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1525 Royal Oak CirCOMMERCIAL BUILDING Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 5 10 Telephone # 651-675-5675 FAX # 651-675-5694 J ??44yU 1f-19-03 Foundation Only New Building Interior Im rovement • Structural Plans (2) sets • Architectural Plans (2) sets • Architectural Plans (2) sets • Civil Plans (2) • Structural Plans (2) • Code Analysis (1) " • Certificate of Survey (1) • Civil Plans (2) • Project Specs (1) • Code Analysis (1) " • Landscaping Plans (2) • Key Plan (1) • Project Specs (1) • Code Analysis (1) • Master Exit Plan (1) • Spec. Insp. & Testing Schedule " • Certificate of Survey (1) • Energy Calculations (1) not always- • Soils Report (1) • Spec. Insp. & Testing Schedule (1) " • Elec. Power & Lighting Form (1) not always" • Meter size must be established • Meter size must be established • Meter size must be established-if applicable 1 • Project Specs (1) 1 • Energy Calculations (1) " 1 1 • Electric Power & Lighting Form (1) 1 1 • Master Exit Plan (1) 1 1 • Emergency Response Site Plan (1) 1 1 • Soils Report (1) 1 • SAC determination -call 651-602-1000 • SAC determination - call 651-602-1 000 SAC determination -call 651-602-1000 Call MN Dept of Health at 651-215-0700 for details regarding food & beverage or lodging facilities. ** Contact Building Inspections for sample and if required when it states "not always". *** Permit for new building or addition will not be processed without Emergency Response Site Plan. Date, Q Construction Cost OCR Site Address eI G ??Ie e4lell Unit/Ste # Tenant Name Former Tenant Name Description of Work 12Qccf-e- ?lc 9,;-? - Property Owner ray c i r9 Q•7 Telephone # (1) /"o ?-r- ? Contractor `C h 4F? Z_/ c ` G.Q/?j 3"L . l_/JC Address e f % J l if? City State s7?/I Zip S J`a Telephone # ( ?r? /off ?? ?p Arch/Engr Registration Address 1 L? City i State Zip Telephone # ( ) "Ir J L I Y - Licensed plumber installing new sewer/water service: Phone #: I hereby apply for a Commercial Building 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 the State of MN Statutes; 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. dw, Applicant's Printed Name Applicant's Signature OFFICE USE ONLY Sub Types l.- 01 Foundation L 14 Apartments ? 15 Lodging ? 25 Miscellaneous Work Types ? 31 New ? 32 Addition ?t 33 Alteration 34 Replacement 01-1 4(!7010- Valuation Census Code 3 7 SAC Units Nbr. of Units Nbr. of Bldgs Type of Const 26 Public Facility ? 30 Accessory Bldg. ? 27 CommerciaVMdustrial ? 32 Ext Alt - Apts. J 28 Greenhouse ? 34 Ext Alt - Comm. ? 29 Antennae L 35 Ext Alt - PF ? 37 Nail Salon ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 37 Demolish (Bldg)" ? 43 Reroof ? 46 Windows/Doors "Demolition (Entire Bldg only) - Give PCA handout to applicant Occupancy MC/ES System Zoning City Water Stories Booster Pump Sq. Ft. PRV Length Fire Sprinklered Width REQUIRED INSPECTIONS Footings (new bldg) Footings (deck) Footings (addition) _ Foundation Drain Tile Y Roof _ Ice & Water X Final -?_ Framing Fireplace - R.I. - Air Test - Final Insulation _ Final/C.O. Y Final/No C.O. Plumbing _ IIVAC Other Pool _ Ftgs _ Air/Gas Tests _ Final Siding _ Stucco _ Stone _ Windows (new/replac went) Retaining Wall Approved By 1:2, -, Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage SAN Permit SAW Surcharge Treatment Plant Park Dedication Trails Dedication Water Quality Copies Other Total `v D G ROYAL OAK CIRCLE 1525 (EAGAN WELLS 8 & 9) 24 4?L.61? RECEIVED MAY 0 7 2001 Environmental Management May 3, 2001 EAGAN Barry C. Sthade ENGINEERING DEPARTMENT D,mctor Mr. Tom Colbert Dakota County City of Eagan Western Service Center 3830 Pilot Knob Road 14955 Galaxie Avenue Eagan, MN 55122-1810 Apple Valley, MN 55124 RE: Annual Registered Well Permit for a well associated with 1525 Royal Oaks Circle, 952.891.7557 Eagan, MN Fax 952.a91.7SR8 Dear Mr. Colbert: www.co.dakota.mn.us A registered use well permit is required by the Environmental Management Department (Department) for all Registered Use Wells located in Dakota County by Dakota County Ordinance No. 114, Section 1203, for the purpose of ensuring compliance with State and County requirements. This is necessary to protect groundwater resources, verify approved operation, and to expedite permanent well sealing upon disuse or permit termination. Fourteen months after the construction of a monitoring, dewatering, product recovery, or other special purpose well, a registered use well permit is required. It is the property owner's responsibility (or the well owner's responsibility if specified in a written agreement) to apply for an initial registered use well permit and to renew such permit annually. The Department must receive a completed registered use well permit application, which is on the reverse side of this letter, by the expiration date of June 30, 2001- Please carefully complete the application, attach items 1 through 4, if applicable, sign the application, and submit it prior to the application deadline. The Department may impose a surcharge of,50% of the total permit fees for incomplete or missing data. The fee for registered well permits is $100.00 per well annually. If this site is under investigation for a petroleum leak, the cost of permitting may be eligible for reimbursement through the Petrofund. State and municipal governments are exempt from the permit fees but are subject to the 50% surcharge for incomplete or missing data on its application and late fees based on the $100 per well permit fee. Late Fees will be assessed as follows: an additional 10% ($10 per well) if payment is received within 30 days after the expiration date; an additional 25%, bringing the total to 35% ($35 per well), if received between 31 and 60 days late; and an additional 40%, bringing the total to 75% ($75 per well) if received over 60 days late. Well permit fees, other bills, and all penalties not paid within 90 days of the permit's expiration date may be assessed against the property owner by certification to the County Auditor for a special tax against the real property. A well that is not in use must be sealed. A monitoring well is "in use" if it is used for water level measurements or sampling at least on an annual basis. Should you choose to have the well sealed by a licensed well contractor instead of renewing the permit, please submit your intention to do so in writing to this office before the permit's expiration date in order to avoid permit renewal, permit fees, and late fees. Upon failure to renew the permit, the well will be considered to be unused and must be permanently sealed by a licensed well contractor with appropriate permits within 90 days.of the-expiration date or you will be required to obtain the registered use well permit. The permit fee and. all. late fees are applicable.: ; _ . Should you have any questionsyou can contact me at (952)891-7010.- Sincerely, V ?r+? CXd l Vanessa L. Demuth Environmental Specialist cB P-.d - rc,dmd 1. , ,r•th 3Y` POn cov-,r-qa AN epuu o1o11 a.nv Env,orca Annual Registered Use Well Permit Application For County. Use Only. Dakota County Environmental Management Department 14955 Galaxie Ave Approval Date: Apple Valley, MN 55124 Check No.:: . (952)891-7010 Fax (952)891-7588 Check Amount: Date Received: . The well that requires permit renewal at this time is listed below: t 439770 1525 Royal Oaks Circle City of Eagan Total number of wells associated with this site, including those not applying for registration: The property owner or well owner if specified in a written agreement shall ATTACH the following to this application, if applicable [should any of the items not apply to this well, write in "NA' next to the item): - 1. A scaled site map with the location of the well identified by Unique Well Number; if a site map has been previously submitted and there have been no structural changes, NA can be indicated, and - 2. Water sample test results from the previous twelve months. This data is required in an electronic format, see our website for the format and sample files; web address http://www.co.dakota.mn.usienvirontwell_permits.htm, and 3. Table of groundwater elevations (msl) and dates the measurements were obtained.. If the water levels are measured to a local datum, the elevation of the local datum must be provided. 4. Check for $100 per well, made payable to "Dakota County Treasurer, unless exempt. Note: If this application is submitted late, add the following late fee to your check: $10 per well if 30 days late; $35 per well if 60 days late; or $75 per well if 90 days late. Note: If the local identification of the well is used in any of the data, then a table of corresponding Minnesota Unique Well Numbers must be provided. The Department may impose a surcharge of 50% of the total permit fees for incomplete or missing data. If there have been any changes to the construction of the well, property or well ownership, please describe below: DECLARATION I declare that the above information is correct. I understand that I must apply to renew the Registered Use Well Permit for this well annually. I also understand that it is the property owner's responsibility to obtain the permit or the well owners responsibility if specified in a written agreement. This well has the required protection and is labeled with a unique well number. All wells are maintained in accordance with the Minnesota Rules Chapter 4725 Wells and Borings and Dakota County Ordinance No. 114. Property or Well Owner (Signature) (Print) Date