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1658 Hunt Dr2005 COMMERCIAL PLUMBING PERMIT APPLICATION 0 C1TY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 l,'i I hereby apply for a Commercial Plumbing Pemut and acknowledge tha[ the info:mation is complete and accurate; that the work will be m wnfocmance with the ordinances and codes of the CiTy of Eagan and with the Plumbing Codes; that I understand tbis is not a pamit, but only an application for a pemut, and work is not tn start without a permit that the work will be in acc ce with the pproved plan in the case of work which requires a review and approvel of plans. ApplicanYs Piuited Name Appli s Signature Date //6 Site Addreas ? ? Unit # Tenant Name Former Tenant Name 7-7 a-2 c Property Owner ? A Telephone # ( ) Contractor ?df Cic c?a? ?? Address ? d AD " 14 .F! ? City ,eOl<«-? ?? Z Telephone # State 2zv z Zip r,q? License # gw? Eapires: ? The App6cant is _ Owner ontractor Other Work Type New Bldg _ Modify Tenant Space RPZ PVB New _ Repair/Rebuild _ Replace ?l Irrigation system Work within public right of-way/easement _ Yes _ No 7 Rain sensars are reuired on irriarion s stems. Description of Work A ?aL/ ? `y`r 0? X`z 0k ?? inquire if Presswe Reduciag Valve is requ'ved on new service, call 651-675-5646 I " j ;S,P f c.C24? Meters - Ca11 6 5 1-675-5 3 00 to venfy th Myti?n ?uc Ty, and bactecia tes[s passed prior to oickine uo meter. Irrigation Size & Type /`f Avg GPM 2" turbo req'd unless smaller size allowed by Public Works Fire Size & PtiCe 3/4" disolacement $161.00 Domestic Size & Type Avg GPM Includes high demand devices? _ Yes _ No Flushometers _ Yes _ No PRV Required _ Yes _ No Permit Fce $50.50 minimum (includes State Surcharge) ? Q/? a ° Conhad Value $ 07 7?v x 1% _$ a Pemut Fee ? / $ Z q Meter(s) J v? Required on all new buildings & boulevard im aLon systems $ Radio Mete[ Read / If pemtit fee is $1,000 or less, surcLarge is $.50 $ State Surcharge ? If permit tee is over $1,000, aurcharge ia $.50 per $1,000 of the Permit Fee ?- FoRowing fees apply only when insta0ing new irrigation system $ ? Water PCrmit Call Jerry W obuhatl at 651fi75-5024 far required fee amouMS Q D / $ (i ?03 Treatment Plant $ O ? ? Water Supply & Storage ? $ ,. -?"0 State Surctiarge I/ ----- ----------------- --------------- -------------- ------ --------------- ------- ------- ----- -----I-------------------------------------- g -- p? `S / q ? Total Fee ? \?S ? CITY USE ONLY REQ[JIRED IN5PECTIONS: _ U.G. _ Air Test _ Gas Tes[ _ Rough In _ Final PLANS SUBM[TTED APPROVED BY: , BUII.DING INSPECTOR General Information • Radio Meter Read (required on all new buildings & boulevazd irrigalion sys[ems- $141.00 • RPZ's mus[ be tested every year and rebuilt every five years. Test results should be mailed to Paui Heuer at the Ciry of Eagan. • A miniwum fee pernut per address is required for the following RPZ's: new, rebuild, reuair, remove. • Water meters include copper horn/strainer, remote wire, and touch-pad meter. METERS RE UII2ING 4-HOUR ADVANCE NOTICE PRIOR TO PICK IIP GPM METERS USE PRICE GPM METERS USE PRICE 1-20 5/8" residential $125.00 4-120 1-1/2" irrigation syst S 735.00 displacement sm commercial turbine** Public Works maximum must approve continuous meter size 10 2-30 3/4" lawn irrigation $161.00 4-160 2" turUine lg urigafion 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 tion s[ems 5-100 1-1/2" bldgs 25-64 units $429.00 maximum displacement & continuous most comm bldgs 50 METERS REOUIItING 30-DAY ADVANCE NOTICE PRIOR TO PICK UP GPM METERS USE PRICE GPM METERS USE PRICE 5-350 3" turbine very Ig irrigation S1,182.00 6-500 4" campound +300 unit bldgs & $3,563.00 syst & production very Ig comm bldgs lines 1/2-320 3" compound +200 unit 6ldgs $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 lgirrigation $2,226.00 syst & production lines CommeMs • To schedule inspwGOn of the inside water line and backflow preven[er, call 651-675-5675. • To amange for water turnon, ca11651-6'75-5300. cc: Maiotenance Division Clerical Technician Jamiary 2005 � � �� i� ' � ___ Use BLU�oY .L' CK Ink �' — ---� � � For Office Use 1 I }' � ��(/ Czt of�a a�� � Pa���#: � � � � � s.� � Pertnit Fee; ': �: 3830 Pilot Knob Roed I � ': ' � Eagan MN 55122 i oate Recelvee: � � !' � I�� Phone:(651)675-5875 � StsH: i � ; ,, , I Fex: (6S1)675-5694 � ' � � L_r..r___;, ;;_____J 2015 RESIDENTIAL PLUMBING PERMIT APPLICATION' '�: ; ��� ��' � �� � a� u..�c� N � , �p �~ �. Data: � ��V"�C'� Slte Addreae: � -- � �C�� Tenan� ��' �—,� �6 O� Sulte#: � ' : � S' : �?'.:;''•;:•'::�`;;,;��°;ya1;�;�';;:,:.;-:''��;;`�� Neme' �4Jt� •`C.`^' ��� Phone: � �,� I �`,ResldenUOwner' ;�: � J'�',`''' ,� ���'` Address I City I Zip: ' � � �' � ��.:�;.;:����: �..�,�`L��(�L-T V�31�{ Cl� G(0'4; ;.;"•;;�'s�'�?'�,.l�,�r�wt;•„;;`�.':.:,.>.. 'tieense#• — : �.......,, . Name• : ;.r;�;.:, :� �� ••. : . ' `r;,.:�:�,��.;,����.�;��:;-�..,;:.-:����� � 0�(1� �-3S �T. �J �; �.-�-v�t� : �CO�t�t8C�01'� Address• A �y: ' �,;<•. �"<' State,�� Zip� � Phone� �1 �"�� 1 `'�� i; � `�"''��`;;��{:''�I��:;�<<�:�:w ''�;�;�; �,,J � �` ���c. ( l,..w.� m' ' j .z �:;�;:;�s�;;;:r:��r�,r��;.�;�:.;v�;.�;;�.>.,.�:?.; Contect��� � Emall: PT�w � C ry;.;Y9•+sis`;s;,. ,�biri.,.iS:j,•}1+3;s.,...,�. . � ! ,. , ;:'�:'��;`;r ,...,,.:•ru:, �' �'"��' �4'�?� � New Replacement _Repair „�Rebuild Modify Space o n ,Q,W. '�`�'YYP,en�of.Work`•:::.:. — — — = ; �''��� �'s;�;:,';� Descrlptlon of work: E �' � .'';�. � ;`.'`''" RESIDENTIAL : ; i ' .�p�,i+l:�tfi::y:';:V.'+K�i;;`IA;',�; . . . ' ' '.�'.�' �. ':�i'f ,. t i ,,:: ,. ;,,;,;;:.,.' .:��"'�� :'. Water Heater s + � ,<�;:.:;';:<;,'�� �t���.. ;.;:;•:�.:%,�.;;' WaterSofte�er ' ' � '.:;.:;;,,.;i��W�;;{�,+�.,:;f.'::+:a:,:,N:::,;r'�;'•''` ' , ., . ,;i�.•�,,�ti.�.Fir' ; ^c�''' I I. ,:w,.?`�:::..:...:...�,��:>;�:;<�::.,�,::r.,,,r.,�-, Lawnlrrigation(�RPZ/ PVB) �����'wiPe�riiit';TYp�'�:�;`,~'�. — 's�k� �,..,ti , , �-��:: Add Plumbing Fixtures�Meln!� �e Level) r.,;,.>:�..s;c��a�:.: ., ,,,;, ..:� , :„� • ;�,,,.t,�::: Septic System ' 'l�.'G.�9�'�::!ay`^ �{� y�"vyir�1,'�'•� 'ti � � :,��.?�„;�;�,;.�::. :wa"�;�•X`r9Q+i��:: , :,;r. �;�:�r;�, Water Tumaround � :,,�'�'i',�•� ', •,'�'',}'� ��� New ' i �;�:� �: "� �,:'��p:..�:l�di�i �� , ; ;M�.y��'��ya' �•'r'� � ��� �d;4"�H�'; i � �',(I •m��,'�,'��? ��.�;,��r������: Abandonment �� i RESIDENTIAL FEES: $60.00 Water Heater,Water Softener,or Water Heate��Softener(includes$5.00 State Su�charge) � ' � ; $60.00 Lawn Irrigation(Includes$5.00 minimum State Surcharge) �, ; ` $60.00 Add Plumbing Fixtures, Seotic Svstem Abandonment,Water Tumatound`(includes$5AU State Su. , ar ,) 'Water Turnaround(add$200.00 If a 5/8"meter Is requlred) � ! � � , I � � �115.00 Seotic Svstem New($10.00 per es bullt)(Includes County fee and$5.00 State Sureharge) , ; � � 10TAL FEES S ' i •� CALL BEFORE YOU DIG. Call Gopher 3tate One Call at(651)d5d•0002 for protectlon against undergrountl tlll �d mage. Call 48 hours before you intend to dlg to recelve locates of underground utilities. www.gooherstateone��IL.4ta ; ; � I I hereby eck�owied9e that lhia informelion le eomplete end accurale;that the work will be In conformsnce wilh the oldlnenees e; c ��s f lhe City of Eagan; that 1 undarslend this Is nol a permlt, but only a� appllcaUon for a permit, and work 1e not to sleR without a permlt;st, t � � rk wiU be in aceordan th the appr ved plan in the case of wo►k which requlres e revlaw and approval of plans. ' � : � - M.�� rb4�s�S�� ' Appllcant's Printed Neme Applicant'a Signature � � �. :; 0 � ,: a, r ;�M.��:� .,�.,@,�,,, s.�� 8„r�,.,�,e. $ .,,� <. .�? TpOf� X�'3 ZO�LO STOZ/6Z/SO