915 Yankee Doodle RdCity Eaanof
�
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
Permit#: f 0O 8- 1
Permit Fee: `O • CO
Date Re
Staff:
eived: 7 U( ^` 1
2011 COMMERCIAL BUILDING PERMIT APPLICATION
Date: Site Address:
Tenant Name:
(Tenant is: New / Existing) Suite #:
Former Tenant:
PROPERTY OWNER
Name: T43{') / Phone:
Address / City / Zip: ''/S V,,7 IAC' a -,-,-//e tz (
Applicant is: Owner Contractor
TYPE OF WORK
Description of work: (�-C/1'3 ,�c�/C� ‹,11'W
Construction Cost:
CONTRACTOR
Name: 1 74_i/4 z, ,. .,'c /------, ''cense#:
Address: �,?-ci-1 ,--- ),9k2 -- -- City: 6e,U-4-6#'
State: Yfri fU Zip: S- -7,c) Phone: (`7 52) - (1/6' -- S' V �.'
Contact:: / ( ✓✓✓
��-� � �/'c Email: j �%u�rt� 01 //U v l -e--75,71,1,;-. ,
)
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. Call 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. 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 an• pproval of plans.
Applidant's Printed N
x
Appli - • nt s Signature
Page 1 of 3
City of Evan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651)675-5675
Fax: (651) 675-5694
Date: 1 5--11
Tenant: VQC04
Use BLUE or BLACK Ink
1
Date Recei ed: t/`/5" G
Staff: ...
INFLOW & INFILTRATION PERMIT APPLICATION
Plumbing / x Sewer & Water
Site Address: 915 )'iikee. Dom& ifd
Suite #:
RESIDENT / OWNER
Name: F1e4 oa' k 1_1_ C-
Phone: 651- `'Z fa -b a d c2 X2/5
? l` i t 55i2 2 1
Address / City / Zip: 332.1 Ake. Col/45 b Fay?
J
CONTRACTOR
Name:
License #:
Address:
City:
State: Zip: Phone:
Contact: Email:
TYPE OF WORK
PLUMBING (Within the building envelope)
Sump Pump Repair
SEWER & WATER (Outside the building envelope)
^ Repair
Other:
Other:
DESCRIPTION
Description of work: A COUet P" reo
d 6^ c CktmoLd.
FEES
$55.00 / Each (includes $5.00 State Surcharge) (Rev. 6-30-10)
TOTAL FEE $ 5510°
*Permit fees will NOT be reimbursed by the City of Eagan. If you plan to submit 1/1 repair costs for
reimbursement, two quotes from qualified contractors must accompany this application. A list of contractors
can be found by visiting www.citvofeadan.com/inflow, or City Hall at 3830 Pilot Knob Rd.
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 ork which requires a review and approval of plans.
,3OI�rL Ca wc ikS C.e p,�{..ol
Applicant's Printed Name
vi~~aa~ oF EaaaN WATER SERVICE PERMIT ~
3795 Pilor Knob Road PERMIT NO.: ~
Eogan, MN 55122 DATE:
Zoning: z---~ No. of Units: 1 ~
Owner: *~?ational Building Centez
Address:
Site Address: ~ankee Doodle & Mike Oollins Dr.
Plumber: '
Meter No.: Connection Chazge: '
Size: Account Deposit: ~
Reader No.: Permit Fee: 10. OOp
I agree to comply with the Village of Eagan Surcharge: . SO ~
Ordinnnees. Misc. Chazges:
Total: ~
By Date Paid: ~
Date of Insp.: Insp.: ~
I
I
; ~
1.'
YILLAtiE OF EA611N ; SE~IVER SERVICE PERMIT ;
3795 Pilpt Knoh Roud ~ ~ PEY4MIT N~.:
Eagan, MN 55122 DATE: ~ ]f.~.3
ZO~g~ r' ~ No. of Units: 1
Owner. - ~`'~t~al Httlldin<7 Centes
Address:
Site Address: Ya~@e ~ale ~ Mike Co~lins Dr.
Plumber: Gll ~
33 - 3~, E~ad+ele ~S/ 3$`~' i
I a~rN !o complq wifh the Villag~ of Eoyan Connection Charge1200. UO 1
O~dinane~s. Account Deposit:
Pernut Fee: 10. 00 '
Sttrcharge: .5C :i
By~ Misc. Chazges: ;
Date of Insp.: Total: ~
Insp.: Date Paid: ~
CITY OF EAGAN
8795 Pilot Knob Road Eagon, MN 'iS1Z2 5 ~ Q ~
PHONE: 494-8100
BUILDING PERMIT ReceiPt # '
Ta be used for -':'~~~'-r ~}i~~ 1• Est. Value n'^~ , Date 19
~ ~ . . , _ _ • r.. ^
5ite Address Erect ? Occuponcy
1'-, ~ G'z~.C~iiTK~c7I.C-' n -
Lot " J' Block Sec/Sub.`" Alter ? Zoning
pQ~~ # Repair ? Fire Zone ~
~
Enlarge Type of Const.
az7'7e.r. a _a . .-~1r~ r a
~ Neme Move ? Stories '
Z (31 C~ t,'Ln : i
_'?!~t'IF' ,nY~c'K?
~ qddress Demolish ? Front ft.
'~'~~'~r~ Grode ? Depth ~ ft.
Ci Phone
~ ~['.7_ } 7"1 ^r n2'S C. Approrals Fee~
Nume
Z~ "?r~,~F-' Assessment Permit
o~ Address ~ - - - ~ ,
u r''' T~'~^T ~ ~ ~ Water & Sew. Surchorge
~ Ci Phone . ~,JS . ,
Potice Plan check
~W Name
~Z Fire SAC
Address Eng. Woter Conn.
aW Ci Phone Planner Water Meter
Countil
I hereby acknowledge that I have read this epplication and state that gldg. Off.
the informetion is correct and agree to comply with all applicable APC Total ~
5tate af Minnesota Statutes nnd City of Eagan Ordinances.
Signcture of Pennittee
A Building Permit Is issued to: T{~~'t~~r~~~ ~~''t' on the express condition thot
nll work shall be done in acco~dance with all applicable State of Minnesota Stotutes and City of Eagon Ordinances.
Building Official
PereNf # Det~ Ipu~d ~~Iffw
Plumbing
Mechanical
INSPECTIONS DATE ~NSP• ROUgh-In Final
Footings Date Insp. Date Irbp.
Foundotion Plumbing
Frome/ins. Methanicoi
Final
Remorks:
r-~ - ~
Receipt J``~ ~ PLUMBING PERRAIT Prrmit No. -
~ CITY OF EAGAN -
, Fea
:
~ ~ ~ ~ Fil1 in numbered spaces S/C - '
~ Type o~ Print legibly Tot.
~ ~
~ 1. Date ia~ 2. Installation Cost
3. Job Address ~STI~ : ~ .TL. ~ ~-at,, ; Blk. ' Tract
. ,
4. Owner v-iJ~~'%i ~f ~ ~
b. Contractor//,_ /Vf< Phone ~
6. Address fi~ f i.
7. City State :1~,. Zip _ ' _ _
8. Building Type: Residential ? Commercial ~l Institutional ?
9. Work Description: New ? Add ? Alter ~r7 Repair ?
10. Describe
11. No. Fixtures No. Fixtures
_ Water Closet Cesspool/Drainfield
8ath tubs Septic Tank
Lavatory Softner
Shower Well
Kitchen Sink
Urinal/Bidet Other
Laundry Tray
Floor Drains
Drinking Ftn.
Slop Sink
Gas Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed : ~ tor
Rough f inal
Inspections: Date Insp_ Date Insp.
This is your pe[mit when numbered and approved.
Approved ~ ~ . CITY OF EAGAN 454~5700
~
NORTi~'.:~
:5't' ~~~;ioLF:SALE LB:t CITY OF ~EAGAN A' ~ +
~ 3830 Pibt Knob Road, P.O. Box 21-199, Eagan, M N 55121 `y ~ ~ 3~ 71
PHONE: 454-8100
BUILDING PERMIT Receipt # ~
Tobeusedtor I.:vT. I~IPR. Est.va~ue S18,ODU Date FCBRUAItI 26 .~g$7
Site Address 915 XANKEE DOU,>L:~ iZU Erect ? Occupancy
Lot~- Block a Sec/Sub. EA~: . C'I'R . I i1U . R~nbdel ? Zoning
Parcel No. Repair ? Type of Const
Additlon ? No. Stories
~ Name ~10RTHbJEST IJHOLEiALE LIIR Move ? l.ength
= 915 YANKP•.i D~JODLE RD Demolish ? Depth
o Address Int. Impr. ? Sq. Ff
Ciry FA(Y,r1ia Phone 454-4985 ~nsta~~ ?
¢ SI:ASUiJt1L BUILUERS Approvals Fs~s
o Name
Address 4 3 21 FOX R I DGE RD Assessment Permit 14 9. 5 0
~ c~ry F''~~'~~' Pnone ~ 2 0 r d 6~ 2 water & Sew. Surcharge 9. 0 U
Police Plan Re~iew 74 • ~5
~
~ W Name 4 54 3 7 I Fire SAC
= Address
~ = Eng. Water Conn.
< W City Phone Planner Watar Meter
Council Road Unit
I hereby acknowledge that I have read this application and state that the gldg. Off. Tr. PI.
information is correct and agree to comply with all applicable State of
Minnesota Statutes and Ciry of Eagan Ordinances. APC Parks
Signature of Permittee_ - Var. Date Copie . 2~
Y ' Total
A euilding Permit is issued to: SI::A$ONAL Bi3 I T,DERS an the express condition that
all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances.
Building Official
P~rmk No. PKmif Holdsr Dai~ Td~phon~ M
Plumbin~ r~ i% `
v~'~ r , ` ~ : ' ' lJ -
H.KA.C. f ~ -i J g
ENCMC ~c ~ g ~',~G~ C
.
Soltan~r
IrapecUon Date Inap. Commenb
FooOngs I ~ ~ y.~ ~
FooUnqsll
Founddbn
Fnminy 3
S
Rooffny
Rouqh Plbq• ~ - ~~'~J .J
~Q " r
Rouqh H1p. ~ ~ .
Insul. P~
Finplae~
Flnal Ntq.
Flnal Plbq. ~
- ~
&dy. Final ~;~-i/-.k~ A,
Cert. Occ.
Deek Fty.
Deck Frmp.
Well
Pr. Disp.
' PERMIT q
~ ~ PLUM8ING PERMIT RECEIPT #
CITY OF EAGAN
3830 PIL~T KNOB ROA~, EAGAN, MN 55122 DATE: 7
CONTRACT PRICE: .3~ rI~ PHONE: 454-8100
Site Address a BLDG. TYPE WORK DESCRIPTION
Lot _ 1~_ Block SeciSub Res. New
~ Mult. Add-on
~ Nam Comm. ~ Repair
~ Address Other
c City hone RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
NO. FIXTURES TOTAL
Name Water Closet - $3.00 1'~
~ Bath Tubs - $3.00
~ Address Lavatory - $3.00
p Ciry Phone Shower - 53.00
Ki?chen Sink - $3.00
FEES UrinalJBidet - S3.00
COMM/IND FEE - 1% OF CONTRACT FEE Laundry Tray - 53.00
APT. BLDGS - COMM RATE APPLIES Floor Drains -$1 50
TOWNHOUSE & CONDO - RES. RATE APPLIES Water Heater - St.50
MINIMUM - RESIDENTIAL FEE - $12.00 Wh~rlpool - $3.00
MINIMUM - COMM/IND FEE -$20.00 Gas Piping Outlets -$1.50
STATE SURGHARGE PER PERMIT - .50 (MINIMUM - 1 PER PERMIn
(ADD $.50 S/C IF PERMIT PRICE GOES Softener -$5.00
BEYOND $1,000.00) Well - $10.00
~ _ Private Disp. - 310.00
` Rough Openings - $1.50
ATURE OF PEFMITT FEE: ~ D O
STATE S/C: ~ ~ ~
FOR: CITY OF EAGAN GRAND TOTAL: ~
yR.'~,;.., ; : ~
, , ~ PERMIT # ~
• ~ • • • MECHANICAL PERMIT RECEIPT # 7~~`' C` ~
CITY OF EAGAN
o~ 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: J'%' `~1 ~
CONTRACT PRICE: ~G PHONE: 454-8100
Site Address BLDG. TYPE WORK DESCRIPTION
Lot ~ Blo ~k ~ Sec/S~b Res. New
` , , _ . ~lt.
Name c J-~ - Muft. Add on
Address ~~~5~ r~ ' Comm. ~ Repair
y City ( Phone ~ Other
Name ; 1. ~ FEES
RES. HVAC 0-100 M BTU -$24.00
c Address ~ J ~ r~"~ ADDITIONAL 50 M BTU - 6.00
p City Phone (RES. HVAC INCLUDES A/C ON NEW
CONSTRUCTION)
GAS OUTLETS (MINIMUM - 1 PER PERMI~ - 1.50 EA.
TYPE OF WORK COMM/IND FEE - 1g'o OF CONTRACT FEE
Forced Air M BTU APT. BLDGS. - COMM. FiATE APPLIES
TOWNHOUSE & CONDOS - RES. RATE APPLIES
Boiler M BTU MINIMUM RESIOENTIAL FEE - ALL ADD-ON 8~
Unit Heater M BTU ~ REMODELS - 12.00
AirCond_ - M 8TU MINIMUM COMMERCIAL FEE ~ - 20.00
Vent CFM STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
Gas Piping Outlets # $ BEYOND $1,000)
Other
FEE: L-~ ~r~ - _ ~
S/C: SIGNATURE~OF PERMITf~E /
TOTAL ~ ~ ' ; ) . ~ t_.!Uj•,_-c,_
FOR: CITY OF EAGAN
~ CITY OF EAGAN Q 8 6;'
3830 Pilot Knob Rosd, P.O. Box 21-199, Ea~o, MN 55121
PH ON E: 454-8100 . .
sUILDING ~ERMIT R~~a #
T~ N w~A iw E' C~~; N l~ u Est. Volue ~ 5~,~~ Date ~.~i ; i,,''i ~ 9'
.
SiteAddre~ ''l:~ YAFdK]:F I3C)(7DL1~. Pfi Erect ? Occupency
Lot Block 4 sec/sub. FAL .';'r ; t Remodel p Zoning
~ ~ - 1 ~ ~ ; ; .S ~ 3 0 - ~ ! Repair ? Type of Conit.
Parcel No. Addition ? No. Stories
Move ? Length
C.~~~.i'+!'~r: c;~i ; ~i;~E:;A.' u i~
~ Name Demoliah ? Depth
Address - r~i-!r. Int Impc ? Sq, Ft.
CILy P~t011@ ~C'Y"44 ( ~fl3~fl~~ ?
Aoo~oraH f~~s
Name i ~r''(, ~ f'~`
Address ' ~ = ' ~ Y' " ` F;1ti' , _ . Nsseument Permit • • ~
u~ City . Phone y-1 E' ~i Woter E, Sew. Surcharge S.~) .
Police Plan Review ! . ~
W N~e Fire SAC
Address Eny. Water Conn.
~ W City Pfione Plonne~ Water Meter
Countil Road Unit
I hereby ocknowledpe thot I hove ?ead this opplication ond stote that r: , b ~
Bldg. Off. Tr. PL
fhe inlormotion is correct o?od ogree to comply with oll applicable APC Pe~
State of Minnesoto Stotutes ond City of Eaqan Ordino~ces.
- Var. Date Copies
Siqnoturc of Pertnittee v_~ . ~
A Building Permit Is issu~d to: `,JL^~.'R: ' oe~ th~ etxpress candiNon Iha~
oll work sholl be done in oc~rdance with oll opplicoble Stote of Minneso~u Stotutes and Ciry of Eoflon Ordi~onces.
Buildinp Offitia~ _ -
•ds~p '~d
i~r?ag
1 WM
:uo~uao~ puxq ~peM
'aap/3u~
I~uld
~ '1c'' '~Id IQ~Id
/Y~'6 y =io/ '6;H I~~Id
a~~du~ j
•~nsu~
'dlH 46noa
'6qld 46noa
8uuooy
~31D£ - . ( In EY~WSJ~
U
uopepuno~
1196upocd
~ ;*'1 $ 1 ~ I s6ulwod
~eyip 'dsu~ ~lea uo~y~~tu~
i~yog
. ~~~i~,~ U'~~~3(,~,. ? ~l t~
~ ~ f , p~ ~i~o ~ ~ ~~«3
S! ' J~ ~j '~'1~A'H
- i) 3 ~ { ("j J ~l4W~Id
# ~uoyda~ol ~~O ~PMH ~l~d 'Wd ~!~'~d ~
_ . _ - T--- . . . ~
~ r /
CITY OF EAGAN FEE
PERMIT # J~
p~ ~ r~ ~ MECHANICAL PERMIT ~
RECEIPT # J ~ 454-8100 S~C
~r~,~ ~ MINIMUM RESIDENTIAL FEE - 510.00 + 5.50 TOTAL
DATE f~~-` ~~k`-'~ MINIMUM COMMERCIAL FEE -$20.00 + 5.50
1. Bldg. Type: Res Comm ,Lti Inst 2. New Add Alter..~ Repair
3. Total Bid Price ~T~~Jz ~e 4. Job Address ~/~7 , ~t~~- ~-"-k ` !c f _ ~
Lot J' Block ~ Sec 7 5. Owner
6. Contractor `!?C,cLI~.CY IY7L f .,~~1~''~L-,f~~:. (J ~ ,ri~ia :~i.- ~ ~ °Ji~y
_ ~Na~~ ~~~5
~ ~ ~s~?~u cc~H~ ma)
T. Contractor Phone # :
RESIDENTIAL HEATING - 01-100,OU0 BTU's -$24.80. Each additional 50,U00 BTU's or fraction -$6.00
RESIDENTIAL COOLING - 01-24,000 BTU's -$12.00. Each additional 6,000 BTU's or fraction -$6.00
MODIFICATIONS/ALTERATIONS -$10.00 minimum fee
HEATING ~ VENTILATING HOT WATER STEAM AIR COND.
AIR PIPING PROCESSED PIPING AIR HAND. EQUIP. RtFRIG.
RES. GA5 PIPING OUTLETS -$1.50 TANKS: LP. UNDERGROUND OTHER
COMM./IND. RATE - 1% OF TOTAL BID PRICE PLUS S•50 STATE SURCHARGE FOR EACH 51,000 OF FEE.
Signed: for
Approved Inspections: Date Rough Insp. Date Final Insp.
.w~qw.~'w .
, CITY OF EAGAN _ ~
` 3830 Pflot Knob Road, P.O. Box 21-199, Esgan, MN 55121 :
~ PH O N E: 454-8100 ;
BUILDING PERMIT Receipt~c
To be used for ~ ~g:~~T EsL Value S~ ~4 ~ VOU pate OC~F~SER 17 ,19~~
Site Address Z~ i°'~~~~:~ ~}~~~~LE i~D OFFICE USE ONLY
L t ZXJBIock ~ Sec/Sub.~~~~ CN~~ On Site Sewage Occupancy
, : MWCC System Zoning j.T
Parcel No. On Site Well (Actual) Const v-1+1
a Name i:'•` i~~ ~~'"f`-f~it,~rA1+8 L1TLI$$R CityWater (Allowable) Y-N
W PRV Required ~ oF Stories
Z Address y1S Y!4i~1KEE LC~i~i~1.8 RD
o LACs~11`i Phone 456~-4985 ~ter Pump Length
City Depth
, o Name 5~~~ ~~ILUEKS S.F. Total 1~~
o i Address ~+~41 PEN?.'Wc: kpY Footprint S.F.
U~ City i~~<~~ Phone ~'~-597'i 170-0652 APPROVALS FEES
~ rc • Engr./Assess. Permit ~4• ~
W Name ~p0
~ = Planner Surcharge
Address 187.QC
~ Z City Phone Council Plan Review
a W Bldg. Off. SAC, City
I hereby acknowledge that I have read this application and state that the Variance SAC, MWCC
information is correct and agree to comply with all applicable State of Water Conn. _
Minnesota Statutes and City of Eaga~ Ordinances. Water Meter
Signature of Permittee Road Unit
::"A3n~AL 14UILDER5
A Building Permit is issued to:_" Treatment P1
on the express condit~on that all work shal I be done in accordance with all
applicable State of Minnesota Statutes and City of Eagan Ordinances. Parks
TOTAL 356•~
Building Official___. . _
Permit No. Permit Hold~~ Date Talephone
Plumbing
H.v.a.c. C, ar~'1 , ~r
Electric C a ' _ l~a ~ ~X~~
~ ~'~'~CC' z~ n i t~`
Softener
Inspection Date Inap. COmment8
Footings I
Footings II
Foundation
Framing ~~8~ 1~1V S~E'E'~~~~~ ~~~~'u< //-Z%-~d' ,D.S
Roofing
Rough Plbg.
Rough Htg. ~ ~
Isul. ~ ~
Fireplace
Final Htg.
Final Plbg.
Bldg. Final
Cert. Occ. ~ m ~ ~ S
Temp. LP
Deck Ftg.
Deck Final
Well
Pr. Disp.
~ , PERMIT #
~ - , . MECHANICAL PERMIT RECEIPT # - '
CITY OF EAGAN , `7 ` ~ ~
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE:
CONTRACT PRICE: PHONE: 454-8100
Site Addre~s ' ~ ~ ' ~-1~ g~, npE WORK DESCRIPTION
Lot-~"r Block Sec/Sub Res. New
~t . . -
~ Name f ~ . 'r Mult Add-on;-~'
~ ~~ii.'_ 7ri~ ~
~o Address " ' ' ? ' ' t.:-' • _ Comm; Repair
Other
c City,~, /t.'} li~ Phonej/ • ~ ~
FEES
~ Name ~ ~ ' ~ r ~ ' ` RES. HVAC 0-100 M BTU - $24.00
c Address I~~ J~ ? f~ r ? r ADDITIONAL 50 M BTU - 6.OU
p City«' n Phone~ -<<`~~ IRES. HVAC INCLUDES A/C ON NEW
CONSTRUCTION)
GAS OUTLETS (MINIMUM - 1 PER PEkMI~ - 1.50 EA.
TYPE OF WORK COMM/IND FEE - 19~a OF CONTRACT FEE
Forced Air M BTU APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE 8~ CONDOS - RES. RATE APPLIES
Boiler M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON 8
Unit Heater M BTU REMODELS - 12.00
Air Cond. M BTU MINIMUM C~MMERCIAL FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
Vent CFM (ADD $.50 S/C IF PERMIT PRICE GOES
Gas Piping Outlets # ~ ~ BEYOND $1,000)
Other _•~n n~ ; i ~ l
z.=< )
, , • r;~_/ ~1~ llru.. i;>ri ~
. FEE i r !
~ ~ ~ ' i ~ ~ l [ ~ ~l ~4-r.
1} rtI C~~ ~~Y~'~ SJC: SIGNATURE OF PERMITTEE ~ !
.
TOTAL• , ~G , ,
FOR: CITY OF EAGAN
For Office Use Only:
~ - ~ .
MECHANICAL PERMlT PERMIT # 't'
CITIf OF EA(iAN RECEIPT #
363Q PILGT KNpB R~AD, EACaAN, MN 55122 DATE:
CONTRACT PRICE: , PHONE: 454-8100
Site Address BLDG. TYPE WORK DESCRIPTION
Lot BJock Se~/Sub pe3 New
- . ;
Name ' ~ ~ ~ ' ~ O r ~ Mult ? Add-on
• • . ~ Comm. Repair
~ Addr~ss.'- _ ~ pther
~ , , f.' ~
c City ~r, r:-~= Phon
, FEES
Name ~ ~ j~~ 6- RES. HVAC 0-100 M BTU -$24.a0
~ Add~ess'~' ~ 0~ ADDITIONAL 50 M BTU - 6.00
p Cily Phone (RES. HVAC INCLUDES A/C ON NEW
CaNSTRUCTION)
GAS OUTLETS (MINIMUM -1 PER PERMI~ - 1.5Q EA.
TYPE OF WORK COMM/IND FEE -1% OF CONTRACT FEE
ForCed Air M BTU APT. BLDGS. - COMM. RATE APPLIES
Boiler M BTU TOWNHOUSE 8 CONDOS - RES. RATE APPLIES
Unit Heater M BTU MINIMUM RESIDENTIAL FEE - ALL AD~-ON d~
REMOOELS - 12.00
Air Cond. M BTU MINIMUM COMMERCIAL FEE - 20.00
Vent CFM STATE SURCHARGE PER PERMIT - .50
Gas Piping Outlets # (ADD $.5D S/C PER EACH $1000.00 OF PERMIT FEE)
Other ~ r ~ i ' .
, f ; ~,tiJ`~~ ~-"~.~~~i~".~;.4 ~
PER~IR FEE: A - ~~P E~
~;~C1~"~D G1 s«: , ~
~ ` j % _ 1 / / % . ~ -Y. ~1 u,SS ~ Y'_..- '
+ L /t, / -
~ /I
~ `1 {
~ ~ . TOTAL: - ~ FOR GTY OF E~~
~ -~a/-~'~ ~~cu , ~Ps/ a~ ea a~-` ~ ~
For OMice Use Only:
~ PERMIT #
MECHANICAL PERMIT
CiTY OF EAGAN RECEIPT # ' ~
PILOT KNOB ROAD, EACiAN, MN 55122
CONTRACT PRICE: P O • 5~-8100 DATE:
Site Addr~ c BLDG. TYPE WORK OESCRIPTION
Lot T' Biock a~ 5; ~SgclSu~b
' - ~ J ~ Res. New
~ Mult Add-on
m Name k'~ Comm~- Repair
Addr
c Ci1y ' ~ Phon `
FEES
Nam@ L ~ RES. HVAC 0-100 M BTU - S24•00
c Addr ~D ADDITIONAL 50 M BTU - 6.00
p City ~r Phone (RES. HVAC INCLUDES NC ON NEW
CONSTRUCTION)
GAS OUTLETS (MINIMUIIA -1 PER PERMf~ - 1.50 EA.
TYPE OF WORK COwlM/IND FEE -196 OF CONTRACT FEE
Forced Air M BTU APT. BLDGS. - COMM. RATE APPLIES
Boiler M BTU TOWNHOUSE & CONDOS - RES. RATE APPLIES
Unit Heate~ M BTU MINIMUM RESIDEFIT'IAL FEE - ALL ADD-0N d~
REMODELS - 12.00
Air Cond. M BTU MINIMUM COMMERCIAL FEE - 20.00
Vent CFM STATE SURCHARGE PER PERMIT - .50
Gas Plping Outlets # (ADD $.50 S/C PER EACH $1000.OU OF PERMIT FE~)~;
Other PERMIT FEE. v.I I .
, ~'c~C~ SIGN U OF PERMtT'fE''Q/
S/C: ~ ~~*~r--...._.-_--
`
..y TOTAL: FOR: CITY OF EAGAN
W
~
~
V
~ ~
~
~
~ ~
~ - s
~ ' ~
~
~
Raaipt MECHANICAL PERMIT Psrmit No.~~~, 3
CITY OF EAGAN
FN
~ ' ' Fill in numbeisd speces ~ S/C _ _ -
Type or Print /egibJy T~
` -
~ 1. Date ~'uly 3i. .~9t~; Installation Cost _ _
`31S Yar?:._:~ .?r~~c'_~. ~
3. Job Address Lot Blk. T~act
4. Owner ~~ortiiweat t71:o'~.w:.:•.~.t~
, 5. Contractor Fr. ~ j ~ _ _ Phone ;:;y ,
~ 6. Address 4:)30 13ca~~u
~ 7. ~il~l tLi~~AJI SjBLE i":1 Z~p ,'~1 i:
8. Buildiny Type: Residential O Commercial Ll Institutional ?
~ 9. Work Dsscription: New ? Add ~ Alter ? Repair ?
t
10. Descxibs Fuel TyPe ~ . ~
11. No. ~qy~p~pi BTU • M. Ea. No. Eauiament CFM
~ Forced Air L i~: . Air Handling:
Mf9. .:t ;~a
BO1~e~ Mech. Exhaust
~9•
Unit Heater
~9• Other
b%~ Air Cond. • .
~;•:Or~
Gat. Pipiny Outlets
1Z. 1 hereby oertify that the above information is true and correct, and I a~es to
comply with all ordinanoes and codes governing this type of work.
S~gn°d : for
ouph Final
Inspections: Date ~ Insp.~ Date Insp.
This is your permit when numbered and approvesi.
Approved CITY OF EAGAN 464-8100
i~
CITY OF EAGAN Remarks-- ~ ~ ~ ~L/1J ~
Addition EA~ANDALE C.NTF TNn PARK eik 1~- Parcel 7 ~ ~~5~~ ~.$1~_C11+
Owner ~~~1-~-~ Street State . ,
.~T~ v / -R S
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRRDING
SAN SEW TRUNK ~ ~.~j~ 21 . 23 2~
SEWER LATERAL ] 2 1 .].1 1
WATERMAIN
WATER LATERAL lg'72
~ WATER AREA 1 2
sew/wat stm ~ 0 1~. 201 .2 1
STORM SEW TRK /3 2 12 . Fj ~ . 00 1 ~
STORM SEW LAT 1C~'~2
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER.
SAC
PARK
CITY OF EAGAN Remarks ~~-~/~~"T-~' ~I3 7Oi / '~A~'
Addition~.~~Q~e jnd ~~C~ Lot Rlf~-~- Parcel ~25~3-1~2
/
~ ner Street ~ ~ State
. ~ Jl !
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK 1
* SEWER LATERAL
WATERMAIN .
* WATER LATERAL
' *WATER AREA
d
STORM 5EW TRK
,t STORM SEW I.AT 1 7
CURB & GUTTER '
SIDEWALK
STREET LIGHT
WATER C~NN.
~UILDING PER.
SAC
PARK
Y OF EAGAN 111. Remarks ~ ~ ~ - °
Additio Eagandale TY1C1. Plt. 1r4 Lot ~.3 Bik ~ Parcel ~ ~ 22 ~ ~ ~
-r.~
Owner `y " ' ~ Street 9~S ~~t;l~~~~ State
1 ~ ~-~r - ; ~ ~ [ ~ ' ~ i ~ ~ % ~ ~ ~ ~ ~
Improvement Date Amount Annual Years Payment Re ' Date
STREET SURF. ~ ' _ $
STREET RESTOR, _ ~
GRADWG - _
SAN SEW TRUNK
SEWER LATERAL
WATERMAIN
WATER LATERAI
* WATER AREA
#
STORM SEW TRK ~
S70RM SEW LAT
CURB & GUTTER '
SIDEWALK
STREET LIGHT
WATER CONN
BUILDIN ER,
sAC 90 . 9 -
RK
cirr oF ea~e,N
' 3795 Pilot Knob Rmd Fegan, MN 53122 N-0_ ~ 51 Q 1
" ~ PHONE: 454-8100
BUILDING PERMIT APPLICATION Receipt # -~°Z S
To 6e wee for s1Zed addn. Est. Vo~ue 12 ~ 000. pate 2-9 _ i v 79
SIM~Address ~ e~a Erect ? Occuponcy B-Z
Lo4 -'3 38 Block 4 Sec/Sub.~a~a16 4 Alter ? Zoning 1-1
Po~~ # Repoir ? Fire Zone 3
Enlar9e Type of Const. T
W Nome W~1PY5 ~dYC~Wdre Move ~ # Stories ii~ d
e2 ~d~~ 925 YdI]~LE2 DOOC~10 RDat3 Demolish ? Front 222 ft.
3
CI ~gan Phone Grade ? Depth fr.
o Ncme ~~fried Const. Inc. Aov~~~• Foas
ori q~~~q ~OZ ElqY1t;Y1 S'tYH2t AssessmeM Permit 39.00
C Far[nington 550~~ 463-2122 wcter & Sew. Surchor9e 6.00
Police Ploncheck2~.~0
tW Nome Fire SAC
Address Eng. Warer Conn.
<W pha~ Planner Water Meter
Council
1 hereby ockrwwledge that I have read this application ond state that Bldg. Off.
the information is mrrect and ogree to mmpiy with all applicable AP~ Total 65.0~
$tota of Minnesota $Mtutes and City of Eogan Ordirwnces.
Signoture of Pertnittee
A Buildng Permit is issued M• p~'hfri Pr7 (Ym~{ Tpr, on the express condition that
oll xrork sholl be done in a r ance ~th appliwb~e State of Minnesota Statutes ond City of Eagon Ordinances.
Buildirg Officiol ~ 1 ~ n ~
~
CITY of EAGAN n?~ 3208
BUILDING PERMIT
Own~= y~ ~ J~'•-~-+~ CN'~~z~ 3795 Piloi Knob Aoad
ss~.~-x:~,e..:~~ . . . Eagan. Mianesota 55122
Addreu (Dss~eai) 454-8100
.
Hvilder .........~1.~~'""'~
'-'-........`.T-~..... ~:<~-.........a-~--.........._
.
.r. Dele 7
Addraa ...................~~`:/:.:r:................----....................................... .....1.....................
DESCAIPTION
Stozisc Ta Se Used For Fson! D~pSh Hstghl~ Est. Cosf P~rmi! F~a R~maslu
,iL v-^^~~..`---^-~-~ I7 ~S~ o-<--v I~ s a~S"~C~ i S
. .1 o,~ti I ci%r../~. ; '
LOCATION - . ~ ! S J
`J S!r e!. Road or olhe: Deaeri ion of oca n Lo! Bloek Ad itioa os Treet
.--z
c.'4~.. ~ J ~ J . ct,..~ -,3-2-- I 1.3~ , /
- - y~s „ % r~.~-~.3 ~ -K-~ ~
'~i~.e~`:
~ ~.ei oas ao! au horise ihe use oi slreels, roada, alleps or aidewalks aor does i! glve !he own~r or 6is ap~n!
1ha rigaf !o ceeate any sifua2ion whieh is a auisanca or which presenfa e hasard !o !he healffi, sefetp. Cppt~Rl~Rq nnd
general malfare !o aapane in !ha communitp. ~ -
THSS PERMIT MUST SE KEPT 023.,THE PREMISE HILE~THE WORK IS IN PAOGAESS.,
. P.tiY- ' v
hes pezmusioa !o eree! a :.............::C.`.:"'"~~ °`~~~t ~ f~
~ T68 is !o eertity. !kal...~~~::._-'--.!~....... ~tV---`* ........c.~...--•-!f•.-........._upop
ihe above described premise subjeci fo e provisions of all applicable Ozdinances for !he Ciip o1 Eagan.
/n i~~
~ ~ ~ ' . Per ~X~--~k
. .........°-"i.`~.E.'...-'----........---°--'°°...... -
'
Mayor ~ Suildinq Insp~etor
~ ~j,; ~ : _
` + 11A ~
CITY o~f EAGAN N° 3208
k , BUILDING PERMIT
~ ' (4~,,-~~ 3785 Pi1o! Knob Road
Own~s ...\/~'s~::ra=~........_ Eagan. Minnesofa 55112
Addre~s (Presenl) 454-8100
~ Sullder .........Q.`.
:R'.^.
:`~'Y:~L~c.!-~:~-t:...._.~'.9.~ ~ - S 7~
~ Dels
Addreu ...................~~`'.f.~:°.:................----...............---.................
DESCRIPTION
- Slosiec Ta Se Ucad For Fron! Depih Haigh! E~l. Co~! PesmS! Fse A merlca
titi-~^-~------~ ~ ~~s, ~ 9° ~
uI G/~.~, 3~ ~ S
LOCATION •SO
Strpel. Road or oiher Dasaripfioa ot/J~.oca~on I Lo! Bloek Ad IHoa os Trae!
f~l~_ ~ - qry~ s ;~~~~..i e-~- ~~ki, ri~ ~ ~ ~,r ~ ~ ~
-~v~ / 02~ ~ ' / J 0. ~~"~"'i/ T
~~Y~h~s
p
L~i~'~doe no! au
ho ize !he use of sireals, roada, alleys or eidewalke noz does S! give !ha owner or hSs egen!
!6e rigk~! !o ereate anp sifuatioa which is a nuisanca or which presax~ls a hasaxd !o !he healf6, safefy, conveateaes aed
general weltare !o aapone in !ke aommuni2p.
THIS PERMIT MUST BE KEPT O~yyy~~~TH~~/~~~E PREMISE HI~TH~E WORK IS IN PRO_GAES~S'`. ~ L .
This is !o carlifp, lha2...~:?~~:$i.....~..~~R~:e°~..~.....haa parmission !o erec! a:=
F~"`~.^`::::`.P,s, yy'pa
!he above described premise subjeai }o e pxovisions of all applicable Ordinances for !he Ciip of Eagan
pe, . - -~-,c:~-ee
Mayor ~ BuIIdinQ Impector
, CITY OF EAGAN 10 8 6 7
' 3830 Pilot Knob Road, P.O. Box 21•199, Eagan, MN 55121
PHONE:454-8100 ~C~%/
BUILDING PERMIT Receipt ~j 1°
Te M wad fa OFFICE ADD Value $50~ 000 pme AUGUST 27 ~y 85
Site Addrest 915 YANKEE DOODLE RD Erect ? occupancy
Lot 33 B~«k 4 Sec/Sub. EAG CTR IND PK 4Remodel ~ Zoninq
10-22503-330-04 RaaB~r ? TypeofConst.
Parcel No. AddRion ? No. Stories
NORTHWEST WHOLESALE LUMBER Move ? ~engtn
Z Name S~E Demoliah ? Depth
Addreaa InL Impr. ? Sq. Ft.
~ City Phone 454-49$S Install ?
~ TIBERON INC Avo~o.ak Fees
O Name
3908 SIBLEY MEM HWY Assessrr~ent Permit 25.00
Addreat
~ Ciry EAGAN phone 454-1600 Woter85ew. Sur~harge
Potice P~anAev~ew 141.50
W Name
Fire SAC
Address Enp. WaterConn.
~W City Phone Plonner WaterMeter
Council Road Unit
1 hereby ackrowledge fhot I hove reod Ihis opplication ond sto~e ihat g~dg. Off. $~6 85 Tr. PL
fhe Inlormofion is corre en ogree to comply with all opplicable AP~ P9rke
Stata of Minnemro StatJ~ d City o e OrdinonrVes.
Var. Date Coples
Siqnoturo of PermiMee Total
A Bullding Permit Iz issued to: I ERON INC on tha axprcst conditlon Iho~
all work shall be dona in accordonce with
~all/g~pipliooble Stote of Min wto Sfatutes ond Ciry of Eaqon Ordirances.
Buildfnq Officlal ~t-~
NORTHWEST WHOLESALE LBR CITY OF EAGAN p
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 N_ 13271
~ PHONE:454-8100 ~
BUILDING PERMIT Receiptp
7obeusedtor INT. IMPR. Est.Value $18~000 Date F'EBRUAR 26 ~g87
Site Address 915 YANKEE DOODLE RD Erect ? Occupancy
Lot_~~elock 4 Secisub. EAG. CTR. IND. ~ulodel ? 2oning
Parcel No. Repair ? Type oi Const
Addition ? No. Stories
~ NORTHWEST WFIOLESALE LBR Move ? Length
w Name ~ Demolish ? Depth
o Address 915 YANKEE DOODLE RD Int. Impr. ? Sq. Fr
Ciry EAGAN pha~e 454-4985 ~nsta~~ ?
a SEASONAL BUILDERS Approvals Fees
o Name
$Q nddress 4321 FOX RIDGE RD Assessment Permit $ 149.5C
~ Ciry EAGAN pnone ~20-0652 Water&Sew. Surcharge 9•~~
~ 454-5971 Police PlanReview 74.7`
a
F i Name Fire SAC
~ o Address Eng. W2tef Conn.
a W City Phone Planner Water Meter
Council Road Unit
Iherebyacknowledgeth tlhavereadthisapplicationandstatethatthe B~dg.Off. TI'.PI.
information is correct d agree to comply with all applicable 5tale of
Minnesota St s an Ciry of Eagan Ordinances. APC PBrks
~ Var. Date Copies
Signetureof Permitte Total $ 233 • 2`-
A Building Permit is issu d to: SEASONAL BUILDERS on the express condition that
all work shall be done i accordance with all applicable S of Minnesota tutes and City of Eagan Ordinances.
Building Official ,
7
CITY OF EAGAN
, ~ 3830 Pilot Knob Road, P.O. Box 21•199, Ea9an, MN 55127 N~ 15797
PHONE:454-8100 ~7p! ~,C~
BUILDINGPERMIT Receipt# °~__!)L ~ ~
To be used for INTERIOR Est. Value $50 000 Date OCTOBER 27 ,7 g~_
IMPROVEMENT ~
Site Address 915 YANKEE DOODLE RD OFFICE USE ONLY
L~o~'L33~BIOCk 4 SeGSub. EAGANDALE CNTR IN On Site Sewege _ Occupancy B-2
PK T MWCCSystem _ Zoning LI
ParcelNO. OnSiteWell _ (ACtuapConst V-N
a Name NORTHWEST WHOLESALE LUMBER Ciry Water _ (Allowable) V-N
W Address -915 YANKEE DOODLE RD PRV Required # ot Stories 7
p Booster Pump _ Length
City EAGAN Phone 454-4985
DeDth
, o Name SEASONAL BUILDERS S.F. Totai -.1_~jpp
o a Address 4641 PENKWE WAY Footprint S.F.
U: City EAGAN Phone 454-5971 720-0652 ppppOVALS FEES
Engr./Assess. Permit 374.00
~W Name
~ W Planner Surcharge 25.00
i~ Address 187.00
a W Ci~y PhOne Council Plan Review
Bldg. OH. SA0. City
I hereby acknowledge that I have read this application and state [hat Ihe Variance SAC, MWCC
information is correct and agree to comply with all plicable State ol Wa~er Conn.
Minnesota Statutes and City of Ea Ordinanc .
Waler Meter
Signature of Permittee ~ Road Unit
A Building Permit is issued to: SEASONA~_$~J7I~D_FR,~_ ireatment Pt
on Ihe ezpress condition t hat all work shal I 6e done i n accordance with all
applicable State of Minnesota S[atutes and City of Eagan OrAinances. Parks
.~1_.~.y~~-fp TOTAL S86.OO
Building Official~ll~4dlN~l..------
?
= ~ CITY o~ EAGAN N4 -.4129
BUILDINC3 PERMIT
3795 Pilo! Knob Road
. ~
Owne: G M. STEWPRT LUMBER CO. -.__LOI3E STAR Ib1DUSTRIEB Eagan. Minaesola 55123
Address (presen!) ...9.1.5....Xankae...Ap.o.d.1.e...Ri1ad........... 454-8100
LEIBFRIED CONSTRIICTION INC.
Buildes 11 / 7/ 7 6
8353„_,-,.,210th_..St. 6a. Lakeville, MN 55044 Dela
Addreas .............a..............._..............
469-3456
DESCAIPTION
8lories To Be Uned Fos Fron! Deplh Haigh! Eel. Cosl Permi! F~a Aamasks
Remodel 33. 00
Open i,umber Storage 10, 200 5. 00 ~/c p~ t'~
LOCATION
SSreel, Road or other Deaeripfion of Locetfon I Lo! Bloelc~ Additioa os TraC
915 Yankee Doodle Road ~3 ~LGL. 38' ~ I ti~~
This permi! doea ao! authori:e 2he use oi slzeels, roads, alleys or sidewellcs aos doas f! gi~a !he ownes or hL agea!
fha rig~! !o creafe aap siluetion which is a nuisaaee or which presents a hazasd !o !he heallh, setety, eonveaieaes and
geaeral welfase fo anyoee in !he communify.
THIS PERMIT MUST BE KEPT ON THE PREMISE WHILE THE WORK IS IN PROGRESS.
Thts is !o cerriip, lhat.._Leibfried Constructig~Permisaion !o ereet a.._.Remodel Storage _upoe
- .
ihe above described p:emise subjee! fo ihe provisions ot all appliaable Ordinaneesr~City of Ea9an
\ _ f~~..~.~~... Uk~"--. . .~i Per ~ .._....tr~~~~... .
.
ayoi 7 Sufldfnp Iw~
_ -~..R,,--~
~ I . ~
~
. ' . ' . . ~ . . .
~
`,":,'~'~*v'S'^"-.u.'-• i.'.. f~.N ' ( ~ 'R~ ~ "I ..:-"y~'Y Wf"
~ . _ . ,
n~u~se oF ~?aaM ~ " ~~ER~S~R,~IICE PERMIT . '
3795 Rb~~Kno Road f k..~~ e._~p ITTT~ ~ . ,
. i ~ .Y
Eoyan, MN SS1M ' ATE ~ . ~ . - -
Zoning: ~-1 ~ '~~rNo; of Units:
: owner: N8tionel OQIItet .3
Address: ~
- Site Addrese: yankee DDOeA16 6 qi1oB ODlli~ Qt.
• Plum6er: ~ .
~F ~ 33 - 3~, Eiraadn/e +I,S/ w
- ~ 1 agree to eemyly wiM tM Vllkga ef Euyan Connectlon Chazge1200.00 ! ~
• ~ ~ O~dinancas. ~ ~ Account Depoeit: ' ~
. Permit Fee: 30.00 ~
, ~ Surchazge: .50 '
~ By: Miec. Chargea: - (?•y~,.
. . ~ 6~ e ~ ~
g Date of Insp.: Totel: ~ ~ ~
Tnan ~ Tlafe PaiA• ~ ` ~I
/D ~.~5D3 33 o D S/ tn
38o c y
~e9anaale
VILLAGE Ob' ~liGAN
3795 Pilot Knob Hoad
Eagan, Minnesota SS~ 22
PN3tI`1IT N0. 171
The Village of Eagan hereby grants to xatz P1tDnbin4 a Heatinq Co.
of 760 Grand Ave., St. Paul 55105
a r.~c~_ pT.nc~. Permit £ r: (Owner) x.a.C. suilding (Rauenhorat)
-~jas n/~fe..e~oa~~e
at _~-cc n_ve._, pursuant to application dated 4/26/74,
Fee Paid: S140.00 dated this 13 d~r of May , 19 ~4 .
.SO s/c
Building Inspector
Niechanical Permits:
Bid Total: 18,000.00
; ~ ~ ~ ~~~1
DATE JC~ q-/~~~
BUILDING PERMIT APPLICATION
Include 2 sets of plans, 1 site plan w/elevations and l.set of energy calcuations.
To be used for ~~Ji'~',c,~~ii~u~: 1 Valuation
Site Address: Z~rn~~s `f ~Y a~ QI d0'h
Lot Block Sec./Sub. Parcel :~umber
:~s- ~ ~ -4 ~ ~ ~l
Owner ~~~~C/L~Tz~~' .~~~'.~Gf/'~~~ Telephone
Address
Contractor p~.~GLt1' CJ~~~' Telephone 02~~~ `
Address ~ 0 ~ ,/~~v/~
~~'~-C~~'t'
Arch/Eng. ~ Telephone
Address
OFFICE USE ONLY
Erect Occupancy
Alter Zoning ~ ` ~
Repair Fire Zone
Enlarge Type of Const. y
Move li of Stories /j~P-
Demollsh Front ~ d'd
Grade Depth 2 y
Date of Approval and Initial ' Fees o D
Assessment Permit ~7 9 ~ _
WaLer/Sewer Surcharge ~ ~
d d
Police Plan Check ~ r
FiYe SAC
Engineer Water Connection
Planner Water Meter
Council
B1dg. Off. B v
A.P.C. TOTAL ~ ~S _
~ .~3 ~
y°'' c~~ ~c~
" MASTER CA ~ ~
~1~~ 33
LOCATION ~jC/1~(i( ' C~I~/ ~ ~
OWNER ~
Cr ~ .
STRUCTURE AND r~~
LAND USED AS 2 ~ ~~~L ~ ~~Y"
-
Issued To
Permit No. Issued Contractor Owner
BUILDING _
PLUMBING ~ ~ CIL~ _
CESSPOOL - SEPTIC TANK
VJELL
EIECTRICAL
HEATING
GAS INSTALLING
SANITARY SEWER
OTHER
OTHER
Approved
Items t(Initial) ~Date Remarks Distance From Well
FOOTING ~ - ~v P' . / - ~ - SEPTIC
FOUNDATION ~ CESSPOOL
FRAMING ~ (o? TILE FIELD FT.
fINAL
ELECTRICAL DEPTH
HE4TING OF WELL ~
GAS INSTALLATION
SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUMBING b' p 0"
WELL
$ANITARY SEWER
Violations Noted '
on 8ack
COMMENTS:
~
~ot~ 33 -3 ek y
' MASTER C~CRD
~/C #y
LOCATION
OWNER ~
STRUCTURE AND ~ ~
IAND USED AS p
~
Issued To
Permit No. Issued Coniractor Owner
6UILDING 3~Q~ .7 4.7e I
~L~
PLUMBING ~ ~
CESSPOOL - SEPTIC TANK
~
YJELL
nN ~
ELECTRICAL ~J~ii`.~~~
HEATING ~
GAS INSTALLING
SANITARY SEWER w.IL~l~/
OTHER
OTHER I
Approved
Items (Ini}ial) Date Remarks Distance From Well '
FOOTING ~ SEPTIC
FOUNDATION ~ CESSPOOL
FRAMING ~ TILE FIEID FT.
FINAL
ELECTRICAL
DEPTH
HEATING ~ ~ ~ OF WELL
GAS INSTALLATION
SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUM81 NG
.
WELL
SANITARY SEWER
.
~ ~
G~-A~ . _ 9
~ ~ ' ' ~ ° " Violations Noted
on Back
COMMENTS:
~o~'_s 33 thrw~$', ~3k ~
~ayan dQ./a. 'f`y
' ~ 5' MASTER CARD
LOCATION t_-,
i ~
~ ~ . r
~ J °q ~ ~
OWNER ~
STRUCTURE AND , , _w~ ~ ~
LAND USED AS /~//~M;
Issued To
Permii No. Issued ~ Contractor Owner
BUILDING D R- 5-7 _
PLUMBWG ~
CESSPOOI - SEPTIC TANK
WELL
ELECTRICAL
HEATING ~
GAS INSTALLING
SANITARY SEWER
OTHER ~ I
I
OTHER
Approved
Items (Initial) Date Remarks Distance From Well
FOOTING SEPTIC
FOUNDATION ~ CESSPOOL
FRAMING ~ TILE FIELD FT.
FINAL
EI_ECTRICAL DEPTH
HEATING ~ ~ OF WELL
GAS INSTALLATION
SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUMBING ~
WELL ~
SANITARY SEWER ~ ~
,
- ' ~~7
- -zq-~~
A' ~J~„' Violations Noted
,~i..d~ ~ ~ ~ y on Back
COMMENTS:
SHE:T 1 OF 2 .
` ° REPORT OF INSNECTION
loepection Reporl By: HAYES CONTRACTORS~ INC. ~ Inepecdon Contreet
No Fire Protection Division No.............................
Conferred With 1010 Currie AV. N. ~ Mj~15. ~ MN 55403 Burceu File ~
(612) 332-9501 xo
G M. Stewart LuI¢b.er.._Co BUILDING OR LOCATION..................................................
REPORT TO
925 Yankee Doodle__.Road 1NSPECTOR ....Roger....gunze................-
3THEET .
CITY k STATE...EagdR~...MinneSOtd DATE......SeP.~.~....6..r....~.9.$3
' -
1. GENERAL Yee N.A.t No~
~ a. Is the building occupied acwrding to information furniehed by owner or owner'e repre- X
eentativc? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ~ ~ ~ ~ .
b. Is occupancy same as previoue inspection acmrding to in(ormation furniehed by owner or $
owner'a rePrgsentative?. . . . . . . . . . . . . . . . . . . . ~ ~ ~ ~
.
c. Are all sys6ems in service?. ~ Y~~~........_......_..
d. Are a1l fire protection systeme eame as lasl inspection aceordinq to inforn~ation furnished 6y X
owner or owner's reNresentative? . . . . . . . . . . . . . .
e. Ie building comNletely sprinklered? . . . . .~.....................................X........... ~ ~ ~ ~
L Arc all ncu• additiuna and building chanRes propedy protected according to information fur- X
nished by owncr or ow~ner's rePresentative?....' .....................................X-..............................._..............'
g. Is all etock or etorage ProPerly below aprinkler piping? . . . . . . . . . . . . . . _ . . . . .
h. Was property trce of fires siuce last inspection~ according Lo intormation turnished by owner X
or owner'e representative? (Gxplain ~nY fire on sepsrate sheet) .
i. In areas protected by wet syatem, does the building appear Lo be properly heated in all
areae, including blind attics, Vcrimeter arcan and are all exterior openinge proteCted againet X
entrence oI cold air? . . . . . . . . . . . . . . . . . . . . . . . . . . : . . . . . . . . . . . . .
3. CONTROL VALVES (Sce 3ection I6)
a. Are all eprinklcr eyetem main wntrol valvee open?. . . ' ' - ' . . . . . . . . . . . . . . . . . . . . . . . . . . . . X ~ O ~ S
A
b. Are all othcr valvee in proper poeition? . . . . . . . . . . . . . . . . ~ ~ ~ ~
~
c. Are all control valvea in good condition end eenled or eupervieed?. . Sealed~ X,..,..
3. WATER SUPPLIE5 (See Section 17) - ~
s. Was a water How teet made and results satiefactoryt . . . . . . . . . . . . . . . . . . . . . . . . . . . ....._X........... ~ O ~ ~
~4. TANKS, PUMPS; FIRE DEPT. CONNECTION5 ~
s. Are fire pumpa, gravity tanka, reservoira and preeaure tanke in good condition and prop- X
erly maintained? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . -
b. Are fire dept. connectiona in satisCactory condition, couplinge free, cape in plece and check X
_
valveetiB6t?
5. WET SYSTEMS (See Section 13) X
e. Are cold-weather valves open or closed ae neceaearyT...... ~
b. Have anti-[reexe eY~tema been teated and left io eatisfacWry conditionT ..........................................X...............----..._--
e. Are alarm valvex, water-6ow indicatoro and retarda in eatis[aetory condition? . X...............-........................._....___
6. DRY SYSTEM3 (SeeSection 14) ~ (ChangOd Dry System to Wet)
s. ls dry val~e in eervice and in 6ood condition?- ~ ..............................X...........-----"---
............_................,X..
b. Ie air preesure and priming weter level normnlt . . . . . . . . . .
c. Ie air compressor in eood condition? . . . . . . . . . . . . . . . . . - . . . . . . . . . . . . . . . . . . . . . . . . . .
d. A'eie low points drained during (all and winter inepectionaT . . . . . . . . . ...............................X.................-'---'
e. Are quickoPening devicee in eervice? X.............._...._---
X
f. Aave dry valvee 6een trip tested satisfactorilY as re9uired? . . . . . . . . . . . .
g. Are dry valves adeQUately protecLed [rom freesiuB2 . . . . . . .........~....X..................------
h. Are valve Louse s¢d heater condition eatisfactory?. - ~
7. SPECIAL SY&TEMS (See Section 18) - ~ .
s. W ere valvee tested sa required?" " - - " . . . . . . . . . . . . . . . . _ . . - - - - - . . . . . - - . .
y.....- "
b. Were'all heat responsive eyetems teated and reeulta eatisfactor ~ °'-'°--""'-'""X""""~""""""""""- "
c. Were aupervieorY featuree teeted and reeults satiefectory?. . . . . ' - - - • . . . . . . .
8. ALARMS ~ ~ X
n. Are water motor and on teat eatiafactor . . . . . . . . . . . . . . ......:X.....-"'~-~............................------
B B Y~ . . . . . . . . . .
b. Is electric alarm teateatie(aetor + Z 36 Seeonds) - . - ..:.............._..._X...---...............----
y
e. Ie eupervieory alarm eervice Leet eatiefactorY? . . . . . . . . . . . . . . . . . . . . .
'E:plain "No" snewers in Item /19 INot ADplicahle ORIGINAL
9. SPRII~HLF,RS-PIPING Yee N.A.t No• '
~~n. Are nl sprin ere in good condition, not obetructed, snd free of wrroaion or loadingT . ~ O~~~....................
b. Are ali eprioklern le~ than 50 Yeare oldT. " " . . . . ' . . . . . . . . . . . ~ ~ ~ ~
e. Are eatra ePrinklere readily svailable?
d. Ie eonditioa of piping, drain velvea,. check vslvee, 6sngere, yreeaure gagea, open eprin- -
Iclero. atrainers aetiafactorY7 . . . . . . . . . . . . . . . . . . . . . . ..........X........ ~ ~ A ~
e. Have aprinklere 6een checked for proper teoiperature ratinR?. • • • • . • . - ~ - ~ - ~ ~ ~ ~ ~ ~ • • . • - - ~ --~--~~._X~,,,,,,, ~ ~ ~ ~ ~
Are Wrta6le fire eztinguie6era in good condition? .............................."'-............X.............-----.._.....................:..
g. Ie hand hoce on eDrinlder eYateme eetistactorYl . . . . . . . . . . - -----'-.........................X..............---.........
10. Date Dry-syetem Pipin8lsat checked (or eWppege.
ll. Dste Dr3'-nyatem Piping leat checked for proper pitch.
12. Dste DrY'Pipe Vslve leat trip teated .
l3. We! Syatema: NoT One Make nnd 1Kodeli.. Vikin.g.._dry.,.conyerted., to.._wet
l4. DrY SYatema: No? Make and Model?
35. Special 3yatem: No? Type
~ Make and ModP1t......_ ..................................................................."'-.............................---.....Candition!............................................................
Open Secured Cloeed Signe
l8. CONTROL VALVES No? Type? Yee No Yee No Yea No Yee No Condition
City Connection Control Valve.. . .
Yenk Control Valvea . .
Pump Control Valvea . . .
9ec4onal Control Valvea . . . . . . . . . .
3yeeemConcrolV~l~ee ......................~'ti'4...._Butterfl-y-----...Yes .Yes...... Yes Good
-
17. WATER-FLOW TEST
Water Preaeuret... ~..~`~...1bS. ~.CITY ........................PSI TANK........................P3I FIRE PUMP........................PBI
Water-How Test?-.....Y.eS...........__ (If none made, w6yT)
Sise Premure Flow Preeaure Size Pressure . Flow Preeeure
Teat Pipe Located Test Pipe Befoze Preesure After Teet Pipe Located Teat Pipe Before Preesure After
On existing 2" .75#.,_....,...70# 76#
drv valve.
~IS. Heat Reaponeive Devicee: TypeT Type o( teet?
ValveNo ....................A.....---B_......C.---..D........E........F........ ValveNo....----------.......A_-'-'--B........C........D........E........F......_
Valve No .....................A.....---B........C........D...----E--......F........ Valve No•--......:............A........B........C........D........E.......-F------
Yslve No .....................A........8:.......C........D........E......_F........ Valve No...................._.A_......B........Q--._..D........E......_F.__._
Ve1ve No ...B_......C........D...._..E........F........ Ya1ve No. - A........B........C........D........E........F.._.._
Auziliary eQuipment: No?...._.......... TypaL........----'-'---- Locationt.................................. T¢et Rewlte?.-----'--
l9. EzplaneGon of sny "No" anewere. ,
'l0. Aecent changee in building occuyancy ar fire protection equipmeot.
21. Adjuatmente or wrrectione made. DTy Sy~tem was converted to wet.
22. Deeirable improvemente. T~jOV2 inspectors test to 7' above floor level.
DUPLICATE TO :
. . .
9TREET _.............................................CITY ~ 9TATE .
. . •G:plain "No" ~aewen in Item f 19 ORIGMAL
/ • . .
/ / ~
1985 BUILDING PERNIT APPLICAiION - CITY OF EAGAN
NOTE: ALL CONTRACTORS MUST BE LICENSED iiITH THE CITY OF EAGAN
~F'(MERUAL~
INCLUDE 2 SETS OF PLANS
~ CERTIFICATES OF SURVEY
0,d=reG~-! 1 SET OF ENERGY CALCULATIONS •
~04/f/a/a'
To Be Used For: Valuation: Date: ~~-ys -
Site Address: Y~~~Q'/: ~ OFFICT E USE ONLY
Lot: Block~ Sect/Sub ~ ect Occupancy
o a a Sa 3- 3 3~: ~o ~ Remodel ~ Zoning
Parcel 11 ~ Repair Type of Const
Addition ~J of Stories
Owner JUc)~77.Aui~S7' !~/~1c~LFSL4/h=lriml3F-'~ Move _ Length
Demolish Depth
Address q/S` YIl~nJK!-~'((~^x9I7Lh
P~ Int.Impr. _ Sq Ft
Install
City/Zip Code ~'~-CaG4rv M fl~,
Phone yS~~/- ~/q~'S'- ApPR0V6L5 FEES
Contractor TI 13L~tin~ ING . Assessments Permit 2P~3~~
- ~ Water/Sewer ~ Surcharge Z5, =
Address 3qp~ 5~~t-y m~~j {~lw I Police Plan Review 14 i.jO
Fire SAC
City/Zip Code ~6~/~/ /yj /~J 6~J"ZZ2- Engr Water Conn
planner Water Meter
Phone q,5 ~/-/~y O d Council Road Unit
Bldg Off~_ Treatment P1
Arch./Engr. APC Parks
Variance Copies
Address TOTAL S p
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1987 BIIILDING PERMIT APPLIC9TION - CITY OF SAGAN
SINGLE FAMILY DWELLINGS
IIYCLDDE 2 SETS OF PLANS~ 3 CERTIFICATSS OF SQROEY, 1 SBT OF ENERGY C9LCOLATIONS
NOTE: ADDRESSES FOR CORNER LORS - COATRACTOR/HOMEOi~iNER MUST DESIGHAYE WHICH ADDRESS
IS DFSIRED. NO CHANGfiS NILL BE ALLOWED ONCE BQILDING PERMIT IS ISSDED.
MOLTIPLE DWELLINGS - RFSIDENTI9L RENTAL DAZTS FOR SALE OBITS
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SOEVEY - CHECg LiITH HLDG. DEPT.~
1 SET OF ENERGY CALCULATIONS
COi~R~RCIAL
, INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS~
1 SET OF SPECIFICATIONS AND 7 SET OF
ENERGY CALCULATIONS~
$2,000 LANDSCAPE BOND
~CM ODE L
To Be Used For: 0/T / C Q Valuation: ~ OOD Date: ~~~5-
Site Address 9~s ~Gnl~fc ~m+~/i° OFFICS QSE ONLY ,
- .
Lot .3 3 Block ~ On Site Sewage_ Occupancy
n MWCC System Zoning
Parcel/Sub • l-_~c, ~1~•~C~ On Site Well _ Type of Const
~ City Water (Actual)
Owner /~~p6f ~ i..2s~ 4J~ic% 5a~! Lt•.,b~P ~Allowable)
~ / ~l of Stories
Address g~s Y'aKkce c%a4~e Length
' Depth
City/Zip Code ~Gau~,Mh S~'fL~ S.F. Total
Phone ~~~y ~ Footprint S.F.
~ 9 ~s 9PPROVALS FEFS
~I ' So
Contractor ~C4So.-,R~ ~d~ /c/,4rS' Assessments Permit 4~~•=
/ Water/Sewer Sureharge ~1.
Address ~/72% /"dK ~+.z74[ ~'iA Police Plan Review '14,~s
Fire SAC, City
City/Zip Code C<rpl~.s .-i Engr SAC, MWCC
r-' Planner Water Conn
Phone ~/S~/- S`~ ~„~a--oro 5~.~ Couneil: Water Meter
Bldg Off Road Unit
Arch./Engr. /~JQF'~C' av~~t~".s' APC Treatment Pl
Variance Parks
Address 9rr ~/4n~<c c~mhc~~ ~ Copies
~
TOTAL 233 . zs
City/Zip Code ~k~a Y ~ ~~1H ,7~.5/ 2Z
Phone U s~ ~ ~ 9 ~s~
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'~-IC£~ _ ' SUD~1= SLtt~k-
~ o ~ A~ 1
1988 BUILDING PERMIT APPLICATION - CITY OF EAGAN
SINGLE FAMILY DWELLINGS ~ ~ ~
INCLUDE 2 SETS OE PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WfiZCH ADDRESS
IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE HUILDING PEPMIT IS ISSUED.
MULTIPLE DWELLZNGS RENTAL QNITS FOR SALE UNITS ~k OF UNITS
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECK WITH HLDG. DEPT.~
7 SET OF ENERGY CALCULATIONS
COhII~RCIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS
CUMMC-azLia~- SEP 2 0 1988
To Be Used For: ~N7ERIa'Z~qp(2ptiE Valuation: ~~~J~ r Date:
Site Address / S ~Q OFFICE USE OYLY
£~S'2'"~ n..
Lot 3 3 Block ~ On site sewage_ Occupancy $'Z .
MWCC system Zoning L
Parcel/Sub f_.4<aR.;.c~=_ Covn~inD.PK' YTk On site well Actual Const ~tii
City water Allowable Sd'N
Owner w, f~;~,~o/~Safi ~v- PAV required _ il of stories 'L
Booster Pump Length
Address p/ ~V„,~,p~ ~ee/% /?G/ Depth
S.F. Total O v
City/Zip (~ode ~aG,~„ ~ _s ;-~t Footprint S.F.
Phone y'Tj~~ ~/qpS'" APPROVALS FEES
Contractor s['~se..s/ /l,,,/.,/r~ s Engr/Assess Permit ~l~Q-.
Planner Surcharge
Address yG !j/ ,~h,~„-~ v~ ,,r Council / Plan Review I 8 ,
Bldg. OfF. y3, ~~~21 SAC~ City N A
City/Zip Code ~~~q _,,.9 .s-rie2 Variance SAC, MWCC ti p,
k'ater Conn u A
Phon~`/s"! s' y~ i ~"'JZ r1- p( f- 2 Water Meter ?.I/~
Road Unit ti A
Arch./Engr. Treatment P1 N A
Parks µfft
Address Capies
TOTAI. s ~ ,
City/Zip Code
Phone 8
~ ~ . - - _ -
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CITY Of-- ~f~GAN
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>k~,t%KYRYF}K~~.'Y~(~(yF?K7K 'M7K7K~ N(k".M~RCXC%I(KCM'~~YnN~YF7K~?K 'Mk(X(~n
1999 BUILDING PERMIT APPLICATION (COMMERCW.)
CITY OF EAGAN
~j ~j ~ Q 651 681-4675 ~ ~ U ~ ~ $ Q1
Re uirements to build n ermit ~f ~ S
Foundation Onl New Construction Interior Im rovement
• Structural Plans (2 sets) . ArchitecWral Plans (2 sets) • ArchitecWral Plans (2 sets)
• Civil Plans (2 sets) • SWCtural Plans (2 sets) • Code Malysis (1) "
• Code Malysis (1) " • Civil Plans (2 sets) • Projed Specs (1 set)
. Projed Specs (1) • Landscaping Plans (2 sets) • Key Plan
• Spec. Insp. & Testing Schedule " • Code Malysis (1) " • Master Exit Plan
• SAC detertninatlon letter irom MClES - • SAC detertnination letter from MC/ES - call • SAC detertninatlon letter hom MClES - pll
ca11651-602-1000 651-602-1000 651-602-1000
• Spec.Insp.BTesfingSchedule (1) " • EnergyCalalaUons (7)notaArays"
. Project Specs (1) • Elec. Power & Lighting Form (1) not aNrays "
. EnergyCalalations (1) "
• ElecVic Power 8 Lighting Form (1) "
. Master Exit Plan
. Soils Re ort 1 ~
" Contact Building Inspections for sample
Food 8 beverage or lodging facilities: Plan must be submitted to Minnesota Department of Health. Call 651-2150700 for details.
DATE: ~'1T~q WORK TYPE: _ NEW ~EMODEL
NPLY ? F-zz. y J
DESCRIPTION OF WORK: v~^^~ 17is~N TO ~7~K i-'r/ ~CSYSt~i
CONSTRUCTION COST: ~i2~~ _ S(X~.'°~ TENANT NAME: ~~,~da~6c-tz l~~t.!u1DRK ~~F{~~r~
SITE ADDRESS: G/I~i Y~'4K~~ I~iDi~ r~Y,~fl- SUITE
LOT ~ 32 BLOCK y SUBD. C" w~ ~Y~O! x~ P.I.D.
Name: 5~y~~~~~ ~Aj/-Ll l~K r.~,€~~E Phone#: ~~I-'!S"7-~~S'
PROPERTY Last Fust
OWNER /
StreetAddress: ~I~~ 11~~
V~L.~
City -~f At~l, State: Zip: `J~lZI 'C~`~/
Company:~~L~~(~--~ ~LIlCF~~Y 1~- Phone fo~z~ Ss~ ~a'2~.~.
CONTRACTOR
Street Address:~~~~~i T~~f~ /V(l
City ~~1~(lU'(~{"{
I~ state: ~N , zip: _ ~y ~
ARCHITECT/
E~iGINEER Company: ~ Phone
Name: Registration
Street Address:
+ C~ty State: Z~P~
S`ewer & water licensed plumber (oniv if installina sewer & water):
1 hereby acknowledge that I have read this application, state tha[ the infor io ' mply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 26 Public Facility ? 28 Greenhouse
? 25 Miscellaneous ~27 Commercial/Industrial ? 29 Antennae
WORK TYPE
? 31 New ? 34 Repairs ? 37 Demolish Bldg. ? 43 Siding/SoffitslFacia
? 32 Addition ? 35 Tenant Impr ? 38 Demolish (Interior) ? 44 Windows/Doors
? 33 Alterations ? 36 Move Bldg. ~ 42 Reroof ? 45 Fire Repair
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. Census Code ~37
(Allowable) First Floor sq. ft. SAC Code 45 0
UBC Occupancy sq. ft. No. of Units
Zoning sq. ft. No. of Bldgs. o
# of Stories sq. ft. MC/ES System
Length sq. ft. City Water
Width Footprint sq. ft. S 10o Fire Sprinklered
APPROVALS
Planning Building ~ Engineering Variance
v
_ ~ . VALUATION: $
Permit Fee ` f ` ~ . -
Surcharge JT6 . ~
Plan Review
MC/ES SAC % SAC
City SAC SAC Units
Water Supply & Storage Meter Size
S/W Permit
S/W Surcharge
Treatment Plant
Park Dedication
Trails Dedication '
Water Quality
;
Other
Copies
Total Id~-l~
L /~,L BL OFFICE USE ONLY
~ /7 ~ ~~E~PT. 7sa~
SUBD ~Y ~°"a' RECEIPT DATE: ~~P q ~
1997 PLUMBING PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55722
(612) 887~875
Pbase wmplete for: ~ all commerciaVndustrial buildings.
• mutti-family buildings when separate permfts ere ~Qj raquired kr each dwelling und.
~ backflow preveMer to be instelletl in mmmercial areas or reaidendal boulevards
DATE: ~ ~ I I~QI I
WORK P: New Const. ~ AddAn _ Repair
DESCRIPTION OF WbRK: ~i:l~.d Go~`'~Q~v
IS WATER METER REQUIRED? Yss _ Mc. FLJg•riDiutETc;iS Tt~ ti~ IN~iALLED? _ Yes No
UNDEROROUNO SPRINKLER SYSTEM
INSTALLING METER7 _ Yes ~ No. NEW SERVICE? _ Yes ~~No WATER FLOW: GPM.
Pressure Redudng Velve may be required if installing new service - contad City's Engineering Depertment at 681-4646.
FAILURE TO PROVIDE THE ABOVE INFORMATION WILL RESULT IN A DELAY OF METER ISSUANCE
FEES
Minimum fee of $25.00 or 1% of contract prica, whichever is greater. Minimum State Surcharge ot $.50 due on all pertnks.
CONTRACTPRICE: S x 1% = S
COMPLETE TH~S AREA ONLY IF INSTALLING UNDERGROUND SPRIHKLER SYSTEM
BACKFLOW PREVENTER FEE a 25.00 ~'Q,: ~ S ~h5 , vO
WATER PERMIT (new service only) 50.D0 = S
WAC (new service only - par conneCion) 780.00 = E
WATER TREATMENT (new service only - per connection) 420.00 = E
CITY INSTA~LED TAP 300.00 = S
METER: 1" = E185.00 , 2" TURBO = 5846.OD = S
PERMIT FEE S
fl6URE SURCHARGE AT 50 CENTS FOR EVERY t1,00D OF PERMR FEE DUE STATE SURCHARCaE S_
TOTAL S e~+.~1 • ~
I hereby adcnowledge that I have read this applicatlon, state Mat the infwmetion is cwrect, and aprae ro oompy with all epplicabk City of Eagan ordinances.
H is the eppliant's responsibiliry to notHy tM property owner that the City of Eagan essumea no liability for a~y dameges e9uaed by the City during ks nortnal
operational and maintenance activRies lo the facilities constructed under this perm%wkhin City propertyJriphtaf•wey/easement.
S1TE ADDRESS: ~ W
~E: 5 S~.
OWNER NAME: ~ D
INSTALIERNAME: ~ TELEPHONE#: V~'-~~l
STREET ADDRESS: e -
CITY: ~ STATE; MN. ZIP:
~aso3. - ~3 ~ - dy C~ ~}}.I. ~,~J~ .~-1 t
OFFlCE USE ONLY • REVERSE SIDE
APPLICAN~~~~~~
I/- S =97
OFFICE USE ONLY
PLUMBING PERMIT (COMMERCIAL)
METER SIZE p$y _ Yes _ No
Domestic
Ircigation
uri~ irv cONNEGTION (APPLIES TO NEW SERVICE ONLY1
$
REVIEWED BY
~ .Q~ ~-/7 - 9 7
Building Inspector Date
To determine meter size
• See if it is indiCated on back of Building Inspections card
• Enter address in PIMS Screen 301 to obtain S8W permit #
• Check PIMS Screens 11D (Remarks)
• If gallons per minute are less than 25, a 1" meter will be required. If gallons per minute are more than 25, a 2" turbo with
streiner will be required. This information is to be supplied by the designer of the system. Consult with Plumbing
Inspector If Licensed Plum6er does not know GPMs.
Bsfiore seL°jnu mr~
Check PIMS Screen 320 for ~p°roval of inspection 2sults. No meter wiii 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. Write
meter type and size on receipt, code to 3716-9220 (meter portion only), and forward copy to Utilily Billing Clerk.
Enter meter size, type, receipt date & amount paid on PIMS Screen 110. Copy of receipt should be given to Utility Billing
Clerk.
Miseellaneous Information
The installer is to contact Building Inspections at 681~675 for inspection of the inside water line and backflow preve~ter. The
Public Works Department may be reached at 681 ~300 for water tum-on.
If ineter is over 5/S, call Public Works and let them know so they can tell you if they have one in stock before plumber goes
over there.
..3.3 - ~3~ ~ 5~--
~ ~a0~~rxz~~,~e
~ • - ~ ~l_ ~ _ 3~- ~
1 Bate:
BUILDIi?G PERD42T AP2L7.CA~T'.)N
LOT BLG:.K ADDS^IOS~
PI~.RCFL & 53CTIOi7 PICTfi6ER 2F UYdPLATTED
ADDRF.SS QF F1fRCEL~I l!J y//a F.I iC V
F I J[~ cs d~ I(~ ~~Y.
701•]ITI~ OC~JPAf~(.'Y USE ~~r~ __L~~/eGjr(°
~o • ~ie.P?'!B t~.f
E£3TIMAT~D COST~~ 2 UO -----t
O?RtER ~ O/.~ i ~-~7 TA fZ ~1J UU,S T/v' ) L S TELEPHONE N0.
AADP.F,SSr~?1Y _ ~ .ld ! ~1}'Z!S ~~~=tsNL~J~C1~ /.nn/.~I. ~G~ 3CJ
CONTRACTOR ~.,~\R id.l~ Il Al5''/~UG70d~.JG TELEFHON~ STO. 3 r5 ~
a~D~ess S3 ~ 3~ 2Jo t~ S-r[pJ -~,~c L-~,' 1/~
l~~?,~ s~o yy
tdote^ Inclede site plan, building plans, and enerc~y calculations 4~ith this
application ~
l ' o~~- ~ ~1~~,~
Siqned~/`/Z'~'!-L.? i<y /u~~~ ,
OFFICE USE
v~ .N~ %
VF1LUlTSOid ~v ~v
SAC
4]ATER COtNEC1ION A ~
YJATER !dlETER
BUILDING PERE~4IT FEE ~ 'I
~ ~
SURCHARG~ FEE
~
PLANI CEECK FE~
rJS ~
PAEtK DEDICFITIOIJ FEE
OTE~R
TOTAL« -
APPROVALS:
ASSESSNlE1VT CLERK BUILDING DEPT. POLICE DEPT.
bBATER & S~V7ER DEPT. FIRE DEPT. PARK DEPT. _
S
,~/~a, ,Q~ ~a.y~,~~ C!~. ~9. Q~.
~ COfVTRACTOR'S MATERIAL & TE5T CC•RTTPICATE
PARTS A& C- SPRINKLER & WATER SPRAY ABOVEGROUN~ PIpING (Fill Out Separete Certificate Fot Eech Riser)
PROCEDURE I
UPON COMPLETION OF WORK, INSPECTION AND TESTS SHAL~ BE MAOE B~' THE CONTRACTOR'S REPRESENTATIVE AN~ WITNESSE~ 8~' ~
AN pWNER'S REPRESENTA7IVE. ALL DEFECTS SHALL BE CORftECTED ANp SYSTEM LEF7 IN SERVIGE BEfORE CONTRACTOR'S MEN i
fINALLV LEAVE THE JOB. '
,A CERTIFICATE SHALL BE FILIED OUT AND SIGNED BY eOTH REPRESENTATIVES. COPIES SHAL~ BE PREPARED FOR APPROVING ~
AUTHORITIES, OWNEHS AND CONTFACTOR. IT IS VNDERSTOOD 7HE OWNER'S REPRESENTATIVE'S SIGNATURE IN NO WAY PftE~-
UDICES ANV CLAIM AGAINST CONTRACTOR FOR FAULTY MATERIAL, POOP wORKMANSHIP, OR FAILUAE TO COMPLY WITH AP~ I
PROVING AUTHORITY'S REQVIREMENTS OR ~OCAL ORDINANCES.
~
PROPERTY NAME DATE ~
STOCK LUMBER COMPANY 10=6-92
PROPERTY AO~RE55
915 Yankee Doodle Road, Eagan, h4J
ACCEPTED BY APPHOVING AV7HORITY('S) NHMES
City of Eagan
ADDRE55
PLANS 3£t30 Pilot Knob Road, Eagan, MN 55121
INSTALLATION CONFORMS TO ACCEVT[D PLANS: ~'ES NO O
, ~EQUIPMENT USE~ IS APPROVED ti'ES ~ NO O
IF NO. STATE DEVIATIONS
HAS PERSON IN CHARGE OF FIRE EnVIPMENT BEEN INSTRUC7E0 AS TO LOCATION
OF CONTROL VALVES AND CARE OF THIS NEW EQUIPMENT? YES ~ NO Q
~ IF YES, GIVE NAME. IF NO, EXPLAIN,
INSTRUC-
T(ONS HAVE COPIE$ OF APPR07RIATE INSTRUCTIONS AND CARE AND MAINTENANCE ~ YES LN NO O
CNARTS AN~ NFPA 13A BEEN LEFT ON PREMISES?
IF YES, GIVE NAME. IF NO, EXPLAIN.
HYDROSTqTIC= Hyaroslatit tesls shail Da maCO at ~ot less [nan 200 051-(13.8 bats~ ~ot two hours or 50 V51 (3.4 Cars)
above itatic pressurc in exteis of 150 P51 (30.3 Oari). Olfierantlal tlry~pipa vatve cte00ers snall be left oDen Curlnq test to
TEST O~avenl tlama9e. All abovegrountl plplnq loakaqa s~all bo stoppotl.
DESCRIP-
TION PNEUMATIC: Eslabllin 40 PSi (2.B Oart) alr preszura an0 measure Crop whlch shall not t%Ceetl ll5 PSi (0.1 bars) In 2<
hours. Tasl prassure tanki at normal waler leval antl alr pressu~e antl moasure alr praszure Crop whlc~ snall nol exceeG 14.
G51 (0.1 bars) in 24 nours. .
TESTS HVDROSTATIC: AL~ PIPIfVG. .
PNEVMATIC: ~RY PIGING DRAIfY
RE~UIRED EQUIPMENT OGERf~TION: ALI,
SERVES 8LDG5:
LOCATION
MAKE MOOEL SIZE QUANTITY TEMPERATURE RATING
Uiking M 2" 50 155°
SPRINKLERS
OR
'
SPRAY
NOZZlES
MATERIAL AND KINp CONFORMS TO NFPA .,,,,NOARo
PIPE AND ~F NONE, EXPLHIN
FITTINGS
"
A l A l: M D E V 1 Ml1XIMUM T~ME TO OPERnTE THfiOUGM TEST PIOE
ALARM VALVE TYPE MAKE ~ MOOEL MIN, SEC.
oa FLOW Existing
INDICATOR , _
I
O~ERATING TEST RESVLTS: ~ ~
TIME TO TRIP TIV TIME WATER AI.AFM
ORY MAKE MOOEL SER. THROUGH TEST PIPE WATEa AIR p(7~NT REACMEO OPERATED
NO. ~"/~THOVT WITN pqE55. P0.[55. A~R TEST pqOVERLV
PIPE O. D. O. D. _ OqE55. OUTLET
MIN. SEC MIN, SEC. P.S.L P.S.~. P.5.1. MIN. SEG YES Np
Vn~vES I - -
Vikin
IF NO, EXP4AIN
OPERATION PlJEUMATIC ? ELECTRIC ? HYORAULIC ?
PIPINC SVPERVISEO: YES ? NO ? DETECTING MEOIA SUPERVISED: YES ? NO O
DELUGE OOES VALVE OPEAATE FRpM THE MANUAL TRIP ANO/OR AEMOTE CONTROL STATIONS? YES ? MO ?
gi IS THERE AN qCCES518LE FqCIIITY IN EACH CIRCVIT FpR TESTINGI VES ? NO O
~F NO, EKPlA1N
PREACTION
VAWES
Do~s Eac~ CI.cWt Opente Does oech Circuit Operata Maximum Time To
MqKE htO~EL Su rvision Losa Alarm~ Valve Relentt? O erate Fieleese:
VES NO YES NO MIN. $EC.
ALl PIGING HY~ROSTATICALLY TESTED AT p51 FOR 2 HOVfYS
DRY PIPING PNEUMATICA~~Y TESTED: YES ~ NO ?
EQVIPMENT OPERATES PROPERI.Y: - VES O NO O
TESTS ~F-NO, STATE REASON
ORAIN TEST: REAOING OF GAGE LOCATED RESIDUAL PRESSUHE WITH VALVE IN
NEAR WATER SVPPLY TEST PIPE: TEST GIPE OPEN WIOE
STATIC PqESSURE P5~ pg~
NUMgER USEiO~ LOCATIONS NUMBER REMOVED
TEST BUiNKS None
WELOEO PIPING YES C~ NO ?
IF YES...
DO VOV CERTIfV AS Tt~E SCRINKLER CONTRACTOR THAT WELDING PROCE~URES COMPLY WITH THE fiEQVIRE•
MENTS OF AWS 030.9, LEVEL AR~7? YES XX NO ?
WELDING 00 VpV CEFiTIFY THAT THE WELpING WAS PEFFpRMEO BV WELOERS QUALIF~ED IN COMPLIANCE wITH THE
REOUIREMENTS OF AWS 030.9, LEVEL AR-3> YES ~1 NO ?
00 YDU C~R71FY THAT WELDING WAS CARRIED OUT IN COMPI,IqNCE ~"/ITH A DOCUMENTED ~UALITY CON•
7ROl PROCEOVRE TO INSVftE THAT ALL DISCS AftE RETRIEVED, THAT OPENINGS IN PIPING AqE SMOOTH,
THqT SLAG ANO OTH[R WEIOING RL'SIDUE ARE REMOVED, ANO THAY THE INTERNAI. DIAMETERS OF
oIPING ARE NOT 7ENETRA7ED> VES Q NO ?
OATE LEFT IN SERVICE WITH Al.L CONTROL VAWES OPEN:
REMARKS
NAME OF SPf71NNLER COfJTHACTOR
CARLSON AUTOM4TIC FIRE PROTECTION COMPANY
GR ERT' OWNER (SIGNED) TITLE
SIGNATUFES\ ~ ~ r
~ , . . O . ~j~ S~ C-~w W " ~ . ~
FOR SPAINKL[R CONTHn TOR SIGrvED)
_ TESTS WITNESSED 81' . ~N~ ~'1l.iJ~!.T` ____TITLE ~ ~ ' OAT~/ ~a (J
~ - 3i'Ci+~si-
AODITIONP.L C%VLANATIONS AND NOTE~
~;~,3, ~o~; C~;~~. ~~A
ci~y oF eagan
3830 PILOT KNOB ROAD. P.O. BOX 27199 VIC ELLISON
EAGAN, MINNESOTA 55121 ~y~
PHONE: (612) 454-8100 TMO~
DAVID K. GUSTAFSON
PAMEIA McCRFA
iHE000RE WACHIER
Couricil Members
October 20, 1988 i~ip~.lqgHE0GE5
CiryAdminisVOlor
EUGENE VAN OVERBEKE
Cily Clerk
NORTHWEST WHOLESALE LUMBER
915 YANKEE DOODLE RD
EAGAN, MN 55121
ATTENTION: MARK BUBBERS
RE: BUILDING PERMIT FOR ADDITION/REMODELING
Dear Mark:
Your recent application for a building permit prompted our plan
reviewer to view your office in order to better understand the
plans that were submitted. On October 5, 1988, he made this
inspection and noted several possible code violations in your
existing office areas. On October 18, 1988, I made an inspection
of your of£ice to determine what needs to be done to correct any
code deficiencies that exist and process your permit application.
With existing buildings, it is often times difficult to attain
strict code compliance without placing undue financial burden on
a building owner. Our position is to make the best of these
situations without hardship to anyone, but to provide a safe
building for employees. With that in mind, we would ask that the
following items be included as part of the work to be done under
the permit you have applied for:
1. Provide handrails on the two short flights of stairs - second
floor.
2. Install lighted exit signs at locations to be determined in
field.
3. Install 5/8" gypsum board inside closets under stairways.
4. Change door swings on required exit doors to swing in the
direction of travel - locations to be determined in field.
5. Check attic area for draft stopping and provide attic access
panels.
THE LONE OAK TREE. ..THE SYMBOL OF STRENGTH AND GROWTH IN OUR COMMUNIiY
6. Provide a one hour separation between the office and lumber
storage.
7. Contact the Metropolitan Waste Control Commission to see if
the conversion of your warehouse building to office space
will require additional SAC charges. If it does, there will
be additional fees that must be paid.
If any future expansion is planned, there are other code issues
that may come into play. At such time that more expansion is
planned, it would be advisable to hire an architect to prepare
the drawings. Depending on the extent of future expansion, we
may require the drawings to be prepared by an architect.
If you should have any questions regarding these issues, please
contact me.
Sincerely,
~ ~-~ti~~
teve Hanson
Assistant Building Official
SH/js
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141HNESOTA PETRALEUI4 SERVICf~ INC,
5333 UNIVERSITY AV£. H,
NINHERPOLIS~ MINNESOTA 55421
571-$490
MRRCN 5, 1990
IOINNESDTA STRTE FIRE f9RRSHRL
450 NORTX SYHDICRTE
ST. PAUL, f91NNESOTA 55104
10R. RRY 6£fFRE,
ENCLOSEA PLERSE FINA PLAHS fOR THE TRNK INSTRLLATION FOR NORTN-
NEST NNOLESRLE LUq,BER~ 915 YRNKEE DOdDLE RORAr E6AN~ NIHNESQTA.
HE NILL BE INSTRLLI TNO 10,000 6RLLON 9' X 21' STEfL STI_Px.
TRHKS. ^-c~-
TNE TANKS NILL BE USED fOR 6RSOLINE RHD. ~ESEL. TNE EXCRVRTION
HILL ALLON fOR R kINIpUl9 QF TNO ffET OF ClTVE7~ OWER TNE TRHK3.
TNE TANKS NILL Bf BHCKfILLED NITN SRNA. EHCN TRNK NILL NRVE FOlIR
IHCN FILL NITN LQCKIHG FILL CAP AHD RDAPTOR AHA HRV£ OVERFILL
PRQTECTION SYSTEM IHSTALLEA FdR TNf AIESEL RNA 6RSOLINE TANKS.
THE VENT NILL BE TNO INCN AHD NILL B£ LOCATEA RT TNE DISPENSIN6
ISLRNA. TNESE NILL EXTENTI 12' R,8Q4E 6RRDE.
THE PRODUCT SUPPLY LINES NILL BE FUSIOH BOHDEA PIPIN6 HITH RNOAES
AT7RCHEA. ERCN &RSOLIHE RHA AIESEL TRNK NILL HRVE R SUBl4£RSIBLE
PUWP fiHA TNERf NILL BE LERK DET£CTOR RT TN£ SUBI4ERSIBLf.
TNE SAIL RESISTIVITY fOR 7NIS LOCRTIOM IS 7,664.7 ARAfS.
If YOU HRVE RHY QUESTIONS AHOUT TNIS PROJECT PLERSE AO NOT NESIS7RTE .
TO CRLL ME RT 57i-8440.
SINCERELY~ ~
~ ~
MR. KEN NIN6RR qJ~~'~
~ ~ y~ ~
~
~o ~ RECEIVED
FMNNL '
~ ~i MAR 0 5 ?.99~
~ ` Fire Marshal Division
St. Paul, MtJ
. ~
,
~ - REVIEI~ED
° SUBJECT TO FINAL INSPECTtON
AND ANY CHANGES N07ED
• CONTACT LOCAL FIRE AUTHORiTY
STR7f of MINNESOTA PRI R TO PROJECT START.
ilRf MRRSHALL INN TA ST E FlRE MARSFl9At
450 NORTH SYNAICRTE
ST. PAUL~ lOIHMESOTA 55104
6i2-296-764i BY` Q
FLRkMRBLE RND COMBUSTIBL£ LIQUTAS Date:
PLRN RE47EN 6UIDELIME
Please fi11 in the following information completely. Nhere not
applicable mark HR. Incosplete information ~rill resaIt in the plans
heing retr[rned.
Aate March 5. I990
for: Cospany North~est NhoZesale Lu~sber
Address 415 Yankee Doodle Road
City Eaan, qinnesota 5512I
Contact 19r. Mike Cordoha Phone
Tank Infoz Size 1 9' X 2i' 2 9' X 21' 3
Capacity IO,000 i0,400
Prodact p oasoline diesel
Construction 5TI-Pz STI-P~
£quipmenta 3uhmersible X S~ction Piping Fr~sion Bonded
Type: fall Service Self Service XX Priyate F~eIing
Corrosion: Soi.i Type Sandy Test Equipment Vibroaro~nd 7,6 .TOh~/Ca
Protection:Type Rnode Installed--Tank Iinc Piping Zinc
RII materials to be suhmitted sha11 be legible and in daplicate.
Inclade plot plan of properEy sho+ving Iocation of adjacent stree~s,
highHays and huildings, sttrface waters, and other pertinent im,~ediate
surroandings,
f ~PL dIII AE
l1/04/85
RECEIYED
MA~~ 0 5 29~
Fire Marshal Divisio~
St Paul, MI+N
I ,
R11 plans suhmitted must show at least the follawing infaraation when
applicable. Check each item below that appears on the plan or nark N/A
if not applicable,
6ive measure~ents from tanks and dispensers to : Property Lines,
B~ildingsr Driveways~ Surface Naters, Self Service RTTEHARNT
Locetion.
Yes N/R Yes N!A
{X) Scale [X) l 1 4ent Ptpe Termination Neighb
lX) i) Property Lines (X) f) Vent Pipe Size
fX) f) B~ilding ts) (X) l) Piping Layout
[X) l) Tank Sise fgallons) CX) C 1 Location of Aispensers
fN) f) Tank Size fdiaensivns] tX) l 1 Naterways
(X) C) Product in Tank [X) Aispenser Protectivn
CX) Tank S~ry Depth C) f) Signsr No Saoking
Shat Off Motor
!X) C) Concrete Thickness Miniaum Rge Far Se1f 3ervice
Over Tank i6 Yearr O!d
CX) C) Tank fill Opening C) C) Fire Extinguisher
tX) l) Ariveaay l} Self-Serve Attendant Location
fX) Emergency Controls CX) C) Undergrv~nd 7ank Location end
Clearance
BY: MR. KEN NIN&ARA
CRmPRNY: ~INNES~TR PETR~LEU~ SERVICf, INC,
RAARESS: 5333 UNIVERSITY RVE. N.E.
CITY, STRTE, ZIP: FRIDLEY. ~INNESOTA 55421
PNON£: [612) 571-8*90
RENRRKS:
RECE9VED
~IAR 0 5 YS9a
Fire Marshal Division
Sh Paul,. Mln4
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RECEIV~D
- REVIEwED ~ „~o5i~o ~
~$U61ECT i'0 flNlsll 1N$PECTION Fire Marshal Division
AND ANY CHANGES ~+1CI~, st. vaul, ?r?N
• CONTACT LOCAL FIRE A~~ N. W. W N OL~ SA ~'E ~S (ti'~ p
PRIOR TO P~01~C1' ST~RT. p LY Cp
NFS~ A STA1E RE MA~,SHAL 4~~ YANlCE6 booB~ 1~oAp ~ca~l M~. 5s~2.1
KAL~: ~ I AMI10V[D ~t DMWN ~Y
By: ~
~ DAT~~ ~ ~ R[VI![D
Date: 3",,
j~~~ ~ lnnesota ef~o eum ecvicre, 1fc. -
' S333 ~nive7zity d~ve. ~ ~
~}ii ey, innesota 5542! o~u?w~Na NuM~~
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,,...~....~...--...oe.•-- .
. . ,
~ ~ MASTER CARD
LOCATION 915 YANKEE DOODLE ROAD
OWNER G. M. STEWART CO. - LONE STAR INDU5TRIES
STRUCTURE AND REMODEL OPF.N LUMBER STORAGE
LAND USED AS
Issued To
Permit No. Issued Con}rac}or Owner
BUILDING 4129 11/7/76 LeibfYied COnStr CtlOri Inc.
PLUMBING
CESSPOOL - SEPTIC TANK
WELL
ELECTRICAL .
HEATING
GAS INSTALLING
SANfTARY SEWER
i
OTHER I
OTHER ~ ~
Approved
Items (Initial) Date Remarks Distance From Well
FOOTING SEPTIC
FOUNDATION CESSPOOL
FRAMING TILE FIELD FT.
FINAL
ELECTRICAL
DEPTH
HEATING OF WELL
GAS INSTALLATION
SEPiIC 7ANK
CESSPOOL
DRAINFIELD .
PWMBING
WELL
SANITARY SEWER
-
Violations No}ed
on Back
COMMENTS:
~I~~ c~~ ~ ~o .~--6
2007 FIRE SUPPRESSION SYSTEMS PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephoue # 651-675-5675
Requirements: 2 complete sets of drawings and specifications
cut sheets on materials and com onents to be used
Date `7 ~ ~ ~ O'~
SiteAddress: ~'1l ~l `tG.u~..~~Qo ~[~P ~
Tenant / Building Name: S~'o~ ~Ca s
1C~~
The Applicant is: _ Owner ~ Contractor _ Other
PROPERTY OWNER SPr?v~
Address:
City: State: Zip:
, CONTRACTOR C( n,~~m~i-e~'~t C'~v- 1viN License ~-C3~- S-
Address: ~7FJ l"I~nnv~
~c~,~s lP (.~-J City: 1~~, / , ,
State: ~ Zip: 55/~_ Phone
ESTIMATED COMPLETION DATE: ~ c~
FIRE PERMIT TI'PE: ~ Sprinkler System of heads _ Fll'e PumP Standpipe
Other:
WpRK TYPE: _ New _ Addition ~i Alterations _ Remodel
Other:
DESCRIPTION OF WORK: ~k Commercial _ Residential _ Educational
Other: 5'
~'zao~
PleaaP cnntim~e on nrxf naaa By
PERMIT FEES
Contract Value $ ~ (j~j ` x .O1 = $ 5(j . ~ Permit Fee
$50.00 Minfmum
$ State Surcharge
To calculate surcharge
If Permit Fee is ~$1,OD0, surcharge is 50 cents.
If Permit Fee is >$1,D00, surcharge increases by $.50
for'each.$1,000 Permit fee, i.e. a$7,500 Pertnit Fee
requires a $1.00 surcharge.
3/4" Displacement Fire Meter -$•174.00 • $ Fire Meter
TOTAL FEE: $ • SC~
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 in accordance with the approved plan in the case of
work which requires a review and approval of plans.
A N~ L. { Y`r ~ I~D I~i(/l
Applicant's Printed Naxne pplicant's Signahue
DO NOT WRITE BELOW THIS LINE
REQfJIIiED INSPECTIONS
_ Hydrostatic Flow Alann Drain Test Rough In .
Trip Pump Test Centrat Starion Final
- /
Conditions of Issuance:
Permit Approve Date: ~ / / ~ / ~
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VILLAGE OF,.EAGAN WATER SERVICE PERMIT
3795'' Pilot -'Knob Road PERMIT NO.: 1562
Egan,MN 55122 DATE: 8/13/74
Zoning: 11 No. of Units: 1
Owner: NBC Yard Office & Whse.
Address:
Site Address: 915 Yankee Doodle Road
Plumber: Katz Plumbing & Heating
Meter No.: Connection Charge:
Size: Account Deposit:
Reader No.: Permit Fee: 10 . 0 0 pd
1 agree to comply with the Village of Eagan Surcharge: . Pd
Ordinances. Misc. Charges:
Total:
By Date Paid:
Date of Insp.• Insp.:
VILLAGE OF.'EAOAN SEWER SERVICE PERMIT
3795 Pilo Knob Road
Eagon,'MN 55122 PERMIT NO.: 2 322
Zoning: I1 DATE: $
Owner: NBC Yard Office & No. of Units:
�h�e.
Address:
Site Address: 915 Yankee Doodle Roam
Plumber:
Plumbing & Beating
I agree to comply with the Village of Eagan Connection Charge:
Ordinances. 3£ Per. 2321
Account Deposit:
Permit Fee:
By
Surcharge: P
Misc. Charges:
Date of Insp.:
Total:
Insp.:
Date Paid:
r
� Use BLUE or BLACK Ink
' r———————————————— � ,�
I For Office Use
� � ���� � ���
��} �� �� �� � Permit#:
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I Permit Fee: �' a /,���' r
3830 Pilot Knob Road � (r� ,.,c%/J
Eagan MN 55122 � � �� `
Phone: (651) 675-5675 i Date Received:
Fax: (651)675-5694 j Staff: i
�-----------------�
2015 COMMERCIAL BUILDING PERMIT APPLICATION
(� .�. . , 1 � `�� �
Date:� ` C�' ����Site Address: �I I � t�''_���� ��� 1"� YC�e�
Tenant Name: �,���� (Tenant is: New/ Existing) Suite#:
�t�r�CES /I2 Former Tenant: ��i���L � �-_
*a � Name: ' � �Phone:� �7�� �-(,J�-��
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.�� ��� Description ofwork: ��.(���1� \�i.�> ��'�'r'f�/�'�G��(Z� � Vl'��
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��,_;, , �� ` Construction Cost: � � �� �r l - � � " j��1 ����
=` Name: License#:
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,�W���'�r -.
F State: � Zi�� Phone: � �
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Contact: Email:
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�,= ' ��� Name: Registration#:
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Licensed plumber installing new sewer/water service: Phone#:
J�fl7'E��faRs s-�ngl��per�i�g'�s����,�r Su����;��S�at�`�'� � � 5 " ' s�f
m: y�t�— , > � � d�a � *� � ���� y���,, /�
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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.aoqherstateonecall.org
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 app' a permi ork is not to start without a
permit;that the work will be in accordance with the approved plan in the case work which equ' s a review a pproval of plans.
X� '��t�. �1G.� � �---�"�� �_ � ,�-'
ApplicanYs Printed Name Applicant's Signature
Page 1 of 3
.
DO NOT WRITE BELOW THIS LINE r
SUB TYPES
_ Foundation _ Public Facility _ Exterior Alteration-Apartments
_ Commercial/Industrial _ Accessory Building _ Exterior Alteration-Commercial
_ Apartments _ Greenhouse/Tent _ Exterior Aiteration-Public Facility
Miscellaneous Antennae
WORK TYPES
New interior Improvement Siding _ Demolish Building*
_ Addition _ Exterior Improvement _ Reroof _ Demolish Interior
Alteration Repair Windows _ Demolish Foundation
_ Replace _ Water Damage _ Fire Repair _ Retaining Wall
Salon Owner Change *Demolition of entire building-give PCA handout to applicant
DESCRIPTION
Valuation Occupancy MCES System
Plan Review Code Edition SAC Units
(25%_100%� Zoning City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Sprinklers
Type of Construction Width
REQUIRED INSPECTIONS
Footings(New Building) Sheetrock
Footings(Deck) Final/C.O. Required
Footings(Addition) Final/No C.O. Required
Foundation Other:
Drain Tile Pooi:_Footings Air/Gas Tests _Final
Roof:_Decking _Insulation _Ice&Water _Final Siding:_Stucco Lath _Stone Lath _Brick
Framing Windows
Fireplace:_Rough In _Air Test _Final Retaining Wall
Insulation Erosion Control
Meter Size: Concrete Entrance Apron
Final C/O Inspection: Schedule Fire Marshal to be present: Yes No
Reviewed By: , Building Inspector Reviewed By: , Planning
COMMERCIAL FEES
Base Fee Water Quality
Surcharge Water Sampling Fee
Plan Review Water Supply 8�Storage(WAC).
MCES SAC Storm Sewer Trunk
City SAC Sewer Trunk
S8�W Permit& Surcharge Water Trunk
Treatment Plant Street Lateral
Treatment Plant(Irrigation) Street
Park Dedication Water Lateral
Trail Dedication Other:
Water Quality TOTAL
Page 2 of 3
��L � � /� � S^
Pe Fleck ��� �3�1��-C ���C T�( -
From: Nye,Jessica <jessica.nye@metc.state.mn.us>
Sent: Friday,July 31, 2015 9:53 AM
Ta Pe99Y Fleck
Subject: RE:June Demo SAC Report
Thanks Peg9Y�
Record show that this was buiit in 1974 and I can find no record of the City remifiting SAC. There is
no SAC credit for this praperty.
From: Peggy Fleck [mailto:pfleck(c�cityofeagan.com]
Sent: Thursday, July 30, 2015 2:26 PM
To: Nye, Jessica
Cc: Chris Russell
Subject: RE: June Demo SAC Report
Hello Jessie,
Per our Engineer,Chris,the main sewer line runs between the twa bui{dings,therefore it is our assumption that it is
connected directly to the main sewer line. Also,the building is approximately 11,000 st.
If you have any further questians, please contact Chris at crussell@citvofea�an.com.
Thanks,
Peg
_ _k.. _�._._.._..._______��_.�.....__�_ ...................�.
From: Nye, Jessica [mailto:jessica.nyeC�metc.state.mn.us]
Sent: Thursday, )uly 30, 2015 7:41 AM
To: Pe99Y Fleck
Subject: ]une Demo SAC Report
Good morning Peggy!
The demo report included a demo for 915 Yankee Doodle Road. Did the old office building have a
separate sewer connection for this specific building? Or was the sewer connected to the main
building?
If separate, we need to know the size of the building.
Thanks!
i
Pe99Y Fleck
From: Nye,Jessica <jessica.nye@metc.state.mn.us>
Sent: Thursday,July 30, 2015 7:41 AM
To: Peggy Fleck
Subject: June Demo SAC Report
Good morning Peggy!
The demo report included a demo for 915 Yankee Doodle Road. Did the old office building have a
separate sewer connection for this specific building? Or was the sewer connected to the main
building?
If separate, we need to know the size of the building.
Thanks!
: Jessie Nye
; Sup�rvi�or, ES R�venue{SAC} � N1�ES �"'rnance
�,
" �,essica:nye a metc.��ate.mn,us
' �. ���.so2.���s t �. ���.so2.loso
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� � � � � � � €
Please visit our SAC website by clicking: SAC Proyram
1
• 4 ���ieiro�olit��i�o!3ncil � �nuirortm�r�ial5e�rices
� 39t31�ok��rt Stre�:t 3�r�rth MCES SAC-D Form
����.�-`-- � S�. i'�ul, (U�inne�o�a 5�'t7'1-'i8t�5 Last Updated: 1 211 4/20 9 4
� 65`l,�f12.1378 � 65�.6�2.it33�1'ax
Sewer Availability Charge{SAC)
2015 DEMt3LITiC)t� DETI�IL REPORT
Customer Community City of Eagan
Reporting Period (month or quarter) ,lune Year 2015
Attention: This form is for reporting all SAC-related demolitions to be placed on record as potential SAC credits.
All demolitions must be reported within 30 days of the end of the calendar year in which the demolition permit is
issued.
Attach MCES SAC-C or Determination Letter for all commercial, institutional/governmental facilities in order to show
how the number of credits were calculated.
Attach a Determination Letter for all industrial facilities permitted by MCES.
Reduce the SAC Units of credit for apartments by 20% and publicly-assisted housing by 40% in order to adjust for
previously reduced charges.
The number of potential SAC units must be rounded to the nearest whole number.
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C=Commercial(attach MCES SAC-C) IG=Institutional/Governmental(attach MCES SAC-C) 1=Industrial(attach Determination Letter)
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Use BIUE or BLACK Ink
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3830 Pilot Knob Road � Date Received: �
Eagan MN 55122 I �
Phone: (651)675-5675 j Staff: j
Fax: (651)675-5694 �_________________
2015 SEWER AND WATER REPAIR / DISCONNECT PERMIT
Date: � "� � r �� Fee: $65.00
�ty Sewer '�i_ty Water Repair sconnect
Description Of Work: ��SC�i N-�-�� ��--- � ��2--. ��'L--+��--
Street Address for Proposed Work_ � �� ��`''"'"���. ���
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Name: Phone:
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Applicant is: Owner Contractor
Licensed Pipelayer Master Plumber � Property Owner
Name: �'� '�'� T �(,N�.�O 4 vt,� �--L� Phone: c�� � '� �t'7� —G O oL d
Address/City/Zip: �`��` ��c� l�L- �'.t-'L=--� "�"c'�'S�+al C,.� --� ��—fC�C�
Pipelayer Training Certification Card#: or Master Plumber License#:
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I acknowledge that the information is complete and accurate and 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.
���.-�-Q S .�-�e,J ���_____�
Applicant(Print Name) Appli Ys Signature
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.qoqherstateonecall.orq
Use BLUE or BLACK Ink
r-----------------
I For Office Use 1
City of Eapn ; Permit#:
!1 I
1 � I
3830 Pilot Knob Road I Permit Fee:
Eagan MN 55122 I Date Received: / 1
Phone: (651)675-5675 1 I
Fax: (651)675-5694 JUN 0 9 �016 1 I
I Staff: I
L--------- -------1
2016 MECHANICAL PERMIT APPLICATION
® Plea/se submit two (2)sets of plans with all commercial applications.
Date: Cry 1 Site Address: q Y(WIJ EL O OO D L&
Tenant: I OG L Wl 13£(� Suite#:
0 R 10#tC n I Name: PO ST(;P 1 D19 A'_T�QI1JAJ S AQk 7" Phone: �o (o�3-1
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Kx Address/City/Zip: S-C) L-O A.)F O A Y1 R �
_ Name: P O M 0 m f T£ R S f Rt)t CC License#: r PC
' Address: �� 302) 6x C c slbr� I�LUf7 City: FFOPhiA)S
t31�t � t0C C/
State: rn Zip: S 5 . �� Phone: ``�3 3" 0 W
_ Contact: D fAUE D Alt C"i Po k rEmail: C+�V c,)rPb 'r �x
New Replacement Additional Alteration Demolition
hype of
Description a
+0 t of work: � �i 2.trio
N Ir �
p '�� � orit mound 'mom pec al + gdlprd r �trt
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R rle. Men, e I Info uI cni fatal` ,
— -
r RESIDENTIAL COMMERCIAL
R� I _Furnace New Construction Interior Improvement
MIK
a
Aft �� �r �� —Air Conditioner Install Piping Processed
Air Exchanger Gas Exterior HVAC Unit
Heat Pump _ Under/Above ground Tank (_Install/ Remove)
Wow y Other
RESIDENTIAL FEES
$60.00 Minimum Add or alteration to an existing unit, includes State Surcharge
$100.00 Residential New, includes State Surcharge =$ TOTAL FEE
COMMERCIAL FEES Contract Value$ -X.01
$60.00 Permit Fee Minimum
$75.00 Underground tank installation/removal, includes State Surcharge =$
S. �� Permit Fee
Surcharge=Contract Value x$0.0005 =$ Surcharge
If the project valuation is over$1 million, please call for Surcharge =$ TOTAL FEE
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.
X n� �,� �� T x bc, 1
Applicant's Printed Name App icant's Signa ure
-m4--=(I
915 Yankee Doodle Rd-Google Maps https://www.google.com/maps/place/915+Yankee+Doodle+Rd,+Eaga...
915 Yankee Doodle Rd
rs� 915 Yankee Doodle Rd, Eagan, MN 55121 C7oc-,Agle
inn
1 of 1 6/6/2016 3:16 PM
p
E.
I: ter` 1
Main Office - 11303 Excelsior Blvd. - Hopkins, MN 55343
Phone: (952)933-4800 - Fax: (952) 939-0418
www.pump-meter.com
Email: pump-meter@pump-meter.com
Pump and Meter Service, Inc.
1
SERVICE • SALES • INSTALLATION /
Bejin Pump Service - A division of Pump & Meter Service, Inc.
3497 129th Street - Chippewa Falls, WI 54729
Phone: (715)723-8223 - Fax: (715)723-7242
City of Eagan
Attn: Scott Peterson
3830 Pilot Knob Road
Eagan, MN 55122
RE: Tank Removal Soil Sampling
Stock Lumber
915 Yankee Doodle Rd
P.O. Box 21099
Eagan, MN 55121
To Whom It May Concern:
Duluth Branch
Phone: (218)389-6359 - Fax: (218) 389-6359
September 16, 2016
I have reviewed the Analytical soil test results
Stock Lumber site and found small detection on
west. Sample #1 page 5 on the report. The sample
non -detect. Eventhough 57 mg/kg is small, it
amount. Let me know if you have any questions.
Thank you.
Sincerely,
PUMP & METER SERVICE, INC.
Enc.
Fueling Systems
Inventory Controls
Line Testing
- Electronic Gauging &
- Fiberglass Tanks & Pipe
Tank Testing
gEmPE1=UM EQUIPMENT INSC
SEP 2 1 21116
from the former
the diesel tank
#2 east tank was
is a reportable
Self-Sery Equipment
Auto Lifts & Parts
Card Control Systems
Compressors
- Service Station Pumps
Canopies
aceAnalytical®
www.pacelabs.com
September 09, 2016
Mr. Ron Smith
Pump & Meter
11303 Excelsior Blvd.
Hopkins, MN 55343
L
RE: Project: 216182 STOCK SiCumbar
Pace Project No.: 10361217
Pace Analytical Services, Inc.
1700 Elm Street - Suite 200
Minneapolis, MN 55414
(612)607-1700
Dear Mr. Smith:
Enclosed are the analytical results for sample(s) received by the laboratory on September 01, 2016.
The results relate only to the samples included in this report. Results reported herein conform to the
most current TNI standards and the laboratory's Quality Assurance Manual, where applicable, unless
otherwise noted in the body of the report.
If you have any questions concerning this report, please feel free to contact me.
Sincerely,
Timothy Sandager
timothy.sandager@pacelabs.com
Project Manager
Enclosures
REPORT OF LABORATORY ANALYSIS
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without the written consent of Pace Analytical Services, Inc..
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CERTIFICATIONS
Project: 216182 STOCK Cumbar
Pace Project No.: 10361217
Pace Analytical Services, Inc.
1700 Elm Street - Suite 200
Minneapolis, MN 55414
(612)607-1700
Minnesota Certification IDs
1700 Elm Street SE Suite 200, Minneapolis, MN 55414
525 N 8th Street, Salina, KS 67401
A2LA Certification #: 2926.01
Alaska Certification #: UST -078
Alaska Certification #MN00064
Alabama Certification #40770
Arizona Certification #: AZ -0014
Arkansas Certification #: 88-0680
Califomia Certification #: 01155CA
Colorado Certification #Pace
Connecticut Certification #: PH -0256
EPA Region 8 Certification #: 8TMS-L
Florida/NELAP Certification #: E87605
Guam Certification #:14-008r
Georgia Certification #: 959
Georgia EPD #: Pace
Idaho Certification #: MN00064
Hawaii Certification #MN00064
Illinois Certification #: 200011
Indiana Certification#C-MN-01
Iowa Certification #: 368
Kansas Certification #: E-10167
Kentucky Dept of Envi. Protection - DW #90062
Kentucky Dept of Envi. Protection - W #:90062
Louisiana DEQ Certification #: 3086
Louisiana DHH #: LA140001
Maine Certification #: 2013011
Maryland Certification #: 322
Michigan DEPH Certification #: 9909
Minnesota Certification #: 027-053-137
Mississippi Certification #: Pace
Montana Certification #: MT0092
Nevada Certification #: MN_00064
Nebraska Certification #: Pace
New Jersey Certification #: MN -002
New York Certification #: 11647
North Carolina Certification #: 530
North Carolina State Public Health #: 27700
North Dakota Certification #: R-036
Ohio EPA#: 4150
Ohio VAP Certification #: CL101
Oklahoma Certification #: 9507
Oregon Certification #: MN200001
Oregon Certification #: MN300001
Pennsylvania Certification #: 68-00563
Puerto Rico Certification
Saipan (CNMI) #:MP0003
South Carolina #:74003001
Texas Certification #: T104704192
Tennessee Certification #: 02818
Utah Certification #: MN000642013-4
Virginia DGS Certification #: 251
VirginiaNELAP Certification #: Pace
Washington Certification #: C486
West Virginia Certification #: 382
West Virginia DHHR #:9952C
Wisconsin Certification #: 999407970
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc..
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SAMPLE SUMMARY
Project: 216182 STOCK Cumber
Pace Project No.: 10361217
Pace Analytical Services, Inc.
1700 Elm Street - Suite 200
Minneapolis, MN 55414
(612)607-1700
Lab ID Sample ID Matrix Date Collected Date Received
10361217001 #1 WEST DIESEL TANK Solid 09/01/16 09:15 09/01/16 15:07
10361217002 #2 EAST DIESEL TANK Solid 09/01/16 10:15 09/01/16 15:07
REPORT OF LABORATORY ANALYSIS
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SAMPLE ANALYTE COUNT
Project: 216182 STOCK Cumber
Pace Project No.: 10361217
Pace Analytical Services, Inc.
1700 Elm Street - Suite 200
Minneapolis, MN 55414
(612)607-1700
Lab ID Sample ID
Method
Analytes
Analysts Reported
10361217001 #1 WEST DIESEL TANK
10361217002 #2 EAST DIESEL TANK
WI MOD DRO MT 2
ASTM D2974 JDL 1
WI MOD DRO MT 2
ASTM D2974 JDL 1
REPORT OF LABORATORY ANALYSIS
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ANALYTICAL RESULTS
Project: 216182 STOCK Cumbar
Pace Project No.: 10361217
Pace Analytical Services, Inc.
1700 Elm Street - Suite 200
Minneapolis, MN 55414
(612)607-1700
Sample: #1 WEST DIESEL TANK Lab ID: 10361217001 Collected: 09/01/16 09:15 Received: 09/01/16 15:07 Matrix: Solid
Results reported on a "dry weight" basis and are adjusted for percent moisture, sample size and any dilutions.
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
WIDRO GCS Analytical Method: WI MOD DRO Preparation Method: WI MOD DRO
WDRO C10 -C28 57.5 mg/kg 10.3 1 09/07/16 08:31 09/09/16 10:02
Surrogates
n-Triacontane (S) 92 %. 50-150 1 09/07/16 08:31 09/09/16 10:02 638-68-6 D5
Dry Weight Analytical Method: ASTM D2974
Percent Moisture 3.2 % 0.10 1 09/08/16 12:33
Sample: #2 EAST DIESEL TANK Lab ID: 10361217002 Collected: 09/01/16 10:15 Received: 09/01/16 15:07 Matrix: Solid
Results reported on a "dry weight" basis and are adjusted for percent moisture, sample size and any dilutions.
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
WIDRO GCS Analytical Method: WI MOD DRO Preparation Method: WI MOD DRO
WDRO C10 -C28 ND mg/kg 10.3 1 09/07/16 08:31 09/09/16 10:25
Surrogates
n-Triacontane (S) 87 %. 50-150 1 09/07/16 08:31 09/09/16 10:25 638-68-6 D5
Dry Weight Analytical Method: ASTM D2974
Percent Moisture 2.8 % 0.10 1 09/08/16 14:14
Date: 09/09/2016 04:30 PM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc..
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QUALITY CONTROL DATA
Project: 216182 STOCK Cumbar
Pace Project No.: 10361217
Pace Analytical Services, Inc.
1700 Elm Street - Suite 200
Minneapolis, MN 55414
(612)607-1700
QC Batch: 434643 Analysis Method: ASTM D2974
QC Batch Method: ASTM D2974 Analysis Description: Dry Weight/Percent Moisture
Associated Lab Samples: 10361217001
SAMPLE DUPLICATE: 2362765
10360748004 Dup Max
Parameter Units Result Result RPD RPD Qualifiers
Percent Moisture
0.69 0.61 12 30
SAMPLE DUPLICATE: 2362766
10361217001 Dup Max
Parameter Units Result Result RPD RPD Qualifiers
Percent Moisture % 3.2 3.4 5 30
Results presented on this page are in the units indicated by the "Units" column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 09/09/2016 04:30 PM without the written consent of Pace Analytical Services, Inc..
Date: 09/09/2016 04:30 PM without the written consent of Pace Analytical Services, Inc..
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QUALITY CONTROL DATA
Project: 216182 STOCK Cumbar
Pace Project No.: 10361217
Pace Analytical Services, Inc.
1700 Elm Street - Suite 200
Minneapolis, MN 55414
(612)607-1700
QC Batch: 434646 Analysis Method: ASTM D2974
QC Batch Method: ASTM D2974 Analysis Description: Dry Weight/Percent Moisture
Associated Lab Samples: 10361217002
SAMPLE DUPLICATE: 2362786
10361221001 Dup Max
Parameter Units Result Result RPD RPD Qualifiers
Percent Moisture % 16.9 15.6 8 30
SAMPLE DUPLICATE: 2362787
10361137005 Dup Max
Parameter Units Result Result RPD RPD Qualifiers
Percent Moisture % 11.3 13.6 18 30
Results presented on this page are In the units Indicated by the "Units" column except where an alternate unit Is presented to the right of the result.
Date: 09/09/2016 04:30 PM
REPORT OF LABORATORY ANALYSIS
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QUALITY CONTROL DATA
Project: 216182 STOCK Cumbar
Pace Project No.: 10361217
Pace Analytical Services, Inc.
1700 Elm Street - Suite 200
Minneapolis, MN 55414
(612)607-1700
QC Batch: 434346 Analysis Method: WI MOD DRO
QC Batch Method: WI MOD DRO Analysis Description: WIDRO GCS
Associated Lab Samples: 10361217001, 10361217002
METHOD BLANK: 2361580 Matrix: Solid
Associated Lab Samples: 10361217001, 10361217002
Blank Reporting
Parameter Units Result Limit Analyzed Qualifiers
VVDRO C10 -C28 mg/kg ND 10.0 09/09/16 08:54
n-Triacontane (S) %. 81 50-150 09/09/16 08:54
LABORATORY CONTROL SAMPLE & LCSD: 2361581 2361582
Spike LCS LCSD LCS LCSD % Rec Max
Parameter Units Conc. Result Result % Rec % Rec Limits RPD RPD Qualifiers
WDRO C10 -C28 mg/kg 80 63.0 66.5 79 83 70-120 5 20
n-Triacontane (S) %. 86 91 50-150
Results presented on this page are in the units Indicated by the "Units" column except where an alternate unit is presented to the right of the result.
Date: 09/09/2016 04:30 PM
REPORT OF LABORATORY ANALYSIS
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QUALIFIERS
Project: 216182 STOCK Cumbar
Pace Project No.: 10361217
Pace Analytical Services, Inc.
1700 Elm Street - Suite 200
Minneapolis, MN 55414
(612)607-1700
DEFINITIONS
DF - Dilution Factor, if reported, represents the factor applied to the reported data due to dilution of the sample aliquot.
ND - Not Detected at or above adjusted reporting limit.
J - Estimated concentration above the adjusted method detection limit and below the adjusted reporting limit.
MDL -Adjusted Method Detection Limit.
PQL - Practical Quantitation Limit.
RL - Reporting Limit.
S - Surrogate
1,2-Diphenylhydrazine decomposes to and cannot be separated from Azobenzene using Method 8270. The result for each analyte is
a combined concentration.
Consistent with EPA guidelines, unrounded data are displayed and have been used to calculate % recovery and RPD values.
LCS(D) - Laboratory Control Sample (Duplicate)
MS(D) - Matrix Spike (Duplicate)
DUP - Sample Duplicate
RPD - Relative Percent Difference
NC - Not Calculable.
SG - Silica Gel - Clean -Up
U - Indicates the compound was analyzed for, but not detected.
N-Nitrosodiphenylamine decomposes and cannot be separated from Diphenylamine using Method 8270. The result reported for
each analyte is a combined concentration.
Pace Analytical is TNI accredited. Contact your Pace PM for the current list of accredited analytes.
TNI - The NELAC Institute.
WORKORDER QUALIFIERS
WO: 10361217
[1] Samples were received outside of the recommended temperature range of 0-6 degrees Celsius. The samples were
received from the field on ice, indicating the cool down process had begun.
ANALYTE QUALIFIERS
D5 The sample was re -weighed into a new container because the sample weight in the original container exceeded the
method specifications.
Date: 09/09/2016 04:30 PM
REPORT OF LABORATORY ANALYSIS
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QUALITY CONTROL DATA CROSS REFERENCE TABLE
Project: 216182 STOCK Cumbar
Pace Project No.: 10361217
Pace Analytical Services, Inc.
1700 Elm Street - Suite 200
Minneapolis, MN 55414
(612)607-1700
Lab ID
Analytical
Sample ID QC Batch Method QC Batch Analytical Method Batch
10361217001 #1 WEST DIESEL TANK WI MOD DRO 434346 WI MOD DRO
10361217002 #2 EAST DIESEL TANK WI MOD DRO 434346 WI MOD DRO
10361217001 #1 WEST DIESEL TANK ASTM D2974 434643
10361217002 #2 EAST DIESEL TANK ASTM D2974 434646
Date: 09/09/2016 04:30 PM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc..
434816
434816
Page 10 of 12