3965 Sibley Memorial Hwy CITY OF EAGAN Remarks
Addition Baz'torl-MCgr'ay Addx1• Lot-_3 . Rlk ~ Parcel 10 13700 030 01
owner sireet 3965 Sibl-ey =n1egi Hwy. SL te-• Eagan, rN 55122
Improvement ~ Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK 1968 113.7 3•79 30
SEWERLATERAL 3 977
* service sfiubs 1977
WATERMAIN
* WATER LATERAL 1977
* WATER AREA 1977
STORM SEW TRK
:t STORM SEW LAT 977
CUR6 & GUTTER
510EWALK
STREET LIGHT
WATER CONN,
BUILOING PER.
SAC
PARK
av-~UVt-1Mc ~rCL '1_
CITY USE ONLY
PERMIT ~Aq 104) RECEIPT DATE: Q I
F.M~G PERMT APMCATION
C1Z'YOP aA6lkN
ft90 rnmBPOB n
$A6", liR w1 tE
051--661-075
WCOMPLEIF APPLJCA]IONIS WILL NOT BE PROCESSFD
Date: J - 2 ~ O ,
WORK TYPE New Bldg _XAdd-on Repair RPZ _ PVB • Irrig,ation systcm
• Must complete reversc side of application also. Required meter size is 2" twbo un leaa smaller size permitted by Pubtic Works
DESCWPTION OF WORK
To inquire U Pressure Reducing Valve is requlred on new service, ca11651-681-4646
METERS - Call 651-681-4300 to verify that hydrostatic, conducrivity, and bacteria tests passed Drlor to uickinQ uo meter
Irrigation Size & Type Avg GPM
Fire Size & Type Avg GPM
Domestic Size 8c Type Avg GPM
Does this include tugh demand devices7 _ Yes _ No
FLUSHOMETERS _ Yes _ No PRV REQUIRED _ Yes _ No
H
Site Address:_ 4-16e-gy ~gwy
Tenant Name: Telephone
(Area coae)
Wes there a previous tenant in this space? _ Y_ N. If Yes, Name: LlAv,kAn4'#'.1_1
Installer Name: LI1/,4S« vje ~G•~G . Telephone
(Area Code)
Installer Address: / D 1t-:) ,~2~?~/! c_~ S T it/ ,
City: 4AZLii5 ulovzz2 State: ,96il1, 2ip Code
o? 00 O -
FEES Contract prlce o0 0~ x 1% ($50.00 minimum) Conh-act Fee $
Meter(s) $
Required on all new buildings & boulevard irrigAtion systems Radio Meter Resd $
Surcharge: $.30 Minimum. If contract fee exceeds $1,000, calculate at State SunAarge $ 50 cents per $1,000 contract fee.
Total From Reverse New Service S
Total S
I hereby acknowledge that I have read this application, state that the information is correct, and agree ta comply with all applicable City of Ea an
ordinances. It is the applicant's responsibility to notify the property owner that the City of Eagan assumes no liability for any i
dwing its normal operarional and maintenance activiries to the facilities constructed this permit within City pro / e~e
. 1
SIGNATURE OF PERMI E
CITY USE ONLY By
REQUIRED INSPECTIONS: _ U.G. _ Air Test _ Gas Test _ Rough In _ Final
APPROVED BY: ~ B[JILDING INSPECTOR
PLANS SUBMITTED o
IRRIGATION SYSTEM (CONT)
Service: _ existing (if coming off domesric line) OR _ new
If "new service"; contact Jerry Wobschall, Finance Co»sultant, to confirm adding fees for:
Water Permit & Surcharge - $ 50.50 $
Water Supply 8c Swrage - S 860.00 $
Water Treatment Plant Chazge - $516.00 per SAC unit $
Fees to be added to front side of apptlcation S
GENERAL INFORMATION
• Radio Meter Read (required on all new buildings & boulevard irrigation systems- $153.00 )
• Wster meters include copperhorn/strainer, remote wire, and touch-pad meter
GPM METERS USE PRICE GPM METERS USE PRICE
1-20 5/8" displacement residential $115.00 4120 1-1/2" irrigarion syst $ 727.00
sm commercial turbine" **must receive
maximum approval from
continuous Public Works
10
2-30 3/4" displacement lawn irrigation $149.00 4160 2" turbine Ig irrigation syst S 899.00
maximum residential &
continuous sm commercial producrion lines
13
3-50 1" displacement very Ig res $194.00 1/4 to 160 2" compound bldgs over $ 1,757.00
bldg to 24 units 65 units
maximum sm commercial &
continuous & Ig comm bldgs
25 irri tion s stems
5-100 1-1/2" bldgs 25-64 units $428.00
meximum displacement &
continuous most comm bldgs
SO
ME'I'ERS REOLnRNG 30-DAY ADVANCE NOTICE PROR TO PICK UP
GPM METERS USE PRICE GPM METERS USE PRICE
5-350 3" turbine very lg irrigstion syst $1,184.00 6-500 4" compound +300 unit bldgs & $3,476.00
8t production lines very Ig comm bldgs
1/2-320 3" compound +200 unit bldgs $2,212.00 10-1000 6" compound +400 unit bldgs $3,711.00
very Ig comm bldgs vcry Ig comm bldgs
15-1000 4" turbine vory Ig irrigatian syst S2,132.00
& production lines
Comments
• To schedule inspection of the inside water line and backflow preventer, ca11651-681-4675.
• To anange for water turn-on, call 651-681-4300.
cc: Kris Forster, Mauitenaece Division Clarical Tachnician Updated I/UI
1-rJ vi - Y1', c
; CITY USE ONLY
PERMIT RECEIPT DATE:
APPROVED BY: INSPECTOR
COMMEtCUkL MECiMICAI. PEPJMiT A"LICATION
CITY OF KA6t4N
S$SO PILOT KNOB RD
EAsM, M1v 55122
651-6$1-4675
Please complete for: all commerciallindustrial buildings
multi-family buildings when separate permits are not required for each dwelling unit
DATE:
siTEaDDREss: 39'G~ blev A~'/~P~
OWNERNAME: PHONE#: -
(AREA CODE)
TENANT NAME (IMPROVEMENTS ONLY): C•~ A• S
WAS THERE A PREVIOUS TENAN'T IN THIS SPACE? _ Y_ N. NAME:
INSTALLER: Q C ` !;1G'
.e,DDREss: / rxoNEu: ~"51
(AREA CODE)
CrrY: STATE: _M/1) Zrn: .S SI/U
WORK TYPE: ew construction _ Install U.G. Tank
~ Interior Improvement _ Remove U.G. Tank
Processed Piping
SpecifyNatureofWor~ A014 'Y~G
/ W
When installing/remaving underground tank, call 651-68I-4675 for inspection by Fire Marshal and
Plumbinglinspectnr. n Fees: 1% of contract pnce OR $50.00 minimum fee, whichever is greater. Underground tank removallinstallation = minimum fee Contractprice: x 1%(Base Fee) State surcharge calculate at $.50 for eacTOTAL ti'
_ i l~P
SIGNAT[JRE P RMITTEE
Updated I/01
CITY USE ONLY '
.
PERMIT RECEIPT DATE:
R£SIDFNTIjEL M£CEARICi4I. PEfiMIT ~PPLICATION
CITY OF Ekfii41Y
S$SO fILAT KROB iiD
SA6kP MlY 55122
651-681-4675
Please complete for: ? single family dwellings
townhomes and condos when permits are required for each unit
Date:
SITE ADDRESS:
OWNER NAME: TELEPHONE
(AREA CODE)
INSTALLER NAME: TELEPHONE
(nRep cooe)
STREET ADDRESS:
CITY: STATE: ZIP:
Place a check mark next to the ermit work t e
New residential dwelling unit under constructionand not owner/occupied $ 70.00
Add-on, modification or alteration to exlstina dwelling unit $ 50.00
. furnace replacement
• air exchanger
• air conditioner
• other
Nature of work:
State Surchar e $ .50
Total $
Reminder: Call for inspections.
SIGNATURE OF PERMITTEE
Updated 1/Ol
~BUILDING PERMIT APPLICATION (COMMERCIAL)
CITY OF EAGAN "a ~
o Cj 651-681-4675
Foundation Onl New Construction Interior Im rovement
. Structural Ptans (2 seGs) . AmhitecNral Plans (2 sets) • Architectu2l Plans (2 sets)
. Civil Plans (2 sets) • SWCtural Plans (2 sets) • Code Analysis (1)
• CeRifcate of Survey (1) • Civll Plans (2 sets) . Project Specs (i seq
. Code Malysis (1) ° • Landscaping Plans (2 sets) . Key Plan (1)
. ProjectSpecs (t) . CodeMalysis (1) . Master Exit Plan (1)
. Spec. Insp. & Testing Schedule " • Certificate of Survey (7) • Energy Calculafions (1) not always"
• Soils Report (t) . Spec. Insp. & Testing Schedule (1) " • Elec. Power & Lighting Form (1) not always"
• Meter size must be established • Meter size must be esta6lished • Meter size must be established - if applicable
• Project5pecs (1)
1 • EnergyCalculalions (1)
1 • ElecVic Paver & Lighting Form (1)
1 • Master Exit Plan (1) 1
! • Fire Protection Plan (1) 1 • Soils Report (1) 1
• MGES SAC determinatlon leiter . MC/ES SAC determination letter • MC/ES SAC determinatlon letter
call 651-602-1000 cail 651-602-1000 call 651-602-1000
Contact Building Inspections ior sample
Food 8 beverage or lodging facili6es: Plan must be submitted to Minnesota Department of Health - call 651-215-0700 for details.
DATE: I~'" 27- Da WORK TYPE: NEW ~ REMODEL COt,ySTRUCTION COST: ~
CUw\ , 'lJ~v`,~ d C~.~c
DESCRIPTION OF WORK: DF/'/C/~ ~j~/Y/pQrG. St• U\; i c~~
~
TENANT NAME: C. D. S SUITE
FORMER TENANT NAM~ C~a/fDu~/l)
~i 2
SITEADDRESS: 39~ 5/1~r~//!'J~'/, }~LJ LOT-:t~_BLOCK~SUBD I~QY}G`A - ~CGrG~
Nazne: W4y -ZA'TA aPY G ~N1't4R Phone#: c 7(03
PROPERTY Last First
OWNER .~y~~
Street Address: 71~i /I ""y 1~.l~¢9~ 0/v0
City / State: Zip:
~0~
Company: 6e-'16GW CO~`J~~UGj/lJ~ Phone#: 30/3
CONTRACTOR
Street Address: g2 C-' G Gf4G% •
Ciry --,L^ # State: /0"/N Zip: '7;3V76
ARCHITECT/
ENGINEER Company: Phone ( )
Name: Registration
Screet Address:
City State:
Licensed plumber lnstallina sewer/water: Phone DEC 2 g Z~~~
Meter Size: ~
I here6y acknowledge that I have read this application, state that the information is correct, and gree t ' tate
of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:
s
OFFICE USE ONLY
BUILDING PERMIT SUBTYPE
? 01 Foundation ? 26 Public Facility ? 30 Accessory Bldg.
? 14 Apartments ? 27 Commercial/Industrial ? 32 ExtAlt-Apts.
? 15 Lodging ? 28 Greenhouse ? 34 Ext Alt - Comm.
? 25 Miscellaneous ? 29 Antennae ? 35 Ext Alt - PF
WORK TYPE
? 31 New ? 34 Repair ? 37 Demolish Bldg. ? 43 Reroof
? 32 Addition ? 35 Tenant Impr ? 38 Demolish (Interior) ? 44 Siding
? 33 Alterations ? 36 Move Bldg. ? 42 Demolish (Found) ? 45 Fire Repair
? 46 Windows/Doors
GENERAL INFORMA ION /
Census Code ~ Zoning sq. ft.
SAC Code ~ # of Stories sq. ft.
No. of Units d Length sq. ft.
No. of Bldgs. 1 Width sq. ft.
Const. (Actual) ~ Basement sq. ft. MC/ES System
(Allowable) First Floor sq. ft. City Water
UBC Occupancy 9 sq. ft. Fire Sprinkiered
MISCELLANEOUS INSPECTIONS
? Gas Service Test ? Heating ? Insulation ? Plumbing ? Stucco/Stone
APPROVALS
Planning Building (~Kvl Engineering Variance
VALUATION:$
Permit Fee
Surcharge
Plan Review
MC/ES SAC % SAC
City SAC SAC Units
Water Supply & Storage Meter Size
S/W Permit
SM/ 5urcharge
Treatment Plant
Park Dedication
Trails Dedication
Water Qualiry
Other
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