4212 Rahn RdPROPERTY
OWNER
Name: / ,14,/ /9 ( / "6 \ - Phone:
CONTRACTOR
Name: i L License #:
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Address: .i City: State: Zip:
Phone: Email:
TYPE OF
WORK
New Replacement Repair RRuild Modify Space Work in R.O.W.
— _ _ _
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Description of work: (f k6 _ ( VZ_ l Oa til
PERMIT TYPE
COMMERCIAL
! New Construction Space
- ' P6412_
_Modify
Irrigation System ( _ yes / no) (_ RPZ / PVB)
_ _
�• Rain sensors required on irrigation systems
• Avg. GPM (2" turbo required unless smaller size allowed by Public Works)
Meters Call (651) 675 -5646 to verity that tests passed prior to picking up meter.
Domestic: Size & Type Fire: 1
Avg. GPM High demand devices? _ Yes No Flushometers _Yes No
COMMERCIAL FEES:
$50.50 Minimum (includes
State Surcharge) OR Contract value $ x 1%
Required
- If Permit Fee is less than
_ $ Permit Fee
on ALL new buildings and boulevard irrigation systems 4 = $ Radio Meter Read
$1,000, surcharge is $.50 = $ Meter(s)
- If Permit Fee is > $1,000,
surcharge increases by $.50 for each $1,000
a $1,001- $2,000 Permit Fee requires a $1.00 surcharge). = $ State Surcharge
$1,000 Permit Fee (i.e.
Following fees apply
Call the City's Engineering
when installing a new lawn irrigation system. $ Water Permit
Department, (651) 675 - 5646, for required fee amounts.
$ Treatment Plant
$ Water Supply & Storage
$ State Surcharge
TOTAL FEES $
City of Doi
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
Use BLUE or BLACK Ink
Permit #: / _--( ..� 74
Permit Fee:
Date Received: �U
Staff:
L
2010 COMMERCIAL PLUMBING PERMIT APPLICATION
Date: Site Address: 7" � j ii' t
Tenant: Suite #:
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454 -0002 for protection against underground utility
damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.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 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
Applicant's Printed Name
x
Applicant's Signature
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