2100 Water Lilly Lane
OFFICE USE ONLY o ~/S
L C BL RECEIPTi/: ~
SUBD. .G~(LGA~~ /'7t5. /LUn~1qiS, ~ ~ RECEIPTDATE: ~s S7
1997 PLUMBING PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55722
(612) 681-4675
Pbase wmplete tor: . ell commerciaUindusUial buil0ings.
• muMi-family 6uildings when seperate permita ere nQ,( repuired for ear.h dwelling unR.
• badcflow proventer to De installed in commerciel arees or resfdential boubvercls
DATE: WORK TYPE: -Is,/ New Const. _ Add-0n _ Repair
DESCRIPTION OF WORK: 912 6' 1 r1 ~ je.r S~ S Ln
IS WATER METER REQUIRED? ,y' Yea _ No. ARE FLUSHOMETERS TO BE INSTALLED? _ Yea ~ No
yNDER6ROUND SPRINKLER SYSTEM
INSTALLING METER? ~ Yes _ No. NEW SERVICE? X Yes _ No WA7ER FLOW: O GPM.
Pressure Redudng Valve may be required if inatall'mg new aervice • cantad Cdy's Engineering Department at 8614646.
FAILURE TO PROVIDE THE ABOVE INFORMATION WILL RESULT IN A DELAY OF METER ISSUANCE
FEES
Ninfmum fee of $25.00 or 1% of wntraG price, whichever is greater. Minimum Stete Surcharge of 5.50 due on all portnits.
CONTRACT PRICE: 3. CJ6G x 1°k =/3O $
~
COMPLETE THIS AREA ONLY IF INSTALLING UNDERGROUND SPRINKLER SYSTEM
BACKFLOW PREVENTER FEE $ 25.00
WATER PERMIT (new service only) 50.00 = S ~
WAC (new service only - per connedion) 780.00 = E •~h~
WATER TREATMENT (new service only - per connection) 420.00 = E
CITY INSTALLED TAP 300.00 = S
METER: 7" = $185.00. 2" TURBO = $846.00 = S o. D O PERMIT FEE $
FI6URE SURCHARGE AT 60 CENT9 FOR EVERY $1,000 Of PFRMR FEE DUE STATE SURCHARGE S
TOTAL a a1aa o o
i hereby aeknowbdge thaf I have read this epplication, state that the informetion is corroct, and egrae to comply with all applicabla Ciry of EaBan ordinances.
ft is the appiicaM's responsibility to notify the pioperty avner that the CNy oT Eegan assumes no IiabilRy for eny demapes cauxd by the City during tls nortnel
operational antl meintenance ectivities to the facilities consWCtad urMer this partnR wifhin City properry/rightaT-wayleasemeM.
SITEADDRESS:
TENANT NAME: STE.
OWNER NAME:
INSTALLER NAME: , TELEPHONE T O Y-~~I~6
STREETADDRESS: ~
CITY: STATE: ZIP:
A LICANT'S SIGNATURE ~ ~
OFFlCE U8E ONLY • REVERBE SICE /V ~7 ~(,j
r~ /Z ID G. .
OFFICE USE ONLY
PLUMBING PERMIT (COMMERCIAL)
METER SIZE Yes _ No
Domestic
irrigation cx~' a
llTILITY GONNECTION (APPLIES TO NEW SERVICF nui v)
$
REVIEWED BY
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 S&W permit #
• Check PIMS Screens 110 (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
strainer will be required. This information is to be supplied by the designer of the system. Consult with Plumbing
Inspector if Licensed Plumber does not know GPMs.
Before selling meter
Check PIMS Screen 320 forap°roval of inspection results. No meter will be sold before all sewer and water inspections are
complete on a new service. If new service lines are not required, one check may be written fbr meter and permit costs. Write
meter type and size on receipt, code to 3716-9220 (meter portion only), and forward copy to Utility Billing Clerk.
Enter meter size, type, receipt date & amount paid on PIMS Screen 110. Copy of receipt should be given to Utility Billing
Clerk.
Mlscellanaous Information
The installer is to corrtact Building Inspections at 681-4675 fbr inspection of the inside water line and backflow preventec The,
Public Works Department may be reached at 681-4300 fbr water tumon.
If ineter is over 5/8, call Public Works and let them know so they can tell you if they have one in stock before plumber goes
overthere.
PLUMBING (RESIDENTIAL)
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone !k 651-675-5675 FAX 9 651-675-5694
Please complete for: Single Family Dwellings
Townhomes and Condos when permits aze required for each unit
Date 0
Site Address Unit # _
Property Owner G Telephone )
Contractor ~ 6^ ~ • ~ ~CT`^7
Address ~0'? ' ~ruv~ ~Qd City /7'd/l44~ °
State Zip Telephone #
The Applicant is _ Owner ~Contractor _ Other
Septic System New _ Refurbished Submk 2 sets of plans and MPC license $ 100.00
Includes County fee. Additional consultant fees may apply.
Alterations To Existing Dwelliog Unit, Including $ 50.00
_ Adding fixlures to lower levels or room additions, excluding water softener and water heater
Abandonment of septic system
_ Water turnaround 5/8" meter if needed -$121.00)
Other:
~ RPZ _ new installafion _ repair '-~ebuild $ 30.00
_ Lawn irrigation system
_ Water softener _ Water heater $ 15.00
_ replacement _ add@ional
1I , ~l ia r.l ,
~l$ 50
StateSurcharge
_ ~ i . N 4 r.. l.' . G
TOtBl / $ '~F--
I hereby apply for a Residential Plumbing Permit and acknowledge that the info ation-is-eoWlete_and_accurate; that the work will
be in conformance with the ordinances and codes of the City of Eagan and with the Plumbing Codes, that i understand [his is not a
permit, but only an application for a permit, and work is not to start without a permit; that work will be in accordance with the
approved plan in the case of work which requires a review and approval of plans.
Applicant's Pnnted Name Applica 's ignature
~
I For:~ee-Use
~
City of Eapn ; Permi,#:
4b~
I Permit Fee: ~'7J C/ ~
3830 Pilot Knob Road i I
EaganMN55122 ~ DateReceived: Q1Q- 'CC~, v '
I
Phone: (651) 675-5675
Fax: (651) 675-5694
C~JVY~w~CCt,G~C, - - - - - -
2008I gamiNTIAL PLUMBING PERM T APPLICATION
Date: (e'31-0 'J Site Address: 00 kl I
Tenant: Suite
RESIDENTIOWNER Name: A JLf-y-,~ Phone:
Address / City / Zip:
ME4fO 7P`r'nr License O S Ai 4 _J
CONTRACTOR Name:
gGar}, c°.
Address: 'a f~' i rPPk
~ .
City: HInCk6e) D5037 • State: ZiP:
Phone: Sl~ Contact Person:
TYPE OF WORK _ New _ Replacement _ Repair ?Rebuild _ Modify Space _ Work in R.O.W.
Description of work:
PERMIT TYPE RESIDENTlAL
Water Heater _ Water Softener
-zLawn Irtigation _Add Plumbing Fixtures
~?RPZ / _'PVB) Main _ Lower Level)
Septic System _ W ater Tumaround
New
Abandonment
RESfDENTIAL FEES:
$50.50 Minimum Wafer Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge)
$30.50 Lawn Irrigation (includes $.50 State Surcharge)
$50.50 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround` (includes $.50 State Surcharge)
'WaterTumaround (add $136.00 if a 518" meter is required)
$100.50 Septic System New ($10.00"per as built) (includes County fee and $.50 State Surcharge) ~
$90.50 Fire Repair (replace burned out appiiances, duclwork, etc.) (includes $.50 State Surcharge)
FEES
I hereby acknowledge that this infortnation is complete and accurate: that the work will be in conformance ~vith the ordinances and codes of the CiTy of
Eagan; that I understand tMis is not a pertnit, 6ut only an application for a pertnit, and vrork is rrot to staR without a it: that the work will be in
accordance vrith the approved plan in the ca/s/e of work which requires a review and approval plans.
x R'1'~`-S x -
qpplicanYs Printed Name ApplicanYs Signature
FOR OfFICE USE Reviewed By; Date:
Required Inspections: _Under Ground Rough-In _AirTest . _Gas'Test _Final
Jul 2516 11:33a 112C Inc 6517889657 PA
Use BLUE or BLACK Ink
Coi --,
� � For Office Use /6
I Penn
it#: v� v j
City of Eap Permit Fee._ail n - CC
3630 Pilot Knob Road I I
Eagan MN 55122 I Date Received:
I I
Phone:(651)675-5675 l Staff: I
Fax: (651)675-5694 -- --------
2016 RESIDENTIAL PLUMBINGf PERMIT APPLICATION
Date: Site dress: 7/
Tenant It C fj I t l G t' Suite#:
_. i Phone: 7 •� / g
Resident/Ownei ` Name: f
Address/City I Zip:--L i 1 '
Name: 1 I�l- �1 C License#:
fi Contractor ' Address: q' Q ( .0)Acorr, J 1 l�City:
s ���
i State:-1'�=—Zip: S 0:7 hone:
P
: Y
t Contact: (`` e l� Email: �� ;
New Replacement _Repair X-Rebuild Modify Space _Work in R.Q.W.
i Type of Work I — — j R�Z f t j r�
R i Description of work: n
f, l RESIDENTIAL " 06 140 a -
} r
Water Heater
i Water Softener
Lawn Irrigation RPZ 1—PVB)
Permit Type I Add Plumbing Fixtures L Main/_Lower Level)
Septic System ;
F
New Water Turnaround f
3 1
_Abandonment
RESIDENTIAL FEES:
$60.00 Water Heater,Water Softener, or Water Heater and Softener(includes State Surcharge)
$60.00 Lawn Irrigation(includes State Surcharge)
$60.00 Add Plumbing Fixtures,Septic System Abandonment,Water Turnaround*(includes State Surcharge) i
I 'Water Turnaround (add$280.00 if a 314"meter is required)
$115.00 Septic System New(includes County fee and State Surcharge) Lo . o b
TOTAL FEES$
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.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 application for a permit, and wooqs 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 fans.
1 I
x n� ene �`�� i ��
x
Applicant's Printed Name Appl s Signature
FOR OFFICE USE Reviewed By: Date:
Required Inspections: Under Ground Rough-in Air Test Gas Test Final
Meter Related Items: Meter Size Radio Read Manometer Staff: