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2840 Lone Oak Pkwy443 Lafayette Road N. ? MINNESOTA DEPARTMEN7 OF St. Paul, Minnesota 55155 J?BOR & INDUSTRY www.doll.state.mn.us I? f?CT 0 2, 2008 (651) 284-5005 1-800-DIAL-DLI l"fY: (651) 297d198 September 30, 2008 White House Custom Colour 2840 Lone Oak Pkwy Eagan MN 55121 APPRaVED FOR USE RE: Hydr Nassenger ? Site: ,White House Custom Colour Car 2840 Lone Oak Pkwy Eagan 55121 ID# 08-16145PT08-01 Dear Sirl175-darrr- Minnesota Statutes Chapter 16B provides that the Department of Labor and Industry, Construction Codes & Licensing Unit, Elevator Safety Section, inspect and approve elevators and manlifts (endless belt lifts) before they can be legally used in Minnesota. An Inspector from the Elevator Safety Section recently inspected your facility and determined it meets requirements of the Minnesota Elevator Safery Code. NOTE: Compliance with Minnesota Rules and the ANSI/ASME A17.1, Safety Code for Elevators and Escalators does not necessarily assure compliance with the Americans W ith Disabilities Act of 1990. ALL ELEVATOR RELATED EQUIPMENT IS SUBJECT TO ANNUAL RENEWAL OF THE OPERATING PERMIT: It is the owner's responsibility to maintain and keep current with all tests in accordance with the ASME A17.1 and the ASME A17.3. Frequencies for the required tests can be found in Chapter 1307 of the Minnesota State Building Code. Failure to maintain and perform the required tests may result in revocation of the annual operating permit. Operation of an elevator related device without a valid operating permit may result in an issuance of a"stop order' from the department and possible penalty of up to $10,000. For more information see our website at: http:l/www.doli.state.mn.us/bc_elevators.html Sincerely, CONSTRUCTI ES & LICENSING ? Tim .?rren State Elevator Inspector tdwlrsg (CE-2) Schoeppner, Dale R., BO, City of Eagan Schindler Elevator Corp. R. J. Ryan ElFormCE2 This infortnation can be provided to you in altemative formats (Braille, large print or audiotape). An Equal Opportunity Employer 443 Lafayette Road N. ? MINNESOTA DEPARTMENT OF (651) 284•5005 St. Paul, MinnesoW 55155 J?BOR & INDUSTRY 1'$00-DIAL-DLI www.doli.state.mn.us TTY: (651) 297-4198 ? ° ?? I ncI 0 2 2oos September 30, 2008 APPROVED FOR USE White House Custom Colour 2840 Lone Oak Pkwy Eagan MN 55121 RE: Hydraulie-N"s'senger - Elevato D# -16261 PT08-01 5ite• hite House Custom Colour Car 2 -kwy - Eagan 55121 Dear SirlMadam: Minnesota Statutes Chapter 166 provides that the Department of Labor and Industry, Construction Codes & Licensing Unit, Elevator Safety Section, inspect and approve elevators and manlifts (endless belt lifts) before they can be legally used in Minnesota. An Inspector from the Elevator Safety Section recently inspected your facility and determined it meets requirements of the Minnesota Elevator Safety Code. NOTE: Compliance with Minnesota Rules and the ANSIIASME A17.1, Safety Code for Elevators and Escalators does not necessarily assure compliance with the Americans W ith Disabilities Act of 1990. ALL ELEVATOR RELATED EQUIPMENT IS SUBJECT TO ANNUAL RENEWAL OF THE OPERATING PERMIT: It is the owner's responsibility to maintain and keep current with all tests in accordance with the ASME A17.1 and the ASME A17.3. Frequencies for the required tests can be found in Chapter 1307 of the Minnesota State Building Code. Failure to maintain and perform the required tests may result in revocation of the annual operating permit. Operation of an elevator related device without a valid operating permit may result in an issuance of a"stop order" from the department and possible penalty of up to $10,000. For more information see our website at: http://www.doli.state.mn.us/bc_elevators.html Sincerely, CONSTRUCTION ES & LICENSING ? Tim D. arren State Elevator Inspector tdw/rsg (CE-2) C Schoeppner, Dale R., BO, City of Eagan Schindler Elevator Corp. R. J. Ryan ElFOrmCE2 This information can be provided to you in alternative fortnats (Breille, large print or audiotape) An Equal Opportunity Employer ? :28 y? L-0 nt l` W v,? Receipl#: 10270 2603897 ? ABSTRACTFEE $4600 I?IIIIII?I?ryIIIIIIINIIIIII?I?IIII q IIII II III Recorded on: 7122l2008 07:52:32PM By: DMB, Deputy Retum to: SEYEPSON SHELOON OOIIGNERiV ETAL 7300 WEST 14TTH STREET STE 600 Jpel T. Beckman County Recoxder NPPLE VALLEV, MN 55124 DdICOT2 COllI1Cj', IVIN WAIVER OF HEARING Special Assessment Authorization The undersigned hereby requests and authorizes the City of Eagan, Minnesota (Dakota County) to assess the following described property owned by it: Lots 1, 2 and 3, Block l, Waters Annex 2"d Addition, City of Eagan, County of Dakota, Minnesota; for the benefit received from the following identified public improvement project: UTILTTY USE QUANTTfY RATE AMOUNT Water Trunk (rev Lot 1, Lot 2, Lot 3) CI 8.65 Acres $2,605/ acre $22,53325 TOTAL $22,533.25 to be spread over five (5) years at an annual interest rate of 6.0%. The undersigned, for itself, its successors and assigns, hereby consents to the levy of these assessments, and further, hereby waives notice of any and all hearings necessary, and waives objections to any technical defects in any proceedings related to these assessments, and fiuther waives the right to object to or appeal from these assessments made pursuant to this agreement, as provided for pursuant to Minnesota Statutes §429.081. DATED: ,? - o? ?- d 0 0 0' OWNER of Lots 2 and 3, Block 1: CSM EQUITIES, L.L.C., a Delawaze limited liability company By:l-/ foPl L RL-etrf Its: ?A°naoor \ DATED: a "aI 0`6 STATE OF MINNESOTA ) ffrNwFrw)ss. COLINTY OF DAK-OTA ) OWNER of Lot 1, Block 1: CMW DEVEL, limited liab' ity ,n By: LVe bb U Its: M Ca.n n e ', LLC, a Minnesota r The foregoing instrument was acknowledged before me this ?t y"day of 2008, by J"oe/ L. Ri (!TZ? the /??c?r? a? er of CSM EQUITIES, L.L.C., a Delaware lunited liability company, on behalf o the company. "' JEAN M CROSBY f?? NOTARY PtJBLIC - MINNESOTA '=a .+', 's+r? My Commiseion Expires Jan. 31, 2010 otary Public STATE OF MINNESOTA ) 11en1)ap;1) ) SS. COUNTY OF D*Kaiiik ) The foregoing instrument was acknowledged before me this 2q day of Fe , 2008, by V?e6b Whife the /?lanu?ec of W DEVELOP a"?:nne&^t=':=°• liability company, on behal`?of the company. EffNOTARY NOt3Ty p I1C APPROVED AS TO FORM: r?- /?:' 4? City Attorney's Office D ated: r/en'l0X - APPROVED AS TO CONTENT: &" '2 PuFshc Works Deparnnent Dated: '5- 1' 00 N THIS INSTRUMENT WAS DRAFTED BY: SEVERSON, SHELDON, DOUGHERTY & MOLENDA, P.A. 7300 West 147th Street, Suite 600 Apple Valley, Minnesota 55124 (952) 432-3136 RBB/jlt (206-26995) City of EaiaIl 3830 Pilot Knob Road Eagan MN 55122 Phone; (651) 675-5675 Fax: (651) 675-5694 0 J"• I % `?1 cSC6-? CtUr-k-d- Plc.'Q 2n08 COMMERCIAL PLIJMB ? - ForOffice Use --------j j Permit #: !/ v j Permi[Fee: ? Date Received:QS •I 1• QV j ? StaR: -----------------, ERMIT oPPLICOTInN Date: SiteAddress: CJSd 41D -Jh e? Ql? Tenant:Whf lc 4yu S e- C 'U/DLf r Suite#: PROPERTY Name: Phone: OWNER CONTRACTOR Name:a /1. At.c_G Givl( GaX License#: PMOLP I-21-2, -7 Address4 2?D/ l r0l w49d (i,f I"Y Statek!/V 2ip:s3 741 Phone:??J ContactPerson: TYPE OF kNew -Replacemen[ _ Repair _ Rebuild _ Modify Space - Work in R.O.W. WORK Description ot work: PERMIT TYPE COMMERCIAL _ New Construction _ Modify Space _ Irrigation System L- yes /_ no) L RPZ PVB) • Rain sensors required on irrigation systems • Avg. GPM (2 turbo required unless smaller size allowed by Public Works) Meters Call (651) 675-5646 to veriry that tests passed wior to oidcinn uo meter. Domestfc: Size & Type Fire: Size & Price 3/4' meter $183.00 Avg. GPM High demand devices? _Yes _No Flushometers _Yes _No PRV Required _Yes _No COMMERCIAL FEES: ? av $50.50 Minimum (includes State Surcharge) OR Comraci value S/a T qA4 P i F _ $ ee erm t Required on ALL new buildings and boulevard irrigation systems 4 _$ aadio Meter Read - tt Permrt Fee is Ie98 then $1,000, surcharge is $.50 =$ Meter(s) - N Permit FM 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 lewn irrigation system. $ water Permit Call the City's Engirreering Departmen4 (651) 675-5646, For required fee amourNS. $ Treatment Plant $ Water Supply & Srorage $ State Surcharge TOTAL FEES $ a y I here0y acknowled8e ihflt this informatwn ia complete and eawrate; Mat the vrork nnll Ea in coniormance with the ortlinances and codes of the Ciry of Eagan, that I urMeretarid ihis a irol a permrt, 6ut onh/ an apphcation for a permil, and wark is not to slarl withou[ a parmit; [hat the work vnll be in accorUance with the apprwed plan in the case of woAc which reqwres a review and approval of plans. X ApplicanYs Printed Name x ApplicaM's Signature FOR OFFlCE USE ?Ap?proved By: 'a Date: Z?"d Required Inspections: ?der Ground YROUgh-In ir Test Gas Test Vinal - Page 1 of 3 May 19, 2008 City of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 RE: Plumbing Pernut White House Custom Colour Firdure Quantities: Three (3) water closets Three (3) lavatories One (1) double compartment sink One (1) mop sink 11uee (3) 6-gallon electric water heaters Five (5) interior hose bibs Two (2) roof drains Two (2) overflow roof drains One (1) relocate one existing overtlow floor roof drains One (1) inflammable waste interceptor Ten (10) floor drains 7512 City of Eapn 3830 Pilot Knob Road Eagan MN 55122 Phone:(651)675-5675 Fax: (651) 675-5694 a??,sEO 1?Cw.17- 460 2008 COMMERCIAL BUILDING PERMIT i--_---------------, i Fnr?oe-(*use /? i j Permit#: (J ? ??(? ? I ? Permit Fee: j ? Date Received: ? Staff: I -----------------? C',?lled 3? ?? APPLICATION oate: 3 r i o g Site Address: ZS 4O co^'c 04v- P#i&v-'"'!tj Tenant Name: _? C?- (Tenant is: _ New / -X-- Existing) Suite #: PROPERTYOWNER Name: WtALC- I MLIiE HA'PVlK* Phone: bS/' by(,'$263 Address ! City / 2ip: Z840 c-oi.+lr orF+A- ?1¢?qM.-?-+y^?- Applicantis: _Owner X Contractor TYPE OF WORK Description of work: 4bbt'Ito.-) 1b 2y, STiNCe b4jL-A1//u6 Construction Cost: CONTRACTOR Name: _ P-1- FL`lA'*) License #: Address: _ 1I00 M+LBrOo"Si} RT%. ao1M Ciry: _ li1LW6aTiC +[etiG.KTS F " rJ State: Mpj zip: S 5/1a Phone: 01 66i 0200 Contact Person: '?TAC-R- G4'0y"'K-W AHCHITECT / Name: _ LAv,+~4 A4.c-g, Registration #: ENGINEER (3g,?..' Address: (ilNtpuJ ST OE City: -IE?Mn LA171W State: NI IJ Zip: $ 5?j ? Y Phone:163'75?'?y?? ContactPerson: TAf-kE$ DbAtH11}efw1C Licensed plumber installing new sewer/water service: Phone #: NOTE: Plans and suppoKing documents that you subm)t are consideied to be pubfic lntormatton. Portians of the information may be classified as nan-public !f you prov/de specilic reasans that would permit the Ci[y to conclude that the are trade secrets. ' I hereby acknowledge that ihis information is complete and accurate; ihat the work will be in confortnance with ihe wdinances 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; ihat ihe work will be in accordance with ihe approved plan in the case of work which requires a review and approval of plans. X J'0l 6rllcrrua" Applicant's Printed Name ??cmymo MAR 13 zoas ? x_ ApplicanYs Signature Page 1 of 3 DO NOT WRITE BELOW THIS LINE SUB TYPES: ? Foundation ? Apartments ? Lodging ? Miscellaneous WORK TYPES: ? New )d Addition ? Alteration ? Replacement ? Public Facility )< Commerciai / Industrlal ? Greenhouse ? Antennae ? Interior Improvement ? Move Building DESCRIPTION: Valuation og 2?000? o00 ^ Occupancy Plan Review ? Code Edition (25%_ 100 /o ? ) Zoning Census Code Stories # of Units ? Square Feet # of Buildings ? Length Type ot Const. Width ? Accessory Building ? Ext. Alteration-Apartments ? Ext. Alteration-Commercial ? Ext. Alteradon-PubliC Facility ? Nail Salon ? Siding ? Demolish Building` ? Reroof ? Demolish Interior ? Fire Repair ? Demalish Foundation ? Windows ? Water Damage " Damolltion (entlre bullding)- give PCA handout to applicant Q/, 5•1) 5•2 MCESSystem 11?/ ZU?0, SAC Units A 4k %7/"> - - Vol City Water ? y ? pLk.GA'?! -• Booster Pump lT? ZLS PRV Fire Sprinklers REQUIRED INSPECTIONS Footings (new bldg) heetrack Footings (deck) FinallC.O. -? Footings (addidon) Final/No C.O. ? Foundation HVAC ?Drain Tile Other: ? Roof: _Ice & Water ?Final Pool: _Footings _Air/Gas Tests Final ? Freming Siding: _Stucco Lath _Stone Lath _Brick Fireplace:_R.I. _AirTest _Final Windows ?'Insulation Retaining Wall Final C/O Inspectio„n?: Schedule Fire Marshal to be present. '?Yes No Reviewed By: / (?'?61- . Building Inspector Reviewed By: ?/YM ?• . Planning COMMERCIAL FEES: Base Fee y 95? .'Jr Surcharge 17,10. ,,.n Plan Review 47 f, ?q SAC-MCES lD? Q50 • a-?? SAC-C ity (? 00 • a.o S/W Permit -- S/W Surcharge -- Treatment Plant Q? 9'0 . 0-0 Treatment Plant (Irrigation) -- Park Dedication - Trail Dedication --' W ater Quality - Water Supply & Storage (WAC) - Financial Guarantee Storm Sewer Trunk Sewer Lateral Street Water Lateral Other ?-- Sewer Trunk " Water Trunk - Total Page 2 of 3 :UA ii Council EnUironmenta2 Services February 25, 2008 Dale Schoeppner Building Official City oF Eagan 3830 Pilot Knob Road Eagan, MN 55122 Dear Mr. Schoeppner: The Metropolitan Council Environmental Services (MCES) Division has determined SAC for the White House Custom Colour addition to be lceated at Waters Annex - 2840 Lone Oak Pkwy within the City of Eagan. This project should be charged 6 SAC Units, as determined below. SAC Units The business information was provided to MCES by the applicant at this time. It is the CiTy's responsibility to substantiate the business use and size at the time of the final inspection. If there is a change in use or size, a redetermination will need to be made. If you have any questions, call me at 651- 602-1378. Sincerely, Jessie Nye ? SAC Coordinator Environmental Services Division JN:kb: 080225A I FEB 2 6 2008 Charges: Office 4305 sq. ft: @ 2400 sq, ft./SAC Unit Manufacturing/Production 25,454 sq. ft. @ 7000 sq. ft./SAC Unit Parking Garage 16 f.u. @ 17 f.u./SAC Unit 1.79 3.64 0.94 Total Charge: 637 or 6 TOM M od cc: File, MCES Peggy Fleck, Eagan- Jack Grotkin, RJ Ryan ?w+.metrocouncd org 390 Robcrt Strect North . St. Paul, MN 55101-1805 •(651) 602-1005 • Fax (651) 602-1477 • 7"CY (651) 291-0904 An Equal Oppommrty Empioyer -)nnf r~qMMERCIAL BUILDING PERMIT nePUCnrion C[ty Of Eagan • 3830 Pilot Knob Road, Eagan Mo 55122 I'elephone # 651-67575675 FAX # 651-675-5694 , ,1 --7i ii,' -? ---7 . Sirudural Plam (Y) sats . Clvll Plans (2) • CeNficaleof5urvey (1) . CodeAnalysia (1) •' . ProjeaSpers (7) • Spea innp. 6 TasUnp Scheaule " • So116Report (1) . lnetar alza must Ce asiabllatietl . 3AC tletarmlmtron - eap 851402•1000 . Archlledurol Plana (2) tets • ArMltedunl Plant (2) aets . SUUquralPlanB (2) • CotleArulysis (1) " • CIWIPIans (2) - ProJed3pflw (1) • LaralseaPirry Plarre (2) • Key Plan (1) • CadaAnalysis (1)" • MaslarExltPlao (1) • CgrHflCetBOi$Utvey (t) • EnaryyCBIW18tlOn6 (1)frol6lWiy&" • SpeG Insp. 6 Tesdng StMdule (1) •• • Eiae. Powx 8 LlpMinp Fwm (1) nW Ylwaya•• • MBtOr 8128 mU8t De e3taEll6hetl • M818f 61E@ Tu6t Ce 981i0dMaE-4 epptlC9D1@ • pfpjBp$p0C5 (7) . EneryYCWalatfonc (i) " J . EleeUle Power 3 LlphBnp Form .• (1) ? . Masmr Exil Plan (1) ) • Emergency Response Slte Plan (1)•" ? . SoI1sRePort (1) I . SACCeIertnlneHOn-u11851402•1 000 • SACdelarminalbn.calt861-002•1000 . Fire Sroirolnn Suhmlttels lau MN Depl oiHeellh at 656215-0700 furdalails regaMing fnod & 6evenRe or btlRing (acilifies. •• Contect Building Impections for sample end if required Pertnit for rye}y building w pddition will imt be processed wilhoui Emergency Resporm Sire Plen. Date 12 / 23_ / D6 ConstrucNon Cost 90r BOO • a-v Slte Addresa 2,0`10 LONZ 00*K P1C?vY UnfUSte q Tenant Name White House Custom Colour Former Tenent Name N/A 2 S GZ , Descrlption of Work ConStruct New Office/Manufacturing Property Owner Mike HaNine Telephone M( )612-396-3378 (Ce I I) Applicant is: _ Owner ',<, Contractor Contact K: ( ) 612-750-6215 Contractor R.J. Ryan Construction, Inc. Addresa 1100 Mendota Ileights Road Ciry Niendnta Nefyhts State MN ZiP 55120 7elephone #( ) 651-681-020D ArcA/Engr Welmen & Sperides Architects Registration # 18681 address 7700 France Avenue S. Ciry Edina State MN ZiP 55435 Telephone H( ) 952-996-9662 -.,4?'? ? Ibc Licensed plumber inatallin e r sewer/water servlce Phone #: i `P- I g ? . , i nemuy eppry wr a commernai nmimng rermrt entl acknowiedge that tne infortnaGOn is compiete ana aaurate; that the wwk will be in conformence with the ordinanees end codes of the City af Engan and the State of MN Statutes; 1 understand this is not a pertnit, but only an application for a permit, end work is not to stan withaut e permit that the work ?yill be in accordance with the approved plen in the case of work which requira a review and approval of plans. / ? n DEC2 6 2DD6 0 6 S/ - ?t 1 -0a 0 `' L P-I 1 , DO NOT WRITE BELOW THIS LINE Sub Types 01 Foundation ? 26 Public Facility ? 30 Accessory Building 14 Apartments ?E" 27 Commercial/Industrial ? 32 Ext Alt-Apartments = 15 Lodging D 28 Greenhouse n 34 Ext Alt-Commercial - 25 Miscellaneous ? 29 Antennae ? 35 Ext Alt-Public Facility - ? 37 Nail Salon Work Types O' 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding , ? 32 Addition ? 36 Move Bldg. ? 42 Demoiish (Foundatlon) ? 45 Fire Repair ? 33 Alteration ? ? 43 Reroof 37 Demolish (Bldg)' ? 46 Windows/Doors ? 34 ReplaCement "Demolition Building - Give PCA handout to applicant . wu 000 ? l'0 Type of Const 8 Width - - - i Valuation ? Plan Rev 100% ? 25%_ Occupancy F'TNpN SEP• MCES System ? SAC Units COLt?t Zoning ?._ City Water Nbr. of Units O Stories 'y Booster Pump ? PRV Ft Sq Nbr. of Bldgs . . Fire Sprinklered Length Required Inspections R.I. _ / Fireplace Air Test _ Final Footings (new bldg) _ Insulation Footings (deck) Sheetrock _ Footings (addi[ion) ? FinaUC.O. Foundation Final/No C.O. Drain Tile ? _ Other Driveway Apron ?Decki I P ? _ Pool _ Ftgs V/Insul ? Final n Air/Gas Tests _ Final r ce Roof ? i _ g Siding _ Stucco La th _ S[one Lath _ Final ng Fram - _ Windows Final CIO Inspection: Schedule Fire Marshal to be pr2sent. v Yes _ No Approved By: r D Plann ing l.-K'lt/c^ Building Inspector ------ - --- ---- - ----------- ------------------- - - ---------------- Base Fee Surcharge Pian Review SAC-MCES SAGCity SIW Permit S1W Surcharge Treatment Plant Treatmeni Plant (Irrigation) Park DedicaGon Trail Dedica6on Water Quality Water Supply & Storage (WAC) IB?7I6.7V 1 41,1 • UO /2? l6s• 8`l DTtm-L F#r WEYf,- ????ious?I aOGLEer'D LvrI'Tt PII? ? ?OUNLYY7'70?W PLZMT . Financial Guarantee Slorm Sewer Trunk Sewer Lateral Street Water Lateral Other Total 4 31.301. &V SewerTrunk Water Trunk V" ? i 2oa6 CUMMERCIAL BUILDING veRnur ArrwcArIox City Ot EaQan ??. ?UNQ?? _/ 3830 Pilot Knob Road, Eagao Ma 55122 ??`? e?/ Telephoae 0 651-673-5675 FAX M 651-675-5694 . 8tlYE11a1 PIHU (x) Mw . AI@nwoum mm Iy wv . CIuN ftm (2) 6 8budiuM Pltm (2) . twnAab a anw cU • ? ftrd (2) . u a M .n. • + m? •? • w rm P?? ?? r p? y ? ? y ??? ? ???l?^vY? (1' ?s ^ ? • 000 ^w,yy ? I . Spw, imp. 6 TnUnnp 3cMAur " . CatlIIaM of 9urwy (1) . 8olb Report (t) . 8pw, Imp. 6 7*NMp SCtNOYN (1) •• . NNnrsftenwtWaUW4M0 • MeNrmWmwtG41WWIsMO PFQW a ? ) Lnayy CwfaiWi4ta (U `" 1 : EaoMo Poww a uphtlrw Rorm (u " J . Mwtv6wNftn f1S 1 • emsrowW IiaaonN SM ran (1) 1 . &m Ropon (1) . SAC tlwmNallan • aMl61-0OA1000 . dAC CsMimkNdOn • pR 0614M2.IOD0 . fln 8appinp BWxnWs . Firo 8uaonulavlu?tnlE? GII MN Deet e Fa 1A u 6SId15-0700 Por dmeils roaardinQ teod & hsvsnYe or 1odlli ; gI, $ 0?j . ? ".m ? COft ANNsis ?.,... ?a • ProtondBY?a (?) Key i iii exuM.n : n uu • Enppy GwA?uau (1) . eac, vow+r a ue?o Ran (u n«•?+r?•. . MNMUu MWIOe aWOMIM aMoOWK'?M 1 1 ? 1 . BACMprminNlon-aN001d?-t00D s?? ContutBulldln4lnipmotioMPor?ampbuidifroqulted Pmmi[ 1br g0yt bWMinl atllltl(II9p Will not be proclaed wltlrow Emer4aloy Weponn Sha Plm. Date 12 / 23 / OB /0/OIYp ,? Comhnctloo Coat SlfeAddren 104d LoNL ahK' Pkyj`l UMlHSt! N Tmmt N¦me Whke House Cuatom Colour L1 Rormer Teaant Nome WA I l.+,J a"?`ti?.n Deurlptlon of Work ConsVuct New OflceMlanufacturlnp Property awner Mlke Hanilne Tdephoae M( )072-39Q-3378 (CC I I) Appllemtls: _ Ownar '& Contnetor CoatutMt ( ) 812'750-8215 Conenctor R.J. RYen CDllstl'uotlon Inc. Addroee 1100 Mendote Fieights Road . G9q Mendote hlslphts 5rote MN yip 55120 TeNphons M( ) 831-881-0200 AKA/Eo`r Welmen & Speridas Archltecls Reglltrstloo N 18881 Addrm 7700 Frenca Avenue S. Ciy Edlne Stata MN ZIp 53435 TelepAOaeX( }?-9"82 om P Ib? °?? 938'930a- Llaernad plumeer ImulBny ? awaNwebr so?vlw. oss Plwee S. ( 1 ) 1 heraby apply Por e Glmnmarciel Building Permtt arM ecknowlefte dm the infommtfon is completa end xcurme: thet the work witl be in eonformenee wlth the ordinsncaa and eodes of tha Ciy of Easen and the Smte oP MN &atwes: I undentand thit tt not a permft, but only en apPliceUon far a pmnit, and wark is noi w start without a permit; tAU the wal[ v/ill 6e in umrdena with tlw approved plen in the eeae of work whlch roquircs a roviaw end appmval uf plans. An Applicant's Printed Neme pPcanYs Sigriature ' DEC2 62006 (?St-?g1" ° Z° ° I , ? ' DO NOT WI2ITE BELOW THIS LINE Su6 Types . G 01 Foundation C 26 Public Facility ? 30 Accessory Building ? 14 Apartments xe 27 Commercial/Industrial ? 32 Ext Alt Aparhnents - _ 15 Lodging ? 28 Greenhouse ? 34 Ext Alt-Commercial 25 Miscellaneous ? 29 Antennae ? 35 Ext Alt-Public Faciliry ? 37 Nail Salon Work Types JR-?31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding p 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)* ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement `Demolition Building -Give PCA handout to applicant Valuation /d/??? ? TypeofConst _7Z?'?/ Width Plan Rev 100% ? 25%_ Occupancy r' l! /110/r 5P17° • MCES System ? SAC Units 9 Zoning ? City Water V/ Nbr. of Units 6 Stories 2- Booster Pump Nbr. of Bldgs ? Sq. Ft. fiT. A&_47t?b PRV Fire Sprinklered Length Re ired Inspections ? Footings (new bldg) _ Fireplace _ R.I. _ Air Test _ Final FooCings (deck) _ Insulation ?Footings (addition) = Sheetrock ?/ Foundation FinaUC.O. DrainTile _ FinaUNo C.O. _ Driveway Apron Other Roof Ice Pr _ Decking _ Insul _ Final _ Pool Ftgs _ Air/Gas Tests _ Final Framing _ Siding _ Stucco Lath _ Stone Lath _ Final - Windows Final C10 Inspection: Schedule Fire Marshal to be present. _ Yes _ No Approved By: PP. Planning Building Inspector --------------------- - ---------------------------- --------------------------------------------------------------------- - -------------------- - ---------------------- Base Fee ?? ?• ZS? Surcharge Plan Review SAGMCES a • a'°' SAC-Ciry 800 . n"° S1W Permit SNV Surcharge v ' ?O Treatment Plant SZ 00 •0"0 financial Guarantee Treatment Plant (Irrigation) ?•0'0 Storm Sewer Trunk Park Dedication Sewer Lateral Sewer Trunk ? Trail Dedication SVeet Water Quality -' Water Lateral Water Trunk Water Supply & Storage (WAC) `" Other[?-ivOSGAfl4F 5'&o Total 4201 cv, ?• ? 1 ' ?t i Metropolitan Council u January 25, 2007 Dale Schoeppner Building Official City of Eagan 3830 Pilot Knob Road Eagan, MN 55122-1810 Deaz Mr. Schoeppner: h 2- Cr LE .'l ??' iE D JAN 2 6 2007 The Metropolitan Council Environmental Services Division has determined SAC for the White House Custom Colour to be located at Lone Oak Pkwy and Lone Oak Drive within the City of Eagan. This project should be charged 8 SAC Units, as determined below. SAC Units Charges: Office 6317 sq. ft. @ 2400 sq. ftJSAC Unit 2.63 Training/Boazd Room 1358 sq. ft. @ 1650 sq. ft./SAC Unit 0.82 Warehouse 12,860 sq. ft. @ 7000 sq. ft./SAC Unit 1.84 Press/Canvas/Photo Room 18,278 sq. ft. @ 7000 sq. ftJSAC Unit 2.61 Total Charge: 7.9 or 8 If you have any questions, ca11 me at 651-602-1378. Sincerely, Je essie N 5AC Technician Environmental Services Division JN:kb: 070125A1 cc: S. Selby, MCES Carolyn Krech, Finance, Eagan Matt Gwost, RJRyan Construction www. metrocouncil.org 390 Robert Street North . 5L Paul, MN 55101-1805 .(651) 602-1000 • Fax (651) 602-1550 • T'CY (651) 291-0904 An Equof OPpormnrty EmpWyer MN Alliant Engmeermg, Inc. LETTER TRANSMITTAL DATE: 7anuary 11, 2007 JOB NO. TO: Mc J. Craig Novaczyk SENT BY SeniorInspector ph - 651.675.5683 City of Eagan 3830 Pilot Knob Road Eagan, MN 55122 FROM: George Abernathy, PE SUBJECT: Whitehouse Custom Colour - Lone Oak Parkway 040110 hand delivered NUMBER DATE DESCRIPTION 2 1 (2) Full Size - Final Civil Drawings (24"ac36") Copy of City Comments REMARKS: Mr. Novaczyk, Please find enclosed 2 copies of the Civil Plans, and a copy of the City comments received from Welman Sperides, for the Whitehouse Custom Colour project site. The requested information in your comments dated 12-26-06 and 14-07 can be found within these drawings. This information has been sent to you in response to comments received and should be included as part of the re-submittal by Welman Sperides. Please call me at 612-767-9330 should you have any questions, comments, or require additional information. Thanks, George Abernathy, PE COPY TO: Brian McCarty/Welman file 7? J JAN i Zdii1 233 Park Avenue South, Suite 300, Minneapolis Minnesota 55415-1108 Phone 612.758.3080, Faa 612.7583099 01,?8i07 17:26 ' WELMAN SPERIDES ARCHITECTS 4 RLLIRNT FAX TRANSMITTAL ro: ba.ovfos _ PRQ.iECT NAM6:W"+ rE laU NS F. C444nYL, Cd645V" ti-- _ PRUJHCE NO: O(? . D " DAT& I • 0 • O & Thc Ileme below nre lronymittede ' El FO?R YOUN INFORMATION ? T+ORYOU&&EV[EW ?/' ,-------..._- '--'-----'---' FORYOURAPPROVAL ?? ---------.._._._ .. _..-'---"--'?--- -' FOR YUUR U56 FOB YOU% &6CORDS E3P- qS RLQUpSTFp ?/' DL+SCRIATION: '-' "-'---------'-- ? __. ..---C_oJtiM'6 S?!?!.YLT e? G6 - rn+M ?(d?Ar? F? ??'1? ? I? IP ._...._..-----.-ll'.?{'?Y1?? r_ `' /r ?• .. . ... .... .._.. COMM&NTS CC: N0.924 P001i004 7700 Fnnre Avc.Sa- tiuim 373 CJinn, MN. 55435 pAonc:(9l21 996-9662 fax:(952)SMI6-9667 wae waerch.com SPERIDES ARCHITECTS ---TOTALPApSS: ? t?. (inclndingtransmiitaq 91-'08i07 1fi:26 ' WELMAN SPERIDES ARCHITECTS 4 ALLIANT city of Eap Mlka Magulre MAYOP Peul Bekken Peggy Cerlson cynaae Fleias Mep 7iltay CoUNCl4 MEMBCPB Thomas Hedges Cm eloeeiwsrAamA MuNicinu CErrren 3830 Pilot Knob Road Eagan, MN 65122-1810 651.875.5000 phone 651.675.5012 fex 651.454.0535 TDD MpireMnnce pacwrr 3501 Coechman Point Eagen, MN 55122 657.675.5300 phona 651.675.5360 tax 651.454.8535 TAD www.cftyoteagan.com THC L.ONE OAKTN6E Th? Bymnol el etrengch and growth in our communlty . January 4, 2007 Jack Grotkin RJ Ryan ConstrucUon 1nc 1100 Mendota Heights Rd Mendota Heights MN 55120 RE: WHITE HOUSE CUSTOM COLOUR 2840 Lone Oak Pkwy Dear Mr. Grotkin; N0.924 P003i004 IJECEIVED JAri O 5 iuub We have completed our review of the cpnstruction documents submitted in pursuit of ohtaining a bullding pertnit for the above-referenced project. This review is not intended to be an exhaustive and camprehensive report. Unless otherwise noted, all references are to the 2000 I.B.C. It is our goal that this review will help you in complying with the applicable codes and we are, there4ore, requesting that the following items be addressed Verify whether you are proposing a separated use or a non-separated use building. Include calculatlons for area increases due to building frontages 'rf you are proposing a non-separated use for this building. Revlse your code analysis to indicate what you have chosen to do. 2. ClassiTy each portion of the building as to its use. 3. Indicste any occupancy separations that may be required if thls building is being built as a mixed occupancy separated use. 4. Revise your code analysis to include the required plumbing fixture count per table 2902.2. 5. Provide the total amount for the desfgn occupant load. 6. Provide details for the required exit enclosures (i.e., rated wall assemblies, rated opening protection, etc.). Reference Table 1005.2.2 and Section 1005.3.2. 7. Provlde UL listings & testing for all rated wall assemblies being used, include the fastening requirements. 8. Provide MSDS shests and a hazardous materials report comparing your quantitfes ta 7ablas 3077 (1) and 307.7 (2). g. M elevator shaH be provlded to access the sacond story storage area per Chapter 1341,0405, item E of the MSBC. 10. Both doors for room 146 shall swing in the direction of exit travel. 11. Pmvide details 8 informatlon concerning ohemlc8l rooms 134 and 203. 01/08i07 17:26 ' WELMAN SPERIDES ARCHITECTS 4 ALLIRNT N0.924 P094i004 12. The papertowel dispensers in toilet rooms shall not encroach on the lavatory clear floor space (reference Chapter 1341.0350, Subpart 19 of the MSBC). 13. Provide door hardware details. 14, Stairvvay guards shall comply with 5ections 1003.2.12 and 10032.12.1. 15. Provide tha location and details for the roof access hatch, ships ladder, and permanent ledder for change of roof elevation access. (Sections 306.5 & 306.51 of the Minnesota State Mechanical Code). ? 16. Provide details for the access road to the rear parking lot. 17. Provide a detail for the accessible parking s(gnage & its installation. 18. Provide a detail for the accessible curb cuts. 19. Separate permits are required for plumbing & machanical work. Sincerely? ? J. Craig Novaczyk Senfor Building Inspector JCN/pf CC: Brian McCarty, Welman Sperides Arch. 7700 France Ave S# 375 Edina, MN 55435 City of Eapn PetGaegen Maron Peggy Carlson Cyndee Fielde Mike Magulre nneg niiey COVNGIL MEM9Eq8 Thomea Nedges CITV AoMINISn1ATOR Mirtaav.w. CENVn 3830 Pllot Knob Road Eagsn, MN 55122-1810 651.675.5000 phone 051.875.5012 lax 651.454.8535 TOD MAINfENANCE FACILRY 3501 Coechmen polnt Eagan, MN $5122 651.875.5300 phone 857.975,5380 Iax 651.454,8535 TDD www.cltyofeayen.com THE LONE OAK TRE! The symbol of sttength and growlh In our cammunity. V00iZ00d 7Z6'ON llecenaber 26, 2006 Jack Grotkin RJ Ry3Il. C0115tCUCC1oII, lI1G, 1100 Meitdvta Heights koad MendotaHeiglats,MN 55120 RE; WHLTE I40U5E CUS701VI COLOUR I,ONE OAK pA.lil(WAY Dear Jsck, o Wc have started our rovicw of the construetion documents submitted in pursuit of obtainirtg 3 building pemtit for the aUove-referenced project. 1'his review is not intended to be un exhaustive and comprehensive report. Unless otherwise noted, all references are to the 2000 I.B.C. It is our goal that this review will help you in cumplying wtih the applicable cpdes and we are, therefore, requesting that thc iFems checked below be addressed: 1 Code Analysis ? 1 Electric Power & Lightizag (F.nclosed) ,J 1 Emergency Response Sitc Plan (Example EncloFed) t Certiftcate of Survey 4 -Laoilse"irrg?s ? Fire Protection System Plan Review In£ormation (Form Enclosed) .J 1 MC/ES SAC determination letter .f Soils Report ? Spceia] Inspections & Tzsting Schedule If you have atty questions xegarding the above items, please feel free to contact me at 651-675- 5683. Sincerely, ,?--- J. Craig Novaczyk SeniorTnspector Cc: Brian McCarty, Welman Sperides Architects, L.L.C. JCN/Ce 1NCI-nFJ E 51D31IHObti S3QI213dS NdW-13M 9Z:LT L0i80iT0 ?sC&JL?? 6k- auu,.(a' /27 ? • ?' ?-? /?J?Cc?,? . ; ?,lq5a J-2.a2.% -? , n WHITE HOUSE CUSTOM COLOUR C1(L1, 61, Waters Annex) ovzsizoo7 Quantit Plant Name Size Root Condition Price Per Unit Landscape Onl L.S. Sym. Qt . SHADE TREES RM 4 Autumn Spire Red Maple 2.5" BB 265.00 1,060.00 SM 5 Sugar Ma le 2.5" BB 265.00 1,325.00 SA 5 SummitAsh 2.5" BB 220.00 1,100.00 GL 3 Greenspire Linden 2.5" BB 265.00 795.00 HL 3 Sk line Hone locust 2.5" BB 265.00 795.00 SO Swam White Oak 2.5" BB 287.00 0.00 NW 1 Niobe Wee in Willow 2.5" BB 165.00 165.00 $5,240.00 ORNAMENTALTREES JL 1 Japanese Tree Lilac 1.5" BB $142.00 142.00 AM Amur Flame Clum 1.5" BB $20.00 0.00 SS 6 S rin Snow Crab 1.5" BB $118.00 708.00 RS 6 Red Splendor Crab 1.5" BB 118.00 708.00 $1, 558.00 CONIFEROUS TREES NP 11 Norwa Pine 6' BB $164.00 SP 3 Scotch Pine 6' BB $164.00 BHS 10 Black Hills S ruce 6' BB $164.00 = $3 CHRI IRC CC 20 can Cranber Bush Com act Ameri 24" ht Pot $13.65 273.00 WE Dwarf Win ed Euon mous 24" (ht) Pot 13.65 0.00 ID 21 Isanti Do wood 24" (ht) BB 11.10 233.10 AW Antohn Waterer S irea 18" ht Pot 11.10 0.00 RR 9 Nearl Wild Rose 18" ht Pot 13.65 122.85 RD 65 Red Twi ed Dogwood 36" (ht) Pot 16.40 1,066.00 SJ 44 Scandia Juni er 24" (d Pot 15.70 690.80 TY 12 Taunton Yew 24" d) BB 47.00 564.00 $2, 949.75 PERENNIALS FG 13 Miscanthus Flame Grass #3 Pot $13.30 172.90 SD 70 Pardon Me Da lil #1 Pot 4.95 346.50 FR 20 Overdam Feather Reed Grass #1 Pot 5.95 119.00 $638.40 SUBTOTAL X 150% TOTAL FINANCIAL GUARANTEE $14,322.15 x 1.5 $21,483.23 January 26, 2007 Pat Geagan Maroa Mr. Brian McCarty Peggy Cadson Welman - Sperides Architects Cyndee Fields 7700 France Avenue South Mike Maguire Edina, MN 55435 Meg Tilley Re: Lot l, Block 1, Waters Annex (White House Custom Colour) COUNCIL MEMBERS Dear Mr. McCarty: Thomas Hedges CITY ADMINISTBATOR I have reviewed the building permit plans you submitted for the above property. The plans are consistent with the Planned Development Agreement and other zoning requirements. However, there are two outstanding items and although these items will not delay issuance of the building permit at this time, we do need to foilow-up on them in the near future. MUNICIPAL CENiEfl First, we need two copies of the Site Lighting Plan. We have an approved Site 3830 Pilot Knob Road Lighting Plan that is part of the Planned Development Agreement, but need the Eagan, MN 551 22-1 61 0 Plans to be included with the building permit plan set. 651.675.5000 pnone Second, when the subdivision of the property was completed late in 2006 with 651.675s012 fax CSM (the property owner at the time), the Development Contract required that the 651.4548535 TDD financial guarantee for lazidscaping be provided with each building permit. Therefore, a letter of credit needs to be provided in the amount of $21,500. This landscape guarantee must remain in place for two years following completion of MAINTENANCE FACILRV the landscaping. A sample letter of credit is attached for your reference. 3501 Coachman Point Eagan, MN 55122 The building permit can be released now with a cash deposit of $7,500. Once we 651.675.5300 phone receive the letter of credif, that will replace the cash escrow and the $7>500 deposit 651.675.5360 fax will be released. 651.454.8535 TDD If you have any questions, please call me at 651-675-5691. Sincerely, www.ciryofeagan.com Pamela Dudziak ? Planner TXE LONE OAK TFlEE The symbol of cc: ' Craig Novaczyk, Senior Inspector strength and growth Jack Grotkin, R J Ryan in our community. City of EapIl In TO: Dale Schoeppner, Building Inspections Scott Peterson, Building Inspections Craig Novaczyk or Mike Lence, Building Inspections Mike Ridley, Planning Carol Tumini, Utility Billing Dale Wegleitner, Fire Department Tom Colbert, Engineering John Gorder, Engineering Leon Weiland, Engineering , Tim Pahr, Engineering Paul Olson, Maintenance Tom Struve, Maintenance Eric Macbeth, Maintenance Paul Heuer, Utilities Mark Anderson, Electrical Inspector FROM: ? Craig Novaczyk, Building Inspector . DATE: July 26, 2007 SUBJECT: Final Inspection For White House Custom Colour 2840 Lone Oak Parkway The Protective Inspections Division will be performing a final inspection at the above referenced property on the first week in August 2007. If you have cause for not granting the Certificate of Occupancy, please submit a "hold requesY" to my attention. The person/department requesting a hoid is responsible for notifying and resolving problems with the affected parties. CD/Bldg Insp/lFormslComm Bldg//Final Inspecbon For _ Upda[ed 2-07 Structural Testing and Special Inspection Program Summary Schedule Project Name White House Custom Colour Project No. Location Permit No. Technical (2) Type of Report Assigned Section Article Description (3) Inspector (4) Frequency (5) Firm (6) 02200 Earthwork SI-T Weekl 03100 Concrete Formwork SI-S Each Visit 03210 Concrete Reinforcement SI-S Each Visit 03300 Cast-in-Place Concrete Tests SI-T Each Test 04200 MasoryIns ections n SI-S EachVisit 04200 Maso nry Tests SI-T Each Test 05100 Structural Steel SI-T Each Visit Notes: This schedule shall be filled out and included in the Strucwral Testing and Special Inspection Program. (1) Permit No. to be provided by the Building Official. (2) Referenced to the specific technical scope section in the program. (3) Use descriptions per IBC Section 1704, as adopted by Minnesota State Building Code (4) Special Inspector - Technical, Special Inspector - Structural, Testing Agency. (5) Weekly, monthly, per test/inspection, per floor, etc. (6) Firm contracted to perform services. ACKNOWLEDGEMENTS Each apprp,priate.rep,r??s,ery;ative shall sign below: Architect: SER: ? SI-S: ? S[-T:/ ? TA: !'6 F: 4e, G.i?'S« Firm: acz Ti? FlT[ri: /7TiTr ,TjyG. Firm: /W- I`? Trc . Firm: LIKO Date: rZA 9106 Date: i Z- 9 8 - ZOVe? Date: Date: I Z-Zfb -Z.onlc Date: 1-2 -ab'- v? L _ _----- If requested by engineer/architect of record or building official, the individual names of all prospective special inspectors and the work they intend to observe shall be identified. Legend: SER = Structural Engineer of Record SI-S = Special Inspector - Suvctural Accepted for the Building Department By Firn4lTl%?(Ul,?f/? ?GGS/j/rt1 L'(/CE[?e: / Zo UG Firm:^/?/ , Date: / L) Ot Firm: {?? CAf1 /U41 Date: iy'M- F;r,t,: sKBM SI-T = Special Inspector - Technical TA = Testing Agency F = Fabricator Date WHITE HOUSE CUSTOM COLOUR - EAGAN, MN Page 8 i . q? White House Custom Colour Hazardous Materials Report , Maxium Product Volume to be Catalog Container Stored On-Site Physical Product Name Number Volume Gallons / Liters Form Kodak Ektacolor Digital 20 Units = 100 Developer Replenisher RT, 5 Gallons or Gallons or 378.5 Aqueous Part A 1290477 18.925 Liters Lilers Liquid 65 - 70 % Water 7732-18-5 15 - 20 % Triethanolamine 102-77-6 5 -10 % 2,2- (hydroxyimino)bis ethanesulfonic acid disodium salt 133986-513 1- 5 % Color Developing Agent 7- 5% Sodium Sulphate 7757-82-6 1- 3% Sodium Hydroxide 1310-73-2 Kodak Ektacolor Digital 20 Units = 100 Developer Replenisher RT, 5 Gallons or Gallons or 378.5 Aqueous Part B 1487982 18.925 Liters Liters Liquid 40 Units = 160 Kodak Ektacolor RA Bleach- 4 Gallons or Gallons or 605.6 Fix and Replenisher, PaA A 1815430 13.437 Liters Liters 40 Units = 200 ,Codak Ektacolor RA Bleach- 5 Gallons or Gallons or 757 Fix and Replenisher, Part B 8471484 18.925 Liters Liters ?Codak Ektacolor PRIME 150 Units = 4.8 Stabilizer and Replenisher 0.032 Gallons Gallons or 18.17 LORR 8264442 or 0.12 Liters Liters 02/08l2007 Table 307.7(1) Flash Physical Table 307.7(2) pH Point Hazard Health Hazard >93 C / Combustible 13.2 >200 F Liquid Class III B 10.1 None None Aqueous Liquid 5.4 None None Aqueous Liquid 5.6 None None Aqueous Liquid 4.3 None None Prepared By: Harvey E. Fowler REM CHMM REA None None None None None Maximum Allowable Quantity Complies 26,400 gallons YES N/A N/A N/A N!A Eastman Kodak Company f .^ White House Custom Colour Hazardous Materials Report Kodak Ektacolor 120 Units = 4.44 Processing Cartridge 75, 0.037 Gallons Gallons or 16.80 Aqueous >93.3 C/ Combustible Developer 5285887 or .143 Liters Liters Liquid 13.7 >200.0 F Liquid Class III B None 26,400 gallons YES 45 - 50 % Diethylene Glycol 171-46-6 25 - 30 °/a Water 7732-18-5 10 -15 % Potassium Carbonate 584A8-7 1 - 5 % Color Developing Agent 1- 5% Potassium Hydroxide 1310-583 1-5%N,N- diethylhydroxylamin 3710-84-7 0.1 - <1% Sodium Hydroxide 1310-73-2 Kodak Ektacolor Processing 120 Units = 63.36 CaAridge 75, Bleach Fix, 0.528 Gallons Gallons or 239.8 Aqueous Part A 5285887 or 2 Liters liters Liquid 5.3 None None None N/A Kodak Ektacolor Processing 120 Units = 31.2 Cartridge 75, Bleach Fix, 0.26 Gallons Gallons or 178.1 Aqueous Part B 5285887 or 1 Liter Liters Liquid 7.1 None None None N/A 120 Units = 20.4 Kodak Ektacolor Processing 0.17 Gallons Gallons or 77.2 Aqueous Cartridge 75, Stabilizer 5285887 or 0.65 Liters Liters Liquid 4.3 None None None N!A s r' c 02/08/2007 Prepared By: Harvey E. Fowler REM CHMM REA Eastman Kodak Company t .. ,. . a??KII Requirements: 2007 FIRE SUPPRESSION SYSTEMS PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 2 complete sets of drawings and specifications cnt shretc nn materialc and cmmnnnents tn he used Date 4 / 10 / 07 L.? n,e- Site Address: 2840L0WOAK PARKWAY Tenant / Building Name: WHITE HOUSE CUSTOM COLOUR The Applicant is: _ Owner ? Contractor _ Other PROPERTYOWNER Yav -,.,...- "^' ? W W Address: City: State: Zip: CONTRACTOR Nardini Fire Equipment Co., Inc. MN License #: N/A Address: 405 County Road E W City: Shoreview State: Minnesota Zip; 55126 Phone #: ESTIMATED COMPLETION DATE: 6 / 1 / 07 FIRE PERMIT TYPE: _ Sprinkler System (# of heads Fire Pump _ Standpipe ? Other: CLEAN AGENT FIRE SUPPRESSION SYSTEM WORK TYPE: ? New Addition Alterations _ Remodel Other: DESCRIPTION OF WORK: ? Commercial Residential _ Educational Other: Please continue on next page PERMIT FEES Contract Value $ 27,954.00 x.O1 =$ 279•54 Permit Fee $50.00 Minimum g .50 State Surcharge To calculate surcharge If Permit Fee is <$1,000, surcharge is 50 cents. If Permit Fee is >$7,000, surcharge increases by $.50 for each $1,000 Permit Fee, i.e. a$1,50D Permit Fee requires a $1.00 surcharge. 3/4" Displacement Fire Meter -$174.00 $ 0.00 Fire Meter TOTAL FEE: $ 280.04 I hereby apply for a Fire Suppression System permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Minnesota Building/Fire Codes; that I understand this is not a permit, but only an application for a permit, and work is noY to start without a permit; that the woxk will be in accordance with the approved plan in the case of work which requires a review and approval of plans. A?hsmr Corr?z? ,A 04? ApplicanYs Printed Name ? Applicant's Sig re DO NOT WRITE BELOW THIS LINE REQUIRED INSPECTIONS _ Hydrostatic _ Flow Alann _ Drain Test ? Rough In _ Trip _ Pump Test _ Central Station ? Finai Conditions of Issuance: Pern?it Approved-? Date: l31/29.i2007 fRl 13:33 b:aS 651=558+3310 i 01119/2807 22:30 5516816235 tA002/004 PAGE 02I04 R.J. RYAN CONSTRUCT. Cfty of Eagah Fire Proteetion System Plan Review Information ]noample4e fnformation 3YLLL delay Ihe precessing of your buitding permiG Date: Street Addras=, Faeility Name: Approz. Start Date: d( ° 7 qpprox. CompleNOn Date: b'7 cn !:z Morrth Year Month Year SprinklerCOniraCtorj/I Kib& ??l??G ??/(???f,? C,p• ?Icensy#; ?Q??j Street Adtlress:/ / ? ? /G -?"j' • CitY' 4 v(- State: t4 • Zip Code: Phone #A'i%-55? 3 3a a Fax #:Lj/'S`?-`'R --k;, A: L77 02 03 134 O5 B: ? E: 0 F: ?1 02 H: 01 112 E13 04 [15 1: pi 02 03 04 M:? 11:01 02 03 04 8: ?9. 02 U:13 Buolding Cpde ConsVUCtion Classlflcxfion (MSC3C Chapter B) I: GA ?B fl• ?A GS IIf: CA 138 IV: OA CiB V: QA O8 Approx. bldg. footprlnt (so:35,2?6 0 _ No. fevels (inci, trsmt.) ? Approx. # of heads: _( _! Sriefly describ6 the primary use of this bullding: Sprinkier System Design Basis SrieBy desuiba tbe swpe of work: 1??516?CI. S?1.Z1&466e_ SCl, ?13 0`13R 013D Edition: 01999 ?2002 O6therNFPA: ? Insurance Co. (attaon ietter) ? Partiai sysfem (attaCh Cotle OffiGial letter) ? Coda v3riance? Fjcplain[ 'Gheak thfs box +?Vl_acknowledging that 13R is the applicable stendard as no ather building credif.s (i.o. height, area, access) have been applisd to thls facility. Verify with the architect vr builder. Pailure 4o provide this ackoowledgment for a 13R d2sign may detay fhis plan raview and permission to commence worK on the projsct. . '01:'19/2007 FR1 13:33 FAY 651+558+3310 pp1. y Public Maln C3 Fire Pump (reted capeGty. Pressure.0TankiReservoir. gal. ('IB supply Is tr m a flre pump, pmvida fac[ory test curve or Ieteat field per€ormance tast antl indicate aflver typa.) Data of Tsst: 'r4 t?J? 'I7D wL Ltio ?W0 F?' f7K'!? k, , (?l l? ?jt'oLFiSs Static Prassure: osi Residuei Pressure: cst Flow: apm i/ Size of Main 7o BJdg: &?in. Combined W/Domestlc9? Y p N Size- in. SolanOid Provided? O Y? N System 7ype: 'I Wet ? Dry filPreaction ? Deluga 14J003/004 01/19/2007 12:38 6516810235 R.J. RY4N fAIJSTRUCT. PAGE 03184 m Station oC COntral Station Monitoring will te provided inr this system (>20 new beetls,>100 newlexisting heads) ?tereSoieu • '` ,'?pMYtIYP?t,??Sta'fiFaD'?°15Y1G??P?te,i.ia.. ;'?: - r, D?erijS.6alatif.: '_ ? -aiard•;.; ?,::?' ' : .' .: •. . . :..:_ _:?:.. .._ .. ,-? - -- .,- - ? - ? Classlfi , in.ii?S tttt?i5"s,; , UC?'! 7 ?? r/o C5lJ o vGf/o?l ?71 1 ggAc j/oN, , lO? ? • Miseeflaneaus storage as dafined in NFPA 93 appfies to this oxaupaney: OY ?v / • ls ihe roof slope greater than 21nches in 12 inches7 OY PfN If yes, roof slope is! . Flammablelcomb, liquld use or storage: QY XN If yes, detall informatian below • Aerosol siorage OY %N Ifyes, detal iMormation balow e Hazardous matertal use or storage pY * If yas, detaif iniormafion below . Plastic manuEacture or storage OY %N If yes, de4afl information helow • High-piled/rack storege (>12 ft) ?Y %M If yes, cornplete page 3 for HPS Detah aFhanrd(s):O???_ ft P(.--?lo4l I have completed the infoematfon on this form acwrately and to Me bost oP my knovAedge. If ihe design antlfor Saope of Work charges from that which is represented he2, I wiEl noGty the Cfty of Eagan's Building lnspectloro Dlvislon in a timety menner. ) havm read and unde` ?tanq innesota Stat+Me regarQinp Flre Protoc[ion licensing and th ior pmvkAn ntortr?adon. ? Printod Name Signature Email address: _ ??!? e°4"1 Requirements: 3830 Pilot Knob Road, Eagan Mn 55122 / a, 2? ?a?ou' Telephone # 651-675-5675 Fax # 651-675-5694 2006 FIRE SUPPRESSION SYSTEMS PERMIT APPLICATION City Of Eagan 2 comp]ete sets of drawings and specifications _d A>rr? - -d ?..mnnnPntc tr, hc n?A CWXIV- + r(e'-vtis Date , I / ?l / o SiteAddress: a,; 1-/ 0 LdnlE QhK PkR+_'(-jRy Tenant / Building Name: W k,-)-e NcsuS P C"?GM Co 1641t The Applicant is: _ Owner ? Contractor _ Other PROPERTY OWNER Address: City: State: Zip: CONTRACTOR /YlN CdAi(,JAy F F ct ?4rjff?e N4N License #: I Stfe? Address: 3I y W %;-1,H 5+. S4(j/ City: [??v M i? GTG? State: /N Nd Zip: Phone #: 9Ca °3y5"-3--f7G ESTINIATED COMPLETION DATE: c:':2 FIRE PERMIT TYPE: _ Sprinkler System (# of heads Fire Pump _ Standpipe ?c Other: ?fF .1 L K?'o 2 EnJ ? a SuRt G6 ?- f.a,?= 5S/6?? WORK TYPE: ? New _ Addition _ Alterations _ Remodel Other: DESCRIPTION OF WORK: X Commercial Residential _ Educational Other: Please continue on reverse side IN PERMIT FEE: $50.50 Minimum Fee (includes State Surcharge) Contract Value $ x.O1 =$ 3?. a7? Permit Fee • If Permit Fee is $1,000 or less, add $.50 => $ State Surcharge lf Permit Fee is over $1,000, add $.50 per $1.000 Permit Fee 3/4" Displacement Fire Meter - $167.00 $ TOTAL FEE: S 52) ' 5-0 I hereby apply for a Fire Suppression System permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Minnesota Building/Fire Codes; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be ia accordance with the approved plan in the case of work which requires a review and approval of plans. S-I-e,,?e KaSc ?.-?' 0:?' ,2%? ApplicanYs Printed Name ApplicanYs Signature DO NOT WRITE BELOW THIS LINE '?1 I t' ' ? ?tEQtrIitE13 IN3PP?'I?IOI?IS ?? ? ? ? `?`? t- ' M1?p ?{j-'?.? ? - x ? 3 ? P1oW rh?ry'larm ?u?PA?Te?t S?o?n Fa??l p c Cond?tiois of Tssuance ji, 5.tF?' 'l?i•ti;ip r ek : ii ?;? 4?F .? ?. ?tr? ? ik s? ?'t{ 'AE (?t . ? 4€ ?E 1l",f, i 3E' II ? qii' , j -? ` ff-I P81'fi11t;k?YI?Y U 1i??1d1114..nij3 Ant'.?16t?f? hot D&t? tn E e? i 0,i? y"?'1. n- iP. " b s ?? ? ? / J00416o 2007COMMERCIAL PLUMBING rFxrvtiT arrLicaTroN &U-1t d CITY OF EAGAN QIf??S ?? o C?C.I?- 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 ?iJ4`f' 05•Ot• O Date?/ ? /0-7 ?.---- SiteAddress Zv`{ I hJNc Unit# Tenant Name IVY Former Tenant Name Property Owner [ N1 iJ 4JZ-.Z??O t?'?t? ?? •-^-- pz?^r? Telephone #( ) Contractor r Address 1 Ito Akxo"-?? bC^-C' City State AAI"-- Zip J?12- Telephone#(65-() License # 5D-4"W Expires: T6e Applicant is _ Owner ? Contractor _ Other Work Type ? New Bldg _ Modify Space _ Irrigation System** 9t Yes No Work in public r-o-w / easement? RPZ _ PVB: ? New _ Repair/Rebuild _ Replace _ Remove Rain sensors are re uired on irri ation s stems Description of Work To mqmre if Pressure Aeducing Valve is r uired on new servic, ca 1 651-675-5646 Me[ers - Call 651-675-5646 to verify that hydrostatic, conductivity, and bacteria tests passed prior to picking up meter. Hzigation Size & Type Avg GPM 2" turbo req'd unless smaller size allowed by Public Works Fue Size & Price 3/4" meter $174.00 n 5 P Domestic Size & Type ? avg GPM _J2 Includes high demand devices? _ 1'es _ No Flushometers 7( Yes _ No PRV Required _ Yes _ No Permit Fee $50.50 mniinexan (includes State Surcharge) Contract Value $ e W, a?'? • V`? x l% Peimit Fee g Meter(s) Required on all new buildings & boulevard irrieation svs[ems $ Radio Meter Read $ ? DL? State Surcharge if nermit fee is less [han $1,000, surcharge is $.50 If nennit fee is more than $1,OD0, surcharge is $.50 Cor esch $1,000 owed. ---- _---- -'-____'-_-_"?' "_"'_'_'-'-""? ' Following fees apply when installing new lawn irrigation system $ Watei Pemnt Call [he City's Engineenng Department, 651-675-5646, for required fee amounts $ Treatment Plant ? (? EBWEP g ' Wa[er Supply & Storage u Ifll $ MAY 0 1 2007 I. 0Q StateStucharge WW ? g Total Fee I hereby apply for a Convnercial Plumbing Permi[ and acknowledge that the informa[ion is comple[e and accurate; that the work vnll be in conformance with the ordinancu and codes of [he Qry of Eagan and with [he Plumbing Codes; that I unders[and this is no[ permil, but only an applica[ion for a permit, and work is not to sta wrthou[ a pemiit; that the work will be in acwrdance wrth the approved plan in the case of wch requires a review and approval of p)ans. WL.-24 k Applica 's Printed Name Signature CITY USE ONLY ? I REQUIRED INSPECTIONS: Y U.G. ? Air Test _ Gas Test / Rough In 0 Final PLANS SUBMITTED APPROVED BY: BUILDING INSPECTOR General Information • Radio Meter Read {required on all new buildings. Boulevard irrigation systems may require a radio read -$153.00 • RPZ's must be tested every yeaz and iebuilt every five years. Test results should be mailed to Paul Heuer at the City of Eagan. • A minimum fee pemvt per address is requued for the following RPZ's: new, rebuild, renair, remove. • Water meters include copper hoin/shainer, remote wire, and touch-pad meter. METERS REOUIRING 4-HOUR ADVANCE NOT'ICE PRIOR TO PICK UP GPM METERS USE PRICE GPM METERS USE PRICE 1-20 518" residential $136.00 4-120 1-1/2" irrigation syst $ 855.00 disptacement or turbine** Public Works maxunum small commercial mast approve continuous meter size 10 2-30 3/4" lawn irrigation $174.00 4-160 2" tm'bine lazge iaigation $ 1,063.00 aximum m displacement residenlial system & continuous or productionlines 15 small commercial 3-50 1" displacement large residential $219.00 1/4 to 160 compound bldgs over $ 2,018.00 bldg to 24 uniu 65 units maximum small commercial 8= continuous & large comm bldgs 25 uri ation systems 5-100 1-1/2" 25-64 unit bldgs $532.00 inaximum displacement & continuous most conun bldgs 50 METERS REOUIRING 30-DAY ADVANCE NOTICE PRIOR TO PICK UP GPM METERS USE PRICE GPM METERS USE PRICE 5-350 3" hu'bine very large irrigation $1,411.00 6-500 4" compound +300 unit 61dgs $3,956.00 system & producrion & very lazga lines comm. bldgs 1/2-320 3" compound +200 unit bldgs $2,577.00 10-1000 6" compound +400 unit bldgs $6,623.00 very lazge ? very lazge comm bldgs comm bldgs 15-1000 4" turbine verylazge $2,533.04 6" wrbo $4,090.00 irrigation systems & producrion lines Comments • To schedule inspechon of the inside water line and backflow preventer, call 651-675-5675. • To arrange for watex tum-on, ca11 65 1-675-52 00. cc: UtiLty Drvision Sys[ems Analys[ December 2006 77Co3D 2007 COMMERCIAL MECHANICAL rERMiT arrLicnTiorr City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Ylease complete for. commerciallndusVial buildings multi-Camily 6uildin s when se arate emits are not re uircd for each dwellin unit P?. Da[e6 llU t Site Street Address z?Z40 LxyuJ (/a,4L /'(i(/ ?j?" Unit # Tenant Name (if applicable) Y y 1 N' 1(J ?CAN WM Previous Tenant Name Property Owner Telephone # ( ) ed I w r /? ? I ? COOtf2Ct0Y M ? , Street Address City hone # ( la5l 45G iVlLLJ 651a1 Tele VI ? Zi St t p p a e ? Bond #: Expires: 2 The Applicaot is _ Owner ? Contracror _ O[her Work Type Y-New Construction _interior [mprovement _Install Piping _ Processed _Gas _Exterior HVAC Unit*` *'HVAC units must be screened Under/Above ground Tank Install Remove When installing/removing tank(s), call for inspection by Fire Marshal and Plumbing Inspectox Nature of Work: / Permit F¢¢S $70.50 Underground tank mswllanoNremoval $50.50 Aftnimum (includes Sta[e Surchazge) ?y r Conhact Value $? x 1% _ $ •? Permit Fee $ oc?0o State Surcharge To calculate surcharge ? If Pertnit Fee is less [han $1,000, surc6arge is 50 cents. MAY 0 2 2007 If Permit Fee is> $1,000, swcharge increases by $.50 for each $1,000 Permit Fee (i e. a$1,001-$2,000 Peamt Fee requires a $1.00 surchazgc). _ „ $ 41 15a. QO Total Fee I hereby acknowledge that this information is complete and accurate; that the work will be in confomiance with the ordinances ana codes of [he Ciry of Eagan and wi[h the Mechanical Codes; that 1 understand this is not a permit, but only an applica 'on for a permit, and work is not to star[ without a permit; that the work will be in accordance with the approved plan in the c e of work which requires a review and approval of plans. Da,uv '!E410 auu) % ApplicanPs Printed Name AppLcant's Signa re ? Approved By: , Inspecror Date: Required Inspections: _ U.G. 6.1. YAir Tes[ - Gas Service Tes[ - Infloor Heat ZFinal 2007 COMMERCIAL MECHAIVICAL rExmuT Arri,icATiorr City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for. commercial/industrial 6uildings multi-familv bnildines when senarate nertnits arc not reauired for each dwelline utllt Loq?7?00 nere 3 i I4 i U-7 Site Street Address a-?'? LA'?? Cli0ile- r?7u'%LJ/, 946A1, 551-1"1 Unit # r' Tenant Name (if applicable) 44fN/TL Previous Tenant Name Property Owner Telephone # ( ) Cootractm ??- Street Address OL20 tbfJ rJ//J.?Q h+v5 !?• City .646NA/bAPouJ State /AZip ?¢Z7 Telephone #(7?? Bond#: Expires: Vv The Applicant is _ Owner ? Contractor _ Other Work Type New Construction _ Interior Improvement _ Install Piping _ Processed _ Gas Under/Above ground Tank Install Remove When installing/removing tank(s), call for inspection by Fire Marshal and Plumbing Inspec[or Nature of Work: P¢rtnlt F¢es $70.50 Underground tank insCalladon/removal $50.50 AfJnimm ??c / SQ JP or Contract Value $(o9.f? o? o. 00 X 1% _ $ kff- Permit Fee $ " 4-1-1° State Surchazge To calculate surcharge If Pecmit Fee is less [han $1,000, surcharge is 50 cents. If Permi Fec is> $1,000, surcharge increases by E30 for eacli $1,000 Penni[ Fee (i.e. a$1,001•$2,000 Permit Fee requires a E1.00 s? harge). ? $ Totai Fee / I hereby acknowledge that this information is complete and accurate; that the work will be m contormance wim me ormnances anu codes of the City of Eagan and with [he Mechanical 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 [he approved plan in the case of work which requires a review and approval of plans. 6,uc- CJt.S orj 00 o 4 a= ApplicanPs Printed Name App icanPs Signature ------------------- -------/? ------°-----------•---------------------- -------------------------------------- ------------•---°---------°-----------•----- Approved By: I7 1 ?- -2 -- U-7 , Inspector Date: - Required Inspections: _ U.G. L 1C.I. - Air Test __)fG as Service Test - Infloor Heat ?Final w or LI ?l W0?'uJ ?z a ?y o C.oct oa? Certificate of Deposit opened by White House Custom Colour in favor of City of Eagan Instructions on disposition of funda for Certficate of Deposit g'11?,?i5opened on 3?pj,^Voq by Vlhite House Custom Colour in Favor of t e City of Eagan." This certificate of deposit represents the financial guarantee for landscaping on Lot 1, Block 1, Waters Annex as required by the City of Eagan for $21,500.00. The City of Eagan has the right at its sole discretion to cash the Certificate as pertains to the landscaping requirements as outlined in the Development Contract(principle only). White House Custom Colour owner (opener) retains rights to the interest. The Certificate may not be cashed without acknowledgement by the City of Eagan either relinquishing its interest or decreasing its interest. The term of the Certificate is for two years at which time the City of Eagan will be required to sign off i£ the certificate is to be terminated. If the City of Eagan decides that it no longer has interest in the Certificate it will relinquish its interest via a letter signed by an authorized signer of the City of Eagan. As it relates to this Certificate, Bank of the West has no responsibility for any part of the underlying transaction. Bank of the west's role is that of standard verification beneficiary/owner. 4White t om Colour N:?,nk,cla? City of Eagan mdadi sANK&WEST CERTIFICATE OF DEPOSIT RECEIPT Branch Name: Inver Grove Heights - 00922 Date of Deposit: 03/0612007 Account Number: 922251509 Am unt of Depos$21,500.00 Today's Date: 03l06/2007 ity Date: 03/0612009 Branch Approval: Velita Frendrup ?o nitial Interest Rate: 4.41 Customer Name CMW DEVELOPMENT LLC Initial Annual Percentage Yeld: 4.50 and Address FBO CITY OF EAGAN c 2694 BARCLAY ST N Interest Payment Method: REDEPOSIT MAPLEWOOD, MN 55109 922251509 Pay Interest to Account #: Interest Payment Frequency: 1 MONTH Phone 651-646r8263 Term: 2 YEARS Deposit receipt nof needed for redemption. Renewal: AUTOMATICALLY RENEW Thank you for opening a Certif rate of Deposi[ wifh Bank of the West. Your account has been opened for the amount and tertns shown abare. Any questions regarding your Cer6ficale of Deposit can 6e answered by your b2nch or by caliing the Bank's Telephone Banking Center (800.48&BANK or 406-847-5030). INFORMATION REGARDING CERTIFICATE OF DEPOSIT ACCOUNTS Minimum Opening Balance $ 2,500.00 Minimum balance required to eam APY $ 2,500.00 ADDITIONAL DEPOSITS - Ii you wish to add tunds to your Certilirate, you may do so during the 10 calendar day grace period follaving the accounYs matur i lv ate. For 7-31 days erirflcates, you may add funds during the 1 calendar day grece periotl folbwing the matunry date. Interest on the adddional tunds botfi cash and nonqsh begins to accrue on the business day you deposit it and al the same rate in effect for the renewed Certificate. The additional funds will mature al the same time as the renewed CerMicate. The minimum amount for an atltlitional deposit is $100.00. THDR4WA - Interest which has been reinvesled may be withdrawn al any time, it the account term and interes[ rale have not changed slnce the renewal. ttwnal l withdrawals wimoul penalty are permitted, dunrg the 10 calendar day grace yeriod folbwing maturity (1 calendar day grece penod for 7-31 days Certificates) for automaticalty renewable Certifiwtes, or upon the death or menNal mcapaGty of the deposita. Accounts closed during the, grece penotl wili forterf aoy interest accrued dunng the grace period. Withdrawals at any other time may be permitted at the bank's discrelion and are sub)ed [o eady wNhdrawal penaltles. on as savings account, or or as a deoosit ro a is accrued on the daily balance. The annualpe rcentage yield assumes ihat interest eamed is reinvestad in the account monthly and all osit for one year frpn the date of deposd, and the interest rate does not change. Inlerest withdrawn during the lerm of the aaount vnll :rcentage yieltl eamed. TERMS OF 32 DAYS OR LONGER - You may choose the frequency of interesl paymenls. IMerest can bepa id as , but must be paid at least once a year. Interest may be reinvested mto the account, credtted to anolher Bank of the West checking or aid by check. TERMS OF 7-31 DAYS - You will receive interest at malurity only. Interest may be reinvesled into the Certificate of Deposit ank of ihe West checking or savings account. MATURITY - Automatically renewable Certificates of Deposit renew automatirally at the rate in eifecl on the maturity date, for the same term and under the same condilions last disclosed (uniess we tell you otheiwise). We will mail a maturity nodce approximate1y 15 days prior to the maturity date (ezcept for 7-14 days terms). The notice will inclutle a phone number you can call on the malurity date (or shortly after) to find oul the interest rate and annual percentage yieltl on your renewetl Certificate of Deposit. A nontenewable Certdicate of Deposit wlll not eam interest beyontl the maturity date, and wlll not renew auloma6tslly at maturity. EARLY ITHD WAL PENALTIES - All penalties are calculated on a simple interest basis. The penalty assessed may reduce the balance remaining on your accounlWer e vn ratl-id wal The penally is calculated at the inferest rate in etfeU al the Ume the Certrficate of DeOosit was opened or lasl renewetl. The penal?es on the amount withdravm are: 7-31 DAYS TERM - 7 tlays simple interest los[, 32 DAYS - 1 YEAR TERM - 30 days simple interest Iost, or OVER 1 YEAR TERM - 180 days simple interest lost. , SHANGES IN TERMS & CANDITIONS - When you open a deposit account with us, you agree to abide by the tertns & conditions detailed on ttiis paye and in t e Account Agreemen you s gn. We can chanye lhese lerms & condrtions at any time. We'll notify you in advance of any changes that aHect your nghls and obligations to the e#ent reqwred by law. You indicafe that you aaepl a change we make by continumg your account relationship unth us or, if the change aflecLS your certificate of deposit, by allowmg the cerfiricate to renew after the change becomes effective. DISCLOSURE OF YOUR ACCOUNT - Account Informalion may be disclosed to third parties when it is required fw govemmeMal repoAing for legal processes, or to parsons or companies w o the Bank believes would IegNmately use such informa4on. Certain transactions are also authomahcally reportaDle to the govemment. OTHER INFORMATION REGARDING DEPOSIT ACCOUNTS - AddiNonal information pertsining to the rules & regulaUOns goveming deposit accouMS can be prova3 you reques a cunent copy o the-6ank?t?Deposit AccouM Disclosure which is available by phone or in person at any of the Bank's brench offces. You may also call our Telephone Banking Center and request ihat we serM you a Deposit Account Disclosure. NON-NEGOTIABLE NOT TRANSFERABLE 120-01820 (Rev.11/O6) TmeDeposHReceiOt COPY DEL'D ? , C N C ? C aUi y? d 3 p dd O- o 6 W ? U N a? 0 m T d F Y C Y c ` O V ? °i m p w m ? ' '? N a mw `oa????m r `\ 1 ? CY WAIVER OF HEARING Special Assessment Authorization The undersigned hereby requests and authorizes the City oF Eagan, Ivfinnesota (Dako1a , ? Courny) to assess the following described property owned by it: Lot i Block 1, Waters Annex, City of Eagan, Courny of Dakota, Minnesota; for the benefrt received from the following iderni8ed public improvemern project: USE QUANTiTY Water Tmnk CI 4.47 Acres TOTAL to be spread over five (5) years at an annual interest rate of 5.5%. RATE $2,430/ acre AMOUNT $10,862.10 $10,862.10 The undersigned, for itself, its successors and assigns, hereby consents to the levy of these assessmems, and further, hereby waives notice of any and a11 hearings necessary, and waives objedions to any technicat defects in any proceedings retated to these assessments, and further waives the riglrt to object to or appeai from these assessments made pursuant to this agreemeK as provided for pursuarnto Mmnesota Statutes §429.081. DATID: I L I z$ f o?, awrEx: CSM EQUPI'IES, L.L.C., a Delaware limited liability company By:" S'o el L R??e Its: p C? C? i?I I? 9 ? DEC 1 8 2006 sTATE aF MESTxESOTA > > ss. COUNTY OF /A,,, cy;,, ) The foregoing instrument was aclmowledged before me thi 2006, by Tor ( Z. R,'e T z , the o n cr Delawaze limited liability company, on behalf of the com any. , !8 7? day of Klf of CSM Equities, L.L.C., a tary Public APPROVED AS TO FORM: City Attomey's Office Dated: t.wl S(u(- . JEAN M CROSBY -p NOTARY PUBLIC -MINNES07A -' My Commisskn F.xpi?as Jan. 31, 2010 APPROVID AS TO CONTENT: z4k Pu c Works Department Dated: l7-' f 9 -Ub THIS INSTRUMENT WAS DRAFTED BY: SEVERSON, SHELDON, DOUGHERTY & MOLENDA, P.A. 7300 West 147th Street, Suite 600 Apple Valiey, M'innesota 55124 (952) 432-3136 MGDfjlt (206-24765) ?(,,) g 7 r 2007 FIRE SUPPRESSION SYSTEMS rExmiT arrLicaTiorr City OfEagan 3830 Pilot Knob Road, Eagan NIN 55122 Telephone # 651-675-5675 Requiremen[s: 2 complete sets of drawings and specifications cut sheetc nn materials and wmnnnents to be used ab3.? Date 3 07 ? Site Address: 2840 t" OAK PARKWAY Tenant / Building Name: WHITE HOUSE CUSTOM COLOUR ` O C?! D D The Applicant is: _ Owner ? Contractor _ Other PROPERTY OVVNER Address: City: State: Zip: COIVTRACTOR Nardini Fire Equipment Co., Ina MN License #: N/A Address: 405 County Road E W City: Shoreview State: Minnesota Z]p; 55126 Phone #: ESTIMATED COMPLETION DATE: FIRE PERMIT TYPE: _ Sprinkler System (# of heads Fire Pump _ Standpipe ? Other: SPRINKLER RELEASING SYSTEM WORK TYPE: ? New Addition Alterations _ Remodel Other: DESCRIPTION OF WORK: ? Commercial _ Residential _ Educational Other: Please continue on next page PERMIT FEES 293, o0 Contract Value $ 27,000.00 x.O] _$ -2719--W Permit Fee $50.00 Minimum $ 't3"50`,5-0 StateSurcharge To calculate surcharge If Permit Fee is <$1,000, surcharge is 50 cents. If Permit Fee is >$1,000, surcharge increases by $.50 for each $1,000 Permit Fee, i.e. a$1,500 Permit Fee requires a $1.00 surcharge. 3/4" Displacement Fire Meter - $174.00 $ 0 Fire Meter TOTAL FEE: $ 283.50 I hereby apply for a Fire Suppression System permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Minnesota Building/Fire Codes; that 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. ROBERT CORRELL JR Applicant's Printed Name ApplicanYs Sign re DO NOT WRITE BELOW THIS LINE REQUIRED INSPECTIONS _ Hydrostatic _ Flow Alarm _ Drain Test x, Rough In _ Trip _ Pump Test _ Central Station ? Final Conditions of Issuance: i Permit Approved by. ? / Date: 3 / ?? rlqo 9- ( "Lnm FlRE CUNPPSCC1011V1 SYS?T'T?.' Mj PiR*,aa ?D?.?aT?e :T- City OF Eagan 3830 rilot Knob Road, Eagan ivfIv 55122 Telephone # 651-675-5675 . Requirements: 2 complete sets of drawings and specifications cut sheeu on materials and comoonents to be used ; i 74, .s-v Date 3 / 13 / C) -7 SiteAddress: o?r8q(7 LLx.n DGK F'Gr?Gc. ?n / i iZiiaui i"BLiiiuiiiS NaiTic: i 1 e.- t"?f?l/?SE. a iC?N'1 C.. C?l LpI.? The Applicarit is: _ Owner X Contractor _ Other PROPERTY OR'NER_ I??? ?1 Address: ?I C?C7 men poT'A- H eqhrs p+?• c,ty: M-ejoor4 1-J21GK_ ?T S State : /hN Zip: 5'5`);1O COIVTRACTOR 5c,wwnrT' r?? I'?o?e,?? w MN' License #: Cr D1S Address: 15-7S A'lthneAcj+a •}v2 City: 5l. P4.1 State: Mo Zip: SS/U7 Phone#: (qj'1-dSt-lK6p ESTIMATED COMPLETION DATE: W?- F1ItE PERMIT TYPE: ?C Sprinkler System (# of heads 4i`1D _ Fire Pump _ Standpipe Other: WORK TYPE: X New Addition Alterations Remodel Other: DESCRIPTION OF WORK: ?i Commercial Residential _ Educational Other: ?<?aYz ccafir«e On ne:tit Palce PERNUT FEES Contract Vafue $ )00ppp" x.01 =$ Permit Fee $50.00 Mirumum $ Q.S'U StateSurchar;e To calculate surcharge If Permit Fee is <$1,000, surcharge is 50 cents. If Permit Fee is >$1,000, surcharge increases by $.50 for each $1,000 Permit Fee, i.e. a$1,500 Permit Fee requires a $1.00 surcharge. 3/4" Displacement Fire MeYer -$174.00 $ /-7 .0b Fire Meter TOTAL F`EE: S ?I -;q So- I hereby apply for a Fire Suppression System permit and aclmowledae that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the ' Minnesota Building/Fire Codes; that I understand this is not a permit, but only an application for a permit, and work is not to scartwithout a permit; that the work wil] be in accordance with the approved plan in the case of work which requires a review and approval of plans. &CLT Seyne? Appiican'L'sPriYitedName Applicant'? giistcdre DO NOT WRITE BELOW THIS LINE REQUIRED INSPECTIONS Hydrostatic ? Plow Alann _ Drain Test ? Rough In ti Trip _ Pump Test _ Central Stafion ? Final Conditions of Issuance: Permit Aogroved b. Date: r7SL a?-- I k 3 3 tr? 2007COMMERCIAL PLUMBING rERMIT arrLicaTiorr CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 Do not combine inside and outside plumbing on the same application;, separate applications and permits are rani iirarl Date nI/? ' i Si[e Address r7 g? o F {q? Y Unit # Tenant Name _u.s(-am Co U.J-earmer Tenant Name Property Owner Telephone # ( ) Contractor Address L a CitS State 1M I 1? / Zip Telep6one #( ) License # ?O ?( F I 1 I Expires: I2 31 D The Applicant is _ Owner _ Contractor _ Other Work Type New Bldg _ Modify Space %,4irigation System** Yes No Work in public r-o-w / easement? RPZ PVB: New _ Repair/Rebuild ! Replace _ Remove Rain sensors are re uired on irri ation s stems Description of Work To inquire if Pressure Aeducmg Valve is required on new service, call 651-675-5646 Meters - Ca11 65 1-675-5646 to verify hat hydrostatic, conductivity, and bacteria tests passed prior to oickina uo meter. Irrigation Size & Type ? Avg GPM 2" turbo ?req'd unless smaller size allowedby 7PubficWorks Fire Size & Price 34" meter 7$ 74.00 Domestic Size & Type Avg GPM Includes high demand devices? _ Yes _No Flushometers Yes No PRV Required _ Yes _ No Permit Fee $50.50 minamum (includes State Surcharge) 1 Contract Value $ x 1% _ $ Permit Fee $ 00Nteter(s) Required on all new buildings & boulevazd im ation s stems $ Radio Meter Read $ State Surcharge If permit fee is less than $1,000, surcharge is $.50 If oertnit fee is more than $1,000, surcharge is $SO for each $1,000 owed. Following fees apply when installing new lawn irrigation system $? ?• 00 Water Permit Call the Cit}+s Engneering Departmen[, 651-675-5646, for required fee amounts ' Treatment Plant ?$ -D - Water Supply & Storage g o ?D State Surcharge $ TotalFee :.?. .,.e I hereby apply for a Commercial Plum6ing Pcrnvt and aclmowletlge that the mtormanon is compiece anu au:uraLc, uwt u« wo?. ..,w?,, ?..??..,.,,? ........ ...... .... ordinances aad codes of [he City of Eagan and with [he Plumbing Codes; that I understand [his is not a pemtit, but only an applicarion for a pertnit, and work is not to start without a pemtit; that the work vriil be in accordance with the approved plan in lhe case of work which requires a review and approval of plans. Applicant's Printed Name ApplicanYs Signature 2007 COMMERCIAL PLUMBING rERrvuT arrLicaTioN CITY OF EAGAN 3830 PILOT KNOS ROAD, EAGAN MN 55122 ?e, cnc eG^!c ?-!!? 0 0A66/f- VJl'V1J-?V?.? Date?? r? Site Address yO??(??(??Uy'Tl!?y? ?,l l? Unit # I Tenant Name WIL ei Tllll? cdWyFormer Tenant Name Property Owner Telephone # ( ) Contractor ? O lt r I? ' Address 'llio City State Zip ?S I Telephone # ((D51) -? License # Expires: I a-5 10- Tbe Applicant is Owner ontractor _ Othec Work Type New Bldg Modify Space _ In-igation System** Yes No Woik in public r-o-w / easement? pug: Repair/Rebuild _ Replace _ Remove Rain sensors are re uired on irri ation s stems Description of Work L/ ? V?M! i i12-i 1 1Q_PZ To inqmre if Pressurc Reducmg Valve is reqmred on new service, call 651 675 5G46 Meters - Call 651-675-5646 [o verify that hydrostahc, conductivity, and bacteria tests passed orior to uickin¢ up meter. Irrigation Size & Type Avg GPM 2" turbo req'd unless smallec size allowed by Public W orks Fire Size & Price 3/4" mecer $174.00 Domestic Size & Type Avg GPM ' Includes high demand devices? _ Pes _ No Flushometers _ Yes _ No PRV Required _ Yes _ No Perntit Pee $50.50 narnimum (includes State Surcharge) Conta'act Value $ x 1% _ s 5Di M Peiinit Fee $ ?'- Meter(s) $ ?-" Radio Meter Read Required on all new buildings & boulevard irrieation svstems g State Suichazge If permi[ fee is less than $1,000, surchurge is $.50 If permit fee is more than $1,000, surcharge is $.50 for esch $1,000 owed. "_""__---- ' ' ' ' ' ' ' _ _ ' ' ' ' ' ' ' ' ' " _ _ _ " -' _ _ _ _ ' _ ' ' ------------------------------------------------- WaterPemut Following fees apply when installing new lawn irrigation system $ Call the Crty's Engineering Depanment, 651-675-5646, for required fee amounts Treatment Plant $ Water Supply & Storage $ State Surcharge g Tota Quf7onformance wi the I hereby apply for a Commerciai rmmomg reuuu e:-- °-°• -° °------ -- ordinances and codes of the City of Eagan and with the Plumbing Codes; that Iumderstand this is not a permrt, 6ut oNy an applicahon sta wichout a perniir, that the work will be in accordance with the approved plan in theCcase of work Ich reqwres a r i and a pf`.? ? • ? ? Applican['s Pr nte Name pp can s' a re =/ 443 Lafayette Road N. xEPARTMENT OF (651) 2s4-5oo5 St. Paul, Minnesota 55155 1-B00-DIAL-DLI www.doli.state.mn.us INDUST.RY TTy: (651)297-4198 August 7, 2007 APPROVED FOR USE CMW Development Co. 161 N. Snelling St. Paul MN 55104 RE: Vertical Reciprocating Conveyor - Elevator ID# -14302PT07-05 Site: White House Custom Colour 2840 Lone Oak P wy. Dear SirlMadam Minnesota Statutes Chapter 166 provides that the Department of Labor and Industry, Building Codes and Standards Unit, Elevator Safety Section, inspect and approve elevators and manlifts (endless belt lifts) before they can be Iegaliy used in Minnesota. An Inspector from the Elevator Safety Section recently inspected your facility and determined it meets requirements of the Minnesota Elevator Safety Code. NOTE: Compliance with Minnesota Rules and the ANSI/ASME A17.1, Safety Code for Elevators and Escalators does not necessarily assure compliance with the Americans W ith Disabilities Act of 1990. NOTE: NEED TO WIELD CROSSHEAD. Sincerely, BUIL1W.eeve ODES ND STANDARDS Gary S tate Elevator Inspector gwr/rsg (CE-2) c. Schoeppner, Dale R., BO, City of Eagan Loading Dock Specialists Inc. R. J. Ryan ElFormCE2 This informa6on can be provided to you in allernative formats (8raille, large print or audiotape). An Equal Opportunity Employer City of EaiaIl 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 6755675 Fax: (651) 675-5694 ----------------, ? FOf 0((?yl$6 ? I ' ?3 ss" ? ? Pertnit Permit Pee: ? Data Fieceived: ' ? Staff: i - - - - - - - - - - - - 2008 MECHANICAL PERMIT APPLICATION Date: Q" Site Address: .' )- 0 4[) L , u? 3(1- ?C E ?? Tenant: ? V? y. t ? C ?. ? .> •l' Suke #: RESIDENT / OWNER Name: Phone: Address / City / Zip: CONTRACTOR Name: 41&a.e_ L. _L e Q License Address: C-Q City: c- State: ?V,, Zip: "' - - Phone: ContactPerson: O TYPE OF WORK - New _ Replacement ? Additional _ Alteration _ Demolition Description of work: NOTE: Both roof mounted and ground moumed mechanlcal equlpment Is requl?ed to ??. be, Screened 6y Clty Code. Please contact #he Mechanica! Irtspector or o»e of the P/anners /or fnfom?eHon on permitted screen/n methods. RESIDENTIAL COMMERC/AL PERMIT TYPE Intenor Improvement Y New Construction . Fumace _ Air Conditioner _ Install Piping _ Processed Air Exchanger - Gas _ EMeriorHVAC Unit ' HVAC units must be screened _ Heat Pump Under / Above graund Tank ? tnstall / Remove) Other " When installing/removing tank(s), call for inspection by Fire Marshal and Plumbinci Ins or RES/DENT/AL FEES: ' $50.50 Minimum Add-on or alteration to an existing unit (includes $.50 State Surcharge) $90.50 Fire repair (replace burned ouc appliances, ducnvork, etc.) (includes $.50 State Suroharge) , , ._. , $ TOTAL FEE COMMERC/AL FEES: ? `fa 3 x 7%, -_ ?.. - $70.50 Underground tank insfallatioNremoval OR Contrect Value $ $50.50 Minimum (includes State Surcharge) . ` _ ? ? 3 ' $ • - n Permit Fee - - If Permi Fee is lees than $7,000, surcharge is $.50. s(? ' Surcharcje - If Permi ? is >;1,000, surcharge increases by $.50 for each =$ ? State $1,000 Pertnit Fee (i.e. a $1,001-$2,000 Parmit Fee requires a $1.00 surcharge). " ' ' qO ' ' $ ? ? '`?J -L:-l'OTAL FEE I here6y acknowledge that Mis information is complete and accurate; that the work will be in coMormaoce with ihe oMinances and cotles of the City of Eagan; that . I understend ihis is not a permit, but only an application for a permit, and work is not to stan without a permit; that the vrork will be in accordance with the approved plan in the case oi vrork which requires a review and appmval W plans. x ?l 'WL4e- r x ApplicanYs Printed Name Applicant's Signature • f FOFFOFFICE USE.: p, Revlewed By: .. . f1' Dste: r ` ; Required lnspectlons: .,_ ,_Under Ground ? Rough In _Air Test 0 Gas Seruice Test In-floor Heaf d'Final r 411? , City of EapIl 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 - ---------, j Foi Office Usa I I ? I Permit#: ? j Permit Fee? I ? ? Date Received: ? I ? I ? StaH: ? ----------------- 2008 FIRE SUPPRESSION SYSTEMS PERMIT APPLICATION" Date: 6 23 08 SiteAddress: 2940 Lot.,F pAk PARKw/A-r EAG,,N MN 55?z? Tenant: Suite #: PROPERTY OWNER Name: W H IT[ HOUZE C%J5'roM COLovR phone: 651" 646- 8253 Z0,90 LONE QAK PARkWA-f Eq601j, MN 5rJ121 Address/ City /Zip: Applicant is: _ Owner x Contractor TYPE OF WORK Description of work: PpD"r?E SpR%tixLCR C3,,tQA(-E J'J NEJ Af_)Dir,oN ro ( Construction Cost: 11 -45, 150, zL- Estimated Completion Date: iZ I 08 CONTRACTOR Name: Sj Mm "T FiRe prxoc[c.T?oN License#: C'0-45 Address: 5?5 MltiNEuquA Avv:uvL W. Ciry: SAI"J' PA`'L' State: N Zip: 55t03 I9?? 651- 251- Gn?to FRCjcL1 Phone: Contact Person: FIRE PERMIT TYPE WORK TYPE x Sprinkler System (# of headsW) New Fire Pump - X Addition Alterations _ Standpipe Remodel Other: Other: DESCRIPTION OF WORK: X Commercial _ Residential _ Educational FEES * $50.50 Minimum (includes State Surcharge) OR Contract Value $ I50• x 1°k 0 _ $ Permit Fee - If Permit Fee is less than $7,000, surcharge is $.50. 12 h S S - N Permit Fee is >$1,000, surcharge increases by $.50 for each urC arge tate =$ V. $7,000 Permit Fee (i.e. a$1,007-$2,000 Permit Fee requires a$1.00 surcharge), $ oO $ TOTAL FEE 3/4" Displacement Fire Meter -$183.00 $ ig 3. Fire Meter ? ? q35. TOTALFEE $ `Requirements: 2 complete sets of drawings and specificatlons, cut sheets on matenais ana componencs co oe usea I hereby apply for a Fire Suppression System permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the Ciry of Eagan and with the Minnesota Building/Fire Codes; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Do.,Jko FacNCU -'? x X ApplicanYs Printed Name ApplicanYs Signature iun.V. FOR OFFICE USE REQUIRED INSPECTIONS ? Hydrostatic _ Flow Alarm ? Drain Test ? Rough In _ Trip _ Pump Test _ Central Station Final T? Conditions of Issuance: Permlt Reviewed 6: Date: City of EapIl 3830 Pilot Knob Road Eagan MN 55122 Phone:(651)675-5675 Fau: (651) 675-5694 Tenant: L-il 7 ?&01 Cjqx?' 4., p6k-?s JUL 2 3 2008 RESIDENT / OWNER Name: Phone: Address / City / Zip: CONTRACTOR Name: ? G Q,n L(? ('? License #: ?1J,'7 Address 5' 440 I rD/Zu;DGCY L?? rG?G 05-0 City: ?vqrrS State: "f Zip: P f u m Phone: Contact erson: TYPE OF WORK - New _ Replacement _ Additional _ Altera6on _ Demolition Description ot work:>! : 4? ls- s? NOTE: Both roof mounted and ground mounted mechanical equipment is requi?ed to be screeneal by City Code. Please conhact the A9echanlcal Inspector or one of the Planners for information on poiTnttted screenin methods. PERMIT TYPE RESIDENT/AL / COMMERC/AL V Fumace New Construc[ion _ Interior Imprwement k"'I P d _ Air Condiiioner rocess6 nstall Piping _ Air Exchanger ? as _ Ec[erior HVAC Unit ' _ HVAC units must be screened _ Heat Pump Under / Ahove ground Tank L- Insfsll /_ Remove) pt{m " When ins[allinyremoving tank(s), call for inspection by Fre Marshal and Plumbin Ins tor RES/DENT/AL FEES: $50.50 Minimum Add-on or alteration to an existing unit (includes $.50 State Surcharge) $90.50 Fire repair (replace bumed out appiiances, ductwork, e[c.) (includes $.50 State Suroharge) $ TOTALFEE COMMERCIAL FEES: 1F 5 oc-6 ' ' x 7% $70.50 Underground tank installation/removal OR Confract Value $ $50.50 Minimum (includes State Surcharge) d 1199 Permit Fee - It Permd Fee is less than 57,000, surcharge is $.50. h 00 S S I urc arge tate • - If P rmi Fee is >§1,000, surcharge increases by $.50 for each =$ $1,000 Pertnit Fee (i.e. a$1,001-$2,000 Permi[ Fee requires a$1.00 surcharge). ? 0 TOTAL FEE $P - ??A" i nereoy acnnowieage mat mis imortnaoon is compiece ano acwrate, matme vronc vnn ce in comortnance wim me ominances ena coues oiuie ?iry o, aayar,; u.. I urWersfand this is not a pertnit, but only an applica6on tor a pertni[, arid work is not to sWA without a pertnd; that the work will be in accorAaxe with the approvetl plan in the case of work which requires a rewew antl approval W plans. x ?si-c4 ?f f ,,n kI n ?-?--,,•?-?- Ap IicanY Prin Name ?- Appli s Signat FOR OFFlCE USE By: -----------------, ? For Office Use l t I ? Permit#: ? Permit Fee: b SI r Q(./ j i ? ? Daze Received: ? I ? i smn: r-' j . ---?u, Daffi: Required Inspections: _Under Ground -)(?Rough In -)?-Air Test _Gas Service Test _In-floor Heat 2008 MECHANICAL PERMIT APPLICATION City of Eapn 3830 Pflot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax:-(851) 675-5694 a?a& (,? C,?kc.?- ?+ pl&VAs ----------, i For ONice Us ? Permit , ?, ? Pertnit Fee: I ? Date Received:C/V' a ??.r?anc?oe J 2008 FIRE SUPPRESSION SYSTEMS PERMIT Dme- 8/5/08 Site Address: 2840 Lone Oak 7enant: White House Custom PROPERTY OWNER Name: Phone: Address / Ciry / Zip Applicant is: _ Owner _ Contractor TYPE OF WORK Description os work: New notification and detection for pre-action system expansion. Construction Cost $18,467.00 Es6ma[ed Completion Date: 9/29/08 CONTRACTOR Name: Nardini Fire Equipment License u: TS00686 Address: 405 County Road E W City: Shoreview State: MN Zip: 55126 Phone: (651) 483-6631 Contact Person: Mac A Nelson [I FIRE PERMIT TYPE WORK TYPE _ Sprinkler System (# of heads ? New ? Addition Fire Pump Standpipe _ Alterations j/ Other: Pre-action system expansion. - Remodel Other: DESCRIPTION OF WORK: _Z/Commercial _ Residential _ Educational FEES $50.50 Minimum (includes State Surcharge) OR Contract Value $18.467.00 x 1°k _ $184.67 Permit Fee - It Pertni[ Fee is less than $1,000, surcharge is $.50. - If Permit Fee is > $7,000, surcharge increases 6y $.50 for each =$ 0.50 State SurChafge $1,000 Permit Fee (i.e. a$1,007-$2,000 Permit Fee requires a$1.OD surcharge). $185.17 TOTAL FEE 3/4" Displacement Fire Meter -$783.00 $ Fire Meter $ TOTAL FEE •Requirements: 2 complete seis of drawings and specifications, cut sheets on materials and components to be used I hereby apply for a Fire Suppression System pertnil and acknowledge ihat the infortnation is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Minnesota Building/Fire Codes; that I undersfand this is not a permit, but only an application for a permit, and work is not to slart wiihout a permit; thal the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. ,,? ? x Mac A. Nelson II x `l?i a"?-`u ! ApplicanPs Printed Name Applicant's Signature FOR OFFICE USE REQUIRED INSPECTIONS _ Hydrostatic _ Flow Alarm _ Drain Test ? Rough In _ Tnp _ Pump Test _ Central Station Final T? Conditions of Issuance: ? Date: v , 13 iSLa V Permit Reviewed by Use BLUE or BLACK Ink I For Office Use 4011b~ EaRd n City of Ci I Permit 5D Permit Fee: 3830 Pilot Knob Road j Eagan MN 55122 Date Received: Phone: (651) 675-5675 Fax: (651) 675-5694 Staff: ~j~'~b>xf2 2010 MECHANICAL PERMIT AP CATION JN Date: ! Site Address: aili~ Tenant ( IA r- Suite RESIDENT / OWNER Name: U.at 1-e )CALL 1 ~ rf-\ Phone: Address / City / Zip: CONTRACTOR Name: Wd2anicxV n(., License Address:: 1~ (1 tt non tom.`~ruJC 7 l...l` rcC e-70 c2iS*: TYK&CS State: Ut 'j Zip: ~ Phone: 1 <Jr J ~ ' a~~3 Contact:~am Email: h., TYPE OF WORK New Replacement Additional Alteration Demolition Description of work: : N PT 's NOTE: Roof mounted-a" ground mounted mechanical equipment is required to be screened by City Code. Please contact the Mechanical Inspector for information on permitted screening methods. PERMIT TYPE RESIDENTIAL COMMERCIAL Furnace New Construction _ Interior Improvement Air Conditioner Install Piping _ Processed _ Air Exchanger Gas _ Exterior HVAC Unit Heat Pump _ Under / Above ground Tank Install / _ Remove) When installing/removing tank(s), call for inspection by Fire Other Marshal and Plumbing Inspector RESIDENTIAL FEES: $50.50 Minimum Add-on or alteration to an existing unit (includes $.50 State Surcharge) $90.50 Fire repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) $ TOTAL FEE COMMERCIAL FEES: $70.50 Underground tank installation/removal OR Contract Value $ 010 / 0 ' x1% $50.50 Minimum (includes State Surcharge) y, $ Permit Fee - If Permit Fee is less than $1,000, surcharge is $.50. - If Permit Fee is > $1,000, surcharge increases by $.50 for each Surcharge $1,000 Permit Fee (i.e. a $1,001-$2,000 Permit Fee requires a $1.00 surcharge). sU TOTAL FEE CALL BEFORE YOU DIG. Call Gopher State One Calf 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.orci 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; the work will be in accordance with~th pproved plan in the case of work which requires a review and approval of plans. x I ~'l~(f W f'ti ~l~Gvh V G> Applicant's Pri ted Name Applicant's S' ature FOR OFFICE USE Reviewed By: Date: 6 Required Inspections: Under Ground Rough In Air Test as Service Test -in-floor Heat ,Final Exterior HVAC Screening Inspection Use BLUE or BLACK Ink w I For Office Use My O~ i Permit f V of I Permit Fee: 3830 Pilot Knob Road I I Eagan MN 55122 I Date Received: I Phone: (651) 675-5675 i j Fax: (651) 675-5694 AGG / 4 2011 Staff: 2012 COMMERCIAL PLUMBING PERMIT APPLICATION Please submit two (2) sets of plans with all commercial application ` Date: Site Address: I Tenant: W t Q(~ Suite PROPERTY a OWNER Name: Cis ~l Phone: (CS1 40` u463 Name: i \2C O.r~~rcaS~ x Gi.Q(k(, C a.L License CONTRACTOR " Address: tM~ Labof,_ tr 4 - C City: CUftaf4l tTI~ State: Zip: ~S5_11 0 Phone: LARd" [ t 2 Email: TYPE OF _ New _ Replacement - Repair _ Rebuild - Modify Space _ Work in R.O.W. WORK Description of work: COMMERCIAL New Construction _ Modify Space _ Irrigation System yes no) ( RPZ / _ PVB) • Rain sensors required on irrigation systems PERMIT TYPE . Avg. GPM (2" turbo rsgt**d 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: $60.00 Minimum (includes $5.00 State Surcharge) OR Contract Value $ x1% Permit Fee Required on ALL new buildings and boulevard irrigation systems + $ Radio Meter Read If the Permit = is less than $10,010, the surcharge is $5.00 $ Meter(s) If the Pe= Fee is > $10,010, the surcharge increases by $.50 for each $1,000 Permit Fee i.e. a $10,010-$11,000 Permit Fee requires a $5.50 surcharge) $ State Surcharge Following fees apply when installing a new lawn irrigation system $ Water Permit Contact the City's Engineering Department, (651) 675-5646, for required fee amounts. $ Treatment Plant $ Water Supply & Storage $ State Surcharge TOTAL FEE C L BE,FQRE YOU l)IG. 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.gogherstateonecall.org I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. x 5o-t_ Tooo X T T Applicant's Printed Name Applica 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 Use BLUE or BLACK Ink �-----------------� � �Z-� PI�;/l.,� �� j Perm��,�0 �� 1 ' Cit of�a aIl -� . b. � 1, � ; � � �, . i Pertriit Fee: �/LY � � 3830 Pilot Knob Road Eagan MN 55122 � �C� � � Z�� i � �' i P hone: (6 5 1)6 7 5-5 6 7 5 �� ,�Q � Date Received: � , : '''"""1 � 1 Fax: (651)675-5694 . . - � Staff: � .�� .��..�! 2014 COMMERCIAL BUILDING PERMIT APPLICATION �� " Date: 10/07/14 Site Addr�ess: 2g40 Lone Oak Pkwy Tenant Name: CMW Development LLC (Tenant is: New I�F�dsting) Suite#: Former Tenant: Name: CMW Development LLC Phone: (800)252-5234 Property Owner Address/City/Zip: %2840 Lone Oak Pkwv Eagan MN 55121 Applicant is: Owner �Contractor Type of Work Description of work: Photovoltiac Installation Construction Cost:$58,000.00 Name: Sundial Solar Consultants License#: IR657533 Contractor Aadress: 4708 York Ave S ��y. Minneapolis State: MN Zip: 55410 Phone: �612)926-8506 (240)463-3688 Contact: Michael Kampmeyer Email: ��Pmeyer@alternativeenergygroupllc.corn Name: Mattson Mcdonald Young Inc Registration#: MN No.47773 Archite+ct/Engineer Address: Basset Creek BUS CTR 901 North 3rd St.#100 C�y. Minneapolis State: MN Zip: 55401 Phone: 612-827-7825 Contact Person: Adam Nei�ebauer Email: adamn@mattsonmacdonald.com Licensed plumber instaliing new sewerlwater service: Phone#: NOTE:Plans and supporting c�cument,s i�rrat yau submit ane cansidered ta be pubiic irrformatior►. Portitrns of the ir►formation may be c/assified as narr public if yau prov�de sp�ciiic reasans that wautd�rmit the City#o conclude that the ar�e 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.orq I hereby acknowledge that this information is �mplete and accurate; that the work will be in conformance writh the orciinances and codes of the City of Eagan;that 1 understand this is not a permit, but only an application for a perrnit, and work is not to start without a permit;that the work will be in accordance with the approved plan in the case of wo ich requires a review and approval of plans. X Glen Goldsby X ApplicanYs Printed Name Applic t's Signature Page 1 of 3 � . ��y� �� --�� '�� DO NOT WRITE BELOW THIS LINE SUB TYPES Foundation _ Public Facility _ E�cterior Alteration–Apartments ✓-Commercial/Industrial _ Accessory Building _ E�cterior Alteration–Commerciai _ Apartments _ Greenhouse/Tent _ Exterior Alteration–Pubiic Facility Misceilaneous Antennae WORK TYPES _ New _ interior Improvement _ Siding _ Demolish Buiiding" �ddition i/' Exterior Improvement Reroof Demolish Interior ✓ Aiteration ��' _ Repair _ Windows _ Demolish Foundation _ Replace � _ Water Damage ____ Fire Repair _ Retaining Wali _ S81on Owner Change *Demolition of entiroe building—give PCA handout to applicant DESCRIPTION � Valuation �$�o�� Occupancy �� MCES System � Pian Review � �,/�� Code Edition t`K-5� SAC Units �' (25%_100%_) �— Zoning �� City Water '�'�� Census Code Stories Booster Pump '�"–� #of Units Syuare Feet PRV �— #of Buildings Length Fire Sprinklers �— Type of Construction � Width REQUIREO INSPECTIONS Footings(New Building) Sheetrock Footings(Deck) F' al/C.O.Required Footings(Addition) Final J No C.O.Required Foundation Other: Drain Tile Pool:_Footings Air/Gas Tests _Final Roof:_Decking _Insulation _Ice&Wa#er _Final Siding:_Stucco Lath _Stone Lath _Brick ✓Framing Windows Fireplace:_Rough In _Air Test _Final Retaining Wall Insulation Erosion Control Meter Size: Final C/O Inspection: Schedule Fire Marshal to be present: Yes �" No '�_ �"`�' � l' i we B . `"V s/�•--s Plannin Reviewed By: , Bu�iding Inspector Rev e d y• g COMMERCIAL fEES Base Fee '7`�� ?`�~ Water Quality Surcharge _ ��.� Water Sampling Fee Plan Review ��d�� 1 Water Supply&Storage(WAC) MCES SAC Storm Sewer Trunk City SAC Sewer Trunk S8�W Permit�Surcharge Water Trunk Treatment Plant Street Lateral Treatment Plant(Irrigation) Street Park Dedication Water Lateral Trail Dedication Other: Water Quality TOTAL `o�� . � Page 2 of 3 Use BLUE or BLACK ink '*City f�i t] gn For Office Use �6 of Eatail I Permit#_ �4' '90 j 1 &c I Permit Fee: 3830 Pilot Knob Road I i Eagan MN 55122 Date Received. I (651)675-5675 i buildinginspections(ucityofeagan.corn j Staff: i 2017 COMMERCIAL PLUMBING PERMIT APPLICATION ❑ Please submit two(2)sets of plans with all commercial applications. Date: 9/19/17 Site Address: 2840 Lone Oak Parkway Tenant: White House Custom Colour Suite#: t Property x Owner' Name: Phone: 651-646-8263 i NAC Name: License#. PC642594 r Contractor Address 1001 Labore Industrial Ct. City. Vadnais Hts. State MN Zip 55110 , Phone: 651-490-9868 Email: service@nac-hvac.com Type of Work —New _Fjepfacent = Repair f Rebuild _Modify Space Work in R 0 W. Description of ork: full rebuild j COMMERCIAL New Construction Modify Space Irrigation System( yes I no)L RPZ/_PVB) • Rain sensors required on irrigation systems Permit Type • Avg.GPM (2"turbo required unless smaller size allowed by Public Works) Meters Call(651)675-5646 to verity that tests passed pnor to picking up meter. Domestic:Size&Type Fire: 1 i Avg.GPM High demand devices?_Yes_No Flushometers Yes No COMMERCIAL FEES Contract Value$ x.01 $60.00 Permit Fee Minimum 60.00 $60.00 PVB/RPZ Permit(includes State Surcharge) = $ Surcharge Surcharge=Contract Value x$0,0005 - If the project valuation is over$1 million,please call for Surcharge =$ �O TOTAL FEE Following fees apply when installing a new lawn irrigation system $ Water Permit Contact the City's Engineering Department,(651)675-5646,for required fee amounts $ —Treatment Plant s i Water Supply&Storage s $ „,„„„„�_ _:, . „.. . „�. . ..____ State Surcharge =$ 60.00 TOTAL FEE You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvoreagan.comtsubscribe. CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of Eagan;that I understand this is not a permit, but only an application for a permit,and work is not to start without a permit;that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans, xPaula Jackson ' t . x Applicants Printed Name Applicant's Signatqe FOR OFFICE USE Approved By: Date: Required inspections: Under Ground Rough-ln Air Test Gas Test final PRV Required: Yes—No Meter Related Items: Meter Size Radio Read Manometer Staff: Page 1 of 3 03/16/2018 FRI 12: 06 FAX 1002/005 f For Office Use - C-14 9IL7 �4 % i 0 :::t:ee EAGAN : ,„,G) - � Date Received: 3830 PILOT KNOB ROAD I EAGAN,MN 55122-1810 (651)675-5675 I TDD;(851)454-8535 I FAX:(651)675.5694 Staff: pulldlnalnsoectloneelcltvofeagatt.cotrt 2018 COMMERCIAL PLUMBING PERMIT APPLICATION 0 Please submit two(2)sets of plans with all commercial applications. Date: 3/16/2018 Site Address: 2840 LONE OAK PARKWAY,EAGAN,MN 55121 Tenant: WHITE HOUSE CUSTOM COLOUR Sults#: 9v 4 ,+ i ±',1•ii i r1 s _h��it' Name: TONY SELBITSCHKA Phone 651-428-6658 gg`iNr.x.i AOR.Piiii. Name' NAC MECHANICAL&ELECTRICAL SERVICESLicense#; TLIC16812';01 r flf},^° Address: 1001 LABORS INDUSTRIAL COURT,SUITE 8 Cil : VADNAIS HEIGHTS She, MN zip: 55110 Nil� ��,�� ,:',f ,a��.7�°';'`i; 651-490.9868 . SERVICEONAC-HVAC.COM �y�;� ti •r,,A4, ,,1�.11Pi, Phone: Email. ita..6.1' ia ++ we✓4' ✓ New Replacement _Repair _Rebuild _Modify Space _Work in R.O.W. `,i?,.,1 algia 'i"I$`' '� {'"4 Description #5 ADD RPZ BEFORE RO.#21 ADO RPZ BEFORE CHEMICAL MIXER "'��,�•trs,•,a,•a. l�,s.�,! of work; Op''i,i�t'?1'4"i:'/'�'jJiy:i��•Q K.a`i�'. r,1 e ;,..e {1'{' ••iii r -• COMMERCIAL _New Construction _Modify Space '!All hwor:14 ) I`.ti•, —Irrigation System(_yes I_no)(✓RPZ/ PVB) aa'" ' r Ml's.' Rain sensors required on Irrigation systems a �,i7,el y v a Avg.GPM (2"turbo required unless smaller size allowed byPublic Works) �iY:,: w(i.," 'iv y" a•', _Meters Call(651)675-5646 to verity that tests passed prior to olcklna ue meter. 1,rtllc,•;1',IS, f.1,�� the Ft W.�""irr.l,y�,1,r,'tji'a�')'r : Domestic:Size&Type Fire: 1 iwg.`,`i,, !!;,; ` ,�(,( `?e, Avg.GPM High demand devices?_ Yes No Fluahomatere-_Yea_No COMMERCIAL FEES Contract Value$1,000.00 x.01 $60.00 Permit Fee Minimum = 80.00 $60.00 PVBIRPZ Permit(Includes State Surcharge) $ Permit Fee a$ .50 • Surcharge Surcharge=Contract Value x$0.0005 If the project valuation le over$1 million,please cell for Surcharge =$ 60.60 TOTAL FEE Following fees apply when Installing a new lawn Irrigation system $ Water Permit Contact the City's Engineering Department,(661)676.6646,for required Ise amounts. $ Treatment Plant $ Water Supply&Storage _..._____.__._ _._._._.�__..___•_---_•__—___tl._._._____.__....._....._.... _....,,._....„.,„,,,..,_„,,,.,.-.,.,..,.,,..,.,... ....,._ _. -•-- _.... _..__ _.....__ State Surcharge ..._._. $60.50 TOTAL FEE You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for en email update on the City'.wahalte et www.citvofeaftan.comisubecrlbe. CALL BEFORE YOU DIG. Cell Gopher State One Call at(061)464.0002 for protection against underground utility damage. I hereby acknowledge that this information le complete end accurate;that the work will be In conformance with the ordInances end codes of the City of Eegen;that I understand this Is nota permit,but only an application fora permit,and work Is not to start without a permit;that the work will be In accordance with the approved plan In the case of work which require.a review end approval of plans, r,,.• a TONYA PRIBNOW I[ '^ F'' a„�f,,,,,.,..„,.._...��"'- .•. Applicant's Printed Name ApplleSt�'s••Slgn:. re”— i eef a // .yo �+,"•i � '" cPy(J,<;," .AJ:rx�• :'Ia'141;400 Ak, Y .'4i,r �i„. ,i,,t /tV„rr, •h r�l•4� Aer�I•Ff "id •J p,%�1tx�'!'+4 ',4. ,'•.;x '�<,' ; �k; �",,*��'', ea ''kpy� �,� 1e�.d �t.,4,1�u,,' ,1J .r " 8,;"i ; .!„1V.kX:.,iliw•; 'n<,b 0d.,.,,.^SisF !�a1Py n t+ r !} ,( � } i ?� h1,k� �yd .r14; ,,,� urNjv;{F� Qf �1,. 1ky, �,'�j`� ' i t 'titti"r,; . wOd'•)'"� i4f��«} � /”�'r t',..",'r , t rr�Mo� yht a,4,14,d S! ${ 61: It SAr, 1r'.i''; - 'IIa)® 6t11W7d.' 9utislI'"1i4 IrhvI $ F �l), " ig0r1I „ •,•��" —A ktA:�/�r, rn h�' ;t"y) !�;�,rt;� J ,r,.::w.i1, %:":,yitt t� ,A:i r�t;C.,,. �.`, ; ;1, , ,ik iy „?„, A .00, .J fv dC,rZ,,al0,"�/,„4,:rqt, 7 Ite*sR��a �dIus '^i`r ) iz �1/ ",,r e ��'Jel��l�rX n1111,vt�IWktei,�\Axr�t� 4uri•a ,A,a�D �u1 �A^ wLF4J4 ,, a ,', Page 1 of 3 C�ECK-c�. PICIC I c� . For Office Use _ I I 1 j Permit #: � I Permit Fee: 1 I pl I Date Received: I 3830 PILOT KNOB ROAD I EAGAN, MN 55122-18101 1 ECEIVE 1 (651) 675-5675 1 TDD: (651) 454-8535 1 FAX: (651) 675-5694 1 Staff: buildinginspections@cityofeagan.com ®� `` L _ _ _ _ _ _ _ _ _ _ _ _ _ 15 1 ��g 2018 COMMERCIAL FIRE ARM PER IT APPLICATION ih-PI .97��,�Date:Site Address: s s�f9a'.. (kt IL PaX''L.o.w ❑ Requirements: 2 complete sets of drawings and specifications, cut sheets on materials and components Property Owner Type of Work Contractor Name: Address / City / Zip: Applicant is: Description of work: Owner Contractor Phone: Construction Cost: v Ci Estimated Completion Date: 1/__1 44-11 D Name: AM 7 � 0- al' t ' rn 1y41.L icense #: ISOML2 Address:' Je--Wek L City: State: Zip: S's-101co Phone: � Contact: T Email: New Work Type Addition Alterations DESCRIPTION OF WORK: FEES $60.00 Permit Fee Minimum Remodel Other: Commercial Residential Educational Surcharge = Contract Value x $0.0005 If the project valuation is over $1 million, please call for Surcharge Contract Value $ :74"; X.01 = $ [. V�.J Permit Fee = $ ,c �� Surcharge* = $ ;+! TOTAL FEE You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.cityofeagan.com/subscribe. I hereby apply for a Fire Alarm permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Minnesota Building/Fire Codes; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and ppprovafof plan, x v' App icant's Printed Name x �im Leala,4rj Applicant's Signature FOR OFFICE USE Reviewed By:Date: Required Inspections: Rough -In ZFFinal Fire Alarm Test RACK�L�W F'REVEN'tRR'P�S7 RQC�()RT Joh Numbor 2 osD2-��s9 RABBIS 000 Moniroal CIrcID S4, Paul, MBmosota G6102 GG'1.602.G606 Addroas / ` !'') p I !� + � 4.��t1L T �i.Jlj Clty y� �1. �',.� ZI � (G. © ner � elephone No. Dste �ll�„�le.�.ou.sc� 'C-c.�57�s�...G�of�rc- I�-Ll%SrG�'7W 3,_3�-Z�j MaIlce�-nnd Mncal of r)ovin �� Slro �••/U ,.� Sorial No. �+ g Loentlon of Ocvlco - — � ��- rlecr�.. �� . Rv, G��-�.�c, �.� Chock Vnlvo 111 Chock Vnlva 112 Rroasure Dliforonlinl Across 111 Prossuro Olfforontinl whon Rollof Oponc SUnhmr �� ` <k; Leakod � Leakod � � None Yeot Doloro Ropalr Closed Closed RS.I. Rs,t. Cleaned Doecribo b C:NIt•t�. (tG�k�i-1 Z �,,,� �e,(,'e�j% Ropalr Plnnl Toet I-eakotl Closod Looketl Closod / P.S.I. ✓ / �.. P.SJ. -3 s Cleaned Clenned Cleaned Commmtls/Malorinle Used: Replaced: Repincod: Replaced: e n� ,r�� r�� Dlac Disc Dlec: � ei,�[ t�QK �C�.�a� Spdnp Spring Upper �� Griido Outdo Lower Pln Rolainer PIn Rolekrer Spring '� I Iingo Rotalner Ringo Retnlnor Diaphragm: Soot Sea! largo; o. ,� olapnragm olapnren�o upper x Lower Smell Seat: Ungar Lowor Snacer: Lowor ninal Test CloeaU Tlghl Closod Tlght Openeda s Reduced Proasuro The above report Is certllled to bo true, CertilfcaUon Nwnber _ v� _.[,_L('p_uJ Inillol Tesl By /� Ropresentinq Ropaired By �/ Ropresontinq Pinal lost By � Repressntinq Whlto -City Yellow -Customer Dnto S- 3".2�y I'�ink - Fllo Ho -moo RACE«LQW PHEV�NT�N TkST 4t�POt�T HANf11S flOfl Mon4roal Grclo S4. Paul, Mlroiosota GG 102 G51.602.0606 ,� �14 �; Address City Zlp �� /� L��d�.ti- P law �� C�-S�,tr. �".� Owner olol)hone No. L)nle t-�i..1e,�..o�-cse, er-t.s7,n�.. �.c� i c,�c- r� 1 � zl7s- �5 7� �- 3 -Zc� MO,AI..toII an`d ��My�odCCal of Dovice Sizo _ Serinl No. '^7 / C� Locntion of Doulco {% 1 � � Two, C t � SQ-'� \d-UfJW� . ._e_... ._... W CIIOai<VAIV011'I Clloclt VnIVo 112 pYasavYe bl((e YAnnnl PI'aafllll'A DI(LAI'ollllal $tYAl11Ai' L` Across Oi wlton Rutlof Opmis ��b Toot aororo LeAked Leakad � Nmte Rapelr Closed Closed RS,1. RS.1. Cleaned RosorlDo 'R,e(� �!l l� 4�► k }�, Z s�C �.Q,l ',<-�% flopoir LoAkaU I.oAked Flnni Toat CloseU Closed q P.S.I. ` //�� r � � P.S.1. r L1 Cleanod Cleaned Cleaned CmnmontslMAloriAls tlsod; Replaced: Replacod: Replaced: Dloa bisc Dlac: Spring Spring Uppar Guido Gulde Lower pin Rotalnor Pln Rotagtar Spring 'b; I Iingo Rotainer Ninge Rololnor Diaphragm: Soal Soai Large: a Dlaphrngm Dlaphrngm Upper Lower Smell SeAI: Uppsr Lowor Spacer: Lowor pinai Teat CloseU T'Ipht Closed Tlghl Opened a � s Reduced Pressure Tho nbove report is cortilled to bo true, Cerllfication NumUery`e'Y�G'to In(Ual Tosl By �� ___ Roproson101g gopaired ey RopresantinU Final lost Oy Represonihlp Date � — ��^2.y2y W01to - CILy Yellow • Customer P61k - Flle HC•1gg6