild Work in Right-Of-Way i41 . 4 4 Description of work: .771j4-c (2) do €z-E7 t_rnix,q,5 fto1S, '€' .k` 1Irrigation System C__yes/_no)( RPZ/ PVB) �Tly. �� � 'mil � r .° • Rain sensors required on irrigation systems r* .: i.j;. � • Avg.GPM (2"turbo required unless smaller size allowed by Public Works) x „ t `., Meter Required-Call Utilities at(651)675-5200 to verity tests passed prior to picking up meter. i:t 1 'T • Domestic:Size&Type II/2. 4k\N\ Fire: 1 f. `, �' , � - Average GPM High demand devices? Yes X No Flushometers_Yes X No COMMERCIAL FEES cK= Contract Value$ 0,0 Z(_ -- x.D'l5 $60.00 Permit Fee Minimum ' $ Wpo.33 Permit Fee $60.00 PVB/RPZ Permit(includes State Surcharge) $ 3 2.d l Surcharge Surcharge=Contract Value x$0.0005 If the project valuation is over$1 million, please call City for Surcharge $ 992- 1 4 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 _=$ 94'1Z" .3—L-1- 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.citvofeagan.com/subscribe. CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. 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 hike Zse-- Applicant's Printed Name pplicant's ';i ,' ire Page 1 of 4 / 5— 5--7 d' r., -. - .,.. tit ..,4,:r;.!';',..;;;;;,...... r�i� ><-< `+; *�'y. #�`: i{. <�' "C. 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M� .11W L-"•". ,.b t ;,� '� y^'V r . ,p;-1 d2. `� .'Z'!.^�'� „4H'?":.� .l. .r' !�{,�.5. �E,.S•f•'...2t!r.: :'f +a :. 7 1.c' ` '�"d a a ::,„., i ; .�4C`:"+ a :,yt� _��?,n';�y�q'',�19���;j� �j�+,�f..�,�w f- ��� � s3'+sr ,y� "�'�Y s.^tt: • +s 9�y'i�:.'sw�.�Y�x"y' �u��''ittit t..J. � A.,to t�� 1.,a� �;d •,..2,. ,. X 2 1. _�) ». J7 T}7^L, ? s�. •,::�L�. ,T„ ®,. •0. C'..f i..{>>.n( L :G? �,'�'^' s.-,....a. 'j':M. .�>.. 'b, ,.... e~- �elat�d erns. -4',i,.•-.7,...,..,::' r,:7:4 r rye�r, t �� a ' ad .,:.:ti.<Mar4 :;.,: , ., ii • ��� . ��. .. a ..*�: ..,I ar eY .ros! J•. .b .re do :�'L'" ,l: rye,' a , - w•�. ',• f .._�'' pn� 1.'Y:'w r441?' r'. 1 d� ,c,.....: tx9l�,":,f' '�g3r'K- ,� a ,� :- 3.,,,r :!�'. , ... .•.,:,.j,.ad t..,,-$.;: ,..1„f ipri-' ., '"i-,,-,. 3: < ,� .`. '*,. ?Si. .� , .', [" d.'r, iii,. `f r}k`; s i "i1 i . �t#.''AS''. f",3,:' '.r •x'..; '.ti+. .' �S.# �f.�.�t�.0• m'.- 3; .'1 '" ,y. ,y�1 "">:,�rr,:,.?t .'BT:a r�' '^�. '4x•T .rci,,,c. h;'.f._: �. a -,11.41...i, #,:' {� :v t ? 3p.f 5 i 1:�Y' 5 >,��. s] e: ,t. ,s ,;d• ..> Page2of4 ii Use r i l'Ill l For Office l • �JI \ cmq. I Permit#: seg/ -7 T i/%. �.. ., .., Permit Fee: �f '� " I �. a I flECElvej staff: Payment Recvd: /_Yes )(No I 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 i 4 � 1 651 675-5675 TDD: (651)454-8535 FAX: (651)675-5694 ( ) I I 1 Plans: Electronic x Paper 1 Plan Submittal: eolans(&cityofeaoan.com BY: L ` 2019 COMMERCIAL BUILDING PERMIT APPLICATION Date: 11-1-19 Site Address: 3535 Blue Cross Rad Tenant Name: Blue Cross Blue Shield (Tenant is: New/ / Existing) Suite#: Former Tenant: Name: Blue Cross MN Phone. Property Owner Address/city/zip: 3535 Blue Cross Road Applicant is: Owner Contractor Type of Work Description of work: Replace exterior railing Construction Cost: $250,000.00 Name: Carlson-LaVine, Inc. License#: Contractor Address: 2965 Partridge Road city: Roseville State: MN Zip: 55113 Phone: 651 .303.8612 Contact: Brad Shamp Email: brads@carisonlavine.Com Name: TKDA Registration#: 50117 444 Cedar Street St. Paul Architect/Engineer Address: City: State: MN Zip: 55101 Phone: 651 .292.4400 Contact Person: Jon LeNOble Email: jon.lenobie@tkda.com 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 website at www.citvofeauan.com/subscribe. 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.gooherstateonecall.orq 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 Brad Shamp ;[ 1-Ds ���' Applicant's Printed Name Applicant's Signatur DO NOT WRITE BELOW THIS LINE / ( Z SUBTYPES '-S 4e,Iua Ceb-S c_ • 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 GA.,.r•� 4....‘1 DESCRIPTION 4 4....‘1/ f��'Its5 Valuation `ZSV 000 Occupancy /J MCES System • Plan Review Code Edition %C L 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 ff8 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 Street/Curb Cut Inspection Sheetrock Other: Roof:_Decking Insulation Ice&Water _Final Meter Size: Siding: Stucco Lath Stone Lath _Brick_EFIS Electronic Set of Final Revised Plans 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: Sched I- ire Marshal to be present: Yes • No Reviewed By: /�I , Planning New Business to Eagan: Reviewed By: ' , Building Inspector FEES A. 75 Water Quality Base Fee IS‘ , Storm Sewer Trunk Surcharge ti fig Sewer Trunk Plan Review # /771 . 89' 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: 3 5-3 d Trail Dedication TOTAL: —,s—,..— Page 2 of 3