1289 Promenade PlCififeC (-le(
City of Eaall e tb4r s
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
WED
Ann2 2011
Use BLUE or BLACK Ink
Permit #:
Permit Fee:
Date Received:
Staff:
J
�i l /
/ t 2011 FIRE SUPPRESSION SYSTEMS PERMIT APPLICATION*
,Y
Date: -di:Pi Site Address: i gb R" dite� JA 6 6
Tenant: \:).-criv•-e"sx_Ci -2._ k 1 " / ( Suite #:
PROPERTY OWNER
Name: r Alw-11-- Phone:
Address / City / Zip:
Applicant is: Owner Contractor
TYPE OF WORK
Description of work: ick..0 ci. �caticd kruxoto1 i) AP / 1
V
Construction Cost 1 coa Estimated Completion Date. - 1
CONTRACTOR
Name: ,S4/11/1\ i t. ki ire )r fec ±c*--- License #: (1_,-(Y2.5
Address: CTrl rn t I. vV' Q j, j � Ql)City: �CI- POL(4
State: 19/1. ) Zip: Ss1.)3 Phone: (c / - S/ 1 giQ
Contact: Email:
FIRE PERMIT TYPE
)L Sprinkler System (# of heads )
WORK TYPE
New Addition
Fire Pump
Standpipe
/._
C � �`�L k��
_ _
_ Alterations _ Remodel
_
Other. �J/ l9
Other: IQ w m�,�..t
DESCRIPTION OF WORK:
Il 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`j "'" 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 use
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 iordance with the approved plan in the case of work
which requires a review and approval of plans.
1/41ILP
Applicant's Printed Name Applicant's Signature
pK9 40(4)6 727
990
CALL BEFORE YOU DIG. CaII Gopher State One CaII at (651) 454-0002 for protection against underground utility damage.
Cali 48 hours before you intend to dig to receive locates of underground utilities. wassutrsneaall.oro
FOR OFFICEU
05l25l2696 19:40 7637555365 DOhN MILLER
2006 COlYIMERCXAL PLUMBING rER T AYPS:ICATION
CI7'X OF EAGAN
3830 PILOT KIVOB ROAD, EAGAI` 55122
651-675-5675
PAGE 03l04
?-6D
I patel_/ 13 /?
SiteAddress q ?i^(l??'?O?G ??QCe Unittt
µ
Rormer Tapan! *ia
Teoant Name
'ah YD vy\l e e
_
PropertyChvner I..Xvc EDLAS lJlVLJ?f? Tet
? phona#(?'j?l ??J"??
N
ConYractor ?IfJY?-??t?? ?+.(.?`(1b1'?la . (11C- - ...
A,ddresa CitY ' Llar?
Sta€e _ rn ?? N Zip Tele ?7?pQ .
hoqe #qd>
License N Expire.s:
Other
Owner Contracwr
Thn Applicant [s
_
?
Work Type Naw Bldg Modify Space ? Irnl xt#on Sys[em*" _ Yes
XCtPZ _ PVB; New C Repair/Rpbuild _ No Work in public r-o-w / easemenrl
eplace _ ltcmove
Itain sanmrs are ze uired ou ix'ti ation s s s
be,cripNon of woriL P v 5+n ar HZe bw I
io inquire ifPresawe RrAucing Y91've requifcd en ncw acrvlcr wI1651-575 5645
P'iet4r5 -- Cali 651-675•53001o verifry thnt hydrooCexic, eanduoiivity, and baoteria tesls pxssod r r to icfua u mxter.
Irrigation Size & Typa Avg GPM 2" turbo re d unless mnaller sirJ allowed by Publlc iVwics
f i[e SIZd FL P(IC9 314" me4?t 67:00
i DomasaC Size & Type Avg GPM 7ncludes gh demavd devices? J,'Yes _ No
i Flsss6ometere _ Yes - No PAV Keqffired ,,,_ Yea _ Na
? Pexmit Fae $50.50 mtafmyg; (includes State 9urcbaxge)
i Contract valve S S •? Permit F.e
$ Meter{s}
I _TLequited on slt pyg Dvi[dings 8c bouf!;Ey?J ''gyye?{jp?smms $ ?23dio Metex Raad
State Surcharge
? If parrinjiyp Is mare t an S1,000, f91'fI11r7,! IS S.SO FOt L3CA 51,000 owed. ?
--.
.
w
_
.
?
-
----
---
--
---------__......,
I Yoitowing feos appry w4en lostatling new lawn irrigativn 3ystem $ ..._?..
?
?
._
..
_____.
?
-
•
W3Cer Pzfiriit I
Cell tde Cky's Engineaing Depxrvnent. 55l-675?5646. Por requited fee imount5
I $
Tcta[ment plattt
Watar Supply & Storago ,
$ ylnte Surchargc
$ • J V Tatal Fee
- - -- ..._- - -- - - - - -
7 herehY eppty for a Cartunercial FNUmbing ?crmit ar.d sckuowlc^ge tLat the infortnetlon 1s xxnplue and curue; ifiaz me wuA will ae W cenRrtnancn wiM the
ordinences and cudes of the CHy afEagan and whh tAe P;umbiag Cades, tbst I undersemd tpis u not c pe S but onFy .a application fbr a pmniy ead wark is nc[ fo
s[art withwta prnrtit; that thp wcrk wili te inaaurdence with the approved p7an in the ca.se ,{tivo:k wkish uires a review and approxal of plans.
ve'l
eS?Ca?
,0._ p icant's r.r.ted IVema applic Ys :g ature
Lot 8 Blk 2 PID #
Plat F.AC:AN PROMFNA?F.
nit)
sly paid
CITY OF EAGAN
1996 SEWER & WATER CONNECTION CHARGES
EXISTING COMMERCIAL PROPERTY
Sewer connection charges Ile Water connection charges F-?
SAC ($tk=
Date prevre
Receipt #_
Sewer permit
Subtotal
* Plumbing
Tap f
& surcharge
Sewerlwater permit #. 28710
Date 08/28/96 Receipt # 63478
?-
Treatment plant ($396/5AC unit)y-, l
Water permit & surcharge 50.50
? .
50.50 Subtotal
:
* Plumbing pecrriit &
Tap
.,,Tdtal
Sewer & water connection charges
SAC ($1,000/unit)
Date previously paid 06/07 46 Receipt # ss37z
Treatment plant ($396/SAC unit) ra.
Sewer & water permit and surcharge 100.50
Subtotal
* Plumbing permit & surcharge
Tap(s) ,-
Total
100.50
The number of SAC units is determined by the Metropolitan Counci! Wastewater Seivices.
* A p/umbing permrt is a/so required. !t will be issued only to a plumberlicensed with the City or to
the building owner if he is actually doing fhe work.
OFFICE USE ONLY
Property owner OPUS CORPORATION PRV
Address 1280 PkOMENADE PL (MECHANICAL ROOM) No. oftaps
Phone no.
Assessments
Plumber G R MECH Waiver
Lot Bik
Plat
PID #
Sewer/water permit #.
Date Receipt
CITY OF EAGAN
1996 SEWER & WATER CONNECTION CNARGES
EXISTING RESIDENTIAL PROPERTY
Sewer connection charges Water connection charges
Sewer availability charge (SAC) $1,000.00 Water availability charge (WAC) $ 760.00
Date previously paid Date previously paid
Receipt # Receipt #
Account deposit 15.00 Account deposit 15.00
Sewer permit & surcharge 50.50 Water permit & surcharge 50.50
Water meter 107.00
Subtotal $ 1,065.50 Treatment plant 396.00
* Piumbing permit & surcharge 20.50 Subtotal $1,328.50
Tap
* Plumbing permit & surcharge 20.50
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
Su6total $2,393.50
* Plumbing permit & surcharge 20.50
Tap(s) -
Total
* A plumbing permit is also required. It will be issued on/y to a plumber licensed with the City or to
the homeowner if he is actually doing the work.
Property owner
Address
Phone no.
Plumber
OFFICE USE ONLY
PRV
No. of taps
Assessments
Waiver
LOT -? BIOCK SUBD. r?
RECEIPT # ?70 DATE - ?
7996 CITY OF EAGAN
IRRIGATION PERMIT (FOR BACKFLOW PREVENTER)
COMMERCIAL INSTALLATIONS: FORM MUST BE COMPLETED BY LICENSED PLUMBER
Date: /Ic
Area/address to be irrigated:
/a S 9 -
Commercial
Residential (6oulevards)
Existing residential
GPM
GPM
Installer: ?Owner ? Plumber AL`
5treet address
City, state & zip code: ??'S ;?Y Phone
Owner N
Street address:
City, state & zip code:
Irrigation contractor, if different than installer:
Telephone #:
Phone #:
I hereby acknowledge that 1 have read this application, state that the information 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 City during its normal
operational and maintenance activities to the facilities constructed under this permit within City
p ropertylright-of-way/easement.
J44?-- /-?- - -
Appli t's signature Title
Approved by:
Date:
PRV ? Yes?? ? No y0ow service ? Yes p&Mo
??eter Size 3 & Cost Q
Gee= due:._ Calculated oy:
PROCEDURE FOR IRRIGATION SYSTEMS - 1996
An irrigation permit is required - please contact Protective Inspections at 681-4675.
Fees
Commercial project: $25.50 irrigation permit to cover installation of backflow preventer.
$50.50 water permit fee only if new service is installed.
$300.00 per tap if installed by City.
Residential project: $20.50 irrigation permit to cover installation of backflow preventer.
$50.50 water permit fee if new service is installed.
$760.00 per connection - WAC.
$396.00 per connection - water treatment facility.
Existing residence: $20.50 irrigation permit to cover installation of backflow preventer -(not
required if backflow preventer previously installed).
Meter charge: If gallons per minute are less than 25, a 1" meter will be required at a cost of
$182.00. If gallons per minute are mare than 25, a 2" turbo with strainer wilf
be required at a cost of $822.00. This information is to be supplied by the
designer of the system.
No meter will be sold before all sewer and water inspections are complete on a new service. If new
service lines are not required, one check may be written for meter and permit costs. Receipt will be coded
to 20-3716 (meter portion only) with pink copy forwarded to Utility Billing Cierk.
The installer is to contact Protective Inspections at 681-4675 for inspection of the inside water line and
backflow preventer. The Public Works Department may be reached at 681-4300 for water turn-on and set
and seal of the meter. Inspection hours are 8:30 a.m. to 3:30 p.m. Monday through Friday. Requests for
A.M. inspections should be made on the preceding work day. Requests for PM inspections will be accepted
until 12:00 noon.
46'
City of Eagan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
CC_
Use BLUE or BLACK Ink
Permit #:
Permit Fee:
Date Received:
Staff:
D
J2011 COMMERCIAL
PLUMBING PERMIT APPLICATION
Date: 6.-31- t I Site Address: S ( ��'C��l . 1 I () Ce. re),5
Tenant: Suite #:
PROPERTY
OWNER
�, C66 .--73
Name: 71/4 /`/� j Y`'\t A 94A \ �'�+�� Phone: Ci Sa - SG -3 -
CONTRACTOR
Name: Ari"-kY" �%v)te-k License #:
Address: HO 1 QA Vcrt-7 City: PO Sail I< < State: NO Zip: SS1l3
G S 1 —G -also t
Phone: Email:
TYPE OF
WORK
New Replacement Repair x Rebuild Modify Space Work in R.O.W.
_ _ _ _
Description of work: RP2-
PERMIT TYPE
COMMERCIAL
New Construction Modify Space
X. Irrigation System (_ yes / no) ( x 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? Flushometers _Yes _No
COMMERCIAL FEES:
$55.00 Minimum (includes
_Yes _No
State Surcharge) OR Contract Value $ x 1%
Required
- If the Permit Fee is Tess
= $ Permit Fee
on ALL new buildings and boulevard irrigation systems 4 = $ Radio Meter Read
than $10,010, the surcharge is $5.00 = $ Meter(s)
- If the Permit Fee is > $10,010,
the surcharge increases by $.50 for each $1,000 Permit Fee
Permit Fee requires a $5.50 surcharge) = $ State Surcharge
(i.e. a $10,010-$11,000
Following fees apply
Call the City's Engineering
when installing a new lawn irrigation system. $ Water Permit
Department, (651) 675-5646, for required fee amounts.
$ Treatment Plant
$ Water Supply & Storage
$ State Surcharge
TOTAL FEES $
CALL BEFORE YOU DIG. CaII 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.gopherstateonecall.orq
I 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 wit be in accordance with the approved
plan jin th caseof
work which requires a review and approval of plans.
x J L/\. /11161—A YN
Applicant's Printed lame
x
Applicant's Signature
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