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1650 Diffley Rd
FOUNDATION OBSERVATIONS REPORT Report Number: 41141070.0017 �� Service Date: 08/28/14 3535 Hoffinan Road East Report Date: 08/28/14 White Bear Lake,MN 55110-5376 651-770-1500 Client Project Holiday Stationstores,Inc. Holiday Stationstore#401 -Car Wash Addition Attn: Scott Alpaugh 1650 Diffley Road 4567 American Blvd W Eagan,MN Bloomington,MN 55437 Project Number: 41141070 SERVICES REQUESTED BY: Dan FOUNDATION TYPE: Shallow footings OBSERVATION LOCATION(S): North foundations for car wash entrance SOIL DESCRIPTION: Gravel base SUBGRADE REVIEW: Firm and stable with the addition of the gravel OBSERVATION RESULTS: Based on our observations, the foundation subgrade preparation at the above-referenced locations appeared to be in general accordance with the project plans and specifications. COMMENTS: See attached pictures Services: Site visit as requested to perform observations on building foundation soils prior to building construction. Terracon Rep.: Andrew T. Schmid,P.E. Reported To: Contractor: Midwest Maintenance&Mechanical Report Distribution: (1)Holiday Stationstores,Inc.,Scott � AlpauQh Reviewed By: __ Andrew T.Schmid,P.E. Department Manager The tests were performed in general accordance with applicable ASTM,AASHTO,or DOT test methods. This report is exclusively for the use of the client indicated above and shall not be reproduced except in full without the written consent of our company. Test results transmitted herein are only applicable to the actual samples tested at the location(s)referenced and are not necessarily indicative of the properties of other apparently similar or identical materials. CT0009,5-5-1Q Rev.6 Page 1 of 1 , � u ��' ` y � . ����� "�� E� , � �� ���` � � �� �� .� „� � �� t��.. � ; =' %<_ , ,�` I , � � � ��'� � 'u, � �� ., - � �� � . _ , = � � � '� �V�' � � � , � ., , � , � ., y, , ,- �y �� � � ,� �� ����� '`�' �`��h �� � ��� � ���„� � �� x � � . , �. d :,. „.. � �� „ : , �,�. ���F � � F�.,� ��� =^� „�� � , 4 � ;� .� :� • z��z� � '��b3 i�� y �,� � s �r,��� +' a i"f�!�".. � s•. �W�vYz�,.:. R E:1i .�-��"`��_�I "".�� ��'�i��l I I�:.:� � i� Ili �I 1 � fl,i i ��� ��,: _ ;-� . Holiday Stalionstores,Inc. � S0e Plan: Sile picWres � Attn:ScottAlpaugh RepoA Number:41141070.0017 rr�con 4567 American Blvtl W Technician: Antlrew T.Schmid,P.E. 3535 Holfman Road Easl Bloomington,MN 55437 Dale: 08/28/14 White Bear Lake,MN 55710.5376 Scale: Not lo Scale 651-770-1500 craozo,io-ze-ii,ae�.o . City of aafl 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 RECEIVI'.L APR Z 4 'MIL Use BLUE or BLACK Ink For Office Use Permit #: _ Permit Fee: Date Received: Staff: 2014 COMMERCIAL PLUMBING PERMIT APPLICATION E Please/submit two (2) sets of plans with all commercial applications. Date: tf-22•i4 Site Address: NS -0 D�-fffey /20 -ad Tenant: fKida 51-cti%GY) `/GI Suite#: /-(once c c. S 1f1i�S Phone: Name: I4 O T S17Yg ge.fr vhtf/7I(O ( (msti t rcense #: ea 09'4 C PM 05-8(470 Address: 3/Z22- ee ✓ CI'?-eK 12d City: I- 110 F -W State: inu Zip: 55(27 Phone: GO1 vn/-518 B' Email: in-( U 4°010 ' , LLC - MC-" 1.("7 ) New Replacement _ Repair )( Rebuild Modify Space _ Work in R.O.W. Description of work: P C(( s• it,>LtS1'i') R -e (9Lti (0( COMMERCIAL New Construction Modify Space Irrigation System ( yes / no) ( RPZ / _ PVB) • Rain sensors required on irrigation systems • Avg. GPM (2" turbo required unless smaller size allowed by Public Works) _ Meters Call (651) 675-5646 to verity that tests passed prior to picking up meter. Domestic: Size & Type Fire: 1 Avg. GPM High demand devices? Yes No Flushometers _Yes COMMERCIAL FEES $55.00 Permit Fee Minimum Contract Value $ 3SS OO x .01 ( _ $ `55 . 0 Permit Fee *If contract value is LESS than $10,010, Surcharge = $5.00 = $ J a D Surcharge* **If contract value is GREATER than $10,010, Surcharge = Contract Value x $0.0005 ***If the project valuation is over $1 million, please call for Surcharge Following fees apply when installing a new lawn irrigation system Contact the City's Engineering Department, (651) 675-5646, for required fee amounts. =$ L� o. 00 TOTAL FEE $ Water Permit $ Treatment Plant $ Water Supply & Storage $ State Surcharge 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 riot 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. f1 x(,t►cU✓0d x Applicant s Printed Name Applicant's Signature Page 1 of 3 2004 COMMERCIAL PLUMBING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 -'5 651-675-5675 Date / 2 Z / O Z -1 a1a`-E 3 Site Address 16s-c) nrrl?=? y QC U nit # - Tenant Name :e.. Former Tenant Name Property Owner Telephone # ( ) Contractor ?CJSII/? ?11U r /f) Z?1C Address ISIS S Iwo St' ?/ City ? State /77 Zip Srg `(3 Telephone # (11iZ 9 3$' ?300 The Applicant is Owner Contractor Other Work Type New Bldg _ Add-on - Repair _ RPZ _ PVB Irrigation system • Rain sensors required. Wobschall to calcula Jerry te fees. Description of Work To 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 tt;as p sed rior ickin me e . / .? Zr, a Irrigation Size & Type 1,?1?„ Q1p t3 ?+hg FPM" 2" bo req'd unless smaller size allowed by Public Works Fire Size & Price 3/4" displacement 5155.00 Domestic Size & Type Avg GPM Includes high demand devices? - Yes - No Flushometers _ Yes - No PRV Required _ Yes _ No Permit Fee $50.50 minimum (includes State Surcharge) Contract Value $ x I% '(:3 0 Base Fee 0 c7 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 $ 50 • Water Permit Contact Jerry Wobschall at 651-675-5024 for required fee amounts $ - b- Treatment Plant l & S W S y torage ater upp el a7 JUL 2 2 2004 $ State Surcharge ------------------------------------------------------ ------------------------------ ---- ---------- -- ----- ------------ ------------------------------- --- gy $ S .d Total Fee I hereby apply for a Commercial Plumbing Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Plumbing Codes; that I understand this is not a permit, but only an application for a permit, and work is not to (start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval .of plans. ( N , Applicant's Printed Name Applicant's Signature 2004 FIRE SUPPRESSION SYSTEMS PERMIT APPLICATION City Of Eagan la 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5694 Requirements: 2 complete sets of drawings and specifications cut sheets on materials and conmonents to be used f1 r? n rr n nn F7771 : Sze Date g l l1 / ? At 2 2004 Site Address: 1650 (' z o o Y Tenant / Building Name: {-r g The Applicant is: Owner Contractor Other PROPERTY OWNER Address: City: F_ a a? v State: M /d Zip: 5-5-112 CONTRACTOR ?or?L t.od i N? d SC?4 f?MNLicenseNo. Address: t/r{YS W. 77,-4 Sf• #/2-5- City: State: M/V Zip: Phone #: '55-1-993-090s ESTIMATED COMPLETION DATE: r?r FIRE PERMIT TYPE: _ Sprinkler System (# of heads - Fire Pump Standpipe Other: ('-102 /41- 3,00 Waf- 64n cs WORK TYPE: 7 New _ Addition _ Alterations _ Remodel Other: DESCRIPTION OF WORK: Commercial _ Residential _ Educational Other: Please continue on reverse side 䕐䵒呉䘠䕅›㔤⸰〵䴠湩浩浵䘠敥⠠湩汣摵獥匠慴整匠牵档牡敧ഩ䌊湯牴捡⁴慖畬․ⰱ″㔭〭❲〰砠⸠ഥ锊䤠敐浲瑩䘠敥椠ㄤ〬〰漠敬獳摡⸤〵晉倠牥業⁴敆獩漠敶ㄤ〬〰摡⸤〵瀠牥ㄤ〮〰倠牥業⁴敆㌊㐯•楄灳慬散敭瑮䘠物敍整ㄤ㔵〮ര吊呏䱁䘠䕅ഺ弊␠ㄠ⸳㔠⁃敐浲瑩䘠敥な瑓瑡畓捲慨杲ഊ␊猠ⱡ癳⁉敨敲祢愠灰祬映牯愠䘠物畓灰敲獳潩祓瑳浥瀠牥業⁴湡捡湫睯敬杤桴瑡琠敨椠普牯慭楴湯椠潣灭敬整愠摮捡畣慲整※桴瑡琠敨眠牯楷汬戠湩挠湯潦浲湡散眠瑩桴牯楤慮据獥愠摮挠摯獥漠桴楃祴漠慅慧湡楷桴琠敨楍湮獥瑯畂汩楤杮䘯物潃敤㭳琠慨⁴⁉湵敤獲慴摮琠楨獩渠瑯愠瀠牥業ⱴ戠瑵漠汮⁹湡愠灰楬慣楴湯映牯愠瀠牥業ⱴ愠摮潷歲椠潮⁴潴猠慴瑲眠瑩潨瑵愠瀠牥業㭴琠慨⁴桴潷歲眠汩敢椠捡潣摲湡散眠瑩桴灡牰癯摥瀠慬湩琠敨挠獡景潷歲眠楨档爠煥極敲敲楶睥愠摮愠灰潲慶景瀠慬獮മ㐊㼱ㄠ䤠⁇ 爷眬吠景൦䄊灰楬慣瑮猧倠楲瑮摥丠浡上ധ䄊灰楬慣瑮猧匠杩慮畴൲䐊⁏低⁔剗呉⁅䕂佌⁗䡔卉 5220 Drew Ave South Minneapolis, Mn 55410 August 24, 2004 Mr. Dale Wegleitner 3830 Pilot Knob Road Eagan, MN 55 1 22-1 897 Dear Mr. Wegleitner, Subject: Eagan Fire Code 2204.3.6 me tro Regarding Code 2204.3.6, our store, the Metro, located,at 1650.Diffley Road, in Eagan, will not require a separate telephone for emergency cut off at the fueling stations. Our security provider, Wellington Security, 612-8224094. has provided a system that will, upon someone pushing the Red emergency cutoff button, will automatically dial the Fire Department. If you have any further questions, please feel free to contact either me, or Wellington Security for more details Respectfully, a ?? ? AUG 2 6 ZU04 J. Thomas Owner the Metro By Jtc 61314 ?COMMERCIAL BUILDING Permit Application City Of Eagan U 3830 Pilot Knob Road, Eagan Mn 55122 f ` Telephone # 651-675-567557 FAX # 651-675-5694 ?... T ICt2c_ Y? paw- LII_ti,-7 Foun ion Only New Building Interior Improvement • Structural Plans (2) sets • Architectural Plans g (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) d • Energy Calculations (1) " l d • Electric Power & Lighting Form (1) " d S • Master Exit Plan (1) 1 1 • Emergency Response Site Plan (1) **' 1 1 • Soils Report (1) S • SAC determination - call 651-602-1 000 • SAC determination - call 651-602-1 000 SAC determination -call 651-602-1000 Call tv1N 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 8 6 / 03 Construction Cost $585,000 Site Address 1650 DIFFLEY RD Unit/Ste # Tenant Name The Metro Convenience Store/Gas Former Tena nt Name Cation Description of Work Convenience Store / Gas Station Property Owner Astleford Tom Galager Telephone#( 763) 497-7144 Contractor VANGUARD CONSTRUCTION INC Address 2350 WYCLIFF ST #11 City ST PAUL State MN Zip 55114 Telephone # (651 ) 644-6545 Arch/Engr LAMPERT ARCHITECTS Registration # 13669 Address 13837 NE Lincoln St City Ham Lake State MN Zip 55304 Telephone # ( 763) 755-1211 ?J 0soI-- 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. 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We provided Special inspection services for the foundation soils, reinforcing steel placement in the foundations and concrete masonry construction, inspection of welds for the convenience store roof and tested the high tensile bolted connections for the canopy. Based on our inspections, it is oLir opinion the foundation soils, steel reinforcement, welding, and structural bolted connections comply with the Project Specifications and details as outlined'on the Structural Drawings. Respectfully, Profeess?ion?al A Engineering ?/Consultants, Inc. / n F. Gislason, Jr., .E. 灓捥慩瑓畲瑣牵污吠獥楴杮愠摮䤠獮数瑣潩捓敨畤敬ⴠ牐橯捥⁴慎敭䴠呅佒䤠䤠倠潲敪瑣丠潌慣楴湯䔠奯䄠䄦‿⁗ൎ倊牥業⁴潎മ匊䕐䥃䱁匠剔䍕啔䅒⁌䕔呓义⁇乁⁄义偓䍅䥔乏灓捥晩捩瑡潩祔数漠敒潰瑲䄠獳杩敮匊捥楴湯䄠瑲捩敬䐠獥牣灩楴湯⠠⤲䤠獮攠季牯⠠⤳䘠敲瀠湥⁴楆浲⠠⤴㜱㐰㌮ㄮ潎整㩳吠楨捳敨畤敬琠敢映汩敬畯⁴湡湩汣摵摥椠桴牰橯捥⁴灳捥晩捩瑡潩䤠普牯慭楴湯甠慮慶汩扡敬愠⁴桴瑡琠浩ⱥ琠敢映汩敬畯⁴桷湥灡汰楹杮映牯愠戠極摬湩数浲瑩മ⠊⤱倠牥業⁴潎潴戠牰癯摩摥戠⁹桴畂汩楤杮传晦捩慩㈨ 獕敤捳楲瑰潩獮瀠牥唠䍂匠捥楴湯ㄠ〷ⰱ愠摡灯整祢䴠湩敮潳慴匠慴整䈠極摬湩潃敤മ⠊⤳匠数楣污䤠獮数瑣牯ⴠ吠捥湨捩污灓捥慩湉灳捥潴瑓畲瑣牵污മ⠊⤴䘠物潣瑮慲瑣摥琠数晲牯敳癲捩獥മ䄊䭃低䱗䑅䕇䕍呎䔊捡灡牰灯楲瑡敲牰獥湥慴楴敶桳污楳湧戠汥睯睏敮㩲䘉物㩭䐉瑡㩥潃瑮慲瑣牯ऺ䔿礿汬湡湮牡楲ഉ䐊瑡㩥湐据牴椿瑲䑩൮㸊牁档楩㩴嬠䘉物㩭䰠浡敢瑲䄠爉ⱃ慄整ഺ匊剅ऺ楆浲ऺ慄整ഺ匊㩓䘉物㩭䘠ृ慄整ഺ吊㩁䘉物㩭䐉瑡㩥䥓吭ऺ楆浲›ृ慄整ഺ吊㩁䘉物㩭䐉瑡㩥䥓吭ऺ楆浲ऺ慄整ഺ䘊ऺ楆浲ऺ慄整ഺ䘊ऺ楆浲ऺ慄整ഺ⸊ㄠ㠸㌰〯ള✊搠ള吊敨椠摮癩摩慵慮敭景愠汬瀠潲灳捥楴敶猠数楣污椠獮数瑣牯湡桴潷歲琠敨⁹湩整摮琠扯敳癲桳污敢椠敤瑮晩敩⠠獕敲敶獲猊摩景映牯晩渠捥獥慳祲⤮敌敧摮›䕓⁒‽畓捶畴慲湅楧敮牥漠敒潣摲匠ⵉ⁔‽灓捥慩湉灳捥潴敔档楮慣⁆‽慆牢捩瑡牯䅔㴠吠獥楴杮䄠敧据⁹䥓匭匠攠楣污䤠獮数瑣牯ⴠ匠牴捵畴慲൬䄊捣灥整潦桴畂汩楤杮䐠灥牡浴湥⁴祢儠嘠娠㼮䐠瑡⹕传㌠ Metropolitan Council Building communities that work August 19, 2003 Environmental Services Dale Schoeppner Building Official City of Eagan 3830 Pilot Knob Road Eagan, MN 55122 4, RE: SAC Determination for the Metro C-Store Tunnel Vehicle Wash with Reclaim System $ Dear Mr. Schoeppner: The Metropolitan Council Environmental Services (MCES) has determined SAC for the Metro C-Store to be located within the City of Eagan. This project should be charged 17 SAC Units. This determination follows: SAC Units Charges: Retail 3120 sq. ft. @ 3000 sq. ft./SAC Unit 1.04 Gas Pumping 1.00 Vehicle Wash (Tunnel with Water Reclaim System) 200 Cars/Day x 20.56 Gals./Veh. @ 274 Gallons/SAC Unit 15.00 Total Charge: 17.04 or 17 The above SAC determination is based on the MCES's understanding that the proposed vehicle wash facility will utilize an on-site water reclaim system thus reducing the discharge to the metropolitan sanitary sewer system. It is our understanding that the city shall inspect all plumbing systems associated with said vehicle wash facility to verify that no cross connections to the water supply system exist so that the reclaim system can be bypassed, and the wash facility operated without reclaimed water use. The equipment supplier for the vehicle wash facility has indicated that the unused connection holes in the "SDM" manifold will be plugged with hex screws and that the screws will be rendered inoperable. This is being requested by the MCES in order to make it nearly impossible to either switch over portions of the facility, or the entire facility to a fully fresh water system. We strongly recommend that the City inspect this equipment upon completion and prior to facility start-up, to verify that this has been completed. In the event that future water records indicate that the reclaim system is not operating as originally designed, a re-determination of SAC shall be made and the appropriate SAC payment shall be forwarded to the MCES. The City may be called upon to inspect the facility to verify that no interconnections between the fresh water supply and the reclaim system exist, and that portions of the water delivery manifold is still "locked out". w .mctrocouncil.org Metro Into Line 602-1888 230 East Fifth Street • St. Paul, Minnesota 55101-1626 • (651) 602-1005 • Fax 602-1 138 • TTY 291-0904 An Egua1 Opportunity Employer August 19, 2003 Metro C-Store Page Two The MCES reserves the right to request and obtain water usage records from the City to verify the operation of the water reclaim system. In the event that our evaluation of these water records indicate that the reclaim system is not operating as originally designed, and it is found that there is a shortage in the original amount of SAC collected for this project, the City will be required to submit the appropriate SAC payment to reflect actual water usage and facility operation. If for some reason, the Owner, either present of future Owner(s), of the vehicle wash facility withdraws the usage of the water reclaim system, or the City cannot accept the terms of this letter, the project should be charged 42 SAC units. This SAC determination assumes the use of the same wash equipment as originally proposed and an average water usage of 49.31 gallons/vehicle. If you have any questions regarding the calculation of SAC units for this facility, the City's obligation to monitor water usage at the site or require information on the criteria used to determine the gallons per vehicle number, please don't hesitate to call Jodi Edwards at (651) 602-1113 or Kyle Colvin at (651) 602-1151. Sincerely, 1?0r)DO d S. Bluhm c! Municipal Services Manager Municipal Services Section DSB:JLE 03081951 cc: S. Selby, MCES Carolyn Krech, Finance Department, Eagan Craig Moss, Vanguard Construction i TO: TOM STRUVE, SUPERINTENDENT OF STREETS & EQUIPMENT DAVE BENNETT, UTILITY CONSTRUCTION INSPECTOR DALE WEGLEITNER, FIRE MARSHAL ERIC MACBETH, WATER RESOURCES COORDINATOR GREGG HOVE, CITY FORESTER JOHN CORDER, ASSISTANT CITY ENGINEER KENT THERKELSEN, CHIEF OF POLICE MARK ANDERSON, ELECTRICAL INSPECTOR MIKE RIDLEY, SENIOR PLANNER PAUL HEUER, SYSTEMS ANALYST SCOTT PETERSON, BUILDING INSPECTOR TOM COLBERT, DIRECTOR OF PUBLIC WORKS TOM PEPPER, CHIEF FINANCIAL OFFICER FROM: CRAIG NOVACZYK, SENIOR INSPECTOR DATE: AUGUST 12, 2003 RE: PLAN REVIEW FOR 1650 DIFFLEY RD Lot 6 Block 1, DIFFLEY PLAZA THE METRO The plans are in our plan review section for your review and comment. #32 Indicate any fees that are to be collected with the building permit: AMOUNT Yes ? No landscape security required ? Yes ?l No water quality dedication I Yes ?j No park dedication Yes ? No trail dedication Yes ? No tree dedication Ye s ? No PRV Required ' ff JJ ( Signature CD/FORMS/BLDG INSP/PLAN REVIEW CRAIG N , ?fv, co ZONING? METER SIZE y '773.0 $f i(LYb • CD Date REVISED 9- 02 Please return this form to my attention with your signed comments and the date of review within seven days. If you have any concerns 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. r 40?dtV of eegen PAT GEAGAN Mayor PEGGY CARLSON CYNDEE FIELDS MIKE MAGUIRE MEG TILLEY Council Members THOMAS HEDGES City Admiaisrraror Municipal Center: 3830 Pilot Knob Road Eagan, MN 55122-1897 Phone: 651.675.5000 Fax: 651.675.5012 TDD: 651.454.8535 Maintenance Facility: 3501 Coachman Point Eagan, MN 55122 Phone: 651.675.5300 Fax: 651.675.5360 TDD: 651.454.8535 w ..cityofeagartxom THE LONE OAK TREE The symbol of strength and growth in our community August 19, 2003 Jim Coen JCJ Associates 6103 Habitat Court Minneapolis, MN 55436 RE: Metro Station - Diffley Plaza Dear Mr. Coen: We have completed our review of the site plan and landscape documents submitted in pursuit of obtaining a building permit for the above referenced project. It is our goal that this review will help you in complying with the applicable codes and we are therefore, requesting that the following items be addressed: 1. A detailed lighting plan must be submitted for the entire site including a photometric paln and specifics on the canopy lighting. 2. The Conditional Use Permit must be recorded with Dakota County prior to issuance of a building permit. If you have any questions feel free to call me at 651-675-5696. Sheila Cartney Planner 稿൳䔊条湡䌠瑩⁹潃湵楣敍瑥湩楍畮整൳䨊汵⁹ⰱ㈠〰ള倊条ശ䌊畯据汩敭扭牥吠汩敬⁹潭敶Ɽ䌠畯据汩敭扭牥䘠敩摬敳潣摮摥愠洠瑯潩潴愠灰潲敶愠慖楲湡散琠桴慭楸畭〱映潯⁴畢汩楤杮猠瑥慢正映潲異汢捩爠杩瑨漭ⵦ慷䄠敹›‵慎㩹〠但剕䌠乏䥄䥔乏䱁唠䕓倠剅䥍協ⴠ䌠䕏⁎䕄䕖佌䵐久⁔則問⁐䱌ൃ䌊瑩⁹摁業楮瑳慲潴效杤獥椠瑮潲畤散桴獩椠整敲慧摲湩潦牵䌠湯楤楴湯污唠敳倠牥業獴琠污潬൷愊挠湯敶楮湥散猠潴敲慧潳楬敮猠污獥慣睲獡湡祰潬楳湧漠潌⁴ⰶ䈠潬正ㄠ楄晦敬⁹汐穡匠湥潩൲倊慬湮牥删摩敬⁹慧敶愠猠慴晦爠灥牯楊潃湥敄敶潬数楤捳獵敳桴楬桧楴杮愠摮氠湡獤慣楰杮漠桴牰灯獯摥瀠潲敪瑣മ䌊汯敬慗湧牥摡慪散瑮瀠潲数瑲⁹睯敮Ⱳ愠歳摥映牯挠慬楲楦慣楴湯爠来牡楤杮琠敨氠湡獤慣楰杮瀠慬Ɱ牴獡湡敲祣汣湩潣瑮楡敮獲湡潨牵景漠数慲楴湯敓楮牯倠慬湮牥删摩敬⁹摡牤獥敳獍慗湧牥猧畱獥楴湯潃湵楣浬浥敢楔汬祥洠癯摥潃湵楣浬浥敢慃汲潳敳潣摮摥愠洠瑯潩潴愠灰潲敶愠潃摮瑩潩慮獕敐浲瑩琠污潬⁷潣癮湥敩据瑳牯湯䰠瑯㘠求捯ⰱ䐠晩汦祥倠慬慺※畳橢捥⁴潴琠敨潦汬睯湩潣摮瑩潩獮祁㩥㔠丠祡›ര吊敨䌠湯楤楴湯污唠敳倠牥業⁴桳污敢爠捥牯敤楷桴䐠歡瑯潃湵祴眠瑩楨〶搠祡景琠敨搠瑡漊灡牰癯污愠摮瀠潲景漠瑩敲潣摲湩敢瀠潲楶敤潴琠敨䌠瑩潎朠潯獤漠晦牥摥映牯猠污桳污敢猠潴敲Ɽ猠汯牯搠獩汰祡摥漠瑵楳敤愠戠極摬湩桔〳₰牧敥灳捡敲畱物浥湥獴栠污敢洠瑥മ㐊‰慃桳瀠牡湡牴楡獬搠摥捩瑡潩牡畤牰潩潴椠獳慵据景愠戠極摬湩数浲瑩മ䌊畯据汩敭扭牥吠汩敬⁹潭敶Ɽ䌠畯据汩敭扭牥䘠敩摬敳潣摮摥愠洠瑯潩潴愠灰潲敶愠潃摮瑩潩慮獕敐浲瑩琠污潬⁷慧潳楬敮猠污獥漠潌⁴ⰶ䈠潬正ㄠ楄晦敬⁹汐穡畳橢捥⁴潴琠敨映汯潬楷杮潣摮瑩潩獮›祁㩥㔠丠祡›ര儊吠敨䌠湯楤楴湯污唠敳倠牥業⁴桳污敢爠捥牯敤楷桴䐠歡瑯潃湵祴眠瑩楨〶搠祡景琠敨搠瑡漊灡牰癯污愠摮瀠潲景漠瑩敲潣摲湩敢瀠潲楶敤潴琠敨䌠瑩慃潮祰氠杩瑨湩桳污敢爠摥捵摥愠瑳瑡摥椠桴瑳晡敲潰瑲മ匊慴晦愠灰潲敶桴慮敭戠慲摮挠湡灯⁹楬桧楴杮മ䌊畯据汩敭扭牥吠汩敬⁹潭敶Ɽ䌠畯据汩敭扭牥䘠敩摬敳潣摮摥愠洠瑯潩潴愠灰潲敶愠潃摮瑩潩慮獕敐浲瑩琠污潬⁷慣睲獡湯䰠瑯㘠求捯ⰱ䐠晩汦祥倠慬慺猠扵敪瑣琠桴潦汬睯湩൧挊湯楤楴湯㩳䄠敹›‴慎㩹ㄠ⠠慍潹敇条湡漠灰獯摥ഩ挊吠敨䌠湯楤楴湯污唠敳倠牥業⁴桳污敢爠捥牯敤楷桴䐠歡瑯潃湵祴眠瑩楨〶搠祡景琠敨搠瑡漊灡牰癯污愠摮瀠潲景漠瑩敲潣摲湩敢瀠潲楶敤潴琠敨䌠瑩瑩‡湅牴⁹湡硥瑩搠潯獲猠慨汬戠汣獯摥搠牵湩慷桳搯祲挠捹敬㍏䰠杩瑨湩桳污慨敶渠楤敲瑣猠畯捲楶楳汢牦浯琠敨瀠扵楬楲桧景眭祡漠摡慪散瑮氠湡潃湵楣浬浥敢楔汬祥洠癯摥潃湵楣浬浥敢楆汥獤猠捥湯敤潭楴湯琠灡牰癯ൡ䌊湯楤楴湯污唠敳倠牥業⁴潴愠汬睯愠瀠汹湯猠杩湯䰠瑯㘠求捯ⰱ䐠晩汦祥倠慬慺祁㩥㈠丠祡›″䌨牡獬湯ബ吊汩敬⁹湡楆汥獤漠灰獯摥⸩潃湵楣浬浥敢慃汲潳潭敶Ɽ䌠畯据汩敭扭牥䘠敩摬敳潣摮摥愠洠瑯潩潴搠物捥⁴楦摮湩獧漠൦昊捡⁴潦敤楮污漠潣摮瑩潩慮獵数浲瑩映牯愠瀠汹湯猠杩湯䰠瑯㘠求捯ⰱ䐠晩汦祥倠慬慺മ䄊敹›″慎㩹㈠⠠敇条湡愠摮䴠条極敲漠灰獯摥 TO: TOM STRUVE, SUPERINTENDENT OF STREETS & EQUIPMENT DAVE BENNETT, UTILITY CONSTRUCTION INSPECTOR DALE WEGLEITNER, FIRE MARSHAL ERIC MACBETH, WATER RESOURCES COORDINATOR GREGG HOVE, CITY FORESTER JOHN GORDER, ASSISTANT CITY ENGINEER KENT THERKELSEN, CHIEF OF POLICE MARK ANDERSON, ELECTRICAL INSPECTOR MIKE RIDLEY, SENIOR PLANNER PAUL HEUER, SYSTEMS ANALYST 'SCOT-T-P-ETERSON,-BUILDING INSPECTOR TOM COLBERT, DIRECTOR OF PUBLIC WORKS TOM PEPPER, CHIEF FINANCIAL OFFICER FROM: CRAIG NOVACZYK, SENIOR INSPECTOR DATE: AUGUST 12, 2003 RE: PLAN REVIEW FOR-1650 DIFFLEY RD Lot 6 Block 1, DIFFLEY PLAZA THE METRO The plans are in our plan review section for your review and comment. Please return this form to my attention with your signed comments and the date of review within seven days. If you have any concerns 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: Y/-e-eid (,*1Cd-14 Indicate any fees that are to be collected with the building permit: AMOUNT ? Yes ? No landscape security required ? Yes ? No water quality dedication ? Yes 0 No park dedication ? Yes ? No trail dedication ? Yes ? No tree dedication ? Yes ? No PRV Required Signature #32 ZONING? METER SIZE Date CD/FGRMSBLDG INSP/PLAN REVIEW CRAIG N REVISED 9- 02 䤭⸢ⴠ吠䵏匠剔噕ⱅ匠偕剅义䕔䑎久⁔䙏匠剔䕅協☠䔠啑偉䕍呎䅄䕖䈠久䕎呔呕䱉呉⁙佃华剔䍕䥔乏䤠华䕐呃剏䅄䕌圠䝅䕌呉䕎ⱒ䘠剉⁅䅍卒䅈ൌ䔊䥒⁃䅍䉃呅ⱈ圠呁剅删卅問䍒卅䌠住䑒义呁剏則䝅⁇佈䕖䥃奔䘠剏卅䕔䨊䡏⁎佇䑒剅十䥓呓乁⁔䥃奔䔠䝎义䕅䬊久⁔䡔剅䕋卌久䡃䕉⁆䙏倠䱏䍉䴊剁⁋乁䕄卒乏䱅䍅剔䍉䱁䤠华䕐呃剏䥍䕋删䑉䕌ⱙ匠久佉⁒䱐乁䕎倊啁⁌䕈䕕ⱒ匠卙䕔卍䄠䅎奌呓䍓呏⁔䕐䕔卒乏啂䱉䥄䝎䤠华䕐呃剏佔⁍佃䉌剅ⱔ䐠剉䍅佔⁒䙏倠䉕䥌⁃佗䭒吊䵏倠偅䕐ⱒ䌠䥈䙅䘠义乁䥃䱁传䙆䍉剅刭佴⹗䌠䅒䝉丠噏䍁奚⁋䕓䥎剏䤠华䕐呃剏䅄䕔›啁啇呓ㄠⰲ㈠〰ള刊㩅倠䅌⁎䕒䥖坅䘠剏ㄠ㔶‰䥄䙆䕌⁙䑒潌⁴‶求捯ⰱ䐠䙉䱆奅倠䅌䅚䡔⁅䕍剔൏吊敨瀠慬獮愠敲椠畯汰湡爠癥敩⁷敳瑣潩潦潹牵爠癥敩⁷湡潣浭湥㌣ല倊敬獡敲畴湲琠楨潦浲琠祭愠瑴湥楴湯眠瑩潹牵猠杩敮潣浭湥獴愠摮琠敨搠瑡景爠癥敩൷眊瑩楨敳敶慤獹晉礠畯栠癡湡⁹潣据牥獮眠瑩桴獥汰湡ⱳ瀠敬獡潳椠摮捩瑡湯琠楨潦浲愠摮潮楴祦愠摮爠獥汯敶琠敨敳椠獳敵楷桴琠敨愠晦捥整慰瑲敩䤠潹⁵牡敲畱獥楴杮琠慨⁴獩畳湡散漠桴戊極摬湩数浲瑩戠敨摬汰慥敳映汩畯⁴桴牰灯牥∠潨摬•敲畱獥⁴潦浲മ䌊浯敭瑮㩳㼠䵏䌠ⱐ∠匧䜠䔧ൡ䤊摮捩瑡湡⁹敦獥琠慨⁴牡潴戠潣汬捥整楷桴琠敨戠極摬湩数浲瑩ऺ啊瑌യऊउ䵁問呎☉╬礠伯㌠ि教ि潎氉湡獤慣数猠捥牵瑩⁹敲畱物摥娉乏义㽇ൟ㼊変獥㼠三९慷整畱污瑩⁹敤楤慣楴湯䴉呅剅匠婉㼊変獥㼠漉瀉牡敤楤慣楴湯ഉ㼊変獥㼠उ牴楡敤楤慣楴湯ഉ㼊変獥㼠漉琉敲敤楤慣楴湯ഉ㼊変獥㼠ㅽ漉倉噒删煥極敲।楓湧瑡牵怊ㄠറ䐊瑡䌊⽄但䵒⽓䱂䝄䤠华⽐䱐乁删噅䕉⁗剃䥁⁇⁎䕒䥖䕓⁄ⴹ〠 TO: TOM STRUVE, SUPERINTENDENT OF STREETS & EQUIPMENT DAVE BENNETT, UTILITY CONSTRUCTION INSPECTOR DALE WEGLEITNER, FIRE MARSHAL ERIC MACBETH, WATER RESOURCES COORDINATOR GREGG HOVE, CITY FORESTER JOHN GORDER, ASSISTANT CITY ENGINEER KENT THERKELSEN, CHIEF OF POLICE MARK ANDERSON, ELECTRICAL INSPECTOR MIKE RIDLEY, SENIOR PLANNER PAUL HEUER, SYSTEMS ANALYST SCOTT PETERSON, BUILDING INSPECTOR TOM COLBERT, DIRECTOR OF PUBLIC WORKS TOM PEPPER, CHIEF FINANCIAL OFFICER FROM: -CRAIGNOVACZYK;,SENIORINSPECTOR DATE: AUGUST 12, 2003 RE: PLAN REVIEW FOR 1650 DIFFLEY RD Lot 6 Block 1, DIFFLEY PLAZA THE METRO The plans are in our plan review section for your review and comment. #32 Please return this form to my attention with your signed comments and the date of review within seven days. If you have any concerns 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 landscape security required ? Yes ? No water quality dedication ? Yes ? No park dedication ? Yes ? No trail dedication ? Yes ? No tree dedication ? Yes ? No PRV Required Signature ZONING? METER SIZE Date CD/FORMS/BLDG INSP/PLAN REVIEW CRAIG N REVISED 9- 02 TO: TOM STRUVE, SUPERINTENDENT OF STREETS & EQUIPMENT #32 DAVE BENNETT, UTILITY CONSTRUCTION INSPECTOR DALE WEGLEITNER, FIRE MARSHAL ERIC MACBETH, WATER RESOURCES COORDINATOR GREGG HOVE, CITY FORESTER JOHN GORDER, ASSISTANT CITY ENGINEER KENT THERKELSEN, CHIEF OF POLICE MARK ANDERSON, ELECTRICAL INSPECTOR MIKE RIDLEY, SENIOR PLANNER PAUL HEUER,"SYSTEMS ANALYST SCOTT PETERSON, BUILDING INSPECTOR TOM COLBERT, DIRECTOR OF PUBLIC WORKS TOM PEPPER, CHIEF FINANCIAL OFFICER FROM: CRAIG NOVACZYK, SENIOR INSPECTOR DATE: AUGUST 12, 2003 RE: PLAN REVIEW FOR 1650 DIFFLEY RD Lot 6 Block 1, DIFFLEY PLAZA THE METRO The plans are in our plan review section for your review and comment. Please return this form to my attention with your signed comments and the date of review within seven days. If you have any concerns 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 landscape security required ? Yes ? No water quality dedication ? Yes ? No park dedication ? Yes ? No trail dedication ? Yes ? No tree dedication ? Ye ? No quired 0 1 ;? Signature CD/FORMS/BLDG INSP/PLAN REVIEW CRAIG N ZONING? METER SIZE Date REVISED 9-02 TO: TOM STRUVE, SUPERINTENDENT OF STREETS & EQUIPMENT DAVE BENNETT, UTILITY CONSTRUCTION INSPECTOR DALE WEGLEITNER, FIRE MARSHAL ERIC MACBETH, WATER RESOURCES COORDINATOR GREGG HOVE, CITY FORESTER JOHN GORDER,.ASSISTANT CITY ENGINEER KENT THERKELSEN, CHIEF OF POLICE MARK ANDERSON, ELECTRICAL INSPECTOR MIKE RIDLEY, SENIOR PLANNER PAUL HEUER, SYSTEMS ANALYST SCOTT PETERSON, BUILDING INSPECTOR TOM COLBERT, DIRECTOR OF PUBLIC WORKS TOM PEPPER, CHIEF FINANCIAL OFFICER FROM: CRAIG NOVACZYK, SENIOR INSPECTOR DATE: AUGUST 12, 2003 RE: PLAN REVIEW FOR 1650 DIFFLEY RD Lot 6 Block 1, DIFFLEY PLAZA THE METRO The plans are in our plan review section for your review and comment. #32 Please return this form to my attention with your signed comments and the date of review within seven days. If you have any concerns 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: QK - i ,"/nom ha &l Gnarn¢ /1k 51 f1' /iu 5 A/ fllrDUr? Gifv fro; A& 03-,77 'h! e ei t 0 ? >< Indicate any fees that are to be collected with the building permit: AMOUNT ? Yes ? No ? Yes ? No ? Yes ? No ? Yes ? No ? Yes ? No Id Yes ? 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If you have any concerns 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 landscape security required ? Yes ?No water quality dedication ? Yes ? No park dedication ? Yes ? No trail dedication ? Yes ? No tree dedication ? -Yos ? No PRV Required Signat re ZONING? METER SIZE ?/2 §?? Date CD/FORMS/BLDG INSP/PLAN REVIEW CRAIGN REVISED 9-02 ,Auq-t29-03 02:30P Lampert Architects 13837 NE Lincoln Street Ham Lake, Minnesota 55304 Phone number: 763-755-1211 Fax number: 763-757-2849 Email: IamperMompert-arc h.com Web Site: www.lampert@lampert-arch.com Send to: from: Phone Number: TAI Pages (Including Coven: 7 Urgent ? Reply ASAP ? Please comment ? Please Review 9 For your Information ? Sign and Return ??V IZIb?. P.O1 D is '-jr;;VQ V7-<-V? L-e?t'-t? EAGAN REV EWE® DATE I' BUILDING INSPECTIONS DEPT.. REVISED PLAN RECEIVED: _°I ?- 03 aq-.,29-03 02:30P O R.D. I WOMEN CD Q Mpg I WALK-IN I 103 4 FREEZER I 7'-1 "a '-0 1/2" 9 A2 tOa I 103 0 HOSE 1 OCC. IB ` ATM I e 7 PAY PHONE n C-STORE FLOOR NORTH t PLAN PARTIAL I1 (D SCALE: 1/8" = V-0" 4- `o (TYP,) - 7r, RETAIL 100 69 OCC. SOFFIT o 10'-0" SELF '? -- --- ERVE 106 - 4'-O"x12'-0" RECESSED F.D. ENTRY MAT nn mO I e I M 0 'v 'v I 'r. P_02 `a I M a M i M v I 0 M LINE OF L] CANOPY VV ABOVE a CASH WRAP 100 r% O 3 \ A5 / r O ? ? N 6. / O N ?O f 100 /r o PROJECT NAME: DATE: TH E METRO 08.29.os Eagan, Minnesota Revised floor plan - new door location .?. LAMPERT ARCHITECTS ??? 13937 NE Lincoln St., Ham Lake, MN 55304 Phone: 763.755.1211 Fax: 763.757.2549 PROJECT NAME: T H E M E T R Eagan, Minnesota Revised elevation Q - new door location LAMPERT ARCHITECTS 13837 NE Lincoln St., Ham Lake, MN 55304 Phone: 763.755.1211 Fax: 763.757.2849 DATE: 08.29 r D C m r' N O W O N W N U v 0 N 2 LAS I LLLVA I IUIN SCALE: 1/8' = 1'-0" .i Moo 9 0 Inr III July 2, 2004 ? I] I LL Mr. J. Thomas Coen 5220 Drew Ave So. Minneapolis, MN 55410 License Pending Dear Mr. Coen: Dakota County This office has completed a preliminary plan review for the Metro store located at 1650 Diffley Road in Eagan, Minnesota. The plan review was conducted as required by Minnesota Statute Chapter 28A and the Minnesota Food Code Chapter 4626. All appropriate permits from the local authorities shall be applied for and issued prior to starting any work on the site. Failure to comply with this may result in a delay or this office not issuing your retail Food Handlers license until the proper permits are issued. Our inspector will verify that the permits have been obtained. The Minnesota Department of Agriculture grants preliminary plan approval to the plans for this proposed food establishment. Upon this agency certifying that all items in this review have been addressed, final plan approval will be granted. This preliminary plan approval is based upon the plans submitted to this office. Any deviation from the approved plans and specifications must have prior approval from this agency. Preliminary approval of the plans and specifications does not constitute endorsement or acceptance of the completed establishment. Periodic on-site inspections may be made during construction. A final inspection of the completed establishment, with equipment installed, must be conducted to determine if it complies with the requirements of the Minnesota Food Code. Contact Food Inspector Norm Danner at 651-429-8595 to arrange for a final inspection prior to stocking any food products. An anticipated completion opening date of August 1, 2004, was indicated on the application form and a contact for this project was listed as J Thomas Coen at 612-925-2513. General Continents This review was for a new 3900 square foot convenience store. A HACCP plan was not submitted with this plan review and is not necessary at this time. The menu indicates hot dogs, bakery items and beverages will be served. Licensing of your firm is dependent upon proper installation of an approved water supply, plumbing and waste system. Our inspector will review your approval letters from the appropriate authorities to insure these requirements are met. Pursuant to MS 31.175 a license shall not be issued or renewed without approved plumbing, water and waste systems. Also our inspector will review approvals from building and fire officials before granting final approval. Please provide copies of approvals for review at the final inspection. 90 West Plato Boulevard • St. Paul, MN 55107-2094 • 651-297-2200 • 1-800-967-ACRI • www.mda. state. mn. us MINNESOTA DEPARTMENT OF AGRICULTURE FROM THE FARM TO YOUR FAMILY An Equal Opportunity Employer • TTY: 651/297-5353/1-800-627-3529 Mr. Coen July 2, 2004 Page 2 Minnesota rewires that all a ui ment be Certified to the National Sanitation Foundation Standards for clean ability durability and Performance New or used equipment not meeting these standards are prohibited. Any equipment installed that does not meet these standards may be ordered removed. Please address each item listed below. Equipment Food equipment shall meet the applicable National Sanitation Foundation (NSF) International food service standards. The equipment shall be determined by NSF International or an American National Standards Institute (ANSI) Z34.1 accredited independent entity, including Underwriters Laboratory or the Edison Testing Laboratory, to be equivalent to the NSF International Standard. The use of equipment, which does not meet the NSF standards, cannot be approved for use. All-bakery equipment must comply with the standards developed by the Bakery Industry Sanitation Standards Committee (BISSC). Custom fabricated or modified equipment must be constructed by a contractor listed by NSF International. The name and address of the fabricator for custom fabricated equipment must be identified. All service counters and other millwork surfaces shall be protected with stainless steel, plastic laminate, or equivalent, covering all exposed wood. In areas where food equipment involves heat or moisture, or where food comes in contact with the surface, a stainless steel finish or approved equivalent material is required. Solid surfaces for food contact, such Corian® or Gibrahor shall be constructed by a fabricator listed by an approved third-party testing agency. They are required to be installed on six- inch legs or a solid base. All exposed wood areas of the custom fabricated counters, including interior areas, shall be covered with a pressure-laminated plastic material meeting the requirements of NSF International Standard No. 35. All hard grain decor wood (e.g. oak) shall be properly sealed with a polyurethane or varnish-like material. Used equipment perviously meeting NSF International, NAMA, or BISSC standards, specified at the time of installation is permitted if it. met the NSF International, NAMA, or BISSC standards, in effect at the time it was manufactured, remains in good repair, is capable of being maintained in a sanitary condition, has food-contact surfaces that are not toxic, does not constitute a health hazard, and is approved by the regulatory authority. Your inspector will evaluate any used equipment to determine if it is acceptable. Provide multi-use equipment, utensils, and food storage containers that are smooth, easily cleanable, and resistant to pitting, chipping, or scratching. All food equipment in a retail food store must be designed as to be easily cleanable, durable and be adequate for its intended use. The use of household utensils or equipment is prohibited. The use of commercial equipment not meeting the NSF standards most be evaluated and approved prior to installation Retail shelving and refrigeration and freezer display cases shall be designed and constructed to be durable and to retain their characteristic qualities under normal use. Mr. Coen July 2, 2004 Page 3 Provide sufficient refrigeration to hold all readily perishable food products at 41°F or less. Provide sufficient ventilation (e.g. louvers, etc.) for the compressor unit to evacuate any buildup of heat at the underside of the cold pans in and about the compressor area. If an ice machine or bulk water unit is to be installed, the waste drain roust be properly plumbed and divert to an indirect waste (air break) floor drain. Food Protection This type of operation requires at least one state Certified Food Manager. If the owner has any questions, please have them discuss this with the area inspector or Minnesota Department of Health, Tracie Zerwas, at 651-215-0843. A current Certified Food Manager Certificate must be available at this establishment for verification. Provide a product stem-type thermometer for checking the internal temperatures of potentially hazardous foods. Thermometers must be provided in all coolers, freezers, and hot holding units where potentially hazardous food is stored, and must be located in an area that is representative of the true air temperature. The internal temperature of potentially hazardous food must be maintained at 41 °F or below, or 140°F or above, except during preparation. Provide a sufficient amount of refrigeration to hold all potentially hazardous food at 41 OF or less. Provide thermometers for all refrigeration and freezer units. All freezer units shall hold food frozen. Food on display must be protected from potential contamination from coughs, sneezes and improper handling through the installation of properly constructed and installed food shields, the use of packaged food items or other effective means of protection. Provide suitable utensils (e.g., tongs, ladles, spatulas, scoops, single-service papers, etc.) to avoid unnecessary manual handling of dispensed food items. Utensils must be stored in an appropriate manner between uses. Separate raw animal foods during storage, preparation, holding, and display from ready-to-eat food by the use of separate equipment, barriers or open space to prevent cross-contamination: Installations All annular openings around pipes and other conduits, where they pass through walls and floors, must be sealed (caulked). All junctures between the wall surface and the edges of attached equipment must be sealed with approved caulk/sealing compound (e.g. three-compartment sink, hand sinks, etc.). If conduit pipes are provided for beverage lines they must extend at least three to four inches above the finished floor elevation at both ends and the annular opening between the beverage lines and the conduit pipe sealed with a hard material and provided with a cleanable finish. All island full service cases must be installed as to be easily cleanable. The following methods area acceptable: (a) easily movable; (b) sealed in place; (c) or sufficient space surrounding to allow cleaning in place. (CIP) The floor under these units shall be finished with the same material as the floors in front or back of the unit. Carpeting however is prohibited. Mr. Coen July 2, 2004 Page 4 All doors to the outside of the establishment must be self-closing and vermin proof. Lightg Provide at least 10-foot candles (110 LUX) of light intensity, at a distance of 30 inches from the floor, in the walk-in refrigeration units, dry food storage areas, and during periods of cleaning. Provide at least 20-foot candles (220 LUX) of light intensity, at a distance of 30 inches from the floor, for areas where food is provided for consumer self-service, including buffets and salad bars, or where fresh produce or packaged foods are sold or offered for consumption, inside equipment including reach-in and undercounter refrigerators, in utensil storage areas, in areas behind a bar used for ware washing, and in toilet rooms. Provide at least 50-foot candles (540 LUX) of light intensity for areas where food employees are working with utensils and equipment where safety is a factor and areas used for ware washing. Provide effective shielding or shatter-resistant bulbs for all light fixtures over exposed food storage, food preparation, food display facilities, clean equipment, utensils and linens, and unwrapped single- service or single-use articles. Plumbine At least one toilet facility and not fewer than the number required by law shall be provided. These facilities must be conveniently located and accessible to employees at all times. Toilet rooms must be provided with self-closing doors, adequate ventilation, hand cleanser, single-use towels or hand drying devices, tissue paper and waste paper receptacles. Toilet rooms shall have at least one covered waste receptacle for sanitary napkins or diapers. A waste receptacle shall be located at each lavatory or group of adjacent lavatories when disposable towels are used. Plumbing plans must be submitted to the Minnesota Department of Health, Engineering Unit, or delegated authority for review and approval prior to installation. All plumbing must be installed according to the Minnesota Plumbing Code, including current amendments. Equipment connected to the potable water supply shall be protected from back-siphonage. Equipment with submerged inlet lines (dish machine, garbage disposal, steam table, urinal, etc.) shall be equipped with an approved backflow preventer. Toilets shall be equipped with an anti-siphonage ballcock assembly. All threaded hose bib connections shall be equipped with an atmospheric vacuum breaker if no shutoff valve will be located downstream, or a pressure vacuum breaker if a shutoff valve will be located downstream. The water line serving a dipper well shall be permanently installed with an air gap on the water line entering the fixture. If a post-mix beverage system is provided, an approved pressure-type, back-flow preventer upstream from the control valve on the carbonator (water line to the carbonator) is required. Install a hot water heater in accordance with NSF Standard #5. It must be of adequate size and recovery rate to provide hot water to all taps during peak water usage. A lack of hot water at these times will require the installation of additional hot water capacity. Mr. Coen July 2, 2004 Page 5 If a grease interceptor or grease trap is required by the city building official; it shall be mounted flush with the floor in an accessible location for maintenance. The lid shall be water tight and securely fastened in place. Under no circumstances shall a grease removal device be installed above the floor. General Labeline Provide complete labeling information is provided on all prepackaged food products offered for sale at self-service. The labeling of these prepackaged food products must include, but is not limited to: 1) The name of the product; 2) Name, address and zip code of manufacturer, packer or distributor; 3) Complete listing of ingredients in the order of predominance by weight. 4) Net weight. Provide open quality assurance dates on all prepackaged foods with a shelf life of 90 days or less. Label the self-service beverage dispenser to include: a) name of beverage; b) any artificial coloring; and c) listing of preservative(s) and its function. Sinks Employee hand washing sinks must be conveniently located in all food preparation, food dispensing and utensil washing areas. Generally this is within 20 feet as a person walks. Ensure hand cleanser, single-use towels, and a fingernail brush is provided at the hand-wash sink located in the food preparation, and ware washing areas. An NSF three compartment, utensil-washing sink with integral drain boards at both ends must be provided for the proper cleaning and sanitizing of all multi-use equipment and utensils. The size of the sink compartment must be large enough to accommodate the largest utensil/equipment, which is to be cleaned and sanitized. Provide and use an appropriate chemical test kit to determine the strength of the sanitizing agent in the final rinse water of the three-compartment sink. If raw food will be cut or combined with other ingredients, or otherwise processed, must be cleaned with water before being used. Provide a separate food preparation sink. Employee hand sinks, utility sinks or utensil-cleaning sinks would not be considered acceptable for use as a food prep sink. At least one service sink or curbed unit with a floor drain shall be provided and conveniently located for mops, wet floor cleaning tools, and disposal of mop water and similar liquid waste. The plans depicted a mop sink. Provide hooks or hang-up brackets at the utility sink for storage of mops and brooms. Provide a barrier between the janitorial mop sink to ensure adequate segregation from the processing, ware washing or a storage are is the distance between sinks is less than 18 inches. Utensil washing and hand washing sinks are designed, approved and restricted to their respective use and may only be used for food preparation. Storaee Adequate approved NSF or equivalent shelving covering the food service operation must be provided to ensure that food products, utensils or single-service articles are stored at least six inches off the floor. An adequate amount of approved shelving must also be provided to ensure food, utensils and single service articles are stored at least six inches off the floor. 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Perforated or fissured drop lay-in ceiling panels are not acceptable in food preparation, food service, and utensil washing or toilet mom areas. Room Finishes: It is our understanding that the following room finish materials will be provided namely: A room finish schedule indicated that you will install epoxy flooring, painted or FRP walls and vinyl rock ceiling tiles. These are acceptable materials. Ventilation All heating appliances which generate either excessive heat, vapors, condensation, greases, odors or fumes, must be properly situated beneath a mechanical exhaust canopy. The canopy and hood construction must meet the applicable standards of the NSF. In addition, the requirements of the 1991 Uniform Mechanical Code and the 1994 amended Minnesota Building Code covering commercial kitchen ventilation systems must be met. The convection oven will need venting and an exhaust hood was noted. Miscellaneous In accordance with the Minnesota Clean Indoor Air Act, this establishment shall be posted as NO SMOKING ALLOWED. Post signs at all public entrances. This facility may not be constructed, remodeled or converted, except in accordance with the plans and specifications as approved by this department. Please contact me for approval of any proposed changes or additions. Thank you for your cooperation in addressing the items outlined in this letter. I shall remain available for consultation and review of your facility's construction progress. Should you encounter any problems though the course of your construction or equipment installation activities, please call me at 651-297-1072. Sincerely, Jim Roettger Food Standards Compliance Officer Dairy and Food Inspection Division JR:djg C: Norm Danner, Food Inspector Lorna Girard, Supervisor City Building Official r- ? D LOOR PLAN NORTH „ 3'-4„ PROJECT NAME: DATE: THE METRO 04.1 Eagan, Minnesota , Addendum 1 - Revision to floor plan LAMPERT ARCHITECTS 13837 NE Lincoln S1., Ham Lake, MN 55304 Phone: 763.755.1211 Fax: 763.757.2849 ZO'd dZo:co vo-Li-find M 0 a a NORTH ELEVATION p' SCALE: 1/8" = 1'-0 a N 0 M 0 Q 0 n rn 3 Q PROJECT NAME: THE METRO Eagan, Minnesota Addendum 2 - Revision to elevation LAMPERT ARCHITECTS rot 13837 NE Lincoln S1., Ham Lcke, MN 55304 Phone: 763.755.1211 Fax: 763.757.2849 DATE: 04.16.04 - J - - J - J I 0 n n WEST ELEVATION SCALE: 1/8" = V-0" a N O M 0 a 0 n rn 7 Q PROJECT NAME: THE METRO Eagan, Minnesota Addendum 3 - Revision to elevation .?, LAMPERT ARCHITECTS 13837 NE Lincoln St., Ham Lake, MN 55304 Phone: -763.755.1211 Fax: 763.757.2849 DATE: 04.16.04 _______________________---- ^-?,-------T PROPOSED CONVENIENCE STORE INTEGRAL CONC. CURB OT ED ANY NORTH N (I )ACCESSIBLE CURB CUT ?N SCALE: 3/32" = 1'-0" PROJECT NAME: -? DATE: 797 T H E M E T R O ?,.f EAGAN 09.02 ' EVIEWED `?) ' Eagan, Minnesota r Accessible curb cut BY CAM 6- LAMPERT ARCHITECTS DATE ° ??? 13837 NE Lincoln St., Ham Lake, MN 55304 Phone: 763.755.1211 Fax: BOIis6 DID INSPECTIONS DEPT., Date: 4 September 2003 To: J. Craig Novaczyk - City of Eagan Senior Inspector Craig Moss - Vanguard Construction Jim Coen - JCJ Associates Al Kastanek - Triple C Technologies From: Benjamin Ruth Project Designer Lampert Architects Re: The Metro To Whom It May Concern: As requested by J. Craig Novaczyk, Senior Inspector for the City of Eagan, I am providing information regarding the accessibility of a water dispensing system available for public use. According to Accessibility Code Chapter 1341 of the Minnesota State Building Code, the maximum high forward reach allowed shall be 48" for a forward approach to an object, and the maximum high side reach allowed shall be 54" for a parallel approach to an object. The water dispensing system provided at The Metro convenience store will be mounted on top of a 36" high service counter. The top of the water dispensing head will sit at a height of 12" above the counter. The overall height of the system is 48"-above the finished floor. In conclusion, the water dispensing system provided at The Metro falls within the guidelines stated in Chapter 1341. Please contact me if you have any questions or comments. Sincerely, ?en3amt Ruth Project Designer EAGAN REVIEWED BY CZ-1k IG- DATE 4.4.03 BUILDING INSPECTIONS DEPT. A R L C A H M I P T E E R C T T s 1 3 8 3 7 N o r I In e a s t L i n c a I n S I r e e t H a m L a k e, M N 5 5 3 0 4 Phone: 763.755.1211 Fax: 763.757.2849 www. lam per larch. corn 08/2 /2003 08:14 651-644-7164 VANGUARD CONST INC PAGE 02 VANGUARD CONSTRUCTION INC 23N WYQIFF ST., Surm 11 3T. PAUL, WNNESOTA 59114 851 / 644 6W FAX 651 / 6{47184 Memorandum Date: August 25, 2003 To: Craig Novacxyk Senior Inspector City of Eagan From: Craig M. Moss, Cft Subject: The Metro 1650 Diffley Road In resptmw to your voice mail message: 1. The carwash equipment will include a 399,000 BTU boiler for hot water and a200,000 BTU boiler for heated exterior slabs. 2. The details for the service counter are attached. 3- Plumbing and mechanical plans will be submitted when subcontractors apply for permits. If you have any other questions, please contact me. Thank you. EAGAN IEWE® EV BY DATE S'Z6 03 - BUILDING INSPEM ION6 DEPT. COMMERCU BUILDING 1 Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5694 Foundation Only New Building Interior Improvement • Structural Plans (2) sets • Architectural Plans. (2) sets • Architectural Plans (2) sets • Civil Plans (2) • Structural Plans (2) • Code Analysis (1) ** • Certificate of Survey (1) • Civil Plans (2) • Project Specs (1) • Code Analysis (1) • Landscaping Plans (2) * Key Plan (1) • Project Specs (1) • Code Analysis (1) • Master Exit Plan (1) • Spec. Insp. & Testing Schedule ** • Certificate of Survey (1) • Energy Calculations (1) not always- • Soils Report (1) • Spec. Insp. & Testing Schedule (1) • Elec. Power & Lighting Form (1) not always** • Meter size must be established • Meter size must be established • Meter size must be established-if applicable L • Project Specs (1) 1 • Energy Calculations (1) ** 1 1 • Electric Power & Lighting Form (1) ** 1 1 • Master Exit Plan (1) l d • Emergency Response Site Plan (1) `** 1 l • Soils Report (1) 1 • 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 /0/ Construction Cost j a Site Address Sy d '4>- d . Unit/Ste # Tenant Name j,4...* n , T z f -Q Former Tena nt Name Description of Work Fu = ( r /,a -'4 6 r, v . Property Owner j/d 1 Z Telephone#(?S/) GIN -?r`1S Contractor lip r 7` t , a? F , ; {o _ P Address f' 0 2 /-/w Z SS l City M 4 ,r ,. .- a State Z!R , 2 1.1 o Telephone # (7<?) L! 5 - YS > 4 Arch/En ^ JR gr Registration # Address (? J City State Telephone # ( ) Licensed plumber installing new sewerhvater 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. Applicant's Printed Name Applicant's Si ature OFFICE USE ONLY Sub Types ? 01 Foundation ? 14 Apartments ? 15 Lodging ? 25 Miscellaneous ? 26 Public Facility X 27 Commercial/Industrial ? 28 Greenhouse ? 29 Antennae ? 30 Accessory Bldg. ? 32 Ext Alt - Apts. ? 34 Ext Alt - Comm. ? 35 Ext Alt - PF ? 37 Nail Salon Work Types X 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 y-C '2 1 000- M - Valuation _ 1 Occupancy MC/ES System Census Code 37-2- Zoning N8 City Water SAC Units O ` Stories Booster Pump Nbr. of Units 1 Sq. Ft. PRV Nbr. of Bldgs a Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS ? Footings (new bldg) Footings (deck) Footings (addition) _ Foundation _ Drain Tile Roof Ice & Water Final ?Framing Fireplace - R.I. -Air Test -Final Insulation Approved By: Aw-, Planning Division Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S/W Permit S/W Surcharge Treatment Plant Park Dedication Trails Dedication Water Quality Copies Other Total _ Final/C.O. FinallNo C.O. Plumbing _ HVAC Other Pool _ Figs _ Air/Gas Tests -Final Siding _ Stucco _ Stone Windows (new/replacement) Retaining Wall Approved By fstGll ?L` Building Inspector 335. ZS~ /o , !ro 217 - *9r ,a3 . &P G SLd?G- . ,PFD-M l7-' McC4+ - PG-GM Ir foZ0bS to / q-io #23 TO: TOM STRUVE, SUPERINTENDENT OF STREETS & EQUIPMENT BOB KRIHA, UTILITY CONSTRUCTION INSPECTOR DALE WEGLEITNER, FIRE MARSHAL ERIC MACBETH, WATER RESOURCES COORDINATOR GREGG HOVE, CITY FORESTER JOHN CORDER, ASSISTANT CITY ENGINEER KENT THERKELSEN, CHIEF OF POLICE MARK ANDERSON, ELECTRICAL INSPECTOR MIKE RIDLEY, SENIOR PLANNER PAUL HEUER, SYSTEMS ANALYST SCOTT PETERSON, BUILDING INSPECTOR TOM COLBERT, DIRECTOR OF PUBLIC WORKS TOM PEPPER, CHIEF FINANCIAL OFFICER FROM: CRAIG NOVACZYK, SENIOR INSPECTOR DATE: 2003 /j/U/BB C4it/py RE: PLAN REVIEW FVM AWL 165-6 The plans are in our plan review section for your review and comment. Please return this form to my attention with your signed comments and the date of review within seven days. If you have any concerns 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 landscape security required water quality dedication park dedication trail dedication tree dedication PRV Required Signature CD/FORMS/BLDG INSP/PLAN REVIEW CRAIG N Date ZONING? METER SIZE REVISED 9- 02 ..1 TO: TOM STRUVE, SUPERINTENDENT OF STREETS & EQUIPMENT DAVE BENNETT, UTILITY CONSTRUCTION INSPECTOR DALE WEGLEITNER, FIRE MARSHAL ERIC MACBETH, WATER RESOURCES COORDINATOR GREGG HOVE, CITY FORESTER JOHN GORDER, ASSISTANT CITY ENGINEER KENT THERKELSEN, CHIEF OF POLICE MARK ANDERSON, ELECTRICAL INSPECTOR MIKE RIDLEY, SENIOR PLANNER PAUL HEUER, SYSTEMS ANALYST SCOTT PETERSON, BUILDING INSPECTOR TOM COLBERT, DIRECTOR OF PUBLIC WORKS TOM PEPPER, CHIEF FINANCIAL OFFICER FROM: CRAIG NOVACZYK, SENIOR INSPECTOR DATE: OCTOBER 20, 2003 RE: PLAN REVIEW FOR 1650 DIFFLEY RD Lot 6 Block 1, DIFFLEY PLAZA THE METRO SHELL FUEL ISLAND CANOPY The plans are in our plan review section for your review and comment. Please return this form to my attention with your signed comments and the date of review within seven days. If you have any concerns 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 landscape security required water quality dedication park dedication trail dedication tree dedication PRV Required CD/FORMS/BLDG INSP/PLAN REVIEW CRAIG N #23 ZONING?1413 METER SIZE to Date REVISED 9- 02 411? PAT GEAGAN Mayor PEGGY CARLSON CYNDEE FIELDS MIKE MAGUIRE MEG TILLEY Council Members city of aagan THOMAS HEDGES Cry Administrator Municipal Center: 3830 Pilot Knob Road Eagan, MN 55122-1897 Phone: 651.675.5000 Fax: 651.675.5012 TDD: 651.454.8535 Maintenance Facilitr. 3501 Coachman Point Eagan, MN 55122 Phone: 651.675.5300 Fax: 651-675.5360 TDD: 651.454.8535 ..ciryofeagan.com THE LONE OAK TREE The symbol of strength and growrh in our community October 21, 2003 Jim Israelson Westside Equipment Co 902 HWY 55 Medina MN 55430 RE: 1650 Diffley Road Metro Fueling Station Dear Jim: We have started our review of the construction documents submitted in pursuit of obtaining a building permit for the canopy at the above reference property. It is our goal that this review will help you in complying with the applicable codes and agreements, therefore, requesting that the following plans be submitted: 1. Lighting plan with photometric specific to the canopy 2. Site plan indicating location including setbacks If you have any questions feel free to call me at 651-675-5696. Sincerely, y eila Cartney Planner EXHIBIT A CITY OF EAGAN CONDITIONAL USE PERMIT WHEREAS, Coen Development Group, LLC has complied with all the requirements of the City of Eagan necessary for obtaining a Conditional Use Permit. NOW THEREFORE, By order of the City Council of the City of Eagan, Dakota County, Minnesota, and subject to the terms and conditions hereof, a Conditional Use Permit is authorized as follows: Permitting a Conditional Use Permit to allow gasoline sales within the confines of a "Neighborhood Business" zone. 2. Said Conditional Use Permit shall apply to the following described property: Lot 6, Block 1, Diffley Plaza Said Conditional Use Permit shall ran with the land as long as all conditional use standards are met. 4. Said Conditional Use Permit shall be subject to conformance with the Eagan City Code and with the conditions set forth herein to include, but not limited to: The Conditional Use Permit shall be recorded at Dakota County within 60 days of approval and proof provided to the City. The CUP shall be continually subject to the following conditions: A. Canopy lighting shall be reduced as stated in the staff report. B. Staff approves the name brand canopy lighting. IN WITNESS WHEREOF, I have hereunto set my hand this 1st day of July 2003. CITY OF EAGAN A Minnesota Municipal Corporation By: Sheila O'Bryan Planner ?? \? - TOM STRUVE, SUPERINTENDENT OF STREETS & EQUIPMENT DAVE BENNETT, UTILITY CONSTRUCTION INSPECTOR DALE WEGLEITNER, FIRE MARSHAL ERIC MACBETH, WATER RESOURCES COORDINATOR GREGG HOVE, CITY FORESTER JOHN GORDER, ASSISTANT CITY ENGINEER KENT THERKELSEN, CHIEF OF POLICE MARK ANDERSON, ELECTRICAL INSPECTOR MIKE RIDLEY, SENIOR PLANNER PAUL HEUER, SYSTEMS ANALYST SCOTT PETERSON, BUILDING INSPECTOR TOM COLBERT, DIRECTOR OF PUBLIC WORKS ?w A TOM PEPPER; CHIEF FINANCIAL OFFICER .' r-FRAWJ: CRAIG NOVACZYK, SENIOR INSPECTOR DATE: OCTOBER 20, 2003 RE: PLAN REVIEW FOR 1650 DIFFLEY RD Lot 6 Block 1, DIFFLEY PLAZA THE METRO SHELL FUEL ISLAND CANOPY The plans are in our plan review section for your review and comment. #23 Please return this form to my attention with your signed comments and the date of review within seven days. If you have any concerns 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: / d. i ?yd t l c 3n. ac {? ?r? r nc ?- 4 o 1> 4?r Gov n - s. Indicate any fees that are to be collected with the building permit: AMOUNT ? Yes ? No ? Yes ? No ? Yes ? N ? Yes ? 11 Yes ? N ? Yes ? landscape security required water quality dedication park dedication trail dedication tree dedication PRV Required ,o ZONING? METER SIZE Signature Date CD/FORMS/BLDG INSP/PLAN REVIEW CRAIG N REVISED 9- 02 TO: TOM STRUVE, SUPERINTENDENT OF STREETS & EQUIPMENT DAVE BENNETT, UTILITY CONSTRUCTION INSPECTOR DALE WEGLEITNER, FIRE MARSHAL ERIC MACBETH, WATER RESOURCES COORDINATOR GREGG HOVE, CITY FORESTER JOHN GORDER, ASSISTANT CITY ENGINEER KENT THERKELSEN, CHIEF OF POLICE MARK ANDERSON, ELECTRICAL INSPECTOR MIKE RIDLEY, SENIOR PLANNER PAUL HEUER, SYSTEMS ANALYST SCOTT PETERSON, BUILDING INSPECTOR TOM COLBERT, DIRECTOR OF PUBLIC WORKS TOM PEPPER, CHIEF FINANCIAL OFFICER FROM: CRAIG NOVACZYK, SENIOR INSPECTOR DATE: OCTOBER 20, 2003 RE: PLAN REVIEW FOR 1650 DIFFLEY RD Lot 6 Block 1, DIFFLEY PLAZA THE METRO SHELL FUEL ISLAND CANOPY The plans are in our plan review section for your review and comment. #23 Please return this form to my attention with your signed comments and the date of review within seven days. If you have any concerns 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: 1? / he e Indicate any fees that are to be collected with the building permit: AMOUNT ? Yes ? No landscape security required ? Yes ? No water quality dedication ? Yes ? No park dedication ? Yes ? No trail dedication ? Yes ? No tree dedication ? `Yes ? No PRV Required %gnature ZONING? METER SIZE w, 2y- 05 Date CD/PORMS/BLDG NSP/PLAN REVIEW CRAIG N REVISED 9- 02 TO: TOM STRUVE, SUPERINTENDENT OF STREETS & EQUIPMENT DAVE BENNETT, UTILITY CONSTRUCTION INSPECTOR DALE WEGLEITNER, FIRE MARSHAL ERIC MACBETH, WATER RESOURCES COORDINATOR GREGG HOVE, CITY FORESTER JOHN GORDER, ASSISTANT CITY ENGINEER KENT THERKELSEN, CHIEF OF POLICE MARK ANDERSON, ELECTRICAL INSPECTOR MIKE RIDLEY, SENIOR PLANNER PAUL HEUER, SYSTEMS ANALYST SCOTT PETERSON, BUILDING INSPECTOR TOM COLBERT, DIRECTOR OF PUBLIC WORKS TOM PEPPER, CHIEF FINANCIAL OFFICER FROM: CRAIG NOVACZYK, SENIOR INSPECTOR DATE: OCTOBER 20, 2003 RE: PLAN REVIEW FOR 1650 DIFFLEY RD Lot 6 Block 1, DIFFLEY PLAZA THE METRO SHELL FUEL ISLAND CANOPY The plans are in our plan review section for your review and comment. #23 Please return this form to my attention with your signed comments and the date of review within seven days. If you have any concerns 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 landscape security required ? Yes ? No water quality dedication ? Yes ? No park dedication ? Yes ? No trail dedication ? Yes /31 No tree dedication ? Yes ? No PRV Required ArPG- Signature CD/FORMS/BL G INSP/PLAN REVIEW CRAIG N ZONING?_ METER SIZE It) ? ?'6 ?3 Date REVISED 9-02 TO: TOM STRUVE, SUPERINTENDENT OF STREETS & EQUIPMENT DAVE BENNETT, UTILITY CONSTRUCTION INSPECTOR DALE WEGLEITNER, FIRE MARSHAL ERIC MACBETH, WATER RESOURCES COORDINATOR GREGG HOVE, CITY FORESTER JOHN CORDER, ASSISTANT CITY ENGINEER KENT THERKELSEN, CHIEF OF POLICE MARK ANDERSON, ELECTRICAL INSPECTOR MIKE RIDLEY, SENIOR PLANNER PAUL HEUER,`SYSTEMS ANALYST SCOTT PETERSON, BUILDING INSPECTOR TOM COLBERT, DIRECTOR OF PUBLIC WORKS TOM PEPPER, CHIEF FINANCIAL OFFICER FROM: CRAIG NOVACZYK, SENIOR INSPECTOR DATE: OCTOBER 20, 2003 RE: PLAN REVIEW FOR 1650 DIFFLEY RD Lot 6 Block 1, DIFFLEY PLAZA THE METRO SHELL FUEL ISLAND CANOPY The plans are in our plan review section for your review and comment. #23 Please return this form to my attention with your signed comments and the date of review within seven days. If you have any concerns 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 landscape security required ? Yes ? No water quality dedication ? Yes ? No park dedication ? Yes ? No trail dedication ? Yes ? No tree dedication Yes No PRV Required Signature ZONING? METER SIZE /z) A/ Z)-3 Date CWFORMS/13MG INSPIPLAN REVIEW CRAIGN REVISED 9- 02 TO: TOM STRUVE, SUPERINTENDENT OF STREETS & EQUIPMENT DAVE BENNETT, UTILITY CONSTRUCTION INSPECTOR DALE WEGLEITNER, FIRE MARSHAL ERIC MACBETH, WATER RESOURCES COORDINATOR GREGG HOVE, CITY FORESTER JOHN GORDER, ASSISTANT CITY ENGINEER KENT THERKELSEN, CHIEF OF POLICE MARK ANDERSON, ELECTRICAL INSPECTOR MIKE RIDLEY, SENIOR PLANNER PAUL HEUER, SYSTEMS ANALYST SCOTT PETERSON, BUILDING INSPECTOR TOM COLBERT, DIRECTOR OF PUBLIC WORKS TOM PEPPER, CHIEF FINANCIAL OFFICER FROM: CRAIG NOVACZYK, SENIOR INSPECTOR DATE: OCTOBER 20, 2003 RE: PLAN REVIEW FOR 1650 DIFFLEY RD Lot 6 Block 1, DIFFLEY PLAZA THE METRO SHELL FUEL ISLAND CANOPY The plans are in our plan review section for your review and comment. Please return this form to my attention with your signed comments and the date of review within seven days. If you have any concerns 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 landscape security required ? Yes , ?( U" `- No water quality dedication ? Yes ? No park dedication ? Yes ? No trail dedication ? Yes ? No tree dedication ? e?i ? No PRV Required Signat e #23 ZONING? METER SIZE Date CD/FORMS/BLDG INSP/PLAN REVIEW CRAIG N REVISED 9- 02 08/24%2004 08:22 651-644-7184 VANGUARD CONST INC PAGE 02 P 203 LITTLE CANADA ROAD SUITE 280 SAINT PAUL MINNESOTA 55117 TEL: 651-490-9266 FAX: 651-490-9265 /PROFESSIONAL ENGINEERING CONSULTANTS INCORPORATED August 19, 2004 Craig Moss Vanguard Construction 2380 Wycliff St, Suite 11 ;,St,, PAulk Minnesota 66114 Subj: Special Inspection Services The Metro Convenience Store & Car Wash Eagan, Minnesota PIC #6314 Dear Mr. Moss: This letter concerns Special Inspection services we provided for the construction of the Convenience Store, Car Wash, and Canopy for the above referenced project. We provided Special Inspection services for the foundation soils, reinforcing steel placement in the foundations and concrete masonry construction, inspection of welds for the convenience store roof and tested the high tensile bolted connections for the canopy. Based on our inspections, it is our opinion the foundation soils, steel reinforcement, welding, and structural bolted connections comply with the Project Specifications and details as outlined on the Structural Drawings. Respectfully, /?Engineering Consultants, Inc. Professional ®?J-? L?-&641 n F. Gislason, Jr.,.E. COMMERCIAL MECHANICAL Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 Please complete for: commercial/industrial buildings multi-family buildings when separate permits are not required for each dwelling unit Date Site Street Address Unit # Tenant Name (if applicable) Previous Tenant Name Property Owner 7-1`71&- /9?ET2a Telephone # ( ) Contractor Street Address City State /1 IA2• Zip 9O Telephone# (763 Bond #: Expires: The Applicant is Owner Contractor Other Work Type - New construction Install -Remove Underground Tank Interior Improvement Schedule inspection during installation or removal of tank Processed Piping Nature of Work: Permit Fee $50.50 Minim m Fee (includes State Surcharge) u Contract Value $ _,J S, Gb0 x 1% = $ ? Permit Fee • If permit fee is $1,000 or less, add $.50 = $ State Surcharge If permit fee is over $1,000, add $.50 per $1,000 Permit Fee $ O? o Total Fee I hereby apply for a Commercial Mechanical 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 Mechanical Codes; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. ?_D ?GfGzf?%?Z Z2 Applicants Printed Name Applicants Signature Approved B . Inspector Date: / 1 TO: TOM STRUVE, SUPERINTENDENT OF STREETS & EQUIPMENT DAVE BENNETT, UTILITY CONSTRUCTION INSPECTOR DALE WEGLEITNER, FIRE MARSHAL ERIC MACBETH, WATER RESOURCES COORDINATOR GREGG HOVE, CITY FORESTER JOHN GORDER, ASSISTANT CITY ENGINEER KENT THERKELSEN, CHIEF OF POLICE MARK ANDERSON, ELECTRICAL INSPECTOR MIKE RIDLEY, SENIOR PLANNER PAUL HEUER, SYSTEMS ANALYST SCOTT PETERSON, BUILDING INSPECTOR TOM COLBERT, DIRECTOR OF PUBLIC WORKS TOM PEPPER, CHIEF FINANCIAL OFFICER FROM: CRAIG NOVACZYI,SENIOR INSPECTOR DATE: OCTOBER 20, 2003 RE: PLAN REVIEW FOR 1650 DIFFLEY RD Lot 6 Block 1, DIFFLEY PLAZA THE METRO SHELL FUEL ISLAND CANOPY The plans are in our plan review section for your review and comment. #23 Please return this form to my attention with your signed comments and the date of review within seven days. If you have any concerns 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 landscape security required water quality dedication park dedication trail dedication tree dedication PRV Required 5P Signature ZONING? METER SIZE is -zy=-o 3 Date CD/FORMS/nLDG INSP/PLAN REVIEW CRAIG N REVISED 9- 02 2004 COMMERCIAL MECHANICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 . `C Telephone # 651-675-5675 Please complete for: commercial/industrial buildings multi-family buildings when separate permits are not required for each dwelling unit Date 7 //17 / O K Site Street Address 16 S-0 D- ? F t,/i) Unit # Tenant Name (if applicable) % G-e (SOLre) Previous Tenant Name Property Owner / ? 1 <<\ Telephone # Contractor G IyAeol" 'c- I ( ) ^ c- StreetAMddress f? GG? Zc?-cam-? C. City lr Lr ??- State / J Zip Telephone # -716'5 ) Y 2 s x170 Bond #: ?7 3 1 `73--? C! Expires: ?r (? Y The Applicant is Owner Contractor Other Work Type C----New Construction - Underground Tank - Install -Remove "see below _ Interior Improvement - Install Piping -Processed L-T-3as Nature of Work: C- -,? Fr&-e- '"'When installing/removing underground tank, call for inspection by Fire Marshal and Plum Permit Fees: 57050 Underground tank installation/removal LBy 9 2004 $50.50 Minimum (includes State Surcharge) or L" u Contract Value $ x 1% _ $ e ep rmit fee is $1,000 or less, add $.50 = $ State Surcharge • If If gM fee is over $1,000, add $.50 for , -, every $1,000 permit fee $ Total Fee I hereby apply for a Commercial Mechanical 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 Mechanical Codes; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plan Applicant's Printed Name Applicant's Si nature Approved By: S? 7 ??? Inspector FIRE SUPPRESSION SYSTEMS Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5694 a(a (o Requirements: 2 complete sets of drawings and specifications cut sheets on materials and components to be used Date (a / /6 / 63 nn Site Address: /(LSD `L?, l?/ec! KDf'-W Tenant / Building Name: 7-4 V-??e rd'r i The Applicant is: Owner X Contractor Other PROPERTY OWNER T4 &-(r7) n Address: ?q I?nccl City: r«n State: M"1 Zip: CONTRACTOR ?ir?.• (? ? ret SA<<wlUt? _(a j tJtU MN License No. &C.r-4N8 Address: 21tlct Wki-44 orr Ae.,d city: .Std. i4w I State: j'$'ivr Zip: M&O t Phone #: (off ? ` 19?i' ' ESTIMATED COMPLETION DATE: / 64 FIRE PERMIT TYPE: Sprinkler System (# of heads - Fire Pump Standpipe Other: WORK TYPE: New - Addition Alterations - Remodel Other: ?? f ! n ut ? 12003 DESCRIPTION OF WORK: Commercial R dential - Ed{ucational By- -_ - -I Other: PLEASE COMPLETE REVERSE SIDE PERMIT FEE: Contract Value $ 11,060 x .01% _ $ lit) -e-u Permit Fee • If Permit Fee is $1,000 or less, add $.50 => $ SO State Surcharge If Permit Fee is over $1,000, add $.50 per $1,000 Permit Fee 3/4" Displacement Fire Meter - $156.00 $ ly.,4u TOTAL FEE: $50.50 Minimum Fee (includes State Surcharge) $ 2(o4- 3O I hereby apply for a Fire Suppression System permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Minnesota Building/Fire Codes; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Lxl t0?25C,?1u k 4 e+,. Applicant's Printed Name cant's ' ature ja -/0.03 Date DO NOT WRITE BELOW THIS LINE REQUIRED INSPECTIONS Hydrostatic Flow Alarm Drain Test 4- Rough In Trip Pump Test Central Station Final Conditions of Issuance: Permit Approved Date: 49 / /9-3,- city of eagan PAT GEAGAN Mayor PEGGY CARLSON CYNDEE FIELDS MIKE MAGUIRE MEG TILLEY Council Members THOMAS HEDGES City Administrator Municipal Center: 3830 Pilot Knob Road Eagan, MN 55122-1897 Phone: 651.675.5000 Fax: 651.675.5012 TDD: 651.454.8535 Maintenance Facility: 3501 Coachman Point Eagan, MN 55122 Phone: 651.675.5300 Fax: 651.675.5360 TDD: 651.454.8535 www.cityofeagan.com THE LONE OAKTREE The symbol of strength and growth in our community August 13, 2003 MR CRAIG MOSS VANGUARD CONSTRUCTION INC 2350 WYCLIFF ST #11 ST PAUL MN 55114 RE: THE METRO 1650 DIFFLEY ROAD Dear Mr. Moss: 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 2000 I.B.C. It is our goal that this review will help you in complying with the applicable codes and we are, therefore, requesting that the following items be addressed: 1. Please provide a second copy of the Civil Plan package 2. SAC determination letter 3. 1 set of project specs 4. 1 Special Inspections And Testing Schedule (enclosed) 5. 1 set of energy calcs 6. Electric Power And Lighting Form (enclosed) 7. Emergency Response Site Plan (sample enclosed) If you have any questions regarding the above requirements, please contact me at 651- 681-5683. Thank you. Sincerely, J. Craig Novaczyk Senior Inspector JCN/j s Encl. ?Ock?q) COMMERCIAL MECHANICAL Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 Please complete for: commercial/industrial buildings multi-family buildings when separate permits are not required for each dwelling unit s ao 6 " Date's/ 2-e / dy n Site Street Address > 6 So ro?cx y Ae o Unit # Tenant Name (if applicable) Ti /` AP.772-d Previous Tenant Name M/ 4f P t O 040- T l hone # ( ) roper y wner e ep Contractor ?orJEc? i f ..4 J7`x Street Address 3i 8 aeJT S, /Vt City i?Jr ffl?otsJ State Zip ;5 S-// f3 Telephone # (4 / ,t ) 7 f3/-3 35S Bond #: Expires: The Applicant is Owner Contractor Other Work Type o 1 zooo ?uN New construction -Install - Remove Underground T Interior Improvement Schedule inspectio n during Installation or remov ytank _ Processed Piping Nature of Work: ?Ni tL ivE /a 7b JZ?v Gowrp rP, .cam Jai u.Vcr.r Fr T / - G9TC_ LPL Permit Fee $50.50 Minimum Fee (includes State Surcharge) Contract Value $ _ A0 s-00 x 1% _ $ .2 OS-•S-c+ Permit Fee • If permit fee is $1,000 or less, add $.50 => $ -3? State Surcharge If permit fee is over $1,000, add $.50 per $1,000 Permit Fee $ $a D 6. 00 Total Fee I hereby apply for a Commercial Mechanical 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 Mechanical Codes; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. ':n y 6??. ApA's Printed Name Applic s Signature Approved By: Inspector Date: 2004 COMMERCIAL MECHANICAL PERMIT APPLICATION City Of Eagan 9 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for: commercial/industrial buildings multi-family buildings when separate permits are not required for each dwelling unit Date /116 / 20 0 + 1 (o? Site Street Address ' j7 lE a Unit # Tenant Name (if applicable) ?tt i f \1-/2? CO ??? "'Y7ev us`Tenant Name / Q S " C) 1, Property Owner Telephone # ( ) Contractor 4E (Z,(nrsy- 60.,2Q Street Address ?;klct<Et A P& S City Nu? E-14 4221 'e State Zip s? L( 1 (0 Telephone # (??Z ) QLz; - tO Bond #: Expires: f 3 ?? (0 0'? q / The Applicant is Owner Contractor Other Work Type New Construction _ Underground Tank _ Install -Remove *"see below ,k Interior Improvement - Install Piping -Processed -Gas Nature of Work: '/1SToI? ito?? EJC JSr t-gO iAN-?P ?JC>ctt/ol GEnI SAIQW04 "When installing/removing underground tank, call for inspection by Fire Marshal and Plumbing Inspector Permit Fees: $70.50 Underground tank installationlremoval D 1 D $50.50 inimmn (includes State Surcharge) JUN 1 7 2004 O 00 Contract Value $ 3'L x 1% e • If eo rmit fee is $1,000 or less, add $.50 = $ State urc ge If ep rmit fee is over $1,000, add $.50 for SO SJ every $1,000 permit fee Total Fee $ I hereby apply for a Commercial Mechanical 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 Mechanical Codes; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the `approved plan in the case of work which requires a review and approval plans. ?So?pk kcR ?IVL Applicant's Printed Name Ap licant Signaturel- p / G t Approved By: j l ?? Inspector 2004 COMMERCIAL PLUMBING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 (? y 651-675-5675 Date L _ /r/ O . Site Address `($? Qt'(=? 4 7 (t (J Unit # Tenant Name CGn (n ( I ?(? t Former Tenant Name Property Owner Telephone # ( ) Contractor VVS ?? LM? tr ??I Address [$15 A- S-t-r. S; S City fC /J?h3 State M/1 zip SV Y3 Telephone # (IM 99J? S??? The Applicant is Owner Contractor Other Work Type New Bldg _ Add-on _ Repair _ RPZ _ PVB _ Irrigation system " Jer Wobschall [o calculate fees. Re aired meter size is 2" turbo fen smaller size ermitted by Public Worlis Description of Work ( J 2u f (xtS S }ei? -f\ To inquire if Pressure Reducing Valve is required on new Service, call 651fi75-5646 Meters - Call 651-675-5300 to verify that hydrostatic, conductivity, and bacteria tests passed prior to picking up.meter Irrigation Size & Type Avg GPM 410 Fire Size & Price 3/*4" displacement $155.00 ' v Domestic Size & Type --?, 17- VAvg UPM ' Includes high demand devices' _ Yes _ No C Flushometers _ Yes No PRV Required _ Yes _ No Permit Fee $50.50 min imam (includes State Surcharge) / Contract Value $ t7 x 1% - $ S .0 y Base Fee $ ySS5 .0 0 Meter(s) Required on all new buildings & boulevard irrigation systems $ { - U 0 Radio Meter Read If base fee is $1400 or less, surcharge is $.50 .? $ -,? 0 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 651-675-5024 far required fee amounts $ Treatment Plant D Water Supply & Storage APR _1 4 2004 state surcharge $ v Total Fee I hereby apply for a Commercial Plumbing Permit an ormation is complete and accurate: that the work will he in contormance with the ordinances and codes of the City of Eagan and with the Plumbing Codes; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and ap roval of plans. 4- / mss s? Applicant's Printed Name Applicant's Signature )-VL4 C" u n_± Eaean f°e:e;p mate.. :e_airit lumber 56(34 PERMIT FEE SUMMA6:v u_T8ui.4C85 PERMIT FEE SiiMMARY PERMIT FEE SUMMARY 4415._545 3i'.SO PEfrIT FEE ;UMMARv 6101.450-9 4891. 00 PERMST FEE SlOMARY Hel.4087 EES, ? PE&:MiT FEE SUMMARY OR1.4Uu' UM F'EM, 1-1 FEE '=t1MMaR'Y EIOIAWN 54 .00 PERMIT FEE 7UMMARY ROL214J 1. 50 PERM_ _ I FEE 5!!MMAf P. Ta6a1 Receipt firvaunt °,863.44 1355c 44; 4b-1 TO: FROM: DATE: SUBJECT: LEGAL: MEMO city of eagan DALE SCHOEPPNER, CHIEF BUILDING OFFICIAL DALE WEGLEITNER, FIRE MARSHAL PAUL OLSON, SUPERINTENDENT OF PARKS MIKE RIDLEY, SENIOR PLANNER CAROL TUMINI, UTILITY BILLING CLERK TIM PARR, ENGINEERING TECHNICIAN LEON WEILAND, CONSTRUCTION INSPECTOR CONSTRUCTION SUPERVISOR TOM COLBERT, PUBLIC WORKS DIRECTOR JOHN GORDER, DEVELOPMENT/DESIGN ENGINEER TOM STRUVE, SUPERINTENDENT OF STREETS & EQUIPMENT PAUL HEUER, SYSTEMS ANALYST ERIC MACBETH, WATER RESOURCE COORDINATOR MARK ANDERSON, ELECTRICAL INSPECTOR SCOTT PETERSON, PLUMBING INSPECTOR CRAIG NOVACZYK, SENIOR INSPECTOR TERRY ZELENKA, COMBINATION INSPECTOR AUGUST 16, 2004 FINAL INSPECTION FOR THE METRO GAS STATION/STORE 1650 DIFFLEY ROAD LOT 1 BLOCK I DIFFLEY PLAZA The Protective Inspections Division will be performing a final inspection at 1650 Diftley Road on Wednesday, August 18, 2004. 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. 11 ,. - 2007 COMMERCIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 (-fix Plans are considered public information unless you state they are trade secret and why. • Structural Plans (2) sets • Civil Plans (2) • Certificate of Survey (1) • Code Analysis (1) • Project Specs (1) • Spec Insp & Testing Schedule (1) " • Soils Report (1) • Meter size must be established • SAC determination -call 651-602-1000 at or • Architectural Plans (2) sets • Code Analysis (1) " • Project Specs (1) • Key Plan (1) • Master Exit Plan (1) • Energy Calculations (1) not always- • Elec. Power & Lighting Form (1) not always" • Meter size must be established-if applicable • SAC determination -call 651-602-1000 facilities. ** Contact Building inspections to see if it is required and for a sample. *** Permit for new building or addition will not be processed without Emergency Response Site Plan. Date II- Construction Cost Y.S?QQU 6d Site Address 1&50 r)JFFLrY rZo Unit/Ste # Tenant Name HOL )VA if 57/.. yio?,?s'>orzE Former Tenant Name SH.E[ e Description of Work WEL LNELYO! Y ` 6?r? l.)7fA? Gc?e.N'7ElJS iNTE/2 can AfGo J2 Property Owner 40: oAV S)b•TioeJSTG'7ESy Ie?e - Telephone # (ys-z )133 O -. R 76 O Applicant is: _y Owner _y Contractor Contact #: ( ) Contractor No Clue, 57-4-TI D V51e7F5 iwe Address ?,5 6) /.,•J'/?r7 )Ct.h/ I3 L:. .?: w . City R eGC r7 eNLiah? State r ?.,4 Zip S'S 1/3-7 Telephone # (qsZ) FI3 a - <3gd% Arch/Engr Registration # Address City State Zip Telephone # ( ) Licensed plumber installing new sewertwater service: Phone #: ( ) I hereby apply for a Commercial Building Permit and acknowledge that the intormation is complete and accurate; that the worK will be m conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; I understand t ?i >,lu•a1a application for a permit, and work is not to start without a permit; that the work will be in accordance with t fft fl n. work which requires a review and approval of plans- To,- e- D. c Eec Applicant's Printed Name • Soils Report (1) • Certificate of Survey (1) • Structural Plans (2) • Architectural Plans (2) sets HVAC units req'd. on bldg elev. / site plan • Civil Plans (2) • Landscaping Plans (2) • Code Analysis (1) ^^ • Energy Calculations (1) " • Emergency Response Site Plan (1) • Spec. Insp. & Testing Schedule (1) " • Electric Power & Lighting Form (1) " • Project Specs (1) • Master Exit Plan (1) • SAC determination - call 651-602-1 000 • Fire Stopping Submittals • Fire SuppressionlAlarm Form Signature DEC 19 2007 . ti - '. I . DO NOT WRITE BELOW THIS LINE Sub Types ? 01 Foundation - 26 Public Facility ? 30 Accessory Building ? 14 Apartments ?-"27 Commercial/Ind ustrial ? 32 Ext Alt-Apartments fl 15 Lodging L 28 Greenhouse _ 34 Ext Alt-Commercial 25 Miscellaneous ? 29 Antennae 7 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 5??33 Alteration ? 37 Demolish (Bldg)` ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement 'Demolition Building -Give PCA handout to applicant Valuation ; ? OOa ?. Type of Const 3M Width Plan Rev 100% r' 25%_ Occupancy MCES System SAC Units -?- Zoningr City Water Nbr. of Units Stories Booster Pump Nbr. of Bldgs Sq. Ft. PRV Fire Sprinklered - r_ Length 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 "f N Final C/O Inspection: Schedule Fire Marshal to be present. o _Yes Approved By: U 1 - Planning % Building Inspector Base Fee Surcharge Plan Review SAC-MCES SAC-City S1W Permit S/W Surcharge Treatment Plant Treatment Plant (Irrigation) Park Dedication Trail Dedication Water Quality Water Supply & Storage (WAC) 4/3.00 /a,so 0160.49- Financial Guarantee Stone Sewer Trunk Sewer Lateral Street Water Lateral Other Total (093,95 Sewer Trunk Water Trunk City of Eap 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 v/-/O c3c6-itw+ CJV C-L ol- plc vu ---------, j For Office Use I I <; I I Permit #: I I Permit Fee: , ??? • 00 j 1 I Date Received: t Staff: Ciro- ----------------- 2008 COMMERCIAL PLUMBING PERMIT APPLICATION Date: - O ?. Site Address: 1 lc So -Z \ JP Bre \ toA () Tenant: lAl7 I,--%rl . SCAT\??.1 S??C Suite #: PROPERTY Name: Phone: OWNER CONTRACTOR 1 Name: ?l l] - Mf_' A,An l IC' om License #: C7Sk3 &0 PM Address: g lo3 QA\IE^&LLT S?City: &.6,t r`te' State:YVWZip: S,L4443 LAC(Cy?Fl..o Phone: '7ko..5` 7?tb <161.-? Contact Person: '%N&kjLF- TYPE OF New Replacement _ Repair _ Rebuild X Modify Space _ Work in R.O.W. WORK Description of work: OE b S,,V 1 5 i-iIL S PERMIT TYPE COMMERCIAL gl ucp-A(? EQU1r• New Construction X Modify Space _ Irrigation System (_ yes no) L_ 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 uv meter. Domestic: Size & Type Fire: Size & Price 3/4" meter 183.00 Avg. GPM High demand devices? _Yes _ No Flushometers _Yes No PRY Required _Yes _No COMMERCIAL FEES: $50.50 Minimum (includes State Surcharge) OR Contract value $ to H 00.00 x1% =$ ?PV. 00 Permit Fee Required on ALL new buildings and boulevard irrigation systems 4 = $ N A Radio Meter Read - It Permit Fee is less than $1,000, surcharge is $.50 = $ N A. Meter(s) - If Permi Fee is > $1,000, surcharge increases by $.50 for each $1,000 SO- $1,000 Permit Fee (i.e. a $1,00142,000 Permit Fee requires a $1.00 surcharge). State Surcharge _ $ k - Following fees apply when Installing a new lawn irrigation system. $ nlra Water Permit Call the City's Engineering Department, (651) 675-5646, for required fee amounts. $ NA Treatment Plant $ n1 w Water Supply & Storage $ •t .?E+ State Surcharge TOTAL FEES $ O • (a r GL FOR OFFICE USE Approved By: Required Inspections: X Under Ground 'X/ROUah-In `,(Air Test Date: !as Test final Page 1 of 3 HOLIDAY STATIONSTORES 4567 American Boulevard West, Bloomington, MN 55437 (952) 830-8700 o STATIOPSTORES City of Eagan December 18, 2007 3 Pilot Knob Road Eagan, Mn 55122 Attn: Building Department Re: Holiday Stationstore 4401 1650 Diffley Road Eagan, MN Dear Building Department: I am submitting to you the Building Permit Application along with the existing and proposed floor plans for the above location. This location was operated as a SHELL station and was recently purchased by Holiday Stationstores, Inc. Holiday Stationstores Inc. is considering a interior remodels and denoted below. 1. Reswing current exit door on front of building 2. Remove existing coffee, pop counters and replace with new counters. 3. Install new food and pop equipment. -/4. Remove old checkout, relocate and replace with new cabinets. ,/5. Remove existing exhaust hood in back room. 6. Relocate door opening leading into back room 7. Possibly add a quarry the floor in the sales area. As you can see the interior work is very minor and may or may not require a building permit, thou I wanted to make you aware of it. I intend to start this project about January 3, 20087. During your plan review if you should have any questions, please feel free to contact me at 952-830-8884 or via fax at 952-830-1678. Sincerely, Holiday Companies Joel D. Geil Construction Supervisor/Project Manager !DEC '19 2007 r - - - - - - - - - - - - For Office Use 1 U11 I Permit City 0f Eaall - j" -1 t,JAY 3830 Pilot Knob Road I Permit Fee: Eagan MN 55122 Phone: (651) 675-5675 I Date Received: I Fax: (651) 675-5694 j Staff: 2008 COMMERCIAL PLUMBING PERMIT APPLICATION Date: Z Q Site Address: 1 ~r1Z j ~ L/ t4 Tenant: 7 y~ Sly Suite PROPERTY OWNER Name: Phone: CONTRACTOR MetroTestlrtg Name: License#: QS--&-q7&, Address: 31222 Cedar Creehi pad State: Zip: BSI Phone:~ f Z Z2) - inckley, MN 55037 Contact Person: TYPE OF WORK New - Replacement - Repair Rebuild Modify Space Work in R.O.W. - ,I - - Description of work: ~P 61!`~/V1 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 $183.00 Avg. GPM High demand devices? Yes _No Flushometers _Yes _No PRV Required _Yes _No COMMERCIAL FEES: $50.50 Minimum (includes State Surcharge) OR Contract Value .55 x 1% 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 eti) State Surcharge TOTAL FEEAL_3(d 7W 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 ap roved plan in the case of work which -equires a review and approval of plans. x Applicant's Printed Name Applicant's Signatur FOR OFFICE USE Approved By: Date: Required Inspections: Under Ground Rough-In Air Test Gas Test Final Page 1 of 3 City of Eaaan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 2009 FIREWORKS SALES AND STORAGE APPLICATION MIMI Applicant requirements 1. An application must be completed and returned at least 30 days prior to outdoor sales and/or storage of fireworks. 2. An applications for indoor sales of fireworks must be submitted between April 1st and June ' st to obtain a permit. 2. A fetter from the property owner granting permission to the applicant to sell and/or store fireworks on the property shall accompany the application. 3. A floor plan designating the area where the fireworks will be sold andior stored shall accompany the application 4. A list of the fireworks that will be sold and/or stored along with the name, weight, quantity, and material safety data sheets (MSDS) shall be included. 5. A copy of the certificate of insurance coverage as per City of Eagan City Ordinance No. 387, Chapter 6. Section 6.53 Fireworks is required. 6 The Fire Marshal or his/her designee will inspect the proposed location for selling and/or storing fireworks to determine if it is a suitable location. 7 A criminal record check will be done on all applicants. 8. A copy of the City of Eagan license (permit) shall be displayed by the register, Date: 5/4/09 BusinessName: Holiday Stationstore #401 Telephone#:(6Sl 686-4525 Display Address: 1650 Diffley Rd, Eacan MN 55122_ Applicant Name: Holiday Stationstores, Inc. Street Address: 4567 American Blvd West City: Blootniaaton State: Minnesota Zip: 55437 Telephone#: (952) 830-8700 Retail seller selling exclusively consumer fireworks: _ Yes X No X Indoor Sales Dates: 5/15 to 7/31/09 - Outdoor Sales Dates: to to to Please check the selections that apply to this permit Outdoor Sales $410.50 X Alt other retail sellers $100.50 (includes: $280.00 Fireworks Permit; $128.50 Tent Permit; $2.00 State Surcharge) Sign Permit $ 25.00 Temporary outdoor event means an exhibition or sale with a duration of 10 or less continuous days which does not occur more than once every 30 days and more than three times per year or a combination of 20 days total in a calendar year (See Outdoor Sales of Fireworks). Fireworks are regulated by MN Statutes 624.20-624.25. In addition to these state laws, all displays, sales, storage and use of fireworks shall comply with City of Eagan Ordinance No. 387, Section 6.53 Fireworks and NFPA 1 124 Standards. I understand and agree to comply with all the provisions of this application and the requirements of the issuing authority Holiday Stationstores, Inc. Applicant Signature James R. Hupp, Assistant Secretary Fireworks Application Page 2 of 9 Tennessen Warning License Application Minnesota law requires that you be informed of the purposes and intended uses of the information you provide to the City of Eagan (the City) during the license application process. Any information about yourself that you provide to the City during the license application process will be used to identif\ you as an applicant and to assess your qualifications for selling fireworks within the City. If you wish to be considered for a permit to sell fireworks, you are required to provide the information requested in the permit application. If you refuse to supply information requested by the City, it may mean that your application will not be considered All individuals in the City who need to know information will have access. Holida Stationstore , Inc. Appiic Signature Date Ja s R. Hupp, Assistant Secretary - - - - - - - - - - - - - - - - Authorization and Consent for Release of Information f, James R. Hupp, Assistant Secretary, freely and voluntarily authorize the City of Eagan to conduct an Name of individual authorizing release investigation to obtain the following information for the purpose of determining my eligibility for a permit to sell fireworks: Name: Hupp James Robert Last First - Middle Date of Birth: 06/04/1958 Driver's License R238122255613 S,a o MN I also release the City of Eagan from any and all liability for its receipt and use of information and records received pursuant to this consent. I further acknowledge that I have carefully read this release, fully understand its terms and legal significance, and execute it voluntarily. Executed this day of 200 Signature Fireworks Application Page 3 of 9 BE&.•OW THIS; LJN;:.. The Police Department has conducted a criminal background check on the aforementioned applicant. Comments: Police Department Representative Date Conditions of Issuance: Background check completed and approved by EPD: Yes No Zoning approval Yes No Facility inspection complete and all violations corrected Yes No Insurance policy approved Yes No Need Site plan, sign permit and written permission of property owner Yes No Building Permit Application for Tent ?J•{o Yes No License approved by., .2L Date approved ~,E OFFj MEMORANDUM EAGAN POLICE DEPARTMENT 3830 Pilot Knob Road Eagan, MN 55122 Li 651-675-5700 651-675-5707 FAX DATE: May 14, 2009 TO: City of Eagan Dale Wegleitner FROM: Sgt. Steve Bolluyt l SUBJECT: Background for Fireworks Application -Holiday Store, 1650 Diffley Road The Eagan Police Department has conducted a background investigation as authorized by the applicants Authorization for Release of Information. A review of the applicant's criminal history, local police contacts and/or records, driving status, and warrant history was completed. After completion of the background for the license applicant, the police department rinds no cause to deny the application based on the criminal records check. Cc: 09-2686 HOLIDAY STATIONSTORES 4567 American Boulevard West, Bloomington, MN 55437 (952) 830-8700 • • a STATIONSTORES May 4, 2009 City Clerk City of Eagan 3830 Pilot Knob Road Eagan, MN 55122 Re: 1650 Diffley Road City Clerk , I am enclosing a completed application of Holiday Stationstores, Inc. for the sale of consumer fireworks in the City of Eagan. The application requests that "a written authorization of the property owner for the applicant's use of the property for the sale of permitted consumer fireworks" be attached. However, the lease between the landlord and Holiday Stationstores, Inc. for the above location allows Holiday Stationstores, Inc. to sell fireworks without the consent of the landlord. I have attached a Certificate of James R. Hupp of Holiday Stationstores, Inc. to that effect. Therefore, the signature of the landlord is not necessary. Thank you for your assistance in this matter. Yours very truly, U -%AD~,L Cassandra Perdue Licensing Assistant Permission to Sell Completed 050209.doc CERTIFICATE I, James R. Hupp, the Assistant Secretary of (Holiday Stationstores, Inc.), certify that the lease for the Holiday Stationstores, Inc. location at 1650 Diffley Road allows (Holiday Stationstores, Inc.) to sell fireworks at that location without the consent of the landlord. J mes R. Hupp STATE OF MINNESOTA ) )ss. COUNTY OF HENNEPIN ) The foregoing Certificate was ackn Wedged before me this 0' day of 2009 by Jam- 5 I Cr?©, Assistant Secretary of Holiday Stati stores, Inc., a Minnesota corporation. AW K PEON ty pubft A ublic Mon 3i 2M2 Permission to Sell Certificate 050209.doc .s-.t = .e/S :str,)s NJ' 'NV-DV 9 uo dp TT~1/J bI~"Id II2IIIJXI3 s w TT TTL~J~ g c ~ a TO-P# >r1 rr~~H0ISw~1~1 M~TTO1~ ` Q'1SOd02idw al I I I I I I I I ~Q ago O\\_ xx a.. J o Z w ~ ~ ~ LL ~ N F $ dos s~~~ w ~x 3 mo S' o^ rc rc o OC gg55 3d ~ x - O a ~ > it ro s.a,wn _ J E /sz, 7J~ 4~ I q ~l s 18 e ~ i .a ev s z ~ Ob os> 4 s D oo0oOQ I 5 '~4Es MINNESOTA EMERGENCY RESPONSE COMMISSION 444 CEDAR ST., SUITE 223, ST. PAUL, MN 55101 y`'aL o PHONE: (651) 297-7372 TIY (651) 282-6555 FAX (651) 296-0459 nnmrt~"' TIER TWO EMERGENCY AND HAZARDOUS CHEMICAL INVENTORY REPORT FORM SPECIFIC INFORMATION BY CHEMICAL ERC IU# Reporting period from Jan. Ito Dec. 31, Page _ of_ pages. *Important: Read all instructions before complc(ing form. Print information in CAPITAL LETTERS. Facility Identification Name H O L I D A Y1 I S T A TI I S-1 Il 01 R1 E Street Address y0 fr L E 0 D City Slate Zip M N 55 1 SIC Code County prKD-r Owner/ Operator Name or Reporting/ Fee Contact Name I J AIM E S H U P P Mailing Address 14 5 6 7 A M E I B I C A N B L V D W E S T City State Zip B L O O M I N G T O N M N 5 5 4 3 7 1 1 2 3 Phone 19 5 2--8 3 0 8 7 0 0 Emergency Contacts Name #1 Title S IT O R E M A N A G E R Phone 24 Hr. Phone F" - loo 13 ~A 1- 7 ( p 9 512 ° 9 2 1 H 5 510 0 Name #2 T S IPA 6 l Title SS~S IPrN hlE Phone 24 Hr. Phone 19 5 2 H 9 2 1'° 5 5 0 0 Form 9 PS•ERCY32 (3/00) TIER TWO EMERGENCY AND HAZARDOUS CHEMICAL INVENTORY REPORT FORM Page of pages. Facility Name r,,-RC ID# - CHEMICAL CAS# 71 1= ? Trade Secret p Chemical Name ro S r ' I . q DESCRIPTION PureQ Mix Solid Liquid O Gas0 El IS O (Check all that apply) El IS Name PHYSICAL Fire Max. Daily Sudden Release Amount (code) I AND 0 of Pressure HEALTH O Reactivity INVENTORY Amount Aount Daily J (code) D HAZARDS 0 Immediate (acute) Number of Days (Check all that apply) On-site 7 O Delayed (chronic) Container Pressure Temperature Storage Locations Site Plan Attached? STORAGE 5 't._ ri CODES AND Yes A LOCATIONS (Non-Confidential) El El I No O CHEMICAL CAS#, L J I- Trade Secret O Chemical Name r e o* KS A r~ n I- y G DESCRIPTION PureQ Mix 0 Solid Liquid O GasO EHS 0 (Check all that appl)) El IS Name PHYSICAL Fire Max. Daily Sudden Release Amount (code) t AND O of Pressure HEALTH 0 Reactivity INVENTORY AAverage mount (code) C ' HAZARDS 0 Immediate (acute) Number of Days (Check all Neat appl),) 0 Delayed (chronic) On-site Container Pressure Temperature Storage cation Site Plan STORAGE e >>I P_ rt; fl Attached? CODES AND Yes 9 LOCATIONS (Nan-Confidential) No O Certification: I certify under the penalty of law that I have personally examined and am familiar with the information submitted in pages one through , and that based on my inquiry of those individuals responsible for obtaining the information, I believe that the submitted information is true, accurate and complete. SEE ATTACHED LETTER FROM SUPPLIER ,4/1/09 Name and official title of owner/operator's authorized representiti'e. Signature Date signed TIER TWO EMERGENCY AND HAZARDOUS CHEMICAL INVENTORY REPORT FORM Page of_ pages. Facility Name ERC ID# ETT-FFTT-TTTT1 CHEMICAL CASH m Trade Secret 0 Chemical Name sao"~- b DESCRIPTION PureQ Mix Solid Liquid O CasQ ERS 0 (Check all that apply) El IS Name PHYSICAL $ Fire Max. Daily AND 0 Sudden Release Amount (code) of Pressure II EA LTFI 0 Reactivity INVENTORY Amount (code) HAZARDS O Immediate (acute) Number of Days On-site 1-71 L (Check all that apply) O Delayed (chronic) Container Pressure Temperature Storage cations Site Plan STORAGE Attached? CODES AND Yes LOCATIONS (Non-Confidential) No Q CHEMICAL CAS# I m Trade Secret p Chemical Name EC51-1 ri C, - Y\ G y DESCRIPTION PureQ Mix Solid Liquid O Gas Q EULS O (Check all that apply) El IS Name PHYSICAL Fife Max. Daily Sudden Release Amount (code) AND 0 of Pressure HEALTH 0 Reactivity INVENTORY Amoun Average Daily Amount (mdc) L~ c7Z HAZARDS 0 Immediate (acute) Number of Days (Clreck all that apply) Q Delayed (chronic) On-site 0i Container Pressure Temperature Storage Locations Site Plan STORAGE vex Attached? CODES AND Yes LOCATIONS (Non-Confidential) No Q Certification: I certify under the penalty of law that I have personally examined and ant familiar with the information submitted in pages one through and that based on my inquiry of those individuals responsible for obtaining the information, l believe that the submitted information is true, accurate and complete. SEE ATTACHED LETTER FROM SUPPLIER IF- LL 4l 1 Name and official title of owner/operator`s authorized representitire Signature Date signed TIER TWO EMERGENCY AND I IAZARDOLIS CUM CAL INVENTORY REPORT FORM Page_ of i)nges. Facility Name F.RC ID# I- CAS# TT= m Trade Secret 0 CHEMICAL Chemical Name I/Vo eez T/F~ c L l~'r ? DESCRIPTION PureO Mixes, Solid) Liquid p Gasp El IS 0 (Check all that apply) El IS Name PHYSICAL Fire Max. Daily Sudden Release Amount (code) AND Q of Pressure 0 Reactivity Amount (code) HAZARDS 0 Immediate (acute) Number of Days On-site (Check all that apply) 0 Delayed (chronic) Container Pressure Temperature , , Storage Locations Site Plan STORAGE (_Ad Attached? CODES AND Yes LOCATIONS (Non-Confidential) No Q CHEMICAL CAS# EE El Trade Secret 0 Chemical Name C' t f TE as 7 ' ( . DESCRIPTION Pure Q Mix Solid Liquid 0 Gas0 EILS 0 (check all that apply) EMS Narue PHYSICAL .0 Fire Max. Daily Sudden Release Amount (code) / AND 0 of Pressure Average Daily HEALTH 0 Reactivity - INVENTORY Amount (code) / HAZARDS 0 Immediate (acute) Number of Days eck all that apply) (Ch 0 Delayed (chronic) Container Pressure Temperature Storage Locations Site Plan At 17-ts~ v r_ r± STORAGE Attached? CODES AND Yes C' LOCATIONS No Q (Von-Confidential) F1 Certification: I certify under the penalty of law that I have personally examined and am familiar with the information submitted in pages one through and that based on my inquiry of those individuals responsible for obtaining the information, I believe that the submitted information is true, accurate and complete. SEE -ATTACHED LETTER FROM SUPPLIER 4/1/09 Name and official title of owner/operator's authorized representitiva Signature Date signed DATE(MM/DD/YYYY) ACORD,. CERTIFICA-FE OF LI.thILIT'y INSURANCE 04/30/2009 PRODUCER Aon Risk services central, Inc. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY Aon Minneapolis MN office AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS 8300 Norman Center Drive CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE suite 1000 COVERAGE AFFORDED BY THE POLICIES BELOW. Minneapolis MN 55437 USA PHONE-(952) 656-8000 FAx- (312) 381-0536 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: National Union Fire Ins Co of Pittsburgh 19445 Holiday Companies, ET AL INSURERB: New Hampshire Ins Co 23841 DBA: Holiday Stationstores 4567 American Blvd. west INSURER C: a Minneapolis MN 55437-1123 USA INSURER D: INSURER E: COVERAGES SIR applies per terms an conditions of the o lcv 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LIMITS SHOWN ARE AS REQUESTED INSR ADD' POLICY EFFECTIVE POLICY EXPIRATION LTR INSR TYPE OF INSURANCE POLICY NUMBER DATE(MM\DD\YY) DATE(MM\DD\YY) LIMITS A GENERAL LIABILITY 0907318 04/01/09 04/01/10 EACH OCCURRENCE $1,000,000 COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $1,000,000 PREMISES (Ea occurence) CLAIMS MADE ? OCCUR MED EXP (Any one person) Exc u e X $500,000 SIR co ? PERSONAL &ADV 1N1URY $1,000,000 ot -1 GENERAL $2,000,000 N GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $2,000,000 ? POLICY El PRO- ? LOC O JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) Z ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS ( Per person) HIRED AUTOS BODILY INJURY U NON OWNED AUTOS (Per accident) PROPERTY DAMAGE (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT e ANY AUTO OTHER THAN EA ACC AUTO ONLY : AGG EXCESS /UMBRELLA LIABILITY EACH OCCURRENCE ? OCCUR ? CLAIMS MADE AGGREGATE e DEDUCTIBLE RETENTION B 60168583 04/01/09 U4/Ui/iU X 1 1 WC STATU- O 1 COMPENSATION AND ADS TORY LIMIT ER B EMPLOYERS' LIABILITY 60168584 04/01/09 04/01/10 E.L. EACH ACCIDENT $1,000,000 ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER/MEMBER EXCLUDED? WI E.L. DISEASE-EA EMPLOYEE $1,000,000 k. If yes, describe under SPECIAL PROVISIONS E.L. DISEASE-POLICY LIMIT $1,000,000 below OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS RE:dba Holiday Stationstore #401, located at 1650 Diffley Road, Egan, MN. This policy will be continued until canceled, at which time the city would be given 30 days written notice. CERTIFICATE HOLDER CANCELLAIION Ci ty of Eagan SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION 3820 Pilot Knob Road DATE THEREOF, THE ISSUING INSURER WILL ENDtn'OR 9O MAIL Eagan MN 55122 USA 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, a}' AUTHORIZED REPRESENTATIVE eS ~/Josa CORD 25~ (2001/08) \(~O7RD CORPORATION 19881M Pro f i is C1 Helping You "C" More Profits P.O. Box 203 Readstown, WI 54652 (800#)866-427-7634 E ax 608 629.5757 Cell 608-632-0004 04/01/2009 Local Fire Marshall / Fireworks Permit Grantee; C Profits, Inc. is a wholesale suppler of fireworks. We specialize in the sale of displays for the convenience store industry. We have enclosed for your information the following items. 1. An item list, this is a sample list of the items that may or may not be in our displays. This is for the generalization of product. We build over 1,300 displays per year. We build each display based on the state law it is intended to be sold in. 2. A photo of our displays. This should give you an idea of our product and display The gross shipping weight of the display is less than 100lbs.. Including all racking and shipping cartons. The Gross Product weight is 751bs. The Net Explosive Mass is Less Than 20 Lbs. per display. Our displays comply with NFPA 1124 (2003 edition) Chapter 7 (Retail Sales) 7.1.3.1 thru 7.1.3.2 weigh exemption for sprinklers and all other requirements of NFPA 1 124 Chapter 7. If you should have any questions as to our product or weights please feel free to contact me directly. I am responsible for product selection and quantities for these displays and can answer your questions. Thank You Michael F. Callaway Phone 608-632-0004 No. of Displays X 20lbs of Net Explosive Mass each = Total Net Explosive Mass of o LBS. will be delivered to this location. pro f is CI Helping You "C'° ore Profits P.O. Box 203 Readstown, WI 54652 (800#) 866-427-7634 Fax 608-629-5757Cell 60.8-632-0.004 UPC Code Description Safe and Sane Category 705834320514 CN Laser Echo 12/48/6 SG Snake 6pk 715244003020 B.C. Attack Vehicle 4pk 715244003402 B.C. Cracker Balls 6pk. 715244002603 B.C. Magnum Flasher 715244003440 B.C. Snakes 6pks 715244008179 B.C. Wailing Wheels 705834320170 C.N. Snakes 6pk. 803888 Cracker Tracker 18/30/6 715244008254 B.C. Ground Bloom 6pk. 715244082544 BC Ground Bloom Flowers NEW UPC.. 715244821242 BC Jumping Jacks 80/6/24 715244008230 B.C. Sup. Jump Jack w/ Crack 50ct. 715244108107 B.C. Tazmanian Devil 4pk. 016597253781 Crackling Dynamite.. 705834270024 Jumbo Ground Bloom 4pk. 652009103406 Jumping Jacks Brick 48/12's 715244020119 BC Party Fountain 36/1 715244020768 BC Careless in California 24/1 715244020508 B.C. Assorted 4's 4pk... 715244020522 B.C. Bubbles 12pk 715244002627 B.C. Castle Geyser Fnt. 715244220144 B.C. Cuckoo Fnt. 2pk. Bagged 715244201426 B.C. Cuckoo Killer Bee Combo 4pk 715244020027 B.C. Diamond Fnt 715244020515 B.C. Jewelry Box Fnt. 715244002184 B.C. Karaoke Fnt. 3pk. 715244020157 B.C. Killer Bees 4pk 715244002634 B.C. Lone Pine Geyser Fnt. 715244002306 B.C. Mammoth Fnt 715244020041 B.C. Midas Touch Fnt. 715244020409 B.C. Mini Pyro Fnt. 715244021109 BC Musky Fnt 6/1 715244020805 B.C. Noise in North Carolina Fnt. 715244002771 B.C. Nuclear Meltdown Fnt. 715244020089 B.C. Pot of Gold Fnt. 715244020096 B.C. Pop Goes the Fnt. 0-f"s I IPCI Helping You "C" More Profits P.O. Box 203 Readstown, WI 54652 (800#) 866-427-7634 Fax 608-629-5757 Cell 608-632-0004 715244002474 B.C. Rainbow Fnt 715244021055 BC Rainbow Fire Fountain 715244002559 B.C. Rata-Tat-Tat Fnt. 715244002689 B.C. Skyline Fnt. 715244002641 B.C. Steam Boat Geyser Fnt. 715244020065 B.C. Toy Soldier 805253113169 Boomer Screaming Melanie Fnt. 705834221149 Cannon Rocket Fountain 6 Mk. 680149002020 Drum Dancing Fnt 680149004598 Family Delight 693234933291 FF Aerial Ballet Fnt. 033943030032 FF Queen or King? Fnt. 705834220807 Fighting Drum Fnt. 652009902184 Gotta Lotta Fnt. 705834220586 Hells Fire Fnt. 652009902153 Lucky Seven Fnt. 3pk 805253012479 Magic in the Garden Fnt. 715244002702 Magnum Reloadable Fnt. 6 shot 652009103420 neutron Bomb Fnt. Rocket 6pk. 805253113145 W.C. On the Fritz Fnt. 680149004581 Saratoga Springs Fnt. 705834000287 Screaming Sorcerer Fnt. 12/1 705834220678 Shell Fnt. Cannon 652009103444 Snow Flower Fnt. 12pk 680149004635 Snow Flake Fnt. 680149007667 Snow Blizzard 705834000294 Star Spangled Shower 12/1 715244002184 W.C. Cajun Whistler Fnt. 3pk. Sub for B.C. Karoke 805253113039 W.C. Pip Squeak Fnt. 705108302703 Winda Gad Zooks (magreloadable) 705108302109 WD Heavy Rhinoceros 693234933253 Hyper Cones 36/2 715244313044 B.C. California Candle 4pk. 805253012813 W.C. California Candle 4pk. 715244000432 BC Little Treasures Assortment 652009903198 Novelty Bag Tanks & Cocks 652009903242 Large Bag (Ultimate) 705108000500 Kids Fun Bag 652009903259 Jumbo (Med)( Ultimate)Bag 705834200014 Cannon Carnival Bag 1 P ts I rofi C1 Helping You "C" More Profits P.O. Box 203 Readstown, WI 54652 (800#)866-427-7634 Fax 608-629-5757 Cell 608-632-0004 Power Play 715244000296 BC Pyro #3 Tray 8/1 652009001146 B.C. #5 Tray 652009001139 BC #4 Tray 4/1 705834000348 Ultimate Pail Assortment 705834000355 Ultimate Bucket (jumbo) 715244000401 B.C. Bucket of Fun 715244003488 B.C. Cone Poppers #3 8pk 705834320125 Cannon Pistol Magnum Poppers 6pk. 715244003471 B.C. Megaphone Popper 6"6pks Smoke Ball Category 705834360428 CN Smoke Balls 12pk Pre Priced $2.99 705834000300 Jumbo Smoke 3pk. 805253020139 Jumbo Smoke Balls 3pk 680149007858 Shogun Smoke Balls 12pk Novelty Smoke Items.. 016597253743 Army Smoke 2pk. Grenade.. 705834360336 Cannon USA Smoke Fnt Smoke Tubes 705834360213 CN Battle Smoke 4 assorted 40/1 652009103413 Color Smoke Tube Single 4 assorted 36/4/1 715244001750 Camo Smoke Tube 144/1 718821162271 Desert Smoke 705834360411 CN Giant Mammoth Smoke 72/1 016597253859 Rip Cord Smoke 3pk 705834320262 CN Snap 6pk. 715244003358 B.C. Super Snap 4pk. 705834320040 Cannon Snaps 6/50/50 652009993106 Nitro Snap 6pk. 705108900220 Winda Bang Snaps 50/50 Category for 10" Sparklers 705834280061 CN Sparkling Glory Gold 10" 48/6/8 680149001290 Shogun #10 Sparklers 6pk 705834280153 CN Sparklers Red White Blue 6pk. Morning Glory Category 715244313068 B.C. Morning Glories 72/box 705108900336 Morning Glories #36 Winda 6pk Large Sparklers 652009991003 #20 Sparklers 693234945133 FF Sparkler #20 Gold Bamboo 48/6.. 680149012050 Shogun #18 Sparkler 6/box P ts rofi C Helping You "C More Profits P.O. Box 203 Readstown, WI 54652 (800_#).66-427-7634Fax 608-629-575.7 Cell 608-632-0004 Not all items will be in each location. Displays will be made up of an assortment of above items or similar. Ili. Profits I Helping You "C" More Profits P.O. Box 203 Readstown, WI 54652 (800#) 866-427-7634 Fax 608-629-5757 Cell 608-632-0004 Small Racks Front k=w €M' _ sew fr' j ~ ICI z C« LI ti r T kFl a Adk )rofils CI Helping You " More Profits P.O. Box 203 Readstown, WI 54652 (800#)866-427-7634 Fax608-629-5757C e II 608.632-0004 Small Rack Back ~x - pi- ~t t SY2 ~ 1 jY { M 1 yp j • t{lW ri r EMERGENCY RESPONSE INFORMATION fZWQRKS. UN0336 (EXPLOSIVE 1.4G) PG (Formerly classified as CLASS CEXPLOSIVES, Common Fireworks) Nocbemical composition is released or exposed during normal handling, storage, and transportation. In the event of a vehicle five or if intense beat reaches the cargo area, the fireworks are likely to ignite. They will burn, spreading burning particles over a limited area. A mass explosion is not expected. Smoke and potentially-irritating gases will be produced in a f e. If the fireworks are spilled as the result of an accident but do not ignite, they can safely be picked up and repackaged. The area should be kept cleared of unnecessary people while this is being done. EMERGENCY ACTION In case of fire,.stop traffic, isolate the immediate area, and deny entry. Keep unnecessary people away. Fire in cargo area can be fought with water spray if necessary, although disposal and site clean up will be simplified If material is allowed to burn. Try to prevent other types of fire from reaching the cargo area. Self-contained breathing apparatus (SCBA) and structural firefighter's protective clothing will provide some limited protection. Firefighters should retreat if fire approaches cargo area and use unmanned hose holder to direct water spray on fire. For additional information, call the F-hipper using the emergency telephone number listed on the shipping papers; if there is no answer, call Chem-Tel's 24-hour number (800-255-3924). ni fi than cargo area): Flood with water. Tire Cues may start again. Unhook and separate tractor from trailer. If (other possible. Remove vehicle that is not involved in fire from five area if you can do so without risk. If cargo area is exposed to heat and flames, direct water spray on outside of container to cool it down. Continue spray until well after fire is out. Cam five; Do pgj move cargo or vehicle if cargo has been exposed to beat. Withdraw from area if and when fire reaches cargo and let fire burn, if situation allows. If fire must be fought, flood with water spray. Use firefighting team to prevent spread of fire to adjacent structures and materials. Promptly isolate the scene by removing all persons from the vicinity of the incident. Obtain more information from compe- tent authorities listed on the shipping papers. SPIt.S, OF CARGO Shut off all ignition sources. Thcic shall be no fates, smoking, tools capable of producing sparks, or flames in the vicinity rf die spilled material. Cautiously pick up the spilled devices and place them in cardboard cartons. fiR AID Call emergency medical care. Use first aid treatment according to the nature of lire injury. 1 • Ma MATERIAL SAFETY DATA- SHEET UN03361.4G CONSUMER FIREWORKS Date Prepared: March 11, 1999 )Elazardous Components: Contains pyrotechnic composition - a solid mixture of oxidizer and fuel that will burn if i ted_ These items are classified as UN0336 1.4G Consumer Fireworks by the U. S. Department of Transportation. o chemical composition is exposed during normal handling and storage. I hyssical/Chemical Chars solubility in Water: Slight teristks ppearauce and Odor: All pyrotechnic composition is contained in a cardboard casing. l Fireand Explosion A zard Data Extinguishing Media: Flood with water if a small amount of fireworks is involved. Special Fire Fighting Procedures: Do not use suffocation methods - devices contain their own oxygen. If a large ammount of fireworks are involved, allow them to burn and prevent spread of fire. unusual Fire and Explosion Hazards: Fireworks will bum rapidly in the event of fire. Reactovily Data ability: Stable conditions to Avoid: Open flames, smoking. Lhcompatibility (Materials to Avoid): Exposure to water may cause items to deteriorate. Hazardous Decomposition or Byproducts: Smoke, nitrogen oxides, and sulfur oxides may be produced in a fire. Ljazardous Polymerization: Will not occur. Health Hazard Data 1jeahh Hazards: Exposure to finished items does not pose any health hazard. Precautions for Safe Hand, ling and [[fie Seeps to be Taken in Case Material is Released or Spilled: No smoking or open flames in vicinity of spilled terial. Carefully pick up and place spilled items in cardboard cartons. Sweep up any exposed chemical composition with a natural-fiber brush. Waste Disposal Method: Dispose by burning in compliance with state and local regulations. Precautions to be taken in Handling and Storing: Avoid open flames, smoking, and high temperatures (above 1degrees F), Keep shipping cartons cool and dry. Control Measures Respiratory protection: None required when handling finished items. otective Gloves: None required. ork/Hygienic Practices: Nb smoking in vicinity of fireworks. EltilER[:FNCY RECPONCF PHONE a (800) 256-3924 City of Esta] 3830 Pilot Knob Road APR $ 2 2010 Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 2010 FIREWORKS SALES AND STORAGE APPLICATION Use BLUE or BLACK Ink Return pages 1-3 only Applicant requirements 1. An application must be completed and retumed at least 30 days prior to outdoor sales and/or storage of fireworks. 2. An applications for Indoorsa/es of fireworks must be submitted between April 1st and June 1st to obtain a permit. 2. A letter from the property owner granting permission to the applicant to sell and/or store fireworks on the property shall accompany the application. 3. A floor plan designating the area where the fireworks will be sold and/or stored shall accompany the application. 4. A list of the fireworks that will be sold and/or stored along with the name, weight, quantity, and material safety data sheets (MSDS) shall be included. 5. A copy of the certificate of insurance coverage as per City of Eagan City Ordinance No. 387, Chapter 6, Section 6.53 Fireworks is required. 6 The Fire Marshal or his/her designee will inspect the proposed location for selling and/or storing fireworks to determine if it is a suitable location. 7 A criminal record check will be done on all applicants. 8. A copy of the City of Eagan license (permit) shall be displayed by the register. Date: 4/19/2010 Business Name: Holiday Stationstore #401 Telephone#: ( 651 ) 686-4525 Display Address: 1650 Diffley Rd, Eagan, MN 55122 Applicant Name: Holiday Stationstores, Inc. Street Address: 4567 American Blvd West City: Bloomington State: MN tip: 55437 Telephone #: ( 952) 830-8700 Retail seller selling exclusively consumer fireworks: X Indoor Sales Dates: 5/10 to 10/31 Yes No Outdoor Sales Dates: to to to Please check the selections that apply to this permit Outdoor Sales $410.50 X All other retail sellers $100.50 (includes: $280.00 Fireworks Permit; $128.50 Tent Permit; $2.00 State Surcharge) Sign Permit $ 25.00 Temporary outdoor event means an exhibition or sale with a duration of 10 or less continuous days which does not occur more than once every 30 days and more than three times per year or a combination of 20 days total in a calendar year. (See Outdoor Sales of Fireworks). Fireworks are regulated by MN Statutes 624.20-624.25. In addition to these state laws, all displays, sales, storage and use of fireworks shall comply with City of Eagan Ordinance No. 387, Section 6.53 Fireworks and NFPA 1124 Standards. 1 understand and agree to comply with all the provisions of this application and the requirements of the issuing authority. Fireworks Application Page 2of9 Holiday Stationstores, Inc Name: Executed this Hupp Last day of Tennessen Warning License Application Minnesota law requires that you be informed of the purposes and intended uses of the information you provide to the City of Eagan (the City) during the license application process. Any information about yourself that you provide to the City during the license application process will be used to identify you as an applicant and to assess your qualifications for selling fireworks within the City. If you wish to be considered for a permit to sell fireworks, you are required to provide the information requested in the permit application. If you refuse to supply information requested by the City, it may mean that your application will not be considered. All individuals in the City who need to know information will have access. Appl nt Signature Date James R. Hupp, Assistant Secretary Authorization and Consent for Release of Information I, James R. Hupp, Assistant Secretary , freely and voluntarily authorize the City of Eagan to conduct an Name of individual authorizing release investigation to obtain the following information for the purpose of determining my eligibility for a permit to sell fireworks: James Robert First Middle Date of Birth: 06/04/1958 Driver's License #: R238122255613 State MN I also release the City of Eagan from any and all liability for its receipt and use of information and records received pursuant to this consent. I further acknowledge that I have carefully read this release, fully understand its terms and legal significance, and execute it voluntarily. 20 r0 `-�- /9 -/0 Signature q3 • Fireworks Application Page 3 of 9 OFFICE USE 0 DO NOT WRITE BELOW`TH The Police Department has conducted a criminal background check on the aforementioned applicant. fr atnpit Comments: Conditions of Issuance: Background check completed and approved by EPD: Zoning approval Facility inspection complete and all violations corrected Insurance policy approved Need Site plan, sign permit and written permission of property owner Building Permit Application for Tent License approved * //d7-ia Date `Yes _ ( Yes Yes Date approved: 6 No No No No No No )0 Holiday City Clerk: STATIONSTORES April 19, 2010 City Clerk City of Eagan 3830 Pilot Knob Road Eagan, MN 55122 Re: 1650 Diffley Road I am enclosing a completed application of Holiday Stationstores, Inc. for the sale of consumer fireworks in the City of Eagan. The application requests that "a written authorization of the property owner for the applicant's use of the property for the sale of permitted consumer fireworks" be attached. However, the lease between the landlord and Holiday Stationstores, Inc. for the above location allows Holiday Stationstores, Inc. to sell fireworks without the consent of the landlord. I have attached a Certificate of James R. Hupp of Holiday Stationstores, Inc. to that effect. Therefore, the signature of the landlord is not necessary. Thank you for your assistance in this matter. Yours very truly, assandra Perdue Licensing Assistant Permission to Sell Completed 041910.doc HOLIDAY STATIONSTORES 4567 American Boulevard West, Bloomington, MN 55437 (952) 830 -8700 I, James R. Hupp, the Assistant Secretary of (Holiday Stationstores, Inc.), certify that the lease for the Holiday Stationstores, Inc. location at 1650 Diffley Road allows (Holiday Stationstores, Inc.) to sell fireworks at that location without the consent of the landlord. STATE OF MINNESOTA ) )ss. COUNTY OF HENNEPIN ) The foregoing Certificate was acknowledged before me this (9 day of 2010 by .�� , Assistant Secretary of Holiday St tionstores, Inc., a Minnesota corporation. Permission to Sell Certificate.doc CERTIFICATE I u e I I- I g PROPOSED FIXTURE PLAN Option 6 Phaze 2 SCAM 1 /S' w w w STATIONSTORE #401 EAGAN, MN 0 02 2 Snap Fireworks, Inc 220 East Wisconsin Ave Reads/own, WI 5 352 60 11-829.4398 Fax 608-829-675T VAVVEsnapllrwasics.com snapselesesn apflriwarlrs.aoan 04/01/2010 Local Fire Marshall / Fireworks Permit Grantee; Snap Fireworks, Inc., formally C Profits, Inc. is a wholesale supplier of fireworks. We specialize in the sale of displays for the convenience store industry. We have enclosed for your information the following items. 1. An item list, this is a sample list of the items that may or may not be in our displays. This is for the generalization of product. We build over 1,300 displays per year. We build each display based on the state law it is intended to be sold in. 2.A photo of our displays. This should give you an idea of our product and display The gross shipping weight of the display is less than 1001bs., Including all racking and shipping cartons. The Gross Product weight is 751bs. The Net Explosive Mass is Less Than 20 Lbs. per display. Our displays comply with NFPA. 1124 (2003 edition) Chapter 7 (Retail Sales) 7.1.3.1 thru 7.1.3.2 weigh exemption for sprinklers and all other requirements ofNFPA 1124 Chapter 7. If you should have any questions as to our product or weights please feel free to contact me directly. I am responsible for product selection and quantities for these displays and can answer your questions. Thank You Michael F. Callaway Phone 608- 632 -0004 No. of Displays X 201bs of Net Explosive Mass each =Total Net Explosive Mass of IBS. will be delivered to this location. LSLS- S29 -B09 suo4eptnbti W pue b Wd6S :E OTOE .T udd UPC Code Description Safe and Sane Category 705834320514 CN Laser Echo 12/48/6 SG Snake 6pk 715244003020 B.C. Attack Vehicle 4pk 715244003402 B.C. Cracker Balls 6pk. 715244002603 B.C. Magnum Flasher 715244003440 B.C. Snakes 6pks 715244008179 B.C. Wailing Wheels 705834320170 C.N. Snakes 6pk. 803888 Cracker Tracker 18/30/6 715244008254 B.C. Ground Bloom 6pk. 715244082544 BC Ground Bloom Flowers NEW UPC.. 71 5244 621 242 BC Jumping Jacks 8016124 715244008230 B.C. Sup. Jump Jack w/ Crack 50ct. 715244108107 B.C. Tazmanian Devil 4pk 016597253781 Cradling Dynamite.. 705834270024 Jumbo Ground Bloom 4pk. 652009103406 Jumping Jacks Brick 48/17s 715244020119 BC Party Fountain 36/1 715244020768 BC Careless in California 24/1 715244020508 B.G. Assorted 4's 4pk... 715244020522 B.C. Bubbles 12pk 715244002627 B.C. Castle Geyser Fnt. 715244220144 B.C. Cuckoo Fnt. 2pk Bagged 715244201426 B.C. Cuckoo Killer Bee Combo 4pk 715244020027 B.C. Diamond Fnt 715244020515 B.C. Jewelry Box Fnt. 715244002184 B.C. Karaoke Fnt. 3pk 715244020157 B.C. Killer Bees 4pk 715244002634 B.C. Lone Pine Geyser Fnt. 715244002306 B.C. Mammoth FM 715244020041 B.C. Midas Touch Fnt. 715244020409 B.C. Mini Pyro Fnt. 715244021109 BC Musky Fnt 6/1 715244020805 B.C. Noise in North Carolina FM. 715244002771 B.C. Nuclear Meltdown Fnt. 715244020089 B.C. Pot of Gold FM, Snap Fireworks Inc 220 East Wisconsin Ave Readstown, 54652 sos-erawnas Fax 608-629-6751 www.lanaprireworkscofn snapsui napflreWOrkLCalin► -. ir...onTn4.Tn .1 JdH 715244020096 B.C. Pop Goes the Fnt. 715244002474 B.C. Rainbow Fnt 715244021055 BC Rainbow Fire Fountain 715244002559 B.C. Rata -Tat -Tat Fnt. 715244002689 B.C. Skyline Fnt. 715244002641 B.G. Steam Boat Geyser Fnt 715244020065 B.C. Toy Soldier 805253113169 Boomer Screaming Melanie Fnt. 705834221149 Cannon Rocket Fountain 6 pk. 660149002020 Drum Dancing FM 680149004598 Family Delight 693234933291 FF Aerial Ballet Fnt. 033943030032 FF Queen or K Fnt. 705834220807 Fighting Drum Fnt. 652009902184 Gotta Lotta Fnt. 705834220586 Hells Fire Fnt 652009902153 Luck Seven Fnt 3pk 805253012479 Magic in the Garden Fnt. 715244002702 Magnum Reloadable Fnt. 6 shot 652009103420 neutron Bomb Fnt. Rocket 6pk. 805253113145 W.C. On the Fritz Fnt 680149004581 Saratoga Springs Fnt 7058340002B7 Screaming Sorcerer Fnt. 1211 705834220678 Shell Fnt. Cannon 552009103444 Snow Flower Fnt. 12pk 680149004635 Snow Flake Fnt 680149007667 Snow Blizzard 705834000294 Star Spangled Shower 12/1 715244002184 W.C. Cajun Whistler Fnt. 3pk. Sub for B.C. Karoke 805253113039 W.C. Pip Squeak Fnt 705108302703 Winda Gad Zooks (magreloadable) 705108302109 WD Heavy Rhinoceros 693234933253 Hyper Cones 36/2 715244313044 B.C. California Candle 4pk. 805253012813 W.C. California Candle 4pk. 715244000432 BC Little Treasures Assortment 652009903198 Novelty Bag Tanks & Cocks 652009903242 Large Bag (Ultimate) 705108000500 Kids Fun Bag Snap Fireworks, Inc 220 East won Ave Readistown, WI 54652 sos42szass Fax 608- &29 -5T57 www.snaptireworks.com salpsales snap leewarks.co n c in , .onTnkrn U OUR W W.aRC:r2 nTn2 4t JdEJ 652009903259 705834200014 Jumbo (Med)( Uttimate)Bag Cannon Carnival Bag Power Play 715244000296 BC Pyro *3 Tray 8/1 852009001146 B.C. #5 Tray 652009001139 BC *4 Tray 4/1 705834000348 Ultimate Pail Assortment 705834000355 Ultimate Bucket gumbo) 715244000401 B.C. Bucket of Fun 715244003488 B.C. Cone Poppers *3 8pk 705834320125 Cannon Pistol Magnum Poppers 6pk. 715244003471 B.C. Megaphone Popper B" Spks Smoke Ball Category 705834360428 CN Smoke Balls 12pk Pre Priced $2.99 705834000300 Jumbo Smoke 3pk. 805253020139 Jumbo Smoke Balls 3pk 680149007858 Shogun Smoke Balls 12pk Novelty Smoke Items.. 016597253743 Army Smoke 2pk. Grenade.. 705834360336 Cannon USA Smoke Fnt Smoke Tubes 705834360213 CN Battle Smoke 4 assorted 4011 652009103413 Color Smoke Tube Single 4 assorted 36/4/1 715244001750 Camo Smoke Tube 144/1 718821162271 Desert Smoke 705834360411 CN Giant Mammoth Smoke 72/1 016597253859 Rip Cord Smoke 3pk 705834320262 CN Snap 6pk. 715244003358 B.C. Super Snap 4pk 705834320040 Cannon Snaps 6/50/50 652009993106 Nitro Snap 6pk. 705108900220 Wanda Bang Snaps 50/50 Category for 10" Sparklers 705834260061 CN Sparkling Glory Gold 10" 48/6/8 880149001290 Shogun *10 Sparklers 6pk 705834280153 CN Sparklers Red Whle Blue 6pk. Morning Glory Category 715244313068 B.C. Morning Glories 72/box c•d Snap Fireworks, Inc 220 East 'Ilan Ave Reads own, WI 54652 3W Fax -8 757 wwwsnaplireworka.ccan aasapsal snapThe orks"com / crc- R74 -an4 sJol.eptnbtl W pie ti Wd6S :E OTOE trT Ddb 705108900336 Morning Glories #36 Winda 6pk Large Sparklers 652009991003 #20 Sparklers 693234945133 FF Sparkler#20 Gold Bamboo 4816.. 680149012050 Shogun #18 Sparkler 6/box Not all items will be in each location. Displays will be made up of an assortment of above items or similar. r1 r. r7O_0n0 Snap Fireworks, Inc 220 East Wisconsin Ave Readstown Viii 54852 608-62S-5398 Fax 29 -5767 wwww sn$pfirevvork:com snapsales.snapflnaworlcs.com sJozeotnbt1 u oue 61. -1Rq:F O102 bi udid EMERGENCY RESPONSE INFORMATION FIREWORKS. UN4033§ (EXPLOSIVE 1.4G) P6 Jr (Formerly classified as CLASS C EXPLOSIVES, Common Fireworks) N;,chexaical composition is released or exposed during norn i handling, storage, and transportation. In the event of a vehicle fire or if intense heat reaches the cargo arcs, the fireworks are b7cely to ignite. They will burn, spreading burning particles over a limited area. A mass explosion is not expected. Smoke and potentially- frntatiag gases will be produced in a If the fireworks arc spilled as the result of an accident but do not ignite they can safely be picked up and repackaged. area should be kept cleamd of unnecessary people while this is being done. )EMERGENCY ACTION In case of fire, stop traffic, isolate the immediate area, and deny entry: Keep unnecessary people away. - Fire in cargo era can be fought with water spray if necessary, although disposal and site clean up will be simplified if material is allowed to burn. Try to prevent other types of fire from reaching the cargo arca. Self - contained breathing apparatus (SC$A) and structural frre6ghter's protective clothing will provide some limited protection. Firefighters should retreat if fire approaches cargo area and use unmanned hose holder to direct water spray on fire. For additional information, call the shipper using the emergency telephone number listed an the shipping papers; if there is no answer, call (;tern -Tel's 24 -hour number (800-2554924). Truck fire (other than cargo area): Flood with water. Tire fats may start again. Unhook and separate tractor front trailer, if posst'ble. Remove vehicle that is sat involved in Ere from fine area if you can do so without risk. If cargo area is exposed to heat and flames, direct water spray on outside of container to cool it down. Continue spray until well after fire is out Canto fee: Deng move cargo or vehicle if cargo has been exposed to heat. Withdraw Erom area if and when fire reaches cargo and let fire burn, if situation allows. If Ere mast be fought, flood with water spray. Use firefighting tenet to prevent spread of fire to adjacent structures and materials. Promptly isolate the scene by removing all persons from the vicinity of the incident. Obtain more information from compe- tent authorities listed on the shipping papers. $PLLi. l?F CARGO Stoat off all ignition sources. There shall be no flans, smoking, tools capable of producing sparks, or Barnes in the vicbtity rr the spilled material. Cautiously pick up lie spilled devices and place barn m cardboard cartons. rmsT AID Calf emergency medical care. Use first aid treatment according to the nature of the injury. n r •d i ci c_co_rrno suoneotnbt w our m wAi,n,14 nif2 bi sib T T • aI MATERIAL SAFETY DATA. S H EFT UNO336 1.4G CONSUMER FIREWORKS pate Prepared: March 11, 1999 HaMliftlithIgtediellitatkagiallgarinalialt gazandous Components: Contains pyrotechnic composition - a solid mixture of oxidizer and fuel that will burn if united. These items are classified m UNO336 1.46 Consumer Fireworks by the U.S. Department of Transportation. N o chemical composition is exposed during normal handling and storage. Phys'cal emiral chars derail s Solubility in Water: Slight .ppearaace mid Odor: All pyrotechnic compositiou is contained in a cardboard casing. Fire nd .inlnaien Hazard Data E st+ingnishing Media: Flood with water if a small amount of fireworks is involved, p etrol Fire Fighting Procedures: Do not use suffocation methods - devices contain their own oxygen. Ifa large aunt of fireworks are involved, allow them to burn and prevent spread afire. ilnusnal Fire and Explosion Hazards: Fireworks will burn rapidly in the event of fire. Reaetivitr Data Stability: Stable nditions to Avoid: Open flames, smoking. Tbeompatibility (Materials to Avoid): Exposure to water may cause items to deteriorate. Hazardous Decomposition or Byproducts: Smoke, nitrogen oxides, and sulfur oxides may be produced is a fire. H azardous Polymerization: Will not occur. Jyealth Hazard Data l4eaith Hazards: Exposure to finished items dots not pose any health hazard. Precautions for Safe Handing and Use Steps to be Taken in Case Material is Released or Spilled: No smoking or open flames in vicinity of spilled i anal. Carefully pick up and place spilled items in cardboard cartons. Sweep up any exposed chemical mposition with a natural -fiber brush. Spine Disposal Method: Dispose by burning in compliance with state and local regulations. P a utious to be taken In Handling sad Storing: Avoid open flames, smoking. and high temperatures (above 1 0 degrees F). Keep shipping cartons cool and dry. CameolMeasnrsa Rl protection: None required when handling finished items. � tective Gloves: None required. o eiciHygieaic Practices: Nb smoking in vicinity of fireworks. E 1FRGFNt "Y AFRPn? FyfONE # (80o) 2564924 / c/ c- aaa -Rn9 s..oleptnbti W PUe 8 WdSO :t OIOZ bi Jdd Facility Identification Name H 0 L I D A Y S TA T I 0 N S T fl R E # Street Address I , D- sTFFL `f , 0% 6 1-0 . City State Zip 1 1t , SIC Pt Code GI Pr M N '5 County Owner/ Operator Name or Reporting/ Fee Contact Name J A M E S H U P P Mailing Address 4 5 6 7 A M E R I C A N V D W E S T City - Zip B L0 0 M IN G T ON r State (MINI ( 5 1 5 1 4 1 3 1 7 1 - 1i 1 i 12131 Phone 9 5 2 8 3 0 8 7 0 0 Emergency Contacts Name #1 e N L'Y�rcr`Psv 0K . Title _Le S T 0 R E M AN A G E R Phone 24 Hr. Phone 4) Name #2 1,, - cb •q -i 510 1 915121 - 191211151510101 MELD Ss n R �&-1v G—S Title p S5 -c S1 w4 M IPr 6,eL Phone 24 Iii. Phone 1p I -- (6, S- \ -- 9 9, I. 3 9 5 2 — 9 2 1' 5 5 0 0 Form R PS -E 0932 (3/001 ERC I1)# MINNESOTA EMERGENCY RESPONSE COMMISSION 444 CEDAR ST., SUITE 223, ST. PAUL, MN 55101 PHONE: (651) 297 -7372 TTY (651) 282 -6555 FAX (651) 296-0459 TIER TWO EMERGENCY AND HAZARDOUS CHEMICAL INVENTORY REPORT FORM SPECIFIC INFORMATION BY CHEMICAL Reporting period from Jan. 1. to Dec. 31, Page of pages. Print information in CAPITAL LETTERS. mpo rtant: Read all instruc before com form. CHEMICAL DESCRIPTION (Check all that apply) CAS# Trade Secret O Chemical Name l G You h C'► . S ; n t1 �' r_S ( t X - 3 T I • `i GJ Pure Mix Solid' Liquid 0 Gas 0 EIS 0 ET 'S Name PHYSICAL AND HEALTH HAZARDS Check all that apply) pP l y) °. Fire Sudden Release O of Pressure 0 Reactivity 0 Immediate (acute) Q Delayed (chronic) ' INVENTORY Max. Daily Amoun (code) I Amount (code) O Number of Days On -site D. STORAGE CODES AND LOCATIONS (Non - Confidential) Container Pressure Temperature Stora a Locatio 5'E;t � S i "1 e Pc ? Site Plan Attached? Yes A No 0 K _' r — .— CHEMICAL DESCRIPTION (Check all that apply) 0 CAS # _ Trade Secret Chemical Name F r e �,`; Cr* 1 A `-)`-)U r ` r me h r r S l Ir vi G1 PureQ Mix 0 Solid A Liquid 0 CasQ Ells 0 EIISName PHYSICAL AND HEALTH HAZARDS (Check all that a .0 ( ppl. Fire udd O . o Pressure en Release 0 Reactivity 0 Immediate (acute) 0 Delayed (chronic) INVENTORY Max. Daily Amount (code) Amount (code) 0 Number of Days On -site STORAGE CODES AND LOCATIONS ( Non- Con Container Pressure Temperature Storage cation • r =`)er A vc�1,e S ` i '� fl Site Plan Attached? Yes 9 No 0 IN M ■ i — 4 — •1 Us R TWO EMERGENCY AND HAZARDOUS CHEMICAL INVENTORY REPORT FORM Pa ge_or_pages. Facility Name ERC ID# Certification: 1 certify under the penalty of law that I have personally examined and ant familiar with the information submitted • in pages one through , and that based on my inquiry of those individuals responsible for obtaining the information, l believe that the submitted information is true, accurate and complete. SEE ATTACHED LETTER FROM SUPPLIER Name and official title of owner/operator's authorized representitir'e. • Signature 14 Date signed CHEMICAL DESCRIPTION (Check all that apply) CAS# Trade Secret 0 Chemical Name p a o - 1 _ e c S (1 , y G b r ) Pure0 Mix 5g Solid Liquid 0 CasO EJS 0 EI IS Name PHYSICAL AND II EA LTEI HAZARDS (Check all that apply) \ Fire 0 Sudden Release of Pressure 0 Ite:►ctivity 0 Immediate (acute) 0 Delayed (chronic) INVENTORY Max. Daily Amount (code) 0 Amount (code) d Number of Days On -site () STORAGE CODES AND LOCATIONS (Non-Confidential) CHEMICAL DESCRIPTION (Check all that apply) Container Pressure Temperature Storage cations ^, ale A C C' > .1P 1' a r Site Plan Attached? Yes No 0 0 I — .— -- CAS# Trade Secret Chemical Name r c;,t , r, C.', n 5 . (J) T 1 ' q L Pure() Mix fA Solid Liquid 0 Gasp ENS 0 El IS Name PHYSICAL AND I-I EA LTH HAZARDS (Check all that apply) Fire Sud den Release O of Pressure 0 Reactivity 0 Immediate (acute) O Delayed (chronic) INVENTORY Max. Daily Amount (co.de) 0 �- ta (code) 0 c7'. Number of Days On -site 7 0 • STORAGE CODES AND LOCATIONS (Non - Confidential) Container Pressure Temperature Storage Loci Lions }} __ arVed.. ` ,• -t� k � A -) Site Plan Attache d? Yes 9 Nu 0 _ — — — —' —" — — .`let; TIER TWO EMERGENCY AND HAZARDOUS CHEMICAL INVENTORY REPORT FORM Page _ofpages. Facility Name ERC ID# Certification: I certify under the penally ()flaw that I have personally examined and ant familiar with the information sub Hilted in pages one through , and that basal on my inquiry of those individuals responsible for obtaining the information, I believe that the submitted information is true, accurate and complete. SEE ATTACHED LETTER FROM SUPPLIER Name and official tide of owner/operator's authorized rcpresentitire Signature 14I1/10j Date signed • TIER TWO EMERGENCY AND HAZARDOUS CIIILMICAL INVENTORY REPORT FORM Page ___ of pages. Facility Name E.RC ID# CHEMICAL DESCRIPTION (Check all that apply) PHYSICAL AND HEALTH FIAZARDS (Check all that apply) STORAGE CODES AND LOCATIONS (Non -Cony dentl al) CAS# Chemical Name El IS Name Trade Secret Q I /VoveZ C : • > h0 .`::1 E ..). , ti � PureQ Mix, A. Solid .Liquid Q GasQ EI1S Q Fire Sudden Release of Pressure Reactivity Immediate (acute) Delayed (chronic) INVENTORY Max. Daily Amount (code) Average Daily Amount (code) Number of Days On -site 101/1 101 l 1 ' 0 Container Pressure Temperature Storage Locations F LFLI Site Plan Attached? Yes No 0 CHEMICAL DESCRIPTION (Check all that apply) PHYSICAL • AND HEALTH HAZARDS (Check all that apply) STORAGE CODES AND LOCATIONS (Non - Confidential) CAS# El-IS Name 111 Chemical Name Trade Secret 0 1 )-i ; E Ms /. /7 C: ) Pure() Mix (Z).... Solid s, Liquid Q CasO EFTS Q 0 0 0 0 Fire Sudden Release of Pressure Reactivity Immediate (acute) Delayed (chronic) INVENTORY Max. Daily Amount (code) Average Daily Amount (code) Number of Days On -site c) / 1 /1 1 b Container Pressure Temperature Storage Locations 741 4(-d 7' 12 • • Site Plan Attached? Yes O Certification: I certify under the penalty of law that 1 have personally examined and am familiar with the information submitted in pages one through , and that based on my inquiry of those individuals responsible for obtaining the information, I believe that the submitted information is true, accurate and complete. SEE LETTER FROM SUPPLIER Name and official title of owner/ operator's authorized representitive. Signature 14/14 1 Date si; ned r n e � Use BLUE or BLACK Ink �-----------------i \a'C'O i For Office Use i • c7���V` � Permit#: / � �� ��'" I City of �a��� �� �1 g��1� ' Permit Fee: �tU b O• �� I 3830 Pilot Knob Road �� j � � Eagan MN 55122 � Date Received: . °'�'� I Phone: (651)675-5675 i �� i Fax: (651)675-5694 � Staff: � I����������������J 2014 COMMERCIAL BUILDING PERMIT APPLICATfON Date: ''�. °� ' 1 Site Address: ��S� �1,F�� �x �b-� �� I� Tenant Name: H�C��1�d-"C ST"�.Tll�'1--��J'CT��Tenant is: New/�_Existing) Suite#: Former Tenant: � Name: �1.�1��-��C �Tl d��"�"P�S Phone: . �� � f i%� SGa .a� a!�/t0 ( C+, '+5;4,.. Property Owner , Address i city i zip: � ��c-�1,��--1l.�`-t°�-�--r , C-'1�—t � �'_l Applicant is: �Owner Contractor ' Description of work: 1 L l r1 � Type of Work� �.�,�,��_ ��c�il'� `���`. Construction Cos. � �� � �� Name: i���c��r.�' �a�rt-�vca%�.u s k�cc.�.�n�cc,i L��i e se#: �� h � � ��°' Address: �S� l�evirSy�✓Q-�►.r�t �✓C_ S- City: � ��c.�. V�il-C� Contractor �a? ���_ s-i3-SSS4 "'�7�`� "�': State: ��1 Zip: �S�"�-�D Phone�C'� C�la- �Cr�- ��-b`�' � ����:. r L > ;, Contact: �rc�N�t�'` �jF��o�� Email: brar�el.h�►S�eQ y1li�wc57"�u�.r,�J�.CUru ' Name:�`'Qa�J�-�r T��'�TL�`�ZJS.1_. .�, Registration#: �>� ��t--a-�T1�Jt''� L—• �--.G � ArchitectlEngineer Address: C,\ � . `?� ���--"'T" city: {�(,,��s�r�►� State:�_Zip: Phone: l�,i 7 °� ��v '���C"3 Contact Person: '"- �iL Licensed plumber installing new sewer/water service: Phone#: ''�NOTE:P/ans and suppoiting documerits that you submit are'`considered to be public�nformation Po,rt�ons of 'u .� �<� the informat�on"may be class�fied as non-public if"you provitle specific reasons that woultl permit the,C�ty to . T ��� �' � ��� conc►ude fhat the ,are;trade':secrets�;: , �.�' � ������ �� � � .�. ' _, , _ , : u �:�� . :,�_�> � CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.aopherstateonecall.ora I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan;that I understand this is not a permit, but only an app ication for a permit, and w k is not to start without a permit;that the work will be in accordance with the approved plan in the case of rk which ires a revi and approval of plans. ' �x `��-t�'�T- �1����� x ApplicanYs Printed Name Applicant's Signature �c�� �e�Q ' �ip�� Page 1 of 3 :1= D 0 J ' , ....' � , � �� f ' . /�(s' I / � � ����� �� 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 ew 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 2 / Valuation C��✓ Q Occupancy � MCES System �es �� a ���� Plan Review � Code Edition �D�'1 �'S G SAC Units — � - �� �s° �� i 25% 100% ✓`~ — �'�' �~ �' � ( _) Zoning �l CityWater soµ ��o�-- I Census Code Stories ----- Booster Pump `--� �°� #of Units Square Feet PRV —' r„__._.__ #of Buildings Length Fire Sprinklers Type of Construction ���,`.,.'� Width -" --� REQUIRED INSPECTIONS Footings(New Building) Sheetrock Footings(Deck) Final/C.O.Required ✓ Footings(Addition) ,/Final/No C.O.Required ✓ Foundation Other: Drain Tile Pool:_Footings Air/Gas Tests _Final Roof:_Decking _Insulation _Ice&Water _Final Siding:_Stucco Lath _Stone Lath _Brick �"Framing Windows Fireplace:_Rough In Air Test Final Retaining Wall Insulation Erosion Control Meter Size: �. �p..... Final C/O Inspection: Schedule Fire Marshal to be present: Yes �o Reviewed B : !�°L�� �--- Buildin Ins ector Reviewed B : ��� Piannin Y , g p Y , g COMMERCIAL FEES Base Fee f �'� ,.�S Water Quality Surcharge ��, �� Water Sampling Fee Plan Review Q , ��' Water Supply�Storage(WAC) MCES SAC Storm Sewer Trunk City SAC Sewer Trunk S&W Permit&Surcharge Water Trunk Treatment Plant Street Lateral Treatment Plant(Irrigation) Street Park Dedication Water Lateral Trail Dedication Other: WaterQuality TOTALr �� �$�>Q� Page 2 of 3 Use BLUE or BLACK Ink ---------------, � For Office Use I Clt of�� �� � � � Permit#: �' � I t �� � � I Permit Fee: ` �S � 3830 Pilot Knob Road I � I Eagan MN 55122 � Date Received: � Phone:(651)675-5675 � Fax:(651)675-5694 � Staff: � �����������������J 2014 COMMERCIAL PLUMBING PERMIT APPLICATION ❑ Please submit two(2)sets of plans with all commercial applications. Date: �� ��'`�f� Site Address: ��J� pl'r"t"`�-y ���� Tenant• ��� �'�-'�lv� �"�Ur� Suite#• Property . . _ OWII@1'' Name: �z � "{i�-- �"�S �,�c:,c. Phone: ��5 Z "�S3d•-�s'$'�'fS' Name: g���E`� ������r�c� C��, License#: (c ��3�i�f Z. C011tl'1CtOC Address: `�� K�� � �� �'v �(w� I�`t ti' City: �� "� State: Zip:� `7�.-�_�`j 1-2cr� �f�zc Phone: (or2.-`�d`t-dS?�t�'`tt�4 Email: YCi G k �k �"�' ��,.�,b�� c:,r , c=�w, Typ�Of WO�k ' —New _Replacement _Repair _Rebuild ,�Modify Space _Work in R.O.W. Description ofwork: � �wSl �.-����w "'ae� "�e�.�, �:�' Vha e. � ;� . COMMERCIAL _New Construction �Modiry Space Irrigation System(_yes/_no)(_RPZ/_PVB) • Rain sensors required on irrigation systems . Permit Type . Avg.GPM (2"turbo required unless smaller size allowed by Public Works) Meters Call(651)675-5646 to verity that tests passed prior to pickinq up meter. Domestic:Size&Type Fire: 1 Avg.GPM High demand devices? Yes No Flushometers_Yes No COMMERC/AL FEES Contract Value$ 1�, `�`�U ' x.01 $55.00 Permit Fee Minimum =� 1 p`� �`� Permit Fee � '`If contract value is LESS than$10,010,Surcharge=$5.00 =$ � ��" Surcharge* ""If contract value is GREATER than$10,010, Surcharge=Contract Value x$0.0005 / �c� *"'If the project valuation is over$1 million, please call for Surcharge =$ l �� TOTAL FEE Following fees apply when installing a new lawn irrigation system $ water Permit Contact the City's Engineering Department,(651)675-5646,for required fee amounts. $ Treatment Plant $ Water Supply&Storage $ State Surcharge _$ TOTAL FEE CALL BEFORE YOU DIG. Call Gopher State One Call at(651}454-0002 for protection against underground utility damage. \ I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. X /�!j±Z�'�C �'�'yyt,,�a X Applicant's Printed Name ApplicanYs Signature FOR OFFICE USE An�^' �y: '�� Date:���/� Required Inspections: Under Ground �Rough-ln _ _,,.� i est =Gas Test �Final PRY Required:_Yes_No . Meter Related ltems: Meter Size Radio Read Manomete� Staff: ' Page 1 of 3 Use BLUE or BLACK ink -----------------, ��'� � � For Office Use I ` s � � 1`t (� �1 n I G n ,t i.�'r j Permit#: � ��� � �lb� U�11���1! . � � � � rmi F : / ��= I 3830 Pilot Knob Road R�c�.���� �,f � Pe t ee � Eagan MN 55122 ��I , 3�°�`-, � Phone: (651)675-5675 .�u` 3 Q �0��► �r�'� (`_,r i Date Received: � Fax: (651)675-5694 C� �� �� � Staff: �'` � � �p" � � ����������_�___�_J 2014 MECHANICAL PERMIT APPLICATION ❑ Please submit two(2)sets of plans with all commercial applications. Date: �f Z°1 ��{ Site Address: ��c5 Q ��FF'Ls�.� �`'i O a C� �"f �� # y0.� Tenant: 1-� O L.�`l�`f��_��C'�'Z ��N C,'a�. W`AS�'� Suite#: ��� ���, � a,, i���� , � � ��� ��' ��� 1 �' '' �i � Name: Phone: ��� I���i���'�C�?1Af�E:�`� � i i . r, ��I"�I�?h���: k� I'P��i,� Address/City/Zip: °� '�d'i� i��� i �i��dN��i. � ''(�i9'��' i'� '� � ._ � Name: YY�,ic�w-�S�' 'C(��1J�"ctJ'(�'l�v ,t CY��U(License#: � p � � �� �i� �Ji�� �:, � � ♦ _ � �����i���i�i � '� � Address: `7 S O Q�¢.t�l�1S`i�...v�•`��4. �dc. S City: rn�ht��.G. �o c�L..� �� �#C�C��' �.�'����'� '�� � �� �G State: MN Zip: Phone: -1�o� —� Sy�-1 — Z"I b O � �� ' "�� ��� ��v � , �� ��� � � � ,ii � � Contact: L-e..c " Email: m � � ��M4�N� p � � �� ! �IiRh 'I���i �New Replacement Additional � Alteration Demolition �� � , , ���r� i i� a '(� � � � ���f�p� ��;���;, Description of work Zn��al.l�0 RAA�ANT N�n.a�.�- � �'x��a.�� S 1'(1�. -� � � � .i I �I i � ��lp�� - 4��," � iI' � i�ii� if �: �i�!-� �y �p��polll� � � a s. II � I i ��D� " 6� �� ��I�I��IUi �. � `�;� (�� f���7t��1t#1iflLSV€�i�� iI Ufl��t� � ��i#l7�4",r�l'�1'�� ``�E'�'' �ti �C1�I���1 �i��'�Q�1� � C`��]� ��� �pi '°�; � I����o a _ � � � � i� °� ��U�I I ii�� ��� i � ��@� p��# ��E �� +� �I C!S �G�+� ��� �ti�' �� ��; l[i iTl�`'�,. �- �'i ll l l��i '� ',r;��. .: ' r e;�,._ 1(�i ��l'� ��- , a i i , i�i�i��t ii i �,', � �,�91��iG� �� i 3 , i'i(6,ilF��ilr{T�I i.,s�� i���i,�' i1T �,.r��91 t�� �� � ��i������� �N���� , RESIDENTIAL COMMERCIAL � ����� o�l�� ����� , ���; ��,�i„,� y,'�� ���� , _Fumace 1l New Construction Interior Improvement � �����i� �� �� �'�� Air Conditioner Install Piping Processed ���� � � �itim �� � — ��� �i � � � Air Exchanger �Gas E�derior HVAC Unit i�� , ���� � j���� — i � �� ° ���' , Heat Pump Under/Above ground Tank �Install/_Remove) � �i�r _ _ � ' � � � ,'' ° �iI!������I��; Other �� — RES/DENTIAL FEES $60.00 Minimum Add or alteration to an existing unit(includes$5.00 State Surcharge) $100.00 Residential New(includes$5.00 State Surcharge) _$ TOTAL FEE COMMERCIAL FEES Contract Value$ I�f'(018.O o x.01 $55.00 Permit Fee Minimum �,/ j� $70.00 Underground tank installation/removal =$� C�` _Permit Fee *If contract value is LESS than$10,010, Surcharge=$5.00 =$ '7�� Surcharge" **If contract value is GREATER than$10,010, Surcharge=Contract Value x$0.0005 **"If the project valuation is over$1 million, please call for Surcharge =� � ������ TOTAL FEE I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan;that I understand this is not a permit, but only an application for a permit,and work is not to start without a permit;that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. s x `M.�L�s LV c�,�. � x Applican 's Printed Name ApplicanYs Signature t. � i i i r�'�a,i i 4 = II " i t €I i tG = �II r ii ° 7a ilh � i i raa' � ` = r . � ?J� L`*`1 �l u'� _Use BLUE or BLACK Ink ' �--- --, � For Office Use � � (�/i � �1� j}f�� t��'( RECEIVED j Permit#: 1 ��-IVV I I � � ��� ����� I Permit Fee: � 3830 Pilot Knob Road AUG � � 2��� � 1 a i E a g a n M N 5 5 1 2 2 � D a t e R e c eiv e d: � '�� �I" � Phone:(651)675-5675 � Fax:(651)675-5694 � Staff: � 2014 COMMERCIAL PLUMBING PERMIT APPLICATION '��f� ❑ Please submit two (2)sets of plans with all commercial applications. � ��',r�✓ Date: � ��! '`�L/ Site Address: ��C+�a !J f`��E ti � � i � � Tenant: `� c Suite#: � ��ti� Property , �%� QWner ; Name: Phone: - r IL 1,� Name: � ^ � �; as; License#: P��3�� t/�� t����� ��, tl� C� Wi. v � .� Cp.'yl.(,- i�� � Con`tractor� �� �_j��� j����,t c�ty: �T�� state: A��z� s`�- r �` �`�� �, Address: S� °�,� ,� p: Phone:_���°-- �� �ol�:vc'� Email: �1��i�C.S' C� �,.�..- e.''� �+��: c.�t xce��,., I T @ bf WOCk —New Replacement Repa'r Rebuild ��Vlodify Space _Work in R.O.W. YP �s��„��► — ,�-�r �-�as+� Description of work: �-+n' � �� — C o v�vl�c.�.'� �e, � r' COMMERCIAL _New Construction �Modify Space �rts�-- R P � �' _Irrigation System(_yes/_no)(_RPZ/ PVB) ' • Rain sensors required on irrigation systems Permit Type . Avg.GPM (2"turbo required unless smaller size allowed by Public Works) Meters Call(651)675-5646 to verity that tests passed prior to pickinq uq meter. Domestic:Size&Type Fire: 1 Avg.GPM High demand devices?_Yes_No Flushometers_Yes_No COMMERC/AL FEES Contract Value$ ���� S� 3� x.01 $55.00 Permit Fee Minimum � _$ � � 3� Permit Fee "If contract value is LESS than$10,010,Surcharge=$5.00 =$ r r 7 Surcharge` "'If contract value is GREATER than$10,010, Surcharge=Contract Value x$0.0005 � � � � I� TOTAL FEE "'tf the project valuation is over$1 million, please call for Surcharge -$ Following fees apply when installing a new lawn irrigation system $ Water Permit Contact the City's Engineering Department,(651)675-5646,for required fee amounts. $ Treatment Plant $ Water Supply&Storage $ State Surcharge _$ TOTAL FEE CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. \ 1 hereby acknowledge that this information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. X N�t�'— �--��� X �`�C' Applicant's Printed Name Applicant's Signature FOR OFFICE USE ` Approved By: �`,,�"i� T Date: � �- � Required Inspections: _Under Ground _Rough-ln Air Test Gas Test Y Final PRV Ret�uired: Yes No Meter Related ltems:: Meter Size Radio Read Manometer: Staff: Page 1 of 3 , Use BLUE or BLACK Ink , . . , --------- , �-------- � � � For Office Use � /'� "�''1 � I ■■(��_• �{�1f�9■ P{f■ �``'� j �` "",,�� � Permit#: �� I V/�� �� L�i. f.4� k"osti$�4 �� .%i�;,. � . � � I v� I � 3830 Pilot Knob Road CALL FOR CREDIT CARD PAYMENT I Permit Fee: � � I � Eagan MN 55122 BARB BARNES 612.$43.3210 � Date Received: � Phone: (651)675-5675 � I Fax: (651)675-5694 � Staff: � I � �________________J 2014 FIRE SUPPRESSION SYSTEMS PERMIT APPLICATION* 141866 Date: 3.13.15 Site Address: 1650 Diffley Road Tenant: Holiday Store#401 Suite#: Name: Phone: �. pr��������'� ' Address/City/Zip: ` Applicant is: Owner X Contractor Ty�e s3�1�f� > Description of work: Add 5 sprinkler heads, flush FDC f' Construction Cost: $1500.00 Estimated Completion Date: 4.6.15 Name: Ahern Fire Protection License#: C039 C�ntra���r: Address: 13705 26th Ave. #110 City: Plymouth State: MN Zip: 55433 Phone: 763.268.0515 ,� Contact: Barb Barnes Email: bbarnes@ahernfire.com FIRE PERMIT TYPE WORK TYPE X Sprinkler System(#of heads� New _Addition Fire Pump _Standpipe X Alterations _Remodel Other: Other: DESCRIPTION OF WORK: X Commercial Residential Educational FEES Contract Value$ 1500.00 x.01 $55.00 Permit Fee Minimum _� 55.00 Permit Fee "If contract value is LESS than$10,010, Surcharge=$5.00 ""If contract value is GREATER than$10,010, Surcharge=Contract Value x$0.0005 =$ •75 Surcharge* ***If the project valuation is over$1 million, please call for Surcharge 55.75 _$ TOTAL FEE 3/4" Displacement Fire Meter-$260.00 =$ Fire Meter _$ TOTAL FEE *Requirements: 2 complete sets of drawings and specifications, cut sheets on materials and components to be used I hereby apply for a Fire Suppression System permit and acknowledge that the information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Minnesota Building/Fire Codes;that I understand this is not a permit, but only an application for a permit,and work is not to start without a permit;that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. X Barb Barnes X Applicant's Printed Name Applicant's Signature CALL FOR CREDIT CARD PAYMENT- BARB AT 612.843.3210 c�- ��� ft��a��ie�a��� ' { � � � r ����� � � % � � � � �� �� �} � �> �f� � � � �,# � REt.tIJIREI?{NSF�E�CTI�t�� � ��� �� ����� , �� �� �������$� ��� � , _ ��. � � t � � �� ��`�� � � � , :, ���� ������ �'�� �# � ' Hydrt?St'd'tCG" � �� r � �` ' ��'�`�,�3�. �"�,x�'� , ': c y �° � . . � `��� ��� �4�� 4� �r�� � '. `' � �� x:�-;� �������� ����C�.. : .. : > � ''�, s ,;t �, { � ����...`�*,` ��*.��.� °�� ., a ' _ � ��., ; ^: �'.Ut1(II�SO(iS(1f ISSU�CIC.�`� `^��` �� 7'' � fi-�.�� �, ,'��� ,�'� �����`�� � "` X ` � �' �?y ���� �.����$.. ��� �e <����� � �. ,� '.' y 't*� ' ,�,, iy � "{'`�>Y _.`'�wro, :'.��.�,§�� -�'x`''ww,�£`�.��'d fi�'� ti ,: � S '.. :` � :l � �� t:�� �� `.-, � kw'*�.w� .*."zf � 4 *�nk l �?+. : �� �� �� � � s. ' � . .� ; . ,„. � ��..� � a. 'x�.%kr� ' 7 r' � �' �� i .� �. m'��� �`°��'���'"�"� �`.� � �' �. .� ti , z ��`� �s � �� n � � � � �..�� ' �: � �� ` � � ��� � � -s� , � x���� �� � �� ���� �������'_� . � ������� ��� u. >z� '�^'° ' � ,; � � ������., ��'��� � � � �� � �}�: � P£�►�(t R�Y1�Y��'t��?�f �� � �� ;: . � `^�.. a a� �,. , t . i �-"'°�� ..�:; v, �. S. *^.: .t.,.�. ; .,,� .� ,�:`� �.; m. �y� ,�*�.` '�-.a".,�� i�,>�.,� � '��3..;, a' ;�' ; . . . ' ; .:.: : � �.�,:... . .s .��. .,�. . �°��`�` �� .�..<��,^`;:�' , xY..4�.s:.. ��i r..�.. .......�.. ..E:. ..,..�. . . .... �.:..... .. ..:. ..... . . ..:�� ... . , � . . z� � For Office Use -I 2'i Permit#: // I i Permit Fee: E AGA N Staff: — I Payment Recvd: Yes po 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 ," (651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 `'E'VE" I Plans: Electronic Paper Plan Submittal: eplans(c cityofeagan.com DEL 182018 2018 COMMERCIAL BUIL G PERMIT PPLICATION Date: 12/17/2018 site address: 1650 Diffley Road, Eagan MN 55122 Tenant Name: Holiday Stationstore #401 (Tenant is: New/ 14 Existing) Suite#: Former Tenant: Name: Holiday Stationstores, LLC Phone: 952-830-8884 Property ownerAddress/city/zip: 4567 American Blvd W Bloomington MN 55437 Applicant is: 1 Owner 1 Contractor Update the drink bar area by modifying and replacing cabinets and adding/relocating equipment Type of Work Description of work: Construction Cost: 10,000 Name: Holiday Stationstores License#: Address: 4567 American Blvd W city: Contractor Bloomington State: MN Zip: 55437 Phone: 952-830-8839 Contact: Joel Geil Email: joel.geil@holidaycompanies.com Name: Registration#: Architect/Engineer Address: City: State: Zip: Phone: Contact Person: Email: Licensed plumber installing new sewer/water service: Phone#: c assif "arid pr� pY rt sit !rea ons that would pe i the C ty to couPlic nte de#tat th y�are nsctr de se t+ fie l� 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.cityofeaqan.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.aooherstateonecall.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 Joel Geil X y ,� Applicant's Printed Name Aircant's Signature DO NOT WRITE BELOW THIS LINE / -3 C/1 S SUB TYPES /o S 6 D-ipocci _ Foundation — Public Facility _ Exterior Alteration–Apartmen Pd. /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 I DJ ebb. 14-4) Occupancy Nil MCES System- t IJ ik ?, Plan Review V Code Edition o IS got 03C SAC Units ND abvite.S, IBJ OSE-ot_oa. I--b. (25%_100% V) Zoning City Water Census Code Stories 1 Booster Pump #of Units 0 Square Feet PRV #of Buildings I Length Fire Sprinklers Type of Construction V•fj 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/N C.O. Required Final C/O Inspection: Sc Fire Marshal to be present: Yes " No Reviewed By: _ , Planning New Business to Eagan: 1t o Reviewed By: I441 to , Building Inspector FEES Water Quality Base Fee ( el I .1 S Storm Sewer Trunk Surcharge 5. OP Sewer Trunk Plan Review 11-4 .'4 Water Trunk MCES SAC Street Lateral City SAC `r Street S&W Permit&Surcharge Water Lateral Treatment Plant --- Stormwater Performance Security Treatment Plant(Irrigation) Landscape Security Park Dedication Other: �t Trail Dedication TOTAL: 49 .32/.31 Page 2 of 3 For Office Use/ ` , ; ; % � , Permit , / ✓-3 72 , E AG N Permit Fee: 3830 PILOT KNOB ROAD EAGAN,MN 55122-1810 RECEIVED `Staff: , Payment Recvd: _Yes A No (651)675-5675 I TDD:(651)454-8535 I FAX:(651)675-5694 Email:buildinciinspections(a-citvofeagan.com JAN 1 o 2019 Plans: Electronic Paper Plan Submittal:eplans(acitvofeagan.com L. 2019 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 viaiemail,CD or flash drive Date: l I 1 D I i"` Site Address: U Lo O{-. H 1i t'�7 -01 . D 14A (A. l -hUYlc -0YP. I Suite Tenant: fn Property J1 Owner Name:_l (t 4A.j. lo F c Phone: GIS z- Z 3 Co — 8 9 84 Name:covntn.&i.in4Aulrv41i'l(i 4 ii eitki 1 License#: PCi,q 3II Ii Contractor Address: vet u2C ((1 tri l/NAi k/bty: flWe9 Ll.Y't/ State:tAN Zip: v� Phone:1-Ill LIM-. /2.1W Email: rcA.Yv Uf @ i cAoov `ct v.,r(.DrY1 New _Replacement _Repair Rebuild _Modify Space _Work in R.O.W. Type of Work. t y� Description of work: I, ,; 4, -„ ; l- r o • , _• - • j in -/)/ COMMERCIAL New Construction O(Modify Space Irrigation System L. yes/_no)(_RPZ/_PVB) • Rain sensors required on Irrigation systems Permit Type • Avg.GPM (2"turbo required unless smaller size allowed by Public Works) Meters Call(651)675-5646 to verity that tests passed prior to picking up meter. Domestic:Size&Type Fire: 1 Avg.GPM High demand devices?_Yes_No Flushometers_Yes_No COMMERCIAL FEES Contract Value$ (et 000 x.015 $60.00 Permit Fee Minimum $60.00 PVB/RPZ Permit(includes State Surcharge) =$ Permit Fee _$ 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 th CALL ALISSA ANTON WITH equired fee amounts. $ Treatment Plant $ Meter Fee PERMIT FEE OR QUESTIONS. $ State Surcharge 651-464-2988 =$ TOTAL FEE You may si Aanton@cpandh.com ity of proposed ordinances by signing up for an email update on the City's website at www.citvofeas, CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 tor 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 fora permit,and work Is not to start without a permit;that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Applicant's Printed Name Applicant's Signature FOR OFFICE USE Approved By: Date:. f - f ppl ! Required Inspections ,_Under,Ground (Rough-In Air Test ,_Gas Test t1/2,---Final PRV Required:—Yes No Meter Related Items: Meter Size Radio Read Manometer Staff: Page 1 of 3