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PLUMBING (COMMERCIAL)
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5694
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Date (!19 / Oq / 0-2-) ? Co ,S ,
Site Address 4z)?o Unit #
Tenant Name Former Tenant Name
Property Owner Telephone # ( )
Contractor
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Address ??j,a'7 (?jpc?? ? °.7 ? City
State (?1N Zip Telep6one # ( ?y?J
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The Applicant is _ Owner _ Conuactor _ Other
Work Type _ New Bldg Add-on Repair RPZ PVB Irrigation system "
• Jer Wobschall to calculate fees. R uired meter size is P' turbo unless smaller size ermitted b Public Worka
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Description of Work n
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To inquire if Pressure Reducing Valve is required on new service, ca11 651-675-5 646 ?
Meters - Cal] 651-675-5300 to verify that hydrostatic, conductivity, and bacteria tests passed prior to oickine uo meter
Irrigarion Size & Type Avg GPM _
Fue Size & Pnce 3/4" disolacement $156.00
Domestic Size & Type Avg GPM Includes high demand devices? _ Yes _ No
Flushometers _ Yes No PRV Required _ Yes _ No
Permit Fee $50.50 minimum (includes State Surcharge)
Contract Value $ x 1% - $ Base Fee
$ Meter(s)
Required on all new buildings & boulevard irrieation svstems $ Radio Meter Read
If base fee is $1,000 or less, sureharge is $.50 $ St3tC $uLC}1&LgC
If base fee is over $1,000, surcharge is $.50 per $1,000 of the Base Fee
Following fees apply only whert installing new irrigation system ---?Y---- $-?--Y-??-----Water Permit ?
Contact Jerry Wobschall at 651675-5024 £or required fee amounts ?
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$ 1- i I I U .) ? State Surch
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$ ? Total-Eee=?
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I hereby apply for a Commercial Plumbing Pemtit and acknowledge that the informa[ion is cbmplet d aceurate; that the work will be in
conformance with the ordinances and codes of the City of Eagan and witn [he PlumUing Codes; [ha d tand this is not a pemvt, but only an
application for a permit, and work is not ro start without a permit [hat the work will be in accord ce it the approved plan in the case of work
which s a rev of plans. 4 -?eo5 sDL% P?
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ApplicanPs Printed Name ?J