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3343 Coachman RdCONIMERCIAL ''4? „ . BDING PERMIT APPLICATION CITY OF EAGAN 651-681-4675 Foundation Onl New Construction Interior Im rovement • Swctural Plans (2) sets • Architectural Plans (2) sets • Architectural Plans (2) seb • Civil Plans (2) . StrucWrel Plans (2) • Code Analysis (1) •' • Certificate ot Survey (1) . Civil Plans (2) • Project Specs (1) • Code Anaiysis (1) •' . Landswping Plans (2) • Key Plan (1) . Project Specs (1) • Code Analysis (1) " • Master Exit Plan (1) • Spec. Insp. & Tesfing Schedule " • Certificate of Survey (t) • Energy Calculations (1) not always" • Soils Report (t) . Spec. Insp. & Testlng Schedule (1) • Elec. Power 8 Lighfing Porm (1) not ahvays•• • Meter size must be esWblished • Meter size must be established • Meter size musl be established - if applicable • ProjectSpecs (1) 1 • Energy Calculations (1) " d ! • Electric Power & Lightlng Form (1) 1 • Master Exit Plan (1) 1 1 . Fire Protection Plan (1)" 1 1 • Soils Report (1) 1 • MGES SAC determination letter . MGES SAC determination letter • MGE5 SAC detarmination letter call 651-602-1000 call 651-602-1000 cail 651-602-1000 Contact Building Inspections for sample Food & beverage or lodging facilities: Plan must be submitted to Minnesota Department of Health - call 651-215-0700 for details. DATE 4G ??O iy WORK TYPE _ NEW JC REMODEL CONSTRUCTION COST // 70 0 i GG SITE ADDRESS TENANT NAME FORMER TENANT NAME SUITE # DESCRIPTION OF WORK -t/Cv ,// Name: ? Jr?l 1%5 ??! Phone#: PROPERTY Last First OWNER ? SueetAddress es-J City (? ? State Zip 7??N'/ comPany CONTRACTOR SheetAddress: cnn:- City State A---? Zip ? 3 Q .?' ARCHITECT/ ENGINEER Company Phone # Name Sheet Address City State Licensed plumber Instaliina new sewer/water service: Phone #: I hereby acknowledge that I have read this application, state that the information Minnesota Statutes and City of Eagan Ordinances. Zip correct, and agree to comply with all applicable State of ? Signature of Applicant ?^ rUpdated 1/01 Registration # May 02 06 01:18p PORT R WELDInG InC. 763-428-7654 ? 31 ?14 2oo6 COMMERCIAL BUILDING rERmrr nrrLicnTIox City Of Eagan 3830 Pilot ICnob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-6755694 . SGUCtural Plaf7s (2) aete . Civll Plans (2) . CertificateofSurvey (7) . CodeAnalysis (1) . Projed Specs (1) . Spec. Insp. & Tesdng Schedule " . SoflsReport (1) • Meter Slze must be eetebOShed . SACdetermination-pllR7-602-1000 . Architectural Plarre (2) sets . Stnrotural Pians (2) . Civil Plans (2) . Landscaping Plana (2) . Code Analysls (1) ° . CeAlficate of Survey (1) . Spec. ImQ. & Testing SchedWe (1) " • Mete! Slze must be estebllahed . Projed5pecs (t) . Energy Calalations (1) " . Electric Power & Lightlnp Form (1) " . Master ExN Plan (1) • EmerAency Reaponse Site Plan (1) . SoilsReport (1) . SAC determinatlon - ca0 651-602-7000 • Fire Stopping Suhmilfals p.4 or-0 . Arcnneuurai ndm . CodeAnalysls (1) •• . Projed Specs (1) . Key Plan (?) . Master Ecit Plan (7) . Energy Cakulalkons (1) iwt eAvays" . Elec. Power 8 Light'mg Fortn (1) rwt aM2ys" • Meter siae must be eateblisM1ed-If applicable ) ? 1 1 1 . SAC delerinination = ea116511'i02-7000 Call MN Dept of Health at 651-21 SD700 for details regarding foad & beverage or ioa6mg tacmncs. , ?• Contact Huilding inspcctions for sample and if requircd MAY z ?•• Pemut for new 6uil(ling or addition witl not be prceessrd without Emagency Response Sito Plan. Date / 00 G?L p,id 2 ConstnictionCost? Z?ooU nr, SiteAddress 3 5 'f Co L?rrn.ri ?r,_2-nr hn ? CCJ.? 1 UnitlSie # -" Tenant Name f Former Tenwt Name i 4LLAvrl rix?k tion of Work ? Descri i13o e)nr ?4o me-of cmd. On W2ek v±n p P Vy R. LI hf Telephone #({IS 1 ) 777- 4 c' < i( t r{'F p t d kt Property Owner f e e e aU ' 11 Applicautis: Owner X Coatractor comacm cb3 ) 4as3 Tn Coetractor 71 O r} 1? W &A'+c. C ? neauees 4-7 00 D-ezrLtronil ta- crtY -YYlinnZ4i. _ State IY1 0.l Z+p 6 534-3 Telephone#(743) Ca$-"1 S3 m ArchlEngr Regjatratiou # Address City State Zip Telep6one#( ) Licerued dumber installing 9=sewerlwater service: Phone#: I herebv aoulv for a Commexcial Building Pernrit and acknowledge tha[ the infortnation is oomplete and accurate; tlmt the woiic will be in cortformance wtith the ordinances and cades of the City of Eagan aad the 5tate or 1vuN Z!itam[es; i unaeisrana uus m wc a W,.Rus Vu. V y o.. application for a pemeit, and wock is not to sfatt without a pemut, that the wodc will be m acco:danre with the appmved plan in the case of work which requires a teview and approval of plans. tYe?tti,?- G I Y?D CJaL?? Yl . 1l _ PYLS. / ?'rd? \' Ce Appli ant's Printed Name,p _we?d Zn?, lican Signa _1t} _Wp,??if, ?}?, Q DO NOT WRITE BEI.OW THIS LINE ?J '? I c? ? Sub Types p 01 Foundation ? 26 Public Facility ? 30 Accessory Building ? 14 Apazhnents 0 27 CommerciaUlndustrial ;,0' 32 Ext Alt Apartments El 15 Lodging 0 28 Greenhouse ? 34 Ext Alt-Commercial G` 25 Miscellaneous n 29 Antennae 0 35 Ext Alt-Public Facility ? 37 Nail Salon Work Types O 31 New ? 35 Int Improvement O 38 Demolish (Interior) ? 44 Siding O 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair O 33 Alteration ? 37 Demolish (Bldg)• ? 43 Reroof ? 48 Windows/Doors V 34 Replacement "Demolition (Entire Bldg only) - Give PCA handout to applieaM Valuatlon 000 Type of Const ViAdth Plan Rev 100%- 25% ? Occupancy 07 MCES System t Cit W SAC UnRS Zoning a er y N6r. of Unils Stories - Booster Pump ? Nbr. of Bldgs Sq. Ft. ? - PRV Length ? Fire Sprinklered ? Required Inspections _ Fooflngs (new bldg) _ FooGngs(deck) _ Footings (addition) Foundation Drain Tile _ Driveway Apron ? Roof _ Ice Pr _ Decking _ Insul _ Final .% Framing Siding _ Stucco Lath _ Stone Lath _ Final Windows Final C/O Inspection: Schedule Fire Marshal to be present. _ Yes _'---No Approved By: Planning rhl- Building Inspector Base Fee Surcharge Plan Review SAGMCES SAGGty SAN Pertnit SNY Surcharge Treatment Plant Treatment Plant (irrigation) Park DedicaGon Trail Dedication Water Quality Water Supply 8 Stwage (WAC) ^ Fireplace _ R.I. _ Air Test _ Fina] Insulation Sheeunck FinaUC.O. ? FinaUNo C.O. Other Pool Ftgs _ Air/Gas Tests Final Financfal Guarantee Sfortn Sewer Trunk Sewer Lateral Street Water Lateral Othar Total 8awer Trunk Water Trunk ?&-007 2U06 COMMERCIAL PLUMBING PERMIT APPLICATLON CTfY OF EAGAN 3830 PILOT K1YOB ROAD, EAGAN MN 55122 651-675-5675 '5D,S-b Datc-fl._1ac) / b(O Site Addnss ' Q G Unit # Tenant Name ? Former Tenant Name Properh Owoer 'I/)x 1 ? < 1Q CJb(fS Telephone#(?JI Contractor lc/L Address p City State Zip °JSH 13 TelephooeN((o5? (fi License # Eapires: -n Q(J The Applicant is _ Owner Coniractor _ C)thet Work'Iype NewBldg _ ModifySpace _IrrigatianSystem"• Yes No Wotkinpu6licr-o-w/easement? I RPZ _ PVB : ?_ New _ RepairlRebuild _ Replace _ Remave T Rain scnsors are reuired on ir ' ation s stems Description of Work n{iw U2-1-ke'f' To'ntquiw d' Pcessure Redacmg Vah-e is roquireJ on ncw service, call 651b75-5646 Me[crs - Cat1651-6755300 to verify tiwt hydrostatiq wndmtivity, and bacteria usts pnssed ?rior to nicitina uo meter. Imgntion Size; & Type Avg GPM 2" hvbo req'd unless smallec size allowed by Public VNoiks Fire Size Br.Rice 3/4" metcr I67.00 Domestic Size 8c Type Avg GPM includes high demaud devices? _ Yes _ No Flushometers _ Yes _ Nu PRV Required _ Yes _ No Permit Fee $50.50 murinnmi [mdudes Sate Surcharge) ContracfValue $ 1% _ $ PermitFee $ Meter(s) RequiicJ un all new buildings & buulevan l imp.ation nvslems $ Radio Mete7 Aeatl $ 3tafe Sueciiage ltpennit fee is kss lhau SI.000, wrcharge is $.50 If prnoit fee is mure fhan $1,000, surcharge it $50 Tor each SI,990 owal. Fdlowing fees aPPlY whm inshifing nrew lawn irrigadon syshm ? r--, J- a[er Permit Call We CitJs Nnginea'vng Departmen4 651 fi75-5646, fur required fx amounta n i n?,?2 4PON_ reatment Plant $ Wa[er Supply & Stornge $ State Surcharge $ TotalFee 7 haeby apply FM a Commescial Plumbing I'amit and admuwledge tlut IMe infpmatmm is complete and accurate; [ha[ the wwk will be m contwman?w ?W tbe md' a•s aod cadcs of the City of Esgan ard with d?e Plumbmg Cadea; tl?at I wdentand tl? is a p?aniiS but only m 1' Sor a pami[, w L not b s ithout a pxmi[; fhat ?he wq(Ic will6e in nlanee with tlw approved plan ?n the caae nEm hich requires a rev al of plnns. ? W r" Appicant PrintedNa[ne jphc 's ignmure ? I O` t O 1 2007 COMMERCIAL BUILDING PERNIlT APPLICATION 42 ? City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone#651-675-5675 Plans are considered public information unless you state they are trade secret and why. • acrucmrai rians in secs i- . Civil Plans (2) • Certifcate of Survey (1) • CodeAnalysis (i) . ProjectSpecs (1) . Spec Insp & Testing Schedule (1) "" • Soils Report (1) . Meter size must be established 1 1 1 1 1 1 • SAC determination - call 651-602-7000 at • Certificate of Survey (1) • Structural Plans (2) • ArchRectural Plans (2) sets r HVAC units req'd. on bldg elev. / sde plan ? Civil Plans (2) Landscaping Plans (2) • CodeAnalysis (i) ° • EnergyCalculaGons (7) " • Emergency Response Sde Plan (9) • Spec.lnsp.&Testing5chedule (1)" • EI ctric Power & Liqhting Form ? " (1) • Pr jectSpecs (1) • Master Exit Plan (1) . SAC determination - call 651-602-1 000 • Fire Stopping Submittals . Fve Suppression/Alarm Form or • Architectural Plans (2) sets . CodeAnalysis (1) " • ProjectSpecs (t) . Key Plan (1) • Master Exit Pian (1) • EnergyCalculations (1)notalways" • Elec. Power & Lighting Fortn (1) not always"' • Meter size must be established-if applicable . SAC determination • call 651-602•1000 Con[act Buifding Inspections to see if it is required and for a sample *** Permit for new building or addition will not be processed wi[hout Emergency Response Site Plan. Date __1_! _?3 L / V7 Construction Cost e)ov ' D o Site Address UniUSte # Tenan[ Name Former Ten ant Name Description of Work &v>Uz°, -Sll`a l/L4-°I? 4Z) ?Aa S PzD± . U Property Owner r/" l12p- Telephone ti Applicaut is: _ Qwner _ C tractor Contact J ? / Contractor iZ c'T' Address City ZAJp Y? l/nl7 State r KA1 Zip Telephone #(??b ArchBngr 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 Ciry 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 [o 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. r_? ??U qge?? _ "? Applicant's Print?d e Applic Ys gna DO NOT WRITE BELOW THIS L1NE Sub Types ? 01 Foundation ? 14 Apartments ? 15 Lodging ,0' 25 Miscellaneous jpl?r? Work Types ? 31 New 0 32 Addition ? 33 Alteration ? 34 Replacement ? 26 Public Facility ? 27 Commercialllndustrial ? 28 Greenhouse ? 29 Antennae ? 35 Int Improvement ? 38 ? 36 Move Bldg. ? 42 ? 37 Demolish (Bldg)* ? 43 •Demolition Building - Give PCA handValuation 4)U6.0V Plan Rev 100°/a 25% SAC Units Nbr. of Units Nbr. of Bldgs Fire Sprinklered Required Inspections Footings (new bldg) ? Footings (deck) _ Footings (addition) _ Foundation _ Drain Tile _ Driveway Apron _ Roof _ Ice Pr _ Decking _ Framing ? 30 ? 32 D 34 ? 35 ? 37 Demolish (Interior) Demolish (FOUnda1 Reroof )ut to applicaM Accessory Building Ext Alt-Aparpnents Ext Alt-Commercial Ext Alt-Public Facility Nail Salon ? 44 Siding ion) ? 45 Fire Repair ? 46 Windows/Doors Type of Const Width Occupancy 1 MCES System Zoning p ?I City Water Stories Booster Pump Sq Ft. PRV Length Code Edition ^ Fireplace _ R.I. _ Air Test _ Final Insulation ' ? Sheetrock FinallC.O. Y FinaUNo C.O. Other Insul _ Final _ Pool Ftgs Air/Gas Tesu Final _ Siding _ Stucco Lath _ Stone Lath _ Final Windows Final C/O Inspection: Schedule Fire Marshal to be present. _ Yes _ No Approved By: Planning ?OL Building Inspector Base Fee Surcharge Plan Review SAGMCES SAGCity SIW Permit SIW Surcharge Treatrnent Plant Treatrnent Plant (Irrigation) Park Dedication Trail Dedica6on Water Quaiity Water Supply $ Storage (WAC) Financial Guarantee Starm Sewer Trunk Sewer Lateral Street Water Lateral Other Total Sewer Trunk Water Trunk a3 ia * City of ?apfl Date: Tenant: Suite #: PROPERTY Name: Q 1r1 d 4. (..?) Q..?Q-s Phone: 65I- 4`54"' 5-765 OWNER CONTRACTOR Name: (L 1 I lai-L Y06 License #: 0I708ItI^ PM- JaU 698 5"J10't" mlv Zi S Address City: iJl -- p: tate Phone: WJI- oGQ? " 0 lo24Contact Person: I?im CY Ie l la-?. TYPE OF New Repl cement Re air aRebuild Modify Space _ Work in R.O.W. - ? WORK 1 -pZ Q hLl ? ' ? Description of work: l T Y 1 PERMITTYPE COMMERC/AL _ New Constructlon _ Modify Space _ Irrigation System (_ yes 1_ no) (_ RPZ PVB) 0 Rain sensors required on irrigation systems . Avg. GPM _(2" tur6o required unless smaller size allowed 6y Public Works) Meters Call (651) 675-5646 to verity that tests passed prior to oickina up meter Domestic: Size & Type Fire: Size & Price 3/4" meter 183.00 Avg. GPM High demand devices? _Yes No Flushometers _Ves No COMMERC/AL FEES: $50.50 Minimum (includes State Surcharge) OR Contracf VaWe $ x 1% Permit Fee Required on ALL new buildings and boulevard irrigation systems 4 _$ Radio Me[er Read - If Permit Fee is less than $1,000, surcharge is $.50 =$ Meter(s) - If Permit Fee i5 >$1,OOQ Sumharge increases Gy $.50 fOr each $1,000 $1,000 Permit Pee (i.e. a$1,001-$2,000 Permit Fee reqmres a$1.00 surcharge) _$ State Surcharge Following fees apply when installing a new lawn irrigation system. $ Water Permit Call the Ciry's Engineering Department, (651) 675-5646, tor required fee amounis. $ Treatment Plant $ Water Supply & Storage $ State Sumharge TOTAL FEES $ ,----. ------------, I Permit#. I ? j Permit Fee: I ? ? Date Received:r, ? ra n rn rP i- l I . , i Staff: _ 2008 COMMERCIAL PLU?MBWG PERMIT APPLICA Site Address: S3 ?I'? l.tJ(.lL? tMQ11/Yld• I hereby acknowledge ihat [his information is comple[e and accurate; that ihe work will be in coniormance wltn ine ominances ano coaes oi me cny a cagan; mac I understand this is not a perrnit, but onry an applica[ion tor a permit, and work is not to start wrthout a '; hat [he wurk will be in accomance with the approved plan m t e case of work whi requires a review and approval of plans ?K-- X? M? L?i ? ?k aa X l?. ApplicanYs Printed Name Applicant's Signature EAGAN TOWNSHIP 3795 Pilot Knob Road St. Paul, Minnesota 55111 Telephone 454-5242 PERMIT FOR WATER SERVICE CONNECTION Date: June 14, 1971 Number: 641 n 55121 Billing Name:Fcn-ride>e Apartnr nt8 #1 Site Address: ,1.1 Owner: nare. Billing Address Plumber: iergborat Plumbing Heating Location of Connection Meter Size Connection Chg. 20704;17 Meter No. 'oY '} Permit Fee inn n_i Meter Reading_ Meter Dep. Meter Sealed: Yes_ Add'l Chg. NO Total Chg. Inspected by +1idea/r Building is a: Date Remarks: Residence Multiple xx No. Units74 Commercial Industrial Other $25.00 RE -INSPECTION FEE FOR IMPROPERLY INSTALLED METERS. By: Chief Inspector In consideration of the issue and delivery to me of the above permit, I hereby agree to do the proposed work in accordance with the rules and regulations of Eagan Township, Dakota County, Minnesota. BY: 1 lu.al: Please notify the above office when ready for inspection and connection. EAGAN TOWNSHIP 3795 Pilot Knob Road St. Paul, Minnesota 55111 Telephone 454-5242 PERMIT FOR SEWER SERVICE CONNECTION DATE• Lm14 l.9 NUMBER 74,3 OWNER: e Ant 11 t Address "+qtr,,: PLUMBER berrlurat P1uuLIng Heatic'tTYPB OF PIPE Cac DESCRIPTION OF BUILDING Industrial No. of units Location of Connections. Connection Charge Permit Fee tq Street Repairs Total Inspected by: Remarks; Chief Inspector In consideration of the issue and delivery hereby agree to do the proposed work in acco rdance ce wiof th above the rules and regulations of Eagan permit, I g n Township, Dakota County, Minnesota }i.t1L'i Coon Lupido, Ninn se en flt work coowaredddy for inspection and connection and before any portion City of Etall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use Permit #: i l 61 (070 /9� OJ Permit Fee: �N Date Received: 1,)/10/- /1 3 Staff: UGI, 2013 COMMERCIAL PLUMBING PERMIT APPLICATION ❑ Please submit two (2) sets of plans with all commercial applications. Date: /Z- /3 Site Address: (13 5/2 Ca Aa,xi.a N AV) • Tenant: / x ',OGi/9f%9g/4tC.4Z Suite #: :`P,roperty <, ; wner Fox Ridge Estates Limited Partnership 1 Name: phone: 651-454-5765 Contractor ' : ,, Name: JCA% /�Lgdd6 License #: "At (:)41,5-5 Address: /9,59 Sh .11vCe XD City: £e6,49,-' State:/'ai Zip: .56 %ZZ Phone: 651-:..3/ 9 ` 5'i.37 Email: CA -t i C 4 e/S44-)14)61.M( • ecA-%- Type of;.Work New _ Replacement Repair X , Rebuild Modify Space _ Work in R.O.W. Description of work: = 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 uo meter. Domestic: Size & Type Fire: 1 Avg. GPM High demand devices? _Yes _ No Flushometers Yes _No COMMERCIAL FEES $55.00 Permit Fee Contract Value $ x .01 Minimum'"``' r.-.$ Jr✓� • Permit Fee *If contract value is **If contract value is ***If the project valuation LESS than $10,010, Surcharge = $5.00 = $ 6 �o • Surcharge* GREATER than $10,010, Surcharge = Contract Value x $0.0005 = $ TOTAL FEE is over $1 million, please call for Surcharge Following fees apply Contact the City's Engineering when installing a new lawn Irrigation system $ Water Permit Department, (651) 675-5646, for required fee amounts. $ Treatment Plant $ Water Supply & Storage $ 649 • 44?State Surcharge $ TOTAL FEE CALL BEFORE YQU 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.aooherstateonecall.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 �VV# A"irah P.�1 Applicant's Printed Name R OFFJCE USE' k is Y�;l M Required lnspec(ioiu x Applicant's Signature Page 1 of 3 ay City of Eagan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 r Use BLUE or BLACK Ink For Office Use Permit #: 1Y7 2 c Permit Fee: LI1 V•517 Date Received: Staff: 2014 COMMERCIAL BUILDING PERMIT AP PLICATION Date: 07'07(i Site Address: 1":) 4 1, - m&. -r Tenant Name: (Tenant is: New / Former Tenant: Existing) Suite #: Property Owner Type of Work Name: C R t( ( g5-1-6446ti-rh 64. `1- Phone: LO Address / City / Zip: Ct6-civntLie3 apiktX !Y) ( Applicant is: Owner Contractor Description of work: —1)14 r O rf,„,,,2 pEpL44C&'MI'.07- Construction Cost:r�$. X00 0° Contractor Name: &yi p; PE ODOR 4,3 G,4sS License #: Address: 39/ SE , 747% 5 T r City: i o 1Jei4pd .- S Architect/Engineer State: ION Zip: SS V0 (o Contact: .33d$Lai E i2ILG Phone: 6/a ' 3;47- 4/043 Email: bbho ( 6+41P; /2 DODQ 4•+/5 ‘444.55 #6o+4.1 Name: Registration #: 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 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.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 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 c e o rk which requires a review and approval of plans. x 1.6.1z//c. Applicant's Printed Nme Applicant's Signa re Page 1 of 3 City of Eapii 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 CO lel. vg -k -e Cl Gi r Use BLUE or BLACK Ink For Office Use I Permit #: l al Ca Permit Fee: 10`D� Date Received: Staff: 2015 R IBENTIAL BUILDING PERMIT APPLICATION Date: Da • /3- - 15 Site Address: 3 33' 3 co.;cw,AAA",/ k .ol • Unit #: /D'+ . =Resident! Name: Phone: Address / City / Zip: Owner r j� ? V Applicant is: Owner pp 7C Contractor Description of work: W; N bo-,...)E.-pt_ANca,4,,,7T" Type ofWork ter ; Construction Cost. %e q, c1Do - _ Multi -Family Building: (Yes x / No ) Company: Et.m); 2� \DooR s C,L.,--., Contact: bs- R -i" Address: 3 `/JS 1 . ,-.3-1=4s4 . City: M: "I►•Ik=.N-- S It Contractor. State: 1.4 NI Zip: 55`-'oL Phone: 49/.2 • -301.9-1/403 Email: License #: 44106 Lead Certificate #: 8.--fi �y 9(D a 5 a If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) In the last 12 months, Yes No If COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING has the City of Eagan issued a permit for a similar plan based on a master plan? yes, date and address of master plan: Licensed Plumber: Mechanical Contractor: Sewer & Water Contractor: Phone: Phone: Phone: NOTE:_ Plans antl pp i g do nth heat, you submit cons de ed=to be public nformatio Portions ofd hie info mattonn maybe classifedas anon puublic rf you provr elspecifr reasonsthat would perfnrt=the'City `to 3 concludelhatktheyare tradessecrets, mss -.. 4 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. Exterior work authorized by a building permit issued in accordance with the Mirpaesota State Building Code must be completed within 180 days of permit issuance. 61. P-7 a etLKt. Applicant's Printed 11ame x Applicant's Signature Page 1 of 3 11/10/16 THU 14:50 FAX 6517741007 FOREMOST MECH 41 City of Evan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 r ij 003 Use BLUE or BLACK Ink For Office Ush°11 Permit #: Permit Fee: (U) + �� Date Received: Staff: 2016 MECHANICAL PERMIT APPLICATION Please submit two (2) sets of plans with all commercial applications. �0 I Date: � �' Site Address: .� t� ed')G. r:liN Mt'W1 ?•C Tenant: Resident/Owner` Contractor Type of Work Name: (°\ &ek CUM' l eSlccAei Address / City / Zip Phone: Suite #: 1 C57 -- qs-q —S 7 63 -- Name: ni s Name:n)Cv\ lG�1 C License#: AddresssI 1 1 141,04 , t L City: ler s -e-A-000 C0 r Y 9 State: M ! (. Zip: 109 Phone: 6S -1—g— Contacts &Y' te'-. (C1Emai1: SkeOlnl`:' i!YICQ Ui \\Q,A_V`t )S a CGi1'� New replacement Additional Alteration Demolition Description of work: e( c 2 C' I a_ NOTE Roof mounted and ground mounted mechanical;equipment is required to be screened by City ..Code.`: