3350 Mike Collins Dr Aug. 11 2012 1~0:21AM 0nr3)q_ /x'43 No. 8918 P, 1
/l tog./
BLUE or BLACK [
Use I
I^For Office Use I
Permit
Apr J Of Eap 1 Permit Fee: fJ r
3830 Pilot Knob Road I
I
Eagan MN 66122 Date Received: l
l
Phone: (651) 676-5676 I
Fax-(661)676-6694 I Slaff_____-- I
2012 COMMERCIAL PLUMBING PERMIT APPLICATION
❑ Please sub it two (2) sets of plans with all commorclalf'appli(c~attiions. n
Date: ✓ Site Address: 5=m/tk-b w I I I > V
Tenant: Suite M
PROPERTY w
OWNER;.; Name: Phone:
Name: ~T I OR07 LicenseM
CONTRACTOR Address: City; State; iyl/ V Zip:.,575/C2j
Phone: Email: -Cdni enn
TYRE OF' New _ Replacement Repair L,-Rebuild _ Modify Space _ Work in R.O.W.
WORK
Description of work:
COMMERCIAL _ New Construction odlfy Space
Irrigation System L_ yes 1 _ no) qe<~Pz I _ PVB)
• Rain sensors required on Irrigation systems
PERMIT, TYPlE Avg. GPM (2" turbo required unless smaller size allowed by Public Works)
_ Motors Call (651) 675-5646 to verily that tests passed prior to nicking up meter.
Domestic: Size & Type Fire: 1
Avg. GPM High demand devices? Yes No Flushomatsrs _Yes No
COMMERCIAL FEES:
$60.00 Mlnlmum (includes $5.00 State Surcharge) OR Contract Value $ x 1%
$ Permit Fee
Required on ALL new buildings and boulevard irrigation systems 4 $ Radio Meter Read
- If the Permit Fee is less than $10,010, the surcharge Is $5.00 $ Meter(s)
- If the Permit Fee is > $10,010, the surcharge increases by $.50 for each $1,000 Permit Fee $ State Surcharge
i.e, a $10,010-$11,000 Permit Fee requires a $5.50 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
CALL BEFORE YOU DIG. Call Gopher State Ono Call at (661) 464.0002 for protection against underground utility damage. Call 48 hours before you
inland to dig to receive locales of underground utilities. www.clopherstategnecall-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'~ x
Applicant's Prl d Name App n re
t
~ Y s Dafe
FOR,OPPIC1= USE ~ 1 x Approved By
tQgt,Iredinspectlons;.: Under Group d Rough-In ` _jtTest _ qskTest Final PRV;R..equlred:^Yes .6
Page 1 of 3
---------------- - -------- rar
CITY OF EAGAN pERM1T # .,
3830 PILOT KNOB ROAD, EAGAN, MN 55122 RECEIPT #
DATE PHONE 454-8100 DATE: ?
? ._..._
? Address
c City Phone
? Add
? City
TYPE OF WORK
Forced Air M BTU
Boiler M BTU
Unit Heater M BTU
Air Cond. M BTU
Vent CFM
Gas Piping Outlets #
Other
CommJlnd. Contract Prfce x 1%
s PERMIT FEE
SIC:
?
TOTAL:
BLDG. TYPE
Res.
Mult.
Comm. X
Other
WORK DESCRIPTION
New Const
Add-on _ L
Repair
FEES
RES. HVAC 0-100 M BTU - $24.00
ADDITIONAL 50 M BTU - 6.00
(RES. HVAC INCLUDES A/C ON NEW
coNSTRucno
M
TOWNHOUSE & CONDOS - FiES. RATE APPLIES
MINIMUM RESIDENTIAL FEE • ALL ADD-ON a
RELODELS (INCLUDES GAS PIPING) - 12.00
GAS OUTLETS (MINIMUFA -1 PER PERMIT-
NEW CONST.) - 1.50EA.
COMAiflIND FEE -196 OF CONTRACT FEE
APT. BLDGS. - COMM. RATE APPLIES
MINIMUM COMMERCIAL FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 5/C PER EACH $1000.00 OF PERMIT FEE)
i
, , :?,
?? ?.,f`? _ ?: ??? - ?J- ?.. r,?>
`
CITY OF EAGAN
tdale Ind. Pk. #} Lot 16 RIk 2 Parcel 10 22503 160 02
Street State EagaT1i MN 55121
Improvement ate A-m-o-Dm Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING 0 1 az
SAN SEW TRUNK 9-
SEWER LATERAL
WATEFiMAIN
*WATER LATERAL 1972
?
WATER AREA 1972
# STORM SEW TRK 6 OQ 226Q 1 Paa.d
?r STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET I.IGHT
WATER CONN,
BUILDING PER.
5AC 2 Q.QQ 77 5-25-72
PARK
INSPECTIDN RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55123 Date Issued:
(612) 681-4675
SITE ADDRESS: APPLICANT:
I 1i ij ?i1?1 c.
11 1 ! I t ttll IN`, t)ft t)IrI rwwi I r+, '1H!_
FANANftAiE f'k!+lYt`..ft 1Wt11lSYNiq! PARK 0 4 i6 1,? ? ;1 IF3-11I1A
PERMIT SUBTYPE:
? ;i:ir•; ? i ?., ??t I'.4
?
TYPE OF 1NORK:
fyFS4,-k3P1 f(lN
ri I a31 4.) 1 r4 1,
R! PAik
{t1ll1 r 1 iVf,
Permit No. Permit Holder Date Tetephone #
SNJ
PLUMBING
HVAC
ELECTRIC
ELECTRIC
Inspection Date Insp. Commerrts
Footings I
Foundation
Framing
Roofi'ng ?L -
Rough Plbg.
Rnugh Htg. 10 .z ?
Isul.
Fireplace
Fnal Htg.
Orsat Test ,
Fnal Plbg. Pibg. Inspector - Notify Plumber
Const. Meter
Engr./Plan
Bldg. Final
Deck Ftg.
Deck Final
Well
Pr. Disp.
/
1 Q ? ??.3 /(o(J d?-
?
TOWN OF EAGAN
3795 Yilot Knob'Road
Eagan, Minnesota;55122
j PERPIIT ND. 66
The Board of Supervisors hereby 4rants to Spring Plumbiug Co.
of 9554 W. Blooming?tbn Freeway. MDLs, 55431 _
a pLUMBINC Permit for: (Owner) Batesville Casket f.p. _
ae 3350 Miice Collins Road i I, pursuant to application dated
9/3U/71 '
,
Fee Paid: $20,00 Dated this day of October 1971
. a c
Building Inspector
Ir-
CITY of EAGAN
BUILDING PERMIT
own.: A.10Z. ? ......0,0.14- .../............................
Address (Preaent) .33.s...2.Q...l.<.L?f?...L?-?-..?..CC..°.? ...............
SuIlder ..............-------....------
Addreu .. . . .??Q. D...J??ctc.•?a.Z`?rt.??ZC.?.ap..a"rA-
Q66 XGhX?,$ Q/+?'e Jdu?6e ? DESCAIPTION
?
.. .
N2 4074
3795 Pilo! Knob Road
Eagan, Minnesata $5122
454-8100
Deis ..1....-.l.?i...... 26 .....................
Biories To Bs Uaed For Fron! Deplh Haigh! Esl. Cos! ' Psrmit Fea Remarlcs
'i?6 ? /yo ? ?lo,oc?
LOCATION - ^s ? _, . n '
/6 1 p-
This permit does no2 auihorise the use of sireels, roads, alleys or sidewalkc aos does it give the ownsr os hls sgea!
the right to ereale any sifualion which is a nuisance or whieh presenls a heaard !o the healfh, safely, aonveaienee and
genaza3 welfare !a anyone in the communifp. THIS PERMIT MUST B?T 9N THE PREMISE WHILE THE WORK IS IN PROGRESS.
a.... .
This is io eartifp, !ha! ... . ... ...........hes parmission !o areet
i?EeGa:?}`
the above described premise subjeci io !he p ovisions of all applicable Ordinances for the Citp of Eagen
....P?. r`..... ..............
..._...?..?°- -°°. _ -
ayor -----•----.................................... Per ...???..?..... Huildiny ."i.._..?`°....?...I
.. .... napeef . . s?
M
EAGAN TOWNSHIP
BUILDING PERMIT
Ownes .......?r...?...?. ._CP._ :................
Addreas (Presen3) ...................................... "___............................._.....
Builder ------ ... ..........................."-.._......... °?'•...........................
--
Addrees ............................ .................... -.......................................
DESCRIPTION
N° 2554
Eagan Township
Town Hall
Dale ......... ??.?.. 171 ....................
Sioriea To Be Used For Fron! Depth Heighl Esi. Cos! Permi! Fee Remarks
ea
ao7
or
I 16 I ? 12, a'-._ .Q----, o?-;& y
This permit doee not aulhosiae the usa of streeis, roads, alleys or sidewalke nor does it gfva the owner or hSs agen!
the righ! Yo creale aap siluffiion which is a nuisanee or whieh presenfs a hazard to the health, safelp, convenience and
general welfare !a anpone in the eommunifp.
THIS PERMIT MUST BE KEPT ON THE PREJ4ISE WHILE THE WORK IS IN PAOGAESS.
Thia ie !o eertify, !hal..??:??-::-?-?--? C.^iy..--''F ......... has permisaion to erect a ....: - -'
.......................... . .... . ...... . .....'_"-_.. _ upoa
..._....-'--'---.. ... ..
the above described premise subjee! !0 the provisiom of the Building Ordinance for Eagan Township edopied Apsil 11.
1955.
.........................?d]::E _ .r.:...._?,+....... - ?.._...:?:?:......_ ?. L??_..kT-c -?
Per .....-------.... .
....... ...... .....----°'---...........................
Chairman o Tnwn Board ? Buildin Ins eclor
C?910W!5?1_ G'o?7s so
p 43447 ?,
Reqoest Date
?.+ ? e Rough-in Inspeclion
Requiretl?
?
? Featly Now }( Will Notify Inspeclor
When Reatly?
?
? Yes X No
I$ licensed contrector ? owner hereby request inspection of above elecirical work at
Jab Atltlress (StreeL Box or Route No.? Ciry
?..
,•
Seciion No. Township Name or No. Range No. Counry
Q
O¢upant (PRINI
b -?.?"CO?i° Phone No.
S 2 - D
7 7
Power ppiier
r/?o?dY c°L i. `G qtldress L?I?4f?
`f ?IO. /
cL.,!
V V
: • /`! .7
Elenncai Contraaor (GonOany Namel
I L 4'G?'?1?c .?? nlratlors Lkense No.
62 ? 12 3
Marltng HOtlness IConVactor or Owner M ing Ins[elle[ion)
?,•o?
i?? ?vP
??????
1q.? ?? 5s??z
:
_
_
n mon eo 5a?we iCon aaonOwner Makinq Ins?ailaoon
ij?`'? .?` ?- P?O?e Number
vyP-
MINNESOTA STATE BOAHD Of ELECTRICITY THIS INSPECTION REOUEST WILL NOT
Griggs-Mitlway Bldg. - Room 5-173 t BE ACCEPTED BV TNE STATE 80ARD
1821 University Ave.. SI. Paul. MN 55106 UNlESS PPOPEF INSPECTION FEE IS
FhoneJ612)66Y-OB00 ENCLOSED
.
REQUEST FOR ELECTRICAL INSPECTION Ee-ooam-oe
b, SE¢ in5bl1Ltq11510r COrtIpIEllng IhiS farm OO b2Ck of yellOW COpy ?75
30
14 344.7 "X" Below Work Covered by This Request
ew Atld Rep. TypeofBuilding AppliancesWired EquipmentWired
Home ? Range TemporaryService
Duplex Electric Heating
Apt. Bullding O[her (Spacify)
?
Comm.llndusirial si
? Farm
Other (syacify) GoNreolor's Femarks:
Compute Inspection Fee Below:
# Other Fee # Service EntranceSize Fee # Cirwits/Feeders Pee
Swimming Pool O to 200 Amps D 4?0 100 Amps
Transformers Above 200 ? Amps ve Amps
Signs inspecmrs use onry: ?
%
r? TO L
Irrigation 8ooms ?
' gff'
Special Inspection
Alarm/Communication THIS INSTALLATION MAY BE OflDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHI ONT .
I, the Electrical Inspector, hereby Ro°9n-'" oata 7?3'r?Z
certify ihat the above inspection has ( oa?e?
i6LonlM1S irom
PERMIT
yCITY OF EAGAN
3830 Pilot Knob Road
Eagan; Minnesota 55123
(612) 681-4675
PERMIT TYPE:
Permit Number:
Date Issued:
Bu:r.i_DrNr.,
001954
7-2 J21.192
SITE ADDRESS:
ja,o rizi:E CcaLi_Iras o,{
LOl": 0I916 3Lf7Cii: 0002
cAC2AIVOALL CENT"ER ]:N17USTR:IAU PA5tK 1U
F',I.IVe; 10-22503-160-02
DESCRIPTION:
_ ROot=lNG
'T3uiidAct Permii 1'ype.
8uaYding"-Wprk Type
'.
?
c
CClMM.jTNC7. MISC.
fZEFAIH
r?Y r
?t '> l ; `:r s i is; j t;
REMARKS:
Rf cr IPr R cvU411?3
FEE SIJMMARY
Il' i5 i f' f f-• ;,'
Suroharqe
Tnta.l F;ac
vALuArzON $16,000
`Y1bGaoo
$:LG9.S6
CONTRACTOR: - Apulict?nt - OWNER:
QUIMB'r L"!7. ..fliE 2:378117G) hQOEKFR WFLDtiNG CO
1132 STTP!SCJN ti1,.VO 3330 M'CKk COLLIFIS f)R
MSNiVCAPOLIS MN 55413 rAGAN MN
{E;12} .37S-1170
I lierszbp achnawlecige thaC I have read th'3,s applicatian and state that the
anl=ormati.on is eor-ret;t and aqree Ca ccamPly with a11 applicable Ntate af M1Yrr.
5tatu Cea and City o t` Eat}an Qrda nances e ?
L
?
:??PPLICANT/ _??PER .?? ?SIGNATl1?RE«? ISSUED 13Y. IGNATI?IR
AM?T E ?
PERMIT # CITY OF EAGAN
REai:TIVAfiE _ 1892 BUILDING PERMIT APPLICATION
681-4675
SINGLE 8 MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
specifications, l copy of energy calcs.
Penalty applies when typing of permit is requested, but not picked up by last working day
of month in which re uest is made or lot chan e is.re uested once ermit is issued.
Date Valuation of wark 39 0 °n .
Site Address: 3 3 5c)
STREE7 SUITE S
Tenant Name: (commercial only)
LOT BLOCR '.L SUBD.C. ?rt4j&`4 P.I.D. N
Descri tion of work: c?9F' ?-r li ,Xs
The applicant is: ? Owner lig"Contractor ? Other (Oeseri6e)
Name p .E Lr/&- ? c) ?..?rr o G, Phoi. e
Property LAST F,RS,
Owner qddress ? ?3 :30 i4 ;/ ? 'ok?i?s
STREET STE /
CitY ? ' ? State ?i Y?/?!t Zip
Company %/d6 ?22 U/." % ?4 r!?.a Phone
Contractor Address tiZ-50,4' ?AIVI'2 License #Qo24C- 9'7Exp.
City 19?7/d// 416'1V160 l? i State {vn /V Z i p
~t ;
Architect/ Company Phone
Engineer Name Registration 8
Address
City State Zip
5ewer 3 water licensed plumber . Processing time for
seMer & water permits is two days once area has been approve .
I hereby acknowledge that I have read this application and state that the information is
correct and agree to comply with all applicable State of Minnesota Statutes and City of
Eagan Ordinances.
Signature of Appl icant:
?
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation O 06 Duplex ? 11 Apt./Lodging
? 02 SF Owg. ? 07 4-Plex O 12 Multi. Misc.
? 03 SF Addition ? OS 8-Plex O 13 Garage(Accessory
? 04 SF Porch ? 09 12-Plex ? 14 Fireplace
? 05 SF Misc. ? 10 Multi. Add'l. ? 15 Deck
WORK TYPE
O 31 New ? 33 Alterations ? 35 Tenant Finish
O 32 Addition ? 34 Repair ? 36 Move
GENERAL INFORMATION
Const. (Actual)
SAllowable)
UBC ccupancy
Zoning
# of Stories
Leagth
Depth
APPROVALS
Planning
Engineering
REGIUIRED INSPECTIONS
? Site
? Mallboard
Basement sq. ft.
lst fl. sq. ft.
2nd F1. sq. ft.
Sq. Ft. total
Footprint Sq. ft.
On-site well
On-site sewage
8uilding
Variance
O Footing
0 Final
? Framing
? Draintile
? Insulation
? Fireplace
Permit fee v.iuacion:
Surcharge
Plan Review
License
MWCC SAC
City SAC
Nater Conn.
Mater Meter .
Acct. Deposit
S/N Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total:
8
?
+9i ?
? lCr Basement F'rnish
? 17 5wim Pool
? 18 Comn./Ind.
? 19 Comm./Ind. Misc.
? 20 Public Facility
? 21 Miscellaneous
? 31 Demolish
MWCC System
City Water
PRV Required
Booster Pump
Fire Sprinkler
Census Code
SAC Code
Assessments
SAC %
SAC Units
Date e
BUILDIPIG PERMIT APPLICATION
I,OT-2?- BIACK L-ADDITION
?ARCEL & STCTION PNPIBER IF UTdPT,ATTED
ADDRFSS OF
ESTLMATED
<
ADDRESS o7 3-+C/
1V0.
TELEPHONS N0.
AADRESS
idote^ Include site plan, building plans, and energy calculations vyit3i this
application
Signed
OFFICE USE
VALUATIOId
sAC ?/0 0.j Gt Q OPo, o a
eaA^,sR co.ailEciioia
WATER AfETER `
s-O
BUILDING PERI32T FEE ?r fD .
SURCHARGE FEE °?? ?,?--
PLAA1 CIiECK FEE . ?? .
PARK DEDIC2\TIO14 FEE ?
arHEn
f
TOTAL*
APPROVALS:
ASSESSMENT CLERIC_?BUILDING DEPT. PQLICE DEPT. _
?
?1AiER & SI:V]ER DEPT. FIRE AEPT. E?=??? ?- BARK Dk?'PT.
v?'
• ' - MASTER CARD
LOCATION 3 3 6Y? Ao; -
OWNER
STRUCTURE AND 11-? -?'
LAND USED AS 7 f
Permit
No.
Issued Issued To
Conirattor Owner
BUILDING
PLUMBING
CESSPOOL - SEPTIC TANK
WELL
ELECTRICAL
HEqTING
GAS INSTALLING
SANITARY SEWER
OTHER
OTHER
Items Approved
(Initial)
Dete
Remarks
Distance From Well
FOOTING SEPTIC
FOUNDATION
FqAnnING CESSPOOL
TILE FIELD FT.
FINAL
ELECTRICAL
HEATING DEPTH
OF WELL
GAS INSTALLATION
SEPTIG TANK
CESSPOOL
DRAINFIELD
PLUMBING
WELL
SANITARY SEWER
?-
Violations Noted
on Back
COMMENTS:
.. . • 1
COMPLIANCE INSPECTION REPORTS
TO BE USED ONLY IN EVENT OF OBSERVED VIOLATIONS
PERMIT NO.
DATE OF INSPECTION
CONDITIONS OP CONSTRUCTION AT THIS INSPECTION
? NO EVIDENCE OF NON-COMPLIqNCE
OBSERVED.
? ACCEPTABLE SUBSTITUTIONS OR
DEVIATIONS.
? NON-COMPLIANCE. BUILDER WILL COMPLY
WITHOUT DELAY.
ITEMIZED AND DESCRIBED A5 FOLLOWS:
NON-COMPLIANCE. Bl11LDER DOES NOT
INTEND TO COMPLY.
COMPLETION OF CERTAIN IMPROVEMENTS
WILL BE DEIAYED 8Y CONDITIONS BEYOND
CONTROL.
? REINSPECTION REQUIRED
REINSPECTION REVEALED
DATE OF REINSPECTION
CE RTI FICATION - I certify that I have carefully inspected the above in which I have no interes[ present or prospective, and that I have repor[ed herein
all significant conditions observed to be at variance wi2h ordinences of the Town of Eagan, approved plans and specifications, and any specific require-
ments tor off-site imprwements relating to the property inspected.
? ALL IMPROVEMENTS ACCEPTABLY COMPLETED
BUILOING INSPECTOR
COMMENTS:
MASTER CARD
• LOCATION
OWNER
STRUCTURE ANb
LAND USEO AS
O ?
Permit
No.
Issued Issued To
Coniractor Owner
BUILDING
PLUMBWG v 4
CESSPOOL - SEPTIC TANK
WELL
ELECTRICAL
H EATI NG
GAS INSTALLING
SANITARV SEWER ?
OTHER . tA
?? I
OTHER
I
•
?
Items Approved
(Initiaq
Date Remarks
Distance From Wefl
=GOTING SEPTIC
POUNDATION ? ? CESSPOOL
FRAMING TIIE FIELD FT.
FiNAL
EI_ECTRICAL
HEAIING ? DEPihI
OF WELL
GAS INSTALLATION
SEPTIC TANK
CESSPOOL . .
DRAINFIELD
-? d_? ?• _
PLUMBING
WELL
SANITARY SEWER Cc,
- D ?
Violations Noted
on Back
COMMENTS:
COMPLIANCE INSPECTION REPORTS
TO BE USED ONIY IN EVENT OF OBSERVED VIOLATIONS
•
PERMIT NO.
CONDITIONS OF CONSTRUCTION AT THIS INSPECTION
? NO EVIDENCE OF NON-COMPLIANCE
OBSERVED.
? ACCEPTABLE SUBSTITUTIONS OR
DEVIATIONS.
DATE OF INSPECTION
? NON-COMPLIANCE. BUIIDER WILL COMPLY
WITHOUT DELAY.
? NON-COMPLIANCE. BUILDER DOES NOT
INTEND TO COMPLY.
? COMPLETION OF CERTAIN IMPROVEMENTS
WILL BE DELAYED 8Y CONDITIQNS BEYOND
CONTROL.
ITEMIZED AND DESCRIBED AS FOLLOWS:
? REINSPECTION REQUIRED DATE OF REINSPECTION •
REINSPECTION REVEALED
CERTI FICATION -1 cenify that I have carefully inspected cha ehove in which 1 have no interest present or prospective, and thai 1 have reported herein
all significant conditions oGserved to be at variance with ordinances of the Town of Eagan, approved plans and specifications, and any specific require-
ments for off-site improvements relating to the property inspected.
? ALL IMPROVEMENTS ACCEPTABIY COMPLETED
BUILDING INSPECTOR DATE
COMMENTS:
II3
CONTRACTOR'S MATERIAL & TEST CERTIFICATE
SPRINKLER SYSTEMS - WATER SPRAY SYSTEMS
PART "A" GENERAL
WORK, INSPECIRON AN? TESTS BHOULb B& MADE BY CONfRACTOR'S AEPREBENTATIVE A!]p WITNESBED SY AN OWNER'S AEPRESENTATNE,
BE CORAELTED A1ID SYSTEM LEFT IN SERVICE BEFORE ODNTRAGTOfi•8 b1E14 FINALLY LEAVE TNE dOH.
A CERTIF[CATE SHOULII BE FiLLED OUT AND SIGNEU BY BOTEi REPRESENTATNES. COPIEB BHOULO B& PRfiPARED POR INSPECTING AUTHORITIES, DWNER AND
CONTRACTOR. TT IS UNDERSTOOD TF[E OWNER'S ftEPRESENTATIV&'3 3iGNATURE IN NO WAY PRE.NDICES ANY CLAIM AGAiNST CONTAAGTOA FOA FAULTY
MATERIAL, YODR WORKMANSFIIP OR FAll.URE TO COMPLY WITH INSPECTING AUTHORTTY'3 AEQUIItEMENTS OR LOCAL ORDIttANCES.
PFOPERTY NAME DATE
Batesville Casket 10-26-76
PROPERTY ADURESS
3350 Piike Co7.lins Drive, Eaganp Minnesota 55121
ACCEPTED BY INSPECl'ION AUTHORTTY ('$) NAMES
Factoxy Mutual
nnnasss
3333 North Mayfair Road
Wauwatosa
Wisconsin 53222
PLANS ,
,
INSCALLATION CONFONM3 TO ACCEPT&D PLANS YES ? NO ?
EQUIPMENT USED I8 APPftOVED Y&S NO ?
IP NO, STATE DEVIATIOM
I
NAS PERSON IN CHAAGE OF FIRE EQUIPMENT BEEN INSTRUCTED AS TO LOCATION OF CONTROL
_ VALVES ANU CARE OF THIS NEW EQUM6fENT YES ?$ NO ?
INSTRUC- IFNO, E%PLAIN
TIONS HAS ACOPY OF INBTRUCTION AND MAINTENANCE CHART BEEN LEFT YES 09 NO ?
AT PLANT
IF NQ ERPLAIN
FLUSHING: Fiow [he required rate un[ii mains are clear a= indicated by no collection of fotetgn macerial in burtap pags a[ wlleta euch as hydraerte and
biaw-offp.
Flueh at [lowe wt leee tM1an 950 GPM [or 6-irch pipe anA ?maller, 1000 GPM (or 8-inch, 1900 GPM for 10-inch. 7000 GPM for 12-inch. Where eupply
TEST canno[ protlvice stipulatetl flmv rate, oCtain maximum available by usung propeNy eized aiscAarge Aevices.
{iYDROSTATIG Hytlro=tatic [est shwltl be matle a[ not less Nan 200 P31 tor Lwo houre or 50 P51 above etatic pressore in excess o[ 150 P31. Dif(eren[ial
tlry-pipe valve clappere should be lef[ open during teat to pievent damage. All abovs grouM pipivg leakage sboulA be ctoppetl.
DESCRIP-
LEA[{ACE: New pipe Iaid with rubber geeketed join[s shoulA, ff the workmanshi0 i=' ¢ati=fac[ory, have no leakage q[ the joints. Un¢a[istaetory amwms
oi leakage usually reeult trom twieted, yinched or cul gaskets. Howeveq eome leakage might result trom smaii amounle o( gri[ or emall imperfectlone.
The amwnt ot leakag¢ at [he joints should oro[ exceetl 2 quarts per hovr per 100 join.e irreepectively of pipe Aiameter. The lcaloge sAOUItl be dietributed
TION over all joint=. I[ such leakage occurs al a few joints ine installation should be considered unsatisfac[ory aM neceseary repaira maAe. New pipe laitl
wiN caulketl lead or leatl-subsUtute }oint= shoultl, it [he workmanship is satis[actory, lave liftle or no leakage a[ the join[s. Anry joint havtM leakage or
more lhan a"sliFM drtp" or "weeping" =hwltl be repairetl. Leakage should rot exceed t oz. (liquid measure) per nour pe[ inch of pipe tliame[er per joint.
The leakage shwltl be Ais[ributetl mer all jnints. I[ such leakage occurs almoal entirely at a tew joims, the lnsta?ation should be considereA unsatietactory
and neceeeary repairs made.
PNEUMATIQ Estabiieli 90 PSI air preseure antl measuce pressurc drop which should rot ezceetl 1 1/2 PSl in 29 hours. lest pressure tank= at rormal
wa[er level antl air preesure, anA measure air preseure drop which should mt exceed 3 3/2 P31 in 29 houre.
PART "B" - UNDERGROUND PIPING
FEEAS BLDGS. '
LocnnoN Cut in to exi.sting oyerhead c m
PIPE TYPE AND CLA83 TYPE JOINT
UNDER-
GROUND CONF°RNacx0 eTUUnaan Yss p xo ?
IF NO, E][PLAIN
PIPES
AND JOINTS NEE?WG ANCNDRAGE CLAMPED, STRAPPED OA BACIED IN ACGUFDANCE ygg ? NO?
WITN STANDARD
JOINTS IFNO, EXPLAIN
TESiS
REQl11RED fLVSHING HYDROSTATIC LEAKAGE
.
NEW U2U)ERGROUTID PIPING PLUSHED ACCORDING TO STAPIDARb Y&3 ?
BY (COMPANY) ,
HOW WAS FLU3hLLNG FLIXV OHTAINED
PUBLIC WATER ? TANK DR AEBERVOIR ? FIRE pUMP ?
FLUSHING THItOUGH WHAT TYpE O?EMNG
' HYD. BUTT. ? OPEN PII`E ?
TESTS LEAD-INS FLUSFED ACCORDING TO STAtIDAFD yEg
BY(COMYANY)
HOWWA3 FLUBFpNG FI.OW 06TAINED
PUBLiC WATEP ? TANKOR R896RVOIIi [] PRE PVbff Q.
THItOUGH WAAT TyPE OPEP]ING '
Y CONN. TO FLANGE & SWGOT ? OPEN PMH.?
- - PriMed N U.B.A.
Form No. 85 Rev. 7/69 (RBprinte0 lp2). -
HYDROSTATIC ALL NEW UNDERGROUND PIPING HYDR03TATICALLY TESTED AT
P. S.I. PON fI0UR3
TEST
TOl'AL MOUNT OF LEAKAGE MEASURED
LEAKAGE caLs. xouns
TEST ALLOWABLE GEAHAGE
GAL6. HDU2S
NVMBER INSTALLED TYPE AND MAISE
ANTS
HYDR pLl OPERATE SA719FACTOAILY
xes ? xo q
CONROL WATER CONTROL VALVES LEFC WIDE OPEN YES ? NO ?
IF NO, STATE REA80N
VALVES
DATE LEFT IN SEAVICE
REMARKS
NAME OF SPRMKLER CONTRACTOR PFOPERTY OWNER (SiGNED) TITLE'
PARTS A & B
FOR SPRINKLER CONl'RACTOR (SIGNED) DATE
SIGNATURES
PART "C" - SPRINKLER & WATER $PRAY ABOVE GROUND PIPING (f7LL OV'f &EPARATE PART "C" FOR EACH R18ER)
SERVES BLDGS.
LOCATION New addition
1 HYDROSTATIC TEST OF ALt PIPING
TESTS
2 PNEUMATIC TEST OF ALL DRY PIPING
REQUIRED
3 EQUIPMENT OPERATION TE§TS OF AlL EQUIPMENT
SPRINKLERS MAKE
MODEL
512E
QUANTITY TEMPEAATUAE
RATING
OR Gk-m su -314"
SPRAY
NOZZLES
PIPE AND MATEAIAL AM) HIkID CONFOAMS TO . STANDARD
'-" IFNONE, EXpbAIN
FITTINGS
ALARM VA W E A L A R M O E V I C E biAXIMUM TIbS TOOPERATE T!Q[OUGN TEST PIPE
OR FLOW TYPE MAKE MODEL MIN. SEC.
INDICATOR Water
OPERATWG TEST RE8ULT8 WATER A3A TRiP TIME
DRY TIME TO'A'RSP PRESS. PAE88. POINT w'ATER ALqpM
MAISE MOUEL 3ER. TIQtWGHTESfPIPE REACHED OPEAATED
AIR
TE?
PIPE ?. WITHOUT WITII PROPENLY
Q. O. D. Q. O. D. PRESS. OVTLET
VALVES MIN. SEC. MIN, SEC. P.S.I." p,5.1. P. S. 1. hllN, SEC YES NO
IF NO, EXP LAIN
OPERATION pgEUMATIC ?ELECIRIC? NYDRIVLIC ?
DELUGE PI1'1NG Si1PERVIBED YES Q No 0 DETECTING MEDIA-BUPERVIBED yE8 O NO ?
& DOES VALVE OPERATE FROM TNE MANUAL TR3P AND/OA REMbTE COM'AOL 9TATION6 yE8 ? NO ?
15 THERE AN ACCESSIBLE FACII,ITY IN EACH CIRCUIT FOP TESTING
YES NO
? ?
IF NO. EXPIAIN
PRED.CTION
DDES F.ACN CRtCU1T OPEAATE DOES EACH CIRCMT OPEAAiE MAXIMUM TIb1E TO
MAKE MODEL SUPERVLSIONLl16SALAFM YALVEPELEASE OPERATERSLEA6E
VALVES
YE6 NO YE3 NO },qN. BEC,
AI,L PIPING HYDROSfATICALLY TESfED A7 PSI ppR gpppg
DRY PIPiNG PNEUMATSCALLY'CESTED yE5 Lj NO?
TESTS EQUIP6fENT OPERATE PROPERLY qg$ 0 tiQb'J
IF NO STATE REASON
RAIN TEST: RE!?] NG OF GACE ]ACATED NEAF A•ATER SiIPPLY TESY PeE: RSSNUAL PREBSUAE Y'TTN VpLVE IN TEST PIPE OPEN WNE:
/S STATICPFES3URE Pel pg
BIANK ?MgER USED IqCATlOT6 NUIfBER R6MOYSD
TESTING None
GASKETS
DATE LEFT IN SERVICE WITR ALL CONTROL VALVEg OPfiN. '
REMARKS 1o-2676
NA6ffi OF SPRIMCI.ER CON7RACTOR ppR PROPERTY. OR'N6R (SIGNSD) 717'16B
raer °c° CARLSON AUIOMATSC F'IRE PROTEGTION 6)
SIGNATURES FOR $i R RACfOA (SIGN&D)
.
f,
7T"-
EAGt1N TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minitesota 55111
Telephone 454-5242
(9/30/71) PfiRMIT POR WATER SERVICE CONNECTTON
Date• October 8/ 1971 Number• 732
Billing Name:Betesville Casket Co. Site Address: 3350 Mike Collins Road
Owner: Batesville Casket Co.
Billing Address 3350 Mike Collins Road
Plumber: SorinQ Plumbine Co.
e?z
Meter Size=-S
/ 67"
Building is a;
Residence
14ultiple No, [Tnits
Commercial xxx
Industrial
Other
Meter No.?,3? PeLmit Fee 10.00 gd 9/30/71
Meter Readicg ,_ Meter Dep. •50 pd j9/30/71
Meter Sealed: Yes_ ' Add'1 Chg.
Id0 ITotal Chg.
Inspected by
Date
Remerks;
By:
Chief Inspector
In conaideration of the iseue and delivery to me of the above permit, I
hereby agree to do tkm proposed work ia accordance with the rules and
regulatiosts of Eagan Townahip, Dakota County, Minnesota.
Bv:
S2rine Plumbine Co. ?
Please aotify the above office when ready for inspection and connection.
I6, - a -</-
fiaJal
??/.
EAGl3Id TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR SEWER SERVICE CONNECTION
9/30/71
DATE: Ociober 8. 1971
OWNER: Batesville Casket Co.
PLUMBER SprinR Plumbing Co.
NUMBER 891
Address 3350 Mike Collins Road
TYPE OF PIPE Heavy Cast Iron
DESCRIPTION OF BUILDING
Industriall Commerciall Residential I Multiple Dwelling i No, of unfts
Location of Connectfona:
ConnecCion Charge
Permit Fee 10.80 pd 9/30/71
.50 pd 9/3U/71 s/c
Street Repairs
Total
Inspected by:
Date
Remarks:
By
Chief Inspector
Ia consideration of the issue anl delivery to me of the above permit, I
hereby agree to do the proposed work in accordance with the rules and
regulations of Eagan Tos•mship, Dakota County, M3nneaota
By
Spring Plumbing Co.
9550 W. Bloomineton Freewav
Minneapolis, Minn. 55431
Please notify when ready for.inspection and coanecCion and before any porCion
of the work is covered.
°?C?O?OO GGi? AUTOMATIC FIRE PROTECTION COMPANY
11986 qiverwood Drive, Burnsville, Minnewb 5533) 1612) 696325p
October 280 1976
Eagan Township
3795 Pi1ot Knob Road
Eagan, Minnesota 55122
Attention: Dale S. Peterson
RE: Batesvil].e Casket
3350 Mike Co7lins Ilrive
Eagan, Mi.nnesota 55121
Dear Sir:
F,hclosed please fi.nd the Contractor's Material and Test Certificate
covering the sprinkler system at the above subject project.
If you have any questions, please contact this office.
Uery truly yours,
CARLSON AUTbMATIC FIRE PROTECTION
companyi
Phillip A. Caxlson `??
President
PAC/ck
1g? -
s ,
,
? AUTOMATIC SPRINKLER SYSTEM - FABRICATION - ENGINEERING
INSPECTIONSERVICECONTRACTS-EMEFiGENCVMAINTENANCE-Z4-HOURSERViCE
DIVISION OF STATE FIRE MARSViAL
.
1296 UNIVERSITY AVENl/E
ST. PAUL, MINNESOTA $5104
TELEPHONE: 1612) 296-7641
October 6, 1976
(n, Qt.wE`P,? •
STATE OF MINNESOTA
DEPARTMENT OF PUBLIC SAFETY
Mr. Pat Dady
Rauenhorst Corp.,
Suite 2200 - :?erttn,,estern Finmcial Center
7900 Ren:es Avenue Srntth
Ypls. , nd 55431
Re: Proposed installation of one 10,000 gallon tmderF;rcimd storage tanlc for a private
service station ior the Batesville Gasket Co., Inc., Eagan, :T1.
Dear Dadv:
The abeve T.mtiar_ed facili_ty has been approveed subject to ccrTliance with State Fire
Marshal Regulations, local ordinaices and percrats, and. the f:ollaaing items:
The tanks shall be installed in ccnfornIance with the stardards car.tained in 2datianal
Fire Protecti.or_ Association, Pmph1et 30, L°73 editicm, Fl=able and Carblustihle Liquios
Coce. Piote especially those provzsiaivs in Chapter II, "Tan; Stcrage" ap. L-3II,
Chapter III, "Piping, Valves and Fittings" pp. 39-41, and ChvIpter NII, "Bull: Plants"
pp. 63-72, as they apply to yaur project.
1. The tar3c shall be su==:ded on a1Z sides witn ardnir-an of six inc?aes o` ir.est
non corrosive saterial.
2. Conrosian protecticro shall be provided for the twk md appurteruarces.
3. The tanlc and pinin¢ s?7iall be tested for tightness prior te being covered ar_d so
certified.
4. If the cark is sJ} ject to traffic, it sha11 be protectee- hy a.runi*Un cf covering
of at least eigfiteer, inches o` u-e11 t?ed sard pius eit?-ner six inches ot corsrete
or eight inches o£ asphaltic cancrete.
?
AN EQUAL OPPORTUNITY EMPLOYER
Pa&c 2.&L z r;e.
?fr. Pat Aady
October 6, 1976
40
5. At least one approved fire extinguishex with a rating of not less t'?an 5 BC
sliall be provic:ed wittun one Ynmclred feet of ti,.e pia*p island azd a11 personnel
shall be thoroughly instructed in its use.
Installation subject to finat aQpraval ar.d inspection by the State Fire P?arshal's Office.
Yotff's very trulY,
tJes Wemer, St2te Fire Marshal
by A. L. LuuYlconen
ASSISTPidT SiAM FI4E Ml1RSHAL
cc: P,on Soch-iess
Fagan Fire I!ept.,
John Karich, bept. of Labar and Indu.stry
Sulie Close, Energy fgmcy
?
July 18, 1991
Minnesota Pollution Control Agency
520 Lafayette Road, Saint Paul, Minnesota 55155-3898
Telephone (612) 296-6300
Mr. Alan Larson
Batesville Casket Company
3350 Mike Collins Drive
Eagan, Minnesota 55121
Dear Mr. Larson:
RE: Petroleum Tank Release Site Closure
Site: Batesville Casket Company, 3350 Mike Collins Drive, Eagan
Site ID#: LEAK00003442
The Minnesota Pollution Control Agency (MPCA) staff has determined that the
cleanup performed in response to the petroleum tank release at the site
referenced above has adequately addressed the petroleum contamination, and
therefore the file regarding this release will be closed.
On October 23, 1990, a petroleum tank release was reported to the MPCA. Since
then, the following corrective actions have been taken in response to the
release:
- One 10,000 gallon underground storage tank previously containing diesel fuel
was removed.
- Approximately 10 cubic yards of petroleum contaminated soils were excavated
and used as controlled fill at an excavation on Collins Drive in Eagan with
MPCA approval.
- Soil excavation extended down to 9 feet below grade. Field soil vapor
headspace analysis utilizing a photoioniza[ion detector indicated levels oE
0.1 to 0.7 parts per million (ppm) at the base of the excavation. Chemical
analyses of two soil samples taken from the north and south ends of the
excavation basin detected 21 and 2.4 ppm, respectively, for total
hydrocarbons as fuel oil. Analysis for benzene, ethyl benzene, toluene,
xylene compounds indicated levels of less than 0.3 ppm. It was confirmed
that the standing water observed in the excavation basin was not ground
water. Based on the available data, the low levels of petroleum
contaminated soil that remain in isolated areas of the site do not pose a
threat to pu6lic health or the environment.
Regional Offices: Duluth • Brainerd • Detroit Lakes • Marshall • Rochester
Equal Opportunity Employer • Printed on Recycled Paper
Mr. Alan Larson
Page 2
July 18, 1991
Based on the currently available information, we concur with the conclusions of
Braun Intertec that these actions have adequately addressed the petroleum tank
release. Therefore, MPCA staff does not intend to require any more
investigation or cleanup work in response to this release. However, the MPCA
reserves the right to reopen this file and require additional work if in the
future more work is determined to be necessary, and this letter does not
release any party from liability for this contamination.
Because you performed the requested work, the state may reimburse you for a
major portion of your costs. The Petroleum Tank Release Cleanup Act
establishes a fund which in certain circumstances provides partial
reimbursement for petroleum tank release cleanup costs. This fund is
administered by the Petroleum Tank Release Compensation Board (Petro Board).
More specific eligibility rules are available from the Petro Board
(612/297-4017).
Thank you for your cooperation with the MPCA in responding to this petroleum
tank release to protect the public health and the environment of the state of
Minnesota. If you have any questions regarding this correspondence, please
call me at 612/297-8578.
Sin erely,
Patrick C. Hanson
Project Manager
Tanks and Spills Section
Hazardous Waste Division
PCH:np
cc: Eugene VanOverbeke, City Clerk, Eagan
Kenneth Southorn, .°i*_ Chief, Eagan
Dave Swenson, Dakota Public Health/Western Service, Apple Valley
Dave Russel, Braun Environmental Laboratories, Mendo[a Heights
2004 COMMERCIAL BUILDING PERNIIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5694
I
• SWCtural Plans (2) sets • ArchRedural Plans (2) sefs • Architecturel Plans (2) sets
• CivilPlans (2) • SWc[uralPlans (2) • CodeAnalysis (1)"
. Certificate of Survey (1) • Civil Plans (2) • Project Specs (1)
• Code Malysis (1) " • Landscaping Plans (2) • Key Plan (1)
. ProjectSpecs (1) • CodeMalysis (1) " • Master Exit Plan (1)
. Spea Insp. & Testing Schedule " • Certificate of Survey (7) • Energy Calwlations (1) not always°
• Soils Report (1) • Spec. Insp. & TesGng Schedule (1) " • Elec. Power & Lightlng Form (1) not aiways"
. Meter size must be eslablished • Meter slze must 6e estabiished • Meter size must be esfablished-'rf applicable
1 • ProjectSpecs (t)
y . EnergyCalCUlations (1)
1 • Electric Power & Lighting Fortn (1)
b . Master Exit Plan (1) 1
1. • Emergency Response Site Plan (1)
1 • SoilsReport (1) 1
• SAC determination - call 651-602-1000 • SAC detertnination - call 651-602-1000 SAC detertnination - cail 651-602-1000
Call MN Deot of Health at 651-215-0700 for details re¢azdintt food & beverage or lodging facilities
•• Contact Building Inspec6ons for sample and if required when it states "not always".
•*• Permit for new building or addition will not be processed without Emergency Response Si[e Plari.
Date aL4 Construction Cost ?? ? ? OC2.OQ
Site Address
Tenant Name ?•
7 v
nr& SC
-?t Unit/Ste #
S Former Tenant Name
Description of Wark Nt'V k" ?? ? ? ??? VLO (' 61- Yf(i 5 C)4?- I Y-l`
PropertyOwuer 80-Gk?ey tti{'\ ;_X/Yls Telephone#((yS() z4S`?-o377
Contractor frA
-?
Address a3 o i c?l SL f A? i vL S-f.2_?f csty l? N?tQ A?'v /i S
State lvIIVIYLP SD Zip Telephone#( (p/1) 7d?^ 7/d-j
Arch/Engr Registration #
Address CitY -
State Zip Telephone # ( )
Licensed plumber installing new sewerlwater service: Phone #: L
_
I hereby apply for a Commercial Building Permit and aclnowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a pemut, 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.
KWt., t) C,N1N-i PA-it-
Applicant's Printed Natne
1,, a..Q ? (2
ApplicanYs Signature
Sub Types
? 01 Foundation
? 14 Apariznents
? 15 Lodging
0 25 Miscellaneous
OFFICE USE ONLY
0 26 Public Facility
X 27 Commercial/Induslrial
O 28 Greenhouse
? 29 Antennae
? 30 Accessory Building
? 32 Ext Alt-Aparknents
? 34 Ext Alt-Commercial
? 35 Ext Alt-Public Facility
0 37 Nail Salon
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)' x 43 Reroof ? 46 Windows/Doors
? 34 Replacement •Demolltlon (Entire Bldg only) - Give PCA handout to appiicant
?
Valuation 7oic00 Occupancy MCES System
Census Code 122-7_ Zoning City W ater
SAC Units Stories Booster Pump
Nbr. of Units ? Sq. Ft. PRV
Nbr. of 81dgs ? Length Fire Sprinklered
Type of Const Width
Reqnired Inspections
_ Foorings (new bldg) Insulation
_ Footings(deck) FinaUC.O.
_ Footings (addition) Final/No C.O.
Foundation Other
Drain Tile
V/
_ Roof Ice Pr
Decking _ Insui _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Framing Siding _ Stucco _ Stone
_ Fireplace _ R.I. _ Air Test _
_ Final _ Windows
Approved B
: Plannin ildi
I
t
C/?
?b?b
y
g !
u
ng
nspec
or
-------
-------------------
----
Base Fee ----------
`-7 '33
Surcharge 3S--
Pian Review
MCES SAC
City SAC
Water Suppiy & Storage (WAC)
S/W Permit
S/W Surcharge
Treatment Plant
Park Dedication
Trails Dedication
Water Quality
Copies
Water Trunk
Sewer Trunk
Other
Total
- a)(--\nQ -
2006 FIRE SUPPRESSION SYSTEMS PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eag Mn 55122
Telephone # 651-675-5675 Fa? 4W??-'JP9c? ?
uu v D
Requirements: 2 complete sets of drawings and specifications FEB Y s 2007
Cut sheet5 on materials and comnnnenrs tn hp „?PA
'SO,=
Date
Site Address:
Tenant / Building Name:
The Applicant is: _ Owner ? Contractor Other
PROPERTY OWNER
Address:
City: State: Zip:
CONTRACTOR MN License #:
l?
Address: City: (2s\
State: Zip: UjWA Phone #:
ESTIMATED COMPLETION DATE; _CS?
FIRE FERMIT TYPE: Sprinkler System (# of heads Fire Pump _ Standpipe
Other:
WORK TYPE: _ New _ Addition _ Alterations ? Remodel
Other:
DESCffiPTION OF WORK: aL Commercial _ Residential _ Educational
_ Other:
??u1 \ w"?s???z11v
Please cantinue on reverse side
PERP'IIT FEE: $50.50 Mirximurte Fee (includes State Sutcharge)
Contract Value $? - Q? x.01 =$ rPermit Fee
• If Permit Fee is $1,000 or less, add $.50 => $
If Permit Fee is over $1,000, add $.50 per
State Surcharge
$1,000 Permit Fee
3/4" Displacement Fire Meter - $167.00
TOTAL FEE:
s ",-)C) -
I hereby apply for a Fire Suppression System permit and acknowledge that the inforxnation is complete and
accurate; that the wark will be in conformance with the ordinances and codes of the City of Eagan and with the
Minnesota Building/Fire Codes; that I understand fhis 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 w7th the approved plan in the case of
work which requires a review and approval of plans.
Applicant's Print Name Ap icant's Si a
DO NOT WRITE BELOW THIS LINE
Clty of Eap
?--------------
I For Qff",?e Usg ?
? Permit#: ?
? Permit Fee: ?
I
I Date Received:
j Staff: I
L - - - - - - - - - - - - - - - - - I
008 COMMERCIAL PLUMBING PERMIT PPLICATION
Date: a4loK SiteAddress: ?Ve/
Tenant: & " LK./C?or- Suite #:
PROPERTY Name: Phone:
OWNER
CONTRACTOR Name: License#:
Address: 1? ? PdCity: State:, 9A IZjp; SSI?I
Phone: (0? -HS,9'-15t? ContactPe rson:
TYPE OF New Replacement Repair ? Rebuild Modify Space Work in R.O.W.
WORK - - y
D
i
ti
f y P,,n -
escr
p
on o
work:
PERMIT TYPE COMMERCIAL
_ New Construction _ Modify Space
_ Irrigation System (_ yes no) RPZ PVB) .
• Rain sensors required on irrigation systems
• Avg. GPM _(2° turbo required unless s maller size allowed by Public Works)
Meters Call (651) 675-5646 to verity that tests passed prior to pickina up meter. .
Domestic: Size & Type Fire: Size & Price 3/4" meter 183.00
. Avg. GPM High demand devices? _Yes _ No
Flushometers_Yes_No PRVRequired _Yes_No
COMMERCIAL FEES:
$50.50 Minimum (includes State Suroharge) OR Contractvaiue E x 1%
?
00
_ $
• Pertnit Fee
Required on ALL new buildings and boulevard irrigation systems ?_$ Radio Meter Read
- If Perrnit Fee is less than $1,000, surcharge is $.50 =$ Meter(5)
- If Permit Fee is >$1,000, surcharge increases by $.50 for each $1,000
$7,000 Permit Fee (i.e. a$7,0Ob$2,OOO Permit Fee requires a $1.00 surcharge). _$ State Surcharge
Following fees appty when installing a new lawn irrigation system. $ --'-- Water Permit
Call the City's Engineering Depadmenf, (651) 675-5646, for required fee amounts. .
$ TreaUnent Plent
$ Water Supply & $torage
$ State Surcharge
TOTAL FEES $
I hereby acknowledge lhat ihis in/ormatlon is completa and accurate; Ihat the work will ba in conformance with the ordinances and codes of the City of Eagan; ihat I understand this
is not a permit, hut onty an application for a permit, antl work is not to start without a permit that [he work will 6e in accordance with the approved playthe rase of work which
requires a review and appmval of plans.
yplicanYs P
FOR OFFICE
- Rei
sUSE... . .,
Page 1 of 3
%
??? ls? lq2"d