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4160 Lexington Ave Use BLUE or BLACK Ink For Office Use---_____1 j ~/J I of Eajan I Permit y I s~,~d i Permit Fee: 3830 Pilot Knob Road I I Eagan MN 55122 Date Received: Phone: (651) 675-5675 l I Fax: (651) 675-5694 I staff------------- 2010 COMMERCIAL P UMBING PERMIT APPLICATION Date: [ D Site Add s: ( t Ley Av,26 , ( Tenant: e ~J Jls dG~/"" Suite PROPERTY OWNER Name: Phone: CONTRACTOR Name: 101 License - Address: E City: WLe Phonell6`) r l Email: ! (/~~l TYPE OF - New - Re)72- ment Repair ebuild _ Modify Space _ Work in R.O.W. WORK Description of work: &Ta-11.1d PERMIT TYPE COMMERCIAL _ New Construction _ Modify Space Irrigation System yes no) RPZ / _ PVB) • Rain sensors required on irrigation systems • Avg. GPM W 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: $50.50 Minimum (includes State Surcharge) OR Contract Value $ X1% = $ Permit Fee Required on ALL new buildings and boulevard irrigation systems 4 = $ Radio Meter Read - If Permit Ee is less than $1,000, surcharge is $.50 = $ Meter(s) - if Er i Fee is > $1,000, surcharge increases by $.50 for each $1,000 $1,000 Permit Fee (i.e. a $1,00142,000 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. Call Gopher State One Call at (651) 45440002 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 rmit, but only an application for a permit, and work is not to start W a permit; that the will be in accordance with the approved plan in a of Ach requires a review and approval of plans. x / //R L-A-IT ~ X Appitca"t's Printed Name Applicant's Signature FOR OFFICE USE Approved By: Date: Required Inspections: Under Ground Rough-In Air Test Gas Test Final PRV Required: , Yes No Page 1 of 3 To b Site Ad . ao0: sdr frFv?_ D?? CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21 •199, Eagan, MN 55121 PHONE: 454•8100 ERMIT Est Value 500900( Lot ?Block Sec/Sub. Parcel No. .? . a Name W ; Address ° City Phone p Name ?` Addre ? City_ U ?y W Name Address Q W City Phone .1 A Receipt # Date ,19 OFFICE USE ONLY On Site Sewage _ Occupency MWCC System _ Zoning On Site Well _ Type of Const City Water _ (Actual) (Allowahle) # of Stories Length Depth S.F. Total Footprint S.F. APPROVALS FEES . 703. Assessments _ Permit WateVSewer _ Surcharge Police Plen Review Fire SAC, City Engr. SAC, MWCC Planner _ WaterConn. Council Water Meter _ I hereby acknowledge that I have read this application and state Bldg. Off. _ Road Unit I thattheinformationisconectandagreetocomplywithallapplicable S APC V i _ TreatmenlPl P k tate of Minnesota Statutes and City ot Eagan Ordinances ar ance _ ar s COpieB : Signature of Permittee 70TAL ' A Building Permit is issued to: on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances Building Official ' Permit No. Permit Holdar Dato TeleDhone 7t Plu,rqbing - 'I H.V.AC. r ? lo ? Etectric Softener Inspectfon Dats InaD• Comments Footings I Footings II Foundation Framing f a: 0. f?• 5. .O?x.IrsG .r r?o .? - ?• Roofing Rough Pibg. ;: .? ,lJ? - ? ?' •- - ,,? ,. Rough Htg. _ 0 NEk?NG /?f?? • ISUI. r ? r! G-?. L / .lenTs Ora'?'t Fireplace 7_/y_y Final Htg. ? Final Plbg. S Bldg. Final A cert oca /03 .v.,•vc,vr?v -.C Lt s Temp. LP /„J Deck Ftg. Deck Frmg. well Pr. Disp. , . ? , CONTRACT PRICE: y ;? , Site Address 44 4 Lot 81ock m Name ? Address ' c City - 4 I Phone , Name ; Address 14 0 C'ry -'U ? ? s=e-.? ' 4 r Phone ? - FEES COMM/IND FEE - 19f, OF CONTRACT FEE APT. BLDGS - COMM RATE APPLIES TOWNHOUSE 8 CONDO - RES. RATE APPLIES MINIMUM - RESIDENTIAL FEE - $12.00 MINIMUM - COMM/IND FEE - $20.00 STATE SURCHARGE PER PERMIT - 50 (ADD $.50 S/C IF PERMIT PRICE GOES BEYOND $1,000.00) ». --? ? - SIGNATURE OF'PERMITTEE' ? PERMIT q ?L? 7 PLUMBING PERMIT RECEIPT # CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: - PHONE: 454-8100 T' BLDG. TYPE WORK DESCRIPTION .iL_ ec/Sub Res. New M ult. Add-on Comm. Repair Other RES. PLBG. ONLY - COMPLETE THE FOLLOWING: NO. FIXTURES TOTAL -Water Cioset - $3.00 $ -Bath Tubs - $3.00 _Lavatory - $3.00 -Shower - $3.00 -Kitchen Sink - $3.00 -Urinal/Bidet - $3.00 -Laundry Tray - $3.00 _Floor Drains - $1.50 -Water Heater - $1.50 _Whirlpool - $3.00 _Gas Piping Outlets - $1.50 (MINIMUM - 1 PER PERMI7) _Softener - $5.00 -Well - $10.00 _Private Disp. - $10.00 _Rough Openings - $7.50 FEE: STATE S/C: FOR: CITY OF EAGAN ? GRAND TOTAL• ;r • MECHAI CI7Y 3830 PILOT KNOB I CONTRACT PRICE 'v PHON Site Address % J_ L ,., /1. Lot_•i _Block ? Sec/Sub ? Name ?o Address ? « c City 1,? phone r? - - : ? Name 4 ' c Address ?' O CitY ? ??---v-??Phone ? TYPE OF WORK Forced Air M BTU Boiler < y r? M BTU R Unit Heater M BTU Air Cond. M BTU $ Vent CFM $ Gas Piping Outlets # $ Other cr FEE: ? S/C: TOTAL• GAN RECEIPT # EAGAN, MN 55122 DATE: 8100 ;BLDG. TYPE Res. Mult ? Comm. omer WORK DESCRIPTION New L-"' Add-on Repair FEES RES. HVAC 0-100 M BTU I -$24.00 ADDITIONAL 50 M BTU - 6.00 (RES. HVAC INCLUDES A/C ON NEW CONSTRUCTION) GAS OUTLETS (MINIMUM - 1 PER PERMM - 1.50 EA. COMM/IND FEE - 1o/a OF CONTR.4CT FEE APT. BLDGS. - COMM. RATE APPLIES TOWNHOUSE & 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 Gr BEYOND $1,000) y _ rt w :1 FOR: CITY OF EAGAN CITY OF EAGAN ' 3830 r71ot Knob Road SEWER SERVI CE PERMIT ? P.O. Box 21199 PERMIT NO.: ??6,? .? t Eagan, MN 5512t DATE: F- 4-F" g: P Zonin 4 No. of Units: ? :Owner 11 Z:PaitilflPS Address: Site Plun I agrse to comply wMh ths qty of Eapan Ordinances. BY ? Connection Charge: It'. 08W;d- ? Account Deposit: ? Permit Fee: 10 . [3t? ?F,i,? Surcharge: Misc. Charges: ? Date of Insp.: TotaL• , Insp.: Date Pafd: `- .., CITY OF EAGAN Permit No: c?6v9. Date:6-9-37_ 3830 Pilot Knob Road Meter No: P.O. Box 21199 Size: Eagan, MN 55121 Reader No: Date: Owner. 2 Partners Site Address:-416(? LeziaQtnn liurnuer. ?- nau Cl Conn. Chg: 10 080 OOpd Zoning: P4 Acct. Dep: No. oi Units: 24 Permit Fee: 1d.00pd Surcharge • 5upd I agree to comply wNh the City of Eagan Tr. Plant -;, 56.Ot?pc _ Ordinances. Meter. By WATER SERVICE PERMIT REQUEST FOR ELECTRICAL INSPECTION . ea-oooot-os 1 See insiruc[ions far compleGnB this form on back ot yellow copy. D r ±8S1 9 "X" Below Work Covered by Ihrs Request NeV4 Addj Rep. TyDe oi Builtling AOPlioncea Wired Equiument Wired Mome Fange Temporary Service Duplex Water Heater Lightin,y Fixtures Apt. Building Dryer Electric Heatin Commercial Bldy. Fumace Silo Unloader industrial Bldg. Air Conditioner Bulk Milk Tenk Farm tM1er $PeUfy Othf.r (SpRr,ilyl 1 ,r pecify Other Olh,r ompute lnspection fee Below M Fee Service Entrence5ize p Pee Faxders/Subteeders N Fe,¢ Circwts 25 '303 0 to 200 qm s 0 to 30 Am s 1 &n - 0 to 30 Arn Above 200_qmps 31 to 100 Amps r/ zp " 31 to 100 q 5 Swimming Pool Above 100_Amps Above 100_Amps Transiormers lrrigation Booms Sv Partial-'Other Fee Signs Speciallnspection $Sp TO Remarks /Q?9 TAL PE 4,17,,? i r Rough-in Dnte 1, the Elactri InspeCtor, heraby tif th t th b Final J91e7 cer y a e a ove inspection has been . ? /d made. This repuest voltl 18 monlhs fmm 7his request void 18 rrronths from ?2 D ". 8 .S-1 9 / // /::? / RequeSt Date Pire No. / Rough=in InsVer,tion Requ?red? ?Neady Now?[Will Nntify Inspec- p 6'/- O Myes ? Nu _ tor When Feady Ky Lmenseo tiectncai Contractor I herebv request inspection of above ? Own er elecirical work instaltad at: Street Address, Boz or Route No. City ectlon o. TOWnship Name or No. Ranpe o. COUnIy D,4` o TW OccuDantIPRINTI Phone No. , i?of - S;41- 59i0 Power Supplier Address eF O RJ Electrical Contractor (COmpany Name) Cnntractor's License No. /wi2-5i ?? ?e e- ?az/ c- Mailinp Address IContractor or Owner Making Insiailation) Ia'167 o,JE Sa Authorized Signare IContractor/Owner Makine Ins[ Ilation) Phone Number ??r„ S90 " ?SSJ MINNES TA STATE BOARD OF ECTRICITY THIS INSPECTION NEQUES7 WILL NOT Griggs-Midway Bldg. - Room N• 91 BE ACCEPTED BY THE STqTE BOAHD 7821 Universitv Ave.. St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (612) 642-0800 ENCLOSED. 24 liNIT M.D. CITY OF EAGAN ?J0 1 3 3 2 8 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PIiOME: 454-8100 (f BUILDII?G PERMIT Receipt # To Aused for APT/GAR Est. Value $500,000 Date MARCH 1 ,19 $7 Site Address 4160 LEXINGTON AVE Lot 11 Block 1 Sec/Sub Parcel No LEXINGTON HILLS c Name H& Z PARTNERS z Address P.O. BOX 2997 o city LA CROSSE phone 608/784-5910 o Name ? a Addre ? Ciry_ FW Name JERRY SATERBAK _u Address N751 BLOOMER MILL RD QW City LACROSSE phone 608/788-2764 OFFICE USE ONLY SQn Site Sewage _ Occupancy R1 MWCC System _ Zoning PD On Site Well _ Type of Const V 1 HR City Water _ (ACtual) (Allowable) # of Stories Length 1A? _ Depth 56 S.F. Total Foatprin[ S.F. ' APPROVALS FEES Assessments _ Permit $ 1,703. 5C Water/Sewer _ Surcharge 7_50• OC Police Plan Revfew 851.75 Fire ? SAC,City 1 ,920,OC Engr. _ SAC, MWCC 1 n, nRn.OC Planner WaterConn. in OAO,OC Council _ Water Meter ? I hereby acknowledge that I have read t application and state Bldg. Off. _ Road Unit 5 OC thattheinformationiscorrectandagreeto omplywithall p licablel APC _ 7reatmenlPl 3,456.OC State af Minnesota Siat and ' t agan Ordina Variance _ Parks N/A. Copies Signature of Permittee TOTAL A Building Permit is issued . H& Z PA TNE S on the express condition that all work shall be done in accordance with all applicable StatAof Minnesota Statutps and City of Eagan Ordinances. Building Official ? `ti-t io 2005 COMMERCIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone 4 651-675-5675 FAX # 651-675-5694 . Structurel Plans (2) sets . Civil Plans (2) . Certificate oi Survey (1) • CodeAnalysis (1) " . ProjectSpecs (1) . Spec. Insp. & Testing Schedule " . Soils RepoR (1) . Meter size must be established 1 t d 1 1 ! . SACdetermination-ca11 651-602-1 00D $ ilg .-15 • Architectural Plans (2) sets • Architectural Plans (2) sets . StructuralPlans (2) • CodeAnalysis (7)" • Civil Plans (2) . Project Specs (7) . Landscaping Plans (2) • Key Plan (1) • Code Analysis (1) " • Master Exit Pfan (1) • Certificate of Survey (1) • Energy Calculations (t) not always'° . Spec. Insp. & Testing Schedule (1) " • Elec. Power & Lighting Form (1) not always'* . Meter size must be established • Meter size must be establishe d-if applicable • Projeci Specs (1) • EnergyCalculations (1) " ? . Electric Power & Lighting Form (1) " y . Master Exit Plan (1) y . Emergency Response Site Plan (1) ••' 1 (1) y . Soils Report . 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 facilihes. ** Contact Building Inspections for sample and if required 'k* Permit for new building or addition will not be processed withoutEmergency Response Site Plan. Date SiteAddress 4* Tenant Name ?G_P?cl Construction Cost oo _ ??? d SU1"1c? IInit/Ste # Ja C? Former Tenant Name _ Descripfion of Work Property Owner Telephone # ( ) _ Contractor 1-tt [Jt, Address );?-(' D State ? pS ^ Zip .s 5 3ei City MG-O V(' C tf Telephone # `f°, Arch/Engr Address State Zip Registration # City Telephone # ( ) Licensed plumber installing new sewer/water service: Phone #: ( ) I hereby apply for a Commercial Building Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; I understand this is not a permit, but only an 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. 6 ?, \?? pp:? 5 , Applicant's Printed Name App tcant's Signature OFFICE USE ONLY Su b Types ? 01 Foundation ? 26 Public Facility ? 30 Accessory Building ? 14 Apartments 0 27 CommerciaUIndustrial ? 32 Ext Alt Apartments ? 15 L,odging 0 28 Greenhouse ? 34 Ext Alt-Commercial ? 25 Miscellaneous ? 29 Antennae ? 35 Ext Alt-Public Facility ? 37 Nail Salon Work Types ? 31 New ? 35 Int Improvement ? 38 Demolish (lnterior) ? 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundati on) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)* ? 43 Reroof ? 46 WindowslDoors ? 34 Replacement 'Uemolition (Entire Bldg only) -Give PCA handnut to applicant Valuation (90? v Plan Rev 100% 25% Census Code SAC Units Nbr. of Units Nbr. of Bldgs Required Inspections _ Footings (new bldg) _ Footings(deck) _ Footings (addition) Foundation Drain Tile _ Driveway Apron Type of Const Occupancy Zoning Stories Sq. Ft. Length _ Roof Ice Pr _ Decking _ Insut _ Final _ Framing Approved By: Base Fee Suroharge Plan Review SAC-MCES SAGCity S/W Petmit SMJ Surcharge Treatment Plant Treatrnent PIaM (Irrigation) Park Dedication 7rail Decication Wafer Qualify Water Suppiy & Storage (WAC) Wdth MCES System City Water Booster Pump PRV Fire Sprinklered _ Fireplace _ R.I. _ Air Test _ Final Insulation FinaUC.O. FinaUNo C.O. Other _ Pool _ Ftgs _ Air/Gas Tests _ Final _ Siding _ Stucco _ Stone _ Windows Planning A-ve Buiiding Inspector Financial Guarantee Storm Sewer Trunk Sewer Lateral Street Water Lateral Other Total Sewer Trunk ? Water Trunk 2005 COMMERCIAL PLUMBING PERMIT APPLICATION « CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 Date / / -7 . /-? ,./ Site Address ?!J '?J/J L? • Unit # `67'-?v?O? Tenant Name Former Tenant Name Property Owner Telephone # ( ) ,r Contractor - ed'' C D?C Address 0 aepS_ City State ? ? Zip ??7 Telephone # ?) License # ?(V 7 Expires: The Applicant is _ Owner Contractor _ Other a Work Type New Bldg Modify Space _ Irrigation System** Yes No Work in public r-o• v / easement? _ RPZ _ PVB: New _ Repair/Rebuild _ Repiace _ Remove Rain sensors are re uired on irriation s s ms Descriptian of Work ? v ' if Pressure Re, Lducing Valve is required on new service, ca11 65 1-6 75-5 646 To inquve Meters - Ca11 6 51-675-5 300 to verify that hydrostatic, conductivity, and bacteria tests passed prior to pickine up meter. Irrigation Size & Type Avg GPM 2° turbo req'd unless smaller size allowed by Public Works Fire Size & PriCe 3/4" displacement $161.00 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 5urcharge) Contract Value $ x 1% _$ ?? Permit Fee $ Meter(s) Required on allnew buildings & boulevazd iaieation svstems $ Radio Meter Read $ •SD State Surcharge If permit fee is less than $1,000, surcharge is $.50 If permit fee is more than $1,000, surcharge is $.50 for each $1,000 owed. ------------------------------------ -------- - Following fees apply when installing new lawn irrigation system $ Water Permit Call John Gorder at 651-675-5645 for required fee amounts $ Treatment Plant $ Water Supply & 5torage $ State Surcharge $ Total Fee 1 hereby apply Tor a Commercial PlumMng Yermit and aclcnowledge that the infbrmahon i ompl and acwrate; ihat the worK wul be m contormance wtcn me 1/0 sd with the Plumbing Codes; that I understa this is not permit, but an application for a perznit, and work is not to ut a ; atthe work w' be in a7cco ce with t e approved plan in the se of wqr hic =wseview and approval of plans. j ? cC1 a'K? Applicant Printed Name pp icants Signature rM.:.?Cnv`VSE QNLi ?, . ? FERMIT #: C> t ? RECEIPI' DATE: 1 ?J CJ :;: . , . CONMHDtCIlkL fI.tJw6 pERN1T 14PPI.ICA110N . ._ , : C1TYad!?A6f?klf ;. . 9890 PDMSBOB $D $wRAkANS5i? ?1-Mi,se7s Dace: WORK T'YPE _ NewBldg _._ Add-on .._. Repair__ RPZ )( _ PVB _' Irrigadon system ' Must complete reverse side ofapplication also: ReqoirEd meter size is 2" turbo ad?smaller size permitted by Public Works DESCRIPTION OF WORK , ?) /- /? / C?7 To inquire if Pressnre Reducing Valve is required.on new seryice, ca11651-681-4646 .., ,.. METERS -.Cal] 651-681-0300 to..yerify that hydrostatic, conductivity, and bactecia tests passed prior to nickina uo meter Irrigation Size & Type ! Fire` - Size & Type - Domestic Size & Type Does dvs include high demand devices? Yes No Avg GPM Avg GPM Avg GPM FLUSHOMETERS _ Yes _ No PRV REQUIRED _ Yes _ No sAda?ess: y?60 ?z°Xi:?g?n ??? S. TenantName:`':?2°X%?!Q)'"Or? /1'r?? /?'}?/?5 Was Hieae a previous tenant in trria spaceR _ Y_ N. If Yes, Name: , Installer Name: /i ?]'e /a /? O.'? ' Instauer aearesS: ?3ti/Da ?, .? ??z r v City: V?Z? ?GGr i S ?"c r?J Telephone #: (Area Code) Telephone #: X?- 9- 2 e) - a?? ?? (Area coae) State: ?"A) Zip Code FEES Contract price $??Y a 1% ($50.00 miaimum) Contract Fee , I.- _..-,__...-:-...a„.. . ,... - ... . Meter(s) $ Required on atl new build'mgs & boulevard irrigation systems (Acct # 92204509) . Radio Meter Read $ ` Sur`charge: $.50 Minimum. If contract fee exceeds $ 1,000, calculate at 50 cents per $1,000 contract fee. Total Frora Revelse Stete Surcharge S `-VO New Service $ Total I hereby eclmowledge that I have read this application, stete that tl?e infoimation is wrnck and agree to comply with all applicable Ciry of Eagan _ ordinances. It is fhe applicent's respovsibility to notifythe property owner that the City ofEagan assumes no Liability for any damages cavsed by e ty durmg its noimal operational and mA;,,ten'ance activiries to the facilities conswcted undet this p it within Pty properry/right-of-wey/easement. SIGNATURE OF PERMITTEE . . . . , ._ . . . ._ ,._ .. - CITY USE ONLY REQUIRED INSPECTIONS: _ U.G. _ Air Test _ Gas Test _ Rough In _ Final PLANS,SUBMTITED APPROVED BY: , BUILDING INSPECTOR CITY USE ONLY PERMIT RECEIPT DATE: ?4 u ? COMMERCLAL PLUMBIN6 PERMIT APPL[ClkTIOR CTfYOF $A6i41Y 3$90 PDAT KROB $D aAsm. MN 55122 651-e61-4e75 fNCOMPLEIF APPLICATIONS WILt NOT BE PROCESSED Date: o? - a 1:9 - 0 I WORK TYPE New Bldg Add-on Repair ? RPZ _ PVB • Irrigation system * Must complete reverse side of application also. Required meter size is 2" turbo unless smaller size permitted by Public Works DESCRIPTION OF WORK P=4 To inquire if Pressure Reducing Valve is required on new service, ca11651-681-4646 METERS - Call 651-6814300 to verify that hydrostatic, conductivity, and bacteria tests passed prior to uickin¢ up meter Irrigation Size & Type _ Fire Size & Type _ Domestic Size & Type Does this include high demand devices7 Yes No Avg GPM Avg GPM Avg GPM FLUSHOMETERS _ Yes _ No PRV REQUIRED _ Yes _ No Site Address: q I ?P C7 L°1,! x? n cl4(:, ,? A 4 L°, S. Tenant Name: L l,X,i nq`t-b I 4'S ? p`5S Telephone #: (os (_?I S o`? - O?{ 3 ?J- (Area Code) Was there a previous tenant in this space? _ Y_ N. If Yes, Name: Installer Name: M + ke- t, A Installer Address: ?q (3 a 10 r 0.i- Nr City: tu._?S ? ? State FEES Contract price S LvVW_ x 1% ($50A0 minimum) Required on all new buildings & boulevard irrigation systems Surcharge: $.50 Minimum. If contract fee exceeds $1,OOQ calculate at 50 cents per $1,000 contract fee. Total From Reverse TYItZ? Zip Code S Sy a? Contract Fee $ J`?d -Oz) Meter(s) $ RaAio Meter Read $ State Surcharge $ . 'J'`- C) New Service $ Total $ I hereby acknowiedge that I have read this application, state that the information is correct, and agree m comply with all applicable City of Eagan ordinances. It is the applicant's responsibility to norify the properry owner that the City of Eagan assumes no liabiliry for any damages caused by the City during its nomial operarional and maintenance activiries to the faciliries constructed under s pe it within City propertylright-of-way/easement. CITY USE ONLY ? ?+ ? f?AR 12 2??. REQUIRED INSPECTIONS: _ U.G. _ Air Test , Gas Test _ Rough nJ ` Final - Telephone #: q S a - 9 0`2 O- oZ Co ? a (Area Code) PLANS SUBMITTED APPROVED BY: CTTV Oh F.:At7AN CA;:iFi:CER: S TF=:fii1lNAL NOt 695 I1fi,TE: 07f13/99 TLMre 0e40e32 II+ . NAMEa 70F' GUN .T.NC :3210 9001 41617 I_CXI:NGTt]N 9+.?FJ Zi. ;5 9001 41F.0CI LFX:CNGTQN 2<C)I] Y Ta+.al. Recei.pt Flmcaunt -a 39.25 CFti. i.:33:t.3 IJSEfi IXi;; NANCV ?K?%KtYF?KXc ??CXt?K?Xtr???Sca??oX?X?k?K#?XYFiK?M}X??XXt>#'?>X?kkvk?'c 'M 1999 BUILDING PERMIT APPLICATION (COMMERCIAL) CITY OF EAGAN `C (651) 681-4675 c? Submit foilowing to obtain necessarv Dermit -t -1--,D - 9? ?9 4??s-- Foundation Oni New Construction Interior Im rovement structural plans (2 sets) architectural plans (2 sets) architectural plans (2 sets ? dvil plans (2 sets) structural plans (2 sets) code analysis (1) " code anatysis (1) '• dvil plans (2 sets) project specs (1 set) projeci specs (1) landscaping plans (2 sets) Key Plan Special Inspections 8 Testing Schedule " code analysis (1) " energy caiculations (1) notaMays " soils report (1) Electric Power & Lighting Fortn (1) notalways " SAC determination letter from MC/ES - SAC determinaGon letter from MC/ES - SAC determination letter from MC/ES - cdll 602-1000 call 602-1000 call 602-1 D00 Special Inspections & Testing Schedule (1) " project specs (1) energy calalations (1) •' Electric Power 8 Li htin Form 1 " .,unnaa aunamg mspecuons ror sampie Food & Beverage or Lodging facilities: Plan must be submitted to Minnesota Department of Health. Call 215-0700 for details. DATE: WORK TYPE: )<,- NEW REMODEL DESCRIPTION OF WORK: CONSTRUCTION COST: TENANT NAME: ??( n Gl?nn ?r I ls ,?? . SITE ADDRESS: LOT 11- BLOCK SUITE #: P.I.D. # ?- Name:J4NL?y-?`'f`J?y?'- i' ? ? ? 1?'? ! Phone ? 03l 3 PROPERTY Last `J First I 01'VNER I ( StreetAddre ll ? y ? ? & I? ?1 ss: ? w c . T, _ I City 1 State: ?/J • Zip: Ss Company: Phone #: COT'TRACTOR Street Address: City State: M/L'- Zip: ARCHITECT,? ENGIIvEER Company: Phone #: tiame: Registration #: Street Address: Ciry State: Zip: Sewer 8 water licensed plumber (only if installing sewer & tnat i nc, JUL 12 1999 ve read this application, state that the information is cor?t, and agree to com ly ? h all applicable 5tate of Eagan Ordinances. {i? Signature of Applicant: ?J 1986 BIIILDING PEfiHTf APPLICATIOA - CITY OF EAG9H HOTE: ALL CON?RAClOES MITST BE LICENSED iiI1°H THS CITY OF EAGAA 3IRGLE FANMY DWELLIIJGS .. _ ,. -? . ' ;-._.. INCLODE 2 SETS OF PLANS, 3 CEATIFICATES OF SURVEY, i SET OF ENERGY CALCIILATIONS M[TL?IPLE DiiELI.INGS - RESIDENTIAL RENTAL Oe1ITS .? FOE SALE QNITS INCLQDE 2 SETS OF PLANS, CERTIFICATE OF SQRVEY - CHEC[ iiITH BLDG. DEPT., 1 SET OF ENERGY CALCULATZONS COMMRCIAI. INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OE SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS, $29000 LANDSCAPE BOND To Be Qsed For: fZV5?T;rG7,!AFF Yaluation: 5C>01 c?v Site Address 41 Co0 LGX • QVe•_ ? OFFICE IILot Block ? Parcel/Sub LL---k • ?'s I ?.?.5 ( S? ` Joe B Hengel & Donald Zietlow Owner D/S/A H& Z Partners Address rn sog 2997 Gity/Zip Code La G`rosse Wi 54601 ? . . _ Phone 608 784 5910 Contractor & Z Partners D/B/A -B Construction Address vn unu 9007 City/Zip Code La Crosse Wi 54601 Phone FnR 7R4 5910 Areh./Engr. jg3= Satarbak 6ddress N751 Blooaer Mill Rd Datei Ereet ? Occupaney (z•I Remodel _ Zoning PD,. R,4) Repair Type of Const SL I HR • ? Addition # oF Stories ?,_ Move _ Length 183 Demolish Depth S(o _ Int.Impr. Sq Ft ZD, ?Do Install APPROVALS FEES , Assessments Permit ( O',?p Water/Sewer Sureharge ZSO. Police Plan Review e?51' F1re • SAC oUo Engr Water Conn 10D D Planner Water Meter i?4 A Council Road Unit !?856, Bldg Off Treatment P1 ?(o APC Parks hl/A ? Variance Copies . TOTAI. ? 34.M1 ' PG(zr? i i - 170l Pa.rref,.t ' ?u P-Gv?AP-CI E- S?, o00 ?o00 ?- ZSc? 2- S0 1 z,?4 2 q- x SDO Z4 ?, 420 _ WA _ u?-j (T 24 X 24?- _ ??? , TPG ___--- 24 x ?4a = 345? --- - ? ,?5? 0•A U . ?: ? 54,197•27x 4 •=k< 136,789•00* . CITY OF EAGAN APPLICATION FOR PERMIT . .. SEWER AND/OR WATER CONNECTION 'A'X•')t'A"A` "A't1'x"X X ]? R'X1r?txl[1?'leZa?xa?R'1'1titX'*'R"A" *ATPI: PAYMBTTP OF FEE AT TIME OF APPLscATIoN DoEs Nar cONSTzTUTE APPxovAL oF PERMIT. nvSPECrzoN oF srwaz P,rm//oR MOM T1VS"1'AT T.ATTQDj$ F]jj/L jVOP $E $(HII'D- UIED UNPIL PIItMLT AAS BFEN APPROVID. - ?:wxwxxwxxxwxwwxwxwwwwxxxw.xwwwx::x P ease Print ? .1) PROPERTY ADDRESS : ? TV L?D /V ? W JE '- LEGAL DESCRIPTION: '- ock/Subdivision or Tax Parce IF EXISTING STRL'C'IURE, DATE OF ORIGINAL BL'ILDZNG PERMIT ISSL'ANCE: . : _ (Mon Year - PRESENT 7ANING/pROPOSID LSE: Q COMAg'.RCIAL/RETAIL/OFFICE ? R-1 SINGLE FANIILY " Q IPIDUSTRIAL, Q R-2 DL?PLEX (Two t?nits) ? INSTI'IL?TIONAL/GOVII2NMENr R-3 TDWNliOLSE (Three + Units ) ( Linits ) . ? R-4 APARTMENT/COPIDUMIIVIT-IIN Units ) 2) rrAME: AoDREss: v ciTY, srAZE, zzP: 0,? pxoNE: 3) ' c ?• NAME: ADDRFSS:_ PL% n L) CITY. STATE. ZIP:___t- pxorE:6 ?,? r?as? iscavsE# o0 ?.1 g J??1 Plumbers License: ? Active EScpired Abt recorded Staff ?t?al 4) .. . i?- NAME: _ ADoREss: CITY. STATE. 2IP:_ PHorrE:_ 6 O s? 7" -5) i? «• • ?. : a • ? - ?? . ? CONNECTIQN M CITY SEMR ? CONNDC.TION TO CITY WATER ? 0'I7M '- 6) ai • • i q PLEASE HOLD APPROVID PERNffT E'OR PICK-UP BY ONE OF ABOSIE ----- Q PLEASE MAI 7 APPROVID PERMIT TO 1? 2. 3r 4. ABOIE . (Circle ) . 7' : FOR -CITY USE ONLY PERMIT # tSSUED r - Pd w/B1dg. Permit i FEES: $ S /O - SZ' S Y /C 'i ' J (J $ $ $ $ $ $ $ $ ..?- $ ?b ? ? $ ?- l0?v?o s UZs71 • U!J 2-1 $ $ $ $ $ $ $ $ $ - 00 $ $ $ $ q2.? 5 3 4'?? 7/ z/? 7 REC?IPT #-- RECEIPT ,:. SEWER PERMIT (INCLUDE SURCHARGE) WATER PERMIT (INCLUDE S[JRCHARGE) WATER METER/COPPERHORN/OL'TSIDE READER WATER TAP (IIVCLL'DE CORPORATION STOP) SEWER TAP ACCOUNT DEPOSIT - SEWER ACCOL'NT DEPOSIT - WATER WAC SAC TRLNK WATER ASSESSMENT TRLiNK SEWER ASSESSMENT LATERAL BENEFIT/TRUNK SEWER LATERAL BENEFIT/TRONK WATER WATER TREATMENT PLANT SURCHARGE OTHER: TOTAL DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? ? YES IF YES, THEN A"PERMIT FOR WORK WITHIN PUBLIC Q ROADWAY" MLST BE ISSLED BY THE ENGINEERING NO DIVISION. LIST AS A CONDITION. SUBJECT TO THE FOLLOWING CONDITIONS: APPROVED BY: !&`'"?--? TITLE: DATE : ? / f ?J ? i HAUGE, EIDE & KELLER, P.A. PAULM.MAUGE ? ,?tlornegt a! (?ol?aw KEVtN w. EIDE TOWN CE?VTRE PROFE3SIONAL BLDG., SUITE 200 DAVID G. KELIER ? 1260 YANAEE DOODLE ROAD LORI M. BELIIN EAGAN, b1INNESOTA 5512-3 DEBRA E. SCHMIDT (612) 456-9000 June 17, 1987 TO: Tom Hedges Tom Colbert X Gene VanOverbeke Dale Runkle FROM: Paul Hauge Kevin Eide X Dave Keller Lori Bellin Debra Schmidt ` ?: Lots?1;4-,7,8 and 11, Block_1_;?Lexington Hills First Addition Project tvo. ".' 47_8 -?° Lexington South, Inc. to the City of Eagan Enclosed please find: Development Contract PUD Agreement 1 Easement Trai1 Easementi Deed ' Other Action requested: Please place this recorded document in your permanent file. cc: Bruce Allen ! ? TRAIL EASEMENT THIS INDENTURE made and entered into this /S 71'` day of ,4 e-I ,c Z,ez- , 1986, by and between LEXINGTON SOUTH, INC., as Grantor, and the CITY OF EAGAN, Dakota County, Minnesota, as Grantee. WITNESSETH WHEREAS, said Grantor is the owner of the tracts of land in the City of Eagan, Dakota County, Minnesota, legally described as follows: Lots 1, 4, 7, 8 and 11, Block 1, Lexington Aills First Addition. NOW THEREFORE, the said Grantor in consideration of One ($1.00) Dollar and other good and valuable consideration to it paid by Grantee; receipt whereof is hereby acknowledged, hereby conveys, warrants and dedicates to said Grantee, its heirs and assigns, for trail purposes, together with the unrestricted right to improve the same, free and clear of all encumbrances, the following described tracts of land: A 10.00 foot wide perpetual easement and across that part of Lots 1, 4, First Addition, according to the Minnesota, the Westerlq line of sa southwesterly lines of said lots and right-of-way of County Road No. 43. for street and trailway purposes over 7, 8 and 11, Block 1, Lexington Hills recorded plat thereof, Dakota County, id easement being the westerly or being parallel with and adjoining the The Grantor, for itself, its h,,??rs, executors, administrators and assigns, does covenant never to cut, damage, destroy or remove any tree or shrub or other natural, growth upon the hereinbefore described premises for the continuance of this easement, and does hereby grant and convey to the said City of Eagan a12 grasses, shrubs, trees and ?atural growth now existing on said lands or that may be hereafter planted or grown thereon. The Grantor, for itself, its heirs, executors, administrators and assigns does hereby release the said City of Eagan, its successors and assigns, from all claims for any and all damages resulting to the lands through and across which the parcel of land hereby conveyed is located by reason of the location, grading, construction, maintenance, and use of a public trail over and upon the premises hereby conveyed and from the uses incident thereto, and the said City of Eagan shall have the right to use and remove all earth and other materials lying within the parcel of land hereby conveyed and the right to construct and maintain, upon the lands adjoining the parcel hereby conveyed, auch portable snow.fences during such months as weather conditions ;make necessary. All s.tumps and other debris resulting from the clearing of the right-of- way will be disposed of by Grantee by burning or otherwise, according to law. The Grantee shall have the right to post such signs and posters along said trail as are deemed necessary and suitable to define the above lands and locate them for public use. r . .. LEXINGTDN HILLS FlRST ADDIT/ON I z ` ?:I ?--- Y..,. t:_ ., ,ft n ,,. ., ,* ,. ,,. ., ?,;. _, ? I ? ?; \\ "' S89'99l9'E 123926 --• - ? _ _ _ •?M '"? aua ? _'_"_-___ " . ... .. ' ? '. o .?.. . ..??.. k s? ' ? p \ . ` ?? ?? ? ? •?? s'..? ±• j ? i ?? ?,? / ?'• 3 op I `? `• ` ` ?/?' \? ~• ? h ?4}'?! ?` a`' ? `b?. ? "":?.>: t, / ?`pa Cp ?''`;.? ??, ,.?'?; '`?i?.? I ; I.. : I ?J.?? G1, 4`'1a. ? ? ` ? ? ? , ?• 6 ? . s V\. g \???•' .I ? ?I ? Street and Trailway Easement EXHIBIT ? \? ? ,?, Fl ,. , 1 ? s' : i•?i'°, '• ~'° ""?? t'? f'? I F )? l1?OG Il?LO' 1 ?l? •? ' C?, ? I K4l II? ? ' g.s? ' •??? 8 I • ? ? '?' ?? 1Y?' ??? • ? wYl? ???? .? I' • ?nti ,v.' - -u?J°----- -------n'°°-- ------ -L ? % ' ?` -• N89Y8WW 62034-- `G' I 1 O \ I ., A 10.00 foot wide Perpetual EasemenY farStreet and Trailway purposes over and acroas that part of Lots 1,4,7,8 and 11, Hlock 1, LEXINGTON HILLS FIRST ADDITION, accordinq to the recorded plat thereof, Dakota County, Minnesota, the taesterly line of said easement being the westerly or Southwesterly linea of said Lots and being parallel with and adjoininq the right-of-way of County Road No. 43. t _ . - -----?-- ' DAKOTA COUNTY NAME / DESCRIPTION AND DELINQUENT TAX RECORD PARCEL IDENTIPICATION OISTFICT: ` A AN yI i -r h l S W PROPERTY DESCRIPTION DIST PLAT LOT BLK u c oo DiS[.ICT S SEC lOT B?o?K RAr.?cE ? j V 50 '5 - ` 4; Ea5, 1';E ;. LEXlRv'-Tu,V HILLS ? T a D TRANSFER DATE CRV.NO, lASTGRANTEE j 1 Ui 29 t37 J1VI5IGN JIY L"cXInU'IL'(v S'?I:TH IiAC 1 :, 3 7 ?;J_+ x1; L uTur T S 1 , i: % ti :ii. H I \c ?tJ H L Z NI?rnS /,? /? ?1 ' ? (?) f/.PL/ • ??yyn/ ?S i 2004 COMMERCIAL PLUMBING PERMIT APPLICATTON CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 7s r?x).C?b Date Site Address Unit # Tenant Name Former Tenant Name Property Owner Telephone # ( ) Contractor -t 4H6' ? ? Address City y1 State I?i YV Zip Telephone #(Ah The Applicant is _ Owner ? Contractor _ Other Work Type _ New Bldg _ Add-on Repair RPZ PVB Irrigation system * * Jerrv Wobschall to calcula[e fees. R uired meter size is 2" turbo unless smalier size ermitted by Public Works Description of Work Lx)-?Lti-? G CC?vp ?Tx-? , To inquire if Pressure Reducmg Valve's required on ne service, ca11 651-675-5646 Meters - Call 651-675-5300 to verify that hydrostafrc, conductivity, and bacteria tests passed urior to oickine uu meter Irrigation Size & Type Avg GPM Fire Size & Price 3/4" dis lacement $155.00 Domestic Size & Type Avg GPM Includes high demand devices? Yes No Flushometers _ Yes _ No PRV Required Yes No Permit Fee $50.50 minimum (includes State Surcharge) Contract Value $ x 1% _$ Base Fee $ Meter(s) Required on all new 6uildings & boulevard irriqation svstems $ Radio Meter Read if base fee is $1,000 or less, surcharge is $.50 $ State Suich3rge if base fee is over $1,000, surcharge is $.50 per $1,000 of the Base Fee _? -------- --- -------------------- Following fees apply only when installing new imgation system $ ?---------- --???---- - Water Pemut Contact Jerry Wobschall at 651-675-5024 for required fee amounts $ ?' ? - • '' ' ` '3'reatment Plant $ Water Sypply & Storage $ State SuJr'fharge -----------------------------------------------------------------------------------------------------' ,.__. -------- -°-- ?- _. . . ..__-----__ -----: --'-r-----'--------"--'-'- $ 50 . 'rJQ Total Fee I hETehv annlv fnr a f'n.n...c...:.,1 vl„«.6:_ - -• • ----------•^- ••---•?••6 • .' afu a?nnUwicuge iim[ mC IiliOR178ilOil is compiete antl accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Plumbing Codes; that 1 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. YaAi,_j qjCc5(_,.,k? ApplicanYs PrinteA Name A ???-- pp ?cants ignature ? ----------- j Far Ofk6e Use j I Permit#: V? I ; ( ? ? j Permit Fee: 70 j ; Date Received: _ I ? Stafl: _J 2008 COMMERCIAL BUILDING PERMIT APPLICATION Date: Site AddrCSi ?()`EXl NGTV-4-j /4cAr S, Tenant Name: IEX?ti bZj,v f'( +cl5 _(Tenant is: New / K- Existing) Suite #: PROPERTY OWNER Name: /?C.9CU2 1A+? Phone: ?SZ Oy97 Address / City / Zip: lOl,O 1 CiT7 Wr.y(?(.? 10 Z Applicant is: _ Owner ?C Contractor TYPE OF WORK Description of work: Construction Cost: CONTRACTOR Name: GtJALKCYZ 4,:,'-j? License#: q2'1`j Address: ZZ-7?/ C/310/0 ? CitY: `S'S 194 "[- State: .v"? zip: Phone:?¢S('ZSI-Q9`d GontactPerson: E-/L(L 4 12-7oS-[o'31?1g` ARCHITECT ! Name: Registration #: ENGINEER Address: City: State: Zip: Phone: Contact Person: Licensed plumber instaliing new sewer/water service: Phqne #: NOTE: Plans and supporting documents that you submit are consideretl to be publlc infvrmatfon. Porfivns of the information may be classifled as non-publiC if yau provide speciflc reasons that would permit the City to conclude that fhe are trade secrefs. I hereby acknowledge that ihis information is complete and accurate; ihat the work will be in conformance with the ordinances and codes of the City ot Eagan; that I understand this is not a permit, but only an application for a permit, and work is noi to start without ermit that the work will be in accordance with the approved plan in the case ol work which requires a review and approval of plans. ?j7 /%? XKm4E- ApplicanYs Printed Name Page 1 of 3 , _ DO NOT WRITE BELOW THIS LINE SUB TYPES: ? Foundation ? Apartments ? Lodging ? Miscellaneous WORK TYPES: ? Public Facility g Commercial/lndustrial ? Greenhouse ? Antennae ? Accessory Building ? Ext. Alteration-Apartments ? Ext. Alteration-Commercial ? Ext. Alteration-Public Facility ? Nail Salon ? New ? Interior Improvement ? Siding ? Demolish Building` ? Addition ? Move Building 0 Reroof ? Demolish Interior ? Alteretion ? Fire Repair ? Demolish Foundation ? Replacement ? Windows ? Water Damage * Demolition (entire building) - give PCA handout to applicant DESCRIPTION: C?o Valuation Zyj DP10 Occupancy MCES System Plan Review Code Edition SAC Units (25%=100°oT? Zoning City Water Census Code Stories Booster Pump # of Units Square Feet PRV # of Buildings r Length Fire Sprinklers Type of Const. Width REQUIRED INSPECTIONS Footings (new bldg) Sheetrock Meter Size: Footings (deck) Fina11C.0. Footings (addition) FinallNo C.O. Foundation HVAC Drain Tile ? Other. Roof: _ Decking _ Insulation L"Final _ IceNVater Pool: _Footings _AiNGas Tests _Final Framing Siding: _Stucco Lath _Stone Lath _Brick Fireplace:_R.I. _AirTest _Final Windows Insulation Retaining Wall Final C!0 Inspection: Schedule Fire Marshal to be present. _ Yes Reviewed By: (A"I', Building Inspector COMMERCIAL FEES: Base Fee ?{SG, ae Surcharge j , ??v Plan Review SAC-MCES SAGCity S/W Permit S/W Surcharge Treatment Plant Treatment Plant (Irrigation) Park Dedication Trail Dedication Water Quality Water Supply & Storage (WAC) Financial Guarantee Storm Sewer Trunk Sewer Lateral Street Water Lateral Other Total W ZI70 •S`v No Reviewed By: Sewer Trunk Water Trunk Planning Page 2 of 3 Use BLUE or BLACK Ink I I For Office Use I a I I Permit C) ( I I City of E I j~ 0 I Permit Fee: 11~~ I I 3830 Pilot Knob Road I I Eagan MN 55122 I Date Received: I Phone: (651) 675-5675 I I Fax: (651) 675-5694 I Staff: L ----------I INFLOW & INFILTRATION PERMIT APPLICATION Plumbing / Sewer & Water i Date: Lq Q,01 -o Site Address: 41 W LSIS~Nv. & ~4t vQ_ So I Tenant: Suite Resident/Owner Name: Phone: II Address/ City/ Zip: L-kWq L~ v2~~ ceo~ V~vv Name: License Contractor Address: City: State: Zip: Phone: Contact: Email: PLUMBING (Within the building envelope) SEWER & WATER (Outside the building envelope) Type of Work Sump Pump Repair Repair Other: Other: Description of work: Q S ~cvv~ ,,c Description FEES $60.00 / Each (includes $5.00 State Surcharge) TOTAL FEE $ *Permit fees will NOT be reimbursed by the City of Eagan. If you plan to submit 1/1 repair costs for reimbursement, two quotes from qualified contractors must accompany this application. A list of contractors can be found by visiting www.citvofeacian.com/inflow, or City Hall at 3830 Pilot Knob Rd. 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.gooherstateonecall.orq I 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~z ~ X\ L Applicant's Printed Name Applicant's Signature FOR OFFICE USE Reviewed By: Date: Required Inspections: -Under Ground -Rough-In -Final Use BLUE or BLACK Ink r For Office Usee~ I Permit Win City of Ea Permit Fee. 3830 Pilot Knob Road I I Eagan MN 55122 Date Received: Phone: (651) 675-5675 I I Fax: (651) 675-5694 I Staff: I I 2014 RESIDENTII/AL BUILDING PERMIT APPLICATION Date: ~Z411LI Site Address: 7/ &62 Unit Name: Lit al S //-4 Phone: X3 - Resident/ Owner Address / City / Zip: f•~>C/~C/~]`z~r~, Applicant is: Owner -,k/- Contractor Type of Work Description of work: K _s~'Oxs Construction Cost: 3!/_2 6'~- Multi-Family Building: (Yes / No Company: (~okl_lcy ~ t714- Contact: Address: _-SO [S lscc 1~~ City: Contractor State: u Zip: ~716 Phone: License ~L 5f3 .%2 7 Y Lead Certificate A"Al- 71/ 5'3,5-/ 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: 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.gopherstateonecall.org I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work 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 App ican6 Printed Name Applicants' pplican s Signature Page 1 of 3 Use BLUE or BLACK Ink r_______________ I I For Office Use Clt of Ea a� � Permit#: '�p �� Y � � ��v� � 3830 Pilot Knob Road � Permit Fee: � I Eagan MN 55122 � � Phone: (651) 675-5675 � Date Received: � Fax: (651) 675-5694 I I � Staff: I �-----------------I 2014 MECHANICAL PERMIT APPLICATION ❑ Please submit two (2) sets of plans with all commercial applications. Date: % % Site Address:_`��Q ��-X��C;r�`'v G� V 1 -S Tenant: Suite#: (� n� Resident/Owner Name: K 1� ��t�c2 ��W�c�E��jw� �hone: ( '�6� -`{.��-.3l/� � Address/City/Zip: � Cr� l.�fS� l��w� �� t� �O�o't-ld�(� Name: l��( (.�J fA`(S Q�( V�(G�� License#:_�f�Y! D�&�� Contractor Address: �3..� ,� ��(,��-�t°'' �-�� l't� City: ��2�°�.� Pi/U�S h'l ti� � State: I1'�ti Zip: �_S ,�1�� Phone: ��cr�' �6� � �c�06 (�L.0�C�� (�C�(.a�.7� � �� Contact: ro.S ��" e`�� ' �� Email: New �Replacement Additional Alteration Demolition � Type of Work Description of work: �� f C�IL�d� � '�f�, � G S �-1�� `TD L��L�� NOTE: Roof mounfed 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 COMMERC/AL _Furnace � New Construction _Interior Improvement � Permit Type —A��co�a�t�one� Install Piping _Processed � _Air Exchanger �Gas _Exterior HVAC Unit � � _Heat Pump _Under/Above ground Tank �Install/_Remove) �,... —Other ��.(�(�-Z/� ��r��d� l° � � � RES/DENTIAL FEES 60.00 Minimum Add or al r i $ te at on to an existing unit(includes$5.00 State Surcharge) $100.00 Residential New(includes$5.00 State Surcharge) _$ TOTAL FEE 1 �._�COMMERCIAL FEES � Contract Value $ �i��v� x.01 $55.00 Permit Fee Minimum $70.00 Underground tank installationlremoval =$ 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� � 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 "r— X �..--- ApplicanY rinted Name ApplicanY i nature FOR OFFICE USE __ Required Inspections:�/ �--- Reviewed By:_ '`<?� V Date: 1� � � - Und�r=gr�und � RoughJn AirTest 4Gas Service Test In-floor-Meat �°Final° HVAG Screening Use BLUE or Bi.�ICK Ink i-----------------f � For tNfice Use � � ' � Pem,�r#:/ �� 71 �� Permit Fee: �� • l.�`� � i I 3830 Pilot Knob Road i � Eagan MN 55122 � Date Received: � Phane:{65i)673-b675 � s�� ,� _ Fax: (651)675�''iS94 `; `----------------- 20'15 RESIDENTIAL PLUMBIIti1G PERMIT APPLICATION D�te: d-'" ( � Site Addre : ��l� '� Tenant• � ` Suite#: '��!�'�S►t��3�* Name: �� "t! �1�� Phone: tL�-►�''L,I�� J� � S� Address 1 City J Zip: �t s� �� ,�" . ,,�J�J r�°'� �.. � � Name: `� icense#:��dfsp"`(l� �!C�'#�1'��' Address: ;�, ..� � C��- � � p: ° � _ f��l�T�`�' State: Zi Phone: f---� � Contac�: � Email: �'- !L�.-� `' New _,Repiacement _Repair ebuild Modify Space Wprk in R.O.W. �r��,� - � .- Description of work: ��-�-if.�"L't� l� r �il��..�, (/�t!�� RESIDENTIAL Water Heater �� Watef Softener ~ Lawn Irriga6on(_RPZ/�PVB) � �� Add Pluml�ing�ix#ares(_Main 1�tower Leve�l) Septic System _New Water Turnaround Abandonment RESIDENTIAL FEES: 560.00 Water Heater,Water Softener, or Water Heater and Softener(includes$5.00 State Surcharge) �r60.00 Lawn}rrigation{inciudes$5.00 minimum State Surcharge) $60.00 Rdd Plumbing Fixtures, Sentic System Abandonment,Water 7umaround*(includes$6,Q0 State Surch�rgej *Water Turnaround(add$200.00 if a 5/8"meter is required) $115.00 Septic Svs#em New($10,00 per as buiit)(includes Caunty fee and$5.00 State Surcherge) P��; - /��i TOTAL FEES� ��1 v CALL BEFt�RE YOU DIG. Cat!Gopher State One Ca11 at(651)454-0002 for protectian against undergraund utility damage. Call 48 hours before you intend to dig to receive locates of anderground utilities. www.go�herstateon�eati.ora I hereby acknowledge that this information is complete and accurate;that the woric wi11 be in conformance with the ordinances and codes af ihe Gity of Eagan; that f unders#and this is nat a permit, 6ut ordy an appiicstian for a permit, ar►d +s not to start withaut a petmit;that the wrork wiH t�+n accordance with the approved pben in the case of work which requires a review and approv pians. x �� X Appifc nt s rin Name Appli S gnature �+C��,�F�t�� ief�i��l��,: ' �►��„�.:�; �q�t�.�sp�E+��` �ru�+�r�►�n� , ,:�� , .�.�„�tir�`�s� �„�.,,�T� �,' .�� e�'#�#��: I�t��,,:�,;, �!��tl,,.,;,� �A�n��r� ' ��