3519 Federal Dr
Use BLUE or BLACK Ink
I Permit I
-7
City of Eap ~ ~ I
R[=C',r-111cl? I -0 V j
I Permit Fee: I
3830 Pilot Knob Road I
Eagan MN 55122 JUN 17 2011 Date Received:
I
Phone: (651) 675-5675 1 Staff~
J
Fax: (651) 675-5694 1 - - - - - - - - - - - - - - - -
2011 COMMERCIAL
/►PERMIT APPLICATION
Q~PLUMBING
Date: Site Address: 351 1 re[~l~/►' a-e 1012
Tenant: S Suite
PROPERTY
OWNER Name: I Y1 Phone:
t-k
lcense
CONTRACTOR Name: Clef') I Inc
Address: 3 d 1" N 2n.,OL
S+ city: pl465 State: Mh(Zip: t 2.
Phone: LbiZ•622.340)-51 Email:
TYPE OF - New _ Replacement _/~Repaiirr V Rebuild - Modify Space _ Work in R.O.W.
WORK I~ GbW F G~ l~~y Z
Description of work:
COMMERCIAL
PERMIT TYPE _ 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 No
COMMERCIAL FEES:
$55.00 Minimum (includes State Surcharge) OR Contract value $ c~ E50 X1%
= $W Permit Fee
Required on ALL new buildings and boulevard irrigation systems 4 = $ Radio Meter Read
- If the Permit Fee is less than $10,010, the surcharge is $5.00 = $ Meter(s)
- If the Permit Fee is > $10,010, the surcharge increases by $.50 for each $1,000 Permit Fee M
(i.e. a $10,010-$11,000 Permit Fee requires a $5.50 surcharge) _ $ -V U 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 $ OO
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.org
I hereby acknowledge that this information is complete and accurate; that the work will be in co formance 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 w out a permit; that the work will be in accordance with the approved
plan athe of work which requires a review and approval of plans.
X ~ x
ApplicanVA Printed Name plicant'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
CASH RECEIPT
?CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGaN, MINNESOTA 55122
. ,
DATE 19
REGEIVED .. . ?
FROM
AMOUNT $
& DOLLARS
?oo
? CASH Q CHECK
POR
?i'/ .r :?-? ...f-??!.•'1 . i -,. ! -._ ? i.::?/?/r.?f? t ?.
rUND CODE AMOUNT
Thank You
59HPi :
White-Payers Copy
Yellow-Posting CopY
Pink-File Copy
BLDG. PERMIT N0.
Q1-3210
01-3422
01-3445
01-3446
01-2155
17-3860
20-2275
20-3865
20-3868
20-3716
20-2252
20-3713
20-3743
79-3866
11-3855
Bldg. Permit
Plan Check
Surch. /tidn:.
SAC/Adm.
Surcharge
Road Unit
SAC
Water Conn.
Water Trmt.
Water Meter
Acct, Dep.
Water Permit
Sewer Permit
Park Ded. ?
Sewer Conn.
192 619
IiJ 1
?z
?-,? ;-F
3 3?j fv -) j
TOTAL - ? ? -'?
' CITY OF EAGAN 12990
? 38 30 PIot Knab Road, P.O. Box 21-199, Eagan, M N 55121
PHONE: 454-8100
BUILDING P ERMIT 33 UNIi Receipt#
To be used tor -' BL DG Est Value $1, 151, v G 0 Date J ! :C :':F3E:: 17 ,1 g;s o
SiteAddress 3 519 FE DERAL JIRIVr; Erect 1!1 Occupancy
Lot 1 Block 3 SeclSub. ROYAL OA=-' CIR Remodel ? Zoning R-Q
Parcel No. i V D AD7 Repair ? Type o( Const V 1?'1, :? I?
Addition ? No. Stories 3 SpAji;n
tV C +AV. Clii i,a.. .. N:iTidERSFiIIPove ? Length 9b5
? ame
1 ?f ?i 5 1: ? :?v?:- 2?a' ` Demolish ?
?' Depth
o Addresg ?j . . x
Int.lmpr. ?
, Sq.Fr 40,200 (3 F.LOORS) J
City ;
Phon ?1 235-403i
e Install O 13,400 ( GARAGI. ) i
z o Name BOR-SON CON$T
$i Address 2001 KiLLEBREW
? city MPLS Phone 854-8444
lu W Name (?RI?SON, ;+:JORUD ARCH
?? Address 4915 W 3 5TH 5T
W Citv -`''•`' Phone 922-6677
I hereby acknowledge that I have read this application and state that the
information is correct and agree to comply with all a plicable State of
Minnesota Statutes and Citv of Eagbn Ordinare
74 l
Signature of Permitt qd -?=?-•
( B R-SON CONST
Fees
Fire SAC 10? y 75.00
Eng. Water Corp ,2 0 0. 0 0
N
Planner
Council /A
Water Meter
Road Unit 7,656• u a
Bldg. Off. 12/17/8 Tr. PI. 5,,148.00
APC Parks
Var. Date Copies
?,
???rF
75
TOtaI
A Building Permit is issued to: on the express condition that
all work shall be done in accordance with ail applicable State of Minnesota Statutes and City of Eagan Ordinances.
Building Official
I - I PKmN No. I wrmn Nokls. I Dah I T~ono N I
Htg.
Hty.
Flnal -
Oce. l-i 0-a' I , /n - 7-.F'7 /',/- /, i
0 K? /-k.rc:;k.Aftu" /'a/,VIg7 - P"g,-? 4.u. i,,,? 0 .
.
. rcnm? ? ff "? • / ?
7L
MECHANICAL PERMIT
CITY OF EAGAN RECEIPT #
3i D DD 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE:
CONTRACT PRICE: ? PHONE: 454-8100 ?
Site Address BLDG. TYPE WORK D S IPTION
Lot ~ Bloc k Sec/Sub
1 Res. New
°-' Name Muft Add-on
Comm? Repair
Address
c Ciry Phone Other
FEES
? Name RES. HVAC 0-100 M BTU -$24.00
Addre ? N ADDITIONAL 50 M BTU - 6.00
3
p City Phone ? (RES. HVAC INCLUDES A/C ON NEW
CONSTRUCTION)
GAS O
UTLETS (MINIMUM - 1 PER PERMIT) - 1.50 EA.
TYPE OF WORK COMM/IND FEE - laib dF CONTFiACT FEE
Forced Air M BTU APT. BLDGS. - COMM. RATE APPLIES
rv1_
Boiler 7 S
v?101 BTU TOWNHOUSE 8 CONDOS - RES. RATE APPLIES
. MINIMUM RESIDENTIAL FEE - ALL ADD-ON &
Unit Heater M BTU REMODELS - 12.00
Air Cond. M BTU MINIMUM COMMERCIAL FEE - 20.00
Vent STATE SURCHARGE PER PERMIT - .50
CFM
?- $ PERMIT PRICE GOES
%
C
l
Gas Piping Outlets # BEYOND $t
p
p
p)
Other ?
FEE
S/C: •?? SIGNA RE OF P 51MITTEE
TOTAL• - ?
FOR: CITY OF EAGAN
.1 .
-T PRICE:
' PERMIT #
MECHANICAL PERMIT RECEIPT #
oZ 'J? .l `I v? CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE I 7
Site Address I BLDG. TYPE
, . ? .., . ,. .., .
SEDGWICK HTG. 8? AIR COND. C? R?'
Name Mutt
? Address 8910 WENTWORTH AVE. S Comm.
c Ciry IN , Other
m
c
3
O
Name .
Address
City _
TYPE OF WORK
Forced Air
Boiler
Unit Heater
Air Cond.
Vent
Gas Piping Outlets #
_.?.? M BTU
M BTU
M BTU
M BTU
CFM
Other ; .?
r''.IG/; •:'?t'-?:*? FEE l?? ?•?L? :'/:. 9y%-?C_' yl' 1"? J.GG1f?
,. ll%i4r -
S/C. SIGNATURE OF PERMITTEE
TOTAL•
FOR CITY OF EAGAN
WORK DESCRIPTION
New
Add-on
Repair
FEES
RES. HVAC 0-100 M BTU
ADDITIONAL 50 M BTU
ADD-ON AIR COND. 0-24 BTU
ADDITIONAL 6 M BTU
GAS OUTLETS
COMM/1ND FEE - 1% OF CONTRACT FEE
MINIMUM - RESIDENTIAL FEE
MINIMUM - COMM/IND FEE
STATE SURCHAFiGE PER PERMIT
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
- $24.00
- 6.00
- 12.00
- 6.00
- 1.50 EA.
10.00
20.00
.50
? CONTRACT PRICE: 7?OD D
Site Address - Fedeapt
Lot 1 BtockSub
; .?.? .
m Name C G
m Address - w ' ?
c Ciry AG?-P &JOd/ IE- Phone -
? Name
3 Address
p City Phone
FEES
COMM/IND FEE - 1% OF CONTRACT FEE
APT. BLDGS - COMM fiATE APPLIES
TOWNHOUSE & 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 .00)
- ka Ai4
SIGNATU E 0 PERMI E
FOR: CITY OF EAGAN
PLUM8ING PERMIT
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122
PHON E: 454-8100
PERMIT # _
RECEIPT # _
DATE:
BLDG. TYPE WORK DE CRIPTION
Res. New
Mult. Add-on
Comm. Repair
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
NQ, FIXTURES TOTAL
S?Water Closet - $3.00 $
Bath Tubs - $3.00
Lavatory - $3.00
--.'A-Shower - $3.00
3,P Ki?chen Sink - $3.00
Urinal/Bidet - $3.00
___Q?Laundry Tray - S3.00
?Floor Drains - $1.50
Water Heater - $1 50
Whirlpool - $3.00
_-.2.Gas Piping Outlets - $1.50
(MINIMUM - 1 PER PERMIT)
Softener - $5.00
Well - $10.00
Private Disp. - $10.00
Rough Openings - $1.50
FEE: ? ?'-
STATE S/C:
, SC
GRAND TOTAL: 7 D 0
? /
'?r -?: -?? ?/'??? ,?? ,??? ?'. ??
.
?- -?
f
.r
i
(ger#i#iratt uf (Orruvanry
Citp of eagan
Mrpartmmt nf Bitilding J.prr#imt
Tliis Certificate issued pursuant to the requiremenls of Secdon 306 of 1he Uniform Burlding
Code certifying tJrat at rhe ttme of rssuance thrs strueture was in compliarrce with the vnriaus
ordinances of the City regulaung buitding construction or use. For the foUowing.•
use chaiGauon .?1yI'. ?d?G, -3'X ?•.. B1a8. Rro,;t rb. 12990
? ???,
Oocupancy'fype r Zonmg Distria Type Const. '.Rv
Owner of Bwldiae Addrcsv
Date:
&oming Ol6cial
POST IN A CONSPICUOUS PLACE
, CITY OF EpGAN
3830 Pllot Krrob Road
P.O. Box 21199
Eagan, MN 55121
Owner.`_S
Site qddress: ??T
Plumber :.tj vsi
...,. ....,?.....t . . ,?y . _ •.w+??
Permit No: 5 b 15 ?{ uI37
Meter No: Date: -
Reader No: SiZe:
Date: _
er
Conn. Chg; 3,20o.()
Qp?
Acct Dep:
Permii Fee; 1J, 00 d
5urcharge: .5
i}pd
Tr. Plant 5 2 4?, .?p d
Meter.
Zoning: ^4
No. of Units; 3-
I agree to comply mfth the City o( Eu9an
Ordinancea.
WATER SERVICE PERMIT
CPrY OF EAGAN
3830 Plbt Knob Road
P.O. Boz 21199
Eagan, MN 55121
Zoning:
-?•.-
agree to cornph, wKh }he CftY a Eagan
irdi.,s....__
of Insp.:
SEWER SERVICE pERMIT
PERMIT NO.: -' % r
DATE: - -
No. of Units: 3 '
Connectlon Charge:
Account Deposit: ,
Permit Fee: ?
Surcharge:
Misc. Charges;
Total: ------_
Date Paid: _
SITE ADDRESS ?????Zd= f1i Unit # Permit # /-9 ?19G'
,d
B ? Sect/Sub.
INSPECTION OATE INSPECTDR OTHER
FRAMIN6
ROU6H PL86.
ROU6H HTG.
IN8UL 16- 21 _9'7'
34 0 Pt.aoc. „
? -
FIREPLACE
FlNAL tIT6.
NMAL PL86.
UMIT FIMAL
CEHT/OCC
INSPECTION DATE INSPECTOR COMMENTS
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
BUILDING PERMIT 33 UNIT PHONE:454-8100 ReceiptN 6 /
N2 12990
, zf 2--?
7o be used for APT BLDG Est Value $1 , 151 , 000 Date DECEMBER 17 , 1986
SiteAddress 3519 FEDERAL DRIVE Erect )D Occupancy R-1/B-1
Lot 1 Black 3 ROYAL OAK CIR Fiemodel
Sec/Sub ? Zaning R-4
Parcel No .
2ND ADD Repair ? Type of Const. V 1HR.
' I IN
. Addition ? No.Staries
I SPRTNK
? ROYAL OAK CIR LTD PARTNERSHIPove ? Length 1 FS
w Name
144 5 Demolish
1ST AVE NO ? Depth Q F
o Address mt. Impr. ? Sq. Ft 4 0.200 (1 FLOORS )
City FARGO Phane 701/235-4031 Instan ? 13
400 (GARAGE)
,
o Name BOR-SON CONST Approvals
8? Address 2001 KILLEBREW Assessment
? c;ry MPLS phone 854-8444 Water&Sew.
F W Name_ CARLSON MJORUD ARCH
um ; nddress 4915 W 35TH ST
a W City MPLS Phone 922-6677
I hereby acknowledge that I have read this application and state that the
inFOrmation is correct antl agree to comply with all _qppijcaible State of
Minnesota Statutes and Ci of E an Or 'ce Signature of Permitt?
[
A euilding Permit is issued to: B R-SON CONST
all work shall be done in accordance with all applicablre State oF Minn so
Police -
Fire
Eng.
Planner-
Council _
Bldg. Off.12
APC
Var. Date-
City o(
Permit $ 3,060.50
Surcharge 560.00
Plan Revie4. 530.25
SAC 18,975.00
Water CoAn3 • 200. 00
Water Meter N A
Road Unit 7,656. 00
Tr.PI. 5,148.00
_ I Copies
7otal $50,129.75
on the express condition that
an Ordinances.
8uilding
This reQUest void . 2 .
18 nwnths hom
C 13 2 5 0/-i. aa°
?l3 oI .`J v2
Renuegt Date.,
" Fira Mu'a. fle ough-in. ? InsUer,cion
Aqu retl Will Notify
dy Nuw ? Inspec-
?Aea
r ?-^
V q ? ?Yes ?NO «r When Ready
[y6censed Eleclrical Contractor 1 hereby request insPection of ebova
? Owner electricel work inslallatl at '
Street Atldress, Box ]4 te N.
?? / Ar?2J CitV
f d?! d
ecUOn o. Township NTme or No. Rflnge No: County
da k4 zlla
OccuGam (PFINT) Phone No.
C.? N
Power OOlier Address
Etectrical Conufactor (Company Namel
COnhdor'S License No.
Lt
Mailing A dress ICo actor or Owner Makine Instailation '
Aut?or d ignature o rocto, Ownar aking Installation) Phone Number
30 60
MINNESOTA STqTE BOABD OFEtEC'TRIGTY THIS INSPECTIpN qEQVEST WILL NpT
Griggs•Midway. Bltlg. - floom N-191 ' eE ACCEPTED BY THE STATE BOARD
1821 Universitv /1ve., St. Vaul. MN 55106 UNLESS PROPER INSPECTION FEE IS
Phone 16121 297-2111 ENCLOSED.
51718 7 HEQUEST FOH ELECTRICAL INSPECTION
1 Sae instructions for compleling this torm on Deck ol Vellow copV.
C 13250 x" Below Work Covered by 7his Requesl
EB-00W1 A4
j
Adi1 Rap, - Type ol Builtling Aoolioncea WireE Equiumenl WireA
Home Range Temporary Service
Duplex Water Heater Liyhtiny Fixtures
Apt. Building ?ryer Electrie Heatin
Commercial Bldg. Fumace Silo Unloader,
Industrial Bldg. Air CorWitioner Buik Milk Tenk
Farm otner ae, v iner ?Snrcievl gUa O
, er Suec, y iher Othcr
amUute lnspection Fee Below p Fee SeMceEntrence5iza M1 iea Fexders/Subteatlers N Fea Circuits
0 to200qm 5 0 to30Am 5 0 10 30Am s
Above 200 qmps 37 to 700 Amps 31 to 100 A s
Swimming Pool Above 100-Am s Above 100_Amps
Transformers Irrigation Booms Partial.'Other Fee
SignS Speciallnspection $ •q'
TOTA
pemarks ? L E ?
? ? ?
Rough-in Date
?. ?he Ele
•
? InsPector, hereby
certily thet the above
Final
? inapection has bean
i' ? made.
•nl..wu?oe? vnin tn mentM fmm
This reauast vaid ?/?(j/e7
e ae"9h2f 2 77 `''i3?,?'-_-.
?a ? ?S
o 0
?? I?? Re?quired? ? ?Featly Nuw d Will Notify InsDec-
Ves No Ior When Heady
?"Licensed ElechiCal Contractor I heraby request inspection oi ebove
? Owner electrical work installad at:
Street Address, Bax or Route No. City
LC[ 'd 'J -?r/ ?OE.eAL U ^?.CiJ? G+9?AN
ecuon Towns i0 Name or No. Range No. County
Occupn PqINT)
1161'41- QAA-" Phone No.
Fower Supplier Atldress
l ,So%a .L/Ec:,e,G fy2n„? ?o.v ?/
Elec?trf' al Co?n ctor ICompany Name) Contractor's License No.
.Ci[1C,? ??ccT,c?c , .yNc.
Mailinp Address ICOnvactor or Owner Making Instailationl
771
-
Aut?orize (Co acto, n MakfnB Installationl
Phone Number
I
/ -a36-9Si?
MINNESOTA STATE BOdRD OF EIEC?RICITV THIS INSPECTION NEQUEST WILI NOT
Grippa•Midway Bidg. - Room N•191 BE ACCEPiED BV THE STATE BOARD
1821 Univeraitv Ave.. Sc. Peul. MN 65100 UNLESS PNOPEN INSPECTION FEE IS
Phone16121642-OBOD ENCLOSEO.
1//jC/? 7 REQUEST FOR ELECTRICAL INSPECT(ON
vellow eopV. 10 ea-ooaoi-os
? ?$7 • ? See instructions_fqq completinq this fmm on 4ack of
"'X" Be/ow Work Covered by This Request ?a ?
?/
NOV4 Addj XeD. TVPe o1 Builtlioe Applientea Wired Equfpmenl Wired
Home Range Temporary Service
Duplex Water Heater Ligh[iny Fixtures
Apt. Building Dryer Electric Heahn
CommercialBidg. Furnace SiloUnloader
Industriyl Bldg. Air Conditioner Bulk Milk Tenk
Farm omar oeci v e1ner
t r Sueci y t er x Oth¢r G
Comnute Insnection fee Below
p Fee ServiceEMrenca3ize k Fee Feedars/Subfeedere k Fee Circuits'
U to 200 qm s 0 to 30 qm s .3 J 9 0 to 30 Am
drpa Above 20 mps 99O?v 37 to 100 Ainps O ?dl 37 to 100 q 5
Swimmin Pool /?pv qbove 100-Amps Above 700_Am s
Transformers ttigation Booms „SC Pdrtia6'Other Fee
Signs SVecial Inspection
TOTAL F
ema.ks V
„.
flouph-in V14 ?1se p y? I, th
e Elacvicel
4& Insoectoq heraby
cer?ity thet the above
Final ?r?9?9_(F? inspeetian has been
r ? ? a madB.
ThM raaueat roltl 18 months from
This repues[ vaitl 8
18 months from .v
? / ? 6 9
D- 4 111
HeQUest ?a?e Fire Npr pouph-in Insoec?ion
Nequired? DHeady Now Q Will Nolify Inspeo
?Ves [] N. lor When fleadv
Ei.J'Llcensed Electrical Contracmr 1 hareby request insoection of ebove
? Owner elecbicel work instalied ac:
Street AAdress, Box r Rome No. - y
ecvon.. Township Name or No. TnBe No. Co ty
Lo4oV, C
OccuUan[(PPINT) Phone No,
Q??s'?q Go/!Sr
Pow¢r SupOlier Address
EI ri?on[ra or ICompany Name ?nnhaclor's Liceree No.
.'e?. Zk Z
Mailmg Address ICon[raclor or Owner Making Instailationl
vu?-r??.
ct /Ow r Makine Installaliunl
tm a?2 Phone Number
a /d-- -7 6 - a5702-
MINN ESOTA STATE BO O OF ELECTRICITV THIS INSPECTION REQUEST WILL NOT
Grigga-Midway 81dg. - Hoom N-197 BE ACCEPTED BY THE STATE BOAND
1821 Universitv Ave.. St. Pnul, MN 55104 UNLESS PROPER INSPECTION FEE IS
Phone (612) 642-0800 ENCLOSED.
REnUEST FOR ELECTRICAL WSPECTION JORN. ee-o/oo-oi-os
/ See inshuctions lor comoleting this fwm on Dnck ot Vellow coov. r
7
1 0 "X" Belaw Work Covered by 7his Request
Add R.P. Tvoe of awieine Aoolinncea Wi.ee EqoiymBnl WireA
Hame Fange Temporary Service
Duplex Water Heater Liqhtiny Fixtures
Apt. Building Dryer Electric Heaun
Commercial Bldy. Fumace Silo Unloader
InAustrial Bldg. Air Conditioner 8ulk Milk Tank
Farm ?n?, o?•?:? v nlno, Isro,,rvr
? ar Speciry Othor Othw
Gompu[e /nspection Fee Be/ow
N Fee ServiceEntmnee5ize tt Fae Feeders/Subfeeders b Fne Circults
0 to200Am s 0 to30Am s 2to30Am s
Above 200 qmps 31 to 100 Amps 31 to 100 qm s
Swimming Pool Above 100-Ainps Above 100_Amps
Transformers Irrigation Booms Partial.'Other Fee
Signs $pecialinspection S
e rks TOTAL FEE
?
flough-in
I•theElecVical
? ? InSpeCtol, her8by
Final
-
'? ?het the nbpve
nspeation has been
,r meae'. - _'-
RiiereQuealvolAlBmonihnimm rj? ?' e?
/
o"
CITY OF EAGAN
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
F^AYl'F: PAYMENf OF FEE AT TIME pF
? APPLICATION DOFS N02 COMTI1[TiE
F APPROVAL OF PERPIIT.
h
` INSPDCIZON OF SEWM ArID/OR FiA'mt
; iicmnr=pNs WIId, NpT BE ScHm-
`. vLm vrrru. rERmuT tIAs sMr
t arPxovID.
1) PROPERTY ADDRESS:
-e
LEGAL DESCRIPTION: " •-
. Lot Block Su division or Tax arcel ID )
IF EXISTSNG STRCL`i[.'RE, DATE OF ORIGINAL BLiILDING PERMIT ISSL'ANCE:
;
J .
PRESENP ZONING/PROPOSID LSE: (Nbn Year
Q CAM`EItCIAL/REPAIy/OFFICE ? R-1 SIIVGLE FAMILY .
Q IIID'STRIAI' R-2 DOPLEX (1t,,o Pnits)
? INSTITUTIONAL/GOVERNMENr [] R-3 7OWDHOC?SE (Three + Units) ( Lhlits)
. ?? R-4 APAR'ID1ENT/CONIDOMINILTI ( 33 Units)
2) • ,{ r• 9
NAM=_ A
AMREss:
CITY, STATE, ZIP: i YI V\
- PHONE:-T
3) u ?: a• NAME: ? ? ? For City CTSe .
- C? h^ ? o ts-e- Plumbers License:
ADDRFSS: Active
CITY, STATE, 2IP: ? Explred
Not recorded
PHONE° MASTER LICENSE# ta InltEal
4) ??• • • i?•
NAME:
_ 1lDDRESS:
CITY, STATE, ZIP:
PHONE:
- R'f Ll
5) ? v. i «• ?• : ? • y. -
E]?'CONNEC'PION 1O CITY SE,'WIIR CpNNECTION 2U CITSC WATER El p'IgIER '. .
6) '? •' ? r ?? PLEASE HOI,D APPROVEa PERPIIT EY)R PICK-UP -BY ONE OF ABOVE _-
C"?. .
PLEASE MAIL APPROVID PERMIT TO 1. 2. 3, 4. AHOVE
? ? ?f ?f?? - (Circle one) '
?A
7) t!r?•' 1 .`. .11?l.?Ierx. . f:en?? L ? ...?
FOR CITY USE ONLY
PERMIT # ISSUED ,
s-
Pd w/Bldg. Permit FEES:
$ $ SEWER PERN7IT (INCLUDE SURCHARGE)
$ $ WATER PERMIT (INCLC'DE SC'RCHARGE)
$ ? $ WATER METER/COPPERHORN/OL'TSIDE READER
$ $ WATER TAP (INCLL'DE CORPORATION STOP)
$ $ SEWER TAP
$ $ ACCOUNT DEPOSIT - SEWER
$ $ ACCOL'NT DEPOSIT - WATER
97C$ I?7 ?? • C? C? $ WAC
$ l? ? 7 s`a o $ SAc
$ $ TRLNK WATER ASSESSMENT
$ $ TRLNK SEWER ASSESSMENT
^$ $ LATERAL BENEFIT/TRUNK SEWER
$ $ LATERAL BENEFIT/TRL'NK WATER
b' $ $ WATER TREATMENT PLANT SURCHARGE
$ $ OTHER:
$ ?7
3Z3
Do $ O
,
1
? T
TAL
RECEIPT RECEIPT
DOES UTILITY CONNECTION REQLIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
? YES IF YES, THEN A"PERMIT FOR WORK SVITHIN PUBLIC
Q ROADWAY" MLST BE ISSUED BY THE ENGIN$ERING
NO DIVISION. LIST AS A CONDITION.
SDBJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY:
TITLE:
DATE :
/ 9 -?o
1986 HQII.DING PEFHiIT APPLICA?IOH - CITY OF EAGAN
NOYS: ALL CONTRACT09S MOSY BB LICBNS6D iiITH THS CITY OF EAGAN
SINGLE FAMILY DWELLING3
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS
MOLTIPLS DiiE[.LINGS - HBSIDENTI9L
INCLUDE 2 SETS OF PLANSt CER
1 SET OF SNERGY CALCULATIONS
HENTAL DIiI?S FOR SALS DNITS
OF SDRV6Y - CHECB iIITH BLDG. DEPT.,
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS,
$2,000 LANDSCAPE BOND
To Be Used For: Qpr• &L O(q. Valuation: k15 hODO Date: LS`'P)r.
3519
Site Address VNN ? De. ? OFFICE DSS OMf.Y
Lot I Bloek t- 3 Z uo
Parcel/Sub &,o-4L DAk Oacte 0-rA0 7
Owner Yo4at- oak Cia LT,*
Address /yVS f -v A?t A?
City/Zip Code F P ?_-!?'?
Phone 7dl- 23s ?y??
Contraetor etiSw ( .6?15'/
Address Z??Df ,?C/Ll?2EW 1/?L
City/21p Code PLS
Phone VSy - T?/
Arch./EnSt'• CA/uss+? /I/?J?2uo k„-A
Address jV915 ' 3 5?57
City/Zip Code /`//Gl7
Phone Il % z.Z - (,(a'77
Erect
Remodel
Repair
Addit3on
Move
Demolish
Int.Impr.
Install
Oceupaney
Zoning
Type of Const
# of Stories
Length
Depth
Sq Ft
AeraovAts FEES
Assessments Permit
Water/Sewer Sureharge
Police Plan Revierr
Fire xSAC
Engr Water Conn
Planner Water Meter
Council Road Unit
Bldg Off Treatment P1
APC Parks
Variance Copies
lY)TAL
MOTE: ADDBESSSS FOR CORNER LOTS - CONTRACTOR/HOPIEOHNEB MIIST DESIGN9Tfi WHZCH ADDRfiSS
IS DESIRED. NO CHANG&S WILL BE ALLOWED ONCE HOILDING PSEMIT IS ISSIIED.
41163, 41aR 60.,L
HEIlO T0: TOH COLHERT, DIRECTOR OF POHLIC WORgS
JIH STORH, PLANNING DEPARTHEN'P
SILL AgINS, ELECTRZCAL INSPECTOR
CRAIG SNQASEH, ElIGINEERIHG TECH
FROH: DOUG REID, BOILDING ZNSPECfIOHS DEPT
DATE: /0?//9/??f •
The Protective Inspections Department will be performing a final inspection
for occupancy of (Q? &4 &/UL J47?L, on
35 03, 09, i9, '2; a3
Please return within 48 hours with your approval or denial. Failure of
response within that time frame will be determined as approval. It will be
each departments responsibility to contact the construction firm with
necessary requirements before Final inspection and notifying the Building
Inspections Department when all requirements have been taken care of.
Thank-you.
DR/Js
APPROVAL; DENIAL:
(SIGNATURE & DATE) (SICNATURE & DATE)
aoos COMMERCIAL PLUMBING rExMiT arPr.icnTiorr
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
450 ?0
Date 7 / 25 /OG
Site Address :3 ErS 19 Fro r Unit #
Tenant Name 1\ pLR d I Oat An+-S. Former Tenant Name
Property Owner Rpc,pa ) Telephone # (ro51 ) ?$ $ ? ?ogJ? ro
Contractor ?eGbdn'Cc3 ) C."c>t'???ac??C's
Address ?? ?i S ) Lc> +' Cit3' 9=_(? 7 6? a
srace fYl 0 zsP 55 ?13 S Telephone #(O[S,4 $3S- 3$) n
License #?>y 07 P f 'O Expires: i a l3 I I a?o
The Applicant is _.Owner ? Contractor _ Other
Work Type New Bldg ._ Modify Space _ Irrigarion System*'' Yes No Work in public r-o-w / easement?
? RPZ _ PVB: New _ Repair/Rebuild _ Replace _ Remove
Rain sensors are re uired on irriastion s stems
Description of Work T Yl°T'cl ? f N ew R P Z O n?? i ? ?°r ?eC-'c). 'Zn AO y?77S
To inquim if Pressure Reducing Valve is required on new service, call 651-675-5646
Meters - Call 651-675-5300 to verify that hydrostatic, cooductivity, and bacteria tests passed prior to oickine uo meter.
Irrigation Size & Type Avg GPM 2" turbo req'd unless smaller size allowed by Public Works
Fire Size & Price 3/4" meter 167.00
Domestic Si2e & Type Avg GPM Includes high demand devices? _ Yes _ No
Flushometers _ Yes _ No PRV Required _ Yes _ Na
Permit Fee $50.50 minimum (inctudes State Surcharge)
Contraa Value $ y S() •? x 1% 0D Permit Fee
$ Meter(s)
Required on alt new buildings Rc boulevard irrieation svstems Radio Meter Read
$ 1 ej(_-) State Surcharge
If petmit fee is less t6an 3 1,000, surcharge is $.50
If oertttit fee is more than $1,000, surcharge is $.50 for each $7,000 owed.
- ' ' ' ' ' ' _ ' ' - ' _ '
Following fees apply when installing new lawn irrigation system $ Water Permit
Call the City's Engineering Departrnent, 651fi75-5646, for required fee amou
TreatmentPlant
D $ Water Supply & Storage
??? 3 1 2?p6 g State Surcharge
? v
$ rj? - SQ Total Fee
1 hereby apply for a Commercial Plumbirtg Peanit and acknowlWge [hat the mformafton is complete ana accurnte; mat me worx ww ne m wnconnance wim mc
ordinances and codes of the City of Eagan and with the Plumbing Codes; that I understand this is not a permi; 6ut onfy an appfication for a pecmit, and work is not to
start vnthout a permit; thaf the work will 6e in accordance witfi the approved plan in the caze ofwork which fequires a review and approval of plans.
ApplicanYsPrintedName ApplicanYsSignature
5 -9GSo7
AUG-06-2008 09:10 From:
City of Ea?aIl
3830 Pllot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fex:(651)675-5694
6127214236 To:651 675 5694 P.3'5
--------------t
j Far.taffl¢'e:IJuo i
? Portndp-,?__ ?
? Pormll Fco•
? Date Recolved:
I
-----------------?
200$ COMMERCIAL BUILDING PERMI7 APPL{CATION
nnre: !j?h /°;r sua anaree6: ?SI 5 FvE?e.oc ne ,,.c'
Tanant Namo: (Tenunt fa: _ New I_.kixiating) Su4te p: - ,,,__
PROPER7YOWNER Namo: 4~4('ct AMc r^S_Vff' Phono:
Adqross/CilylZiP'.. _?j? ;Qif#rVA" M/
/---?.....
i
A
X C
li
pp
cant
s: _ Owner
onlraGOr
TYPE OF WORK Doscription of work:
Constructan Coet:
CONTRACTpR Neme: H[_4?[•o2,bg /el10'r -Licanse u: g.3108'
Addres5: 210/ E . 4?67)1
S? • _ .._.
Ciry- M1A/.VqTt45 _ SlaTa: Zip: !r _1_rY
- Phons:irgf2.-'? Z-/ ?z.?'/S CuntactPerson: JGE4 CL'0+06'NG
ARCHITECT! Regisirationa:
ENQINEER
Addross
Ciry: _Stato: Zip: ,.?
Phone: Contacl Porson: _
Licenaed plumDer inslallinp p= saworlwatar sarvice: Phone p:
NOTE:;P/ans
ro.consldoretf to bd, publlc Inlo+msNon. PorNons ot
snd auppaNng documenfs that yau submlt a
.
.
ybllc II you pravlde,specllAC ?rasons thai would qe?mlt the. C/ey tu
1tie ]nlormedon may be c/assHled as nonp
,
;conelu? thef t"Yiffl traek aecrets.
I heraby acknowledpe that this informelion is complels aM accurata; ihet Iha work will be in contormanrq wllh Ine OrNnaneea and codoe of tha Clty W
E9pan; thal I undoremnd Ihi6 ie nnt n pormlt, lkd oniy an applicali0n lof p parmll, aM vmrk IG not lo Ctarl withoul e parmil: ihat tha wofN wlll Ub In
attnd0neq w91n Iho appravod plan In Ino uua o1 wprk whkh r9qulro9 a rovl0w and apprwal cl plmw.
x `?' .?oei C(-a?.dE?v,.?G x
AppliCanYa Prlnfetl Neme Appqg?wSlgn9ture
Pdge 1 of 3
gV 2007 COMMERCIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagau Mn 55122
Telephone # 651-675-5675
Plans are considered pu6lic information unless you state they are trade secret and why.
. 5Vuctural Plans (2) sets
• Civil Plans (2)
• Certlficateo(Survey (1)
• CodeMalysis (1) "
• ProjedSpecs (i)
• Spec Insp & Tesfing Schedule (1) '•
• SoilsReport
• Meter size must be established
SAC delermination - w11651-602-W00
• Soils Report (1)
• Ceriificate of Survey (1)
. Structural Plans (2)
• Architectural Plans (2) sets
FIVAC units req'd. on bldg elev . ! site plan
• Civil Pians (2)
• Landsraping Plans (2)
• CodeMalysis (1) "
• EnergyCalculations (1)"
• Emergency Response Site Plan (1)
. Spec.Insp.BTesting Schedule (1) "
• ElecUic Power 8 Lighting Form (7) "
• ProjectSpecs (1)
• Master Exit Plan (7)
• SAC determination - call 651-602-7 000
• Fire Stopping Su6mirials
. Fire SuppressloNAlarm Form
. Meter ske must be esfablished
• CotleMalysis (1) "
• ProjedSpecs (t)
• Key Plan (1)
. Master Exit Plan (1)
. Energy Calculations (1) not always"
. Elec. Power 8 Lighting Fortn (1) not always"'
. Meter size must be established-'rf applipble
)
)
1
)
1
• SACdetermination-ca1165"02-7000
Call MN Depl of Health at 651-201-4500 for details reguding Tood & beverage or lodging facili[ies.
•' Contact Building Inspections to see if it is required and for a sarnple. -
*•' Permit for new buitding or addition wilt not be processed without Emergency Response Site Plan.
Date/0 / o / 67
Site Address 3$' 15 ?=Coc.t ? ??'t
Tenant Name 1?b?,,af Chw Construction Cost '? /f J 8• 60
UniUSte #
Former Tenant Name
Description of Work Rer ^ IZ =*? n.z t ae». c;
PropertyOwner t?e+?n?-2sc,H ?rt.e?nt1 ? ,,,t?s rir?L Telephone#( 77'S Z+B -1328
Applicantis: Owner K Contractor Contact#: ((,12 ) 7aS- 594 l 14,.... ??.accrvc.
Contractor ??.+c c>?. ? o?!
Address yY07 +3c4- C.av-s t7n
State TX $? r' 32.G City fl.,s,o•-?
Zip 7$? H rO Telephone #( Svz) 2G `h 32 L
Arch/Engr
Address
State Registration #
City
Zip Telephone # ( )
Licensed plumber installing new sewedwater service: Phone #:
[ hereby apply for a Commercial Building Permit and acknowledge that the information is complete and accurate; that the work will be in
conformance with the ordinances and codes of the Ciry of Eagan and the State of MN Statutes; I understand this is not a pennit, 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.
1)C.v?s-. ?Sr+¢iat
Applicant's Printed Name Appliea-fit's Signature
DO NOT WRITE BELOW THIS LINE
Sub Types
? Ol Foundation ? 26 PublicFacility ? 30 Accessory Building
u 14 Apartments ,0' 27 CommerciaV[ndustrial ? 32 Ext Alt-Apartments
? 15 Lodging ? 28 Greenhouse ? 34 Ext Alt-Commercial
? 25 Miscellaneous ? 29 An[ennae ? 35 Ext Alt-Public Facility
n 37 Nail Salon
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bidg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish(Bldg)' Er? 43 Reroof ? 46 WindowslDoors
? 34 ReplaCement •Demolltion Building - Give PCA handout to applleant
ValuaUon ZD TypeofConst Wdth
Plan Rev 100%/V' b Occupancy MCES System
SAC Units Zoning City Water
Nbr. of Units Stories Booster Pump
Nbr. of Bldgs Sq. Ft. PRV
Fire Sprinklered Length
Required Iuspections
_ Footings (new bldg) _ Fireplace _ R.I. _ Air Test _ Final
_ Footings (deck) _ Insulation
_ Footings (addition) _ Sheetrock
Foundation FinaUC.O.
Drain Tile Final/No C.O.
Driveway pron ? Other
? Roof Ice Pr _ Decking _ Insul _ Final _ Pool . Ftgs Air/Gas Tes[s Final
_ Framing _ Siding _ Stucco Lath _ Stone Lath _ Final
Windows
Final C/O Inspection: Schedule Fire Marshal to tie present. _ Yes _ No
Approved By: Planning CXAIA? B uilding Inspector
Base Fee
Suroharge
Plan Review
SAC-MCES
SAGCity
SIW Pertnit
SIW Surcharge
Treatment Piant
Treatrnent Plant (Irriga6on)
Park DedicaGon
Trail Dedica6on
Water Quality
Water Suppty & Storage (WAC)
Financial Guarantee
Storm Sewer Trunk
Sewer Lateral
Street
Water lateral
Other
Total
Sewer Trunk
Water Trunk