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3904 Cedarvale Dr L6+ I 3 8 lock. t Cop A-t) a- C~Q V 1/ 444444~OMMERCIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5694 J C) C • Structural Plans (2) sets Architectural Plans (2) sets • Architectural Plans (2) sets • Civil Plans (2) • Structural Plans (2) • Code Analysis (1) " • Certificate of Survey (1) • Civil Plans (2) • Project Specs (1) • Code Analysis (1) " • Landscaping Plans (2) • Key Plan (1) • Project Specs (1) • Code Analysis (1) " • Master Exit Plan (1) • Spec. Insp. & Testing Schedule " • Certificate of Survey (1) • Energy Calculations (1) not always" • Soils Report (1) • Spec. Insp. & Testing Schedule (1) • Elec. Power & Lighting Form (1) not always- • Meter size must be established • Meter size must be established • Meter size must be established-if applicable 1 • Project Specs (1) L • Energy Calculations (1) l • Electric Power & Lighting Form (1) 1 • Master Exit Plan (1) l l • Emergency Response Site Plan (1) 1 • Solis Report (1) L • SAC determination -call 651.602-1000 • SAC determination - call 651.602.1000 SAC determination -call 651-602-1000 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 when it states "not always". Permit for new building or addition will not be processed without Emergency Response Site Plan. Date / / 03 Construction Cost 3( o-99 SiteAddress 3901/ (~Jq/Q144:! J; bA Unit/Ste # Tenant Name 141{'IE2 /G A-n/ f{GG75 f Former Tenant Name D 15D AS Description of Work - U of BV(ZbJ 5 3 G Property Owner A4 E 2 ( CArJ 4C-e-75 f iI )V1So LS Telephone #(6,5-1) Contractor 401.4-414 GuT { i~NS tRU~T onl 1 (~Joo we/2t~ NR IwJc- Address t(o y 7je 2G tLJ!~ T]2 City M4,PLE+22 fao 6 State M 2 Zip '7 f Telephone # (6 SI 23o -IK x O Arch/Engr F ~ Registration # Address 1 2 2004 City State Zip Telephone # ( ) JR~ 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 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. Kc-~T lC . Tsy= ~2~ t a~nr- r- Applicant's Printed Name' Applicant's Si gplqe l OFFICE USE ONLY Sub Types ❑ 01 Foundation ❑ 26 Public Facility ❑ 30 Accessory Building ❑ 14 Apartments ❑ 27 Commercial/Industrial ❑ 32 Ext Alt-Apartments ❑ 15 Lodging ❑ 28 Greenhouse ❑ 34 Ext Alt-Commercial ❑ 25 Miscellaneous ❑ 29 Antennae ❑ 35 Ext Alt-Public Facility ❑ 37 Nail Salon Work Types ❑ 31 New ❑ 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 2,000 m F Occupancy MCES System Census Code 37 Zoning L' City Water SAC Units ` G Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const V ' Width Required Inspections Footings (new bldg) _ Insulation Footings (deck) 0 FT4 CFVE-E STAwc,IN Final/C.O. Footings (addition) / V_,*~Final/NO C.O. Foundation _ Other _ Drain Tile Roof _ Ice Pr _ Decking - Insul _ Final - Pool _ Ftgs _ Air/Gas Tests -Final Framing - Siding _ Stucco - Stone Fireplace _ R.I. -Air Test -Final - Windows Approved By: Planning Building Inspector - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Base Fee O Surcharge 1.6 J Plan Review MCES SAC City SAC Water Supply & Storage (WAC) S/W Permit S/W Surcharge Treatment Plant Park Dedication Trails Dedication Water Quality Copies Water Trunk Sewer Trunk Other Total 70 ,6 v j u v~ ptk `j/ v ~y CtM1A4~' i dC r------ -----i 'For Office Use D 75- I City of EaV~ , Permit _ I I I Permit Fee: ©r I 3830 Pilot Knob Road Eagan MN 55122 i Date Received: Phone: (651) 675-5675 I I Fax: (651) 675-5694 I Staff: , 2009 SEWER AND WATER REPAIR / DISCONNECT PERMIT Date: 9- / 7 + 0 / Fee: $50.50 City Sewer City Water Repair Disconnect Description Of Work: 1 S( e c cG C t ~Gw ~I r Street Address for Proposed Work / o - 1 Ledftal±~ C, i- I OWNER Name: 1)6 6(?A Phone: Address / City / Zip: Applicant is: Owner Contractor Licensed Pipelayer* Master Plumber Property Owner Name: 11~ In U ! ~:CI~L lil f t~1 5~'2 Phone: Z,112 - v 7-0 -7 -(v6 Address/ City /Zip: Pipelayer Training Certification Card 7 or Master Plumber License I acknowledge that the information is complete and accurate and that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes. I understand this is not a permit, but only an application for a permit, and work is not to start without a permit. ~a r Applicant (Print Name) Applicant's Signature For Office Use ! ! f t Permit* ® - f qty of Eap ! ~ ! I Permit Fee: ® ! ! 3830 Pilot Knob Road I I Eagan MN 55122 Date Received: ! Phone: (651) 675-5675 ! Fax: (661) 676-6694 i Staff: f 2009 COMMERCIAL BUILDING PERMIT APPLICATION Date: site Addr,: 3 9o y C ea cirvo /e Dr;Ve Tenant Name: (Tenant is: New Existing) Suite Former Tenant: PROPERTY OWNER Name: dako fer Coon 't7 6D4 Phone: 651 ' 6 75- q YS 7 Address/City /Zip:. i22 t Town 6e4 re Dr;vt? Applicant is: Owner Contractor TYPE OF WORK Description of work: Q V i ~d~ 9 D em o h'J i o n Construction Cost CONTRACTOR Name: V1;e ken A ya-re r E Xea Vdf- 5@9 -1"1 License* Address. 136540 County Ra4d Z/ / city: C-0/0411"t State: HN zip: 55.E 2 Z Phone: q6' 2 - X tf- 2 23) contact person: Do n ARCHITECT / Name: Me. hSSa 7410horn Registration ENGINEER Address: City: State: Zip: Phone: Contact Person: Licensed plumber installing new sewed/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 speck reasons that would permit the City to conclude that the are trade secrets. I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and odes 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 Don w;ekenHavser x t,(7a►y►• !21/.~~.hOm~auar Applicanre Printed Name Applicant's Signature Page 1 of 3