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4110 Lexington Ave Use BLUE or BLACK Ink Awk. I-----------------~ 1 For Office Use City of Eajan ; Permit I Permit Fee: r~ 3830 Pilot Knob Road I Eagan MN 65122 i Date Received: Phone: (661) 676.6675 I staff: I Fax: (651) 676-6684 i 1 2010 COMMERCIAL PLUMBIN jG ER, cMIT APPLICATION Date: /0 Site Ad ress: ~ " Tenant rJl 7 Suite M PROPERTY OWNER Name: / S Phone: /A2 eo"'~ CONTRACTOR Name: License * z 1 Address: City: Stat Zip6W Phone. //A J - Y Email. w/v TYPE OF _ New Repl ceme~njt~ _ Repairs K Rebuild Modify Space _ Work in R.O.W. WORK Description of work: PERMIT TYPE COMMERCIAL T New Construction 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 Pubic Works) Meters Call (651) 675-5646 to verity that tests passed prior to pickirm up meter. Domestic: Size & Type Fire: 1 Avg. GPM High demand devices? Yes No Flushometers ,_,-Yes _,_,No COMMERCIAL FEES. $50.50 Minimum (includes State Surcharge) OR Contract value $ r- x 1% _ $ Permit Fee Required on ALL new buildings and boulevard irrigation systems 4 = $ Radio Meter Read If r i Fee is Im than $1,000, surcharge is $.50 = $ Meter(s) - If Permit Fee is > $1,000, surcharge increases by $50 for each $1,000 $1,000 Permit Fee (i.e. a $1,001-$2,000 Permit Fee requires a $1.00 surcharge). = $ ' State Surcharge Following fees apply when installing a new lawn irrigation system. $ Water Permit Call the City's Engineering Department, (651) 675-5646, for required fee amounts. $ Treatment Plant $ Water Supply & Storage $ State Surcharge TOTAL FEES $ CALL BEFORE YOU DIG. Cali Gopher State One Cali at (651) 4640002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permt that the rk will be in accordance with the approved plan in thegwrof work l requires a review and approval of plans. x x Applica is Printed Name Applicant's Signature FOR OFFICE USE Approved By: Date: Required Inspections: -Under Ground Rough-In Air Test Gas Test Final PRV Required: Yes No Page 1 of 3 ir i CITY OF El4GAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 i SITE ADDRESS: , I ?! t 4? i 1 ': I tJ, I„r4 ;,•; I; ,. I ?IlI'4 1111 1' I PERMIT SUBTYPE: I nrIPl ; i 1111 ,: ( .1 CTION RECORD PERMIT TYPE: Permit Number: Date Issued: APPLICANT: t ui cI :ut i 1`4 1? i 11 1. ? I q?k 01111, TYPE OF WORK: !YI ',t 1? f 1' 1 1 C1N ? 141 r> n I r, ( ili' 1 Hliflf { Ni i ) INSPECTION D. ON TYPE D• dlll.?flll ? N 1? Fil, i fllll'll f pJ I 1 I i iNni ? i kl, Permk No. Permit Holder Date Telephone # S/W PLUMBING HVAC ELECTRIC ELECTRIC Inspection Date Inap. CommeMs Footings I Foundatian Framing Rooting Rough Plbg. Rough Htg. Isul. Fireplace Final Htg. Orsat Test Ffnal Plbg. Pibg. Inspector - Notity Plumber Const. Meter Engr./Plan Bldg. Final Deck Ftg. Deck Final Well Pr. Disp. ? ' . iLul? CONTRACT PRICE: Site Address LotBIoc4? ? „ t?. ? ?. ? Name m Address L'J -,x`-'7 I y . r ciry_a :.rosse w? ? Name ; Addre 0 City:.., TYPE OF WORK Forced Air Boiler Unit Heater Air Cond. Vent Gas Piping Outlets # I Other L ?. PERMIT # MECHANICAL PERMIT ? • CITY OP EAGAN RECEIPT # ?- PILOT KNOB ROAD, EAGAN, MN 55122 DATE: ?; i „ PHONE: 454-8100 --.j BLDG. TYPE WORK DESCRIPTION Sec/Sub Res. New X Mult Add-on Comm. Repair ione'•''; ?)tilu Other M BTU M BTU M BTU M BTU CFM FEE 'c3.vU Sic: • ?u TOTAL• i",• ;+ FEES RES. HVAC 0-100 M BTU -$24.00 ADDITIONAL 50 M BTU - 6.00 (RES. HVAC INCLUDES A/C ON NEW CONSTRUCTION) GAS OUTLETS (MINIMUM - 1 PER PERMIn - 1.50 EA. COMM/IND FEE - 1% OF CONTR.4CT FEE APT. BLDGS. - COMM. RATE APPLIES TOWNHOUSE 8 CONDOS - RES. RATE APPLIES MINIMUM RESIDENTIAL FEE - ALL ADD-ON 8 REMODELS - 12.00 MINIMUM COMMERCIAL FEE - 20.00 STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GOES BEYOND $1,000) - ! SIGNA'UpE OF PERMITTEk .. V FOR: CITY OF EAGAN CONTRACT PRICE: , .fi . _ . " ` .. .. . . , t.. w -... u . . .. . -uPERMIT q PLUMBING PERMIT ? CITY OF EAGAN RECEIPT ii 3830 PIIOT KNOB ROAD, EAGAN, MN 55122 DATE: G.5 (:l u'. ::!, PHONE: 454-8100 Site Address 'L1 ?i Lr _ y? n Lot " Block ?9 . Sec/Sub ? Name rlin pc,l " ' m i Address t'U ,' 2 7`i7 c Ciry oSS2 ??l PhoneJ`.;:; i.?,i Name i u i: F3 Pt;1oYScl ` c Address '' ziii, 21 ?` ? Ciryl? CrosSC ?1 PhonebUB 764 FE ES COMM/IND FEE - 1% OF CONTRACT FEE APT. BLDGS - COMM RATE APPLIES TOWNHOUSE & CONDO - RES. RATE APPLIES MINIMUM - RESIDENTIAL F EE - $12.00 MINIMUM - COMM/IND FEE - $20.00 STATE SURCHARGE PER PE RMIT - 50 (ADD $.50 S/C IF PERMIT PR I,CE GOES BEYOND $1,000.00 V SIGNATURE OF IbE MITTEE FOR: CITY OF EAGAN BLDG. TYPE WORK DESCRIPTION Res. New Mult. ? Add-on Comm. Repair Other RES. PLBG. ONLY - COMPIETE THE FOLLOWING: NO. FIXTURES TOTAL -Water CloBet - $3.00 $ _Bath Tubs"? $3.00 _Lavatory - $3.00 _Shower - $3.00 _Ki!chen Sink -,$3.00 _UrinaliBidet -?53.00 _Laundry Trayx= ?$3.00 _Floor Drains - $1.50 yW?kter Heater - $1.50 -Whipool - $3.00 _Gasiping OutIeNJ'- $1.50 (MINIMUM - 1 PEAFERMin -Softqher - $5.00 - , -Well ='$10.00 _Private Disp. - $10.00 _Rough Openings - $1.50 FEE: . SC1 STATE S/C: GRAND TOTAL: " '" • ?` ` ? (gertifiratr n# (Orrupttnry Citp of (Eagan liepttrtmrnf u# liuilding Awprrtiun This Certifuate issued pursuant to the requiremenu of Sectinn 306 of the Urdjorm Building Code cenifying that at the time of rssuance thrs structure was in compliance with the various ordinances of the Ciry regulating building construction or use. For the foUowing.• um chwisnoon 24 UHIT AP'' . Mdg. Pernt;t Na. 14273 Oxuo+ncr TYaX RI zoning wma P?J rya Com, V 1}IIt O? of auflding H$ Z PAITNFRS Addv= ?. 0. BCQC 2997, LACR(?SSE aWimngndana, AMNl;E ?? L3, Bl, t.E}.ZI3GICAV AlT?S 1 D„m r?4'1Y 24, 1988 eWaing offki POST IN A CONSPICUOUS PIACE , BUILDING I To be useti for ? . . CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHON E: 454-8100 PE R M IT Receipt # Est. Value Date ,19 Site Address Lot Bfock Parcel No. W Name = Address 3 ° City , p Name ? < Address City fQ IJ W Name W W ? _ g Address Q W City I hereby acknowledge that I he information is correct and a9i Minnesota Statutes and City o Signature ot Permittee A Building Permit is issued to: on the expresscondition ihat a applicable State of Minnesota Building Officia! Sec/Sub. ' Phone ,e read this application and state that the ?e to comply with all applicable State of Eagan Ordinances. work shall be done in accordance with all itatutes and City ot Eagan Ordinances. OFFIC E USE ONLY On SRe Sewage Occupancy MWCC System _ Zoning On Site Well (Actuaq Const Ciry Water (Allowable) PRV Required # of Stories Booster Pump _ Length Depth S.F. Total Footprint S.F. APPROVALS Engr./Assess. Planner Council Bldg. Off. Variance FEES ? Permit - Surcharge Plan Review SAC, City SAC, MWCC Water Conn. Water Meter Road Unit Treatment P1 Parks ' TOTAL / _ Permit No. Permit Holdar Data Talaphone # Plumbin 9 ;- H.V.AC. Electric - .C;?:i ? ? ??: fi, ?"?C?! ? ? /•?? 8` /' yC- Softener -`( r Inspectfon Date Insp. Commeflts Footings I Footings II Foundation Framing Roofing Rough Plbg. k.?? ?'? Rough Htg. ? Isul. 3 2- ? Fireplace Final Htg. Final Plbg. 61dg. Final Cert.Occ. I ! Temp. LP Deck Ftg. Deck Final Well Pf. Disp. ?. ?. CITY OF EAGAN ? 3830 Pilot Knob Road ! P.O. Box?1199 i Eagan, MN 55321 ? Owner. Site Address: Plumber:. Permit No: B/P No: s ?: :: • Aee So L3 BZ Date: i. -i_ ? Date: 11) - la MWCC: Zoning. , r CityChg: No. of Units: ' Acct. Dep: Permit Fee: I agree to comply wlth the City ol Eagan Surcharge: • `«n,' Ordinances. Misa- I SEWER SERVICE PERMIT olloniia.=, , . "W"., CITY OF EAGAN Permit No: ? 3830 Pilot Knob Road Date: _! '. P.O. Boz 21 ygg Meter No: Reader No: Size: ? Eagan, MN 55121 Date: _-- ; Owner. Site Address: Plumber. e j ? . .?t._ ----------------- Conn. Chg: ! J i) p ? i ? Acct Dep: Zoning: p:4 ; ' ? Permit Fee: ?? No. oi Units: 24 Surcharge: ? 50nd Tr. Plant_ '?- I e9ree to comply with the City of Eagan A56 c??"`? Ordinances. Meter. Misc.: By WATER SERVICE PERMIT ? --------- --------_.??__-- -- _? _ , k j CITY OF EAGAN ` 3630 Pllot Krdb Road ? P.O. Box 21199 F Eagan, MN 55121 Owner. ? Site Address: nnwcc: - clri cng: _ Acct Dep:_ Permit Fee: Surcharge: ¦,,e.. Permit No: Date: B/P No: Date: s So RLL) mply with ffia GlY d EaOae ? a By ? _ - ER SfRVICE PERMIT -0 ? CITY OF EAGAN 3830 Pilot Knob Road P.O. Bos 21199 Eagan, MN 55121 Permit No:_ Date: '3 9 7 ? Sf 1? ?„ Ra?? Meter No: siZe: Reader No: 12 f Date: ??- Fartners ICL Address: 710 Lecin„xon 1?ce So L3 S1 ' Tna ',lonaal ?g/AWAaosa.- Conn. Chg: '-' 08!?.?dQ?c1•-' ? oning: '.`* Cai.?ti:'df?l?4?fit&'J ?4 ? Acct. Dep: ., ? riC.. Permit Fee: Surcharge: with the City ot Eagan` Tr. Plant Ii56 ? Meter. Misc.: WATER SERVIC rThiS re4uest void 18 nx1n[hs from ' D . 6 J 2 9 6 ?16?.' ' Fire No. / u h-in InsUection ? Fequest Da Z te pe. uired? ?ReaAY Nuw?Will Nofifv. inspec- Yes ?No tor When fleatly ' ? Licensed Electncal Contractor I hereby requesc inspection of ebove wnrk iRatalled at: Street Address. Box or Route No. Cltv IIO ? ? ecUOn o. Township Name or No. J Range No. Counry i ? Ole /7ilKo Occupant (PRINT) Phone No, f4 L 'I^Z (pQ?" -? Iu Power Supvlier Address K o 774 £uc crrn i c Electrical Contrac tor IComDany Nemel TZ; ;n? /.?'7 Z-,P_ Mailine p.ddress lCOntractor or Owner Making Inst ailaUOn) l? N b n e! Making naWre (Con[ractor/ AuthOrized istallatinN Um er Phonc k rr?nn? ocn?iccr wi? I Nnr MINK'ESOTA STATE BOAflD EJF ELECTRICITY BE ACCEPTED BY THE STATE BOARD Griggs-Midway Bldg. - poom N-191 UNLESS PqOPER INSPECTION FEE IS 1827 Universitv Ave.. St. Paul. MN 55104 ENClOSED. Phane (612) 642-0800 _ ?????/?rJ REQUEST FOR ELECTRICAL INSPECTION ee-ooooi-os /?` ? See iostructions for comvleting this form on 6ack of yellow copy. ?(7Q? D6i 29 6 X"' Below Work Covered by This Request ? ,4dd Rep. Type Of Building ApPliancea Wired Equipmenl Wired Home Range Temporary Service Duplex Water Heater Lightiny Fixtures Apt. Building Dryer Hectrie HeaLn Commercial Bldy. Furnace Silo Unloader Industrial Bldg. Air Conditioner Bulk Milk Tank Farm tn"' ne." v oiner isuec0y) t er peCify Other Other omnute lnspection Fee Below q Fee SBrvice EMrenCeSize N Pee Feeders /S ubfeeders k Feei Circuits ?.' 0 to200Am s 0 to30Am s t ?to3QAn s Above 200 qi»ps 31 to 100 Amps 31 to 100 Am S Swimming Pool Above 100_Am s Above 100_Amps Transformers Irrigation Booms p Partial.'Other Fee Si gns Spec ia l Inspection ? S • TOTAL pemarks ?OSt3J FE JA E/ fi Rough- in Q ?/'?? - U'tE I, the Elactnca InsDector, heraby certify fhet the above Pinal L) '?}e ?? ' speetion hes been ?? made. This request vold 18 montba This requesl void 18 months trom O D 69337 1y?? Rr.nuest Date ° / Fire No. vRouph-in Ins' ction Required? V []Rendy Now []WiII NotifY. InypeC- (?' DYes No tor When Ready ?Licensed ElecVical Contractor 1 heraby request iection of a6?ove ? ? Owner electrical work installed at v Street Address. Box or Route No. City O L,r ic/ G 7?.tJ ? ? ection o. 7ownship Name or No. Range No. County ? l /26 / 2' nl / / GLL: OccuVdnt IPRINTI Phone No. ---j ?G Power SupVlier Address ?E- G Electrical Contractor (Company Nume) Conirncfo,'s License No. ?'- Mailing AdJress IContractor or Owner MakinO Instailation) ?- ? Authori2ed 5? nature 1 ntraCtor?Owner Making Ins[all ion) Phone Number MINNE.'rOTp STATE BOAflD OF EbtCTRICITV THIS INSPECTION REQUEST WILL NOT Griggs-Midway 81dg. - Room N-191 BE ACCEPTED BV THE STATE BOARD 1821 Universitv Ave.. St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (612) 642-0800 ENCLOSED. REQUEST FOR ELECTRiCAL INSPECTION ee-ooooi-os ? See instructians for completine this torm on 6ack of Yellow copy. 6-a3 3 7 -"X" Below Work Covered by Thrs Request ?jy7lv? Add Rep. Type of BuilEing Applioncea Wirad EquiVnient Wired Home Ranye Temporary Service Duplex Water Heater Liyhtin,y Fixtures Apt. Building Dryer Electrie Heahn Commercial Bidy. Fumace Silo Unloader Mdiistrial Bldg. Air Conditioner Bulk Milk Tenk Fafm Other Pec1fV Other(Sp„oify) ,nu /n?nnrfinn Fnn q Fee ServiceEntrenceSize H Fee -Feeders"5ubfeeAers M Fee Circuits U to 200 qmps 0 ro 30 Am s 0 jo 30 An s Above 200 Amp 31 to 100 Amps 31 to 100 qm s Swimming Pool I Above 100-Amps Above 100_Amps Transformers Irrigation Booms „j0 Partial?:Other Fee Signs I I ISpeciallnspection 1$V , l., ? ? TOTAL ugh-in I, tha E @c In5D0ttor; F S? ? FFF??? riiiy thal the a6ov0 Final / ??1e,( ?? - yF?spection has ?? ? A /Lf? Imade. n118 f9QU8Sl VOId CITY OF EAGAN (v! 14 2 7 3 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 BUILDING PERMIT PHONE:454-8100 Receipt # -1 c(5 t a5 To be used for 24-UNIT APT Est. Value $500, 000 Date OCTOBER 8 87 Site Address 4110 LEXINGTON AVE Lot 3 Block 1 Sec/Sub. LEXINGTON HILLS ] Parcel No a Name H& Z PARTNERS ; Address P.O. BOX 2997 0 City LACROSSE Phone 608/784-5910 I Name SAME I o0 Address ? City Phone rQ pjW Name SATERBAK ARCHITECTS i? Address N751 BLOOMER MILL RD aW City LACROSSE Phone_ 608/788-2764 I hereby acknowledge that I have read this application and state that the information is correct and ree to comply with all pplicable State of Minnesota Statutes and Cit of ,. ?fSances. Signature of Permiftee ?C? A Building Permit is issued to: H& Z PARTNFRS on the express condition that all workshall be done in accordance with all applicable State of Minne ota Statutes a. City,of Eagan Ordinances. Building OHicial ? OFFICE USE ONLY On Ske Sewage _ Occupancy Rl MWCC System X Zoning pD On Site Well (Actual) Const V 1HR City Water X (Allowable) V 1 HR PRV Required _ # of Stories 2 Booster Pump _ Length 183 Depth 56 S.F. Total 20,500 Footprint S.F. 10_,2.50 APPROVALS FEES $ 1,703.50 Engr./Assess. Permit Planner Surcharge 250.00 Council Plan Review 851.75 Bldg. Off. SAC, City 1,920.00 Variance SAC, MWCC 10 1,OS0.00 Water Conn. 10, 080.00 WaterMeter N/A Road Unit 5,856.00 7reatment Pl 3 , 456.00 Parks N/A TOTAL $341197.25 C? 1--yo 9 2005 COMMERCIAL PLUMBING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 ??) ?;? Date 2 / ;I / wos Site Address Unit # Tenant Name ?? ( Former Tenant Name \ 'C Property Owner ? *Att 7- 7 N Telephone #(1?? Contractor 152. Ulf Address 3,q City State N ZipSa4 Telephone#(U2) q)) - 21) Sl License # U)`'j 3,?a?>VVI Expires: The Applicant is _ Owner _ Contractor _ Other Work Type New Bldg _ Modify Tenant Space RPZ PVB _ New Repair/ build _ Replace _ Irrigation system Work within public right of-way/easement _ Yes _ No Rain sensors are re uired on irriation s stems Description of Work Pettl t IGI "21/?lC.?v`G , Q,V7Q 410 2- t ? 'Po inquire if Pressure Reducing Valve is r ired on new service, call 651-675-5646 Meters - Call 651-675-5300 to verify that hydrostatic, conductiviry, and bacteria tests passed urior to oickin¢ ua meter. lrrigation Size & Type Avg GPM 2" turbo req'd unless smaller size allowed by Public Works Fire Size & Price 3/4" disolacement 5161.00 Domestic Size & Type Avg GPM Includes high demand devices? _ Yes _ No Flushometers _ Yes _ No PRV Required _ Yes _ No Permit Fee $50.50 minimum (includes State Surcharge) Contract Value $ x 1% _ $ ?•? Pernrit Fee $ Meter(s) Required on all new buildings & boulevazd irrieation svstems $ Radio Meter Read If permit fee is $1,000 or less, surcharge is $.50 $ State Surcharge If permit fee is over $1,000, surcharge is $.50 per $1,000 of the Permit Fee Following fees apply only when installing new irrigation system ? $ ? Water Percnit Call Jeay Wobschall at 651-675-5024 forrequired fee amounts $ Treatrnent Plant $ Water Supply & Storage $ State Surcharge ----------- ---------------------------------------------------------------------- $ ? • v V Total Fee I hereby apply for a Commercial Plumbing Pemut and aclmowledge that the informarion is complete and accurate; conformance with the ordinanccs and codes of the City of Eagan and with the Plumbing Codes; that I understand this is application for a permit, and work is not to start u+ithout a permit; that the work will be in accordance with the approved which requires a review and approval of plans. A ?`?(1? c.i?ctc ? INes?4 mcc n ?/ ? ApplicanPs Printed Name pp icanPs Signature T JUi? u 0 2005 CITY USE ONLY REQUIRED INSPECTIONS: _ U.G. _ Air Test _ Gas Test _ Rough In _ Final PLANS SUBMITTED APPROVED BY: :?D f' BUILDING INSPECTOR General Information • Radio Meter Read (required on all new buildings & boulevard irrigation systems- $141.00 • RPZ's must be tested every yeaz and rebuilt every five years. Test results should be mailed to Paul Heuer at the City of Eagan. • A minimum fee permit per address is required for the following RPZ's: new, rebuild, repair, remove. • Water meters include copper horn/strainer, remote wire, and touch-pad meter. METERS REOUIRING 4-FIOUR ADVANCE NOTICE PRIOR TO PICK UP GPM METERS USE PRICE GPM METERS USE PRICE 1-20 518" residential $125.00 4-120 1-1/2" imgation syst $ 735.00 displacement sm commercial turbine** Public Works maximum must approve cont inuous meter size 10 2-30 3/4° lawn irrigation $161.00 4-160 2" turbine lg irrigarion syst $ 931.00 maximum displacement residential & continuous sm commercial production lines 15 3-50 1" displacement very lg res $296.00 1/4 to 160 2" compound bldgs over $ 1,849.00 bldg to 24 units 65 units maximum sm commercial & continuous & lg comm bldgs 25 irri arion s stems 5-100 1-1/2" bldgs 25-64 units $429.00 maxunum displacement & continuous most comm bldgs 50 METERS REOUIRING 30-DAY ADVANCE NOTICE PRIOR TO PICK UP GPM METERS USE PRICE GPM METERS USE PRICE ? 5-350 3" turbine very lg irrigation $1,182.00 6-500 4" compound +300 unit bldgs & $3,563.00 syst & production very lg comm bldgs lines 1/2-320 3" compound +200 unit bldgs $2,282.00 10-1000 6" compound +400 unit bldgs $6,076.00 very Ig comm bldgs very Ig comm bldgs 15-1000 4" turbine very lg irrigation $2,226.00 syst & production lines c;omments • To schedule inspection of the inside water line and backflow preventer, ca11651-675-5675. • To arrange for water turn-on, ca11651-675-5300. , ca Maintenance Division Clerica] Technician January 2005 ! ?? ??,F? ? ?'Y ?v ? ? f5 4! 0 a?•*? v. ? " V . ' .?f - . . . _ f { / ' 4j f a • ? , . ' _ fp?v ?ry?^?, }?"(? jyy[$(+S k 'q ! . .. ?'*'.i'?.I?.Y•1f?'J'&?1C?-? &. q PBRMPf ItHCBIPT,DATE: ?.?? . . . `.,"• . ".?.':., ?:W!?!: f)ei:"::aIi){; "i:t VVRV1lSYfYV?O{DlNG tEl?maa 1'LI"TWVli1aV1\ .., ??M KNOB ftD 851-601-4875 WORK TYPE_-- -.. New Bldg.. Add-0n _ Repair. _.RPZ . ?_ PVS IrriSation sYstem - • Must complete rcversc side of application also: Rcquired metcr size is 2" Uubo anless smalla size permitted by Public Works DESCRIPTION OF WORK _?/ To inquire if Pressnre Reducing.Valve is required.on new service, ca11651-681-4G46 _..,: ,_- ,_. .,METERS - Call. 651-681-4300 to?verify. that hydrostatic, conductiyity, and bacteria tests passed arior to oickine ao meter _ Irrigation Size 8c Type - Fire's Size& Type _ Domestic Size & Type Does this include high demand devices? FLUSHOMETERS Site Address: _ Yes _ No _ Yes 7 .IL`'.Y f h c _ Tenant Name•: `/; Tooo /V r (,O-?& Telephone #: (Ara Code) `' Was tliere a previous tensnt in this space? _ Y_ N. If Yes, Name: - Installer Name: 1?e -? A/?do Telephorie #: ? Installer Address: / (prea coae) : city: D 14 ?S Ae ? State: FEES Contract price $I?J YUC. a 1% ($50.00 minimnm) Contract Fee Zip Code S ?,e6. _....,.,.. _.._ .. ...ar?_?..,.,.. ,.. ,__..,.. _ . ? .,. . .. Meter(s) $ Required on all new buildiags &;tioulevard.irrigatioa.systems (Acet # 9220=4509) Radio Meter Read $ Surchsrge:' $.SO 1Vlinimum.` If contract fee exceeds $1,000, calculate at 50 cents per $1,000 conuact fee. ` Total From Reverse State Sarcharge S .?? New Service $ Total $ I hereby aclmowledge that I have read this application, state that the information is comct, aad agee to compty with all applicable City of Eagan ocdiuances. It is th-e applic4nYs responsibiliryto notify tbeproperryowner thaz the Cityof Eagan assumes no liability for aaydamages caused by the City during its normal operational and maintenance activities to the facilities consavcted uuder this pa. m it within G??,ty properry/right-of-way/easement SIGNATURE OF PERMITTEE . . .. _, . _,_.... _ . ..._ ._ . CITY USE ONLY REQUIRED INSPECTIONS: _ U.G. _ Ai; Test _ Gas Test PLANS.SUBMITTID " APPROVEDBY: ,. . .,.; _ Rough In _ Final BUILDING INSPECTOR Avg GPM Avg GPM Avg GPM No PRV REQUIRED _ Yes _ No CITY USE ONLY PERNIIT #: l ? 1 (? RECEIPT DATE: COM?d?RCIRL PI.UMIFH:PERMT AffUCATIOA crrYaFEA6M 38so PH= uos Rn KAs". Mx ssiz2 asi-6ai-U7s INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED Date: C1.) - CR 1:9 ' 0 I WORK TYPE New Btdg Add-on _ Repair ? RPZ _ PVB Irrigation system • Must compiete reverse side of application also. Required meter size is 2" turbo unles smaller size permitted by Public Works DESCRIPT[ON OF WORK -g p Z \ (-- t??v ? i YlS40 l, e.CC tl el,J NIQI "i e, To inquire if Pressure Reducing Valve is required on new service, call 651-6814646 METERS - Ca11651-681-4300 to verify that hydrostadc, conductivity, and bacteria tests passed urior to alcldns uo meter Irrigation Size & Type Fire Size & Type Avg GPM Avg GPM Domestic 5ize & Type Avg GPM Does this include high demand devices? _ Yes _ No FLUSHOMETERS Yes No PRV REQUIRED _ Yes _ No Site Address: _1-ii l'O L sI.A d r` A %4 e, S Tenant Name: LeX,%(-%qjo n Telephone #: CoS -?I S a- ? 3 I 3 (Area Code) Was there a previous tenant in this space? _ Y_ N. If Yes, Name: Installer Name: M + V [nstatler Address: City: L.L i S State: FEES Contract price $ & 9a. o a x 1% ($50.00 minimum) Required on all new buitdings & boulevard irrigaNon systems Surcharge: $.50 Minimum If contract fee exceeds $1,000, calculate at 50 cents per $1,000 contract fee. Total From Reverse MQ? zip Code S Sy a? Contract Fee S 5O . ob Meter(s) $ Raaio Meter Read $ State Surc6arge New Service $ Total $ s0 . S o I hereby acknowledge that I have read this applicaROn, state that the information is correct, and agree to comply with all applicable City of Eagan ordinances. It is the applicanYs responsibility to notify the property owner that the City of Eagan assumes no liability for any damages caused by the City during its normal operational and maintenance acriviries to the facilities constructed under thi 5ermit ithin City perty/right-of-wayJeasement. ) SIGAIATURE OF'PE ,?-'' CITY USE ONLY REQUIRED INSPECTIONS: _ U.G. _ Air Test _ Gas Test _ Rough In _ Final PLANS SUBMITTED APPROVED BY: , BU[LDING INSPECTOR Telephone #: q S a - 9 a (Area Code) ? CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 SITE ADDRESS: P.I.N.: 10-45025-030-01 DESCRIPTION: PERMIT PERMIT TYPE: Permit Number: Date Issued: 4119 LEXINGTON L07: 3 BLOCK: 1 LEXINGTON HILLS (APT ROOFING) B,uilding-Permit Type YBuilding ,.WoArk Type -_-a i flVE COMM./IND. MISC. REPASR (Ik-- s ??=yy BUILDING 024539 09/15/94 ? ? ?-C?u REMARKS: FEE SUMMARY Base Fee Surcharge Total Fee VALUATION $135.00 $6.06 $141.90 $12,000 CONTRACTOR: - ATOP RQOFING GO 1845 UNIVERSITY 5T PAUL MN (612) 649-0156 Applicant -- OWNER: 26490156 REACOR L7D AVE 4116 LEXINGTtlN AVE 55104 EAGAN MN 55123 (612)452-6313 I hereby acknawlecige that I have read this information is correct and agree to comply Statut nd City E an Ordinaness. L ? APPLICAN /PE ITEE SIGNATURE applicaCian and state that the wS.th all applicable State of Mn. J fISSUEDBY: IG URE , CITY OF EAGAN 1994 BUILDING PERMIT APPLICATION 681-4675 ? . ,.. SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy calcs. COMMERCI 2 sets of architectural & structural plans, 1 set of specifications, 1 copy of energy calcs- Penalty applies: 1) when permit is typed, but not picked up by last working day of month in which request is made, 2) address is changed or 3) lot change is requested once permit is issued. Qate Valuation of work / 2•&-wr' Site Address: 'W/b 4,e v.r.? ? UCd cf, L? STREET SUITE # Tenant Name: (commercial only) LOT BLOCK =T SUBD. # Descri tion of work: '0-- 111U The applicant is: ? Owner Contractor ? Other (Describe) Name ? ItaG -?-'a l 2u?.? ?? Phone ?tfz' L Property LAST FIRST Owner Address ?/l6zn((&A? xe STREET STE # City ±4 ao State Udl Zip Company .Q-2"D4 ?A a)? Phone Contractor Address Udtueirr 44-7 License # Exp. City A-6- State /) d) Zip srO Company lJGllic Phone Architect/ Engineer Name Registration # Address ' City State Zip Sewer & water licensed plumber Processing time for sewer & water permits is two days once area has been approved. I hereby acknowledge that I have d this application and state that the information is correct and agree to comply w' appl' ble State of esota Statutes and City of Eagan Ordinances. !v ! Signature of Applicant: ? OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging O 02 SF Dwg. ? 07 4-Plex ? 12 Multi. Misc. ? 03 SF Addition ? 08 8-Plex ? 13 Garage/Accessary O 04 SF Porch ? 09 12-Plex ? 14 Fireplace ? 05 SF Misc. O 10 Multi. Add'1. ? 15 Deck WOR K TYPE ? 31 New 0 33 Alterations ? 35 Tenant Finish O 32 Addition ? 34 Repair ? 36 Move GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Depth APPROVALS Planning Engineering REQUIRED tNSPECTIONS ? .Site ? Wallboard Basement sq. ft. lst fl. sq. ft. 2nd F1. sq. ft. Sq. Ft. total Footprint Sq. ft. On-site well On-site sewage Building Variance ? Footing O Final ? Framing 11 Draintile ? Insulation ? Fireplace Permit Fee Surcharge. Plan Review _- License MWCC SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment P1. Road Unit Park Ded. Trails Ded. Copies Other Total: SAC % SAC Units vatvat;oo: g 1z • 4??0 ,.;?• . ,,. ,,?.a? a?_,:? . ? 16 Basement Finish ? 17 Swim Pool O 18 Comm./Ind. ? 19 Comm./Ind. Misc. 0 20 Public Facility b 21 Miscellaneous O 37 Demolish MWCC System City Water PRV Required Booster Pump Fire Sprinkler Census Code SAC Code Census Bldg Census Unit Assessments a / 73 1987 B[TILDING PERMIT APPLICATION - CITY OF EAGAN SINGLE FAMILY DWELLINGS INCLiJDE 2 SSfS OF PLANS, 3 CERTIFICATES OF SORVEY, 1 5ET OF ENERGY CALCQI.A?IONS HOTE: ADDRE55ES FOR CORAER LOTS - CONTRACTOR/HOME01iiNEE HIIST DESIGNATE WHICH ADDRESS I5 DFSIRED. NO CHANGES WILL BE ALLOWED ONCE BOILDING PERMIT IS ISSDED. MOLTIPLE DWELLINGS - RFSIDENTIAL RENTAL DNITS X FOR SALE i1NITS INCLL'DE 2 SETS OF PLANS, CERTIFICST? CF SITRVEY - CHECK iTITE BLDG. DEPT., 1 SET OF ENERGY CALCULATIONS CONIlMERCIAI. INCLUDE 2 SETS OF ARCHITEC'TURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS, $2,000 LANDSCAPE BOND To Be Used For:Multifamily Valuation: nd C? QCO Date: Site Address q--( o LE?X .,k\/E. OFFICS DSS ONLY Lot 3 Block On Site Sewage_ Occupancy MWCC System ? Zoning Parcel/Sub Lexington Hillls First Additio On Site Well Type of Const City Water ? (Actual) Owner H & Z PARTNIIZS (Allowable) # of Stories Address PO BOX 2997 Length Depth City/Zip Code La Crosse Wi 54602 S.F. Total Fooiprint S.F. Phone 608 784 5910 J APPROVALS FEES Contractor H& Z Partners Address PO BOX 2997 Assessments Water/Sewer Police Permit Surcharge Plan Review Fire SAC, City City/2ip Code La Crosse Wi 54602 Engr SAC, MWCC Planner Water Conn Phone 60R 7R4 5910 Council Water Meter Bldg Off Road Unit Areh./Engr. Saterbak Architects APC Treatment P1 Variance Parks Address N 751 Bloomer Mill Rd Copies TOTAL City/Zip CodeLa Crosse Wi 54601 Phone # 608 788 276 CITY OF EAGAN APPLICATION FOR PERMIT , SE1NER AND/OR WATER CONNECTION xxrxxxxxxxxxxxxxxxxxR::rrxxxx:xx?xxe *10'PE: PAYMENT OF FEE AT TIME pE' APPLscATIoN ooFS Norr ooNSTITuTE * APPxovAr. oF PERMIT. * INSPFX`TZON OF SEM ANID/OR M1TER INSTALATTONS WII.,L NOT BE SC?HED-- ULFD L7NPIL PFPJ-nT AAS BFEN APPRaVED. ------------------------------- , P ease Print 1) PROpERTY ADDRESS : L.. ,C_X ! N(r.'jo rJ A YFi "' LEGAL DESCRIPTION: L„4T 3 c4 OGlf sion or Tax Parce IF E7QSTING STRL'C.'![JRE, DATE OF ORIGINAL BLILDING PERMiT ISSUANCE: . : (Nbn Year PRESENT ZONING/PROPOSID LISE: ? CO'A'tERCIAL/Rh'PAiL/OFFICE ? R-1 SINGLE FAMILY . Q IAIDt'STRIAL ? R-2 DLPLEX (Ztao Dnits) n INSTITU'PIOLVAL,/GOVERNMENT ? R-3 TOWDIIiOUSE (Three + Units) ( Lfiits) . ? R-4 APAR7.ma1'P/CONIDOMINILTM (_jj/ Units ) --- IvAME: PAn ADDREss: p. o_ _ ciTr, srATE, ziP: L._a C",5:F.0 w ? rc. PxorE: 6o F 3) • ?:7• For City Use . ?: Piumber : xDDxFSS: p O Active CITY, STATE, ZIP: J.,a C r° fj e -? i f EcAired S ` Not recorded PHONE: 6°f 7r`Y.3YJ /0 MAgM LICENSE# D O 2/ 6?' M f Staff Initial 4) •a • • ?..ui?e? IvAMEa?/a? ? ?AP7N?P?f _ ADnRESS: !.° o, 6 o,C 9 9 cl' 7 • CITY, STATE, ZIP: ?4 C° ?o f'S e o i PHONE: ,(Otf `1 •/ O •5) u - a: ?• : a • a - ?? ? CONNEC,TION M CITY SEWII2 Ej CONNDCrION TO CITY EaATER ri 0'TfEEt ' . 6) ?? • i' ? PI,F.ASE HOLD APPROVID PERMIT EC)R PICK-UP BY ONE OF ABpVE .-- PLF.ASE MAIL APPROVID PERMIT TO 1. 2. 31 4, ABOVE (Circle one) ' 7) r r• • ? ? ?i? f'?.se-??+ ?;? N r?emr- r ?•,-r...r. f ? -?3 -?7' : F'OR :CITY USE ONLY PERMIT # TSSUED - , 3 Pd w/Bldg. Permit FEES: $ $ $ $ /?1•Sn $ $ $ $ $ $ $ $ $ $ '-7° $ $ $ $ $ $ $ $ _ O $ $ $ $ %2"5.I -JU" ' D (1 s RECEIPT RECEIPT . SEWER PERMIT (INCLUDE SURCHARGE) WATER PERMIT (INCLUDE SURCHARGE) WATER METER/COPPERHORN/OL'TSIDE READER WATER TAP (INCLUDE CORPORATION STOP) SEWER TAP ACCOUNT DEPOSIT - SEWER ACCOUNT DEPOSIT - WATER WAC SAC TRUNK WATER ASSESSMENT TRL'NK SEWER ASSESSMENT LATERAL BENEFIT/TRUIVK SEWER LATERAL BENEFIT/TRONK WATER WATER TREATMENT PLANT SLRCHARGE OTHER: TOTAL DOES UTILITY CONNECTION REQLIRE EXCAVATION IN PUBLIC RIGHT OF WAY? F__j YES IF YES, THEN A"PERMIT FOR WORK WITHIN PUBLIC ROADWAY" MUST BE ISSIIED BY THE ENGINEERING E:f NO DIVISION. LIST AS A CONDITION. SUBJECT TO THE FOLLOWING CONDITIONS: APPROVED BY: , TITLE: DATE: A?//•5 /f 7 ""I crTY OF Er:rAN , ??? ??th,,,. ? ; ..> ..A_.,a.?. DFI'Cl: c 04IRG!99 '.D,; NAME e TCIf' (:,IJ+d .T. 'r?'_?+1G?.':.'i;:? 7001 4:I:lt:l I..Ii::X •]1V 900J. 41.LD t...L:X rr:r?MINraL .T T M':_ : ?r aVE f iVE No o s3r?4 :I. `.'i ::3C.1::35 4.00 '>?= ir.-?._,?.'r_?? ., 1-a'i;a:;. it(.?,_,?y:lj:Yl; AR?C.??_!Y',?;„ rk??.a???49-? ... tJSC-_:R :[D: \ANCY 1999 BUILDING PERMIT APPLICATION (COMMERCIAL) ? CITY OF EAGAN (651) 681-4675 Submit followina to obtain necessarv nPrmit 'I -?"--7 _ c( f Foundatilon Onl New Construction Interior Im rovement structural plans (2 sets) architectural plans (2 sets) architedural plans (2 sets) civil plans (2 sets) structural plans (2 sets) code analysis (1) •' code analysis 0 )" civil plans (2 sets) project specs (t seQ project specs (1) landscaping plans (2 sets) Key Plan Speciai Inspections & Testing Schedule " code analysis (1) " energy calculations (1) not always ° soils repoR (1) Eleclric Power & Lighting Form (1) not always " SAC determination letter from MC/ES - SAC determination letter from MC/ES - SAC determination letter from MC/ES - cal l 602-1000 call 602-1000 caII 602-1000 Special Inspections & Testing Schedule (1) " project specs (1), energy wlculations (1) •• . ..--- Electric Power 8 Li htin Form 1 '• oI.. vaarUuIy iiipYcUuVI IJ WI SdfI1pIC Food & Beverage qr Lodging facilities: Pian must be submitted to Minnesota Department of Health. Call 215-0700 for details. DATE: I? ?/ WORK TYPE: _ NEW _ REMODEL DESCRIPTION OF WORK: ? ?U / , CONSTRUC TI0 ST: . 1-- D TENANT NAME ?l? ?I2??Z.??? Lf? ??'c c ? SITE ADDRESS: 17 n , SUITE #: -a ?,?,,?A LOT ? BLOCK SUBD. _?-`f?? 41 I_C P.I.D. # ? c v? m (Ae"06n li? I`Tame: L.. Phone #: PROPERTI' Last ?tirst OWIVER Street Address: ( Il Lf dCI hG /1'I I ay, CitY E=m J State: ?/U. Zip: Company:A Phone #t: (l?l •? ' ??T CONTR4CTOR Street Address:?L ?p? ?61-1? Ci ,' ? State: Zip: ARCHITECT/ ENIGINEER Company: Phone #: tiame: Regisuation #: Street Address: City State: Zip: I Sewer 8 water licensed plumber (only if installing sewer 8 I hereby acknowledge that I have read this application, state that the information is co(?ct, and agree to co ly 'th all applicable State of r,eso+= s??ri of Eagan Ordinances. Y 1 ??CEIVED ?J pPR 2 0 1999 Signature of Appticant: BY: OFFICE USE ONLY BUILDING PERMIT TYPE ? ? 01 Fourtdation ? 18 CommJlnd. WORK TYPE ? 31 New ? 32 Addition GENERAL INFORMATION Const. (Actual) (Aiiurrit5l8) UBC Occupancy Zoning # of Stories Length Width APPROVALS Plannina ? 19 Comm./Ind. Misc. ? 20 Public Facility 0 33 Alterations ? 34 Repair Basement sq. ft. y /' u f"11.?1 lool Sti. Il, sq. ft. sq. ft. sq. ft. sq. ft. Footprint sq. ft. Permit Fee Surcharge Plan Review MC/ES SAC , City SAC Water Supply & Storage SIW Permit S!W Surcharge Treatment Plant Park Dedication Trails Dedication Water Quality Other Building Engineering ? 21 Miscellaneous ? 35 Tenant Finish ? 37 Demolition VALUATION 41 -C) ? °to SAG SAC Units Meter Size z . Copies • " . Total Census Code SAC. Code Census Unit Census Bldg. MC/ES System City Water Fire Sprinklered Variance ?. ? $ , i i CLAIM VOUCHER - REF'UND REQUEST , - CITY aF EAGAN • MAKE CHECI{ PAYABLE TO: Top Gun, Inc. ADDRESS: 10736 Normandale Blvd. Bloomingtoa, MN 55437 LOCATION: 4110 Lexiagton Ave P.I.D.lLEGAi,: Lot 3 Block 1 Lexington Hills RECEIPT #/DATE: 107493/4-28-99 VALUATION: $8,000.00 REASON FOR REFUND: Valuation was incorrect PERMIT #: 35400 TYPE OF REFUND: Electrical Permit 3211-9001 $ Plumbing Permit 3212-9001 $ Mechanical Permit 3213-9001 $ Building Permit Fee 3210-9001 $ 56.00 Plan Review Fee 3422-9001 $ SAC (MC/WS) 2275-9220 $ SAC (City) 3866-9379 $ SAC (Admin) 3446-9001 $ Water Connection 3865-9220 $ Sewer Permit 3743-9220 $ Water Permit 3713-9220 $ Account Deposit 2252-9220 $ Water Meter 3716-9220 $ Water Treatment 3868-9220 $ Surcharge 2155-9001 $ Utility Acct Overpayment 2250-9220 $ Curb Box Deposit Refund 2253-9220 $ Construction Meter Dep Refund 2254-9220 $ Water Usage Charge 3711-9220 $ Other $ TOTAL $ 56.00 [ declaze under the penalties of law that this account, claim, or demand is just and that no part of it has been paid. ?'V SIGNATURE ? 1- C) 1 DATE i- -----------, ? For Offce`,:Use ? I Permit#: j Permil Fee: `/ o ? I I I ? Date Received: ? I I ? Siait: ? -J 2008 COMMERCIAL BUILDING PERMIT APPLICATION Date: 7 Z 0? Site AddressD zEKfnJ67U,u Tenant Name: LEXIti6'ti/u ft+cC,s (Tenant is: New / k Existing) Suite #: PROPERTY OWNER Name: gkf1Co2 , 1tic- Phone: 9SZ'S95' V Y97 Address / City / Zip: 6qd 1 C, TY WtIT/%( 4--' L d2- Applicant is: _ Owner ac Contractor TYPE OF WORK Description of work: 221g! of?? Construction Cost: CONTRACTOR Name: G?ALIC&YL License#: ?ZZ9 Address: Z77z/ Ci910P '4?) City: S"S J''Avt_ State: N10 Zip: Pnone:?S(-ZS(-0910 ContactPerson: C/L(t le ARCHITECT / Name: Registration #: ENGINEER Address: City: State: Zip: Phone: Contact Person: Licensed plumber installing new sewer/water service: Phone #: NOTE: Plans and supporting documents that you submii are considered to be publFc informatlon. Portions of the Information may be classifled ss non•pub(ic if you provide specific reasons that would permit the City to conclude that the are frade secrefs. I hereby acknowledge that this iniormation is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand ihis is not a permit, but only an application for a permit, and work is not to start withoui ermit; that the work will be in acwrdance with the approved plan in the case ot work which requires a review and approval of plans. x g7''GE- ?L.A"„ Applicant's Printed Name Page 1 of 3 . DO NOT WRITE BELOW THIS LINE SUB TYPES: ? Foundation ? Public Facility ? Accessory Building ? Apartments x Commercial / Industrial ? Ext. Alteration-Apartments ? Lodging ? Greenhouse ? Ext. Alteration-Commercial ? Miscellaneous ? Antennae ? Ext. Alteration-Public Facility ? NailSalon WORK TYPES: ? New ? Interior Improvement ? Siding ? Demolish Building' O Addition ? Move Building X Reroof ? Demolish Interior ? Altera6on ? Fire Repair ? Demolish Foundation ? Replacement ? Windows ? Water Damage " Demolition (entire building) - give PCA handout to applicant DESCRIPTION: ? Valuation 0 Occupancy MCES System Plan Review -- Code Edition SAC Units (25%=100% Zoning City Water Census Code Stories Booster Pump # of Units Square Feet PRV # of Buildings Length Fire Sprinklers Type of Const Width REQUIRED INSPECTIONS Footings (new bldg) Footings (deck) Footings (addition) Foundation Drein Tile ? ? Roof: _ Decking _ Insulation ?Final N IceMfater Framing Fireplace:_R.I. AirTest _Final Insulation Final C!O Inspection: Schedule Fire Marshal to be present. _ Yes Reviewed By: C9"6:1-- . Building Inspector Sheetrock Meter Size: FinaUC.O. ?Final/No C.O. HVAC Other: Pool: _Footings _AirlGas Tests _Final Siding: _Stucco Lath _Stone Lath _Brick Windows Retaining Wall No Reviewed By: , Planning COMMERCIAL FEES: Base Fee `? `?5 ? • a-o Surcharge Plan Review SAC-MCES SAC-C ity S/W Permit Financial Guarantee S1W Surcharge Storm Sewer Trunk Treatment Plant 5ewer Lateral Treatment Plant (Irrigation) Street Park Dedication Water Lateral Trail Dedication Other Water Quality Water Supply & Storage (WAC) Total Sewer Trunk Water Trunk Page 2 of 3 Use BLUE or BLACK Ink r - - - - - - - - - - - - - - - - - I For Office Use ,Ilk Permit City of Ea Permit Fee: J 1 l I 3830 Pilot Knob Road I I Eagan MN 55122 Date Received: 4 ; Phone: (651) 675-5675 I I Fax: (651) 675-5694 I Staff: I I c/ 2014 RESIDENTIAL BUILDING PERMIT APPLICATION Date: / ,y Site Address: / ~ki~e f~~ ✓ Sri- Unit M. 61 Name: Phone: 7~~8~ 3JJ~ Resident/ Owner Address /City /Zip: 21&6 Le ,rJ~7'01) A'.e 51S0 3 Applicant is: Owner K Contractor Type of Work Description of work: ~'e s oft' _ Construction Cost: v r~S Multi-Family Building: (Yes / No Company: 14 Aeal, ~V 1_e` ,0,rS 1ef' Contact: ~C ~ Contractor Address: 5966 13 ec.ckSkre_ Goc~ AA city: State: XN Zip: 557 to Phone: lp 5/- J'S- 6 3 0 License S8 3.1 7 Lead Certificate A4 7V S'3 S=J If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: I Phone: Sewer & Water Contractor: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.oopherstateonecall.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. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. X_ 4.~ X .z- Applicant's Printed Name Applicant's Signature Page 1 of 3 Use BLUE or BLACK Ink r_________________ I For Office Use � � Permit#: � O p J� � Clty of Ea�a� , `�,��f , 3830 Pilot Knob Road � Permit Fee: (..5� 1 Eagan MN 55122 � � Phone: (651)675-5675 � Date Received: � Fax: (651)675-5694 � I � Staff: I �-----------------I 2014 MECHANICAL PERMIT APPLICATION ❑ Please submit two (2) sets of plans with all commercial applications. Date: f� � I� _Site Address: ' 1�� h�K�ti� f�'"v �U� �b'�Gi� � Tenant: Suite#: � Resident/Owner Name: �� +� {'{�� ,�-y+c� s m��f Phone: ��u3-1{3�f- 3//� Address/City/Zip: �� e� ��s� �" ��v�i� ' �f h- ��'?�9f i?f� �,�.3�{� , Name:__� � � W�y$ �(1�r�.,5 �icense#:_��Yl C�S� 6�6 Contractor Address: C �S � �c�C�n f�- t,(� .��- city: �l r�('�, � f�iv�S v v�� State:�Zip: ,5..5 �(� Phone: �.l,a`! ' �b�' �02 C�� !� r/ �� Contact: (� �' c�1�° 7��3� Email: New �Replacement Additional Alteration Demolition � Type of Work Description of work: NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened by City Code. Please contact the Mechanical Inspector for information on permitted screening methods. RESIDENTIAL COMMERCIAL � � =Furnace _New Construction =Interior Improvement � Permit Type Air Conditioner Install Piping Processed _Air Exchanger �Gas P�P��'� Exterior HVAC Unit _Heat Pump _Under/Above ground Tank �Install!_Remove) _Other �� Y.. -- �_� _.,� RESIDENTIAL FEES $60.00 Minimum Add or alteration to an existing unit(includes$5.00 State Surcharge) �`� $100.00 Residential New(includes$5.00 State Surcharge) _ $�(��d TOTAL FEE � COMMERCIAL FEES �� Contract Value$ x.01 �� $55.00 Permit Fee Minimum � s $70.00 Underground tank installation/removal =$ 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 *"'`If the project valuation is over$1 million, please call for Surcharge = � TOTAL FEE j - - _ _ - _ 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 i: �tV 1� x Applican 's rinted Name ApplicanY S' nature FOR OFFICE USE __ Required Inspections: Reviewed By: Date:�� -°- Und�rgr-0und Rough ln Air Test YGas Service Test In-flaor-Meat �Far�al �; - HVAC Screening Use BLlJE or BLACK tnk �-----------------j � For C3fBcs Use � �� f �� ; P�„t#: j�� C� � � � � � 3830 Pilot Knob Raad i PermitFee: �7�' - `��; ; Eagan MN 55122 ; Date Received: � Phone: {651)6T5�5675 i s�� i Fax: (651j 675-5594 `----------------- 2015 RESIDENTIAL PLUMBING PERMiT APPLICATf4N Q�te: �---� � s��e�� ess: �-�-< <C� Le�� -� � � Tenan#• � l� � t � • Suite#: � ; � �� ,��1�� . �� -- �`��,�( � ��'�d�1Al'ri�t'` ' Name: Phane' - Address/City 1 Zip: �� i_. y �.� �°" .� �--.� Nama: 4 ' ��°'(� icense#: ,� �t1��i�t#�" Address: ;�.' � � C��- � � / p� /�;r�'� S#ate:�Zip' ��"�� PhOn6:��-''��/� "� �t'�"( I� r--, � � � !�.-� Gontact: '� Email: �� ' New _Repiacement �Repair RebuPid Modity Space Wortc in R.QW, i��C. ' — — .-- Description of work: '�� I �O! '^ ��s'�.(, � �Q�--� ' RESIDENTIAL Water Heater �. ` � �� Water Softener � lawn lrrigation(_RPZ/�PVB) � �� Add Plumbing Fi�ctures�Main I_Lovwer Leve!) 5eptic System hlew Water 7umaround Abandanment RESIDENTlAL FEES: $60A0 Water Heater,Water Safiener, or Water Heater and Softener(includes$5.0o State Surd,arge) $6Q.00 Lawn Irrigation(inciudes$5AD minimum State Surcharge) $B0.00 Add Plumbing Fixtures,Septic System Abandonment.Water Tumaround'`(includes�5,00 State Surcharge) '`Water Turnaround(add$200.00 if a 5f8"meter is requiredj $115.00 SeDtic$vstem New($10.00 per as bui(t)(includes County fee and$5.00 State Surcharge) � TOTAL.FEES$ �� CALL BEFtDRE YOU DIG. Calt Gnpher State One Cail at(651)454-0Od2 for protectian against underground utility damage. Ca1148 hours before you intend to dig to receive locates of underground uUlities. uwvw.gapherstateoneeall.orQ I hereby acknawtedge that this informa#ion is complete and accurate;that 2he woHc will be in conformance with the ordinances and codes of the City of Eagan; that t understand this is not a permit, but ortly an appticati+m for a permit, a work is rtot ta s#art without a perm+t, that the raork xriN be in accordance with the approv plan in the case of wrork which requires a review and app of�ans. � � C App ci1 ant s Printed Name App{ nt's gnature 1�4�+��'��i�� ur�ra�� ;; �� q��pe�s; �.1�d��n� ' , ��h=l� „��r 7`e�`k �„�T�. ��' Met��l��i�� tEef��t��Y,.,.. #�tl�s R�a�i,,..,,.�.:,;: �n��r::�.-�..� , 5t�