4146 Oakbrooke TrMAY -17-2010 08:34 PM
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C.ty ofEa��
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675.5675
Pax: (651) 675-5684
2010 COMMERCIAL PLUMB!
s In 9528911800
Date _ S 'L i i, Site Address:
P.9
Use BLUE or BLACK Ink
Permit #:___5:1L41
Pett Fee:
Date Received:
Bred_
G PERMIT APPLICATION
V e -4)4(2_
#:
Tenant -..OP Suite
PROPERTY
OWNER
Name:
•CONTRACTOR
Phone:
license # r r
Address:
TYPE OF
WORK,
PERMIT TYPE
AMONINIMPOOMMIOY
..,_ Naw
UORepair Rebuild Modify Sims— Work in R.O.W.
SO2
Description of w+orle
COMMERCIAL
, New Construction Modify Spa
_ Irritation System L._ yet _ no) (__ RPZY P B)
• Rain sensors required on irrigation webers
• Avg. GPM(2" turbo required unless smaller shoe Mimed by Public Worke)
_ Meters Call 051) 675-5646 to verity Met testa passed prior to oickina un meter.
Domestic: Size &lypeFire; 1
Avg. GPM High demand devices? Yes No Ftushomsters Yeses No
01,-6-1141ER r FEES:
$50.50 Minim ,� • (includes State Surcharge) OR Contract Value $.. x 1%
a $ Permit Fee
Required on ALL new budidings and boulevard Irrigation systems 4 a $. J_ Radlo Meter Read
a $ Meter(e)
a$ State $A e
. If matj IB teas titan $1.000, surcharge 15 $ 50
If Paint fig la p $1,000, surobsge trlaea a by $.50 for each 11,000
"odd Permit Free �. a $1,00142,000 Permf Fee requires a $1.00 surcharge).
Following fees apply when installing a new lawn irrigation system. $_, , Water Permit
Cal the CriY's Erne,!,$ Department, (set) 675.5545, for required fee amounts.
$ Treairn6ln Plant
$ Water Supply & Storke
....L.a==,.,--- State Surcharge
TOTAL FEES $ 0,4'-‘4,
CALLF.FORE YOU DIG. Call Gopher State One Call at (661) 454.0002 for protection against underground utility
•
damage. Cali 48 hours before you intend to dig to receive locates of underground utilities. tommgberstideonecall.ora
1 hereby acknowledge that thla information is complete and scrxtrate: that the work w41 ba to conformance with the ordinances and codes of the City of Eagan: that 1
underetand this is not a permit, but only an appllcaiton for a premt, and work h not to start Without a permit that the work will be In accordance with t hs approved
plan In the case of workuires,* review and approval of ne.
App 1cant'e Printed Name Applicant's Signature
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371o 9220 046 oAt;IRc7r)I:r 635.00
37:1.9 Sl?20 i.Lic:, hFd'.F.;Rriry,{:E ;O,.OfJ
3865 53220 4:1.46 UAKY'.•'r'OUY.'' 835.00
2868 9220 W5 (76aI'Y:;RUOF`E -iE.o.aC)
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L B CITY USE ONLY RECEIPT #:
SUBD. L_J(Z?. Y? J? C;YN[ e J r? RECEIPT DATE l?
APPROVED BY: , INSPECTOR PLiJIvIBING PERMIT #
1999 fLUMBINfi PERhI1T (CQMhIEfiC1AL)
CITY OF F-A&AN
3$30 PILOT KNOS fiD
EA&AN,1HN 55122
(651) 681-4675
Please complete for: all commerciaVindustrial buildings
multi-family 6uildings when separate 6uilding permits are not requved for each dwelling unit
installation of backflow preventer in commercia] areas or residential boulevards
Date: Work Type: _ New Bldg. _ Add-on _ Repair OC U.G. Sprinkler _ RPZ
Description of W ork:_ Vo U l. Ev I}RD f R-21(, rkTt o rQ
To inquire if Pressure Reducing Valve is required on new service, call 681-41
FEf..S
1°/o of conhact price or $30.00 minimum Contract Price: $ x 1% _ $
COMPLETE THIS AREA ONLY IF INSTALLING UNDERGROLIND SPRINKLER SYSTEM
"
Backflow Preventer Permit Fee - $ 30.00 $ 30 ItIZ" -rl?a-e?o =° O
Water bleter: 2" Turbo - $ 889.00 unless plan approved for smaller size $ ?0 3 S ? 4?
Serrice: _ existing (if coming off domestic line) OR 9 new
If "nex- service". contnct Jerrv Wobschal7 Finmtre Consultant to conftrm addine fees for° p
Water Permit & Surcharge - $ 50.50 $ So d'a w ? i
Water Supply & Storage - $ 825.00 $ $ 2? W CO N fJ
Water Treatment Plant Charge - $ 468.00 $ 4v 8°`? VJ T{LM-f'
Permit Fee $ d. Q Q
State surcharge is calculated from Pernut Fee at right -
$.50 for each $ 1.000 with a minimum of $.50 due
State Surcharge $ SURUN4 / •D 0
Total Fee $ a o 0 9" 0 (D
e
• I hereby acknowledge that I have read this applicanon, state that the informarion is correct, and agree to comply with all applicable City
of Eagan ordinances. It is the applicant's responsibility to notify the property owner that the City of Eagan assumes no liability for any
` damages caused by the Ciry during its norma] operarional and maintenance activities to the faciliries constructed under this permit within
Ciry property/right-of-way/easement.
SITE ADDRESS: 41 N fP D11-v-f3R-oolc.Er -}'R A lt-
TENANTNAME: puUTE- ?FGME.S TELEPHONE#: 1s51 4572-5-700
. (AREACODE)
IN'STALLER NAME: VE414M A^2'L P?-? P? 1 rJ (.,? TELEPH0NE #: ?17-
J'?C• G'- C° •?2j
(AREA CODE)
STREET ADD?RESS:
CITY: / i? 'A S?ATE: IZLi ? ZIP 5?T7S.^
OF PERMITTEE
CITY USE ONLY
D01iESTIC 114ETER SIZE _ COMPOTJNTD _ TURBO
PRV: Yes No
• Contact Utility Billing Division for price: 651- 681-4631.
IRRIGATION METER SIZE:
• 2" turbo unless approval for smaller meter granted by Public Works.
• Contact Utiliry Billing Division for price: 651-681-4631.
PRIOR TO SELLING A METER:
• Enter site address on Screen 301, Permit Inquiry, to obtain sewer and water pemut numher.
• On PIMS Screen 320, enter sewer and water pemut # to check [hat hydrostatic, conductivity, and bacteria tests have been
approved. If not, do not issue meter.
Miscellaneous Infcrmation
• Merer larger than 5/8" - ask plumber to wait while you call Central Maintenance (ext. 300) and verify that one is in stock.
• To schedule mspection of the inside water line and backflow preventer, ca11651-681-4675.
• To schedule water tum-on, call 651-681-4300.
CD/Permit torms/plbg permi[ (comm) 1999
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Eagan, MN
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OAKBROUKE 3 65 I
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DIFFLEY
Minnesota Division El
1355 Mendota Heights Road Suite 300 Mendota Heights, Minnesota 55120 11RE
OAKBROOKE THIlZD ADDITION
ADDRESS SHEET
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P?
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ROAD
;xEEr no.
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City of Eapll
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
r
Use BLUE or BLACK Ink
For Office Use 1
Permit #: S", " 3
Permit Fee: lPl�
Date Received:
Staff:
L
2013 COMMERCIAL PLUMBING PERMIT APPLICATION
Please submit two (2) sets of plans with all commercial applications.
Site Address: ° l Z / /% 2 E 7----•<-/f I G --
Date:
Tenant:
Property
Owner
Contractor
Type of Work
y �
Permit Type
L
Name:
vie- gk,6' Fav,,/ 4s
Name: //�c"7eh', ' lL)410/44
Phone:
Suite #:
Lc5 License #: /674 -
Address:
Phone:
�!J?d l ,t//1't4 /2E City: lvt,L (1,-14Z€ 4-C State:,/✓ Zip: 5702?
657- 5?- /69'3
Email: /L t ea'c)(/ McS fie --6
New iJr✓ Replacement Repair _ Rebuild Modify Space _ Work in R.O.W.
Description of work: 4`ON
COMMERCIAL New Construction Modify Space
✓ Irrigation System ( pie yes / _ no) (,( 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 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
$55.00 Permit Fee Minimum
Contract Value $ x .01
= $ Permit Fee
*If contract value is LESS than $10,010, Surcharge = $5.00 = $ Surcharge*
**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
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 One Call at (651) 454-0002 for protection against underground utility damage. \
1 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 -12;E Ai/ego/el
Applicant's Printed Name
cant's Signature
FOR OFFICE USE Approved By: Date:
Required Inspections: Under Ground _Rough -In Air Test Gas Test _Final PRV Required: — Yes
Meter Related Items: Meter Size Radio Read Staff:
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