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1501 Central Pkwy Metropolitan Council 19 0 Buitdinq communities that work Environmental Services January 31, 2002 Dale Schoeppner Building Official City of Eagan 3830 Pilot Knob Road Eagan, MN 55122 Dear Mr. Schoeppner. The Metropolitan Council Environmental Services Division has determined SAC for the City of Eagan Central Park Community Center to be located within the City of Eagan. This project should be charged 32 SAC Units, as determined below. SAC Units Charges: Community Room 5376 sq. ft. @ 1650 sq. ft./SAC Unit 3.26 Children's/Senior Center 4392 sq. ft. @ 2400 sq. ft./SAC Unit 1.83 Teen Center 1440 sq. ft. @ 2400 sq. ft./SAC Unit 0.60 Gym/Exercise 18304 sq. ft. @ 700 sq. ft./SAC Unit 26.15 Total Charge: 31.84 or 32 If you have any questions, call me at 602-1113- S", n- rely, Jodi . Edwards Staff Specialist Municipal Services Section JLE: (173) 02013158 Cc: S. Selby, MCES j Carolyn Krech, Finance Department, Eagan FER 0 rL, William Armstrong, TKDA e By want•.nletrocouncll.org Metro info Line 602-1888 230 Fast Fifth Slreet • St. 11au1, Minnesota 55101-1626 • (651) 602-1005 Fax 602-1138 TrY 291-0904 An Equal OYPnnnnitt, Employer 6512511879 FEB-20-2003 14:44 SUMMIT FIRE PROTECTION 6512511879 P.01i01 FAX TRANSMITTAL Summit Fire Protection SUMMIT 7301 ApoOo Drive FIRE PROTECTION Lino Lakes, MN M014 0111ee: 661-2swaso Fu: 651-251-1879 MN License No. 000075 WI License No. S00000139 DATE:2/20/03 ❑ FOR YOUR INFORMATION FAX NUMBER: 952-931-9941 COMPANY:-Stahl Construction ATTENTION: Mike Hefren ❑ FOR BID DUE FROM: Chris Gill DATE en NUMBER OF PAGES: 1 RE: Central Park Community Center (INCLUDING TRANSMITTAL SHEET) MESSAGE: Mr. Hefren. I met with Mike Butler and the City of Eagan Fire Marsha n site on February 20, 2003 to discuss the potential fire hazard in the play room Specifically, we looked at the indoor la and that has ben assembled. It has been requested that w provide additional fire rotec 'on to the areas where th oor area has been sub tiall obstructed due to plastic paneling for a couple of reasons First of all, in areas where obstructions occur, there isg Botential for a fire to build up without bein c~ inrd by the overhead sprinkler system Secondly, it was noted that the flooring in that area will be constructed of recycled tires with a foam to in both items com osed of combustible material. We went throu a cou le different options: 1) increasing the overhead coverage to protect a higher hazard occupancy. 2) adding sldewall sprinkler heads to the soffit in that area 3) extending the sprinkler sxstent from the first floors stem into the actual assembly to tect as which have been sub tantiall obstructed from the overhead s stem. U on careful revi w it was ed u on b all arties that the most a ro -date course of action is toe tend s ri ers/ i in into the lay d oun e ui ment in areas which were feasible. feasible, we de errni ed s ci c areas which were least accessible from the user aka children). et provided an acce table level of rote lion. will submit ricin for this than a as s on ible. SIGNED Chris Gillen CC: Dale W. (Fire Marshal City of Fraea-n) FAX: 05 1-675-5694 TOTAL P.01 • SPECIAL INSPECTION AND TESTING SCHEDULE (To be used in accordance with the 'Guidelines for Special Inspection and Testing^) PROJECT NAME C6,`rC Q.A. pp,2v- co,nn+.nya~-~y c.EN't~"e-. PROJECT NO. LOCATION CN'C y ee U44'A#z "t-1 (1) PERMIT NO. _ SPECIAL INSPECTION SCHEDULE ~cation Type of Report Assigned c c on Articl Desc tion 2 Firm 3 re enc Firm 4 03-t_po RaNC-oa.c.. r.1~e TW ` SZ. pE2 PouA' 0 0o c.o,vcalct6 T~ Pia POU A OS%'t0 A..XU"<>A Sc.._C5 SZ PtQ POQA~ 06l'i-0 WEB ~wlt+ SZ VJ r4L 05%'L.o %J%6V% STpkgV~N .z,rab Si WtbKL OMZOO s:QVCt ~Cn M d 2 SIC- TESTING SCHEDULE PE~i SOU 03300 Cow1CRE.T sseaac+l.~ A~4 S~.JMO -14 otizoo 12.15N1 'TEST w W `Lk K1~Y Notes: This schedule to be filled out and included in the project specification. inf-_=ati: 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 170,;S (3) Special Inspector, Testing Agent or Fabricator. (4) Firm contracted to perform services. ACKNOWLEDGMENTS Each appropri zepr entative must sign below: Owner: / i~ Firm: C, /-/c %Date: r4Z.z, Contrac 1i)- ~ "Firm: ~%i f sib %Date: Architee - ' Firm: Date: f Ly ~'Z SER: Firm: ~ ya Date: ('al r1 • SI: Firm: B/atr.r Date: 2-,s- Oz • SI: Firm: Date: 2-S^ 07- irm: r Date: 2 ° 2 TA - Firm.-x- TA: Firm: ~wrn Date: Z F: Firm: Date: F: Firm: Date: • The individual names of all prospective special inspectors and the work they intend tt 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: Department of Administration SO May 28, 2003 Eagan Central Park Comm. Ctr. 1501 Central Parkway Eagan MN RE: Hydraulic Passenger - Elevator ID# -08692PT02-01 Site: Eagan Central Park Comm. Ctr. 1501 Central Parkway Eagan 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 Bill J. Reinke State Elevator Inspector bjr/kad (CE-2) c: Schoeppner, Dale R., BO, City of Eagan ThyssenKrupp Elevator. Stahl Construction 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 city of eagen PAT GEAGAN February 19, 2003 Mayor PEGGY CARLSON MR MIKE BEBAULT CYNDEE FIELDS STAHL CONSTRUCTION CO. MIKE MAGUIRE 5900 ROWLAND ROAD MEG TILLEY MINNETONKA MN 55343 Council Members RE; CENTRAL PARK COMMUNITY CENTER 1501 CENTRAL PARKWAY THOMAS HEDGES EAGAN MN 55122 City Administrator Dear Mr. Bebault: During a preliminary walk through prior to the final inspection, I noticed that the sinks in the teen center, craft room and the lone oak room didn't comply with Municipal Center: Chapter 1341 of the MSBC. 3830 Pilot Knob Road Eagan, MN 55122-1897 Please be advised that these sinks shall comply with Chapter 1341.0405, Item K, Phone: 651.675.5000 Sub item (3). Fax: 651.675.5012 I also have a concern that the intumecent paint used on two structural columns, TOD:651.454.8535 located @ grid lines 6-B6 and 8-C, may fall short of a 1HR rated assembly. Please supply the U.L. listed and tested assembly for this application. Maintenance Facility: If you have any questions regarding the above requirements, please feel free to 3501 Coachman Point contact me at 651-675-5683. Eagan, MN 55122 Sincerely, Phone: GS 1.675.5300 Fax: 651.675-5360 TDD: 651.454.8535 J. Craig Novaczyk Senior Inspector w .cityofeagan.com JCN/ld cc: Dale Schoeppner, Chief Building Official Bill Armstrong, TKDA Architects, 1500 Piper Jaffray Plaza, 444 Cedar St, THE LONE OAK TREE St. Paul MN 55101-2140 The symbol of strength and growth in our communirv MEMO city of eagan TO: DALE SCHOEPPNER, CHIEF BUILDING OFFICIAL DALE WEGLEITNER, FIRE MARSHAL PAUL OLSON, SUPERINTENDENT OF PARKS MIKE RIDLEY, SENIOR PLANNER CAROL TUMINI, UTILITY BILLING CLERK BOB KRIHA, CONSTRUCTION INSPECTOR STAN LEXVOLD, CONSTRUCTION SUPERVISOR TOM COLBERT, PUBLIC WORKS DIRECTOR JOHN GORDER, DEVELOPMENT/DESIGN ENGINEER ARNIE ERHART, SUPERINTENDENT OF STREETS & EQUIPMENT PAUL HEUER, SYSTEMS ANALYST ERIC MACBETH, WATER RESOURCE COORDINATOR MARK ANDERSON, ELECTRICAL INSPECTOR SCOTT PETERSON, PLUMBING INSPECTOR FROM: TERRY ZELENKA, COMBINATION INSPECTOR DATE: FEBRUARY 19, 2003 SUBJECT: FINAL INSPECTION FOR COMMUNITY CENTER 1501 CENTRAL PARKWAY LEGAL: LOT 1 BLOCK 1 UNISY PARK 2ND The Protective Inspections Division will be performing a final inspection at 1501 Central Parkway on Friday, March 21, 2003. If you are requesting that the Certificate of Occupancy be held, please fill out the proper hold request form. Failure to return the hold request form will be considered your approval. The person, or department, requesting the hold is responsible for notifying and resolving any problems with the affected parties. CD/bldg insp/misc/final insp - comm bldgs CITY USE ONLY PERMIT#: Tj UU D RECEIPT DATE: 2002 COMMERCIAL PLUMBING PERMIT APPLICATION CITY of E.AGAN 3880 PILOT KNOB RD PAGAN, NON 55122 651-661,4675 INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED Date: WORK TYPE r`t New Bldg _ Add-on Repair _ RPZ PVB _ * Irrigation system * Jerry Wobschall to calculate fees. Required meter size is 2" turbo unless smaller size permitted by Public Works DESCRIPTION OF WORK To inquire if Pressure Reducing Valve is required on new service, call 651-6814646 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 $152.00 Domestic Size & Type Avg GPM Does this include high demand devices? Yes No FLUSHOMETERS -Yes -No PRV REQUIRED Yes _ No Site Address: Tenant Name:/{yi) L.o7~HJi/Nl/Cy ~e.. Telephone (Area Code) Was there a previous tenant in this space? _ Y 10 N. If Yes, Name: Installer Name: SUY-JAjjZ A;.?E Po7`eC;~64_~ Telephone#: (S/ (Area Code) Installer Address: ?301 k es PplIz2 C3(JP City: L/rq)D / (it kes State: X A) Zip Code S :5 6J V FEES Contract price $ x 1% ($50.00 min) Plbg Permit $ Meter(s) $ Required on all new buildings & boulevard irrigation systems Radio Meter Read $ Surcharge: $.50 Minimum. If base fee exceeds $1,000, calculate at State Surcharge $ 50 cents per $1,000 base. Sub Total/Total $ Supplementary fees for new irrigation system: ater Permit $ 50.00 9,6 Contact Jerry Wobschall at (651) 681-4624 regarding fees Treatment Plant $ 540.00 Water Supply & Storage $ State Surcharge S U Total $ 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 the property owner that the City of Eagan asaum-es no liability for any damages caused by the City during its normal operational and maintenance activities to the facilities constructed under this. rt within Ci ropert /right-of--way/easement. SIGNATURE OF PERMITTEE CITY USE ONLY REQUIRED INSPECTIONS: U.G. Air Test Gas Test Rough In Final PLANS SUBMITTED APPROVED BY: , BUILDING INSPECTOR GENERAL INFORMATION • Radio Meter Read (required on all new buildings & boulevard irrigation systems- $157.00 (Acct Code # 9220-4509) • RPZ's must be rebuilt every five years. A minimum fee permit (per address) is required for RPZ rebuilding or repairing. • Water meters include copper hom/strainer, remote wire, and touch-pad meter GPM METERS USE PRICE GPM METERS USE PRICE 1-20 5/8" displacement residential $118.00 4-120 1-1/2" irrigation syst $ 745.00 sm commercial turbine** **must receive maximum approval from continuous Public Works 10 2-30 3/4" displacement lawn irrigation $152.00 4-160 2" turbine Ig irrigation syst $ 923.00 maximum residential & continuous sm commercial production lines 15 3-50 1" displacement very lg res $199.00 1/4 to 160 2" compound bldgs over $ 1,798.00 bldg to 24 units 65 units maximum sm commercial & continuous & lg cc= bldgs 25 irrigation systems 5-100 1-1/2" bldgs 25-64 units $439.00 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 syst $1,214.00 6-500 4" compound +300 unit bldgs & $3,562.00 & production lines very lg comm bldgs 1/2-320 3" compound +200 unit bldgs $2,264.00 10-1000 6" compound +400 unit bldgs $5,900.00 very lg comm bldgs very lg comm bldgs 15-1000 4" turbine very Ig irrigation syst $2,184.00 & production lines Comments • To schedule inspection of the inside water line and backflow preventer, call 651-6814675. • To arrange for water turn-on, call 651-681-4300. cc: Kris Forster, Maintenance Division Clerical Technician Updated 2/02 e,a u.ae -...-mow, a.w aan. x&..n~ m,.-.. v..u.,a •'>t ma _.-'e':t n -eta-ae .,e..,.v. , .v a~..fi.:uLe .3.~a...v..:u3_* ~4 4L~YCn..V MINNES07 A DEPARTMENiorHEAETH Protecting, maintaining and improving the health ofall Minnesotans September 10, 2002 City of Eagan c/o Mr. Eugene Van Overbeke, Clerk Eagan City Hall 3830 Pilot Knob Road Eagan, Minnesota 55122 Dear Mr. Overbeke: Subject: Food and Beverage Equipment at Central Park Community Center, Eagan, Dakota County, Minnesota, Plan No. 030659 We are enclosing a copy of our report covering an examination of plans and specifications on the above-designated project. The plans and specifications appear to be in general compliance with the standards of this department. Please see the enclosed report for additional changes and/or comments. It is the project owner's responsibility to retain the plans at the project location. This review does not pertain to the Engineering design (i.e., plumbing, swimming pools, service connections, sewage systems). A separate report regarding the Engineering Review will be sent. Ten working days prior to completion of the project, please contact Ms. Pamela Steinbach with our Metro district office at 651/632-5147 in order to arrange for a final on-site inspection. If you have any questions in regard to the information contained in this report, please contact me at 651/215-0862. Sincerely, Steve Craig F-- U Public Health Sanitarian Environmental Health Ser P.O. Box 64975 St. Paul, Minnesota 55164- 9 5 SEP 1 8 7002 SJC:jlr Enclosure cc: Landmark Restaurant Equipment and Design Mr. Dirk House, Plumbing Inspector Ms Papelj Stein aCh Minnesota Department of Health General Information: (651) 215- 800 s AD/TY: (651) 215-8980 ■ Minnesota Relay Service: (800) 627-3529 ■ www.health.state.mn.us For directions to any of the MDH locations, call (651) 215-5800 ■ An equal opportunity employer MINNESOTA DEPARTMENT OF HEALTH Division of Environmental Health REPORT ON PLANS Plans and specifications on food and beverage equipment: Central Park Community Center, Plan No. 030659 Location: Eagan, Dakota County, Minnesota Date Examined: September 10, 2002 Date Received: August 20, 2002 Submitted by: Stahl Construction Company, 5900 Rowland Road, Minnetonka, Minnesota 55343 Ownership: City of Eagan, c/o Mr. Eugene Van Overbeke, Clerk, Eagan City Hall, 3830 Pilot Knob Road, Eagan, Minnesota 55122 The following are corrections or requests for additional information necessary before construction of your project: 1. Food and Beverage service equipment must meet the applicable standards of NSF International. Evaluation to these standards by ETL and UL are also approved. The proper sticker must be displayed. 2. Primary food preparation surfaces (tables/counters) must be of stainless steel construction in compliance with Standard No. 2 of NSF International. 3. Provide and adequate amount of storage space for supplies necessary for operation. Provide approved shelving, a minimum of six inches above the floor. a. shelving must be NSF approved. b. cleaning products, chemicals and personal items must be stored separate and below food and clean utensils. 4. Provide a minimum of a three-compartment sink meeting the applicable standards of NSF International with two integrally attached drainboards in the utensil washing area. Bar glass washing sinks are not acceptable for food utensil washing and sanitizing. Sink bowls must be large enough to accept the largest utensil to be cleaned. 5. Provide and routinely use a chemical test kit to determine the strength of the sanitizing agent in the final rinse water of the three-compartment utensil washing sink. Central Park Community Center -2- September 10, 2002 Food and Beverage Equipment Plan No. 030659 6. Floors in kitchens; other rooms where food is stored, prepared or washed; dressing or locker rooms and toilet rooms shall be smooth, nonabsorbent and easy to clean, and durable. a. Quarry tile floors are strongly recommended. b. The minimum, acceptable flooring is commercial-grade (1/8 - inch thick), vinyl composition tile with a 4 - inch base coving at the floor-wall juncture. 7. Wall surfaces in food preparation, dishwashing and storage areas shall be smooth, light colored, easily cleanable and nonabsorbent to the highest level of splash or spray. a. Sheetrock with an enamel paint finish meets the minimum standards for nonsplash and dry storage areas. b. Wall surfaces in splash zones or high moisture areas such as dishwashing, hand and janitorial sink areas, etc., must be finished with durable, nonabsorbent materials such as: 1) a fiber glass reinforced panel (such as Glasbord or similar product), or 2) ceramic tile. c. Stainless steel or equivalent materials should be installed behind the cooking line. 8. Ceilings in food preparation, dishwashing, food storage areas, and bar areas shall be smooth, nonabsorbent, light colored, easily cleanable, and must not be perforated, fissured or textured. 9. Approved walk-in flooring material includes: a. properly installed quarry tile or ceramic b. a factory provided metal floor 10. All equipment must be installed so that it is easily cleanable, that is, either easily movable, sealed in place or having sufficient space surrounding the unit to clean in place. 11. All artificial lighting fixtures located in food preparation areas, food storage areas, dishwashing areas and walk-ins shall be effectively shielded to prevent glass breakage onto food or food contact surfaces. Central Park Community Center -3- September 10, 2002 Food and Beverage Equipment Plan No. 030659 Install a sufficient number of vapor-proof light fixtures in the walk-in cooler and/or freezer to provide a minimum of 10 foot-candles of light throughout the unit(s). 12. Provide a separate mop sink. 13. Custom made food and beverage equipment shall be constructed to meet NSF International Standards, and be manufactured by an authorized fabricator. 14. All hot water generating equipment (water heaters) must comply with Standard No. 5 of NSF International, and be of adequate capacity to meet the anticipated demand of the establishment- 15. Hollow base cabinetry is not approved. Cabinetry must be on 6 inch legs for easy cleaning, or on solid concrete pedestals. 16. Walk-in cooler shelving must be NSF International approved stainless steel, factory precoated epoxy, or other materials designed for this type environment. Chrome or zinc shelving is not approved. Approved: Steve Public Health Sanitarian Environmental Health Services P.O. Box 64975 St. Paul, Minnesota 55164-0975 41b~ city of acigan PATRICIA E. AWADA APRIL 3, 2002 Mayor PAUL BAKKEN MR HARRY HEARN PEGGYCARISON STAHL CONSTRUCTION 5900 ROWLAND RD CYNDEEFIELDS MINNETONKA MN 55343 MEG TILLEY Council Members RE: ROTARY BANDSHELL FACILITY 1501CENTRAL PARKWAY THOMAS HEDGES Dear Mr. Hearn: GtyAdministrator We have started 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 1997 U.B.C. It is our goal that this review will help you in complying with the applicable codes and we are, therefore, Municipal Center: requesting that the items checked below be addressed: 3830 Pilot Knob Road Eagan, MN 55122-1897 2 sets Plumbing Plans 1 Project Specs 2 sets Mechanical Plans 1 Energy Calculations Phone: 651.681.4600 2 sets Civil Plans I Electric Power & Lighting Form Fax: 651.681.4612 2 sets Landscaping Plans I Master Exit Plan TDD: 651.454.8535 1 Code Analysis I Fire Protection Plan (see below) 1 Certificate of Survey 1 MC/ES SAC determination letter 1 Spec. Insp. & Testing Schedule ( 1 Soils Report Maintenance Facility: Other: Design drawings for seating 3501 Coachman Point Eagan, MN 55122 If you have any questions regarding the above requirements, please feel free to contact me at 651-681-4683. Phone: 651.681.4300 Fax: 651.681.4360 Sif cerely, \ TDD: 651.454.8535 www.cityoFeagan.cam J. Craig Novaczyk Senior Inspector JCN/js THELONEOAKTREE Enclosures The symbol of strength and growth in our community C` ` I 2004 COMMERCIAL PLUMBING PERMIT APPLICATION CITY OF EAGAN S~ 3830 PILOT KNOB ROAD, EAGAN MN 55122 S 651-675-5675 Date Site Address l 7 t e~awt G e,7 f-g Pu r Unit # Tenant Name r Former Tenant Name Property Owner / L I r 0 /C /s e Telephone J )G~cS c~p d C) ule L Contractor Ac /,q Address / /'C 11e, j City State yy - Telephone The Applicant is Owner Contractor Other Work Type _ New Bldg Add-on _ Repair RPZ _ PVB _ Irrigation system . Jer Wobschall to calculate fees. Required roeer mze is 2" turbo unless smaller size permitted b Public Works Description of Work J U A- C (-O P) e~ ecczz 7/ L9 To inquire if Pressure Reducing Valve is required on new service, call 651-675-5646 S/e'.-r ` r Meters - Call 651-675-5300 to verify that hydrostatic, conductivity, and bacteria tests passed prior to picking un meter Irrigation Size & Type Avg GPM Fire Size & Price 3/4" displacement $155.00 Domestic Size & Type Avg GPM Includes high demand devices? - Yes - No Flushometers _ Yes No PRV Required _ Yes No Permit Fee $50.50 minimum Cmeludes State Surcharge) Contract Value $ x 1% _ $ Base Fee $ Meter(s) Required on all new buildings boulevard irrigation systems $ Radio Meter Read If base fee is $1,000 or less, surcharge is $.50 $ State Surcharge If base fee is over $1,000, surcharge is $.50 per $1,000 of the Base Fee Following fees apply only when installing new irrigation system _ $ Water Permit Contact Jerry Wobschall at 651-675-5024 for required fee amounts $ Treatment Plant $ Water Supply & Storage $ e Surcharge - - - al Fee JU 004 I hereby apply for a Commercial Plumbing Permit and acknowledge that the info ation is comple[ and accura ; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Plumb' 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 in accordance with the approved plan in the case of work whiic~ wires a review And approval of plans. Applicant's Printed Name Applicant's Signature CITY USE ONLY REQUIRED INSPECTIONS: U.G. Air Test Gas Test Rough In Final 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 rebuilt every five years. A minimum fee permit per address is required for RPZ rebuilding or repairing. • Water meters include copper horn/strainer, remote wire, and touch-pad meter GPM METERS USE PRICE GPM METERS USE PRICE 1-20 5/8" residential $121.00 4-120 1-1/2" irrigation syst $ 788.00 displacement sm commercial turbine" must receive maximum continuous approval O from Public Works 2-30 3/4" lawn irrigation $155.00 4-160 2" turbine lg irrigation syst $ 992.00 maximum displacement residential & continuous sm commercial production lines 15 3-50 1" displacement very lg tea $200.00 1/4 to 160 2" compound bldgs over $ 1,880.00 bldg to 24 units 65 units maximum sm commercial & continuous & Ig comm bldgs 25 irrigation systems 5-100 1-U2" bldgs 25-64 units $488.00 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 Ig irrigation $1,338.00 6-500 4" compound +300 unit bldgs & $3,749.00 syst & production very Ig comm bldgs lines 1/2-320 3" compound +200 unit bldgs $2,407.00 10-1000 6" compound +400 unit bldgs $6,124.00 very lg comm bldgs very lg comm bldgs 15-1000 4" turbine very Ig irrigation $2,384.00 cyst & production lines Comments • To schedule inspection of the inside water line and backfiow preventer, call 651-675-5675. • To arrange for water turn-on, call 651-675-5300. cc: Maintenance Division Clerical Technician Updated 8/03 CITY USE ONLY J P 70& a PERMIT* Lp1i O I I RECEIPT DATE: APPROVED BY: 7 P INSPECTOR 8008 COMMIiItCIAL MECHANICAL PEPJW APPLICATION CITY OF EA GM 3830 PILOT KNOB RD EA"N, MN 55188 651-6$1-4675 Please complete for: all commercial/industrial buildings multi-family buildings when separate permits are not required for each dwelling unit DATE: 20C3Z SITE ADDRESS: 1'JVLJAW CC--() Val VV l ~Vt~ C ~ti > OWNER NAME: V PHONE jo~E l - LARD NA TENANT NAME p1PR 2ENTS ONLY): WAS THERE A PREVIOUS TENANT IN THIS SPACE? Y N. NAME: INSTALLER: _"4~~r'f_~t g~Ar e0rpl STREETAD`DRESS: (7S S Otn1LLSSd I )3 CITY: STATE: ZIP: TELEPHONE WORK TYPE: New construction Install U.G. Tank Interior Improvement Remove U.G. Tank Processed Piping Ckll Specify Nature of Work: Z.Q,XINLN When installing/removing underground lank, call 651-681-4675 for in ection by Fire Marshal and Plumbing inspector. Fees: I% of contract price OR $50.00 minimum fee, whichever is greater. D Underground tank removal/installation = minimum fee MAY 0 7 2002 Contract price: $5C&CW x 1% _ $ 5 O S~ U . U ggase Fee) State surcharge 3 . Uo calculate at $.50 for TOTAL $ 9 'NA F PERM TTEE Updated 1/02 -r e -7 CITY USE ONLY - j GCO PERMIT So' o I IJ RECEIPT DATE: ] _ O 21302 COMME§tCIAL PLUMBING PERMIT APPLICATION CITY OF BAB:AN 3630 PILOT KNOB IiD EAGAN, MN S518E 651-6$1-4675 INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED Date: WORK TYPE k New Bldg; _ Add-on Repair _ RPZ PVB Irrigation system • Jerry Wobschall to calculate fees. Required meter size is 2" turbo unless smaller size permitted by Public Works DESCRIPTION OF WORK -Sn To inquire if Pressure Reducing ve is required on new service, call 651-6814646 METERS - Call 651-681-4300 to verify that hydrostatic, conductivity, and bacteria tests passed prior to nicking un meter Irrigation Size & Type Avg GPM Fire Size & Price 3/4" displacement $152,00 Domestic Size & Type Avg GPM Does this include high demand devices? - Yes _ No FLUSHOMETERS -Yes -No PRV REQUIRED _ Yes _ No SiteAddress:16b\ CC (-V~rl ~prku5U.10 Tenant Name: c ,MU1 ° Ck C., win 1 Telephone (Area Code) Was there a previous tenant in this space? f Y _ N. If Yes, Name: 1 - ~a Installer Name: kp'611+_,ryN ~j Telephone 105k- 401 ' -1 '7 (Area Code) Installer Address: 1 1~1 WL7 S~ City: k.-.i cs O ti State: MtO Zip Code 11 FEES Contract price $?Wz Imp x 1% ($50.00 min) Plbg Permit $ C Meter(s) $ Required on all new buildings & boulevard irrigation systems Radio Meter Read $ Surcharge: $.50 Minimum. If base fee exceeds $1,000, calculate at State Surcharge $ U . 50 cents per $1,000 bill e. Sub TotallTotal $ - Supplementary fees for new irrigation system: Water Permit $ 50.00 Contact Jerry Wobschall at (651) 681-4624 regarding fees Treatment Plant $ 540.00 Water Supply & Stora State 110- a W$ Total 1CMp 07 I hereby acknowledge that I have read this application, state that the information is correct, and a wee to compl ble City of Eagan ordinances. It'tstheapplicant's responsibility to notify the property owner that the City ofEaganass to d or any damages caused by the City during its normal operational and maintenance activities to the facilities constructed der this permit 'thin property/right-of--way/easement. SI iATURE OF PE TTEE IRRIGATION SYSTEM (CONT) CITY USE ONLY REQUIRED INSPECTIONS: U.G. Air Test Gas Test Rough In Final PLANS SUBMITTED APPROVED BY: 5 P r , BUILDING INSPECTOR GENERAL INFORMATION • Radio Meter Read (required on all new buildings & boulevard irrigation systems- $157.00 (Acct Code # 9220-4509) • Water meters include copper horn/strainer, remote wire, and touch-pad meter GPM METERS USE PRICE GPM METERS USE PRICE 1-20 518" displacement residential $118.00 4-120 1-1/2" irrigation syst $ 745.00 sm commercial turbine** **must receive maximum approval from continuous Public Works 10 2-30 3/4" displacement lawn irrigation $152.00 4-160 turbine 1g irrigation syst $ 923.00 maximum residential & continuous sm commercial production lines 15 3-50 1" displacement very Ig res $199.00 1/4 to 160 2" compound bldgs over $ 1,798.00 bldg to 24 units 65 units maximum sm commercial & continuous & lgcomm bldgs 25 irrigation systems 5-100 1-1/2" bldgs 25-64 units $439.00 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 Ig irrigation syst $1,214.00 6-500 compound +300 unit bldgs & $3,562.00 & production lines very Ig comm bldgs 1/2-320 3" compound +200 unit bldgs $2,264.00 10-1000 6" compound +400 unit bldgs $5,900.00 very Ig comm bldgs very Ig cotnm bldgs 15-1000 4" turbine very Ig irrigation syst $2,184.00 & production lines Comments • To schedule inspection of the inside water line and backflow preventer, call 651-681-4675. • To arrange for water turn-on, call 651-681-4300. cc: Kris Forster, Maintenance Division Clerical Technician Updated 10101 COMMERCIAL' . 5~ 2002 BUILDING PERMIT APPLICATION / CITY OF EAGAN "Te 'a6& $O 651-681-4675 u°3o-oa 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 • Electric Power & Lighting Form (1) 1 • Master Exit Plan (1) 1 1 • Fire Protection Plan (1)" ! 1 • Soils Report (1) 1 • MC/ES SAC determination letter • MC/ES SAC determination letter • MC1ES SAC determination letter call 651-602-1000 call 651.602-1000 call 651.602-1000 Contact Building Inspections for sample Food & beverage or lodging facilidies -submit plan to MN Department of Health. Call 651-215-0700 for details. DATE: 01-18-02 WORKTYPE: % NEW REMODEL CONSTRUCTION COST: $7,159,136.00 SITE ADDRESS: 1501 Central Parkway. Eafan MN 55122 TENANT NAME: City of Eagan, Eagan Central Park Community Ceu2IdfTE M FORMER TENANT NAME, IF APPLICABLE: N/A DESCRIPTION OF WORK Excavation, Foundations, Enclosure. M.E.P Systems for New Facility City Of Eagan Name: Vraa Kenneth Phone#:( fis1-fiR)i-4fifin PROPERTY Last First OWNER Street Address: 3830 Pilot Knob Road City: Eagan State: MN Zip: 55122-1897 Construction Mamager Company: Stahl Construction Company Phone#: ( 952 ) 931-9300 CONTRACTOR Street Address:_5 goo Rowland goad City: 1Kinnetori State: MN Zip: 55343 ARCHITECT/ ENGINEER Company: TKLIA Architects and Engineers Phone ( 651 )292-4536 Name: William J. Armstrong, AIA Registration /~O (vim Street Address: 1500 Piper Jaffrey Plaza 444 Cedar Street City: St. Paul. State: MN Zip: 55101-2140 Licensed plumber installing new sewer/water service: Northern Air Corporatio hone#: 6( 51 ) 490-9868 I hereby acknowledge that I have read this application, state that the info 's correct, d iree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. \l Signature of Applicant: Updated 1102 OFFICE USE ONLY SUBTYPE 01 Foundation /fir 26 Public Facility ❑ 30 Accessory Bldg. ❑ 14 Apartments --zX 27 Commercial/Industrial ❑ 32 Ext Alt - Apts. ❑ d5 Lodging ❑ 28 Greenhouse ❑ 34 ExtAlt - Comm. ❑ 25 Miscellaneous ❑ 29 Antennae ❑ 35 Ext Alt - PF ❑ 37 Nail Salon WORK TYPE X 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 3 f $ Zoning sq. ft. SAC Code # of Stories sq. ft. No. of Units I Length 2 -f sq. ft. No. ofBldgs. I Width 21 -/o" sq. ft. Const. (Actual) 1I Basement sq. ft. MC/ES System (Allowable)i~fn First Floor sq. ft. S5 gf City Water ✓ UBC Occupancy A •z.l; A-5-.O sq. ft. Fire Sprinklered MISCELLANEOUS INSPECTIONS ❑ Gas Service Test ❑ Heating ❑ Insulation ❑ Plumbing ❑ Stucco/Stone APPROVALS Planning Building lfm~ Engineering Variance VALUATION $ Z. Permit Fee ~ Surcharge L 0)-p . LSO J Plan Review MC/ES SAC % SAC City SAC SAC Units 32 FA-1T) w`rrW rVVA/O. P&*-,Cd it Water Supply & Storage Meter Size S/W Permit S/W Surcharge Treatment Plant Park Dedication Trails Dedication Water Quality Other ^ Copies Total G D-7 ,V0 Log -30, Vt 90 PLUMBING (COMMERCIAL) 1r Permit Application Sc_ a 3 City Of Eagan O c~ 3830 Pilot Knob Road, Eagan Mn 55122 Telephone 9 651-675-5675 FAX # 651-675-5674 Date 02h-~6- 6C7 _ Site Address 1501 Cent.ral Parkway Unit# Tenant Name Eagan Community Center Former Tenant Name Property Owner Telephone # ( ) Contractor Dakota P1 unlbi ng and Heati na Inc Address 3650 uenneh.ec Drive #102 City Eagan State MN Zip 55122 Telephone # (651) 454-6645 The Applicant is Owner X Contractor Other Work Type _ New Bldg _ Add-on _ Repair _ RPZ _ PVB Irrigation system . Jer Wobschall to calculate fees. Required meter size is 2" turbo unless smaller size permitted b Public Works Description of Work Water Softener$Bypass 1o inquire if Pressure Reducing Valve is required on new service, call 651-675-5646 Meters - Call 651-675-5300 to verify that hydrostatic, conductivity, and bacteria tests passed prior to.uickine•no-meter. - l Irrigation Size & Type Avg GPM D v I' l Fire Size & Price 33/4disr~lacement $156.00 MAP 4 209.3) III Domestic Size & Type Avg GPM Includes high def W and devices? - Yes No Flushometers - Yes _ No PRV Required _ Yes 20 Permit Fee $50.50 minimum l .includes State Surcharge) Contract Value $ x .01% _ $ Base Fee $ Meter(s) Required on all new buildings & boulevard irrigation systems $ Radio Meter Read If base fee is $1,000 or less, surcharge is $.50 $ State Surcharge If base fee is over $1,000, surcharge is $SO per $1,000 of the Base Fee Following fees apply only when installing new irrigation system $ Water Permit Contact Jerry Wobschall at 651-675-50:24 for required fee amounts $ Treatment Plant $ Water Supply & Storage $ State Surcharge S 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 ith the approved plan in the case of work which requires a review and approval cf plans. Applicant's Printed Name Applicant' ignature CITY USE ONLY REQUIRED INSPECTIONS: _ U.G. Air Test - Gas Test Rough In Final PLANS SUBMITTED APPROVED BY: 'J 1" 3 03 , BUILDING INSPECTOR General Information • Radio Meter Read (required on all new buildings & boulevard irrigation systems- $157.00 • RPZ's must be rebuilt every five years. A minimum fee permit per address is required for RPZ rebuilding or repairing. • Water meters include copper hom/strainer, remote wire, and touch-pad meter GPM METERS USE PRICE GPM METERS USE PRICE 1-20 5/8" residential $121.00 4-120 1-1/2" irrigation syst $ 781.00 displacement am commercial turbine" must receive maximum continuous approval 10 from Public Works 2-30 3/4" lawn irrigation $156.00 4-160 2" turbine lg irrigation syst $ 982.00 maximum displacement residential & continuous am commercial production lines 15 3-50 1" displacement very Ig res $200.00 1/4 to 160 2" compound bldgs over $ 1,860.00 bldg to 24 units 65 units maximum am commercial & continuous & Ig comm bldgs 25 irrigation systems 5-100 1-1/2" bldgs 25-64 units $484.00 maximum displacement & continuous most comm bldgs 50 METERS REOUIRING 30-DAY ADVANCE NOTICE PRIOR TO PICK UP GPM METERS USE PRICE GPM METERS USE PRICE 5-350 3" turbine very Ig irrigation $1,328.00 6-500 4" compound +300 unit bldgs & $3,702.00 syst & production very Ig comm bldgs lines 1/2-320 3" compound +200 unit blcigs $2,411.00 10-1000 6" compound +400 unit bldgs $6,100.00 very Ig comm bidgs very Ig comm bidgs 15-1000 4" turbine very lgirrigation $2,329.00 syst & production lines Comments • To schedule inspection of the inside water line and backflow preventer, call 651-675-5675. • To arrange for water tum-on, call 651-675-5300. cc: Maintenance Division Clerical Technician Updated 1/03 VM"Clw J 2002 BUILDING PE RMIT APPLICAT ON 1-31-D a- CITY OF PAGAN 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 d (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. Map. & 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 . Electric Power & Lighting Form (1) 1 . Master Exit Plan (1) 1 1 • Fire Protection Plan (i) 1 • Soils Report (1) 1 MC/ES SAC determination letter . MC/ES SAC determination letter . MC/ES SAC determination letter call 651602-1000 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: 01-18-02 WORKTYPE: K NEW REMODEL CONSTRUCTION COST: $7,159,136.00 SITE ADDRESS: 1501 Central Parkway Eagan HN 55122 TENANT NAME: City of Eagan, Eagan Central Park Comunity CerilkiffEM FORMER TENANT NAME, IF APPLICABLE: N/A DESCRIPTION OF WORK Excavation, Foundations, Enclosure. M.E.P Systems for New Facility City Of Eagan Name: Vraa Kenneth Phone ( 651-Fgh _466n PROPERTY Last First OWNER Street Address: 3830 Pilot Knob Road City: Eagan State: MN Zip: 55122-1897 Construction r Manager' Company: Stahl Construction Cotapany Phone#: ( 952 ) 93i-9300 CONTRACTOR Street Address: 5900 Rowland Road City: Minnetnnka State: MN Zip: 55344 ARCHITECT/ ENGINEER Company: TKDA Architects and Engineers phone ( 651 )292-4536 Name: William J. Armstrong, ATA Registration#: Street Address: 1500 Piper Jaffrey Plaza 444 Cedar Street City: St. Paul. State: MN Zip: 55101-2140 Licensed plumber Installing new sewer/water service: Northern Air CorporationPhone( 651 ~ 490-9868 1 hereby acknowledge that I have read this application, state that the infor 's correct, d ree to comp y 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 X' 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 3 I& Zoning P sq. ft. SAC Code 50 # of Stories sq. ft. No. of Units I Length 37 - 2sq. ft. No. of Bldgs. 1 Width 215- /o " sq. ft. Const. (Actual) H ar Basement sq. ft. MC/ES System (Allowable) I MR, First Floor sq. ft. :55 O City Water UBC Occupancy A•2.!- h3 -5 sq. ft. Fire SprinMered - MISCELLANEOUS INSPECTIONS Gas Service Test a Heating ❑ Insulation E) Plumbing ❑ Stucco/Stone APPROVALS Planning Building (_!o Engineering Variance a a VALUATION $ /0)006) Permit Fee Surcharge 5, 00 Plan Review MC/ES SAC 35~~~• lGO %SAC /00°16 City SAC - SAC Units 2 .Water Supply & Storage - Meter Size S/W 'ermit SPoV Surcharge Treatment Plant Park Dedication _ Trails Dedication Water Quality - Other - Copies Total 5 30)4olr• ~O PERMIT City of Eagan Permit Type: Sewer/Water 3830 PILOT KNOB RD Permit Number: EA051034 EAGAN, MN 55122 - Date Issued: 0670372062 (651) 681-4675 v 3 •~t c3 t~Lj 1-3 l - O o Site Address: 1501 Central Pkwy Lot: 1 Block: I Addition: Unisys Park 2nd PID: 10-79951-010-01 Use: Community Center Description: Sub Type: Commercial Work Type: New Description: VE 22655 Remarks: Fee Summary: Contractor: Applicant - Owner: Northern Air Corp St. Lie.: 3615PM City of Eagan 75 S. Owasso Blvd 3830 Pilot Knob Road Little Canada, MN 55117 6514909868 Eagan, MN 55122 651-681-4660 I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Applicant/Pemritee: Signature Issued By: Signature JZ3Co/A`l CITY USE ONLY PERMIT RECEIPT DATE: APPROVED BY: -,:5- 1Z-0ZINSPECTOR 2002 COMMERCIAL MECHANICAL PERMIT APPLICATION CITY Of EAGAN 3630 PILOT KNOB RD KAGAN, BIN 55182 651-661-4675 Please complete for: all commerciallindustrial buildings q multi-family buildings when separate permits are not required for each dwelling unit DATE: / - J a a a_ SITE ADDRESS: OWNERNAME: UZTv 6 PHONE#: d' f TENANT NAME (IMTROVEMEN4 ONLY): WAS THERE A PREVIOUS TENANT IN THIS SPACE? Y N. NAME: 14 INSTALLER: TAV6N-s neC/ kz( V"I'CA ()D.v JrAC1 /~Nq° ~f1 v STREET ADDRESS: -5-2160 J / , J1 Soil) 4y CITY: g / ~F Al k4ld STATE: IAVIAI ZIP: 0 0 TELEPHONE -5-0%6' 09- 7 Y 3 a- WORK TYPE: New construction Install U.G. Tank Interior Improvement Remove U.G. Tank _ Processed Piping / j Specify Nature of Work: 14 VA G S{/ Cd ev°~¢ / When installing/removing underground tank, call 651-681-4675 for inspection by Fire Marshal and Plumbing inspector FPi Fees: 1% ofcontract price OR $50.00 minimum fee, whichever is greater. Underground tank removal/installation minimum fee 2 Contract price: $ 3 1x I%$ (Base Fee) State surcharge calculate at $.50 for each $1,OD0 ase`Fee TOTAL S[ ATURE OF PERMITTEE Updated 1/02 W r- %I\ 2006 COMMERCIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5694 C Gee=,, ur-il O'C" X53 \ °"k • 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) _AJ • 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 4 l • Project Specs (1) '31'` 1 • Energy Calculations (1) 1 l • Electric Power & Lighting Form (1) " l l • Master Exit Plan (1) l 1 • Emergency Response Site Plan (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 Permit for new building or addition will not be processed without Emergency Response Site Plan. Date - 2-r9 d6 Construction Cost Z, > Site Address / So l 4fE,4ItZr}4- PACkw. - Unit/Ste # Tenant Name C Z7`( OF Former Tenant Name UL Description of Work ~ZW&7-Z✓[?SO J Ur S?e~~.9G~ SN4PA3 Property Owner CZ77-`( Q P- EAK Telephone # Applicantis: _LCOwner Contractor Contact#: Contractor M4 - ~Os Address City State Zip Telephone # ( ) ~3~ t, t2 Arch/Engr Registration # Address City State Zip Telephone # ( ) 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 MN Statutes; I understand this is not a permit, but only an applica' n 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 hic requires a review and approval of plans. L e A` Appl ant's Printed Name Applicant's Signature DO NOT WRITE BELOW THIS LINE Sub Types ❑ 01 Foundation ❑ 26 Public Facility ❑ 30 Accessory Building ❑ 14 Apartments ,d 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)' ❑ 43 Reroof ❑ 46 Windows/Doors ❑ 34 Replacement 'Demolition (Entire Bldg only) -Give PCA handout to applicant Valuation I~0 ft-a Type of Const t3 Width Plan Rev 100% _ 25% _ Occupancy MCES System SAC Units - (2 Zoning City Water Nbr. of Units Stories Booster Pump Nbr. of Bldgs 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 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 ' Surcharge oo Plan Review SAC-MCES SAC-City S/W Permit SAW 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 Page 1 of 1 Jenny Hildebrandt - - - - From: Sue Sheridan Sent: Tuesday, April 18, 2006 3:06 PM To: Jenny Hildebrandt Subject: RE: Adjustment request The journal entry # is 111400 dated 04/30/06. sue From: Jenny Hildebrandt Sent: Tuesday, April 18, 2006 1:12 PM To: Sue Sheridan Cc: Jan Severson Subject: Adjustment request Hello, Sue. Parks came and requested a permit be issued for a storage shed at 1501 Central Parkway. I entered/issued the permit with a date of this coming Saturday, the 22nd. The fee was $1.00 for the State Surcharge. Can you please do an adjustment for that $1.00? Thank you. Jen Hildebrandt City of Eagan Building Inspections 651/675-5673 04/18/2006 1/00. 6-D 2ookFIREWORKS/PYROTECHNIC SPECIAL EFFECTS DISPLAYS PERMIT APPLICATION City of Eagan 3830 Pilot Knob Road, Eagan, MN 55122 Telephone 651-675-5675 Fax 651-675-5694 Application must be completed and returned at least 15 days prior to date of display and include • Proof of a $1,000,000 Bond or Certificate of Insurance. • A diagram of the ground, or indoor display facilities, drawn to scale or with dimensions included, illustrating the point at which the fireworks/pyrotechnic special effects are to be discharged; location of ground pieces; location of all buildings, highways, streets, communication lines and other possible overhead obstructions; and the lines behind which the audience will be restrained. For proximate audience (e.g. indoor displays), the diagram must also include the fallout radius for each pyrotechnic device used during the display. • Names and ages. of all assistants participating in the display. L q Date of Display: ? /--J' / 2OV6 Time of Display: Display Address: ~Gyc~ C rn"U 19 Cen?41- ~ /.SUI Ccnft-y, ~Y f L a~~vr Applicant (sponsoring organization): e Address: City: L~agci-~i State:. ~Zip: 5377- 7 Telephone 7 9'7, Authorized Agent: Address: 15-6' 7 471 T4~ City State: /y{ ✓Zip: S-577-2- Telephone 6,57 5 3 7- 79 Supervising Operator: Certificate No. aS'37 w~ /o~~STi' 9 Manner & Place of Storage of Fireworks/Pyrotechnic Special Effects Prior to Display: 11r~ /*)gg Type of Fireworks/Pyrot hnic Special Effects to be Discharged: 3 G T ~Y~rNer~e.S crtri rh C1.i4l "OL*r Quantity: [Permit Fee: $100.50 (includes state surcharge) * If a fire watch is needed, an additional fee will be assessed in accordance with the City's fee schedule. The State of Minnesota requires that this display be conducted under the direct supervision of a pyrotechnic operator certified by the State ~Fire /Marshal. 1, /4 °e--s understand and agree to comply with all provisions of this application and the requirements of the issuing authority, and will ensure that the fireworks/pyrotechnic special effects are discharged in a manner that will not endan a ons property or constitute a nuisance. y7-a6~ t /Agent Discharge of the listed fireworks on the date and above location is hereby approved subject to the following conditions, if any: Date: Fire Chief / Fire Marsh Certificate of Insurance 464609 Issue Date: 07/28/2006 PRODUCER THIS CERTIFICATE IS ISSUED ASA MATTER OF INFORMATION ONLY AND Combined Specialties International, Inc. CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE 8362 Tamarack Village DOES NOTAMEND, EXTEND OR LATER THE COVERAGE AFFORDED BY THE Suite 119 POLICIES BELOW. Woodbury Minnesota 55125 INSURERS AFFORDING COVERAGE INSURER A: Underwriters, Lloyds of London INSURED INSURER B: Hollywood Pyrotechnics, Inc. INSURER C'. 1567 Antler Point Eagan Minnesota 55122 INSURFR I) COVERAGES THIS ISTO CERTIFY THATTHE POLICIESOF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE NAMED INSURED ABOVE FOR THE PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES INCLUDING, BUT NOT LIMITED TO THOSE FOLLOWING: LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, ADDITIONAL CONDITIONS AND EXCLUSIONS: 1) THE INSURANCE EVIDENCED BY THIS CERTIFICATE IS LIABILITY INSURANCE ONLY, IT IS NOTA BOND OR ANY FORM OF SURETY AGAINST WHICH SOMEONE OTHER AN "INSURED' MAYASSERTA CLAIM OR BRING ANY ACTION. SUBJECT TO POLICY TERMS, CONDITIONS, DEFINITIONS AND EXCLUSIONS THE INSURANCE ONLY INDEMNIFIES AN INSURED AGAINST CERTAIN LEGAL LIABILITY. 2) THE INSURANCE DOES NOT COVER CLAIMS FOR BODILY INJURYOR PROPERTY DAMAGE OF THE NAMED INSURED'S SHOOTER(S) ASSISTANT(S) OR ANYOTHER PERSON(S) INCLUDING ANY VOLUTEER(S) PARTICIPATING IN ANY WAY IN ANY DISPLAY OR SPECIAL EFFECT PERFORMED OR EXECUTED BY THE NAMED INSURED. 3)COVERAGE DOES NOTAPPLYTO CLAIMS FOR BODILY INJURY OR PROPERTY DAMAGEARISING OUT OF THE INSUREDS FAILURE TO FOLLOW NFPA OR OTHER APPLICABLE REQUIREMENTS, LAWS OR RECOMMENDATIONS, INCLUDING THOSE RELATING TO POST DISPLAY OR SPECIAL EFFECT SEARCHES OR CLEAN UP. CO TYPE OF INSURANCE POUCYNUMBER POLICYEFFECTIVE POLICY EXPIRATION LIMITS LTR DATE (MMIDDYY) DATE (MMlDD/" A GENERAL LIABILITY 11447020281006 June 01, 2006 June 01, 2007 EACH ACCIDENT $1,000,000 CLAIMS MADE MEDICAL EXP $5,000 (any one person) FIRE LEGAL LIABILITY $50,000 GENERAL AGGREGATE $2,000,000 PRODUCTS-COMP/OPSAGG $1,000,000 AUTOMOBILE LIA&LITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY $ ANY OWNED AUTO SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per person) EXCESS LIABILITY EACH ACCIDENT $ FOLLOWING FORM AGGREGATE $ WORKERS COMPENSATION WC STATU- OTHER AND TORY LIMITS EMPLOYERS' LIABILITY $ E.L. EACH ACCIDENT $ E.L. DISEASE-EA EMPLOYER $ E.L. DISEASE-POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONSA/EHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Kristine Klasen; Eagan Community Center and City of Eagan are Additional Insured as respects the September 9, 2006 Fireworks Display at Eagan Community Center, 1501 Central Parkway, Eagan, MN CERTIFICATE HOLDER CANCELLATION Kristine Klasen SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE c/o Kristal Spa & Salon THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE 1380 Marice Drive CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO Eagan, MN 55121 OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES AUTHORIZED REPRESENTATIVE/ Mira LaCous President / Display operator Hollywood Pyrotechnics, Inc. 1567 Antler Point Eagan, MN 55122 miraLhollywoodpyrotechnics cam HOLLYWOOD 651-454-7976 or 651-454-7975 fax I-866-PYR041 PYR0411(797-6411) toll-free PYROTECHNICS INC 612-730-9380 mobile July 27U', 2006 Site Survey Kristine Klasen Wedding September 9th, 2006 Eagan Community Center Safety :0 The audience is on the patio of the Eagan Community Center. Fireworks will be displayed from two locations. One on a path near a pond, which will be 2.5" and less diameter (mainly cakes and candles. The other location will be behind the gazebo area and has a 280' or greater safety radius, and will contain up to 4" material. The main body of the display is 3" and less, with only a few 4" shells for larger emphasis and effect. The display will be shot electrically from a location near the gazebo. Spotters will be with the primary audience, and in the woods to watch fall out and effect presentation. Trails around the firework display area will be taped off with CAUTION tape. NWA O o p c ~ o pp d . CPO 0 g° c eras O~ O 1(~~ o O ,,CCU Area Under ~D DO O ® Canshuctlon 0 e~ B 17° B C D ° C~jC~~ Communl ~ ~ CCC ~nr~r D 4001. ® r Central kwy_--~ U Argosy University _ (under consVUCtion) LO i ed-Martin rking 1 O • B USN _ It. m Fm ~ ,J )i ar.auaca, N Community Center/Central Park Area o se ~o Ow Comm C I~°Pt - TI+tS Di~tre~Nt~ S1rM.t_ ~gyAt~ 'it1~ ~ GbMbtN~s~n exit Doa2w~-r®tN M1N114t76V1 FJTJ ss o t%, T'7 Coil GRZTF_ PAZ G &r I. 2 L M eyU ✓ Fshce IZ ✓R~'r~ 4 2J ss~S HEADER ilUD5 q 1 CT R -E 0 DOUBLE JACK 5TUD5 LOOR ® O.N. DOOR OPENING Q K tai ° P` 7-0 NOTE: VERIFY ALL ROUGH OPENINO WITH rrE srn-arts DOOR AND NINDON MANUFAGTURER5 MrN~walY.~i. ~ - IF;- FRONT FRAMING ELEVATION la' f LOIM rYrv~l ~ V 5 y~o_c TOP PLATE .o. R.O.' 5TUD5 1 LX .V 1~ 1 FLOOR NOTE: VERI ROUGH OPENING WITH + DOOR AND WINDOW MANUFACTURERS - SIDE FRAMING ELEVATION . F~~r~2 CUu S7-2uca-~»,,.~ TR.u~A r~ 16 I y r~ p~K ~ rQ ' 1 ~ I I TC, Y 3 xYxts P£Y ~G lY 72EArE~ S! , `f re~d-rd N p , 2-x4.5 wits, ►107 SUPPo~r r a 7 2' SPk-" . Sum ~br 2 7x(." '3oitrs ; Fes- SuPP~--~- . 4 , l,6 O.C. • - ~ Crs~vr; Proms Lx~Tt. EL~+wr SECOND TOP PLATE - (OVERLAP THE 70P PLATE OF THE OTHER WALL) TOP PLATE OR PLATE I sruos II i II DOUBLE STUD CORNER POST BLOCKING MUDSILL (PRESSURE TREATED) nR "l s 7~6 K ri'K~gk 4 of 121~~" ~ Al tfwn. p4ov2' DETAIL P2 - WALL CONSTRUCTION r' yPvn uc6Q 3 SFT SH3+'w `~S >GE ROOF SHEATHING ILL r7o FTNG FASCIA BOARD FELT RAFTER RIM 5OFFIT PANEL 4EL KALL 5HEATHING "F" CHANNEL VINYL EAVE SOFFIT DETAIL i CITY OF EAGAN APPLICATION / PERMIT FOR DISPLAY OF FIREWORKS/PYROTECHNIC SPECIAL EFFECTS Applicant instructions: fd 1. This application must be coTrleteedd and retuned at least 15 days prior d e ofd pl 2. Fee upon application is $ Y ,,O S andmust be made ayable to O 7~ > f Name of applicant (Sponsoring Organizat~iJon)_:,_,J/ , r zl C, Address of applicant: 7./ ~7 Z Z Name of authorized agent of applicant: 6'=9 Address of agent: /i~ 7 p l',7 t 1e ~ Telephone number of agent: b S y~f 71::;1"b1- Date of display: Time of display: Location of display: Manner and place of storage of fireworks/pyrotechnic special effects prior to display: /~euaca Z, yt~ i VI Wn~S~~f /~I~ Type & number of fireworks/pyrotechnic special effects to be discharged: / l 5 G / ~r a~5 Minnesota state law requires that this display be conducted under the direct supervision of a pyrotechnic operator certified by the State Fire Marshal. Name of supervising operator: A/.o~ lr Certificate No.: 0577 I understand and agree to comply with all provisions of this application and the requirements of the issuing authority, and will ensure that the fireworks/pyrotechnic special effects are discharged in a manner that will not endanger persons or property or constitute a nuisance. Signature of applicant (or agent of application: 7 S Gr Required attachments. lowing attachments must be included with this application: 1. Proof of and or certificate of insurance in amount of at least $ / ~ a ` 2. A diagram of the ground, or facilities (for indoor displays), at which the display will be held. This diagram (drawn to scale or with dimensions included) must show the point at which the fireworks/pyrotechnic special effects are to be discharged; the location of ground pieces; the location of all buildings, highways, streets, communication lines and other possible overhead obstructions; and the lines behind which the audience will be restrained. For proximate audience (e.g. indoor) displays, the diagram must also show the fallout radius for each pyrotechnic device used during the display. 3. Names and ages of all assistants that will be participating in the display. The discharge of the listed fireworks on the date and at the location shown on this application is hereby approved, subject to the following conditions, if any: Signature of fire chief/county sheriff: Date: Signature of issuing authori .k\\~ vys Date: '7' AO^" 0 Use BLUE or BLACK Ink 1-----------------~ I Permit ' f Q5 I City of Ea aii 1 Permit Fee: J 1 3830 Pilot Knob Road 1 Eagan MN 55122 Date Received: Phone: (651) 675-5675 Fax: (651) 675-5694 05 C XJc C~ G~ Staff: - - - 2009 FIREWORKS / PYROTECHNICS APPLICATION Application must be completed and returned at least 15 days Prior to date of display and include: • Proof of a $1,000,000 Bond or Certificate of Insurance. • A diagram of the ground, or indoor display facilities, drawn to scale or with dimensions included, illustrating the point at which the fireworks/pyrotechnic special effects are to be discharged; location of ground pieces; location of all buildings, highways, streets, communication lines and other possible overhead obstructions; and the lines behind which the audience will be restrained. For proximate audience (e.g. indoor displays), the diagram must also include the fallout radius for each pyrotechnic device used during the display. • Names and ages of all assistants participating in the display. • Pyrotechnics plan-requires: Certifications that are set, scenery, and rigging materials are inherently flame-retardant or have been treated to achieve flame retardancy. (NFPA 1126: 4-3.2) Date of Display: Sept 26 , 2009 Time of Display: Between 8pm and 10pm, for 15 minutes Display Address: Eagan Community Center, 1501 Central Parkway, Eagan, MN 55121 APPLICANT/ Name: Hollywood Pyrotechnics, Inc. Phone: 651-454-7976 SPONSORING ORGANIZATION Address/ City/ Zi : 1567 Antler Point, Eagan, MN 55122 AUTHORIZED Name: Mira LaCous Phone: 651-454-7976 AGENT Address /City /Zip: 1567 Antler Point, Eagan, MN 55122 SUPERVISING Mira La Cous 0537 OPERATOR Name: Certificate Number: Manner & place of storage of fireworks/ pyrotechnic special effects prior to display: HP I Magazine, as certified by BATFE in Pine City MN Type of fireworks/ pyrotechnic special effects prior to display: 1.3G and 1.4G Fireworks to a maximum of 4" in size, requiring 280 feet per NFPA 1123 and MN requirements Type of fireworks/ pyrotechnic special effects to be discharged: Same as above Quanti : $ 2. 0 0 0 Permit Fee: k100 $0 (includes $.50 state surcharge) *If a fire watch is needed, an additional fee will be assessed in accordance with the City's fee schedule The State of Minnesota requires that this display be conducted under the direct supervision of a pyrotechnic operator certified by the State Fire Marshal. 1 Mira LaCous understand and agree to comply with all provisions of this application and the requirements of the issuing authority, and will ensure that the fireworks/pyrotechnic special effects are discharged in a manner that will not endanger persons of or to a nuisance. X Date: x 9-10-09 scant /Agent Discharge of the listed fireworks on the date and above location is hereby appro ed subject to the f owing co5fions, i ny: CAIr C h SST Date: 2S 1 Fire Ch" f it ars Mira LaCous President / Display Operator Hollywood Pyrotechnics, Inc. 1567 Antler Point i Eagan, MN 55122 miral@hollywoodpyrotechnics.com Rol I VU"o 651-454-7976 or 651-454-7975 fax low I W 0 1-866-PYR0411(797-6411) tall-free PYROTECHNICS INC 612-730-9380 mobile September 9"', 2009 Eagan Fire Marshal, Hello, we have been asked back for another small firework displays at the Eagan Community Center. We have performed many times there over the past number of years. It will be exciting to return. Enclosed please find the display application, site layout, insurance, license information and other support documents. If you have any questions, please let me know. Thank you for your continued support. Also, we have performed the Eagan High School Home Comings for the past many years. The booster club that sponsors it is all new this year and is moving slow. We are pressing to find the right people and get it contracted. I believe that date is soon, but we are still confirming. Sincerely, ~ i us Minnesota Department of Public Safety State Fire Marshal Division Application for Permit Display of Outdoor Fireworks Instructions: Complete this application, attach the permit fee, proof of bond or insurance in the specified amount, a copy of the plan for the use of pyrotechnics, and submit to the address below at least 15 days prior to the date of the display. If approved, permits will be issued to the Sponsoring Organization named on the application. Minnesota Department of Public Safety State Fire Marshal Division 444 Cedar Street, Suite 145 St. Paul, MN 55101 Hours: 8:00 am to 4:30 PM, Monday - Friday (Excluding Holidays) Name of Sponsoring Organization: Hollywood Pyrotechnics, Inc Address of Sponsoring Organization: 1567 Antler Point, Eagan, MN 55122 Name of Authorized Agent - Sponsoring Organization: Mira LaCous, Hollywood Pyrotechnics, Inc. Address of Agent: 1567 Antler Point. Eagan, MN 55122 Phone Number: 651-454-7976 Fax: 651-454-7975 e-mail: mira(cDhollywoodoyrotechnics.com Location of Display: Eagan Community Center, 1501 Central Parkway, Eagan. MN 55121 Date and Time of Displays: September 26 . 2009 between 8:30 and 10:00, for 15 minutes Manner and Place of Storage of Fireworks / Pyrotechnic Special Effects Prior to Display: Firework effects will be transported from off site storage (HPI BATF compliant Magazine) to the shoot site the morning of the display. Type and Number of Fireworks / Pyrotechnic Special Effects to be Discharged: All product is 1.3G, designed for outdoor aerial use. Sizes up to 4" will be used, requiring 280 feet safety distance per NFPA 1123 and MN Statues. Minnesota Statute (MS 624.20) requires fireworks displays to be conducted under the direct supervision of a fireworks operator certified by the Minnesota State Fire Marshal. Name of Supervising Operator: Mira La Cous MN Certificate Number: B 0537 or: Robert Rowe MN Certificate Number: B 0599 Signature of Authorized Agent: Date: Required Attachments: 1. Permit Fee: $ 2. Proof of bond or insurance in the amount of $1.0 million (minimum) 3. Plan for the location and safety distance of pyrotechnics. (Required by NFPA 1123). If this application is approved and a permit issued, I understand and agree to ensure that the fireworks display for which this application has been filed will be conducted in full compliance with Minnesota Statute 624.20 - 25, the Minnesota State Fire Code, and National Fire Protection Association Standard 1123. The discharge of the listed fireworks on the date and at the location shown on this application is hereby approved, subject to the following conditions, if any: Signature of fire chief/county sheriff: Date: Signature of issuing authority: Date: HOLLYWOOD PYROTECHNICS INC Mira LaCous President / Display Operator Hollywood Pyrotechnics, Inc. 1567 Antler Paint Eagan, MN 55122 miraE hollywaodpyrotechnics.com 651-454-7976 or 651-454-7975 fax 1-866-PYR0411(797-6411) tall -free 612-730-9380 mobile Site Survey Eagan Community Center September 26th, 2009 InaeyOate Apr 20097,<*' lYS'Ceneue eureeue^(- D 2009 Tele S wS Geologies Spivey 44°50'22 -112,N '' 93'10'',15 30' W ,reIev 258171. The display site is the park and trails behind the Eagan Community Center. The display site, to the North East of the Gazebo offers great viewing as well as safe distances to audience and occupied structures. The safe distance is 280 feet to the building, and great to roadways, audience and neighboring structures. The fireworks display is 100% electronically fired, and is setup along the pond shore with mines, comets, and low level effects (multi -shot cake effects), and the main display of 2.5", 3" and 4" shells is at the main site behind the Gazebo. The trails will have caution tape added for safety, and will be monitored for restricted access during the display. Most trails can remain open during setup, except our setup areas. The truck can get easy access to the trails off of Central Parkway. ,,),6 s q1- CERTIFICATE OF INSURANCE This certificate of insurance is NOT an insurance policy and does not amend, extend or alter the coverage afforded by the policy listed herein. The terms, conditions and exclusions of the policy govern the rights and obligations of the Company to the named insured and any other insureds and may substantially limit coverage. Provisions of any other contract, including agreements between the insured and anyone else, cannot and do not amend, extend, or alter any terms, conditions or exclusions in the policy. Additional insured and other endorsements may be authorized only by the Company or its appointed General Agent. Where reference is made to an Aggregate Limit, such limit is the Company's maximum liability under the Policy for the entire policy period regardless of the number of insureds, claimants or occurrences. Date 09/03/2009 NAMED INSURED Hollywood Pyrotechnics. Inc. NAMED INSURED'S ADDRESS 1567 Antler Point Eagan. MN 55122 INSURANCE COMPANY NAME: National Fire & Marine Insurance Company INSURANCE COMPANY ADDRESS: 3024 Harney Street • Omaha, Nebraska • 68131-3580 POLICY TYPE OF INSURANCE LIMITS INCEPTION DATE NUMBER EXPIRATION DATE 72LPS010835 COMMERCIAL GENERAL LIABILITY - Occurrence Form 05/15/2009 ® Premises-Operations 05/15/2010 ® Products/Completed Operations ❑ Other (Specify) Each Occurrence Limit $ 2.000.000. Damage to Premises Rented $ 100,000. Medical Expense Limit (Any One Person) $ 5,000. Personal & Advertising Injury Limit $1,000,000. General Aggregate Limit $ 2.000.000. Products-Completed Operations Aggregate Limit $ 2,000,000. POLICY INCLUDES COMPANY-SPECIFIC NON-STANDARD ENDORSEMENTS WHICH MAY BE RESTRICTIVE OR EXCLUSIONARY IN NATURE. his Certificate is not evidence of additional insured status for the certificate holder nor is it descriptive of coverage for any additional insured. The Certificateholder h een named as an additional insured under the terms of a M-5350 (10/2008) endorsement to the policy. For a description of the coverage, please refer to the policy. Fireworks Display Show Date: 09/26/2009 Fireworks Display Show Location: Eagan Community Center, 1501 Central Parkway, Eagan, MN 55121 Katie Ordahl, Bryan Wilkins, Eagan Community Center and City of Eagan are added as additional insureds per the attached endorsement. In the event of any material change in or cancellation of said policy, the Company's appointed General Agent may, but is not obligated to, notify the party to whom this Certificate is issued of such change or cancellation. The COMPANY undertakes no responsibility by reason of any failure to provide such notification. This Certificate issued to: This Certific sued by: Katie Ordahl & Bryan Wilkins By 1801 Southcross Drive Northern States Agency. Inc. (Company General Agent) Burnsville MN 55306 Retail Producing Agent: Ryder, Rosacker, McCue & Huston 509 W Koenig Street P.O. Box 1228 M-5238a (02/2007) Grand Island, NE 68802 M-5350 (10/2008) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED SCHEDULE Name of Person or Organization (Additional Insured): A person or organization for which designation as an "additional insured" (and subject to Section A below) is required by written contract with the Named Insured. Location of Covered Operations: Only the locations at which the Named Insured performs work or operations under written contract with the Additional Insured. A. Who Is An Insured (Section II) is amended to include as an insured the person or organization (called "additional insured") shown in the Schedule but only with respect to liability arising out of: 1. Your ongoing operations performed for the additional insured(s) at the location designated above; or 2. Your ongoing operations at the location designated above if the additional insured is the owner of the designated location; or 3. Acts or omissions of the additional insured(s) in connection with their general supervision of such operations. B. With respect to the insurance afforded these additional insureds, the following additional provisions apply: This insurance does not apply to: 1. "Bodily injury", "property damage" or "personal and advertising injury" for which the additional insured(s) are obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the additional insured(s) would have in the absence of the contract or agreement. 2. "Bodily injury", "property damage" or "personal and advertising injury" arising out of any act or omission of the additional insured(s) or any of their "employees", other than the general supervision by the additional insured(s) of your ongoing operations performed for the additional insured(s). 3. "Property damage" to: a. Property owned, used or occupied by or rented to the additional insured(s); b. Property in the care, custody, or control of the additional insured(s) or over which the additional insured(s) are for any purpose exercising physical control; or c. "Your work". 4. "Bodily injury", "property damage" or "personal and advertising injury" occurring after "your work" at the involved designated location has been completed. Company Name Policy Number Endorsement Effective Named Insured Countersigned by (Authorized Representative) (The Attaching Clause need be completed only when this endorsement is issued subsequent to preparation of the policy.) M-5350 (10/2008) Contains copyrighted material of Insurance Services Office, Inc. 0 1996 used with permission STATE FIRE MARSHAL - Fireworks Operator License Search By Name Results Page 1 of I MINNFSOTA DEPARTMENT OF PUBLIC SAFETY STATE FIRE MARSHAL Fireworks Operator License Search By Name Results Your search for la cous resulted in 1 hits Name Certificate Type Certificate # Issue Date Expiration Certification Date Status La Cous, Mira K Both (Indoor & Outdoor) 0537 8/3/2008 8/212012 Valid Records 1 to 1 of 1 NEWS-EAR-CH I .Last Modified: July 30, 2008. For additional information, contact Robert Dahm, Minnesota State Fire Marshal Division, at Robert. Dahm@state. mn. us or (651)215-0500. Minnesota State Fire Marshal Division 444 Cedar St., Suite 145 St. Paul, MN 55101-5145 651-215-0500 - voice 651-215-0525-fax 651-282-6555 - TDD https://www.dps.state.mn.us/fmarshal/f nfireworks/Public/FWNameResults.asp?L_NAME... 7/30/2008 "nn 1 lvitly I OF I HE TREASURY - BUREAU OF ALCOHOL, TOBACCO AND FIREARMS to I LICENSE/PERMIT (18 U.S.C. CHAPTER 40, EXPLOSIVES in accordance with the provisions of Title xi, organized crime Control Act of 1970, and the regulations issued thereunder (27 3 CFR Part 555)you may engage in the activity specified in this license/permit within the limitations of Chapter 40, Title 18, United States code and the regulations issued thereunder, until the expiration date shown. See "WARNING" and 'NOTICES" on back. Christopher R. Reeves ucEias DIRECTATF Chief, Federal Explosives Licensing Center (FELC). NUMBER 1 37 CORRESPONDENCE Bureau of Alcohol, Tobacco, Firearms and Explosives TO 244 Needy Road IXPIFi4T10N.. Martinsburg, West Virginia 25401-9431 DATE Tele hone:l-877March 1, 2010 a h 1, 2( -2833352 Fax: 1-304-260-1141 NOME remises Address LACOUS, MIRA KRISTINA & ROWE, ROBERT BARRETT 1567 ANTLER POINTS? YOU must notify theFELCatleast todays tlefore mei EAGAN,, K4N 55122- TYPE OF LICENSE OR PERMIT 51-IMPORTER OF FIREWORKS (DISPLAY) CHIEF, FEDERAL EXPLOSIVES UCENSlW CENTER (FELC) Christo her R. Reeves PURCHASING CERTIFICATION Mailing Address CHANGES? You must notify the FELL at least 10 days before the chat I certify that this is a true copy of a license/permit issued to me to engage in the activity specified. HOLLYWOOD PYROTECHNICS INC `l/ ~ LACOUS, MIRA KRISTINA & ROWE, ROBERT f - - BARRETT AT UREOFLICENSEE/PERMITTEE) 1567 ANTLER POINT EAGAN, MN 55122- The licensee/permittee named herein shall use a reproduction of this license/permit to assist a transferor of explosives to verify the. identity and status of the licenseelpermittee as provided in 27 CFA Part 555. The signature on each reproduction must be an ORIGINAL signature. ATF F 5400.14/5400.15, Part 1 (8(89) HOLLYWOOD PYROTECHNICS INC Mira LaCous President / Display Operator Hollywood Pyrotechnics, Inc. 1587 Antler Point Eagan, MN 55122 miralhollywoodpyrotechnics.com 651-454-7978 or 851-454-7975 fax I-866-PYRI]411(797-8411) toll-free opos-- Thank you for taking the time to look at Hollywood Pyrotechnics. Our sales team member will review some of the key options, display site needs and more with you. They are all experienced display operators and are continually trained and backed by our larger organization. Talk to anyone in the company to get your questions answered, but let us know which sales representative you are working with. Hollywood Pyrotechnics is a part of many communities, in the shows we do, the advanced training courses we offer (certified display operator course instructors by PGI), and in our memberships of organizations around the globe. Below is a sample of some of the key affiliations Hollywood Pyrotechnics maintains. Pyrotechnics Guild International AMERICAN PYROTECHNICS ASSOCIATION American Pyrotechnics Association International Fireworks Association n NFPA National Fire Protection Association Hollywood Pyrotechnics holds licenses for display operation in Minnesota, Nebraska, and other states in the area requiring it. We also serve other areas as needed. While many states (Wisconsin, Iowa, etc) still do not require licensing, we follow strict NFPA guidelines and adhere to the highest safety standards. Hollywood Pyrotechnics can perform exceptional firework displays on water, land, structures and more. Better Business Bureau Bureau of ATF and Explosives The Firework product a company uses is very important. There are many brands, and many different grades of product. The grade of the product is determine by the range of effects, the intensity of the colors, and the failure rate (duds). Hollywood Pyrotechnics focuses on some of the best product available. Hollywood Pyrotechnics works closely with our factories, in China and beyond for the best products. In 2005 Hollywood Pyrotechnics formed a new partnership, and has US distribution rights of one of the leading firework providers of Asia and the US, Smart Star. Smart Star has focused on high quality, affordable prices and safety standards amongst the highest in the industry. Smart Star has been a leading provider of quality fireworks for many years. Hollywood 11 Pyrotechnics is proud to be a leading ' i importer and product designer for .�Smart Star. 4:7" Hollywood Pyrotechnics selects, designs and imports its own products from leading manufactures under exclusive arrangements. We are a leading provider of displays in the upper Midwest, and a leading importer of products for companies across the entire USA. We know the product, and we know how to use it. The officers and employees of Hollywood Pyrotechnics are civic minded. We provide many hours of volunteer services to many organizations. We donate Fireworks displays to non-profit organizations for fund raising. We are board members of regional non-profit boards for education and free music, such as the Minnesota Sinfonia. We are also key organizers and volunteers for the PGI conventions and other events. We are here for our communities, and the people that need us. But most importantly we are here to provide you the best Firework display possible. Let us know your needs. We are happy to provide a quote for our services, and help you understand how they differ from our competitors, such as our primary utilization of electronic firing systems. We fire all our displays electronically, with 100% of the product preloaded. Also, don't forget we are experts on proximate fireworks, and indoor fireworks as well. We even do movie special effects. This experience gives us the most robust insight to your needs. Book a show today to see the difference. Copyright © 2007-2009 Hollywood Pyrotechnics, Inc. C7 MINNESOTA DEPArtTMEXT OF L Bt R: & INDt, Plus tbing Bond & fnsi Tancc Certificate t.gndirui:doM'COdes a1HliF Llcenslitg DIYIIFIon Lics"ing mW Cortlttcation S#Nlcga! 4441.0ayetla Rda .ft St• Paul, MN 66166 Webatte:WWWAQ sta "Og ";.rmll: t)LI.LlcaneeitltatWwmif:us ;7s1*01hione: 851-U"080 "This is to certify that the cettlflcelte Wider IS in Compliance with Minnesota Statut, 6613288.46, Subd. 2 for calendar year 2009 and may engage in, the plumbing trade in all areas of the state of Minnesota except cities and towns with a population of more than 5,000 according to `the most recootfederst:densug;(MS''3269 46), JAMES E SCKNDEL License: 72322MR BURSCHVILLE C04STRUCTION INC zJ 11440 78TH ST NE PO BOX 65 HANGVER, Mi!l 55341 Bond ID: 14522088 Liability Insurance ID: CP300007926 2009 WESTERN SURETY CO WESTERN NATIONAL INSURANCE MUCA Pipelayer Training GONWIIINM~XTL PCHAR'D SCHENDEL . 'has completed the Pipe Laying Training G Course through the r L^~ t a~ t 55 i:i Minrles0 a Ut: Ii1:y Cunt to ociat ion r. and is a Certified Pipe Layer having nsomplefed the required course work In pipe laying and the r Minnesota Plumbing Code. f to Pipe' Laying as datermin9d bye'kyle - 111lirirle$oto Depelrtmeat of Heal l 2336 " Minnesota utility contractors Association 7616 currell Blvd-, Suite 165, Woodbury, MN 55125 (651) 73S-39o8,1-800-567-MU(,t (651) 735-4018 (fax) Ze SJbd ond1SNOO 3-7IAHosana 99ZVL6b69L TZ :b0 60aZ/bI/ZI a 4 L~ 56 Burschvllle Construction Inc CS L zc 11440 8th St NE PO Box 65 Hanover, MN 55341 'telephone 763497-4242 Fax 763-497.4266 E-mail: burschvilleconst a@embarquIail.com Important Fax Date: Attention: Company: ZPV Fax Number: (ate i l ~'7.S 4 From: e RE: i r 4_ 1, AA 'A JI.C~-A C`G,~-Fri f ar I'L c.NA* 4.r 4S Number of pages: (including cover sheet) If you do not receive all pages or they are not readable, please contact us as soon as possible. Thank You! TO 39Vd ondiSNOO 3-1-IIAHosdne 99ZVL6V69L TZ:b0 6002/PT/ZT 99EVLGV29L Use BLUE or BLACK Ink For Office Use I I J non City of EaEd Permit C1 -7 I Permit Fee: I 3830 Pilot Knob Road 1 I Eagan MN 55122 Date Received: Phone: (651) 675-5675 Fax: (651) 675-5694 staff: - - - - - - - - - - - - - - - - - J 2010 COMMERCIAL BUILDING PERMIT APPLICATION Date: ` v J Site Address: Tenant Name: OF FL (Tenant is: New Existing) Suite Former Tenant: PROPERTY OWNER Name: C . U .yAn Phone: Z Address / City / Zip: Applicant is: Owner Contractor TYPE OF WORK Description of work: La n s } rN PIP via- Construction Cost: S CONTRACTOR Name: License Address: City: State: Zip: Phone: Contact: iUA Email: ARCHITECT / Name: Registration ENGINEER Address: City: State: Zip: Phone: Contact Person: Email Licensed plumber installing new sewer/water service: Phone NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that 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.org 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; t the work will be in accordance with the approved plan in the case of wo V h re fires a review and approval of plans. X r1 U L ~j X Applicant's Printed Name ~~n Applicant's Signature D C~ E OF D 1 of 2 JAN 2 5 2010 Page 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 .7' 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 t10 Occupancy MCES System Plan Review Code Edition Z061 SAC Units (25% 100%_) Zoning ~ V 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) -71 Final / No C.O. Required Foundation HVAC Drain Tile Other: Roof: -Decking -Insulation -ice & Water -Final Pool: -Footings -Air/Gas Tests -Final Framing Siding: -Stucco Lath -Stone Lath -Brick Fireplace: -Rough In -Air Test -Final Windows Insulation Retaining Wall Meter Size: Erosion Control Final C/O Inspection: Schedule Fire Marshal to be present: Yes V/No Reviewed By: Ce*1 , Building Inspector Reviewed By::~ Planning COMMERCIAL FEES Base Fee Water Quality Surcharge 7 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 Page 2 of 2 For' Office Us C ity 1!a I Permit 3'& I of i I 3830 Pilot Knob Road I Permit Fee: Eagan MN 55122 I I Phone: (651) 675-5675 Date Received: I Fax: (651) 675-5694 I I I Staff: 2009 COMMERCIAL PLUMBING PERMIT APPLICATION Date: T` 2 3 Site Address: v~ <e M+~ -J rltua ' L-~ Tenant: C-l Suite PROPERTY Name: Phone: OWNER CONTRACTOR Name: C.0 LL L License OS /0 -7S h Address:93-S-O1 1-4,- -V City: StateAh ZipSS 3 L/3 Phon .JS'Z -`j L/ L/- e S ~L/ Contact Person: 13 n V cL U 1-4 TYPE OF Newieplacement _ Repair _ Rebuild _ Modify Spa Work in R.O.W. WORK 1 Description of work: v S i .4- ~i 4L - 01 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: 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 _ $ Radio Meter Read - If Permit Fee is less than $1,000, surcharge is $.50 = $ Meter(s) - If Permit 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 $ I hereby acknowledge that this information is complete and accurate; that the work be in conformance wi 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 to s hout a ennit; t the work will be in accordance with the approved plan in the case of which require a review and approval of plans. > nu ~ ~.A 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 TO: KENT THERKELSEN, CHIEF OF POLICE JAMIE VERBRUGGE, ASSISTANT TO THE CITY ADMINISTRATOR DALE WEGLEITNER, FIRE MARSHAL SCOTT PETERSON, PLUMBING INSPECTOR MARK ANDERSON, ELECTRICAL INSPECTOR TOM PEPPER, (ACTING) FINANCE DIRECTOR MIKE RIDLEY, SENIOR PLANNER GREGG HOVE, SUPERVISOR OF FORESTRY ERIC MACBETH, WATER RESOURCES TOM COLBERT, PUBLIC WORKS DIRECTOR JOHN GORDER, DEVELOPMENT/DESIGN ENGINEER ARNIE ERHART, SUPERINTENDENT OF STREETS AND EQUIPMENT PAUL HEUER, SYSTEMS ANALYST BOB KRIHA, CONSTRUCTION INSPECTOR FROM: CRAIG NOVACZYK, BUILDING INSPECTOR DATE: MAY 31, 2001 #31 RE: PLAN REVIEW -1501 COMMUNITY PKWY - CENTRAL PARK COMMUNITY CENTER The plans are in our plan review section for your review and comment. Please return this form to mv attention with your signed comments and the date of review within seven days. lf you have any concems with these plans, please so indicate on this form and notify and resolve these issues with the affected parties. If you are requesting that issuance of the building permit be held, please fill out the proper "hold" request form. Comments: Indicate any fees that are to be collected with the building permit: AMOUNT ? Yes ? No ? Yes ? No ? Yes ? No ? Yes ? No ? Yes ? No ? Yes ? No Signature CD/FORMS/PLAN REV IEW CRAIG N UPDATED 4-6-01 landscape security required water quality dedication pazk dedication uail dedication tree dedication PRV Required Date ZONING? METER SIZE Mar 01 2011 3:38PM RES#Specialty#PUrotechnic 9528732859 p.3 Use BLUE or BLACK Ink r - - - Permit t of u1 i C 6 I Permit Fee: 0 I 3830 Pilot Knob Road Eagan N 55122 I Date Received: I Phone: 651) 675.5675 I I Fax: J65 ) 675-5694 j Staff: I i t-----------------I 2011 FIREWORKS / PYROTECHNICS APPLICATION Application must compl2ted an retu ed at lea 15 days Prior to data of dimplay and Include: • Proof of a $1,000,000 Bond or Certificate Insurance. A diagram of t e ground, br indoor display facilities, drawn to scale or with dimensions included, illustrating the point at which the fireworks/pyrotec nic special effects are to be discharged; location of ground pieces; location of all buildings, highways, streets, communication lines and other possib a overhead obstructions; land the lines behind which the audience will be restrained. For proximate audience (e.g. Indoor displays), the diagram mus also Include the fallout radius for each pyrotechnic device used during the display. • Names and age of all assistants participating in the display. Pyrotechnics pla -requires: Certifications that are set, scenery, and rigging materials are inherently flame-retardant or have been treated to achieve flame retardancy (NFPA 1126: 4-3.2) Date of Display: July 4th, 201 1 Time of Display; a fox. 10:00 PM JQ Display Address! APPLICAN I Name: Citj of Eagan/Eagan 4th of July Ccnm. Phone: SPONSORI G ORGANIZA iION Address / Gi / Zi : 3830 Pilot Knob Road Eagan, MN 55122 I AUTHORIZED Name: RES Specialty Pyrotechnics Inc. Phone: 952-873-3113 AGENT Address / Ci / Zip: SUPERVISI IS OPERAT R Name: Haman Certificate Number. B01 99 Manner & place f storage of fireworks /:pyrotechnic special effects prior to display: N/A Delivered Day of Show Type of fireworks / pyrotechnic special effects prior to display: See Attached List Type of fireworks] / pyrotechnic special affects to be discharged: See Attached List i Quantit : Permit Fee: l , includes; $5.00 State surcharge) *If a fire watch s needed, an additional fee will be assessed in accordance with the City's fee schedule CALL BEFO E YOU DI Calla opher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours bef, re you intend to dig toreceive locates of underground utilities. www cooherstateonecall.ora i The State of Min esota requires that this display be conducted under the direct supervision of a pyrotechnic operator certified by the State Fire Marshal. I Darcy Tad:hen understand and agree to comply with all provisions of this application and the requirements of th issuing authority, and : ill ensure that the fireworksipyrotechnic special effects are discharged in a manner that will not 410-17 a ersons o rcon ' ute, a nuisanc . 3/1/11 Date: x Ap-pftslft /Agen Discharge of the ~isted works o the Oate and above location Is hereby approved subject to the following conditions, if any: e I it ~ Date: ~ 'r//4 A*94,j h e arshal I I Mar 01 2011 3:38PM RES#Specialty#Pyrotechnic 9528732859 p.4 Applicarit Instructions:, This application miust be completed and returned at least 15 days prior to date of display. Fee upon application is and must be made payable to City of Eagan. Name ol applicant (Sponsoring Organization): Eagan 4th of July Committee, City of Eagan Addres~ of applicant: 38301 Pilot Knob Road, Eagan, MN 55122 Name ol~ authorized agbnt of applicant: RES Specialty Pyrotechnics Inc. Address of agent: 21595 2816th Street, Belle Plaine, MN 56011 Telephdne number of agent: 852-873-3113 Date of Ulsplay: July 4th, 2011 Time of display: approx.10:00 PM i Locatio~ of display: Eagan Community Center Manneriand place of storage of fireworkslpyrotechnic special effects prior to display: NIA Delivered Day of how. Type & umber of fireworksslpyrotechnic special effects to be discharged: See Attached List Minnes to State law requires that this display be conducted under the direct supervision of a pyrotechnic operator certified by the State Fire Marshal Name df supervising operator: Erv Haman Certificate 9: B0199 I under tand and agree to comply with all provisions of this application and the requirements of the issuing authorit y, and will ensure th0it the fireworkslpyrotechnic special effects are discharged in a manner that will not endangbr persons or properi or stltute a I e. Signat4e of applicant (or agen to of application: 311111 1 Require attachments: The following attachments must be Included with this ppiication: 1. Proof bf a bond or certificate of insurance in the amount of at least $1,000,000.00 2. A die ram of the grounds, or facilities (for indoor displays), at which the display will be held. This diagram (drawn to scale or with dimenslo is included) must show the point at which the fireworks/pyrotechnic special effects are to be discharged; the location of ground pieces; a location of all buildings, highways, streets, communication lines and other possible overhead obstructions; and the lines behind m1hich the audience will be restrained. For proximate audience (e.g. Indoor) displays, the diagram must also show the fallout radius fo each pyrotechnic deviceused during the display. 3. Name and ages of all assistan s that will be participating In the display. The discharge of the listed fireworks on the date and at the location shown on this application is hereby appro4d, subject to the following conditions, if a i Date: 3' Signature of fire chief/county sheriff: Signature of issuing authority: Date: i 1 i Mar 01 2011 3:38PM RES#Specialt!j#P!jrotechnic 9528732859 p.5 i i i i i City of Eagan Ju~y 4tn~ 2011 I Lead Technician DOB License # ErviHaman 9/17/49 B0199 I Assistants I. Da Palmer 7/10/79 n/a Pa ! Haman 5/1/80 n/a B ,O Raby 3/6/77 n/a Jon!Slavik 11/10/82 n/a Prgduct List I 3" $hells 130 4" $hells 100 5" hells 44 M4ti Shot Cakes 4 I i Apr 20 2011 1:26PM RES#Specialt5#Pyrotechnic 9528732859 p.l 7 FIRIEWORIM OPERATOR CERTIFICATE Ervin J Hamim 120 Kff tdge Ct. NE New Prague. MIN 58071 Certi i No. CertiffFSate Type 1 q, p 1 t1 i>Jaae Extrirmlovi tame t 11112 120112011 lsjaed By: mmm to 0e"tftem of PWIC safety, state lore Marshal Divis4on 444 Ceder $t., sufite 145 at. P>; Ul, MN 55101-5145 This certificate is not transferable Jerry Rosendahl Minnes&.9 SUde Fire Marsha{ Mar 01 2011 3:38PM RES#Specialty#PUrotechnic 9528732859 p.6 °A CERTIFICATE OF LIABILITY INSURANCE osio~i2 ' THIS CERTIFICAT IS ISSUED AS A MATTE OF INFORMATION ONLY AND CONFERS NO RIGHTS UPONTHE CERTIFICATE HOLDER.THt3 CERTIFICATE DO S NOT AFFIRMATI ELY R NEGATIVELY AMEND, EXTEND OR ALTERTHE COVERAGE AFFORDED SYTHE POLICIES BELOW. THIS CE TIFICATE OF INSUOANC DOES NOT CONSTITUTE A CONTRACT BETWEENTHE ISSUING INSURER(S), AUTHORIZED REPRESENTATIV OR PRODUCER, AND T CERTIFICATE HOLDER. IMPORTANT: If th certificate holders an ADDITIONAL INSURED, the pollcy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and con itions of the policy, cer-Win policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder i lieu of such endokseme t a CONTACT PRODUCER I NAND: MCGRIFF, SEIBELS & V61-LIMMS, INC. NAM E Eal 800 4762211 C No P.O.Box 10265 At Birmingham, AL 35202 AOD INSURER S) AFFORDING COVERAGE NAIC # INSURERA:James River Insurance Cam an 122M i INSURERB:Redland Insurance Company 37303 INSURED R E S Specialty Pyrotec nics 21595 286th Street INSURER C : Belle Plains, MN 56011. INSURER D : INSURER E ; USURER F: COVERAGES I C TIFI ATE NUMBER:8P2CCVL7 REVISION NUMBER: THIS IS TO CERTIF THAT THE POLICIESIOF IN URANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWi HSTANDING ANY R UIR 1ENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS 1 ~C] CERTIFICATE MAY AFFORDEDBYTHEPOLICIESDESCRIBEDHEREINISSUBJECTTOALLTHETERMS, MAYBE ISSUED OR MAY P. RTAIN, THE INSURANCE EXCLUSIONS AND ONOITTONS OF SUCH POL IES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. RO= LL7R TYPE 9F INSURANCE POUCYNUMBER NM/ EF MMID FJ(P LIlNfr3 A GENERAL UABIIJ37 81 -W01/2010 0410112011 EACH OCCURRENCE $ 1,000,000 DAMAGE To Rtli P I ES Ek ccurrence S 1DO,ODD X COMMERCIAL:1GENERAL LMIUTY EXCLUDED CLAIMS CJI ADE I - - ~ OCCUR MED EXP (Arty one person) $ PERSONAL. &ADV INJURY $ 1,000,000 X PerPrjAgg~ plmil GENERAL AGGREGATE S 5,000,000 PRODUCTS-COMPIOPAGG S 2.000,000 GEN'L AGGREGATE LIMIT APPLIES PER: $ X PCUC Y PRO- LOC L GL 0 4101i2011 1 000000 T B AUTOMOBILE LIABILITY P GA0001 5 04 1/2D10 S X ANYAUTO (Perpa ion) S D SCHEDULED (Per ac ident) S ALL OWNE AUTOS I AUTOS MA E NON-OWNED X HIRED AUTO' X AUTOS Gam $1000 deductible Coll. $1000 deductible x FlWedc p UMBRELUItIAa X OCCUR 0037 01 0410112010 0410112011 EACH OCCURRENCE S 4,000,000 4,000,ODO [~DEED EXCESS UABI CLAIMSMADE AGGREGATE S ETENTION S STATU- 0711- WORKERS CUM SATION IMiT9 AND EMPLOYERS' IIU~A~B-IL~ITY YIN E.L. EACH ACCIDENT S, ANY PROPRIE'rOR/PAR _ER1EXECUTIVE N ! A - $ OFFICERIMEMBEREXCLUGEG7 Mendabory In NH) EL.DISFJISE-FAEMPLOYEE I 1 If yes, descrtbaundbr DESCRIPTION OF E.L_ DISEAS E - POLICY LIMIT $ PERA710NS below S S S DESCRIPTION OF DPE TIONS I LOCATIONS f VS01CLES (Attach ACORD 101, AddRlonal Remarks Schedule, R more space Is required) Data of Display: July l4th. 2011 Location: Eagan Community Center Eagan 4th of July Committee; City of Eagan, MN terms conditions and exclusions. policy Above listed is/are Included as Additional Insured respects to the General Liability policy as required by written contract subject to Certificate Holder is ditional Insured under General Liability and Aulornobile Liability as required by written contract. CERTIFICATE H ALDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE (EXPIRATION DATETHEREOF, NOTICE WR.L BE DELIVERED IN ACCORDANCE WIT H THE POLICY PROVISIONS. City of Eagan ! AUTHORIZED REPRESENTATIVE LL 3830 Pllat Knob RoAd 1 / ' ~K ~ ' " Eagan, MN 55122 j 4 i Page 1 of 2 ®1988-2010 ACORD CORPORATION. All lights reserved. i ACORD 25 (201005) The ACORD name and logo are registered marks of ACORD i Mar 01 2011 3:39PM RES#Specialty#Pyrotechnic 9528732859 p.7 ISSUE DATE 03/01/2011 ADDITIONAL INFORMATION PRODUCER CERTIFICATE HOLDER MCGRIFF, SEIBEL~ 8 WILLIAMS, INC. City of Eagan P.O. Box 10265 3830 Pilot Knob Road Birmingham, AL 35202 Eagan, MN 55122 PHONE: 800-476-211 INSURED R E S 5peciaily Pyrotechnics 21595 286th Slneal Belle Plaine, MN 5011 Leased / Rented Vehicles/Hired Phys Damage (6mth or less) policy Numbex; PICGA0001355 Company: Praetorian Insurance Company Effective; 5/01/10 - 5/01/2oi1 Coverages; Limit: $50,000 Deductibles: Comprehensive: $ 100 Collision; $1,000 j Catiitate ID p 8P2CCVL7 ,page 2 of 2 Mar 01 2011 3:39PM RES#Specialty#Purotechnic 9528732859 p.8 S h poi- s , ~ APPEIVDDXA +at $c r .04 (mc, ~e r 4 Ai f Kr i r w„ r od; , ~ III ~ }if' y A~ ~ I 4 rYq w ~ tLti177~Lzi' . i a t y T -"1 1 oT 7 aAM r s ~'Ydi" T 'Ilky;t "s I : i Mar 01 2011 3:38PM RES#Specialty#Pyrotechnic 9528732859 p.2 oi i Specialty Pyrotechnics i F~ X Cover Sheet Dale Wegleitner From: Darcy Tacheny To: City of Eagan Fire Marshal I FaxE (651)-.675-5694 Fax: 952-873-2859 Phone: (651)675-5682 Phone: 952-873-3113 Date: 3/1/2011 Pages: Subject: July 4t Pireworks Celebration 2011 Notts: Hello Dale: Please find attached the permit application for the July 41 Celebration 2011 for the City of Eagan. We look forward to putting on a spectacular display for everyone. j If you have any questions or concerns, feel free to give us a call. ; ank y adv ce. Darcy Tache y RES Inc. i I i -i i I i I I i i Use BLUE or BLACK Ink 1-------- ti~ I For Office Use _ - I city Eap t Permit Z't I Permit Fee: 3830 Pilot Knob Road RECEIVED t i0`J Eagan MN 55122 Date Received: j Phone: (651) 675.5675 MAR a 2012 I t Fax: (651) 675-5694 i staff: j 2012 COMMERCIAL BUILDING PERMIT APPLICATION Date: 5- t) Site Address 15t? I' ~-ent r a 1 Fqf kW 4 Y E a j g n, r)I X51 a 1 Tenant Name: l~ r 0- L a g o ll {Tenant is: New 1 E)dsting) Suite _ Former Tenant: / / w. _ . Name: tt r ~y Phone: 6 5I --~75 - -55,5Z PROPERTY OWNER Address/City IZip:,AS I ben t4I Q~kij a Y, -a a1, MAZ 5-5/2 l i Applicant ls- Owner Contractor Description of work: R r? Q T' ? L PI Lqd d za rot- ~b4-11t-'-Ct~S TYPE OF WORK a g i Construction cost: t}bA ' Name: '16 Z " 4 q C(2 bh -f yr r 8lt,-tlj License 2 qj? CONTRACTOR Address: 032' 111' Z--rtl N F S I--e- -a 00 city: 17 ~►'i L R i `State; 1' l t v Zip: b Phone 3- e-13 l 6 dO a Contact PC, 14/k r t-s- Email: og-Er . C k o(' f oc l rt M.,,.._., .r. s Name: F! lln Q n.f rt;{~' f ec t Registration M ARCHITECT/ ? Address: 1 f0 rr f 4r Wo, Sit 3 o I City St• ` A v ENGINEER i 6,51- State: Zip: 5 5 I1L Phone: ' 6 q 5S 2S Contact Person: Q Email 11 Licensed plumber installing new s_ewedwaterservice: y 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 conch that the are trade secrets i 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.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 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 N! ft Applicant's Printed Mime Apptr ants Signature - ✓ Page f of 3 l ~D-1~ l Ce Ck -'j , '7 DO NOT WRITE `BELOW THIS LINE SUB TYPES Foundation /,public Facility Exterior Alteration-Apartments o~Commerciai / 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 l / Valuation It, oOG Occupancy A.S. s MCES System Plan Review i'~ i4e Code Edition Sb~i SAC Units 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) _T 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 Water Quality Surcharge 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 Page 2 of 3 PERMIT City of Eagan GOp4- Permit Type: Fireworks 3830 Pilot Knob Rd Permit Number: EA104041 Eagan, MN 55122 tit Date Issued: 05/02/2012 (651) 675-5675 E~jn www.ci.eagan.mn.us o Site Address: 1501 Central Pkwy Lot: 2 Block: 1 Addition: Eagan Central Park PID: 10-22409-01-020 Use: Eagan Community Center Description: Sub Type: Pyrotechnic Special Effects Display Sign Permit Required: N Work Type: Ground Display Tent Permit Required: N Description: 4th of July Funfest Temporary Event: N Sales Dates: to Number of Days: 0 to to Comments: PLEASE CONTACT FIRE MARSHAL, DARRIN BRAMWELL, ONE WEEK PRIOR TO JULY 4TH TO DISCUSS SET UP & INSPECTION. CONTACT HIM NO LATER THAN JUNE 27TH. 651-675-5900 OR 651-675-5905. Fee Summary: Fl - Pyrotechnics $100.00 0801.4096 Surcharge-Fixed $5.00 9001.2195 Total: $105.00 Contractor: - Applicant - Owner: Pyrotechnic Display Inc City of Eagan 9405 River Road SE C/O Thomas Hedges Clear Lake MN 55319 3830 Pilot Knob Rd (320) 743-6496 Eagan MN 55122 I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. INSPECTION RECORD City of Eagan Permit Type: Fireworks 3830 Pilot Knob Rd Permit Number: EA104041 Eagan, MN 55122 Date Issued: 5/2/2012 (651) 675-5675 www.ci.eagan.mn.us,, Site Address: 1501 Central Pkwy Lot: 2 Block: 1 Addition: Eagan Central Park PID: 10-22409-01-020 Use: Eagan Community Center Sub Type: Pyrotechnic Special Effects Display Pyrotechnic Display Inc Work Type: Ground Display (320) 743-6496 Description: 4th of July Funfest Mark Hanson lnspection'[}pe 1);ata Inspector I Final PLEASE CONTACT FIRE MARSHAL, DARRIN BRAMWELL, ONE WEEK PRIOR TO JULY 4TH TO DISCUSS SET UP & INSPECTION. CONTACT HIM NO LATER THAN JUNE 27TH. 651-675-5900 OR 651-675-5905. II * Contractor is responsible for erosion control * House #s required for final inspection. * 4-hour notice for permanent water turn-on for new building: 651-675-5200. Use BLUE or BLACK Ink r For Office Use. e. ,s Permit qo City of Ea a~ ~ I permit Fee: ~ I 3830 Pilot Knob Road Eagan MN 55122 I Date Received: I Phone: (651) 675-5675 Fax: (651) 675-5694 j Staff: I t-----------------I 2012 FIREWORKS / PYROTECHNICS APPLICATION Application must be completed and returned at least 15 days prior to date of display and include: • Proof of a $1,000,000 Bond or Certificate of Insurance. • A diagram of the ground, or indoor display facilities, drawn to scale or with dimensions included, illustrating the point at which the fireworks/pyrotechnic special effects are to be discharged; location of ground pieces; location of all buildings, highways, streets, communication lines and other possible overhead obstructions; and the lines behind which the audience will be restrained. For proximate audience (e.g. indoor displays), the diagram must also include the fallout radius for each pyrotechnic device used during the display. • Names and ages of all assistants participating in the display. • Pyrotechnics plan-requires: Certifications that are set, scenery, and rigging materials are inherently flame-retardant or have been treated to achieve flame retardancy. (NFPA 1126: 4-3.2) Date of Display: July 4, 2012Time of Display: about 10pm Display Address: Eagan Community Center, 1501 Central Parkway, Eagan, MN APPLICANT I Committee 651-675-5004 SPONSORING Name: City of Eagan/Eagan s July 4th Funfest Phone: ORGANIZATION Address/ Cit / Zi : 3830 Pilot Knob Road, Eagan, MN 55122 AUTHORIZED Name: Pyrotec!nic Display, Inc. Phone: 320-743-6496 AGENT Address / City / Zip: 9405 River Road SE, Clear Lake, MN 55319 - SUPERVISING OPERATOR Name: Jamie Puls Certificate Number: 0 0431 Manner & place of storage of fireworks / pyrotechnic special effects prior to display: N/A Delivered on the day of the show Type of fireworks / pyrotechnic special effects prior to display: See Attached List Type of fireworks / pyrotechnic special effects to be discharged: See Attached List Quanti : Permit Fee: $105.00 (includes $5.00 State surcharge) "If a fire watch is needed, an additional fee will be assessed in accordance with the City's fee schedule 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 The State of Minnesota requires that this display be conducted under the direct supervision of a pyrotechnic operator certifie by the State Fire Marshal. I n_0bkJJ C N15 a-),\ , understand and agree to comply with all provisions of this application and the requirements of,the issuing authority, and will ensure that the fireworks/pyrotechnic special effects are discharged in a manner that will not end ng persoris r properto constitute a nuisance. x -00 CN 0,-n J) a Date: x Applic t /Agent Discharge of the listed fireworks on the date and above location is hereby approved subject to the following conditions, if any: i r Date: Fire C ie ire rshaI ,aC40Mv CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 4/19/2012 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements . PRODUCER O NAME: Britton-Gallagher and Associates, Inc. PHONN E :4 - 4 -4711 Alc No):440-248-5406 6240 SOM Center Rd. E-MAIL Cleveland OH 44139 ADDRESS: INSURERS AFFORDING COVERAGE NAIC # INSURER A:LeXington Insurance INSURED INSURER B :AX S Surplus Ins Company Pyrotechnic Display Inc. INSURER C:Granite State Insurance Co. 23809 8450 W. St. Francis Road INSURER D :M W Insurers Association Frankfort IL 60423 INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: 1595135103 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER MM/DD MM/DD A GENERAL LIABILITY 3056807-02 /30/2011 /30/2012 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $50,000 CLAIMS-MADE 1XI OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2,000,000 POLICY X PRO- LOC $ C AUTOMOBILE LIABILITY CA196568832 /30/2011 /30/2012 Ea accidents G 1,000,000 X ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $1,000,000 AUTOS AUTOS NON-OWNED PROPERTY DAMAGE X HIRED AUTOS X AUTOS Per accident $ B UMBRELLA LIAB X OCCUR EAU733983 /30/2011 /30/2012 EACH OCCURRENCE $4,000,000 X EXCESS LIAR CLAIMS-MADE AGGREGATE $4,000,000 DED RETENTION $ $ p WORKERS COMPENSATION MNAR0000019718 (MN) /30/2011 /30/2012 X WC STATU- OTH- AND EMPLOYERS' LIABILITY TORY LIMITS Y/" ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? ❑ N/A (Mandatory in NH) E.L. DISEASE - EA EMPLOYE $1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) DISPLAY DATE: July 4, 2012 LOCATION: Central Park, 1501 Central parkway, Eagan, Minnesota ADDITIONAL INSURED: City of Eagan, Minnesota; Eagan Funfest Committee i CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Eagan ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Ms. Joanna Foote 3830 Pilot Knob Road AUTHORIZED REPRESENTATIVE Eagan MN 55122 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD I Names and ages of all assistants participating in the display: Michele Puls 43 Paul Medlicott 30 Levi Blakeman 25 Jesse Anderson 22 Titus Torkelson 31 Product list: Aerial Shells: 2.5" 288 3" 550 4" 200 5" 135 6" 100 8" 58 Box Items 10 City of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675-5675 www.ci.eagan.mn.us COAD PERMIT 4111 C!tyofEaaan Permit Type: Fireworks Permit Number: EA110569 Date Issued: 05/16/2013 Site Address: 1501 Central Pkwy Lot: 2 Block: 1 Addition: Eagan Central Park PID: 10-22409-01-020 Use: Eagan Community Center Description: Sub Type: Pyrotechnic Special Effects Display Sign Permit Required: N Work Type: Ground Display Tent Permit Required: N Description: 4th of July Funfest Temporary Event: N Sales Dates: to Number of Days: 0 to to Comments: PLEASE CONTACT FIRE MARSHAL, DARRIN BRAMWELL, ONE WEEK PRIOR TO JULY 4TH TO DISCUSS SET UP & INSPECTION. CONTACT HIM NO LATER THAN JUNE 27TH. 651-675-5900 OR 651-675-5905. Fee Summary: FI - Pyrotechnics Surcharge -Fixed $100.00 $5.00 0801.4096 9001.2195 Total: $105.00 Contractor: Pyrotechnic Display Inc 9405 River Road SE Clear Lake MN 55319 (320) 743-6496 - Applicant - Owner: City of Eagan 3830 Pilot Knob Rd Eagan MN 55122 I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. *City o Eakan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use , � C Permit #: 1105104 Permit Fee: / l/ 1i, 5 j. Date Received: ) L 13 Staff: 2013 FIREWORKS / PYROTECHNICS APPLICATION Application must be completed and returned at least 15 days prior to date of display and include: • Proof of a $1,000,000 Bond or Certificate of Insurance. • A diagram of the ground, or indoor display facilities, drawn to scale or with dimensions included, illustrating the point at which the fireworks/pyrotechnic special effects are to be discharged; location of ground pieces; location of all buildings, highways, streets, communication lines and other possible overhead obstructions; and the lines behind which the audience will be restrained. For proximate audience (e.g. indoor displays), the diagram must also include the fallout radius for each pyrotechnic device used during the display. • Names and ages of all assistants participating in the display. • Pyrotechnics plan -requires: Certifications that are set, scenery, and rigging materials are inherently flame-retardant or have been treated to achieve flame retardancy. (NFPA 1126: 4-3.2) Date of Display: _ July 4, 2013 Time of Display: about lOpm Display Address: Eagan Community Center, 1501 Central Parkway, Eagan, MN Cne: tt651-675-5004 Name: City. of Eagan/Eagan's July 4th Funfe lone: Address / City / Zip: 3830 Pilot Knob Road, Eagan, MN 55122 Name: Pyrotechnic Display, Inc. Address / City / Zip: 9405 River Name: Jamie Puls Phone: 320-743-6496 X1 Road SE, Clear Lake, MN 55319 Certificate Number: 0 0431 Manner & place of storage of fireworks / pyrotechnic special effects prior to display: NA Delivered on site the day of the show Type of fireworks / pyrotechnic special effects prior to display: See Attached Ltst Type of fireworks / pyrotechnic special effects to be discharged: See Attached List Quantity: Permit Fee: .f) (includes $5.00 State surcharge) *If a fire watch is needed, an additional fee will be assessed in accordance with the City's fee schedule 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 The State of Minnesota requires that this display be conducted under the direct supervision of a pyrotechnic operator certifi - d by the State Fire Marshal. requirements of the epdfri perso x Applicant /Agent Discharge of the li understand and agree to comply with all provisions of this application and the suing authority, and will ensure that the fireworks/pyrotechnic special effects are discharged in a manner that will not propert r constitute a nuisance. Date: x fireworks on the date and above location is hereby approved subject to the following conditions, if any: :i74MAA/°4 Date: Fire Chief / Fire Marshal A►CCIREP CERTIFICATE OF LIABILITY INSURANCE ir---- -- DATE (MM/DD/YYYY) 5/2/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Britton Gallagher One Cleveland Center, Floor 30 1375 East 9th Street Cleveland OH 44114 CONTACT NAME: PHO (A/C. No. EXe:216-658-7100 FAX No):216-658 7101 E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A :Lexington Insurance Co INSURER R :Axis Surplus Ins Company LIABILITY COMMERCIAL GENERAL LIABILITY INSURED Pyrotechnic Display Inc. 8450 W. St. Francis Road Frankfort IL 60423 INSURER c :Granite State Insurance Co. 23809 INSURER D :MN WC Insurers Association 9/30/2013 INSURER E : $1,000,000 INSURER F : $50,000 COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYI) POLICY EXP (MMIDD/YYYY) LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY 33056807-03 9/30/2012 9/30/2013 EACH OCCURRENCE $1,000,000 DAMAGE TO PREMISES EaENTEoccu ence) $50,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE POLICY LIMIT APPLIES X jECOT- PER: LOC PRODUCTS - COMP/OP AGG $2,000,000 $ C AUTOMOBILE X X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS X SCHEDULED AUTOS NON -OWNED AUTOS CA196568833 9/30/2012 9/30/2013 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY(Per accident)$1,000,000 PROPERTY DAMAGE (Per accident) $ $ B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE EAU733983 9/30/2012 9/30/2013 EACH OCCURRENCE $4,000,000 AGGREGATE $4,000,000 DED RETENT ON $ $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N / A MNAR0000019718 (MN) 9/30/2012 9/30/2013 X WC STATU- TORY LIMITS OTH- ER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) DISPLAY DATE: July 4, 2013 LOCATION: Central Park, 1501 Central parkway, Eagan, Minnesota ADDITIONAL INSURED: City of Eagan, Minnesota; Eagan Funfest Committee OLDER CANCELLATION City of Eagan Attn: Ms. Joanna Foote 3830 Pilot Knob Road Eagan MN 55122 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2010/05) © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Names & ages of assistants participating in the July 4, 2013 display: Michele Puls 44 Paul Medlicott 31 Levi Blakeman 26 Jesse Anderson 23 Titus Torkelson 32 Product List: Aerial Shells: 2.5" 288 3" 550 4" 200 5" 135 6" 100 8" 58 Box Items 10 L 1 MINNESOTA STATUTES 2012 624.22 624.22 FIREWORKS DISPLAYS; PERMIT; OPERATOR CERTIFICATION. Subdivision 1. General requirements; permit; investigation; fee. (a) Sections 624.20 to 624.25 do not prohibit the supervised display of fireworks by a statutory or home rule charter city, fair association, amusement park, or other organization, except that: (1) a fireworks display may be conducted only when supervised by an operator certified by the state fire marshal; and (2) a fireworks display must either be given by a municipality or fair association within its own limits, or by any other organization, whether public or private, only after a permit for the display has first been secured. (b) An application for a permit for an outdoor fireworks display must be made in writing to the municipal clerk at least 15 days in advance of the date of the display and must list the name of an operator who is certified by the state fire marshal and will supervise the display. The application must be promptly referred to the chief of the fire department, who shall make an investigation to determine whether the operator of the display is competent and is certified by the state fire marshal, and whether the display is of such a character and is to be so located, discharged, or fired that it will not be hazardous to property or endanger any person. The fire chief shall report the results of this investigation to the clerk. If the fire chief reports that the operator is certified, that in the chief's opinion the operator is competent, and that the fireworks display as planned will conform to the safety guidelines of the state fire marshal provided for in paragraph (0, the clerk shall issue a permit for the display when the applicant pays a permit fee. (c) When the supervised outdoor fireworks display for which a permit is sought is to be held outside the limits of an incorporated municipality, the application must be made to the county auditor, and the auditor shall perform duties imposed by sections 624.20 to 624.25 upon the clerk of the municipality. When an application is made to the auditor, the county sheriff shall perform the duties imposed on the fire chief of the municipality by sections 624.20 to 624.25. (d) An application for an indoor fireworks display permit must be made in writing to the state fire marshal by the operator of the facility in which the display is to occur at least 15 days in advance of the date of any performance, show, or event which will include the discharge of fireworks inside a building or structure. The application must list the name of an operator who is certified by the state fire marshal and will supervise the display. The state fire marshal shall make an investigation to determine whether the operator of the display is competent and is properly certified and whether the display is of such a character and is to be so located, discharged, or fired that it will not be hazardous to property or endanger any person. If the state fire marshal determines that the operator is certified and competent, that the indoor fireworks display as planned will conform to the safety guidelines provided for in paragraph (f), and that adequate notice will be given to inform patrons of the indoor fireworks display, the state fire marshal shall issue a permit for the display when the applicant pays an indoor fireworks fee of $150 and reimburses the fire marshal for costs of inspection. Receipts from the indoor fireworks fee and inspection reimbursements must be deposited in the general fund as a nondedicated receipt. The state fire marshal may issue a single permit for multiple indoor fireworks displays when all of the displays are to take place at the same venue as part of a series of performances by the same performer or group of performers. A copy of the application must be promptly conveyed to the chief of the local fire department, who shall make appropriate preparations to ensure public safety in the vicinity of the display. The operator of a facility where an indoor fireworks display occurs Copyright CO 2012 by the Office of the Revisor of Statutes, State of Minnesota. All Rights Reserved. 2 MINNESOTA STATUTES 2012 624.22 must provide notice in a prominent place as approved by the state fire marshal to inform patrons attending a performance when indoor fireworks will be part of that performance. The state fire marshal may grant a local fire chief the authority to issue permits for indoor fireworks displays. Before issuing a permit, a local fire chief must make the determinations required in this paragraph. (e) After a permit has been granted under either paragraph (b) or (d), sales, possession, use and distribution of fireworks for a display are lawful for that purpose only. A permit is not transferable. (f) The state fire marshal shall adopt and disseminate to political subdivisions rules establishing guidelines on fireworks display safety that are consistent with sections 624.20 to 624.25 and the most recent edition of the State Fire Code, to insure that fireworks displays are given safely. In the guidelines, the state fire marshal shall allow political subdivisions to exempt the use of relatively safe fireworks for theatrical special effects, ceremonial occasions, and other limited purposes, as determined by the state fire marshal. Subd. 2. Operator certification requirements. (a) An applicant to be a supervising operator of a fireworks display shall meet the requirements of this subdivision before the applicant is certified by the state fire marshal. (b) An applicant must be at least 21 years old. (c) An applicant must have completed a written examination, administered or approved by the state fire marshal, and achieved a passing score of at least 70 percent. The state fire marshal must be satisfied that achieving a passing score on the examination satisfactorily demonstrates the applicant's knowledge of statutes, codes, and nationally recognized standards concerning safe practices for the discharge and display of fireworks. (d) An applicant shall apply in writing to the state fire marshal by completing and signing an application form provided by the state fire marshal. (e) An applicant shall submit evidence of experience, which must include active participation as an assistant or operator in the performance of at least five fireworks displays, at least one of which must have occurred in the current or preceding year. Subd. 3. Certification application; fee. An applicant shall submit a completed initial application form including references and evidence of experience and successful completion of the written examination. Applicants shall pay a certification fee of $100 to the State Fire Marshal Division of the Department of Public Safety. The state fire marshal shall review the application and send to the applicant written confirmation or denial of certification within 30 days of receipt of the application. Certification is valid for a period of four years from the date of issuance. Subd. 4. Classification. When an applicant has met the requirements of subdivisions 2 and 3, the state fire marshal shall certify and classify the operator for supervising proximate audience displays, including indoor fireworks displays, for supervising traditional outdoor fireworks displays, or for supervising both types of displays, based on the operator's documented experience. Subd. 5. Responsibilities of operator. The operator is responsible for ensuring the fireworks display is organized and operated in accordance with the state fire marshal's guidelines described in subdivision 1. Subd. 6. Reports. (a) The certified operator shall submit a written report to the state fire marshal within ten days following a fireworks display conducted by the operator if any of the following occurred: Copyright © 2012 by the Office of the Revisor of Statutes, State of Minnesota. All Rights Reserved. 3 MINNESOTA STATUTES 2012 624.22 (1) an injury to any person resulting from the display of fireworks; (2) a fire or damage to property resulting from the display of fireworks; or (3) an unsafe or defective pyrotechnic product or equipment was used or observed. (b) The certified operator shall submit a written report to the state fire marshal within 30 days following any other fireworks displays supervised by the operator. (c) The state fire marshal may require other information from operators relating to fireworks displays. Subd. 7. Operator certification renewal. An applicant shall submit a completed renewal application form prepared and provided by the state fire marshal, which must include at least the dates, locations, and authorities issuing the permits for at least three fireworks displays participated in or supervised by the applicant and conducted during the past four years. An applicant shall pay a certification renewal fee of $100 to the State Fire Marshal Division of the Department of Public Safety. The state fire marshal shall review the application and send to the applicant written confirmation or denial of certification renewal within 30 days of receipt of the application. Certification is valid for a period of four years from the date of issuance. Subd. 8. Suspension, revocation, or refusal to renew certification. (a) The state fire marshal may suspend, revoke, or refuse to renew certification of an operator if the operator has: (1) submitted a fraudulent application; (2) caused or permitted a fire or safety hazard to exist or occur during the storage, transportation, handling, preparation, or use of fireworks; (3) conducted a display of fireworks without receipt of a permit required by the state or a political subdivision; (4) conducted a display of fireworks with assistants who were not at least 18 years of age, properly instructed, and continually supervised; or (5) otherwise failed to comply with any federal or state law or regulation, or the guidelines, relating to fireworks. (b) Any person aggrieved by a decision made by the state fire marshal under this subdivision may petition the state fire marshal in writing to reconsider the decision. The state fire marshal shall render a decision in writing within 30 days of receipt of the written request for reconsideration. Following reconsideration, the person may appeal the decision to the district court. Subd. 9. Database. The commissioner of public safety shall maintain a database of the information required under this section for purposes of (1) law enforcement, (2) investigative inquiries made under subdivision 1, and (3) the accumulation and statistical analysis of information relative to fireworks displays. History: 1941 c 125 s 3; 1973 c 123 art 5 s 7; 1985 c 248 s 70; 1986 c 444; 1995 c 226 art 4 s 23; 1997 c 187 art 1 s 23; 1Sp2003 c 2 art 4 s 28; 2005 c 136 art 9 s 13; 2006 c 260 art 3 s 24 Copyright © 2012 by the Office of the Revisor of Statutes, State of Minnesota. All Rights Reserved. MINUTES OF A REGULAR MEETING OF THE EAGAN CITY COUNCIL Eagan, Minnesota MARCH 5, 2013 A Listening Session was held at 6:00 p.m. prior to the regular City Council meeting. Present were Mayor Maguire, Councilmembers Bakken, Fields, Hansen and Tilley. At 6:10 p.m., the City Council held a closed session to discuss land negotiations at 4232 Blackhawk Road. The closed session concluded at 6:20 p.m. A regular meeting of the Eagan City Council was held on Tuesday, March 5, 2013 at 6:30 p.m. at the Eagan Municipal Center. Present were Mayor Maguire, Councilmembers Bakken, Fields, Hansen, and Tilley. Also present were Acting City Administrator Miller, Director of Finance Pepper, Director of Community Development Hohenstein, City Planner Ridley, Director of Public Works Matthys, Assistant City Engineer Nelson, Communications Director Garrison, Director of Parks and Recreation Johnson, Fire Chief Scott, Police Chief McDonald, and Executive Assistant Stevenson. AGENDA Acting City Administrator Miller noted a change on the Consent Agenda. Miller noted a closed session was held to discuss land negotiations at 4232 Blackhawk Road. Councilmember Hansen moved, Councilmember Fields seconded a motion to approve the agenda as presented. Aye: 5 Nay: 0 RECOGNITIONS AND PRESENTATION There were no recognitions or presentations. CONSENT AGENDA Acting City Administrator Miller noted that Item M. Approve Final Plat — Bennerotte Addition was pulled. Councilmember Tilley moved, Councilmember Hansen seconded a motion to approve the Consent Agenda as modified. Aye: 5 Nay: 0 A. It was recommended to approve the minutes of February 12 and 19, 2013. B. Personnel items 1. It was recommended to approve the hiring of Seasonal Employees in Parks & Recreation. C. It is recommended to approve Check Registers dated February 14 and 21, 2013. D. It is recommended to approve a resolution delegating authority to pay claims to the Assistant Finance Director or the Finance Director. E. It was recommended to award Contract 13-02 (Citywide Street Revitalization). F. It was recommended to approve Plans & Specifications for Contract 13-04 (Citywide Street Revitalization) and Authorize Advertisement for Bids March 28, 2013. G. It was recommended to approve Xcel Energy Undergrounding & Relocation Agreements — Cedar Grove Area (City Project No. 888 and 1088). City Council Meeting Minutes March 5, 2013 2 page H. It was recommended to approve Assessment Agreement — Ecolab, City Project No. 1016R, Ames Crossing Road Street & Utility Improvements. I. It was recommended to approve Plans & Specifications for Contract 13-11 (2013 Water Quality Storm Sewer Improvements) and Authorize Advertisement for Bids March 28, 2013. J. It was recommended to approve Telecommunication Lease Agreement Amendment — T -Mobile (Southern Lakes Reservoir). K. It was recommended to appoint. Assistant Finance Director as alternate to Minnesota Valley Transit Authority Board. L. It was recommended to cancel the March 12, 2013 Special City Council Meeting. M. Item was pulled. N. It was recommended to approve a Resolution to Schedule a Public Hearing to Consider Modifications of TIF District No.1. 0. It was recommended to preparation of an Ordinance Amendment to City Code Chapter 10, Section 10.01, relative to Storage, Deposit and Disposal of Refuse. P. It was recommended to approve the 2013 contract for July 4th Funfest fireworks and authorize the Mayor and City Clerk to sign all appropriate documents. Q. It was recommended to approve the 2013 Use Agreement for Blue Cross Blue Shield fields. R. It was recommended to approve the Public Works Committee Recommendation — Inflow & Infiltration Surcharge Appeals. S. It was recommended to authorize submittal of letter to federal authorities regarding Comcast rate and equipment charges. T. It was recommended to approve a Resolution accepting a $100.00 donation from Mr. and Mrs. Gregg Judge in honor of Police Canine Maverick who died in 2012. PUBLIC HEARINGS PROJECT 1111 (GREAT OAKS) STREET IMPROVEMENTS Director of Public Works Matthys introduced the item noting Project 1111 provided for street improvements within the Great Oaks neighborhood. Assistant City Engineer Nelson gave a staff report on the project. Mayor Maguire opened the public hearing. There being no public comment, he turned the discussion back to the Council. Councilmember Fields moved, Councilmember Bakken seconded a motion to approve Project 1111 (Great Oaks - Street Improvements) as presented and authorize the preparation of detailed plans and specifications. Aye: 5 Nay: 0 PROJECT 1105 (THE OAKS OF BRIDGEWATER 1sT — 3RD ADDITIONS) STREET IMPROVEMENTS Director of Public Works Matthys introduced the item noting Project 1105 provided for street improvements within The Oaks of Bridgewater 1st — 3rd Additions. Assistant City Engineer Nelson gave a staff report on the project. 11101 City of Eaaali 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 2013 COMMERCIAL Date: U /C)Nd L 1r3 Site Address: Tenant NCUI�_XA't Y Use BLUE or BLACK Ink r ForPermit #: (/ ` J Offic% e Use , /s41111 Permit Fee: Date Received: Staff: L ' BUILDING PERMIT APPLICATION F -e -4v Cert)(, c-vd-rrc,t-0 PaJ-kt.03,-# ,./ vets t ame. n %a f `jr7LAS li v Name: (Tenant is: New / Existing)y�Suite #: Former Tenant: a )l I'Z`t Jtvu,4 C-' c1 3C/3 -1[S 3 (j Phone: Ji -`3- 1 [S Ct Address / City /Zip: Applicant is: Owner Contractor Description of work: 3 1-.4'+ k 46 Construction Cost: c3-0 (tk)i 5o Grl &u*Lt, CM041 MVO p4 $IlitM DSr e Name: .�1cY-e. �� 4- -- P --(244j Address 1t O3 ( vu ( I Kol City: Eat/ :;t State: r . /v Zip: 155 LT <9 Phone: n Contact:? `6( N' ----r) Email: License #: ) Name: Registration #: Address: City: State: Zip: Phone: Contact Person: Email: Licensed plumber installing new sewer/water service: 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 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 a ication 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 k whichi equs a review and approval of plans. Applicant's Printed Name Applicant's Signature Page 1 of 3 lS®I ,1 r4I J°k DO NOT WRITE BELOW THIS LIN SUB TYPES Foundation Public Facility Commercial / Industrial ,Accessory Building Apartments ✓ Greenhouse / Tent Miscellaneous Antennae WORK TYPES New Interior Improvement Addition Exterior Improvement Alteration Replace Salon Owner Change DESCRIPTION Valuation Plan Review (25%_ 100%) Census Code # of Units # of Buildings Type of Construction Repair Water Damage FIX et. Fee - REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) Foundation Occupancy Code Edition Zoning Stories Square Feet Length Width Drain Tile Roof: _Decking Insulation Ice & Water / Framing Fireplace: Rough In _Air Test Final Insulation Meter Size: Final Final CIO Inspection: Schedule Fire Marshal to be present: Reviewed By: 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 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 2Zt7Mt 6 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 Yes No , Building Inspector Reviewed By: !?i5.0 -e) Water Quality Water Supply & Storage (WAC) Storm Sewer Trunk Sewer Trunk Water Trunk Street Lateral Street Water Lateral Other: TOTAL° (35, 0-6 , Planning Page 2 of 3 Co City of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675-5675 www.ci.eagan.mn.us PERMIT Permit Type: Fireworks Permit Number: EA116030 • Date Issued: 10/02/2013 CityofEaan Site Address: 1501 Central Pkwy Lot: 2 Block: 1 Addition: Eagan Central Park PID: 10-22409-01-020 Use: Description: Sub Type: Pyrotechnic Special Effects Display Sign Permit Required: N Work Type: Ground Display Tent Permit Required: N Description: Temporary Event: N Sales Dates: to Number of Days: 0 to to Comments: PLEASE CONTACT FIRE MARSHAL, DARRIN BRAMWELL, ONE WEEK PRIOR TO OCTOBER 12 TO DISCUSS SET UP & INSPECTION. CONTACT HIM NO LATER THAN OCTOBER 4TH. 651-675-5900 OR 651-675-5905 Fee Summary: FI - Pyrotechnics $100.00 0801.4096 Surcharge -Fixed $5.00 9001.2195 FI - Fire Department Personnel $530.00 1221.4242 Total: $635.00 Contractor: Pyrotechnic Display Inc 9405 River Road SE Clear Lake MN 55319 (320) 743-6496 - Applicant - Owner: City of Eagan C/O Thomas Hedges 3830 Pilot Knob Rd Eagan MN 55122 I hereby acknowledge that 1 have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. City otEap 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use Permit #: t. J% 03() Permit Fee: Date Received: Staff: 2013 FIREWORKS / PYROTECHNICS APPLICATION J Application must be completed and returned at least 15 days prior to date of display and include: • Proof of a $1,000,000 Bond or Certificate of Insurance. • A diagram of the ground, or indoor display facilities, drawn to scale or with dimensions included, illustrating the point at which the fireworks/pyrotechnic special effects are to be discharged; location of ground pieces; location of all buildings, highways, streets, communication lines and other possible overhead obstructions; and the lines behind which the audience will be restrained. For proximate audience (e.g. indoor displays), the diagram must also include the fallout radius for each pyrotechnic device used during the display. • Names and ages of all assistants participating in the display. jtale Nowak &Patrick Mehl ,'36 CteRtt tCt4TE 0814, VAU) EY4tees • Pyrotechnics plan -requires: Certifications that are set, scenery, and rigging materials are inherently flame-retardant or have been treated to achieve flame retardancy. (NFPA 1126: 4-3.2) Date of Display: 10-12-13 Time of Display: 5: 50pm and about /0ihnn Display Address: Eagan Community Center -1501 Central Parkway, Eagan, MN 55121 Wel-/g CocrrwooK Otift') CALL BEFORE YOU DIG. CaII 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 The State of Minnesota requires that this display be conducted under the direct supervision of a pyrotechnic operator certified by the State Fire Marshal. 1, Dale Nowak by_Beckc Hanson , understand and agree to comply with all provisions of this application and the requirements of the issuing authority, and will ensure that the fireworks/pyrotechnic special effects are discharged in a manner that will not endanger ersons or property praconstitute a nuisance. x Applicant /Age Discharge of th &r - 44 Fire Chief / Fire Marshal Date: x q -Z 1) _ 13 fireworks on the date and above location is hereby approved subject to the following conditions, if any: $ 105 t PERK fa - mor Hoelsch6E7ToBias Wedding Pyrotechnic Display, Inc 320-743-6496 X 1 Name: p y� Phone: Address9405 River Road SE, Clear Lake, MN 55319 /City /Zip: same Phone: Address /City /Zip. _--. ---------- lu000k 4 ouTittoolt, Name: Dale Nowak Certificate Number: B 0246 Manner & place of storage product __ of fireworks / pyrotechnic special effects prior to display: will be delivered and loaded and shot immediately—no storage Type of fireworks / pyrotechnic Please see special effects prior to display: a quick 10-15 second blast at 5: 50pm and the attached sheet a 3-4 minute display at"16 /Jyn Type of fireworks / pyrotechnic Please see special effects to be discharged: the attached product list ______ Quantity: Permit Fee: + (includes $5.00 State surcharge) *If a fire watch is needed, an additional fee will be assessed in accordance with the City's fee schedule CALL BEFORE YOU DIG. CaII 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 The State of Minnesota requires that this display be conducted under the direct supervision of a pyrotechnic operator certified by the State Fire Marshal. 1, Dale Nowak by_Beckc Hanson , understand and agree to comply with all provisions of this application and the requirements of the issuing authority, and will ensure that the fireworks/pyrotechnic special effects are discharged in a manner that will not endanger ersons or property praconstitute a nuisance. x Applicant /Age Discharge of th &r - 44 Fire Chief / Fire Marshal Date: x q -Z 1) _ 13 fireworks on the date and above location is hereby approved subject to the following conditions, if any: $ 105 t PERK fa - Hoelscher-Tobias Wedding 40/12/13 — Product Summary 2.5" Aerial Shells 55 3" Mines 12 Under 2" Multi-shot Boxes 11 2.5" Aerial Shell Boxes 3 44°50'21,97" NI FAX COVER PAGE To: City of Eagan 6516755694 From: Pyrotechnic Display Inc. Date: Tue Oct 01 2013 09:04:30 AM MST Subject: Proof of Insurance for Pyrotechnic Display Inc. Pages: 2 Message: Attached is a copy of the current insurance certificate for your records. Please email/fax the signed fireworks permit as soon as you are able. Thank you for working with us on this project! Becky Hanson, Pyrotechnic Display, Inc. AC O/RUob, 46.---' CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIVVVY) 10/1/2013 THIS CERTIFICATE IS ISSUED AS A MATTEROF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Britton Gallagher One Cleveland Center, Floor 30 1375 East 9th Street Cleveland OH 44114 CONTACT NAME: PHONE FAX (A/C, No, Ext):21 6-658-7100 lac. No):216-658-7101 E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A:EVereSt Indemnity Insurance Co COMMERCIAL GENERAL LIABILITY INSURED Pyrotechnic Display Inc. 8450 W. St. Francis Road Frankfort IL 60423 INSURER B :Axis Surplus Ins Company SI8ML00006-131 INSURER C :Everest National Insurance Company 9/30/2014 INSURER 0 :MN WC Insurers Association $1,000,000 INSURER E : $300,000 INSURER F: COVERAGES CERTIFICATE NUMBER: 421901696 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR LTR TYPE OF INSURANCE ADSL INSR SUBR WVO POLICY NUMBER (MM/DD/YPOLICY Y Y) ICY EXP (MMFF LDO/YYYY) LIMITS A GENERALLIABIUTY X COMMERCIAL GENERAL LIABILITY SI8ML00006-131 9/30/2013 9/30/2014 EACH OCCURRENCE $1,000,000 DAMA • N PREMISES Ea occurrence $300,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $3,000 000 GENERAL AGGREGATE $3,000,000 GENL AGGREGATE 7 POLICY X LIMIT APPLIES IM PER: LOC PRODUCTS - COMP/OP AGG $3,000,000 C AUTOMOBILE X X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS X _ SCHEDULED AUTOS NON -OWNED AUTOS SIBCA00006-131 9/30/2013 9/30/2014 COMBINED SINGLE LIMIL Ea accident 1 000,000 BODILY INJURY (Per person) $ BODLY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ $ 6 X UMBRELLALIAB EXCESS UAB X OCCUR CLAMS -MADE EAU733983 9/30/2013 9/30/2014 EACH OCCURRENCE $4,000,000 AGGREGATE $4,000,000 DED RETENTION$ $ p WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below V / NER N / A MNAR0000019718 (MN) 9/30/2013 9/30/2014 STATU- OTH- X WC E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, it more space is required) DATE OF DISPLAY: October 12, 2013 LOCATION: Eagan Community Center, Eagan, Minnesota ADDITIONAL INSURED: City of Eagan, Minnesota; Ms. Cindy Hoelscher; Mr. Christopher Tobias CERTIFICATE HOLDER I City of Eagan Re: Ms. Cindy Hoelscher Wedding 3830 Pilot Knob Road Eagan MN 55122 SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2010/05) © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACGRD® CERTIFICATE OF LIABILITY INSURANCE Imo„-- DATE (MM/DDIYYYY) 10/1/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Britton Gallagher - One Cleveland Center, Floor 30 1375 East 9th Street Cleveland OH 44114 CONTACT NAME: PHONE FAX EXtt:216-658 7100 (A/c, No):216-658-7101 E-MAIio ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A :Everest Indemnity Insurance Co LIABILITY COMMERCIAL GENERAL LIABILITY INSURED Pyrotechnic Display Inc. 8450 W. St. Francis Road Frankfort IL 60423 INSURER B :Axis Surplus Ins Company SI8ML00006-131 INSURERC :Everest National Insurance Company 3/30/2014 INSURER D :MN WC Insurers Association $1,000,000 INSURER E : $300,000 INSURER F : COVERAGES CERTIFICATE NUMBER: 421901696 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF (MMIDD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY SI8ML00006-131 9/30/2013 3/30/2014 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $300,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $3,000,000 GENERAL AGGREGATE $3,000,000 GEN'L AGGREGATE —I POLICY X LIMIT APPLIES ism PER: LOC PRODUCTS - COMP/OP AGG $3,000,000 $ C AUTOMOBILE X X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS X SCHEDULED AUTOS NON -OWNED AUTOS SI8CA00006-131 9/30/2013 3/30/2014 COMBINED SINGLI=LIMIT (Ea accident) $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE EAU733983 9/30/2013 9/30/2014 EACH OCCURRENCE $4,000,000 AGGREGATE $4,000,000 DED RETENTION $ $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A MNAR0000019718 (MN) 9/30/2013 9/30/2014 X WC STATU- OTH- TORY LIMITS ER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) DATE OF DISPLAY: October 12, 2013 LOCATION: Eagan Community Center, Eagan, Minnesota ADDITIONAL INSURED: City of Eagan, Minnesota; Ms. Cindy Hoelscher; Mr. Christopher Tobias CERTIFICATE HOLDER CANCELLATION City of Eagan Re: Ms. Cindy Hoelscher Wedding 3830 Pilot Knob Road Eagan MN 55122 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2010/05) © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD K ~ Use BLUE or BLACK Ink I For Office Use Permit 66 City of Ea~(,1 Permit Fee. S 3830 Pilot Knob Road I Eagan MN 55122 I _ (3 I Phone: (651) 675-5675 i Date Received: I~ Fax: (651) 675-5694 j Staff: j 1------------- ---1 013 COMMERCIAL BUILDING PERMIT APPLICATION Date: 9/1- Site Address: Tenant Name: eA Ate (Tenant is: New/- Existing) Suite Former Tenant: Name: Phone: Property Owner Address / City / Zip: ~J d Aft" w,6 k Applicant is: Owner Contractor Type of Work Description of work: Construction Cost: Name: License ~7, 3 _~17 Contractor # Address:` City: State: Zip: Phone: Contact: Email: . Name: Registration Architect/Engineer :Address: City: 3 State: Zip: Phone: Contact Person: Email: _ e. _ , mow. _ 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. A a. _ . w m . . - 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 wh' r ires review and approval of plans. Applicant's Printed Name App can gnat Page 1 of 3 DO NOT WRITE BELOW THIS LINE ~7Coj SUB TYPES Foundation ✓r'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 v-rRepair Windows Demolish Foundation Replace _ Water Damage Fire Repair _ Retaining Wall _ Salon Owner Change *Demolition of entire building - give PCA handout to applicant DESCRIPTION Valuation 1650 Occupancy MCES System - a Plan Review yl p 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 / 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: kL , Building Inspector Reviewed By: , Planning COMMERCIAL FEES Base Fee Water Quality Surcharge 4.00 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 Page 2 of 3 � Use BLUE or BLACK Ink � r----------------^ iFor Office Use� � � I � � Permit#: � � � Clt of Ea a� � , .� � Y � � f�ermit Fee: � �� 3830 Pilot Knob Road � � Eagan MN 55122 � � Phone: (651) 675-5675 RECEIVED i Date Received: i Fax: (651) 675-5694 �UN 19 �01� j Staff: j . �---------------1��`�'�� 2014 COMMERCIAL BUILDING PEF�A(IIT APPLICATION �,�� l GI t t5 b � �. a��.��c,v ��c �... Date:�6 � t Site Address: Tenant Name: � ` �- (Tenant is: f�e.w/ EXisfing) Suite#: ' Former Tenant: � Name: � �� Phone: Property'Owner Adaress i city i zip: �� , ` Applicant is: Owner Contractor � �� Type of Work Description of work: �LYt/� � J�✓��v �d X.`K/ �x �� p��x�,� J Construction Cost: ! j,)_ �,�-�-� Name: Q'S �'T•�'t.� License#: � COittl'1CtOY Address: � �� -:�vt-x V�� City: �� 1 �'`,[" i � State: �'IV Zip: �./J � Phone: ��' � � �� r � Contact�� Email: �� y�"S . Name: � Registration#: ArchitectlEngineer : Address: city: � State: Zip: Phone: ` Contact Person: Email: Licensed plumber installing new sewer/water service: Phone#: NOTE:Plans and supporting.documents that you submit are considered to be public information. Portions of the informafion 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 ap ' ation 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 wor which requires view and approval of plans. x VV �t� �1� �.�,� x ApplicanYs Print��e. ��e�; n ApplicanYs Signature �ir_ v rc.�,X Page 1 of 3 �� a�' r �7g7 n�c� r - �s�3 -c �� P"''� � ��i �n}�-n� � ^ DO NOT WRITE BELOW THIS INE �� - � SUB TYPES _ Foundation _ Public Facility Exterior Alteration-Apartments Commercial/Industrial /Accessory Building Exterior Alteration-Commercial _ Apartments ✓ Greenhouse/Tent _ Exterior Alteration-Public Facility Miscellaneous Antennae W RK 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 �'�� i Occupancy U MCES System IV � Plan Review Code Edition `1l.�� 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 �(• �j 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 =lnsulation _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 Ins ection: Schedule Fire Marshal to be resent: �Yes No p p Reviewed By: , Building Inspector Reviewed By: , Planning COMMERCIAL FEES Base Fee ��.6 d Water Quality Surcharge Water Sampling Fee Plan Review 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(Irrigation) Street Park Dedication Water Lateral Trail Dedication � Other: ° . • WaterQuality , TOtAL � l'�jS,�� Page 2 of 3 � � � � � Use BLUE or BLACK Ink �_____----�_��__ � Far Office Use � � � Permit#: ��d.J � Clt of �a a� � �� I Permit Fee: /�� I 3830 Pilot Knob Road � � Eagan MN 55122 � �� "�� Phone: (651)675-5675 i Date Received: � Fax: (651)675-5694 j Staff: �� I t_------ -------� 2014 COMMERCtAL BUILDING PERMIT APPLICATION Date: Si e Address: {�� 1,�� • - Tenant Name: (Tenant is: New! Existing) Suite#: Former Tenant: , � '� �` Name: � Phone: l�'}L��~J�U �� ' �- � s: �' � � � , .,'b # � �tr + ;„b �< � g�� ,� ��'�s� �x�°#k Address!City/ZiP' I�0 �� '� � �� `� ��'�� '�� C14L1.� �. Ftil�FOi�S FpQ. P(C.�,tS� ��,`� �`�� ; Applicant is: Owner Contractor 3-- OS3 , '� � _� � �� ,�� ; �, � .�y��,��,�� .� Description of work: . � > , . � t ,� 't` Construction Cost: � ��b �� t � � � 3 � �7 � #- �� .� q � �� s� �� z , � , Name: License#: ( A� k } � � q$ �;�� '�� " Address: �� City: �� t� s�`��'��"�M'�'A��C�F�' �; A h ��F,, �r� ,�� r3ro .� �� l�----- '......L.�lcs.' d��.�� wt�v'T �"�i$�+% F"F; � S kt tq � � State• �� Zi Phone� � � �" � .d ` ! �r = ` �` Contact: Email: � � ,. t rc`�, " r> `��"'y . . . . . .. . . . . � ` ' Pb�� Name: Registration#: � a ��' � � � �` � � �� ,� Address: City: �,� ��, .n�t r<: �r,�,��'- 'w a �`ra y� t:r9t i£*r; ¢�;'� �� State: Zip: Phone: �� ,�i ,,��; �,��.�,��x ; ��'��:�€�*� � �� ,��,��'x'' ,', ��`��3�,,,� ��,.,s: < '� Contact Person: Email: � ; 3 Licensed plumber installing new sewer/water service: Phone#: &�NDT�'��P/ans�'�n��a�t��i�h��tl't�r�a��=��,�,yt�u��i��l��t?�>,�r��f�l�r��#"�a�,mm �11��', �.,' ,�fh�,/#ifori�i��i�n�i�ra,��b��cla��f�� `��1� �� ` � �� '�� c``6 t 1 r� i�� 3 f� . � ��s� h � . �,.Y �� r�j ia� °3'*� y r ��r't �` r�'`" � y,' �,w . �` ; t:' . . # <,rri ,�,,.:;^4��, .,' .r s<r: ..� ,�. i��' �s��#� �,,��',��«,��.r.�a��"� �f ,i �e,S. �d. .�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 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 mit, and k is not to start without a permit;that the will be in accordance with the approved plan in the cas f work which r ides a r i �nd pproval of plans. / x �UI(� U,�{� � x ApplicanYs Printed Name lica s Signature ' Page 1 of 3 J � • �• l` f. � I 5u � �� /�t�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 _ Interior Improvement _ Siding _ Demolish Building" _ Addition _ Exterior Improvement _ Reroof _ Demolish Interior _ Alteration _ Repair , Windows _ Demolish Foundation _ Repiace _ Water Damage _ Fire Repair _ Retaining Wall _ Salon OwnBr Change *Demolition of entire building-give PCA handout to applicant DESCRIPTION Valuatlon �X Occupancy �_ MCES System � � Plan Review b�'� Code Edition 2b07M5$L SAC Units ° _ 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) -✓ Fina!!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 AirTest `Final Retaining Wall Insulation Erosion Control Meter Size• Final C/O Inspection: Schedule Fire Marshal to be present: `�r Yes No Reviewed By: l�� . Building Inspector Reviewed By: Pianning COMMERCIAL FEES Base Fee t3S•"'� Water Quality Surcharge INGLb • V1laterSampiing Fee Plan Revfew 0• � Water Supply 8�Storage(WAC) MCES SAC Storm Sewer Trunk City SAC Sewer Trunk S8W Permit�Surcharge Water Trunk Treatment Plant Street Lateral Treatment Plant(lrrigation) Street Park Dedication Water Lateral Trai1 Dedication Other: � Water Quality TOTAL `�'�'� Page 2 of 3 . Use BLUE or BLACK Ink � r————————————————^ I For Office Use � I � � Permit#: � � I Clt of �� Il � �� Y � � Permit Fee: �� 3830 Pilot Knob Road � � Eagan MN 55122 � � I Date Received: �� I Phone: (651) 675-5675 ��f°�� i � Fax: (651) 675-5694 � Staff: I Jt��`� 9 7 Z�`1� �--------------�,1�� . 2015 COMMERCIAL BUILDING PERMIT APPLICATION (�,�'I"� . �la � l ' b 1 �-t•� �- �ts► �� Date• � ,�'Z ��firte Address: � '�\� �/ � 1 �� Tenant Name�.�Ol��`��_ ' �l� �YY (Tenant is: New/�Existing) Suite#: ��A �� y� ��' Former Tenant: � ��, '�,; Name: (�Q- Phone: ��, �� r�`� -i,�� , �� Address/City/Zip: d I � � ��r� � �� -��--�-�� .�� .�a f � ��:° �� Applicant is� Owner Contractor --'� Cl,�/t �j�� `� A o i c� y � z�� ; , � c��uo ► �- � � �)C� , Description of work: � � � X � k ��'��/�; �, , � ,.--- ��` � � �: Construction Cost: �� ,�� :��: _'�� Name: � S �� License#: COiI'�1'I�C'�C�r , Address: , l:� City��,�'"+✓��f r �' l : State: Zip: Phone: I�Z.f `L"'1�'' �J 1� �,r,xi� s r . � �:�� Contact: Email: � u 4„ " , ' "�� ` �� Name: Registration#: , � ` � �Address: City: ,��'��'ff�@C�/�tl��"` ��`�� , :; State: Zip: Phone: ' Contact Person: Email: Licensed plumber installing new seweNwater service: Phone#: �'�7'�, P�arrs ancl s�,p��r��q�u�e��t,��r`�"t��t��G�'��t��e �� k t �F�� For�i �`' �`h�e rn�ort�a�tl�rn�»�y��"��'��t�`1��,��d��#�` �+��q��{ �"#�!�+��t� . ,; = ;: " ,; t ` �l�l�l�,�i�# ::��t`8�8'S�ii3. . ..�.,�„#.F . , � �x 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.4opherstateonecall.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 k which requires a review and approval of plans. X `v� o�►'�� v�r✓tc�� X ,� Applicant's Printed Name ._, A plican '�9 nature �— �� U.C�1�� C �JJ�'� C,� � Page 1 of 3 ��— �� ,`7 �� 3��" �1 ;� � ��1 �-� �� Q -�'ti` � [jc,� �,r'�rc. � �k� . DO NOT WRITE BELOW THIS L NE � �� _ SUB TYPES _ Foundation _ Public Facility _ Exterior Alteration-Apartments _ Commercial/Industrial Accessory Building Exterior Alteration-Commercial _ Apartments �Greenhouse/Tent _ Exterior Alteration-Public Facility Miscelianeous Antennae W RK 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 �G�t'C �- Occupancy �1 MCES System � � Plan Review t�.tGL`p Code Edition 'f�(S k�aQj�,. SAC Units (25%=100%� � �.(�p Zoning City Water Census Code Stories Booster Pump #of Units �1�,�.JQ(��"'S 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: Concrete Entrance Apron Final C/O Inspection: Schedule Fire Marshal to be present: 'f Yes No Reviewed By: (�� , Building Inspector Reviewed By: , Planning COMMERCIAL FEES Base Fee I�a�- �' Water Quality Surcharge s= "� Water Sampling Fee Plan Review Water Supply 8�Storage(WAC) MCES SAC Storm Sewer Trunk City SAC Sewer Trunk SS�W Permit&Surcharge Water Trunk Treatment Plant Street Lateral Treatment Plant(Irrigation) Street Park Dedication Water Lateral Trail Dedication Other: Water Quality TOTAL� ��..�" :�':- ��' Page 2 of 3 ♦ � �'' Use BLUE or BLACK ink ;�� i-------- ---------�j�r� � Fo�o�n�u� � i Permit#: ��%� 1' .��/'� C�ty of ��aIl � . . 2 �- �� Pertnd F�, � a � 3830 Pilot Knob Road Eagan MN 55122 E Date Received: �� OS j Phone:(651}675-5675 Fax: (651}675-569a �� '�� '��` j � 1 � staff: � ��..... , .r r.a..s�,r .....+��.�J 2015 COMMERCIAL BUILDING PERMIT APPLICATION � �,,�'� � j , �` � �L �� -. Date: � ite Addres �: �� tt"{�N1 � ��f� � �� '� `f'r�� /- �"7 ��lj Tenant Name: � �' (Ten t is: New/ Existing) Suite#: 'd- 1�� 71r� � �� Forrner Tenant: �j �"�p�� .tfin�yr . .. .. . . / � �w�� , �� r�� Phone: �["(.1��,J�� .- ,y;�. � Name: � � + �x�� ;��,�' �� ' '° ��,<PCOp+BI#�f Address/City/Zip: � �,:s�*� �r . �;. �t. p , ks. . . . . .. . � .. . . . �� . � � . . . .�� . ' ��,. K s� ApPlicant is: Owner Contrador �°"F°�'��""�'�� "��;.. t- �� I'� 1�, � � � p��*' ��`�'�.� Description of work: � .�`��'� , 0 m ,O1"1�� ""; � � . R ..�� . �. . : „,M. ' : ��,�m Constn�ction Cost �,� � ,�. �x � ,��, >t,��°��` Name: �� License#: � �y � ��'r ��'i�4�,.,"��". ' r � ��"��,�'`f ��; Address: � �� City: ��,Contra to /� �� , �� "i F�� 3 � State:�,Zip: Phone: � � � � � � ��#y� �.,.�� ,r � r ' .._-. ��; W,.� � Contact: - . EmaiL• r __ �, ... ., �,. �- �. � c .� �� ,; -�_� � Name:�� Registration#: 4�..; r�^ 4` � � r ;�%,1 �r ��.� �. . Ite Eng1 ee Address: city: , "�� State: 2ip: Phone: ��fr �� #' �x �� .,� .s.:� Cantact Person: Email: ��,,., ...�.�r Licensed plumber installing,pgay sewer/water service; Phone#; NOTE:"P/an nd sup'�`i�In dticumenfs�tTia�� o��ubinit��r+e�cons''Jtler,e�l�to be�Eui"�i%f,�c�Jnform�tJon�.P,a "�cirls f�' � ,. ,, �� w �# � � �:: � ��» x� �, �� ti �u« ��.�E-.� �� '^�s� z * t)F , .g : �� r� �a� ��c3��'�. �. 't�` s�lirforamatfar+ a�r�6e.c/asslfleal¢�,,�no.,„�u�►!c� ou��rov�l�s,pe� on�s a % �#` �if�r � . � .� .� �.��,� °.�. � � ��u .� ��,�;��conalucle � e ��ars�'traale�s,ecr,e .,a .,�.,, � • �,��, + ,� t �;� y CAL� BEFQRE YOU DIG. Call Gopher 8tate One Call at(661j 45d-0002 for protection against underground utility damage. Call 48 hours befo►e you intend to dig to receive locates of underground utilities. www.aooherstateonecali.oro I he�eby acknowledge that this inforrnation is complete and accurate; that the work will be in conformance with the ordinances and c�des of the City of Eagan;that I understand this is not a pertriit,but only an application for; permit,and �ic is not to start without a permit;that the ric wiil be in ccordance with the approved pian in#he case' fi work which ires a a approval of plans. x �� , t � Applicant's PNnted Name ' lican s Signa�re ` Page 1 af 3 . ��, �� :�� er. /�� ► � r.�.��,�.� f�� DO N�T WRITE BE�OW THIS L1NE �� SUB TYPES _ Foundation _ Public Facility _ Extericr Altsration-Apartments _ Commercial/lndustrial _ AccessaryBuilding _ EuterlorAl�ration-Commercial _ Apa�tments ✓ Cireenhouse/Tent _ Exterior Al�ration-Pubtic Facility _ Mlscellaneous ,� Ant,ennae WORK TYPES `� New _ In#erior Improvement ____ S[dln�g _ Demolish Buliding* _ AddiUon _ Exterior tmprovemcnt _ Reroof _ Demollsh Interior � Alteratfon _ Repair _ Windows _ Demoltsh Foundation _ Replace _ Water Damage � Fire Repalr r Retaining Wall _ Salon Owner Change 'Demalition of entire buiiding-give PCA handout to applicant DESCI�I�TION Valuatton �1X�D � Occupancy V� MCES System /� 61- Plan Review Code Edition 2�/S ML3G SAC Units (25%_1�°!0� Zoning� City Water Census Code Stories Boaster Pump #of Units Square Feet PRV #of Buildings — Length Fire Sprinklers Type of Constructlon — Width REQUIRED INSPECTIONS Footings{New Buiiding) Sheetrock Faotfngs{Deck) �/ Final/C.0.Requit+ed Footings{Addltion) Final/No C.O.Required Foundation Other: Drain Tile Pool:_Foatings Air/Gas Tests „_Final Roof:_Decking _Insulation _Ice&Water _Final SEding:_Stutxo Lath _Stone Lath _Brick Praming W[ndows Fireplace:_Rough In Air Test _Finai Itetaining Wall Insulation Erosion Control Meter Size: Concrete Entrance Apron FinaC C/O Inspection:Schedule Fire Marshal to be present: ✓^ Yes No Reviewed By: ��G . Buitding Inspector Reviewed By: Planning COMMERCtAL FEES Base Fee ��S•''° Water Quality Surcharge l�ttu� Water Sampling Fee Ptan Review /�rG�-'D , Water Supply 8�Storage(WAC) . MCES SAC Storm Sewer Trunk City SAC Sewer 7runk S�W Permtt 8�Surcharge Water T�unk Treatment Plant Street Lateral Treatment Plant(Irrigation) Street Park Dedication Water Lateral Trail Dedication Other. Water Quality TOTAL �3 S � Page 2 of 3 443 Lafayette Road N. (651)284�005 �1 +t�"`�"� ��.�f�'"�° �; "� t'��` St. Paul, Minnesota 55155 � 1-800-DIAL-DLI www.dli.mn.gov � � � �� TTY: (651)297-4198 � _ _ October 07, 2015 I City of Eagan �,, 3830 Pilot Knob Road ' EAGAN �_.-{�- -�''� ANNUAL OPERATING PERMIT Subjec • PASSENGER Elevator ID#: ELV-08692 ' �9�� E�gan C�mmunity Center 1501 Central Pkwy EAG _.._.____.___..___ 55121 � �_..__....__�. ' Dear Sir/Madam: Minnesota Statutes Chapter 326B provides that the Department of Labor and Industry, '� Construction Codes and License Unit, Elevator Safety Section, issues annual operating permits for all related elevator equipment. The issuance of this permit does no# necessarily I mean that the elevator related device is in full compliance with all the rules of the department. It is the owner's responsibilitX 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. For more information visit our website at: http://www.dli.mn.gov/ccld/elevator.asp NOTE: 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$10,000.00. Sincerely, CONSTRUCTION CODES AND LICENSING J Bill J. Reinke Chief Elevator lnspector CCLD/Elevator Safety Section This information can be provided to you in alternative formats(Braille, large print or audio). An Equal Opportunity Employer 443 Lafayette Road N. (651)284-5005 �� , � �� St. Paul, Minnesota 55155 � 1-800-DIAL-DLI www.dli.mn.gov �� : �; � ,,� � TTY: (651)297-4198 `� A NNUAL 4PERATING PERMIT PASSENGER SITE: Eagan Community Center Address: 1501 Central Pkwy City: EAGAN MN State of Minnesota ID No.: ELV-08692 Approval is based upon the requirements set forth in the Minnesota Statues, Chapter 326B.184 Expired Date: 10/01/2016 Inspector: Bill Reinke Department of Labor and Industry Construction Codes and Licensing Div. Elevator Safety Section 443 Lafayette Road N. St. Paul, MN 55155 This information can be provided to you in alternative formats(Braille, large print or audio). An Equal Opportunity Employer 41.111111' CityofEaali 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Date: r Use BLUE or BLACK Ink For Office UseI G Permit#: /7q9 5. 10,5-4 Permit Fee: / 3 Date Received: 61.29 -1 Staff. 2016 COMMERCIAL BUILD NG PERMIT APPLICATION ite Addre : j b t ,�, r -1 vki /- 6' 0 7- 7/ (Tenant le: New / Existing) Suite #: PVfVt Tenant Name: Former Tenant: Property Owner Name: fix r r C�i i1�U `t� ��1.�" 4 Phone: 661615-555") Address / City / I hfl 1 &VF11-J tt'�)1 � Applicant is: Owner Contractor of Work Description ofwork:TV/0A t) 1' Uilivt t Construction Cost 5 1-#.bbA60 ontraCtor Architect/Eng neer; Name: Address: State: r�7 Contact: J 1 �o11c) : (64-1 License #: City: awiA- Phone: q62.--61411.-- 39'9 I Email: opm Name: Registration #: Address: City: State: Zip: Phone: Contact Person: Email: Licensed plumber installing new sewer/water service: Phone #: NOTE: iPlans and supporting documents:; that you submit are.consldered to be publlc fnformatlon., the,informatlon may; be classified as non-public if you provide specific reasons that.wouidperrnlf concludethat they are, trade: secrets:' 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.00pherstateonecall.or5t 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 rmit, and work is not to start without a permit; that the rk will be in accordance with the approved plan in the case .f work which ' ' =s a -vi - = nd • • oval of plans. 3/Ame, vitiltkp!1� Applicant's Printed Name �L I ..LLJ lica s Sig Page 1 of 3 e‘ribe74-1 (AV ` DO NOT WRITE BELOW THIS LINE SUB TYPES Foundation Commercial / Industrial Apartments Miscellaneous WORK TYPES vNew 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 F IXES5 feE. CMJ6PtE4 Occupancy Code Edition Zoning Stories Square Feet Length Width REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) Foundation Drain Tile Roof: _Decking _Insulation _Ice & Water Framing 30 Minutes 1 Hour Fireplace: _Rough In Air Test _Final Insulation Meter Size: Final 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 tD(5 MSG PF 1 (74 'pec CJD ' Sheetrock MCES System SAC Units City Water Booster Pump PRV Fire Sprinklers / Final / C.O. Required V 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 Final CIO Inspection: Schedule Fire Marshal to be present: ✓Yes No Reviewed By: 014. , Building Inspector 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 114 GLA Storm Sewer Trunk Sewer Trunk Water Trunk Street Lateral Street Water Lateral Other: Reviewed By: a�2 TOTAL: 1345 , Planning Page 2 of 3 Use BLUE or BLACK Ink 1 r For Office Use CityPermit#: /�5(p-- ------7of Eaall �s c � 1.7-V?v? Permit Fee: 3830 Pilot Knob Road /// /6 Eagan MN 55122 Date Received: 0 rl 7 " Phone: (651) 675-5675 r..::CEIVED Fax: (651) 675-5694 JUN 14 log Staff: 2017 COMMERCIAL( BUILDING PERMIT APPLICATION to Date: / /� )17 Site Address: ) 5u I Com-" ` ( , �' ,=)'c Tenant Na e. A5-(" .( ,ln c-Rn`1 411:1 (Tenant is: New/ sting) Suite#: C.-1,a Former Tenant Name: 04.' . EG cC, .{J\. Phone: � ,. .. .a...� .m k � 1 Property Owner Address/City/Zip:) �.��, '<. rai Pc� 7k.-t.,t..(4.L' 1 Applicant is: Owner Contractor i Description of work -2vx � i� I- fox 20 r 30k30 7.--.4(11--__S Type of Work / ca, —— _ Construction Cost: `Ir / c-72 1 - �`� W Name pA. �,w., /. � y__? e .FrP �w., , `. .,. .N.sc____, -- �L�LL�L License#: 1,,t lI Cit 1 y. .� /yl�� ContractorAddress: �g S C CA- N 1 State: \111\i Zip: 6-3 43c\ Phone: O 3 ` 2 , At 1 Contact:-J N"1 /ma_ t., r -v ) �;� i e5 tf CC)‘ill' Vie: — bRegistration#: Architect/Engineer I 7 , V ar A.. :ss: •� City: State: Zip: &5/— hone: € Email: Contact Pers. • Licensed plumber installing new sewer/water service: Phone#: NOTE:Plans and supporting documents that you submit are considered to be pub-lc information. Portions of y 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.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. AAP X 1 G�c�, 1-.- 0 ,,'1'? E di X ` , l 4 2-- Applicant's Printed Name App icant's Signa ure Page 1 of 3 c11a43 ( (ivy DO NOT WRITE BELOW THIS LINE �L/ 6 S SUB TYPES k 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 fuer, I Occupancy u MCES System Plan Review (N1j$ Code Edition to($ MBG 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 V•PP Width REQUIRED INSPECTIONS Footings_New Building Deck_Addition Drain Tile Foundation Foundation Before Backfill Retaining Wall Vapor Barrier Erosion Control Framing 30 Minutes 1 Hour Steel Reinforcement Insulation Concrete Entrance Apron Sheetrock Other: Roof:_Decking Insulation Ice&Water Final Meter Size: Siding: Stucco Lath _Stone Lath _Brick EFIS Electronic As-Built Plans Required Windows Fireplace:_Rough In _Air Test _Final Final/C.O. Required Pool: Footings _Air/Gas Tests _Final V Final/No C.O. Required Final CIO Inspection: Schedule Fire Marshal to bepresent: V/Yes No Reviewed By: I Lk , Planning New Business to Eagan: Reviewed By: , Building Inspector FEES Water Quality Base Fee (35. 157 Storm Sewer Trunk Surcharge 1141.1.0 Sewer Trunk Plan Review 1 AI(AA 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: Trail Dedication TOTAL: I S'S• &- Page 2 of 3 Use BLUE or BLACK Ink r .- For For Office Use City of Eaaall :::::eT .I11 / tit( e e_, 3830 Pilot Knob Road Eagan MN 55122 Date Received: /l Phone: (651) 675-5675 r :..CEIVED _ llt Fax: (651) 675-5694 Staff: til JUN 0 7 2017 t 2017 COMMERCIAL BUILDING PERMIT APPLICATION / .0 f Date: 5-1►Q�l, Site Address: Ci -1i .1 &4. �--, (€ f.#'.' /"i Tl' 6,e1"- it C&171-1-iZig-( Tenant Name: F)Iv FEST 6() (Tenant is: New/ Existing) Suite#: j/ COIL/ ' Former Tenant: Name: ei o Hw Phone: G s—1 4 7r- rs-a l Property Owner Address/City/Zip: '1176 /"l fort- k 'k ,cd I Applicant is: Owner X Contractor I Description of work: f c- OF ( 7 eo sf. t"fr /- 1 Type of Work TSI ACRE, WAConstruction Cost , Name: Filo, _ . a,/7�it 1 7 4JLice se#: r /� - Contractor Address: ,,/�$ o I C/-c€-. ✓ 4i?h ( City: 1fr.? State: !/I/t/ Zip: rr7` J Phone: 7C2-- ?Y2 33 Contact: fi-tr414 CifC Email: 5-4y .4,,G {, Name: 414 Registration#: Architect/Engineer 1 Address: City: State: Zip: Phone: I Contact Person: Email: } 5 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 '... na..:a.o...+m...n conclude that the are trade secrets... ,. ....... ........ .... ..va..« ».�+ _+w...ue.J 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 requir s a review and approval of plans. tt/A4feef I x iivel#1., ill oteuia./' n-y, re/5.- i x Applicant's Printed Name ' Applic nt's Sig Lure Page iof 3 An /40 f Ci'ii / ek-air-DO !NOT WRITE BELOW THIS LINE C e t/ ' 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 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 $ Fes wkjvet. Occupancy LA MCES System W/A Plan Review --- Code Edition ZD IS mlbc, SAC Units (25% 100% ) Zoning rf City Water Census Code Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Sprinklers Type of Construction V . 5 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 Concrete Entrance Apron Insulation Other: Sheetrock Meter Size: Roof:_Decking _Insulation _Ice&Water _Final 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: , Planning New Business to Eagan: Aft Reviewed By: �% G' , Building Inspector FEES Water Quality Base Fee WM Vt > Storm Sewer Trunk '7 Surcharge Sewer Trunk Plan Review WM VSD 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: Page 2 of 3 Use BLUE or BLACK Ink J..�� C For Office Use/ l� (� ::::ee: '*' City ofEaall ,►'1 f 3.> •0`-' .-1- 3830 Pilot Knob Road Zrx Eagan MN 55122 t tt ''--$ -15-1.1 Phone: (651) 675-5675 Date Received: Fax: (651) 675-5694 Staff: 1)6- L 2017 COMMERCIAL BUILDING PERMIT APPLICATION N. Date: 66Y I hl D I Site Address: 150 i 0.0 �I V1L / Tenant Name: \i,)01/1e,�IU�(/1I I -IPIZJA (Tenant is: New/ Existing) Suite#: ,t; """ " fieu Former Tenant: (.051-14015-555o ,_,, 0 � Name: 12k4 Phone:Address/City/Zip: 6 � �1AU� y l,3O 3•� Applicant is: Owner Contractor •tel .. p n loil �1 Description of work: ' ' 9 • wt_/ �V/� it All OF �f I J� i . uype o • k t Ili D tConstruction Cost: �1l tt j UI�imA Walt 11- °��' � Name: License#: l-,,, (QDD JAI S� 3:443, _ Address: City: ACITII3 (?�I�CaiCO = I W State: III : .554-1+ Phone: qA I� L� 1 U me6UV'Wn1 /lNn �i�- Q-IyPContact: 1,1 Email: V Name: Registration#: 6 h(tect •uneer Address: City: -- State: Zip: Phone: ' Contact Person: Email: Licensed plumber installing new sewer/water service: Phone#: x ' O /ans`a Supp• trig docum� that you sub r • ed to be ublic information Portions r ormat hill, 01 RitliNki-s. _ mn may b� lassifre •,n-public if o • • •-' ' °',"ea • , =that would permit the'City to . h<< Y: -Al ,' (udelhat - .., ,a ., -PL..�P,A �- , ,. 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 re. ir-s a review .nd approval of plans. 1 l / 1 , Fijr x J4 ( kWC -13P x Applicant's Printed Name Ap• can/ Signature 66 i-41- 1 / I Page 1 of 3 f5--oi biki, / iPer` j DO NOT WRITE BELOW THIS LINE 4 /6( ( JC SUB TYPES _ Foundation _ Public Facility _ Exterior Alteration—Apartments _ Commercial/Industrial Accessory Building _ Exterior Alteration—Commercial Apartments 7 Greenhouse/Tent _ Exterior Alteration—Public Facility Miscellaneous Antennae WORK TYPES New _ Interior Improvement Siding Demolish Building* _ Addition i 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 Coot)u Occupancy iA, MCES System Plan Review "! Code Edition calf h►1te,.... SAC Units PA (25%_100% ) Zoning City Water Census Code Stories Booster Pump #of Units Square Feet /,8b0 PRV #of Buildings Length Fire Sprinklers Type of Construction PA Width REQUIRED INSPECTIONS Footings_New Building_Deck Addition Drain Tile Foundation Foundation Before Backfill Retaining Wall Vapor Barrier Erosion Control Framing 30 Minutes 1 Hour Steel Reinforcement Insulation Concrete Entrance Apron Sheetrock Other: Roof:_Decking Insulation _Ice&Water _Final Meter Size: Siding:_Stucco Lath _Stone Lath Brick_EFIS Electronic As-Built Plans Required Windows Fireplace:_Rough In Air Test _Final Final/C.O.Required Pool:_Footings Air/Gas Tests Final ?c Final/No C.O. Required Final C/O Inspection: Schedule Fire Marshal to be present: )4 Yes No Reviewed By: , Planning New Business to Eagan: Reviewed By: 4„ ' , ,,--.--, , Building Inspector FEES Water Quality Base Fee Storm Sewer Trunk Surcharge Sewer Trunk Plan Review 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 DedicationTOTAL: °3$ - e��``1L) Page 2 of 3 CA likt .Ak • a>. r For Office Use � t 0 # f E AGA .,ii AL�1t) �� ::::ee : —F � � } % , , 1 N � *. .. .... �A (�c : I/, r c(i iii- S / I n, /t. <r Date Received: 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 `J J I (651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 1 Staff: buildinginspectionsaa.cityofeagan.com 2018 COMMERCIAL PLUMBING PERMIT APPLICATION El Please submit two(2)sets of plans with all commercial applications. Date: 1/11/18 Site Address: 1501 Central Parkway Tenant: City of Eagan Suite#: .1 Pro r" i � Name: City of Eagan Phone: % Name: Nasseff Mechanical Contractors License#: PC642789 \\ AN'igTION El PAddress: 122 S Wabasha Street City: St Paul State: MN Zip: 55107 �a0F r „ ° Phone: Email: . :46 p g' _New Replacement Repair _Rebuild Modify Space Work in R.O.W. & Description of work: at, /.4q•k:: COMMERCIAL New Construction Modify Space %r'' _Irrigation System(_yes/ no)(_RPZ/ PVB) '/ • Rain sensors required on irrigation systems '$3 Permit-Type • Avg.GPM (2"turbo required unless smaller size allowed by Public Works) gggiv-:!:.:.: 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 Contract Value$1800 x.01 $60.00 Permit Fee Minimum $60.00 PVB/RPZ Permit(includes State Surcharge) _$ 60 Permit Fee =$ 0.90 Surcharge Surcharge=Contract Value x$0.0005 If the project valuation is over$1 million,please call for Surcharge =$ 60.90 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 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. j' xSteve Treptow x / - 7 ---- Applicant's Printed Name Applic«ants Signature ' mW ' / 4f � in ',A NAR'., . F ICEUSE « ovedBy � �,Z 0��4- ✓y6ay a 9y q .�� 6 =, reel Inspectiot Und round ��Re, Air Test Gas Test ai d y e N o -; '. r+-r W ' is r gip. r i%✓ e i 9s >", t % N Mete etated Item Mete Ze ✓a ®tW Y..d (R R .E.M � <,,, - ' El, �,� :(7. Page 1 of 3 C14/1 r For Office Use I /-if�/ % t : : 4 X531 �:+ +.... E AG A iNk,� Permit#: 1 "' v ,- , Permit Fee: /� �!,,.., ..1 / � G0184 ,SAN 1 c Date Received: I 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 `' I (651)675-5675 l TDD: (651)454-8535 I FAX:(651)675-5694 `�� Staff: j buildinclinspections a.citvofeagan.com f1'� 2018 MECHANICAL PERMIT APPLICATION El Please submit two(2)sets of plans with all commercial applications. Date: 1/11/18 site Address: 1501 Cnetral Parkway Tenant: City of Eagan Suite#: "° a t, Name: City of Eagan Phone: Retro „ t� MY10,,,, ` ''4*/ta: Address/City/Zip: � ' Name: Nasseff Mechanic) Contractors License#: MB005095 122 S Wabasha Street St Paul COntrs qt® Address: City: �` State: MN Zip: 55107 Phone: 651.777-0001 contact: Steve Treptow Email: Stevet@nasseff.com ,, *A . / R* New Replacement Additional X Alteration Demolition t o of Work Description of work: NOTE:Ft- and mounte 'nec ,cai a r>t is � scree/ Code 1 ani l Respects f• * on Otut n A , k v 11 t ., ``ry RESIDENTIAL COMMERCIAL Furnace il New Construction x Interior Improvement itT s —Air Conditioner _Install Piping Processed jit , -A. r Exchanger _Gas _Exterior HVAC Unit ;p4 Heat Pump Under/Above ground Tank (_Install/_Remove) r .,..:-:-..A.....,„-;.. 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 2300.00 x.01 $ $60.00 Permit Fee Minimum Contract Value $75.00 Underground tank installation/removal,includes State Surcharge =$ 60.00 Permit Fee 1.15 Surcharge Surcharge=Contract Value x$0.0005 =$ If the project valuation is over$1 million, please call for Surcharge =$ 61.15 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 witho 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. xSteve Treptow x F ' oESE ` S Applicant's SignatureApplicant's Printed Name �� • tis. ra y ®aROFFICUE a e dB' /s -V.a e o�• ed ons :+ . iC f ' r pa A ,, f ervcTomfgruno eo ``k Use BLUE or BLACK Ink _tit ti ©f E For Office U e . , , 0 v � Permit#: 4/17b � � � 3p►N 11 ZQ1$' Permit Fee: 94t I S O 01 Date Received: i ' I r l IC 3830 Pilot Knob Road I Eagan MN 55122 Staff: ,6 Phone: (651)675-5675 I Fax: (651)675-5694 L buildinginspections@cityofeagan.com 2017 COMMERCIAL BUILDING PERMIT APPLICATION Date: 1/9/18 Site Address: 1501 Central Parkway, Eagan, MN Tenant Name: Eagan Community Center (Tenant is: New/ X Existing) Suite#: Former Tenant: City of Eagan Name: Phone: Property Owner3830 Pilot Knob Road Address/City/Zip: Applicant is: Owner Contractor Type of Work Description of work: interior remodeling 48 000.00 s Construction Cost: ' Market & Johnson, Inc. IR653559 Name: License#: Contractor Address: 7300 Hudson Blvd, Suite 165 City: Oakdale MN 55128 651-340-6146 State: Zip: Phone: Randy LaFaive rlafaive@market-johnson.com Contact: Email: Name: Wold Architects and Engineers 24281 • Registration#: 332 Minnesota Street, Suite W2000 St. Paul Architect/Engineer Address: City: MN 55101 651-227-7773 State: Zip: Phone: . Contact Person: Melissa Stein Email: mstein@woldae.com . �w.W ..�w ._... _ .., wm. Licensed plumber installing new sewer/water service: Phone#: NOTE:Plans and supporting documents that you submit areconsidered to be public information. Portions of the information may be classified as nonpublic 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.citvofeagan.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.000herstateonecall.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. 01" 109 x Randy LaFaive x (.2 Applicant's Printed Name Applicant's Signatur- Page 1 of 3 DO NOT WRITE BELOW THIS LINE /'7 76 /SUB TYPES Foundation Public Facility p Exterior Alteration-Ap — g. Commercial/Industrial Accessory Building _ Exterior Alteration-Commercial _ Apartments _ Greenhouse/Tent _ Exterior Alteration-Public Facility Miscellaneous Antennae WORK TYPES _ New @?e 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 4 4(8e)._,_/___>4(8e)._,_/___> Occupancy /4"3<-1.0 MCES System f/ Plan Review Code Edition 2v/S- AV- SAC Units Ce.,/,‘re- (25% Mer(25% 100% ✓) Zoning City Water t✓ Census Code Stories Booster Pump -- #of Units Square Feet PRV -- #of Buildings Length Fire Sprinklers ✓ Type of Construction e Width REQUIRED INSPECTIONS Footings—New Building_Deck_Addition Drain Tile Foundation Foundation Before Backfill Retaining Wall Vapor Barrier Erosion Control )j Framing 30 Minutes )X 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 2( Final/No C.O. Required Final CIO Inspection: Schedule Fire Marshal to be present: es No Reviewed By: j., , Planning New Business to Eagan: Reviewed By: , Building Inspector FEES Water Quality Base Fee L, 8"1"-1:11° Storm Sewer Trunk Surcharge I.. Sewer Trunk Plan Review ew. ,�,J t3 Water Trunk \, r MCES SAC Street Lateral City SAC I Street S&W Permit& Surcharge Water Lateral Treatment Plant Stormwater Performance Security Treatment Plant(Irrigation) i Landscape Security Park Dedication ,: / Other: 2l Trail Dedication TOTAL: Page 2 of 3 [VICES USt:Letter Reference: 18011062 Address ID:354254 Payment ID:408111 Date of Determination:01/10/18 Determination Expiration:01/10/20 / Greetings! Please see the determination below. Project Name: Eagan Community Center Project Address: 1501 Central Parkway Suite#/Campus: N/A City Name: Eagan Applicant: Randy Lafaive, Market&Johnson Inc. Special Notes: We have reviewed the SAC determination application for the above project and location and have concluded a determination will not be required. It is the Councils understanding that the scope of work for this toilet and sink demo will not be changing the use or size of chargeable spaces from those spaces previously reported to MCES on 02/2002. Therefore,a determination will not be required, nor will SAC be due. Net SAC: 0 —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: tory.mcculloughPmetc.state.mn.us. Thank you, Cory McCullough SAC Technician Please visit our SAC website by going to: http://www.metrocouncil.org/SACprogram 390 Robert Street North I St. Paul,MN 55101-1805 Phone 651.602 1000 I Fax 651.602.1550 I I I Y 651.2" 1 OtrO4 metrocouncil.orci METROPOLITAN COUN -. ,iVED FEBQ a 2018 S B 0 y r For Office Use I #% i ° * ® u � :::: #Fee: e„,,,„ ',0#.0 E AG A N 'Id 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: buildinciinspectionsta cityofeagan.com i 2018 FIRE SUPPRESSION SYSTEMS PERMIT APPLICATION Date: 1/11/18 Site Address: 1501 Central Parkway Tenant: City of Eagan Suite#: 0 Requirements: 2 complete sets of drawings and specifications, cut sheets on materials and components ��z e�� iii City of Eagan ' Ow , Name: Phone: pro ,nll �1 Address/City/Zip: 1, Applicant is: Owner X Contractor �Ot` Description of work: add 1 head and relocate 1 head 0 � ,,;.. Construction Cost: 2500 Estimated Completion Date: y Nasseff Mehcanical Name: License#: , re Address: 122 South Wabasha Street City: Paul Contra MN 55107 651-777 0001 �5 ' �. z State: Zip: Phone: 0 / ti o L N,„Z %` Contact' Steve Treptow Email: stevet@na ,eff.com _�, FIRE PERMIT TYPE WORK TYPE \',_ V Sprinkler System(#of heads 2) New _Addition Fire Pump Standpipe ✓ Alterations _Remodel Other: Other: DESCRIPTION OF WORK: V Commercial Residential Educational FEES $2500 Contract Value$ x.01 $60.00 Permit Fee Minimum 60.00 _$ • Permit Fee Surcharge=Contract Value x$0.0005 ...--- If .-”If the project valuation is over$1 million, please call for Surcharge / �_$ •03 1.�5 Surcharge $100.00 Residential New(includes State Surcharge) 1,a =$ TOTAL FEE 3/4"Fire Meter-$290.00 =$ Fire Meter _$ 60.03 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 acco dance with the approved plan in the case of work which requires a review and approval of plans. xSteve Treptow x 7' (? Applicant's Printed Name Applicant's Signature /17 • REQl11REEi(NSPCTt� °� i,/i/ i /� q� ��roSta I w Alarm iii ie�// Fa1EY i �/ y s �pF 3 i/r jib/ rr For Office Use i �$r Permit#: ./LigxeW # EAGAN Permit Fee: ,-- 6ici. 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: buildinginspections ancityofeagan.com L 2018 SEWER AND WATER CONNECTION AND AVAILABILITY CHARGES EXISTING COMMERCIAL PROPERTY �-2 5 1 e Date: � ; r 8 Property Owner: Ci 'F y ��a°'� y 'v Q -Pt $0 I Cam �4k1 t.'lCu--y Phone Number: d/2-2 52-0.S-2--r � Address: / o41l1tyfi*0 ` 4 Plumber: f 4 k° L,(1` i 7 c<.5,Iy.c, Contact Name. i2ya" �u"i\h-1-"4".\ ;41.1 SEV 1 v WATER .r Sewer Service Water Service Sewer lateral charge Water lateral charge Sewer trunk Water trunk City SAC @$114/unit Water supply storage MCES SAC @$2,485/unit Receipt#: , Date: Receipt#: , Date: Treatment Plant @$924.50/unit Permit Fee, including State Surcharge $65.00 Permit Fee, Including State Surcharge $65.00 TOTAL: *Plumbing Permit Required—water meter to be acquired with building permit TOTAL: • Sewer Service /Jbu� �� Water Service Sewer lateral charge 7// E J2 Water lateral charge `7 Sewer trunk Water trunk k C4111 City SAC MCES SAC Receipt# , Date Water supply&storage Receipt# , Date Treatment plant Permit Fee, including State Surcharge $129.00 *Plumbing Permit Required—water meter to be acquired with building permit TOTAL: Number of SAC units is determined by the Metropolitan Council Environmental Services (651) 602-1000. 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. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org Cc: City of Eagan Finance Department For Office Use , % i , Permit#:EAGAN Permit Fee: Date Received: a 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 RELIEVED (651)675-5675 I TDD:(651)454-8535 I FAX:(651)675-5694 Staff: 1g42-- buildinginspections(&citvofeagan.com L CO infl U ri` SUN ' u 2018 2018 L UILDING PERMIT APPLICATION Date: Site Address: J Unit#: Nam Jtk1 Gt 46OVl CL11 tG( G t�:l Pone:(.f5 1 31/37/5-9- VResident/ i 1254,d-1�IOG9 /d � l'Owrier Address/City/Zip Applicant is: .."\c" Owner Contractors ' rlil inn )'1 k6. 55.E 4.3 Description of work: `O ` � 1 GC ,CCU pe ,n d /2c f 7k a 4 Construction Cost: (UCS , ' r Multi-Famil Building:(Yes /No ) Company-..., f � � r Contact:. 976141 Contractor, Address: City: State: Zip: Phone: Email: License#: Lead Certificate#: If the project is exempt from lead certification, please explain why: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? Yes No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer&Water Contractor: Phone: Fire Suppression Contractor: Phone: NOTE:Plans and supporting documents that you submit are con eyed p e public inf tion Portions of the ;t ation may be classified as,non public if you provide specific reasons that wouldryi itte to l de thatf ey at trade se .. ,. ... 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.citvofeanan.com/subscribe. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. 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.cooherstateonecall.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 appr I of plans. `nr vV a(Oa rri4.0 x ce- ' Applicant's Printed Name Applicant's Signature DO NOT WRITE BELOW THIS LINE 1 ,(— / CE-1 l "(4-141(/. / ' 6 SUB TYPES Foundation _ Fireplace _ Porch(3-Season) _ Exterior Alteration (Single Family) Single Family Garage Porch(4-Season) _ Exterior Alteration (Multi) _ Multi _ Deck _ Porch(Screen/Gazebo/Pergola) _ Miscellaneous 01 of Plex Lower Level Pool Accessory Building WORK TYPES New _ Interior Improvement _ Siding — Demolish Building* Addition _ Move Building _ Reroof _ Demolish Interior Alteration _ Fire Repair _ Windows _ Demolish Foundation Replace Repair Egress Window _ Water Damage Retaining Wall *Demolition of entire building—give PCA handout to applicant — DESCRIPTION TE_YVT I2 44 r Valuation F!R It PEE Occupancy MCES System Plan Review /Net+ Code Edition SAC Units (25% 100% ) I.ve-L.'D Zoning City Water Census Code Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Suppression Required Type of Construction Width REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings (Deck) Final/C.O. Required Footings (Addition) V Final/No C.O. Required Foundation Foundation Before Backfill HVAC_Gas Service Test Gas Line Air Test Roof:_Ice &Water Final Pool: Footings Air/Gas Tests _Final Framing 30 Minutes 1 Hour Drain Tile Fireplace: Rough In Air Test _Final Siding: _Stucco Lath _Stone Lath _Brick_EFIS Insulation Windows Sheathing Retaining Wall: _Footings_Backfill_Final Sheetrock Radon Control Fire Walls Fire Suppression: _Rough In Final Braced Walls Erosion Control Shower Pan Other: Reviewed By: -eg411 ' , Building Inspector RESIDENTIAL FEES T' tAALN ' Base Fee /35 0-c' l 1/ 6 Surcharge /Na-b - Plan Review /NGL�O MCES SAC City SAC Utility Connection Charge S&W Permit&Surcharge Treatment Plant Copies TOTAL /3 S,a-c, Page 2 of 3 - fi211214Q „s ^' � For Office Use � m a °sa 111 (.9` :::::: VE AG A N : 47 ,..‘i , -CT '101 �a -49?- /g I T r . IV ED Date Received: 1 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 71� --r,<._� I (651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 Staff: I 7 I Plan Submittal: eolanscityofeagan.com MAY 0 2 2018 L 2018 COMMERCIAL BUILDING PERMIT APPLICATION C ,.)i Pte- 51014 5 ilior Ct Date: 5.,2, �1 Site Address: /.1(71 Ce-+4-I ci -i 4 C /J 557 2- -- Tenant Tenant Name: (Tenant is: New/ Existing) Suite#: Former Tenant: '7 OOD f f ; Name: 1. + 6,..... reel Phone: �� S Pry Address I City/Zip: 1%30 P Lr}- )40,0 b Al man Pvi SS12-2_ Applicant is: Owner Contractor 4k F, ' ...1.,,W.,,,,...,/,..t;'..,” r �,, . `r_ Description of work: Sp)A-5�'`p/rc� les// S c'f✓k t,"f'�4�- Construction Cost: 1-101) 0(20. c2T) Name: GVYNr'1CRe1 Ata_ G✓¢ 4-?•z,,P1 *641'1+5License#: Cot e,or` Address: SO? L;b-r+ci d..)sri✓`e /Of City: V 0/Vit ' (�oS' 333' 30('G �� State: IA)/ Zip: 5�5 �� Phone: `. Contact: 1 y 101 lit)e-45 1l Email: 4-6/ fd e Gr.S y rvG 4 toe-) :, Name: l•lbq- Registration#: Arc to t/Eng Address: City: State: Zip: Phone: Contact Person: Email: Licensed plumber installing new sewer/water service: if"64-69 I'`/t Ii+iGs Phone#: 74.03—(733-3&'Sl' !TE P andscrppor"ti mens i p '.su ` ar dib „ rr a o :4,w4 t " � r as ?art if ns that �' 1' 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.citvofeaoan.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. /� x ry/4- I14. ''e(c', x l,t I ‘1 Applicant's Printed Name Ap. cant's Signature ` DO NOT WRITE BELOW THIS LINE lqe9 c 6 SUB TYPES ��C/ CCP-t 1 Fnu Foundation X 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 feif 0®V Occupancy MCES System Plan Review t/ Code Edition Zo/S A8& SAC Units (25%_100% •/) Zoning — City Water ✓ Census Code Stories Booster Pump #of Units Square Feet 7c7 PRV ✓ #of Buildings Length Fire Sprinklers Type of Construction AM 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 I Electronic Set of Final Revised Plans Windows e Fireplace: Rough In Air Test Final V Final/C.O. Required Pool: Footings Air/Gas Tests Final Final Ito C.O. Required Final C/O Inspection: Schedule Fire Marshal to be present: Yes No Reviewed By: 1 , Planning New Business to Eagan: Reviewed By: _ , Building Inspector FEES Water Quality Base Fee "`' Storm Sewer Trunk Surcharge tit 20 4 °t` Sewer Trunk -- Plan Review '' Water Trunk MCES SAC Street Lateral City SAC Street S&W Permit&Surcharge i1fte, Water Lateral — Treatment Plant Stormwater Performance Security Treatment Plant(Irrigation) ` " Landscape Security Park Dedication Other: 2.041-11. Trail Dedication TOTAL: Page 2 of 3 MCES USE: Letter Reference: 180619B1 Address ID:354254 Payment ID:412401 Date of Determination: 06/19/18 Determination Expiration:06/19/20 Greetings! Please see the determination below. Project Name: City of Eagan-Splashpad Project Address: 1501 Central Parkway Suite U/Campus: N/A City Name: Eagan Applicant: Jeff Corniea, Commercial Recreation Specialists Special Notes: None Charge Calculation: Splash Pad: 150 gallons per minute x 3 minutes @ 274 gallons/SAC= 1.64 Total Charge: 1.64 Credit Calculation: N/A Total Credit: 0 Net SAC: 1.64 —or— 2 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.mn.us. Thank you, Toni Janzig SAC Technician Please visit our SAC website by going to: http://www.metrocouncil.org/SACprogram 390 Robert street North 1 St. Paul,MN 55101-1805 Phone 651.602:1000 1 Fax 651.602.1550 j TTY 651.291.0904 J otrocouncil.org MTROP� OIITAN o An Equal Opportunit,,Eavv yer For Office Use 11 cl1� e Permit#: e :. °oo0 Permit Fee: s+r,1 Staff: L J 3830 PILOT KNOB ROAD i EAGAN, MN 55122-1810 Payment Recvd: Yes _No (651)675-5675 TDD: (651)454-8535 I FAX: (651)675-5694 I I Email: buildinginspectionst cityofeagan.com I I Plan Submittal: eplans(c�cityofeagan.com L Plans: Electronic Paper 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: 5/31/18 Site Address: 1501 Central Parkwa Tenant: Central Park 1 J' Suite#: Property Owner Name: City of Eagan Phone: 651-675-5675 Name: Wenzel-Plymouth Plumbing License#: PM061555 Contractor Eagan Address: 1959 Shawnee Rd,#130 MN 55122 City: State: Zip: Phone: 651-319-4137 Email: cmichles@wppmn.com V New Replacement Repair Rebuild Modify Space Work in R.O.W. Type of Work — Description of work: COMMERCIAL ✓ New Construction Modify Space Irrigation System( yes/ no)( RPZ/_PVB) y"'/"Z • Rain sensors required on irrigation systems Permit Type • Avg.GPM (2"turbo required unless smaller size allowed by Public Works) V Meters Call(651)675-5646 to verity that tests passed prior to picking up meter. / " 6s./41. Domestic:Size&Type Fire: 1 Avg.GPM High demand devices? Yes No Flushometers Yes_No COMMERCIAL FEES ' ' 00 Contract Value$ , x.01 $60.00 Permit Fee Minimum U $60.00 PVB/RPZ Permit(includes State Surcharge) _$ Permit Fee =$ 7 Surcharge Surcharge=Contract Value x$0.0005 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 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.ns /n l'es/7/71-e0°Ig-C-•-' X �i$/r`'` /`ii�//!S�//i x i 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 Meter Related Items: Meter Size Radio Read Manometer Staff: Page 1 of 3 IzEAcEIV1D. ../g For Office Use JUN 26 2018 //• C / i Permit#: a € ______,LC�.T II(C( /' a � � , Permit Fee: I %. 'k .As o I %,,,,,,,,,,, � , E AG A N Staff: R�) I Payment Recvd: _Yes ✓ No I 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 I (651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 I I Plan Submittal: eplans(a cityofeagan.com LPlans:_Electronic Paper i J , 2018 COMMERCIAL BUILDING PERMIT APPLICATION c , -1 SC 726-,76,64../ Date: 6/25/18 site Address: 1501 Central Parkway, Eagan, MN 55122 fo: ,En. Tenant Name: City of Eagan Community Center (Tenant is: New/ ✓ Existing) Suite#: Former Tenant: 1.___ Name: City of Eagan Phone: 651 g iProperty Owner Address/City/zip: 3830 Pilot Knob Rd Applicant is: Owner ✓ Contractor Description of work: Staking Tents into ground - all tents will be staked Type of Work Zo'x 440 # r 1eEvhtiss P ' !I- Construction Cost: Apres Event Decor & Tent Rental Name: License#: I Contractor Address: 5801 Clearwater Dr city: Minnetonka MN 55343 952-942-3399 State: Zip: Phone: Contact Susan Byrne Email: sbyrne@apresparty.com Name: Registration#: Architect/Engineer Address. City: i State: Zip: Phone: I Contact Person: Email: 1 Licensed plumber installing new sewer/water service: Phone#: s 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.citvofeaoan.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 Digitally signed by Susan Byrne X Susan Byrne XSusa n 1 Byrne Date:2018.06.2513:21:25 -05'00' Applicant's Printed Name Applicant's Signature II uy..G %al ., DO NOT WRITE BELOW THIS LIN / ,5'6.) ?/2 SUB TYPES /50 it C64-//69-4 r46v' ` Foundation — Public Facility _ Exterior Alteratio -Apartments Commercial I Industrial Accessory Building Exterior Alteration-Commercial Apartments ✓ Greenhouse I 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 Fan. Occupancy {oi MCES System NAr Plan Review PICA-4) Code Edition Zeis til BC SAC Units (25%_100%_) Zoning City Water Census Code Stories Booster Pump #of Units Square Feet 800 PRV #of Buildings / Length of b Fire Sprinklers Type of Construction Width 20 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 1 Final/No C.O.Required Final C/O Inspection: Schedule Fire Marshal to be present: /Yes No Reviewed By: E. • , PlanningNew Business to Eagan: �� Y 9 Reviewed By: (!lOriL , Building Inspector FEES Water Quality Base Fee /35.°'° Storm Sewer Trunk i Surcharge /14144-6 Sewer Trunk e Plan Review INC L..0 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: Trail Dedication TOTAL: 4 /3 c. 0-' Page 2 of 3 For Office Use Permit#:% 1=/✓�3 '% • � • Penn it Fee: EAGAN Staff: _____; Payment Recvd: Yes No 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: eoIans a(�cityofeagan.com L 2018 COMMERCIAL BUILDING PERMIT APPLICATION 1501 Central Parkway, Eagan, MN 55122 Date: 6/25/18 site Address: Tenant Name: City of Eagan Community Center (Tenant is: New/ Existing) Suite#: Former Tenant: Name: City of Eagan Phone: 651 Property Owner Address/city/Zip: 3830 Pilot Knob Rd Applicant is: Owner 1 Contractor Type of Work Description of work: Staking Tents into ground - all tents will be staked Construction Cost: Name: Apres Event Decor & Tent Rental License#: Contractor Address: 5801 Clearwater Dr City: Minnetonka State: MN Zip: 55343 Phone: 952-942-3399 Contact: Susan Byrne Email: sbyrne@apresparty.com Name: Registration#: Architect/Engineer Address: City: State: Zip: Phone: Contact Person: Email: Licensed plumber installing new sewer/water service: Phone#: NOTE:Plans and supporting documents that you submit are considered to be public information. Portions of the information maybe 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(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. Digitally signed by Susan Byrne X Susan Byrne xSusan Byrne ate: 2018. 06.2513:21:25 Applicant's Printed Name Applicant's Signature - DO NOT WRITE BELOW THIS LINE /, /��0 SUB TYPES /S© f 0.071'[W ( Pki Foundation _ Public Facility _ Exterior Alteration-- artments — 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 FIMD F.£j Occupancy tit MCES System NV& Plan Review - - Code Edition 1 15 MBC/ SAC Units (25% 100%_) — Zoning City Water Census Code Stories Booster PumpIr #of Units Square Feet PRV #of Buildings ((o)TICS t'iA-c t• Length Fire Sprinklers Type of Construction si • 8 Width REQUIRED INSPECTIONS Footings_New Building_Deck Addition Drain Tile Foundation Foundation Before Backfill Retaining Wall Vapor Barrier Erosion Control Framing 30 Minutes 1 Hour Steel Reinforcement Insulation 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: Schedule Fire Marshal to be present: /Yes No Reviewed By: , Planning New Business to Eagan: Reviewed By: , Building Inspector FEES Water Quality Base Fee Storm Sewer Trunk Surcharge Sewer Trunk Plan Review 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: Trail Dedication TOTAL: Page 2 of 3 0 For Office Use Permit#: /57. 3D2 13CCr- ,, t ,i ::tFee ,/ dd►EIVE Payment Recvd: Yes No 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651)675-5675 I TDD:(651)454-8535 I FAX:(651)675-569 JUN 0 4 2019 I Plans: Electronic Paper Plan Submittal: eplans(&citvofeacian.com L BY: 2019 COMMERCIAL BUILDI IT APPLICATION (pai Date: tp/4/0Site Address: ��j., ililiCkj af it-Wati Eatt-r)6. -ez Tenant Name: �.r7 -4,14- - V (Tenant is: New/ )Existing) Suite#: Former Tenant: a f [ Name: i l' e99T C '[ �.o' Ir Phone: Property Owner 113.:(:) / Address/City/Zip. 771r21-164-/-11-Det'y Applicant is: Owner x Contractor L4PreS Type of Work Description of wor Z.A'� ---Liii frj_J Construction Cost: �- Name:- PCRS ? * �' uat License#: Contractor Address: / •City: �,k)1 Le' 5 a- /.�z _ 317 State: Zip:�,� �� Phone"':' Contact ME2� •-�./k Email:y6(G(tRDglare 6ili - Name: >f"0 ' �-�-�'` V Registration#: 1 Architect/Engineer Address: -1 & � O Og City: � a-4( _ 1 r 7 State: ' Y l Zip: 1 ..5�,�•( Phone: ��,1 - J 3 115 Contact Pers • a raw) Email:(red,Dr a-f-I l (015, 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 maybe;; 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.citvofeagan.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.000herstateonecall.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 lans. 4,440 U � _ 4%Xlanci-- Eo r may' x Applicant's Printed Name Applicant's Signature DO NOT WRITE BELOW THIS LINE SUB TYPES _ Foundation _ Public Facility — Exterior Alteration-Apartments — Commercial/Industrial Accessory Building — Exterior Alteration-Commercial _ Apartments s/ Greenhouse/Tent — Exterior Alteration-Public Facility _ Miscellaneous _ Antennae WORK TYPES VNew — 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 F ixtv fv Occupancy V, MCES System NA- Plan Review 1 iJ CCP Code Edition SAC Units (25%_100% ) 114 GL-$ Zoning City Water Census Code Stories Booster Pump #of Units (3)TENT6 Square Feet 860 pet,M^'- PRV #of Buildings Length Fire Sprinklers Type of Construction 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 C/O Inspection: Schedule Fire Marshal to be present: ✓Yes No J Reviewed By: Ctit-!G S • /V' , Planning New Business to Eagan: b Reviewed By: �i4J?G "/, , Building Inspector FEES Water Quality Base Fee /3 S•b'O Storm Sewer Trunk Surcharge 1NGLD Sewer Trunk Plan Review /NGt%D 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: Trail Dedication TOTAL: /3 5--€5t) Page 2 of 3 1 For Office Use E AG A NPermit#: /- ----7e- 'e(----- 1 ........ ., .., Permit Fee: /gs -op _ I Staff: I 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 tiEC IM E j Payment Recvd: Yes No I I (651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-569r I Plan Submittal:eplanscityofeaqan.com �P i 1 21319 L Plans: Electronic Paper J 2019 COMMERCIAL BUii, 5 ' - ' T APPLICATION Date: 8/26/19 Site Address: 1501 Central Parkway Tenant Name: Thomson Reuters I Jacque Churchill // 65/ (Tenant is: New/ Existing) Suite#: Ji-cit. c4, i.6 l^ �4 -sem 7 '7 ( Former Tenant: 77101,410,1 ,C . Name: City of Eagan Phone: 651-675-5550 Property Owner Address/city/zip: 1501 Central Parkway Applicant is: Owner Contractor Type of Work Description of work: Placement of one 60'X80' tent Construction Cost: $5,000 Name: Ultimate Events License#: Contractor Address: 13405 15th Ave N City: Plymouth State: MN Zip: 55441 Phone: 763-559-8368 Contact: Gina Vincent Email: 6vincent@ue-mn.com Name: Registration#: Architect/Engtheelr Address: City: State: Zip: Phone: Contact Person: Email: Licensed plumber installing new sewer/water service: Phone#: NOTE:Plans and supporting documents that you submit are considered to be public information. Portions of the information maybe classified as nonpublic 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.citvofeaqan.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. / is.Fir, 1 XJAWIA-e- V I Y v dI --y x Applicant's Printed Name Ap,, ant! Signature w • DO NOT WRITE BELOW THIS LINE /- 7 S SUB TYPES / ( C -)..t, 4 ( 1Q4/wq Foundation — Public Facility _ Exterior Alteration-apartments Commercial/Industrial _ Accessory Building Exterior Alteration-Commercial Apartments Greenhouse/Tent _ Exterior Alteration-Public Facility Miscellaneous Antennae — W9RK TYPES b/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 rr ,, Valuation f tltt t f - Occupancy vl MCES System NA Plan Review — Code Edition 26(S- MPSC SAC Units (25% 100% ) Zoning FT City Water Census Code Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Sprinklers 1 Type of Construction I.6 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 V Final/No C.O.Required Final C/O Inspection: Schedule Fire Marshal to be present: i/Yes No Reviewed By: �---. , Planning New Business to Eagan: tsi b Reviewed By: G 4,(o , Building Inspector FEES Water Quality Base Fee 13C.a-o Storm Sewer Trunk Surcharge I Ne-LI) Sewer Trunk Plan Review t N tL b 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: Trail Dedication TOTAL: `t 13 5(..Al"-‘ . 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