3893 North Ridge DrOFFICE USE ONLY
L BL
? RECEIPT #:
SUBD. RECEIPT DATE:
1997 PLUMBING PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD.
EAGAN, MN 55122
(612) 687 -4675
Please compiete for: . all commerciaVindustriel buildings.
• mutti-famiy build'mgs when aeparate pertnita nreag( required for each dwelling untt.
• backNOw preventer to be instelled in commeraal areas or resitlential boubvards
DATE:
DESCRIPTION OF WORK:
WORK TYPE: _ New Conat. _ Add-0n _ Repair
IS WATER METER REQUIRED? _ Yes _ No. ARE FLLISHOMETERS TO BE INSTALLED? _ Yes _ No
SlNDERGROUNO SPRINKLER 3VSTEM
INSTALLING METER7 _ Yes _ No. NEW SERVICE? _ Yes _ No WATER FLOW: GPM.
Pressure Redueing VeNe may be required if installing new service - wntact Ciry's Engineering DepartmeM at 681-4646.
FAILURE TO PROVIDE THE ABOVE INFORMATION WILL RESULT IN A DELAY OP METER ISSUANCE
FEES
Minimum fee ot E25.00 ar t°h of contrad price, whichever is greater. Minlmum Stete Sutcharge ot $.50 tlue on all permits
CONTRACTPRICE: $ x 1% = $_
COMPLETE THIS AREA ONLY IF INSTALLING UNDERGROUND SPRINKLER SYSTEM
BACKFLOW PREVENTER FEE $ 25.00 = $ vs. ac
WATER PERMIT (new service onty) 50.00 = $, 8'a •0?
WAC (new service only - per connection) 780.00 = S o
WATER TREATMENT (new aervice onty - per connection) 420.00 = i O.op
CITY INSTALLED TAP 300.00 = $
METER: V = $185.00. 2• ruReo = $846.00 = y
?y?lc0, o-D
n ?/ c .., ?, .
PERMR FEE $ 71D?T".7-°?-
F16URE SIIRCMARGE AT 50 CENTS FOR EVERY i1,000 OF
PERMIT FEE CUe ??
STATE SURCHARGE $ '
TOTAL $.11160,50
I Mreby acknowkdge that I have read this appikation, stele that the information is coneU, and agree to comply witA all sppliceble City of Eagan ordinancea.
k is the appliceM's responsibilily ro notiy the property owner that the City of Eagan assumas no Ilabiliry for any dameges cause0 by the City during its normal
operetional and maintenance adivfties ta the natructed is rtnk wkhiry6lty property/right-of-weyleasemeM.
SITE AODRESS:
TENANT NAME: SIE. # :
OWNER NAME:
INSTALLER NAME: I 11? . ,R TELEPHONE #:
STREET ADDRESS: - `??a ?o ?0.J? ?P •
CITV:
y ?s ?>
? q 7l aS G? a`? ?I?Z
ocFlCe use onLv • neVEasE sIoe
ZIP: 6:?S I0 a-
METER SIZE
Domestic
Irrigation
OFFICE USE ONLY I
PLUM8ING PERMiT (COMMERCIAL)
p$y Yes
i
JTILITY CONNECTION (APPLIES TO NEW SERVICE ONLY)
$
REVIEWED BY
Building Inspector
determin
• See if it is indicated on back of Building inspections card
• Enter address in PIMS Screen 301 to obtain S&W permit #
• Check PIMS Screens 110 (Remarks) 'i
• If gallons per minute are less than 25, a 1" meter will be required. If gallons per minute are m
strainer will be required. This information is to be supplied by the design'er of the system
Inspector if Lieensed Plum6er does not know GPMs. ?
linv meter
Check PIMS Screen 320 for anitgroval of inspection resuits. No meter will be sold before all sewe
compiete on a new service. If new service lines are not required, one check maylbe written for me
meter type and size on receipt, code to 3716-9220 (meter poRion only), and forward copy W Util
Enter meter size, type, rece'rpt #, date & amount paid on PIMS Screen 110. Copy of receipt shoi
Clerk. I'
miscenaneous mrortnauon
The installer is to contad Building Inspections at 681-4675 for inspection of the inside water line an
Public Works Department may be reached at 681-4300 far water tum-on.
.
If ineter is over 5/8, call Pubiic Works and let them know so they can teil you if they have one in
overthere. .
e than 25, a 2" turbo with
ConsuN with Plumbing
and water inspections are
Dr and permit costs. Write
y Billing Clerk.
be given ro Utility Billing
backflow preventer. The
before plumber goes