1257 Northwood PkwyC?9 691
2005 COMMERCIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
s o
Date N / I $ / S"
Site Address i02 57 N o R T4 W O n D t?KwY Unit #
Tenant Name ?411111 Be e(,pN1a FueU 1ru ¢E Former Tenant Name
Property Owner SAf'At Telephone #( )
Contractor 2 ?ACTa0 ?'YIcGN6N%O-AL XuC.
Address 01?SD ( I114lLEY UICW C0At, City tOcN Y-icr91[It
State /)1n1 Zip 5534tI Telephone# (95*? QqI•q957
License # Expires:
The Applicant is _ Owner X Contractor _ Other
Work Type New Bldg _ Modify Tenant Space RPZ PVB New Repair/Rebuild _ Replace
_ Irrigation system Work within public right of-way/easement _ Yes _ No
Rain sensors are re uired on irri ation s stems
Description of Work KAA?LiD epZ
To inquire if Pressure Reducing Valve is required on new service, call 651 b7S-5646
Meters - Cal] 651-675-5300 to verify that hydros[atic, conductiviry, and bacteria tests passed prior to picldn¢ uo meter.
Irrigation Size & Type Avg GPM 2" turbo req'd unless smaller size allowed by Public Works
Fire Size & Price 3/4" displacement 5161.00
Domestic Size & Type Avg GPM Includes high demand devices? _ Yes _ No
Flushometers _ Yes _ No PRV Required _ Yes _ No
Permit Fee S50.50 minimum (includes State Surcharge)
ContractValue $ x 1% _ $ PermitFee
$ Meter(s)
Required on all new buildings & boulevard irrieation systems $ Radio Meter Read
If perrttit fee is $1,000 or less, surcharge is $.50 $ $t3tC SLLTCh3i'g0
If permi[ fee is over $1,000, surcharge is $.50 per $1,000 of the Permi[ Fee
Following fees apply only when ins[alling new irrigatiou system ?$ ? Water Permit
Call Jerry Wobschall at 651-675-5024 for required fee amounts
$ Treatment Plant
$ Water Supply & Storage
$ State Surcharge
------------------------------------------------------------------------------------------------------------------- ? -
$ ,5 0 S? -----°--'-----------------------------
Total Fee
I hereby apply for a Commercial Plumbing Pemvt and acknowledge that the infocmation is complete and accurate ftr},at - e art-will-be-in__
?t y r
conformance with the ordinances and codes of the City of Eagan and with the Plumbing Codes; that I understand this lfjnot a perm?t56 q
application for a pertnit, and work is not to start without a pemvt; that the work will be in accordance with the approv d''plan in the case of-wo?I
which requires a review and approval of plans. A P ,Z L
R
6 Z5
17EUUrs EDrLAQOS
ApplicanYs Printed Name AppicanPs Sigiature IF„
CTTY USE ONLY
REQUIRED INSPECTIONS: _ U.G. _ Air Tes[ _ Gas Test _ Rough In _ Final
PLAVS SUBMITTED APPROVED BY: . BUILDING INSPECTOR
General Information
• Radio Meter Read (required on all new buildings & boulevazd irrigation systems- $141.00
• RPZ's must be tested every year and rebuilt every five years. Test results should be mailed to Paul Heuer at the City of Eagan.
• A minimum fee permit per address is required for the following RPZ's: new, rebuild, reoair, remove.
• W ater meters include copper horn/strainer, remote wire, and touch-pad meter.
METERS REOUIRING 4-HOUR ADVANCE NOTICE PRIOR TO PICK UP
GPM
i METERS tiSE PRICE GPM METERS USE PRICE
1-20 5/8" residential $125.00 4-120 1-1/2" irrigation Syst $ 735.00 '
displacement smcommercial turbine'* Pubtic Works
maximum must approve
conrinuous metersize
10
2-30 3/4" lawn nrigation $161.00 4-160 2" turbine lg irrigarion syst $ 931.00
maximum displacement residenrial &
continuous sm commercial producrion lines
15
I
3-50 1" displacement very lg res $296.00 1/4 to 160 2" compound bldgs over $ 1,849.00
bldg to 24 units 65 units
maximum sm commercial &
continuous & lg comm bldgs
25 irriation s stems
5-100 1-1/2" bldgs 25-64 units
maximum
displacement
& F
continuous most comm bldgs
I n
50
METERS REpUIRING 30-DAY ADVANCE NOTICE PRIOR TO PICK UP
GPM METERS USE PRICE GPM METERS USE PRICE
5-350 3" turbine very Ig irrigation $1,182.00 6-500 4" compound +300 unit bldgs & $3,563.00
syst & production very Ig comm bldgs
lines
1/2-320 3" compound +200 unit bldgs $2,282.00 10-1000 6" compound +400 unit bldgs $6,076.00
very lg comm bldgs very Ig comm bldgs
15-1000 4" turbine verylgirrigation $2,226.00
syst
& production lines
Comments
• To schedule inspecrion of the inside water line and backflow preventer, ca11651-675-5675.
• To arrange for water hun-on, call 651-675-5300.
cc: Maintenance Division Clerical Technician January 2005
L 1 B
SuBD. L C<..k.Ck v?
APPROVED
CITY USE ONLY
`Y
xECErnr a-
RECEIPT DATE
PLUMBING PERMIT # 59 t O?
INSPECTOR
2000 PLUNIDING PERMIT (COI+IlYIL+RCIAL)
CITY OF EAGAN
3830 PILOT EINOS RD
EAGAN, MU 55122
651-681-4675
Please complete for: all commerciaVindustrial buildings
multi-family buildings when separate building permits are not requireA for each dwelling unit
installation of backflow preventer in commercial areas or residential boulevards
Date: ) -'rl c1 Work Type: ? New Bldg. _ Add-on _ Repair _ U.G. Sprinkler _ RPZ
Descripuon
To inquire
9A 'S. yJ, p, g,-c
Valve is reauired on new
FEES
1% of contract price or $30.00 minicnum
ca11681-4646.
ContractPrice: $ SI b x 1% _
(D C)
CO"LETE THIS AREA ONLY IF INSTALLING VNDERGROUND SPRINlfLER $YSTEM
Base Fee - $ 30.00
Water Meter: 2" Turbo - $897.00 unless plan approved for smaller size $
1-1/2" Turbo - $ 726.00
Service: _ existing (if coming off domestic line) OR _ new
/f "new service ". contact Jerrv Wobschall. Finance Consultant to conf:rm addinp fees for:
Water Permit & Surcharge - $ 50.50
Water Supply & Storage - $ 840.00
Water Treahnent Plant Chazge - $ 492.00
cc: DlaneDawns,!ltilityBilltdg - undergroundspNxklerpermits
. BaseFee S ?j l 5.C) C?
State Surchazee State Surcharge $ - 7
$.50 minimum; calculate at $.50 far each $1,000 Base Fee Total Fee $ 1Vi • 5
I hereby aclanowledge that I have resd this applicatioq state that [he information is conect, and agree to comply with all applicable Ciry af Eagan
ordinances. It is the applicant's responsibility to notify the property owner thaz the City of Eagan assumes no liability for any damages caused by the
City during its normal operational and maintenance activiaes to the facilities construc[ed under ihis permi[ within City property/rightof-way/easemenC
SITEADDRESS: IZS1 OC7R? wOGC
TENANT NAME: U4"bl4 2ca,? TELEPHONE #: ?_ 4S Z- 7`j O O
(AREA CODE)
Au&
Az
!?
' (Z - eI
4 ? --q-qs 1
INSTALLER NAME: , TELEPHONE #:
'v-l
Qa
' (? .
? (AREA CODE)
STREET ADDRESS:
CITY: C?- ?.'H W 2 k? (Z STATE: ZIP: j53
?
?- ? '?
SIGNATURE OF PERMITTEE
CITY USE ONLY
DOMESTIC METER SIZE: COMPOUND _ TURBO I'
• Contact Utility Billing Division for price: 651- 681-4631.
IRRIGATION METER SIZE:
• 2" turbo unless approval for smaller meter ganted by Public Works. I
• Contact Utiliry Billing Division for price: 651-6814631. I;
PRV: Yes No
PRIOR TO SELLING A METER:
• On Permit Entry screen, enter site address to look up sewer and water permit #. Select S&W Pe I it and check that hydrostatic
and conductivity tests have been approved. If not, do not issue meter.
I
Miscellaneous
• Meter lazger than 5/8" - ask plumber to wait while you call Central Maintenance (ext. 300) and yerify that one is in stock.
• To schedule inspection of the inside water line and backflow preventer, call 651-681-4675. I
• To schedule water turn-on, call 651-681-4300. I
CD/Permit forms/plbg permit (comm) 2000
TO: KENT THERKELSEN, CffiEF OF POLICE
JAMIE VERBRUGGE, ASSISTANT TO THE CITY ADMINISTRATOR
DALE WEGLEITNER, FIRE MARSHAL
PLUMBING INSPECTOR: DIRK HOUSE
ELECTRICALINSPECTOR
PUBLIC WORKS/ ENGINEERING DIVISION /UTILITIES/STREETS
GENE VANOVERBEKE, FINANCE DIRECTOR
MIKE RIDLEY, SENIOR PLANNER
ERIC MACBETH, WATER RESOURCES
GREGG HOVE, SUPERVISOR OF FORESTRY
FROM: TERRY ZELENKA, BUILDINC INSPECTOR
DATE: NOVEMBER 19, 1999
RE: PLAN REVIEW: Ll, Bl. EAGAN PROMENADE 3RD j
The _ preliminary X construction plans for Ea2an Slumberland aze in our plan
review section for your review and comment.
Please return this form to Dale Schoeppner with your signed comments and the date of
review. If you have any concems with these plans, piease so indicate on this form and notify and
resolve these issues with the affected parties. If you are requesting that issuance of the building
permit be held, please fill out the proper "hold" request form.
Comments:
Indicate any fees that aze to be collected with the building permit:
AMOUNT
? Yes ? No landscape security required
? Yes ? No water quality dedication
? Yes ? No park dedication
? Yes ? No trail dedication
? Yes ? No tree dedication
? Yes ? No
ZONING?
Signature
CD/FORMS/PLANREVIEW WAYNEM
Date
rITY OF EAGAN
CASHTER: JS TF..RMINAI. NOe 007
DAjTEa 1 2/17/39 TIME: 13:35e05
IL
NiF. I iAGMAN Cf]NSTRIJCTION TNC.
3210 9001 ic^25r NORTHWOOD iB1.25
3866 9379 125' NCIRTH140011 i?000.00
2257 3001 1257 NOFiTH1400D 5?000.00
3855 3:328 :L'2.57 NOFITI"IWOOD 227653.00
2?75 9220 1.257 NORTHWQDA 109,':595.00
3446 9001 1257 NOFTHWOOL 105.00
2155 5001 9.257 PlOIiThIWUUD 0.50
3743 3t.'.2D 1257 NORTNWOOU 50.00
2t55 91701 1257 NORTHNI00D 5.00
3869 9220 1257 NClRTHWCIOD 4? 680. DO
CR12:L3E,3 CONTINUE
L1SER IDa JAN CQNTINIIE
<5 * w 3q, 1oy
CONTINUE
CITY QF EAGFlN
CASHIEFi: JS TEI"iMSNAL. N0: OOi
DATE:: 12/17/99 TIME9 13:35:06
IC1:
NAt1E, I•1AGMFlN CON5TFUCTTON INC.
3713 9220 1257 N(JFTH1400D , 50.00
T'ota:l. Receipt Ainouni;: 447119.75
CR121.3C,3
USEfi ID: 7AN
? 1999 BUII.DING PERNIIT APPLICATION (COMMERCIAL)
2 C r? ?'7 C? CITY OF EAGAN
651681-4675
Requirements to buildinq permit
Foundation Onl New Construction Interior Im rovement
• Struclural Plans (2 sets) • Archltectural Plans ^ (2 sets) • Archilecturel Plans (2 sets)
• Civil Plans (2 sets) • Structural Plans - (2 sets) • Code Malysis (1) "
• Code Analysis (1) " . Civil Plans ^ (2 seLS) • Project Specs (1 set)
. Project Specs (1) • Landscaping Plans ? (2 sets) • Key Plan .
• Spec. Insp. & Testing Schedule • Code Malysis (1) " • Master Exit Plan
• SAC determination letter hom MGES - • SAC determination letter from MGES,- pll • SAC determination IeHer from MGES - call
call 651-602-1000 651-602-1000 651-602-1000
• Spec.insp.&TestingSchedule ('I) " • EnergyCalculations (7)notalways"
• Projed Specs (1) • Elec. Power & Lighting Form (1) not always ."
• Energy Calculations (1) "
• Electric Power 8 Lighting Form (,1) "
• Master Exit Plan •
. Soils Re ort 1
" Contact Building Inspections for sample
Food & beverage or lodging facilities: Plan must be submitted to Minnesota Department of Health. Call 651-215-0700 for details.
DATE: II / I?/ ICT t WORK TYPE: 7?. NEW REMODEL
DESCRIPTION OF WORK: ?e ?ck- ; \ 5-/ -Q
CONSTRUCTION COST: I I, &o, Oou c
NAME: S`V VM V)&', 1ct- v\ C/,
SITE ADDRESS:
SUITE #:
LOT? BLOCK? SUBD. ?a.Qcx?n ?0-+/??AC?4-0P.I.D.#
(Fc" \ [?V'?pvm4n)
Name: )'-\C.1V50"1 ??t,??+"???5 Phone#: b5 `1 ?KZ-75-00
PROPERTY Last F'ust
OVV:VER ? l
StreetAddress: ?0 60 Cev?'!E'v v? I? e I\ a?'ic/?
City ?u,.n,k. A C-'s- State: N ? . Zip:
?
Company: ?GQ yV?c&1? CO-LSA vV? Phone#: ?`?-S4S`' S JS?
CONTRACTOR Is Street Address: S3Sl J?5-??n \0 jC P v'2
City 04. kp u t'SB?? k State: P ? Nvi Zip: SS ? I?
ARCHITECT/ /''1 ? l
ENGINEER Company:l__.,m,y? (1, jTa f'?• Phone#: p I G-33(?" // W`=' ` ?f
Name: l?'O?J?? ?1?• ? Registration #f: f1 UTS
? Street Address: G? ?-l 1 V ?? a ?? ?' e P? 3(?q I
` City 1%Y1 Vt eq Pa'' S State: vi Vi Zip: s S?TD I
' S pCL rVrA k ?? a/??t I-?t 9 57L'
Sewer & water licensed plumber (oniv if installina sewer & water): c-?
1 here6y acknowledge that I have read this application, state that the information =recand gAtply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances. a?J
Signature of Applicant.
?
OFFICE USE ONLY
BUILDING PERMIT TYPE
X 01 Foundation
? 25 Miscellaneous
WORK TYPE
? 26 Public Facility ? 28 Greenhouse
" 27 Commerciai/Industrial ? 29 Antennae
?it 31 New ? 34 Repairs ? 37 Demolish Bldg. ? 43 Siding/Soffits/Facia
? 32 Addition ? 35 Tenant Impr ? 38 Demolish (Interior) ? 44 Windows/Doors
? 33 Alterations ? 36 Move Bldg. ? 42 Reroof ? 45 Fire Repair
GENERAL INFORMATION
Const. (Actual) O?I/ Basement sq . ft. Census Code 3 Z9
(Allowable) ? First Floor sq . ft. ? `Z.r SAC Code 3?
UBC Occupancy j
sq
. ft.
No. of Units
O=
Zoning sq . ft. No. of Bldgs: /
# of Stories sq. ft. MC/ES System y? r
Length (?3 sq . ft. City Water Ye s
Width 2v3 Footprint sq. ft. 3y s? Fire Sprinklered es
APPROVALS
Planning Building t) s : Engineering Variance
Permit Fee ? g I 3S ? 10j
Surcharge 5 ?U
Plan Review ( f37, 8
MC/ES SAC 1-4x D,S"Oo
City SAC (o x ? pp ;? / Ooo
Water Supply & Storage -------?
S/W Permit /8 0
S/W Surcharge , S o
Treatment Plant (ok y6? ? ? o
Park Dedication ? ?.?.frs?5 ; Oei
Trails Dedication
Water Quality
Other LAcHoSfAf'IN(+p 5" ? 00 d, G o
Copies
'fotal
'#q , I I 9.--] 5
VALUATION:
?DVNAo?tanj otitLY:
?-_
% sac
SAC Units ?
Meter Size
$
1
?
;.
I city oF eagan
PATRICIA E. AWADA
Mayor
DeCCri1bCL 2, 1999 PAUL BAKKEN
BEA BLOMQUtST
PEGGY A. CARLSON
SANDRA A. MASIN
Council Members
HAGMAN CONSTRUCTION THOMAS HEDGES
MR BRYAN BROBERG atv ndminirnarar
5353 GAMBLE DR e. J. vnN ovEaeEKe
PARKDALE 4 SUITE 100 ci+v aark
MINNEAPOLIS MN 55416
RE: SLUMBERLAND OF EAGAN
LOT 9, BLOCK 2, EAGAN PROMENADE
Dear Bryan:
We have completed our review of the construction documents submitted in pursuit of obtaining a
bnilding permit for the above-referenced project. This review is not intended to be an exhaustive
and comprehensive report. Unless otherwise noted, all references are to the 1997 U.B.C. It is
our goal that this review will help you in complying with the applicable codes and we are,
therefore, requesting that the following items be addressed.
Please submit the following:
1. 5AC determination letter
2. Special Inspections & Testing Schedule
3. one set of energy calculations
4. Electrical Power & Lighting Form
5. Dimensions from all property lines to the building
Please be advised that the City's Planning Department has requested that a building permit not
be issued for this project until such time as the plazuiing requirements aze satisfied. Any
questions regazding these requirements should be directed to Pam Dudziak at 651-681-4691.
If you have any questions, please call me at 651-681-4683. Thank you.
Sincerely,
J. Craig Novaczyk
Combination Building Inspector
MUNICIPAL CENTER THE IONE OAK TREE MAINiENANCE FAdLIN
3830 PILOT KNOB ROAD
EAGAN. MINNESOTA 55122-1897 THE SVM80L OF STREN6TH AND GROWTH IN OUR COMMUNIN 3501 COACHMAN POINT
EAGAN. MINNESOTA 55122
PHONE(651)681-4600 PHONE:(651)691-4300
FAx, (65I) 681-4612 Equal Opportunity Employer FAx: (651) 681-4360
7DD: (651) 454-8535 TDD', (651) 454-8535
CITY OF EAGAN
CASN:[Ek: JS TEFMINAL N0, 032
DAT,E; 12/20/93 TSME: 15:20.14
IDf
NRMEa NAGMAN C0N5TRlJCTION 7:NC.
321.0 3001 1257 NORWODU F'F. 7?944.75
34929001 1257 NOFWOOLI F'Y. 57164.09
2155 9001 1257 NORWOUD PI{ 756.00
t
7oka1 Fier.eip+, pmollnt: 13j8f.4.B4
cRi.ztaoa
usER .r.D: JaN
? 9 Og J 1999 BUILDING PERMIT APPLICATION (COMMERCIAL) 4 / 3) Fj(p y, &CL
CITY OF EAGAN ?
651 681-4675 nIC'Cti?s?_c.c?? 1 a -1 `7 • q 9
Requirements to building permit
Foundation Onl New Construction Interior Im rovement
• SWCtural Plans (2 sets) . Architectural Plans - (2 sets) • Mchitectural Plans (2 sets)
• Civil Plans (2 seLs) • SWctural Plans - (2 sets) • Code Malysis (t) ••
• Code Anarysis (1) " • Civil Plans ^ (2 sets) • Project Specs (1 seq
• Project Specs (1) . Landscaping Plans ? (2 sets) • Key Plan
• Spec. Insp. & Testing Schedule " • Code Malysis (1) " • Master Exit Plan
• SAC determination letter from MCIES - • SAC determination letter from MGES - call • SAC determinatlon letter Bom MClES - call
call 651-602-1000 651-602-1000 651-602•1000
• Spec. Insp. & Testing Schedule (1) " • Energy Calculations (1) not ah,rays"
. PrqeUSpecs (t) • EIec.POwer&LightingForm (1)notaMays°
• EnergyCalala6ons (1) "
• Electric Powar & Lightlng Form (1) "
• Master Exit Plan •
• Soiis Re oR (1) 1
" Contact Building Inspections for sample
Food 8 beverage or lodging facilities: Plan must be submitted to Minnesota Department of Health. Call 651-215-0700 for details.
DATE: I/ lI ?/ !cr ef WORK TYPE: NEW _ REMODEL
DESCRIPTION OF WORK:
oG
CONSTRUCTION COST: I S O OCr,? TENF
SITE ADDRESS:
NAME:
LOJ L4-, SUITE #:
LOT ? BLOCK? SUBD. ? ?n , •+/? ??ctcX P.I.D. #
1 ? J ?y1i411
Il ?P?? l I w )
Name: kCAY 50 vi ??l?? ?" ???' S Phone #: k5 1-0Z-7 S00
PROPERT'Y Last Fust
OW\'ER /
SneetAddress: ? KJ 0 l.,e,X?C'v v.' lt e 1S a4ck
City h. ? 4 1 r-- Cr.t.A a o? ? State: ? / 1 +\ N Y? . Zip:
Company: !S54 V1? c.t.1A 00 '1.5iV ? GAV v "1 Phone #:
CONTRACTOR
Street Address: ? v' r v'2
City 94A0VC SV->C4r I L State: P ? V1 ?` Zip: SS T Ito
ARCHITECT/ C. ? f? 1 /p I / ?v/ -1 7-?
EtiGWEER Company: Phone#: L v
? Name: l.9'0.J?1 ?1?7?• ? Registration #: I1 U 7.5_
Street Address:
? 1 J`
Ciry lm,? Vi vi eq ?p o State: /"" KVI Zip: s S?fO l
Sewer & water licensed plumber
I hereby acknowledge that I have read this applicatlon, state that the information
of Minnesota Statutes and Ciry of Eagan Ordinances. ,
with all applica6le State
nV 1 8 '?^?
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation
? 25 Miscellaneous
WORK TYPE
? 26 Public Facility
W27 Commercial/Industrial
43 Siding/Soffits/Facia
44 Windows/Doors
45 Fire Repair
I
0 31 New O 34 Repairs ? 37 Demolish Bidg. ?
? 32 Addition ? 35 Tenant Impr ? 38 Demolish (Interior) ?
? 33 Alterations ? 36 Move Bldg. ? 42 Reroof ?
GENERAL INFORMATION
Const. (Actual) „jj ?
Z,4J
APPROVALS
(Allowable)
UBC Occupancy ?j
Zoning
# of Stories 7-
Length 165-
Width ?.03
Planning
Basement sq. ft.
First Floor sq. ft.
sq.ft.
sq.ft.
sq. ft.
sq. ft.
Footprint sq. ft.
Buiiding n.S •
Census Codel 3,;V1
? SAC Code
No. of Units I! I
No. of Bldgs.
MC/ES System
City Water !
? Fire Sprinkiered
I
l
Engineering Variance
? 28 Greenhouse
? 29 Ante'Inae
Permit Fee
Surcharge ou
Plan Review .S 11400,
MC/ES SAC L42Ly-"- 0
City SAC . ; ?s..._,.,.
Water Supply 8 Storage
SiW Permit
S/W Surcharge ??- -?---?-
Treatment Plant ?
Park Dedication
Trails Dedication
Water Quality
Other
Copies '
VALUATION:
?/U)Duu,oed
% SAC _ ?*
SAC Units /v
Meter Size
1 L4o,0 0 C,
c
Total j 31 N V' 0 ?
L? BL ) CITY USE ONLY ?./ 0?? PERMIT*
v(
? AA?I? o
1
? Y
f1 ,
.
1
?{ 7g q
?
SUBD. I
UV
E.Y1G RECEIPT#:
APPROVEDB `?6??- , INSPECTOR RECEIPT DATE: 3-? I-0 0
2000 I+ECBANICAL PERMIT (COI+MRCIAL)
CITY Off EAGAN
3830 PILOT EQIOB RD
EAGAN, 1+N 55122
651-681-4675
Please complete for: all commerciaUndusfial 6uildings
multi-family buildings when separate pertnits are not required for each dwelling unit
DAT'E: MARCH 7, 2000
WORK TYPE: X New construction _ Install U.G. Tank
_ Interior Improvement _ Remove U.G. Tank
_ Processed Piping
When insla![ing/removing underground tank, call 651-681-4675 jor inspectiox by fue marshal and
p[umbing inspector.
Description of work:
HVAC
Fees: 1% of contract price OR $30.00 minimum fee, whichever is greater.
Underground tank removaUinstapation = minimum fee
Contractprice: $ $0,000.00 xl%=S 800.00 (BaseFee)
State surcharge .50 calculate at $.50 for each $1,000 Base Fee
TOTAL $ 8D0.50
SITEADDRESS: 1257 NORTHWOOD PARKWAY
OWNERNAME: SLUMBERLAND PHONE#:
, (AREA CODE)
TENANT NAME (IMPROVEMENfS ONL1):
WAS TfERE A PREVIOUS TENANT IN THIS SPACE? _ Y_ N. NAME:
INSTALLER: CONRAD MECHANICAL CONTRACTORS, INC.
ADDRESS: 509 1ST AVENUE NE
C]'['y; MINNEAPOLIS
PHONE #: 612 - 379-8200
(AREA CODE)
STATE: MN ZIP: 55413
?
?
SIGNATURE OF PERM?'
?.?
O?J
u.u,? I?? ?
LOT _ BL
SUBD.
RECEIPT #:
RECEIPT DATE:
2000 MECHANICAI, PERMIT (RESIDENTIAL)
CITY OF EAGAN ,
3830 PIIAT IQJOB RD i
EAGAN LN 55122
651-681-4675
Date:
Comp1_ete fhis seotien 2.!?, if yca ..re insal!ing F?S',-",C u, a siagle fan, i:y dwal.:ag, toa:ahome ur %;ondo unrier
construction and not ownedoccupied.
• HVAC: 0-100 M B T U
ADDITIONAL 50 M BTU
• Gas outlets (minimum of one requ'ved @$3.00 ea.)
I $ 30.00
I 6.00
State Surcharge .50
Total I, $
11
Complete this sec6on on[v if you are remodeline, adding to. or reoairin¢ an existing single-family dwelling,
townhome, or condo. Please indicate if it is a new item, alteration, or repair. li
_ New _ Alteration _ Repair _ Otherl
_ Fumace _ Air conditioning
_ A'v exchanger Other
Fee ? $ 30.00
State Surcharge .50
Total I' $ 30.50
Reminder: Call jor inspections
SI7'E ADDRESS:
OWNER NAME: PHONE if: I'.
(AREA CODE)
INSTALLER NAME: PHONE #:
(AREA CODE)
STREET ADDRESS:
CITY: STATE: II ZIP:
SIGNATURE OF PERMITfEE
I
CITY USE ONLY
PERMIT #:
; :?,.r d. ...
?
city of eagan
MEMO
TO: DALE SCHOEPPNER, ASSISTANT BUILDING OFFICIAi.
DALE WEGLEITNER, FIRE MARSHAL
PAUL OLSON, SUPERINTENDENT OF PARKS
MIKE RIDLEY, SENIOR PLANNER
DIANE DOWNS, UTILITY BILLING CLERK
BOB KRIHA, CONSTRUCTION INSPECTOR
STAN LEXVOLD, CONSTRUCTION SUPERVISOR
TOM COLBERT, PUBLIC WORI{S DIRECTOR
JOHN GORDER, DEVELOPMENT/DESIGN ENGINEER
ARNIE ERHART, SUPERINTENDENT OF STREETS & EQUIPMENT
PAUL HELiER, SYSTEMS ANALYST
FROM: CRAIG NOVACZYK, COMBINATION INSPECTOR
DATE: APRIL 28, 2000
SUBJECT: FINAL INSPECTION OF 1257 NORTHWOOD PARKWAY
SLUMBERLAND
LEGAL: LOT 1, BLOCK 1 EAGAN PROMENADE 3RD
The Protective Inspections Division will be performing a fmal inspection of 1257
Northwood Parkway on Wednesday, May 3, 2000.
If you are requesting that the Certificate of Occupancy be held, please fill out the proper
hold request form. Failure to retum the hold request form will be considered your approval. The
person, or department, requesting the hold is responsible for notifying and resolving any
problems with the affected parties.
kun
CD/bldg insp/misc/final insp - comm bldgs
c19
rrrv cr- r_asaN
c4,sHrE:r,: f:f. T'EF:MINAL NO° E?`33
Ih-1TFE. 04?28/00 7TMC: 14:36e3i
ILi;:
NFIME.. SPARTAP! MF:CHAN.T.CAL
:i71.f-, 9220 1 i./2° DIf:;Pl_ArE 426.00
32ii2 9001 BChFL.W PERM:[1' ;30.OC1
215; ; 9001 E+CI;FI:rI f'EICt1TT 0.50
Tota1 Recei.p+, Amc;uni;: 456.50
cRi2c638
u:,cR r.n- E;Ar}iz
CITY USE ONLY
L` B RECEIPT It: g
i;) ?? (p
SUBD. L(?o(?lOt ?I V Ir? mP.1lq ? ? ? RECEfPT DA1'E `? - c?c?
APPROVED B1": , INSPECTOR PLUMBING PERMI'C #
2000 PLL7MffiING PERMIT (CObMRCIAL)
CITY OF EAGAN
3830 PILOT IINOB RD
EAGAN, 1•IIQ 55122
651-681-4675
Please complete for: all commerciaUindustriai buildings
multi-family buildings when separate building pertnits are not required for each dwelling uni[
installation of backflow prevenmr in commercial areas or residentia( houlevards
Date: Work Type: -_-/-New Bldg. _ Add-on _ Repair _ U.G. Sprinkler 7`RPZ
Description of
To iuquire
1% of contract price or $30.00 minimum
Reducing Valve ie required on new service, cs11651-681-4646.
FEES
Contract Price: $
COMPLETE THIS AREA ONLY IF INSTALLING UNDERGRO[
Base Fee -
Water Meter: 2" Turbo - $897.00 unless plan approved for smaller size
1-1l2" Turbo - $ 726.00
t-Y?lt - 4-?-Co.v 0
X i% = $ JC). v v
$ 30.00
$
Li ?Co .c? l?
Service: _ existing (if coming off domestic line) OR _ new
If "new service ". contact Jerrv R'obschalL Finance Consultant to confirm addrnr (ees for:
Water Permit & Surcharge - $ 50.50 $
Water Supply & Storage - S 840.00 $
Water Treatment Plant Charge - $ 492.00 $
cc: Diane Dnwns, Ufi[iry Bi!(irtg - urtdergrourtd sprinlcln pernutr
Base Fee S
State Surcharee State Surcharge S - S
$.50 minimum; calculate at $.50 for each $1,000 Base Fee Total Fce S \
z/SL C.
I hereby acknowledge that I have read this application, state thaz the information is cortect, and agree to comply with ali applicable City of agan
ordinances. It is the applicanYs responsibility to notify the property owner that the Ciry of Eagan auumes no liability for any damages caused by the
Ciry during its notmal operational and maintenance activities to Ihe facilities constrticted under this pertnit within City propertylright-of-way/easement.
S[TE ADDRESS: '`b'?-?4W G&S 1a4kwdy
TENANT NAME.C&v'1 ABa`^?t?+ H? TELEPHONE tl:
/ (AREA CODE)
WAS TFERE A PREVIOUS TENANT IN THIS SPACE? Y . ?N NAME:
/-
INSTALLER NAME',!? ? vl a n I? ITELEPHONE #: ?(AREA CODE)
STREET ADDRESS: ??1 G! V d/ ? U`?J ??
C[TY: STATE:h'l 0-\ ZIP: S^5?
- 7,--
P,
CITY USE ONLY
DOMESTIC METER SIZE: COMPOUND TURBO
• Contact Utility Billing Division for price: 651- 681-4631.
IRRIGATION METER SIZE:
• 2" turbo unless approval for smaller meter granred by Public Works. II
• Contact Utiliry Billing Division for price: 65 L681-4631.
PRV: Yes No ?
PRIOR TO SELLING A METER:
• On Permit Entry screen, enter site address to look up sewer and water permit #. Select S&W Pertnit and check that hydrostatic
and conductivity tesu have been approved. If not, do not issue meter.
Miscellaneous '
• Meter lazger than 518" - ask plumber to wait while you call Central Maintenance (ext. 300) and verify thaz one is in stock.
• To schedule inspection of the inside water line and backflow preventer, ca11 65 1-6 8 1-4675.
• To schedule water tum-on, call 651-681-4300.
CD/Permit forme/plbg permi[ (comm) 2000
?-----------------
i
i
? Permit#: /? ? ?
I
? Pennit Fee:
I ?
I ?
I Date Received: ?
? I
I
j Staff: I
?-----------------?
2009 COMMERCIAL PLUMBING PERMI?T APPLICATION
oate: S- / 3- 0 9 Site Address: /
??S 7 / v C%( ? i.s/aCe?S `"'ca( j4 Wu./
?
Tenant: !?-ev?fJ?/'ri:it? ????'jL#n 1 Suite
PROPERTY ? Phone: (i???- yG?-?7O0
h?
rJ
N
94
OWNER ame:
,
an
?
CONTRACTOR Name:A'}'krm., 14-?vnun 6"?ur.rl,nr Spt?dcSLicensett: O0 3-(3 - P/1
Address: ?SZJ .?1?• I/e-/r)C-?n ? City: Ah?Ic-Joocl State:/*Zip:6
Phone: f5'0 Contact Person: ?1 an
TYPE OF _ New /` Replacement Repair _ Rebuild _ Modify Space _ Work in R.O.W.
-
WORK ?? n
Descriptionofwork: P?G?t, l?' ?1-z t?,4'1N G„v RP-2-
PERMIT TYPE COMMERCIAL
New Construc 'on Modify Space
?
?
, RPZ !_ PVB)
Irrigation System (_ yes /no) (
• Rain sensors required o irri ation systems
• Avg. GPM (2" turbo required unless smaller size allowed by Public Works)
Meters Calf (651) 675-56461o venty that tes[s passed prior [o pickina up meter.
Domestic: Size & Type Fire: Size & Price 3/4" meter 2$ 03.00
Avg. GPM High demand devices? Yes No Flushometers Yes No
COMMERCIAL FEES:
$50.50 Minimum (includes State Surcharge) OR Contractvawe $ x 7%
_ $ Permit Fee
Required on ALL new buildings and boulevard irrigation systems Radio Meter Read
- IF Pertnit Fee is Iess than $1,000, surcharge is $.50 =$ Meter(s)
- If Pertnit Fee is 1 $1,000, surcharge increases by $.50 for each $1,000
$1,000 Pertnit Fee (i.e. a$1,001,$2,OD0 Permit Fee requires a$1.00 surcharge). _$ State Surcharge
Following fees apply when installing a new lawn irrigation system. $ Water Pertnit
Call the City's Engineering Department, (651) 675-5646, for required fee amounts.
$ Treatment Plant
$ Water Supply & Storage
$ State Surcharge
TOTAL FEES 8
I hereby acknowledge that this information is complete and accurate; that ihe worK will be in coniormance witn tne ominances ana coaes or me uiy ui Eagan; mac
I understand this is nol a pertnit, but only an application for a pettnit, and work is not to slart withou[ a permit; [hat the work wdl 6e in accordance wilh the approved
plan in the case of work which requires a review and approval of plans. 17, 'o
x /-'JV14? CM .. 4o4YYl nyl
AppticanYs Pr' ted Name
Page 1 of 3
2009 SEWER AND WATER CONNECTION AND AVAILABILITY CHARGES
EXISTING COMMERCIAL PROPERTY (if applicable)
Date:
Property Owner:
Address:
Plumher:
Phone Number:
Contact Name: I. = ""LO1y "-"-•• ??°""" .`?
Sewer Service
Sewer lateral charge
Sewer trunk
City SAC @ $7001 unit
MCES SAC @ $2,0001 unit
Receipt#: , Date:
Septic abandonment
Permit Fee
State Surcharge
TOTAL:
Water Service
Water lateral charge
Water trunk
Water supply storage
Receipt #: , Date:
Treatment Plant @ $735 / unit
$ 50.00 Permit Fee $ 50.00
$ 50.00 State Surcharge $ 0.50
$ 0.50 `Plumbing Permit Required - water meter to be
acqw}ed with building permit T07AL:
Sewer Service
Water Service
Sewer lateral charge
Water lateral charge
Sewertrunk
Water trunk
City SAC
MCES SAC
Receipt # , Date
Water supply & storage
Receipt # , Date
Treatment plant
Septic abandonment $ 5D.00
Permit Fee $ 100.00
State Surcharge $ 0.50
`Plumbing Permit Required - water meter to be
acquired with building permit TOTAL:
Number of SAC units is defermined by the Metropolitan Council Environmental Services (651) 602-1000.
Sanitary Sewer Trunk Connection Charge applies if not charged sewer trunk by assessment in the past
1-5 SAC units $ 1,635/ SAC unit
6-10 SAC units
$ 410 / SAC unit ?-----------------
11+ SAC units $ 465 / SAC Unit
? Pe/mit #: I
I
? Permit Fee: i
? I
I I
I Date Received: I
I I
I I
? Staff: I
i_________________I
Cc: City of Eagan Finance Department
Page 2 of 3
4111111'
City of Eagan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUEor BLACK Ink
For Office Use
Permit #:
Permit Fee:
Date Received:
Staff:
2014 MECHANICAL PERMIT APPLICATION
0 Please submit two (2) sets of plans with all commercial applications.
Date: / 1 /7 Site Address://f7 r�rrv�
/l.i/•
Tenant:
Name:
1°133
Suite #:
J
Phone:
Address / City / Zip:
Name: j<7,17, e % i i c q % License*
Address: AU— r" 6;A -tier: City: J,*'
State: /1/ Zip: ar�02' Phone: � 2
Contact ,,,Email:'J.rl‘. . &J'c 4—Atcm.
New d/ Replacement Additional Alteration Demolition
RESIDENTIAL
Furnace
Air Conditioner
Air Exchanger
Heat Pump
Other
COMMERCIAL
New Construction Interior Improvement
Install Piping Processed
Gas Exterior HVAC Unit
Under/Above ground Tank L install / Remove)
RESIDENTIAL FEES
$60.00 Minimum Add or alteration to an existing unit (includes $5.00 State Surcharge)
$100.00 Residential New (includes $5.00 State Surcharge)
COMMERCIAL FEES
$55.00 Permit Fee Minimum
$70.00 Underground tank installation/removal
*If contract value is LESS than $10,010, Surcharge = $5.00
**If contract value is GREATER than $10,010, Surcharge = Contract Value x $0.0005
***If the project valuation is over $1 million, please call for Surcharge
TOTAL FEE
Contract Value $ 0000 x .01
470, 00
Permit Fee
_ $ 2 O Surcharge*
= $ , ' Co TOTAL FEE
I hereby acknowled9e 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.
Applicants Printed Name
� Use BLUE or BLACK Ink
�------------ --i
, \��,� ��,,� � For Office Use ——— I
. .4 � l,,
- �� �� i Permit#: �v� I
C�tV 4f �� �� � � � . ��- �
eJ � � Permit Fee: �
3830 Pilot Knob Road � I
EaganMN55122 �����-� �'��a ���`=`� �f�'�� �����ENT � DateReceived: j
Phone: (651)675-5675
Fax: (651)675-5694 ��'�� ������ ���'�� ��`*'`�•���� � I
� Staff: �
I �
`____�___________J
2015 FIRE SUPPRESSION SYSTEMS P'ERMIT APPLICATION* 149103
Date: 4.29.15 Site Address: 1257 Northwood Parkway
Tenant: Slumberland Suite#:
Name: Phone:
Property Owner qddress�City�zip:
Applicant is: Owner Contractor
Type of Work Description of work: Modify 6 sprinkler heads in offic,e and new customer service areas
Construction Cost: $1300.00 Estim<ated Completion Date: �•24.15
Name: Ahern Fire Protection License#: C039
Contractor Address: 13705 26th Ave. #110 City: Plvmouth
State: MN Zip: 55441 Phone: 163.268.0515
Contact: Barb Barnes Email: bbarnes(a�ahernfire.com
FIRE PERMIT TYPE WORN;TYPE
X Sprinkler System (#of heads� Ne�w _Addition
Fire Pump _Standpipe X Alterations _Remodel
� Other: Other:
� DESCRIPTION OF WORK: X Commercial Residential Educational
� — — —
FEES
$55.00 Permit Fee Minimum Contract Value$ 1300.00 x.01
*If contract value is LESS than$10,010, Surcharge=$5.00 55.00
**If contract value is GREATER than$10,010, Surcharge=Contract Value x$0.0005 -� Permit Fee
***If the project valuation is over$1 million, please call for Surcharge _$ 5.00 Surcharge"
$100.00 Residential New(includes$5.00 State Surcharge) _� 60.00 TOTAL FEE
3/4" Displacement Fire Meter-$270.00 =$ Fire Meter
� _$ TOTAL FEE
*Requirements: 2 complete sets of drawings and specifications,cut sheets on imaterials and components to be used
I hereby apply for a Fire Suppression System permit and acknowledge that the information is ccimplete 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 approval of plans.
x Barb Barnes x_G��!�(.!� �L�:��--�'�
Applicant's Printed Name Applicanit's Signature
k°A1 i �t"1R t�`R�[�11'i t'""e:�l�� DAV(!1l�1�lT _ Rf1RF2 t1"T' F;'{'� Rd^, ����^�
: � �--��� � �
FOR OFFICE USE
REQUIRED INSPECTIONS
Hydrostatic Flow Alarm prain Tes# Rough In
Trip Pump Test Gein#ral Station (��Finat
Conditions of Issuance:
r- � �.._ �
Permit Reviewed by�: � i}a#e:' � J � J ��
`�
� ��" �
.
Use BLUE or BLACK Ink
---------i
� For Office Use �
� � I
/� I Permit#: � � I
C�t of �a}JaIl � . , � �
� b � Permit Fee: � �
3830 Pilot Knob Road /
Eagan MN 55122 i /�� i
Phone: (651)675-5675 � Date Received: + � �_ /� �
I �
Fax: (651)675-5694 � Staff: � �
---------------G��� �
2015 COMMERCIAL BUILDING PERh111T APPLICATION �,����
Date: ��'3-1 S Site Address: /ZS 7 �o�r,�/ Wv�i� ��itKw-�tY ��
Tenant Name: SLGtMaEllGAti,p (Tenant is:__New/ t�' Existing) Suite#:
Former Tenai�t:
r; ��:f,�; -��� Name: ��4A30i✓ �n/j"f� 1''�/l/S� Phone: (v5/' �j182- 7cSOb
J f' ,, ��
�,,, r r ,fX Address/City/Zip: c3��Od CL�t/7�!/IGGf�i0� L�r��a�.�/�.¢a.� iYIN $���7
f1 �� F• ,
��,� ��� '� ' Applicant is: Owner Contractor�. /y�lC�l/>E�/� �
,r�, �' r,
r' .. �.� ,/ j . ..
��`� �`�%' � Description ofwork:S�v1'�i�ts�l, �c�M00�"L.
���,� r"ri' �'
'' � Construction Cost: /'��� 7�
�
- ; ` � Name:_�j"L4� 1�T1���f°tiLL�0�'►r �L C License#:
�; �r —
r;�����'� �. � � � Address: Td� � ��f SSe. �� Cit ��LCe �2SS � �'
� �' � � , — Y�
� / �,+ �[
�
;�,�r'"��,.,�',�'`��r``;�, :���.� State: �-�-� Zip: �a�z� Phone:=�lo J�-,�d�- l,:l�I I
� '�r ,�; n 1�
�j: ;��� �� " Contact: .,�/�rl�t�d' � `�2
" '�;'� �'� EmaiL � •1n� �' � I�r+.�SCdKS'�'ru�D11�C0/�'t
� ";
�f �
�r �� ,r , . �'
`�" � '��,� `� �� Name: I'�A7�tq� (�. $LE�,S Registration#: l'�v7'rl
f��;��;ff��'��"�'� f � `f%`� —
.�r'�';�`� � ��`
��� ����������,��� /.1
� `�%� r� �`.�.�, Address: ��7D hC,ySil�.r�7o•t� Av�' � r�ZO� _City: ✓��IQi.v�4�G/f
,�,�� �r r� '';�
�f;;�";��`` ���,��~'r���f i�,�� State:�z�p: 5S�+fo 1 Phone:�'L "<S'4 7� /3 vD
s�'�'������'F���,''
�f�,��f'� ���f��l�,����;�
�- F,.�'fi, ��,r�, % Contact Person: � �.✓ Email: r7o O�:n �+qcc rG��-�0•�
Licensed plumber installing new sewer/water service: Phone#:
r ,
� � ; - ; �
� J
F,�,�• � , f r �✓` r .. r � f` � F. 3 "!' ,f. �'�
� � ,.+'l.,�, �� � .f f; r r�
.,v� �;�f/�'; ,i�'�F�?l., F 'F'���f%'� f �'� �,,��! r" � ! �r� � ��' A7�f•��i f,,e'�,.
� y i,�� � r
CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for pr•otection against underground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities. www.qopherstateonecall.orq
I hereby acknowledge that this information is complete and accurate; that the work �roill be in conformance with the ordinances and
codes of the City of Eagan; that I understand this is not a permit, but only an applicaticm 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 wh�h requires a review and approval of plans.
,// %
X �'�[.� rr C,a��tik X ��---�.•�l�
ApplicanYs Printed Name ApplicanYs Signature
Page 1 of 3
� ��r � � ���? �U���-��v�� �°
• DO NOT WRITE BELOW THIS LIINE � 3 dL��
SUB TYPES
Foundation Public Facility Exterior Alteration-Apartments
�ommercial/Industrial _ Accessory Building _ ExteriorAlteration-Commercial
Apartments Greenhouse/Tent Exterior Alteration-Public Facility
Miscellaneous Antennae
WORK TYPES
_ New _ Interior Improvement _ Siding _ Demolish Building*
_ Addition _ Exterior Improvement _ Reroof _ Demolish Interior
�i4lteration _ Repair _ Windows _ Demolish Foundation
_ Replace _ Water Damage _ Fire Repair _ Retaining Wall
_ Salon Owner Change *Demolition of entire building-give PCA handout to applicant
DESCRIPTION
Valuation ����j� Occupancy _� MCES System ytf
Plan Review �� Code Edition �� /KS� SAC Units ��l:� 5—
(25%_100%� Zoning `;� City Water �''�rw�
Census Code Stories Booster Pump �
#of Units Square Feet PRV �'
#of Buildings Length Fire Sprinklers -y.,r,�
��.�`
Type of Construction Width
REQUIRED INSPECTIONS
Footings(New Building) Sheetrock
Footings(Deck) Final/C.�O.Required
Footings(Addition� ✓�Final/Nci C.O.Required
Foundation Other:
Drain Tile Pool:_Footings _Air/Gas Tests _Final
Roof:_Decking _Insulation _Ice&Water _Final Siding:__Stucco Lath _Stone Lath _Brick
✓ Framing Windows
Fireplace:_Rough In _Air Test _Final Retaininc�Wall
Insulation Erosion(:ontrol
Meter Size: Concrete Entrance Apron
Final C/O Inspection: Schedule Fire Marshal to be present: Yes �N�� �.. , �
Reviewed By: �� �-• , Building Inspector Reviewed By: � , Planning
COMMERCIAL FEES
Base Fee ��.�.� Water Quality
Surcharge 33.Q� Water Sampling Fee
Plan Review Sa��� �� 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��3 S�, o /
Page 2 of 3
Use BLUE or BLACK Ink
For Office Use
Permit#: /1(51) 'i(-P
41)1,01/`° Cityof
Permit Fee:
3830 Pilot Knob Road v
Eagan MN 55122 Date Received:
Phone:(651)675-0675 Staff:
Fax:(651)675-5694 L
2017 SEWER AND WATER REPAIR / DISCONNECT PERMIT
Date: 8/21/17 Fee: $65.00
City Sewer City Water ✓ Repair Disconnect
Description Of Work: Replacement of 20' of 12" storm sewer
Street Address for Proposed Work 1257 Northwood Parkway
Name: Slumberland Furniture Phone:
Owner Information Address,City,Zip: 1257 Northwood Pkwy
Applicant is: Owner ✓ Contractor
Licensed Pipelayer ✓ Master Plumber Property Owner
Name: Valley-Rich Co., Inc. Phone: 952-448-3002
Address/City/Zip: 147 N Jonathan Blvd, Chaska, MN 55318
Pipelayer Training Certification Card#: 7250 or Master Plumber License#:
I acknowledge that the information is complete and accurate and 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 permit, but only an applic tion for a permit, and work is
not to start without a permit.
Matt Miklya / 04. u% 0/1
Applicant(Print Name) Applicant's Signature
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.citvofeagan.com/subscribe.
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.aonherstateonecall.org