1273 Promenade PleA
City of 1/9/7)�.
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694 7011
Use BLUE or BLACK Ink
Permit #: gKci7
0 a
Permit Fee: �� F
Date Received:
Staff:
JI
2011 FIRE SUPPRESSION SYSTEMS PERMI APPLICATION*
Date: 4 ' 6 [ Site Address: 1 4.-1 �fnMNoj ac/ 2-u C E --
Tenant: F 'vim- �f c c d �_ /fir/. /���1 �� / 'Suite
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PROPERTY OWNER
Name: L AtY .L Phone:
Address / City / Zip:
Applicant is: Owner Contractor
_TYPE
OF WORK
Description of work: &tL Qa1/2 1 r I 's ,t__A_.
.c�
J—"IIIIIPPME-
00.111100•1111
Construction Cost: 1 ezr Estimated Completion Date: - /
CONTRACTOR
Name: ,S(1fCy1tP f�±PeiC'N�-- License#: (1_,
Address: (Th'l i t t 1, v Q j, 4 c PDCity: 11, Pa4
State: ILIA ) Zip: SS/ 63 Phone: 1 F ptcSPc !0 0O
Contact: Email:
FIRE PERMIT TYPE
1. Sprinkler System (# of heads )
WORK TYPE
New Addition
Fire Pump
Standpipe
_ _
_Alterations _Remodel
_
Other:
Other:RepICtile rvtir9.rn.
DESCRIPTION OF WORK:
if Commercial Residential Educational
FEES
$55.00 Minimum (includes
State Surcharge) OR
$10,010, surcharge is $ 5.00
surcharge increases by $.50 for each $1,000
Fee requires a $ 5.50 surcharge)
Contract Value $ /C --- x 1%
- If the Permit Fee is Tess than
= $ Permit Fee
Permit Fee = $ Surcharge
- If the Permit Fee is > $10,010,
(i.e. a $10,010-$11,010 Permit
$ 5 - TOTAL FEE
3/4" Displacement Fire Meter - $204.00
$ Fire Meter
$ TOTAL FEE
*Requirements: 2 complete sets of drawings and specifications, cut sheets on materials and components to be used
I hereby apply for a Fire Suppression System permit and acknowledge 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 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 irdance with the approved plan in the case of work
which requires a review and approval of plans.
icove 1.L�
Applicant's Printed Name
ip
Applicant's Signature
/1104'26// c L
CALL BEFORE YOU DIG. Call Gopher State One Cali at (651) 454-0002 for protection against underground utility damage.
CaII 48 hours before you intend to dig to receive locates of underground utilities. )vww_ppheJstat-In_sm1J,.t t
Conditions of.lssuan
Permit Reviewe
3 4 5- 5 6 8? io-7NLY miz aaue,t xoia ie momn, imm .auaoson am vrinka i105box
PLEASE PRINT OR TYPE
Raquesf Dntq' Rough.in i speclion requiredY Yea ? No liupedion OtherThon Rough-In: ? Ready Naw ? Will Gall
(You musl wll Ihe inspenor wiun rccdy? Doro Ready:
I, Of licensed contracfor ? owner hereby request inspedion of ihe above elecfrical work of:
bb Pddmsz fSheet, Box, ar Nou No.
i2 -?` P Ciry Sp Code
ss?zz
Sedion o. Townahip Nome or Na. Runge No. Firo No. Counry
ci?
t M%
?
alL P? ?
Power SvpPli Address
Eletlnml Conhatlor (Compmry Name?
e r?N(/ • Conhador li<ense Na./
?..L..VD G Maner Gc No. jPlam Elan. Only)
Mailing dmss (Conlmcbr i Owner Perfor ing Installalion?
=0'--
?
AuNwnzad i alu oMra er Performing Iruhllofion)
hon
EB-OOOOIA-10 6/95 STATEBOAflDCOPY-SEEINS7NVCTION30NBACKOFYELLOW ?
0
IIII I II II IIIII I I 11II IIII II? IIII IIII 1821O FOR ?
Univ Ssky AveRmi?A? IPaPMNT O 4
* 0 3 4 5 5 6 8 0* Phone (e12) sa2-osoo ?)?(?
Home Duplez Apt. Bldg. Other: Of New Addn
Commercial Indusfrial Farm Remod Re air
Air Cond. H}g. Equip. Water Hfr. Load Mgm}. Other:
D er Ron e Elec. Heat Tem . Service
'X" a6ove the work covered by Ihis request. Enter remarks in this space and on fhe back of the white copy only.
Calculate Inspection Fee - 7his Inspedion Request will not be accepted withoW the correci fee:
OHier Fee # Service Enhance Size Fee # Ciro,ih/Feeders Fee
Mobile Home Park Stnll 0 to 200 Amps 0 to 100 Amps
Street LTg./Troffic Sig. Above 200 Amps A6ove 100 Amps
Transformer/Generatar iNSpECron'SUSeoNLY TOT/?.
$ign/Ou}Iine Ug. Xfmr. / ?? Z r
Alartn/Rema}e Conirol ?
$wimming Pool I Mn aM Mat I ins ected ? nsbllatian described heran on the doW sMed
lfflgaM1an BOOm Rooghin Da1e
$pacial Ins
edion
p
Invesfigative Fee
THIS INSTALLATION MAY BE ORDERED 151SCONNECTED IF NOT COMPLETED WITHIN 18 ONTHS.
Lot 8 Bik 2 PID #
Plat F.AGnN PROMF.NADE
Sewer/water pertnit #, 28709
Date 08/28/46 Receipt# 63478
CITY OF EAGAN
1996 SEWER & WATER CONNECTION CHARGES
EXISTING COMMERCIAL PROPERTY
5ewer connection
5AC ($1;000/unit)
Date previously
Receipt # ?
Sewer permit and
Subtotal
* Plumbing p "" it & surcharge
Tap
Ns Water connection charges i'
? Treatment plant ($396/SAC unit) /
Water permit & surcharge 50.50
50.50 Subtotal
Plumbing pemiit & surcharge
Tap
,T-dtal ,
Sewer & water connection charges
SAC ($1,000/unit)
Date previously paid n6io7ia6 Receipt # 58372
Treatment plant ($396/SAC unit) Pa.
Sewer & water permit and surcharge 100.50
Subtotal
* Piumbing permit & surcharge
Tap(s) ?
Total 100.50
The number of SAC units is determined 6y the Metropolitan Council Wastewater Services.
* A plumbing permit is also required. It will be issued on/y to a plumber licensed with the City or to
the building owner if he is actually doing the work.
OFFICE USE ONLY
Property owner OPUS CORPOBATION PRV
Address 1273 PROMENADE PL (MECHANICAL ROOM) No. oftaps
Phone no.
Assessments
Plumber c R MECx Waiver
Lat Blk
Plat
PID #
Sewer/water permit #,
Date Receipt #
CITY OF EAGAN
1996 SEWER & WATER CONNECTION CHARGES
EXISTING RESIDENTIAL PROPERTY
Sewer connection charges Water connection charges
Sewer availability charge (SAC)
Date previously paid
Receipt #
Account deposit
Sewer permit & surcharge
Su6total
$1,000.00 Water availability charge (WAC)
Date previously paid
Receipt #
15.00 Account deposit
50.50 Water permit & surcharge
Water meter
$ 1,065.50 Treatment plant
* Plumbing permit & surcharge 20.50 Subtotal
Tap
* Plumbing permit & surcharge
Total Tap
Total
Sewer & water connection charges
Sewer availability charge (SAC) $1,000.00
Date previously paid Receipt #
Water availability charge (WAC) 760.00
Date previously paid Receipt #
Account deposit 30.00
Sewer & water permit and surcharge 100.50
Water meter 107.00
Treatment plant 396.00
Subtotal $2,393.50
* Plumbing permit & surcharge 20.50
Tap(s) ?
Total
$ 760.00
15.00
50.50
107.00
396.00
$1,328.50
20.50
* A plumbing permit is also required. It will be issued only to a plumber licensed wifh the City or to
the homeowner if he is acfua/ly doing the work.
Property owner
Address
Phone no.
Plumber
OFFICE USE ONLY
PRV
No. of taps
Assessments
Waiver