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4538 Slater Rd06/11/2010 FRI 11:56 FAX City of Eaall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 575-5654 JUN 1IREM 002/005 Use BLUE or BLACK Ink WNW Permit #: /,, Permit Fee: J77' 6 Data Received: Staff: 1 2010 COMMERCIAL BUILDING PERMIT�jAPPLICATION �,;/�/ Date; —11) Site Address: 11 3 r51o.. l4cN-).0 56 Tenant Name: (Tenant is: New / — Existing) Suite #: Former Tenant: PROPERTY OWNER Name; Q,1ANU.INO h :48Q LLP Phone: Address / City / Zip: _ Applicant is: Owner Contractor T Description of work: LJec,IL FN-rt-)t,t3 Co 5N - TYPE OF WORK Construction Cost: -, CONTRACTOR Name: 1 e../A'S .eN\1 Ldcense #: ) -g C? Address: 23E /pt.-- /fm ��1Le&VJ T_State: , L763)City: Y v t i 1F Zip: 'i,5 - Phone: l/�b— 00 Contact: S+\MA Email: el SI W e___Cileale,jaLc f ARCHITECT / ENGINEER Name: ,g 1 " S .. r Rri'\N..,l+.. Re istration #: O Address�0O WDA 0x, W, City: /1/1/0)S /)S Stale: ryV Zip: S. i 5 Phone: Contact Person: ei U_ra✓l Email: %i . JiCAes s Q%U‘ N Le, Licensed plumber installing new sewer/water service: Phone #: : ., ITlr trpjao`,`rtigiir'0oau„liq ' l yt ►'1':SttPM/ ,,a;OI):P#�' 1d0i*Tfo :be 01111:01,0 :tafi�ol ,t `P# ; ons of V !{.,,03,00# ,yxi ,x, fl,n t� rUr 11, Ili Sf x, Jl ,lh � � !1 th 0mittd� 1740, be:G( si elf ori" fiblia if 6. y.�J�► e`C$ , ifi0:rt atsib'r ;fitattwbgrti;' . oo t. ��'i. l � r ?• ,i,s Ps ]� pY�� . Yy � c�rS � r„� i�. 1, k��, � TS i'Y, ��l r },+ ,� u y i , SJt ,u l k {i.1! � ah, '>x �' n � !: P 9 ! t ”! y�. , s ` �� t . � ; .,N1/2!‘1',,L`.'il lrflY i1,. �vl r ., k 11ul ,ow {'`1! d! t4 L 1+ c,1,': ,:,ti,a . . y .con�(adt�'tX��t tttxey!'ardiiYr'�d�•s��s: `•. � ` . ;,�'y , ,:s,,�� i�,1s,p_1r �;,;t,,N,s,,�i� �"htr+. . ,,;,.!r',. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 46 hours before you intend to dig to receive locates of underground utilities. www.dooherstateonecallorg 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 will be in accordance with the approved plan in the case of work which requir s a review and approval of plans_ S- Ak x L J Applicant's Printed Name Applicant's Signature Page 1 of 3 M SUB TYPES Foundation Single Family Multi 01 of_Plex Accessory Building WORK TYPES New Addition Alteration Replace Retaining Wall DESCRIPTION Valuation Plan Review (25%_ 100% Census Code # of Units # of Buildings Lfss'- (-Xy) 5( DO NOT WRITE BELOW THIS LINE Fireplace Garage Deck Lower Level Porch (3 -Season) _ Porch (4 -Season) Porch (Screen/Gazebo/Pergola) Pool poktimpii-L-Amfl-065 Interior Improvement Move Building Fire Repair Repair 0 17 Type of Construction V f REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) Foundation Drain Tile Roof: _Ice & Water _Final Framing Fireplace: Rough In _Air Test X Insulation Meter Size: Reviewed By: Occupancy Code Edition Zoning Stories Square Feet Length Width Final T'L Siding Reroof Windows Egress Window _ Storm Damage Exterior Alteration (Single Family) _ Exterior Alteration (Multi) Miscellaneous Demolish Building* Demolish Interior Demolish Foundation Water Damage *Demolition of entire building — give PCA handout to applicant MCES System SAC Units City Water Booster Pump PRV Fire Sprinklers Sheetrock Final / C.O. Required Final / No C.O. Required ` HVAC Other: Pool: _Footings _Air/Gas Tests Final Siding: _Stucco Lath _Stone Lath _Brick Windows Retaining Wall: _ Footings , Backfill Radon Control Erosion Control , Building Inspector Final RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL P6(4c k)ev iAr r71/0') o(-2\ Page 2 of 2 City of Eaall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink Permit #: Permit Fee: Date Received: Staff: 2010 RESIDENTIAL BUILDING PERMIT APPLICATION Date: //'�� Site Address: Tenant: 453 S )-151-I- Suite #: RESIDENT / OWNER Name: C t/1f1(),,rvr, i 6 e, Er0 P ( irA.2PPhone: Address / City / Zip: 211 -Set ? S c Applicant is: Owner Contractor TYPE OF WORK Description of work: n,c�,an� i�ep) ie'mtni d- C i i n) Rep%,, 4 Construction Cost: b/ OOD Multi -Family Building: (Yes x / No ) CONTRACTOR Name: CD oCAcE,n ( (Yy0 etAY License #: /7% Address: (?S J O -I Alit t W- City: 01Cle.r'1 1 It iky State: ,M J Zip: -5"--1/c):7 Phone: 70 .S4/Q J/-. ? OD Contact: SthJ('% all: Email: ,1-( P LJ t 'e • bet co_ co M. COMPLETE In the last 12 months, has No If yes, THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING the City of Eagan issued a permit for a similar plan based on a master plan? date and address of master plan: _Yes Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets. 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.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 will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Applicant's Printed Name Applicant's Signature Page 1 of 2 ~-~Z--~. . CITY OF EAGAN . _ _ . . . 3630 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 1~ ~'t ~ x PHONE:454-8100 BUILDIMG PERMIT Receipt ik ~ ' ' SEE BP To be used for 12 UNIT t~l, D. Est value 11325 Date ~OVt:i~1BER 21 , tg 85 Site Address 4 54 2 SLATFR RD Erect Q~ Occupancy SEE BP 11325 ~ Loi 2 Block 2 Sec/Sub. GINNAMON RIDGE Remodel ? Zoning 7TH ADDI'1'ION Repair ? Type ot Const Parcel No. Addkion ? No, Stories Z Name CINNAMOP~ RIDGE LTD PARTNER~HI~1DVe ? ~ength 1117 MARQUE'.['TE AVE. , STE 2pQ Demolish O Depth o Address InL Impr. ? Sq. Ft c~ty MPLS pnone 332-5544 ~n~~~ p o Name F'~NA b SOiVS INC Approvals Fses Address 7490 MARKET PL DR Assessment Permit " ~ BDEN P~,~RIE 941-0282 Water 8 Sew. Surcharge WINn50R FARICY A~CHITECTS Police Plan Review W W Name Fire SAC Addres~ i ' Eng. Water Conn. < W Ciry ' one Planner Water Meter Council Road Unit Iherebyacknowledgethatlhavereadthisapplicationandstatethatme B~dg.Off. 11/21/ ~r. PI. information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. APC Parks / Var. Date Copies Signature of Permittee f~``----~~ FRANA 8 SONS INC Total A Building Permit is issued to: on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building OHicial - - PKmN No. P~rmk HoIdK D~te TM~phom 1k Plumbiny 9 H.V.A.C. , ; ~y.L . ~`~~h'7 El~c+rie G (e ~ G ~ ~N~ I~~'G-~., `1 ~ ~ ~O Y' ~O Q ~ S 3~ S ~ s~.~K L 3 ~ ~ 1~11~/~~ " e.~,,~ 5 ~ ~ ~ ~l.s ~a ~ ii ~ ~ In.p~cnon Dan Inap. Comms~t~ FooHnp~ I ~ FooHny~ II FoundsNon F~sminy _ . ~~.~3 _ _ RooH~y Rouph Pibp. ~ f~ ,C%. C_ _ 1 Rouyh Htp. f, I'+ 7~' s~' ~ in~ul. ~ ~ Fh~plac~ FMN Hty. ~j. L}.~j'~ Flnal Plby. .Z-~~ ~ Bldp. Final . '1 ~ j~Q Cert. Occ. 7 Dsck Ffp. Deck Frnty. D~sedb~ Locatloe: Weil Pr. Disp. PERMIT # ' . ~ , ~ PLUMBING PERMIT RECEIPT # ~ ~ ~ CITY OF EAGAN ~ s~h o0 3630 PILOT KNOB ROAD,,EAGAN, MN 55121 DATE; J~~'~ CONTRACT PRIC~x~'.7 3"~ ' PHONE: 454-8100 Site Add~ess ~ ~r" n~ BLDG. TYPE WORK dESCRIPTION Lot Block Sec/Sub ~ ' ~ ' ~ ~ d Res. New Name G`~ GG Mult Add-on ~ Address 60u r, .~Pt i'rv Comm~ Repair ~ Ciiy ~ Phone ~S ~ ~ Other Name r~` n~" ~~3 C N~. F17(TURES TOTAL ~ Water Closet - $3.U0 = Address ~ 9~ R Gr G ~ ~Bath Tubs - $3.OQ p Ci f~ t Phone ' ~a Lavatory -$3.00 Shower - $3.00 FEES ~Kitchen Sink - $3.OQ COMM/IND FEE - 1~/0 ~F CONTRACT FEE Urinal/Bidet -$3.OQ MINIMiJM - RESIDENTIAL FEE _ $~p,pp ~~undry Tray - $3.00 MINIMUM - C~MM/IND FEE _ 2p,pp Floor Drair~ -$1.50 STATE SURCHARGE PER PERMIT _ ~~ater Heater -$1,50 (ADD $.50 S/C IF PERMIT PRICE GOES Whirlpool -$3.00 Gas Piping Outlets - $1.5U BEYOND $1,000.00) Softener - $5.00 Well - $10.00 ~ ; Pri~ate Disp. - $1 Q.00 ~ Rough Openings - $1.5Q SIGNAT E OF PERMITTEE FEE: ~ STATE S/C: ~ "d(" ~ GRAND TOTA ~ v ~ FOR: CITY OF EAGAN , _ r, ~ ~~r~ifir~t~ uf (~rru~~cnr~ ~itp of ~agan ~p~pttt uf ~u~ld'mg .~~s~prtinn This Cerrificate issued pursuant to the requirements of Section 306 of the Uniform Building Code certifying that at the time of issuance this structure was in compliance with !he various ordinances of the City regulating 8uilding cons~ructron ar use. For the folTowir~g.• ; . Usc Classifxx6an ~ . ~dg. Pbrmi[ No. Oocupency 'I)+pe Zooing Diatrict Type Coml .~,r~~:~<.•{- 'T"~.A.': i• ~ '.r~t~'j~'. A'(*"' .~`~~.a5 Owoa of Buildi~ . . - - - Addiess ' Bw7ding Addres -f ` ~.j.,~1 ~:t . 't,a%A: ~ L,ocaliry ~ ~ ~ } Lk~ : ~ 7 , ~ c~-: `;Y-A 4, Bw7d'n~g 06~cia1 . POST 1N A COTJSPfCUOUS PLACE ~ , . ` . CITY OF EAGAN ` , 3830 PNot Knob Road, P.O. Box 21-199, Esgan, MN 55121 ~`~3 ~ ~ PHONE: 454-810~ ~ BUfLDING PERMIT ~~;g gp Receipt# To be used for 12 UN Z T M. D. Est va~ue 113 2 5 oate ~UV'F.MBF.'R 21 ~ 9 8 5 SiteAddress g538 SLATER RD Erect L~ Occupency SEF. 8P 11325 Lot 2 Block l Sec/Sub. CINNAMQN RIDGI: Remodel ? 2oning Parcel No. 7TH ADDITION Repair ? Type of Const Addition ? No. Stories W Name ~ I HC2AtdON RIDGE L^i D PMTNERSf~P ~ Length 1117 f'':ARQUETTE AVE STE 2 0~emolish ? Depth o Address nt Impr. ? Sq. F! l~1PL~hone 332-5544 ~nsta~~ ? o Name ~~A ~ S~NS INC Approvals FNs ~i Address 74 .-,~'~~RKET PL DR Assessment Permit ~ F.UEN P~,{~IE 941-0282 Water 8 Sew. Surcharge Police Plan Review i~INDSOR FA1?ICY ARCHITECTS W W Name Fire SAC 2~3 w 5TH ST - STE 375 AddreST PhU 22?-0655 Eng. Water Conn. < W City IPhone Planner Water Meter Council Road Unit I hereby acknowledge that I have read this application and state that the B~dg. Ofi. 11 2~ 8 Tr. PI. information is correct and agree to comply with all applicable State of Minnesota Statutes and City ai Eagan p~dinances. APC Perks ~ ~ Var. Date Copie~ Signature of Permittce TOtAI FRANA 8 SONS INC A Building Permit is issued to: on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Oiticial - ~ . ~ ~ . P«mR No. P~m~N Hold~. Dab TN~phon~ N Plumbfny 7 b `3~l ~ f g~ H.i/.A.C. ~'02 / ' 1 , . -1~-~ % ~iS'7 E~~ a ~ ~ v _ e.r~ ` s 3 ~ a ~ C,.3 ~7a ~ ~-~_~Q.~ ~f ~ ~ . - oiLc, ~ ~ ~38 Y S ' ~ In~pecdon Da1~ Insp. Commems Foodny~l ' FooBn~t 11 Foundatbn Fnminp G ~ RooNny - ~ Rouyh Plbp. 01:~ J . D ~ ~ ~ . `U Rouqh Mlp. s ~ '~'l Y4 ' n Flr~placo Finsl Hty. 3. Ffnal Plbq. -~1 Bldy. FMN ~77 Grt.Occ. 8 ~ Deck Fty. D~dc F?m~. DNCrib~ Loeatloa: WNI Pr. D~p. ^ . _ _ , . . . t. ' • PERMIT # ~ ~ ~ U . ' ~ ~ ' ~ ' ' PLUMBING PERMIT , RECEIPT # ~ ~ ~ CITY OF EAGAN oa 3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE: CONTRACT PRIC~iZ3~~'O ' PHONE: 454-8100 ~ Y- Site Address S~a-~ BLDG. TYPE WORK DESCRIPTION Lot Biock Sec/Sub Res. New L F-m Name e~1 CC Mult Add-on ~ ~ Address • ~ t~•' « r~?e Comm. ~ Repair c City ~-s~'~`' Phone -!~b ~ Other N FtXTURES TOTAL Name r~ u E o`' S -~r~ Water Closet -$3.00 3 Address 9D ~~k t a ~/v e 8ath Tubs -$3.00 0 Ci~y ~r ra i Phone O~ 8 ~ Lavatory -$3.00 Shower - $3.00 FEES ~Kitchen Sink - $3.00 COMM/IND FEE - 146 OF CONTRACT FEE Urinal/Bidet -$3.00 MINIMJM - RESIDENTIAL FEE _ $~p,pp ~~undry Tray - $3.00 MINIMUM - COMM/IND FEE _~.Qp Floor Drairis -$1.50 ~Water He~ter - $1.50 STATE SURCHARGE PER PERMIT - .50 Whirlpool -$3.00 {ADD $.50 S/C IF PERMIT PRICE GOES Gas Piping Outlets -$1.50 BEYOND $1,000.00) Softener - $5.00 Well - $10.00 / Private Disp. - $10.00 Rough Openings - ~1.50 SIGNAT E QF PERMITTEE FEE STATE S/C: ~ FOR: CITY OF EAGAN GRAND TOTAL: . . . ~ , . ~ T . r-~77Y"~f-'"~°~'T (i`L~PIR"'V111-`~"i . ' ~a':, .,v. d'r.r ..-o . .~.~-;w.~ . . a..,. , .:n,-r . . ~ ' PERMIT # x-~ MECHANICAL PERMIT RECEIPT # ~ ~ l CITY OF EA~3AN . ~ / ~ l :1~~~ : _ 3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE CONTRACT PRICE: `)44 . 5'i PHONE 454-8100 Site Address ' - ~ ~ ~ ~ • BLDG. TYPE WORK DESCRIPTION Lot Block ~ Sec/Sub ~r , ~ ~ Res. New .{Li..i, i..,l..i'J ~ Name ~ ~.•_~nn~,,~:.. ;~r~ve Mult Add-on ~ Address Comm. Repair c City Phone ~ ~ Other Name , : • ` " ~c,.~ _nc. FEES c Address i ~;;a I: ce [ a~ r;~ ti. FiES. HVAC 0-100 M BTU -~24.00 O C~ty L. en ra r e Phone _ ADDITIONAL 50 M BTU - 6.00 ADD-ON AIR COND. 0-24 BTU - 12.00 TYPE OF WORK ADDITIONAL 6 M BTU - 6.00 0'.)0 - ZU . uU GAS OUTLETS - 1.50 EA. Forced Air M BTU COMM/IND FEE - 144, OF CONTRACT FEE Boiler M BTU MINIMUM - RESIDENTIAL FEE - 10.00 Unit Heater M BTU MINIMUM - COMM/IND FEE - 2Q.00 Air Cond. M BTU STATE SURCHARGE PER PERMIT - .50 Vent CFM (ADD $,50 S/C IF PERMIT PRICE GOES BEYOND $1,000.00) Gas Piping Outlgts # Other ' 7,._,~.~'~ ~ ~ FEE ---r~ - r ~ . S/C: ' SIGNATURE OF PERMITTEE . TOTAL• ' FOR; CITY OF EAGAN CI7Y OF EAGAN WAT~t SERVICE PERNUT 3830 Pilot K~ob Road P. O. Box 21199 ' PERMIT NO.: Eagan, MN 55121 DATE: Zoninp ' No. of Units: ' ' ' p„~~, %'raua E~ '?Glls ~1~~5: Sita /~ddrcss: 4~'''°!+5;2 Sl.ater ?:~~3d L2 B2 ~inr.~-~•:~:i I'r'~,- , t :'C.~:AlliCa~~ PlUmber. - AAetsr No.: la 3 ~ . Stze; ~rL••ROCIC unt~~~IPr~ Read~r No.: dl ~ng i~i - - ~)Q 1~~e.. to ae.py ~ Cif~~~~- c,~e; 50L,~• .n i,~~R ~ ~ = . ~ t;t,.:~ E~ ey ~ ~ ~ ~ ~f `Z ; ~ ~t 6 ~ z gd CITY OF EAGAN WATER SERVJCE PERMR 3830 Pilot Knob Road P. O. Box 21199 PERMIT NO.: , Eegan, MN 55121 D/1TE: =-~n. 7• Zoniny: No. af Units: ~ ~ : ~ > ~N'fIQ?~ FI: ~ V SOE:s ~1'lfs: Stq /?ddress: ~S fi 4542 Slat~r ::c~;~c~ L2 3~ c- , ..:mar~_x.~1 , Pluenber, :~Tt*.rL^. c1. `r~c~:8*1; c~ ~ Metar No.: Connection Charqe: 0(' . L)~~•.~s Size; Account p,epastt: Raoder (Vo.: Pe?mit Fee: i'. S)'J ^c! ~~w #e ee~pir ~!M Ck~r ef Surd+arge: , a~'n:j MO"~' Misc. CMrfles: - - •'i Totol: ~y DaM Paid: i ~ Dofe of Ins~.: CITY OF EAGAN SEW~ SERVlCE PERMiT 3830 Pilot Knob Road P. O. Box 21 ~ 99 PERMIT NO.: 9~ 5 Eagan, MN 55121 D~~; f,_~ ZO1~~: No. of Units: IIn it s Owna6: ~Y~r2& bc .^iiDT28 Address: Site Add?ess: ~5~ ~5542 S~~ter ~~,~;7 - 7 n-: r•~,•-..~•..~~ n,: s- - Piumber. Mec';~nica~.- ' "77~" " ,.4U0.~10pct ~w« ro eN,p1r wtli r~. Ciry~ ai E.~.w C.onnecrton G+o~pe: l n R. O~dhnee~s. Acoount Depo.it: , P~?mk Fee: - 1 ^ ; : ~ : ~ ; By 5"'ch°"°'' ° ~ : Mtic. Chonpss; Dote of Inap.: Totol: Irup.: D~s Poid: CITY OF EAGAN , ' 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 N~ 113 4 4 PHONE: 454-8100 7~ BUILDING PERMIT SEE BP Receipt# ~5~ Tobeusedtor 12 UNIT M.D. Est.Value 11325 Date NOVEMBER 21 ,~g 85 SiteAddress 4542 SLATER RD Erect ~7 occupancy SEE BP 11325 Lot 2 Block z Sec/Sub. CINNAMON RIDGE Remodel ? Zoning Parcel No. 7TH ADDITION Repair ? Type of Const. Additian ? No. Stories w Name CINNAMON RIDGE LTD PARTNERSHI~ove ? Length 3 Address1117 MAROUETTE AVE.. STE 200 emolish ? Depth ° MPLS Phone 332-5544 InstallPr. Sq.Ft Ciry ~ FRANA & SONS INC Approvais Fees i o Name SEE P $a Address~490 MARKET PL DR Assessment Permit ~ Ciry EDEN P$~~2IE 941-0282 WaterBSew. Surcharg~~ u= WINDSOR FARICY ARCHITECTS Police PlanReview W W Name Fire SAC 2 W STH ST. - STE 375 Address Eng. Water Conn. <W ST PA~]~~e 227-0655 Planner WaterMeter ' Council Road Unit ' Iherebyacknowledgethatlhavereadthisapplicationandstatethatthe gldg.Off. 11/21/ STf.PI. information is correct and agree to comply with all applicable State of Minnesota Statutes and Cjty~~Qf Ea ~Ordinan~ APC PafkS 6/1~~1 I Signature of Permitlee tkC+--b.!& Va~. Date COpies Total A~euilding Permit is issued to: FRANA & SONS INC on the express condition ihat all work shall be done in accordance with all applicy. e State of Minn ota tatutes and City of Eagen Ordinances. , Building Official ~ CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 N~. 113 4 3 ~ PHONE: 454-5700 ~~7~ BUILDING PERMIT SEE BP Receiptp Tobeusedfor 12 UNIT M.D. EstValue 11325 DBie NOVEMBER 21 ~g 85 SiteAddress 4538 SLATER RD Erect ~9 Occupancy SEE BP 11325 Lot 2 Block 2 Sec/Sub. CINNAMON RIDGE Remodel ? Zoning ' ParcelNO. 7TH ADDITION Repair ? TypeoiCOnst. Addition ? No. Stories w Name CINNAMON RIDGE LTD PARTNERSII`1~ ~ ~ength 3 Address 1117 A7ARQUETTE AVE. ~ STE 2Q(~emo~ish ? Depih ° MPL 332-5544 nt~mpr. ? Sq.Ft Ciry SPNone Install ? a APProvals Fees o Name FRANA & SONS INC Address 7490 MARKET PL DR Assessment Permit SEE BP ~ ~;ry EDEN PR~~IE 941-0282 WaterRSew. Surcharge 11325 Police Plan Review ~ W Name WINDSOR FARICY ARCHITECTS Fire SAC Address 28 W STH ST - STE 375 Eng. WaterConn. aw ~;~y ST PAUlphone 2z~'Q655 P~anner WaterMeter Council Road Unit ' Iherebyacknowledgethatlhavereadthisapplicationandstatethatthe gldg.Otf. 11~21/g Tr.PI. information is correct and agree to comply with all applicable State oi Minnesota Statutes and Ciry„pf agan dinanc~ APC Parks tV Var. Date Copies Signature of Permittee Total FRANA & SONS INC A Building Permit is issued to: on the express condition that all work shall be done in accordance with all applicable~ate of M~ininesota tu =_s and City of Eagan Ordinances. Building Official r r ~ . . - . ~y , . . . . Thia~nou 't void ! ( ~ / ~ ~8/ / X ~ / 18 montli om J ~ 1~ 17 2~~~, a a, L~~, ~ i~s y- '$epuest Da~e Fire No. Rouph-in Inspcr.tion ~ Re~qw~reA? ~Ready Nuw ~.vill Nolify, InsVec- - ~ ~res ?NO ~o~ When fleedy [.}Hcensed Electrical Canvactor 1 haraby request inspaction of ebove ? Own¢r " elaetricel work installed at: ~ - Street Address, Box or 0.oute No. Ci[v ys 2 - .vs~~ ~ ecuon o. Township.Name or No. anee No. ou ~ty OccuUentIPRIN 1 r" ~ Phone No. y Powar Supplier ~ Atldress ~ ^i ElecVical CoMractor ICOmpanV Nnmel nn~ractor's License No. «~Z oy~33 MailinB A~~ress IContrac[or or Owner Makind Instailationl ~ ~ Aut~orized Sig re lCon ctod er Ma ng Installatinn) Phone Number 9yr s6~~. THIS INSPECTION flEQVEST WILL NOT MINNESOTA STA E BOAND Of ELECT CITV GriB9s-Midway Bldg. - Noom N•791 BE ACCEPTED 0Y THE STATE BOARD UNLESS PXOPER INSPECTION FEE IS iB21 University Ava., St Paul. MN 55100 Phone 18121297.2111 ENCLOSED. ~~f.-,~([~ S/~ REUUEST FOR ELECTRICAL INSPECTION EB-ODU01-04 ti ~ . L 1 See inst~uc[ians ~or COmplBtinp Lhis lorm on back o7 Yellow capy. ~ j "X" Below Work Covered by This Request 13172 - f` Atld Nep. Typa ol Builtling Applioncee Wired Equiumen~ Wired Home Ranye Temporary Service Duplex WOter Heater Lightiny Fixtures Apl. Building Dryer Eleclric He2Un Commercial Bldy. Fumace Silo Unloader. Industrial BIAy. Air Conditioner Bulk Mllk Tdnk Farm ~n~~ oer.i y Other ISpcr.ilyl f .r uccify ther Otnir omuute Inspec[ion fee Below N Fae ServiceEntranca5izo tt Fee Feedars~Subleeders k Fex Cimuits 0 to 200 Am s ~ 73 0 to 30 qm s 0 tn 30 F~m Above 200 qmps 31 to 700 Amps 31 to 100 qm s Swimming Pool A6ove 100_Amps Above 100_AmV~ Transformers Irrigation Boort~s Partial.'Other Fee Signs Special InsUect~on 5 emarks Jl.~.S' TOTAL FEE C ~/l~~` / Hough•in Dnie xhe Elecvic6l (/~~Z~ Inspector,-keraby ~ certifv ~het the above Final ~%~~e'/ L9 inspeetion has been . ~ ~ l9 ~ ( rrede. Rils repueat vo1E 18 monRa iram This ~eques[ voiA ~ / ~ ` / ~ D 18 month5./.om ~ `Y d (p ~e, ~1. 6 9 0 ~ ~ ~ ~ a , ~ nn ? ~ ~ ~ o Request Dace Fire No. Flough-in InsuecUOn a Hequired~ ~Aeady Nuw~Will Nntity Inspec- ?Yes ?NO ~or When fleady ~Licensed Elecvi~al Contmcmr I hereby repuest inspec[ion ol abo~e • Owner electricel work installed et Streei ACdress. Bo> or Poote No. Citv ~S- ~ `l5 J '4~ `'1,5 ~e~r" ecUOn o. TownshiD Name or No. Range No. County OccupantlPqlNT) P~onc No. Power Supplie~ AddreSs Elecvical Convacror (COmpany Namel ConVacm~'s License No. K' nt '`1Z cs ~oo S~ 1 MailinB Address IContractor or Owner Makine Instai ationl 1.t, t Pl o",. Mt~ SS4~ 1 AuMorized Signature Gonv ctor/ wner Ma 'nB ~ stalla~ionl Ph ne Number SS3- MINNESOTA STATE BOAflD OF ELECTRICITY THIS INSPECTION NEQUEST WILI NOT Grie9s-MidwaY A~dg. - Room N-~91 BE ACCEPTED BY THE STATE 60AND UNLESS PROPER INSPECTION FEF IS 1821 IlnivarsitY Ave.. 51. Paul, MN 55704 Pnnnw 16121297-2111 ENCLOSED. p 4~ ~L REQUEST F,r`R ELECTRICAL INSPECTION „ ee-oocwi.nn / ~ ~ See ~si~is for completin9 this brm on back oi Vellow copy. ` D ' 16 9 0 • ~ X" Below Work Covered by This Request Ad NeD- Type oi euiltline Aoo~~encae Wiretl Equipmenl Wired Home Range Temporary Servfce Duplex Water Heater Lightiny Fixtures r Apt. Building Dryer Electric Heahn Commercial Bldy. Fumace Silo Unloade~, Industrial Bldg. Air Conditioner 8ulk Milk Tank Parm . ~n~~ oec~ v oiner IsnnnrylF~ ~ 1.r Succi y Other OtherTV t ompute lnspection Fee 8elow p Fee ServiceEntrenceSize N Fee Feade~s/Subieeders 4 Fev Circuits 0 to 200 Am s 0 to 30 qm s 0 to 30 Am s Above 200 qmps~~ 31 to 100 qmps 37 to 100 Am ~ Swimmin Pool Above 100_Am s Above 100_Am s Transtormers Irrigation Booms PartiaL'Oth Signs Special Inspection TOTAL k" pemxrks 5~~0 ~~Q~ • floueh-in Date ' I, the Elec ' Insoeetor, here0v cerlity thet tha xbove Final ' D'nte / {~spection ~es been C.~ . ~ meAe. ~Me repuest voie 18 monihe irom ~ C I T Y O F E A G A f~ ~"70~' oF ~~'T T~ °F . * ~rrsc~zoH nors rxrr ~ APPLICATION FOR PERMIT *~P~~ OF PE~2hffT. ~ ~ INSPECTION OF SE.S~i Atd1/Cgt WA'~2 : ' ,*f Tucmnr,r nmTONS WIIS. Nf7r BE-~ SEWER AND/OR WATER CONNECTlON ~ UI~ID UNt'II, PERrffT AAS BEH1J • ~ APPROVID. rt w ~ - - ' *:r,r*****:c***~k**x:r***,rf*:x~~-r*:*:yr*~ Please Pr~.nt ~ 1) PROPERTY ADDRESS: 45~/.~~y-,~Slater Rd LEGAL DESCRIpTION: 2 Cinnomon Rid e 7th Addition ~ Lot Slock Subdivision or Tax Parcel ID ) EZCISTIb:G STRC'CiL~RE, DATE OF ORIGINAL .B()ILDIN:,•PERNLIT ISSUADK:E: PRFSENi' ZONII~G/pROPOSID L~SE: (~n Year) ~ CONY•~CIAL/REI`p,IL/OFFICE ~ R-1 SSI~LE FAMILY . Q IDIDC'STRI.AL ~ R-2 DOPLEX ('14~ Dnits) ILSTITL~TIONAI,/GO~ ~ R-3 TUWDII-IOC~SE (Three + Units) ( L~~~ ~ R-4 APARTMENT/CObIDOM2NIUM (2)( 12 Units) Z~ ~ Np,N1E: FRANA & SONS ADDRESS: 7490 Market P1ace Drive ~ITY, STATE, ZIP: Eden Prairie, Mn 55344 PHOi~: 3) • u For City L~se . ~ME'--~~ ' ,~iGnnFi MECHANICAL ' A~~RESS= 3600 K~iJNEGEC DtiIVE, EAGAY, 41iNN.55122 Pl~rs i'1CEClSE' , ACt7.~7E . CITY, STATE, ZIP: . ~cPireci . Not recarded PHONE: (~STER I,Z(:ENSE# 001445M2 St Imtyal 4) • ~ i~• . . . . FAANA' & SONS _ AnDRFSS: 7qgp Market Piace Drive ~ ~I'PY; STATE, ZIP: Eden Prairie, Mn 55344 ~ PHONE: . 'S) ~ 'i - i•~ r: • : ~ - a~ - a~ ~ CbNNECi'ION ~ CITY SEWER ~~N~,~ION TO CZTY WATc^Et p~~ a . 6) ~ PLEASE HOLD ApPROVID PERMIT FOR PICK-U P BY ONE OF AB~VE - . - - - PLEASE ApPROVFa PEI2hLiT ~ 1, 2, 4. A~IE (Circ`te one) 7) r u•- 7/2/86 _ • ^f' ~ Y'" 0i' . . 'C~..'tii''`~ • ID. ~ : M:I. 11 • I'. • ~ l:t• n Y'JI• • ~ . ' '.tlJl 1 1 1 . :il' ~ :A' • ~ ~ J~ . ~ ~ ~ L" M1 ~OR CITY USE ONLY ~ . PERMIT ISSUED ' .7_ 3 _ Pd w/Bldg. Permit FEES: $ ~G' S~' SEWER PERMIT (INCLUDE SURCHARGE) $ $ fD-,5~~ WATER PERMIT (INCLUDE SLRCHARGE) . $ $ WATER METER/COPPERHORN/OC'TSIDE READER $ $ WATER TAP (INCLL~DE CDRPORATION STOP) S $ SEWER TAP $ $ ACCUUNT DEPGSIT - SEWER $ _ $ ACCOL'NT DEPOSIT - WA~w'RR $ C~ 4~ C~ ~ t,--~_ $ wA~ . S ~ C} C7 , UZ~ $ SAC . $ ~ TRUNK WATER ASSESSMENT S $ TRL~NK SEWER ASSESSMENT ' $ $ • LATERAL BENEFIT/TRL~N"K SEWER $ $ LATERAL BEN°FIT/TRC~NK WATER ~f ' _"ert~ $ WATER TREATMENT PLANT SURCHARGE $ $ OTHER: $ v~ y ~ Y 7'C/7j $ l/Z~ TOTAL ~~75" S~ 3% RECEIPT.#r RECElPT ~ DOES UTILITY CONNECTION REQUIRE EXCP.VATION IN PUBLIC RICHT OF WAY? ~ YES IF YES, THEN A"PERMIT FOR WORK LQITHIN PUBLIC Q ROADWAY" MUST BE ISSUED BY THE ENGINEERING NO DIVISION. LIST AS A CONDITION. SC~BJECT TO THE FOLLOWI[VG CONDITIONS: APPROVED BY: TITLE: DATE: _ X/(p City of Eaafl 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Date: 2 1d Tenant: Si Use BLUE or BLACK Ink Permit #: 'G2 Q c 7 Permit Fee: 70o -sD Date Received: 3 J Staff: 2010 MECHANICAL PERMIT APPLICATION Site Address: `J n� 1ac d - -_.J t'e_ LLde`5 L15 102- v� d /`1 �D-1 s Suite #: J RESIDENT / OWNER Nanneek.er Uorp, Phone: Address/City/Zip: 900 Anud Ave S• rrrtpf5 •55 %c — CONTRACTOR Name: t V l e License #: " 7 �`�d 790 &rd ei,Address: / /( .I P / L�' Ci/ i l'\4 • E City: 14G(zri Vl f /k - State: ITYW Zip: (5533 7 Phone: 95-07 — `239/71 7,723c Contact: Email: TYPE OF WORK New replacement Additional Alteration Demolition ! Description of work: L' 1Q.0 e- 9- ( / C ' NOTE Roof mounted and ground mounted mechanical equipment is required to be screened by City Coder Please contact the Mechanical Inspector ford}formation on permitted screening' methods PERMIT TYPE Furnace RESIDENTIAL COMMERCIAL _ New Construction i---Triterior Improvement Air Conditioner Install Piping _ Processed Air Exchanger Gas Exterior HVAC Unit _ Heat Pump _ Under / Above ground Tank ( Install / _ Remove) Other ** When installing/removing tank(s), call for inspection by Fire Marshal and Plumbing Inspector RESIDENTIAL FEES: $50.50 Minimum Add-on or alteration to an existing unit (includes burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) ��y $.50 State Surcharge) $ 701 000 TOTAL FEE $90.50 Fire repair (replace COMMERCIAL FEES: $70.50 Underground tank $50.50 Minimum (includes installation/removal OR State Surcharge) surcharge is $.50. increases by $.50 for each Permit Fee requires a $1.00 surcharge). • Contract Value $ W ,_ 00 x 1% = $ Permit Fee - If Permit Fee is less than $1,000, = $ i J v Surcharge - If Permit Fee is > $1,000, surcharge $1,000 Permit Fee (i.e. a $1,001-$2,000 �7 = $ /' 0 • 6d TOTAL FEE 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.aopherstateonecall.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 will be in accordance with the approved plan in the case of work which requires a review and approval of plans kook J yep Applicant's Printed Name FOR OFFICE USE Required Inspections: x Applican s igna ur City of Eapll 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink wow Permit #: Permit Fee: Date Received: Staff: 372 2010 COMMERCIAL PLUMBING PERMIT APPLICATION Site Address: 4 3g; S Icc te_T Y\ pa -S L/ 6 c1/ Date .3123110 Tenant: Suite #: J PROPERTY OWNER ff P C S I A 90 O z/ JO Name: Sne j �� Cor o o',��-�Or� Phone: � 7 CONTRACTOR Name: &Ivanced Y l tlOchcin iced , t,LC License #: Address: l j / Z G i Yf I C -C el City: 13(.04-1\5v. i ie State: ir' Zip: 5-5737 Phone: 95-2- - gYS -- c710 0 Email: d re acicJo 1%-cec rn.e ck t' 3 ccI , cow-) TYPE OF WORK New / v Replacement _ Repair Rebuild Modify Space Work in R.O.W. _ _ _ Description of work: U ep lace_ p0 y w'r +h e ex p ; pe_ PERMIT TYPE COMMERCIAL New Construction •Modify Space Irrigation System ( yes /A 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: $50.50 Minimum (includes State Surcharge) OR Contract Value $ e5 -73{.'x .1% Required - If Permit Fee is less than _$ 5. 73PermitFee on ALL new buildings and boulevard irrigation systems 4 = $ Radio Meter Read $1,000, surcharge is $.50 = $ Meter(s) - If Permit Fee is > $1,000, surcharge increases by $.50 for each $1,000 ,C 0 a $1,001-$2,000 Permit Fee requires a $1.00 surcharge). = $ r 5State Surcharge $1,000 Permit Fee (i.e. 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 $_ • 2 5 CALL BEFORE YOU DIG. Call Gopher State One CaII 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 withgut-a permit; that theyvork yAII be in accordance with the approved plan in the case of work which requires a review and approval of plans. Ge -re cj f Applicant's Printed Name ✓ FOR OFFICE! pproved x Applicant's Signatur Date: !, Required Inspections _Under Ground Rough -In Air Test Gas Test Final PRV Require Page I of 3 City of Eaali 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink Permit Fee: Date Received: 4-7 Staff: 2010 COMMERCIAL BUILDING PERMIT APPLICATION Date: -8- 10 Site Address: 4453g I £-t--ef Tenant Name: (Tenant is: New / Existing) Suite #: Former Tenant: PROPERTY OWNER Name: SI. lTCT fpa r-0, .N. P(1one: Address / City / Zip: / d _e/6.+-er QOc FCL9 t A, 711 TV Com7.2.2 Applicant is: Owner 'X' Contractor TYPE OF WORK Description ofwork: %.e -R-00 .- 44-.. IL 1 dr'j5 °- Grt/ E- Sint-thee-1- - `'Construction ConstructionCost: 30, COD CONTRACTOR Name: G «t'V ,t1 eantrc f J O M / J X 1 C License #: / 79-6 Address: 30S" /0�� 1-7v&- M City: Go /c/eA Vie;!ky State: I f I Al Zip: SCys,17 Phone: C7&) .C7/6 "^ /S'0 Contact: -C� S9I1i,i Email: S1-W.S. CD 1 'i\i -eik co - co M ARCHITECT / ENGINEER Name: Registration #: Address: City: State: Zip: Phone: Contact Person: Email: Licensed plumber installing new sewer/water service: Phone #: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets. 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 will be in accordance with the approved plan in the case of work which requi-es a review and approval of plans. xS-prJ nL Applicant's Printed Name Applicant's Signature Page 1 of 3 Gity of E:aaall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 2010 RESIDNTIAL BUILDING PERMIT APPLICATION C4:144 Date: /2 / 6 Site Address: 415-1/2 — S-3 0 sithr- keI 12 it1-19 Tenant: Suite #: BLUE or BLACK Ink; 9qqPermit #: Permit Fee: x-71171 < r Date Received: Staff: RESIDENT / OWNER TYPE OF WORK CONTRACTOR S 1'-1 J J. Name: v - ! T� C$ i Phone: 9� 3 Address / Cit/Zi : �6Oa k.Ir L-1• Ss toed y p �ps / M ...1yo• 1-411-41(4‘ Ilk" SI - 3 6 "" Applicant is: Owner is Contractor Description of work: (L k . /i /� l d // L'Q /J,Qi1 Construction Cost fir/ e a a COName: / f L r- c,G �i e• Address: 6 aL y State: Y"�-� Zip: 3 / Contact: �lre Phone: Multi -Family Building: (Yes ' )C / No License #: Cao City: , --� /-VP o- /24 Email: I b G iA.-a r Q. ffre.'f �l.Qd J. t0 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: Att.. �t b») � v `f _. #ii d'o {nist, tJf j °•!!ti�X'`. ®!, ds=r+in:�C.a.°09 11,.5.^.a'fU°.Y�9"°�A.�.p 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.aopherstateonecall.orq I hereby acknowledge that this information is complete and accurate; that the work will be in co ance 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 wo is of to start without a permit; that the work will be in accordance. A itb.41. e-/apppproved plat .,., in the case of ..,....hickrequires - review and -" :---- - - x j G -e / 1l 6 HCl !c A AC -4 Applicant's Printed Name Appli nt's Signature uv NU l virtu l t t3tLOW THIS LINE SUB TYPES Foundation Single Family Multi 01 of Plex Accessory Building WORK TYPES New Addition Alteration )( Replace /_� Retaining Wal DESCRIPTION Valuation Plan Review (25% 100% Census Code # of Units # of Buildings Type of Construction t-/ t/ L/7c Fireplace _ Garage Deck Lower Level n fl Interior Improvement Move Building Fire Repair Repair 1 Porch (3 -Season) Porch (4 -Season) Porch (Screen/Gazebo/Pergola Pool Occupancy Code Edition Zoning Stories Square Feet Length Width REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) Foundation Drain Tile Roof: _Ice & Water Final Framing Fireplace: _Rough In Air Test _Final Insulation Meter Size: Reviewed By: T2 — Siding Reroof Windows — Storm Damage Exterior Alteration (Single Family) _ Exterior Alteration (Multi) Miscellaneous Demolish Building* _ Demolish Interior Demolish Foundation Egress Window — Water Damage *Demolition of entire building — give PCA handout to applicant MCES System SAC Units City Water Booster Pump PRV Fire Sprinklers Sheetrock Final / C.O. Required 7 Final / No C.O. Required HVAC Other: Pool: _Footings Air/Gas Tests _Final Siding: Stucco Lath Stone Lath Brick Windows Retaining Wall: Footings — Backfill Final Radon Control Erosion Control Building Inspector RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL ry,44,6-wAte P6-0 97° ( c2c2 fiev,/“ Page 2 of 2 r City of EaQall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use Permit #: 11501(o Permit Fee: S(04 . v I Date Received: "i `19 1 1-2, Staff: 2013 COMMERCIAL 1/BUILDING ,,PERMIT APPLICATION ! Date: ��/ 9/1) � 3 Site Address: 759/'7 53 g 94 kr Oa Tenant Name: 6:44/10A1 on a (i 5c_ (Tenant is: New / Existing) Suite #: Former Tenant: Property Owner Name: 91.e / /- 6f -190"'A /LA \ Phone: q502 35' - 5 D ) /d00 i1/vpk-S Irossroott Address / City / Zip: Applicant is: Owner X Contractor Type of Work Description of work: tZ i �. 64p Oft a :O l l Construction Cost: 130 3 5Z Contractor Architect/Engineer Name: &/ ") License #: /9C/6 6 Address: 5335 v City: ? State: I Zip: 53109- Phone: 71.3 — 5/W /3 00 t Contact: a Vt4 "'l / Email: da 'iy� %moi , 1 d -C6.1 Lo • Co Name: Registration #: Address: City: State: Zip: Phone: Contact Person: Email: Licensed plumber installing new sewer/water service: Phone #: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets. 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.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 will be in accordance with the approved plan in the case of work which requires a review and approval of plans. 064 (i(Ato--7 Applicant's Printed Nanhe Applicant's Signature Page 1 of 3