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1001 Station TrCity atEapu lJUN 01 RECD I ck--i. u0El Use BLUE or BLACK Ink Permit #: Permit Fee: 3830 Pilot Knob Road Eagan M N 55122 &mac ` e� 4-0 9 Date Received: Phone: (651) 675-5675 tp4AAAA Fax: (651) 675-5694 A i%l7s JZR (-ti 15 0i1-1-1 Oki/16d, Staff: 2010 FIRE SUPPRESSION YSTEMS PERMIT APPLICATION* Date: 5/e2C410 Site Address: 1001 STATi otJ TRA\ .. , EM443 MPJ Tenant: Suite #: J PROPERTY OWNER Name: GIT`{ OF EALtAAt.) Phone: Address / City / Zip: 3 3O (tLo`r KNOPa (t.0a0, l k`44.1,M1.1 Applicant is: Owner )( Contractor TYPE OF WORK Description of work: Flag SPR►Nt A- fat-- e4et..l AANoc..- sAFEW Construction Cost: 18)960. oU Estimated Completion Date: a'/I )1 t CONTRACTOR Name: 60P-HP4J` (l Et..\ itAAFCj.1Ahiii Mc License #: CO3S Address: &Vt BAST F6 =s -i" AVsNCity: JfitRA,. State: AN Zip: i Phone: -c`t9 -Aped Contact: &r PD LR�Stj Email: c--kc...csen2.gee`Ka.nn_olen.ca-N� FIRE PERMIT TYPE Sprinkler System (# of heads Standpipe WORK TYPE ,&New Fire Pump _Addition _Alterations _Remodel _ _ Other: Other: _ DESCRIPTION OF WORK: Commercial Residential Educational ,)L _ _ FEES $50.50 Minimum (includes State Surcharge) OR surcharge is $.50. increases by $.50 for each Permit Fee requires a $1.00 surcharge). Contract Value $ 1$, go x 1% - If Permit FAQ is Tess than $1,000, _ $ Permit Fee = $ —v State Surcharge - If Permit Fee is > $1,000, surcharge $1,000 Permit Fee (i.e. a $1,001-$2,000 $ TOTAL FEE 3/4" Displacement Fire Meter - $203.00 ^ $ . ---0 Fire Meter 9 rC9 22% TOTAL FEE equirements: 2 complete sets of drawings and specifications, cut sheets on materials and components to be used 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 o. th derstand 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 approved plan in the case of work which requires a review and approval of plans. x t1-1Ab UAP—Ssi Applicant's Printed Name App icant's Signature /00/ SiSf16/* CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utilitydamage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.aopherstateonecall.org FOR OFFICE USE REQUIRED INSPECTIONS Hydrostatic Trip Conditions of 1ssuanee: Permit Reviewed ta; 07/21/2010 WED 14:48 FAX 2184444505 Peterson Sheet Metal 1004/004 C!ty of Eaau 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 rJUL21REesg Use BLUE or BLACK Ink F0t•. ceUse Permit #: Permit Fee: Q Date Received: Staff: 2010 MECHANICAL PERMIT APPLICATION Date: 717-1110 Site Address: 100 t �' �f (� - �177t i E ac Gt n AA) Suite #: Tenant: PV S RESIDENT 1 OWNER Name: Ct 0,i-4 in Phone: Address / City 1 Zip: CONTRACTOR Name: Pe4 ed.So i 5111 . hie 4. ( License #: 1 ( � Address: Jit- genes 41 . A-vc N City: gc�r►�i1 �r S : tai l State: M---0� Zip: s{,C,0( phone: 2(8 "`7s'1''�. V y" 4-`"// Contact: c IQSO�?Tici11 P---- Email: Gfon «r / ,re 6€rn TYPE OF WORK New Replacement Additional _ Alteration Demolition Description of work: f\JeW LUQ 91,:c.>-(-.. f NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened by City Code. Please contact the Mechanical Inspector for information on permitted screening methods. PERMIT TYPE RESIDENTIAL.. . ... Furnace Co . u ti.. . COMMERCIAL. _ New Construction Interior Improvement X New Air Conditioner Install Piping _ Processed Air Exchanger Gas____.. Exterior HVAC Unit Heat Pump _ Under / Above ground Tank (_ Install / _ Remove) Other **When installing/removing tank(s), call for inspection by Fire Marshal and Plumbing Inspector RESIDENTIAL FEES: $50.50 Minimum Add-on or alteration to an existing unit (includes burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) $.50 State Surcharge) $ TOTAL FEE $90.50 Fire repair (replace COMMERCIAL FEES: $70.50 Underground tank $50.50 Minimum (includes installation/removal OR State Surcharge) surcharge is $.50. increases by $.50 for each Permit Fee requires a $1.00 surcharge). Contract Value $ '37) 000rO0 x 1% $ 3) .7, 0.00 Permit Fee - If Permit Fee is Tess than $1,000, = $ 3-' fo) Surcharge - If Permit Fee is > $1,000, surcharge $1,000 Permit Fee (i.e. a $1,001-$2,000 = $ 1I 1,,00 TOTAL FEE CALL BEFORE YOU DIG. Call Gopher State One Call at (851) 454-0002 for protection against underground utility damage. Cali 48 hours before you intend to dig to receive locates of underground utilities, wwwoherstateonecalt.or 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. �-t x `1 ASo v cA (I xLam'\ Applicant's Prin d Name Appant's Signa fire FOR OFFICE USE Reviewed Sy: h 1 Date: Required Inspections: , Under Groundough In _Air Test \4Gas Service Test In -floor Heat01 Finai Exterior HVAC Screening Inspection Receipt#: 93476 ABSTRACT FEE $46.00 Return to: SEVERSON SHELDON DOUGHERTY ETAL 7300 WEST 147TH STREET STE 600 APPLE VALLEY, MN 55124 ec►tM P cIAUL Iv 0400 ora a,5 2727133 Recorded on: 4/28 2010 12:00:01 PM By: DDW, Deputy Joel T. Beckman County Recorder Dakota County, MN DRAINAGE AND UTILITY AND TEMPORARY CONSTRUCTION EASEMENT THIS DRAINAGE AND UTILITY AND TEMPORARY CONS 'RUCTION EASEMENT is made this /7 day of A "re / , 2010, between RAHN FAMILY LIMITED PARTNERSHIP, a Minnesota limited partnership, (hereinafter referred to as "Landowner"), and the CITY OF EAGAN, a municipal corporation, organized under the laws of the State of Minnesota, (hereinafter referred to as the "City"). WITNES SETH: That the Landowner, in consideration of the sum of One Dollar ($1.00) and other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, does hereby grant and convey unto the City, its successors and assigns, a permanent drainage and utility easements and temporary construction easements over, under and across the following described premises, situated within Dakota County, Minnesota, to -wit: A 20.00 foot permanent drainage and utility easement and a 60.00 foot temporary construction easement, the centerline of which is described as follows: Beginning at the Southwest Corner of Lot 1, Block 1, Eagan Fire Station No. 2, thence North 52 degrees 13 minutes 48 seconds West a distance of 23.73 feet, thence North 79 degrees 20 minutes 46 seconds West a distance of 163.50 feet and there terminating. TOGETHER WITH: A 20.00 foot permanent drainage and utility easement and a 80.00 foot temporary construction easement, the centerline of which is described as follows: Commencing at the Southwest Corner of Lot 1, Block 1, Eagan Fire Station No. 2, thence South 0 degrees 29 minutes 59 Seconds a distance of 60.01 feet, thence South 89 degrees 37 minutes 50 Seconds East a distance of 438.00 feet .to the point of beginning, thence South 0 degrees 08 minutes 06 seconds West a distance of 147.00 feet, thence South 44 degrees 22 minutes 41 seconds East a distance of 61.06 to a point on the west right-of-way of Wescott Woodlands and there terminating. See also Exhibit "A" attached hereto and incorporated herein. All temporary construction easements to expire on January 1, 2011. The grant of the foregoing permanent easements for drainage and utility purposes includes the right of the City, its contractors, agents and servants to enter upon the premises at all reasonable times to construct, reconstruct, inspect, repair and maintain pipes, conduits and mains; and the further right to remove trees, brush, undergrowth and other obstructions. After completion of such construction, maintenance, repair or removal, the City shall restore the premises to the condition in which it was found prior to the commencement of such actions, save only for the necessary removal of trees, brush, undergrowth and other obstructions. The grant of the foregoing temporary construction easements for site grading purposes includes the right of the City, its contractors, agents and servants to enter upon the premises at all reasonable times to construct, reconstruct and inspect site grading and the further right to remove trees, brush, undergrowth and other obstructions. After completion of such construction, maintenance, repair or removal, the City shall restore the premises to the condition in which it was found prior to the commencement of such actions, save only for the necessary removal of trees, brush, undergrowth and other obstructions, subject only to permanent easement alterations. And the Landowner, its successors and assigns, does covenant with the City, its successors and assigns, that it is the Landowner of the premises aforesaid and has good right to grant and convey the easement herein to the City. IN TESTIMONY WHEREOF, the Landowner has caused this easement to be executed as of the day and year first above written. RAHN FAMILY LIMITED PARTNERSHIP, a Minnesota limited partnership 2 STATE OF /4 ) )ss. COUNTY OF ,DA0-6?4 ) The foregoing instrument was acknowledged before me this /V day of /TPX/ t. , 2010, by/1 0440A• `.."1/71.-1), the �2- P. Ge�-L�c-Q._ rof RA FAMILY LIMITED PARTNERSHIP, a Minnesota limited partnership, on behalf of the limited partnership. iwwwwwvvvvvvvvvvvvyvvvvyvvvvy RICHARD J. GABRIEL } Notary Public -Minnesota My Commission Expires Jan 31, 2015 APPROVED AS TO FORM: City Attorney's Office Dated: '06 /(a APPROVED AS TO CONTENT: ,4y4 Pu is Works Department Dated: (4.1 THIS INSTRUMENT WAS DRAFTED BY: SEVERSON, SHELDON, DOUGHERTY & MOLENDA, P.A. 7300 West 147th Street, Suite 600 Apple Valley MN 55124 (952) 432-3136 (RBB: 206-29816) Easement No. 1216 3 Station Campus Ease.ptlf 20.0' DRAINAGE & UTILITY EASEMENT 60.0' TEMPORARY CONSTRUCTION EASEMENT ( Descriptionl) Alt Or oI YANKEE DOODLE ROAD 163.50' N 79°20'46" W i 23.73' N 52°13'48" W — — 438.0' N 89°37'50" W — — 10-01400-012-25 Permanent drainage and utility easements and temporary construction easements over, under and across the following property, situated within Dakota County, Minnesota: The East 1/2 of the Northwest 1/4 of Section 14, Township 27, Range 23, except the Carriage Hills Club House Addition and except the North 499.00 feet of the East 508.64 feet of the Northeast 1/4 of the Northwest 1/4 of said Section 14. Easement Description 1: A 20.00 foot permanent drainage and utility easement and a 60.00 foot temporary construction easement, the centerline of which is described as follows: Beginning at the Southwest Corner of Lot 1, Block 1, Eagan Fire Station No.2, thence North 52 degrees 13 minutes 48 seconds West a distance of 23.73 feet, thence North 79 degrees 20 minutes 46 seconds West a distance of 163.50 feet and there terminating. And, Easement Description 2: A 20.00 foot permanent drainage and utility easement and a 80.00 foot temporary construction easement, the centerline of which is described as follows: Commencing at the Southwest Corner of Lot 1, Block 1, Eagan Fire Station No. 2, thence South 0 degrees 29 Minutes 59 Seconds a distance of 60.01 feet, thence South 89 degrees 37 minutes 50 Seconds East a distance of 438.00 feet to the point of beginning, thence South 0 degrees 08 minutes 06 seconds West a distance of 147.00 feet, thence South 44 degrees 22 minutes 41 seconds East a c distance of 61.06 to a point on the west right-of-way of Wescott Woodlands and there terminating. „r Easement Description 2: A 20.00 foot permanent drainage and utility easement and a 80.00 foot temporary construction easement, the centerline of which is described as follows: All temporary construction easements to expire January 1, 2011 147.00' L S 0°08'06" W 61.06 -•."— S •�S 44°22'41" E WESCOTT WOODLANDS 20.0' DRAINAGE & UTILITY EASEMENT 80.0' TEMPORARY CONSTRUCTION EASEMENT ( Description 2) a EXHIBIT 4/9/2010 Engineering Department Drainage and Utility Easements P.I.D. 10-01400-012-25 Exhibit 1 PROPERTY OWNER r. Name: L ` v � . C- ..,rtr "� Phone: (OS I (o.--)S - jle-7 CONTRACTOR Name: VIA, I 7pn °ik, vt \PN :: - c . License #: Q 0 10 -1 <I >(Y1 Address: ?,o c..-_ - - `i :O. i tOSc City: - €. t ,wry State: r(V\ Zip: R Phone: '�I (c' ci +8) Email: "\-#."- CO, yr,, n ne n k 041 brn3 . C'On7 TYPE OF WORK New Replacement Repair Rebuild Modify Space _ Work in R.O.W. — _ _ Description of work: PERMIT TYPE COMMERCIAL New Construction Modify Space _ _ 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: 8 ^� $50.50 Minimum (includes State Surcharge) OR Contract value$ x 1% 0O Required - If Permit Fee is less than C� _ $ en Permit Fee ?'o' on ALL new buildings and boulevard irrigation systems 4 - $ Radio Meter Read , � ate, $1,000, surcharge is $.50 = $ Meter(s) tY - If Permit ege is > $1,000, surcharge increases by $.50 for each $1,000 a $1,00142,000 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 $ 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675 -5675 Fax: (651) 675 -5694 APR 27 2010 Use BLUE or BLACK Ink Permit #: Permit Fee: Date Received: Staff: 2010 COMMERCIAL PLUMBING PERMIT APPLICATION Date: Y of 'off / d Site Address: 1 U( it ` 1 (( 1 w� ( Tenant: 'a b(i Suite #: CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. CaII 48 hours before you intend to dig to receive locates of underground utilities. www.aopherstateonecall.ora 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 MI n elvokA Pc.oet'LRiRG - ("4brlat. l Applicant's Printed Name A . • 'cant's Signature 1 •q38 3 00 Ari Page 1 of 3 RESIDENT / OWNER N I Address /City /Zip: �'32 , PILOT A-no r- ZOFr5 FAGR - 0, (fl r 1 6 - , - =•l 3.. a CONTRACTOR N Name: 1(`(1 I (1 ntiOnI R r} Lv mtI.1G.. hC - License #: Address: 3a6 tJ4. t- 5_ ?O ix.Yx it 8") City: ~fir LAc'O State: ('nn Zip: J Phone: 7(0? l - cI ? I Contact: T ti1Sr7, - )£, 1 c_ .g. Email: rr a-@ rn 'roe i l I' ,,,bin, C0 TYPE OF WORK N New Replacement Additional Alteration Demolition Description of work: NO TE: Roof mounted and ground mounted mechanical equipment is required to be screened by City C ode. Please contact the Mechanical Inspector for information on permitted screening methods PERMIT TYPE F RESIDENTIAL C COMMERCIAL Air Conditioner _ Install Piping Processed Air Exchanger G _ I Heat Pump U Under / Above ground Tank ( Install / _ Remove) _ H ** When installing /removing tank(s), call for inspection by Fire RESIDENTIAL FEES: $50.50 Minimum Add -on o or alteration to an existing unit (includes $ $.50 State Surcharge) $90.50 Fire repair (replace b COMMERCIAL FEES: $70.50 Underground tank i installation /removal OR C Contract Value ' I SC, `t ! x 1% „f}� ' �J = $ 6 .O4) Permit Fee 4 - If Permit Fee is Tess than $1,000, s 4Q - If Permit Fee is > $1,000, surcharge i $1,000 Permit Fee (i.e. a $1,001 - _ $ TOTAL FEE CityorEaall Date: 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675 -5675 Fax: (651) 675 -5694 Tenant: - (/(171; A x I►'I=n4i<ra �L�M+1B1A6 - ggis11 'TJA gae1L. Applicants Printed Name APR %I 2 010 2010 MECHANICAL PERMIT APPLICATION y acQ o '0 Site Address: 1001 S i Pv O n co L.. icants Signature Reviewed By: _ Use BLUE or BLACK Ink etel c Permit #: 93 3 - - Permit Fee: /• v Date Received: Staff: (O FOR OFFICE USE Under Ground Rough In :Air Test rGas Service Test in -floor Heat Required Inspections: Exterior HVAC Screening Inspection 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.aooherstateonecall.ora 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. zrvktAsuE4 P PROPERTY OWNER` Name: e i - l'y ©4 G c4 j C. ra Phone: Address / City / Zip: 3530 Pi 104 k ii. D1, 1-C' Applicant is: X Owner Contractor TYPE OF WORK Description of work: New Pubkc f J/, 4 y Construction Cost: SF OO © ©O CONTRACTOR Name: 04 0 . , 6os. R _or License #: Address: 900 ,Pr /a4. 1c40-11 /?4 City: A a s,. S tate: MA - . 0 V - 7057 ! ri Zip: SS te /a hone:9 4:47,3 3 �"V 4 Contact: Email: ARCHITECT / ENGINEER Name: SaMot Left c-/ Registration t I4 A9 AS Address: 710C. (EX ti 41 . ' e-f City: i ✓t/I C f •`S State: Wi 1'4 Zip: C ®K Phone: 6I Z - 7C:8 "6 700 Contact Person:13, ;`c.../ 3k0 Email: b et s+ro/ 1 ' RNic , C Licensed plumber installing new sewer /water service: (i (1E-1 —g 014( Pho he # : NO TE Plans and supporting documents that you subm!t pre considered to b e p ublic !nformafron Portions of r fh information S may be classified as non - public ff y '0' rovide specific reasons that wauld perm th Cit►r fo conclude tfat.they trade secr Or 44 City of Eapll 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675 -5675 Fax: (651) 675 -5694 x Tow. GIN r5 Applicant's Printed Name Dm // Gg�/ . r Ap • icant's Signature Use BLUE or BLACK Ink Permit #: 3 Permit Fee: Date Received: Staff: 2010 COMMERCIAL BUILDING PERMIT APPLICATION Date: 1 30 1 /0 Site Address: / C7°1 s T1� MA-; t Tenant Name: Pu b lIt_ SA -Pe 4 Ce n-(.r (Tenant is: New / - sr 41 41 .16 i Existing) Suite #: Former Tenant: CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454 -0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.orq I hereby acknowledge that this information is complete and accurate; that the work will be in coriformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an ap• ' - ion 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 o work hich requires a eview and approval of plans. Page 1 of 3 /007 j--7/911/ 0l1 DO NOT WRITE BELOW THIS LINE SUB TYPES Foundation Apartments Lodging Miscellaneous WORK TYPES )New Addition Alteration Replace Retaining Wall DESCRIPTION Valuation U` ©0 add Occupancy Plan Review L4.441/A„p Code Edition (25% 100 %0) Zoning Census Code Stories # of Units Square Feet # of Buildings Length Type of Construction . 00 Width REQUIRED INSPECTIONS /1 Footings (New Building) Footings (Deck) Footings (Addition) X Foundation Drain Tile Roof: _Decking Insulation _Ice & Water Final Framing Fireplace: Rough In Air Test _Final Insulation Meter Size: COMMERCIAL FEES Base Fee Surcharge. C .n�+-a-c-o v Plan Review MCES SAC- 0- 4-tsi City SAC S &W Permit & Surcharge Treatment Plant Treatment Plant (Irrigation) Park Dedication Trail Dedication Water Quality Public Facility Commercial / Industrial Greenhouse / Tent Antennae Interior Improvement Exterior Improvement Repair Water Damage (' Jo'VE1> as / &CO . 00 WPWed (Le / 800.00 WAAva -P Accessory Building _ Exterior Alteration— Apartments _ Exterior Alteration — Commercial Exterior Alteration — Public Facility Siding Reroof Windows Fire Repair 5L .1 007 ` PtsefC. Final CIO Inspection: Schedule Fire Marshal to be present: }C Yes No Reviewed By: fiat, , Building Inspector Sheetrock Final / C.O. Required Final /No C.O. Required Other: Pool: Footings Air/Gas Tests _Final Siding: _Stucco Lath Stone Lath _Brick Windows Retaining Wall Erosion Control Water Quality Water Supply & Storage (WAC) Storm Sewer Trunk Sewer Trunk Water Trunk Street Lateral Street Water Lateral Other: *Demolition of entire building - give PCA handout to applicant MCES System SAC Units City Water Booster Pump PRV Fire Sprinklers Reviewed By: , Planning TOTAL Demolish Building* _ Demolish Interior Demolish Foundation Salon Owner Change S yes yeo Page 2 of 3 Metropolitan Council AA April 26, 2010 Dale Schoeppner Building Official City of Eagan 3830 Pilot Knob Road Eagan, MN 55122 Dear Mr. Schoeppner: The Metropolitan Councii Environmental Services (MCES) Division has determined SAC for th Safety Center to be located at roof " ,z: Trail within the City of Eagan. This project should be charged 8 SAC Units, as determined below. Sincerely, 144 on Cappaert SAC Technician Environmental Services Division tot 2414 SAC Units Environmental Services Charges: Office 2206 sq. ft. @ 2400 sq. ft. /SAC Unit 0.92 Meeting Room 3837 sq. ft. @ 1650 sq. ft. /SAC Unit 2.33 Secure Garage 13 f.u. @ 17 f.u. /SAC Unit 0.76 Storage 4196 sq. ft. @ 7000 sq. ft. /SAC Unit 0.60 Firefighers 6 people x 75 gal. /person @ 274 gal. /SAC Unit 1.64 Truck Wash 5 trucks x 3.5 gal. /truck x 20 min. @ 274 gal. /SAC Unit 1.28 Total Charge: 7.53 or 8 The business information was provided to MCES by the applicant at this time. It is the City's responsibility to substantiate the business use and size at the time of the final inspection. If there is a change in use or size, a redetermination will need to be made. If you have any quesrions, call me at 631-602-1118 or cn ail karon .cappaert @metc.state.mn.us. KC:kb: I'00426A 1 Determination expiration: April 26, 2012 cc: J. Nye, MCES Peggy Fleck, Eagan Tom Ginter, Bossardt Corp. (email) www.metrocouncil.org 390 Robert Street North • St. Paul, MN 55101 -1805 • (651) 602 -1005 • Fax (651) 602 -1477 • TTY (651) 291 -0904 An Equal Opportunity Employer From:NSI Mechanical City of Ekon 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 763 235 9811 09/11/2012 15:05 ot, C (A #262 P.001/001 Use BLUE or BLACK Ink For Office Use i Permit #: LY n Permit Fee: Date Received: Staff: 2012 MECHANICAL PERMIT APPLICATION ❑ Please submit two (2) sets of plans with all commercial applications. Date: 09/11/12 Site Address: 1001 Station Trail, Eagan, MN 55121 Tenant: Fire Station # 2 Suite #: Name: City of Eagan RESIDENT I OWNER Address/City/Zip: 3830 Pilot Knob Road Name: Horwitz NS/I Phone: 651-675-5675 License #: Address: 4401 Quebec Avenue North City: New Hope State: MN Zip: 55428 Phone: 763-533-1900 Contact: Marty Verduzco Email: mverduzco®horwitz-nsi.com _ New _ Replacement _ Additional X Alteration Demolition Description of work: Installing (5) smoke dampers NOTE: Roof mounted and ground mounted mechanical equipment is requlred;to be screened by City ,i Code. Please contact the Mechanical Inspector for information on permitted screening methods. RESIDENTIAL Fumace Air Conditioner Air Exchanger _ Heat Pump Other RESIDENTIAL FEES: $60.00 Minimum Add-on or alteration to an existing unit (includes $5,00 State Surcharge) $100.00 Fire repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) COMMERCIAL FEES: $75.00 Underground tank installation/removal (includes 55.00 State Surcharge) $60.00 Minimum (includes State Surcharge) - If the Permit Fee is Tess than $10,010, surcharge is $ 5.00 - If the Permit Fee is > 510,010, surcharge increases by $.50 for each $1,000 Permit Fee (i.e. a $10,010-$11,010 Permit Fee requires a $ 5.50 surcharge) COMMERCIAL New Construction X Interior Improvement Install Piping Gas Processed Exterior HVAC Unit Under / Above ground Tank ( Install / _ Remove) TOTAL FEE OR Contract Value $ `T 45—C..) x 1% $ Permit Fee _ $ Surcharge $ TOTAL FEE CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.orq I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. x Marty Verduzco Applicant's Printed Name x Applicant's Signature FOR OFFICE USE Required Inspections: Reviewed By: .> Date: 1 2' S. Underground _D Rough In ^ Air Test _ Gas Service Test - In -floor Heat Final HVAC Screening if 1 � tni Fsp PIsMO i,i Ex�sr. fsv iKSrqucu Emsr mg. fs» mstttae iN EnfT. %xZD KD lNsrfrccEo ill nor. /70/ZLtfirr NS/I� Marty Verduzco, LEEO® AP PROJECT MANAGER email MVERDUZCO@HORWITZ-NSI.COM direct cell 763-235-9844 612-309-2237 Fax e+ -i Nr Service 763-235-9834 763-235-9833 HEATING I REFRIGERATION 1 AIR CONDITIONING 1 SHEETMETAL (PLUMBING ilddress 4401 QUEBEC AVE. N NEW HOPE, MN 55428 City of Evan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 2012 COMMERCIAL Use BLUE or BLACK Ink For Office Use Permit #: Permit Fee: Date Received: Staff: 9. Z7 -j Z A% FIRE PERMIT APPLICATION* Date:LitiG 12 Site Address: 1001 ST TICJ TRAIL EACIAN ,MN 551 2S J Tenant: Suite #: PROPERTY OWNER Name: C I T Y ©F .PAT' Phone: Address / City / Zip: Applicant is: Owner Contractor Description of work: INSTALL, NSW 1 -lee STEM lt) S'EAVEF &cct1 Construction Cost:p CC"' QQ IO Estimated Completion Date: IO/111/I2 O Name: tCgfl LAN;) FIgE 4- ST cu IT.1? License #: TSCA; 8 57 Address: (NC L.cNE ChK. Z.I) Iiy City: EAC -0 State: MN Zip: Contact: (KAI6) jCg.I -!�U X New Addition Alterations Remodel Other: Phone: 6S I Email: C gSDAN 6 N 5 - AML CCM DESCRIPTION OF WORK: X Commercial Residential _ Educational FEES $60.00 Minimum (includes State Surcharge) OR - If the Permit Fee is less than $10,010, surcharge is $ 5.00 - If the Permit Fee is > $10,010, surcharge increases by $.50 for each $1,000 Permit Fee (i.e. a $10,010-$11,010 Permit Fee requires a $ 5.50 surcharge) Contract Value $ x 1% = $ Permit Fee = $ Surcharge = $ TOTAL FEE *Requirements: 2 complete sets of drawings and specifications, cut sheets on materials and components to be used I hereby apply for a Fire Alarm 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. x gElkr WECIAWE1<:Tl Applicant's Printed Name FOR OFFICE USE Required Inspections: Rough -1 eviewed B nal Fire Alarm Test x UkivtCn--- Applicant's Signature MINNESOTA MDH DEPARTMENT OF HEALTH Minnesota D lient of Health' Well Manage t Section 625 North Robert Street, P.O. Box 64975 St. Paul, Minnesota 55164-0975 651/201-4600 or 800/383-9808 Deaf and hard -of -hearing: TTY 651/201-5797 Vertical Heat Exchanger Location VERTICAL HEAT EXCHANGER RECORD County Name 4. U \ ck Township Name Township No. ' Range No. Section No. Frr}a/ction ' /�'', j Depth (completed) Si Date Work Completed �imiEter House Member, Street Name, City, and ZIP Code of Vertical Heat Exchanger Location MU\ `\>> (A -) (I ---r-1 (III r(L ic,� \MN\ ';55 ))-3 Hole Diameter q - Aj in. o _l '' J ft. Pip Dia 7/i/ inches in. to ft. , Show exact location of vertical heat exchanger section grid with "X." Sketch map of N installation. Show Number of Bore Holes . t Capacity (Tons) . L I pr lines, roads. 1 Pipe Material' _ .. ._ _ pHigh Density PolYethylene IIIOther h 1 v u.ldn gs, w 1 ; Type of Joint ■ Butt Fusion �- 1, P , 1 1 Mite --___________ \, Socket Fusion PROPERTY C 1 OWNER'S NAME l�� {{ V i'- ( C k t" (a , 1 Other Property owner's mailing addressk different than vertical heat exchanger location indicated above. X! I ) U- F+ 1--2( 1 �t')�n Ju`. -')9)- Type of Grout Used (Indicate Product Name) ■ Cement Sand from to ft. • Neat Cement from to ft. Bentonite from (') _ . to •-, S .!) g Thermally Enhanced Bentonite from to ft. ❑ Other from to ft. Geological Materials Color Hardness of Formation From To Type of Coolant Used (Indicate Product Name) ■ Water Propylene Glycol , 1,- f'° } % ■ Other Pressure Test of Installed Piping Test Pressure (lbs.) /c;'., Test Duration (minutes) ? !h. Contractor's Certification This vertical heat exchanger was constructed under my jurisdiction and this report is true to the best of my knowledge and belief. } (c\C Stin - Cu�jWr\ \ )/\-)C_��(.1,T T Contctor Business Name T License No. Remarks, Elevation Source of Data, etc. h -' `, (1 f Certified Representative Signature T Certification No. T Date T dame of Driller ate f Name of Heat Pump Installer (HVAC Contractor), if different (Optional) Copy for Owner origs\vert heat exchanger record MDH.doc 7/17/2009R