3573 Blue Jay WayPROPERTY
OWNER
Name: S\N - M� ' Yuma.. Phone: 1 3f L..Of I SC ! (.9 '/ 73
CONTRACTOR
Name: 1 (=vhpv—.. ` \,r\S License* bk0 b 0-4 S ' (` .
Address: PAI AQ\t- Or f Cod \A' %`j \ State W \ Zip: SS 1 13
�Ciity
i m
4 1 knnC,11
Phone:(ca�J\ o1 r0 / Email: 1"er C t rilk`A‘k , C''W .. ■
TYPE OF
WORK
New Replacement ) Repair X Rebuild Modify Space Work in R.O.W.
_ _ _
Description of work: RE. `LSD T
PERMIT TYPE
COMMERCIAL
New Construction Modify Space
X Irrigation System ( _ yes / no) (A 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.
QI
Domestic: Size & Type 0 la 11 -ttr9 (.4.5- 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 Tess 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 Eaaaft
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
2010 COMM G N
Date 1 (� Site Address:
Tenant: ��e. 1 Y c
x ,�4� y` LI
Applicant's Prin d Name
P
- 8' J ,, 7 1�/6� .
ERCIAL PLUMBIN ERMIT APPUCATIO
x
Applicant'
Permit #: R(l7
Permit Fee: - -60
Date Received:
Staff:
Suite #:
Use BLUE or BLACK Ink
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. Iwww.ciopherstateonecall.orcI
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 accordan ith the approved
plan in the case of work which requires a review and approval of plans.
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� Use BLUE or BLACK Ink
Ir----------------
I For Office Use �
J • � ��.:�/�-�-� �.-
C�� O{'�1n nn i Permit#: �
� 1 liQ�all � PermitFee: C(�(1 ` �� I
3830 Pilot Knob Road �
Eagan MN 55122 j Date Received: �
Phone: (651)675-5675 I �
Fax: (651)675-5694 I Staff: �
�-----------------�
2015 COMMERCIAL PLUMBING PERMIT APPLICATION
❑ Please su mit two(2)sets of plans with all commercial applications.
Date: � Z3 /� Site Address: �� �� B�k� �ce..�, �a-�i
Tenant: Suite#:
P�tlpL�ty } I (�
Qwil#:i Name: C..{'X� �,. To �" (�-f,C �o►�.�,d� miv �o Phone:
Name:�� IV.c1t.5e w .�-v'���-t-5 License#: �����`�`�`'�
�������� " Address:���� �1 ��a-�t.Jr�e� ��City: �n)���, State:�N Zip: �/��
�� Phone: 1r51"��v�'1 "1�YB� Email: �2,�vi c..�� jc.,� lu.n.�,� , �,�. �
' _New Replacement _Repair �Rebuild _Modify Space Work in R.O.W.
T�/'�S��"�t3'C�� ' — _ ,
Description of work: �'��r�� �U �: 1 k,� ,ti5 3�7 S l�PZ �y e�.! ���'r'�d e� f�`'�"(
: COMMERCIAL New Construction Modify Space
Irrigation System(_yes/_no)(_RPZ/_PVB)
• Rain sensors required on irrigation systems
Pe�'���:T•�l� • Avg.GPM (2"turbo required unless smaller size allowed by Public Works)
Meters Call(651)675-5646 to verity that tests passed�rior to qickinq up meter.
Domestic:Size&Type Fire: 1
Avg.GPM High demand devices?_Yes_No Flushometers_Yes No
COMMERCIAL FEES Contract Value$ x.01
$60.00 Permit Fee Minimum, includes State Surcharge =$ Permit Fee �
*If contract value is GREATER than$2,010, Surcharge=Contract Value x$0.0005 =$ Succharge*
If the project valuation is over$1 million, please call for Surcharge
_$ TOTAL FEE
Following fees apply when installing a new lawn irrigation system $ Water Permit
Contact the City's Engineering Department,(651)675-5646,for required fee amounts. $ Treatment Plant
$ Water Supply&Storage
$ State Surcharge
_$ TOTAL FEE
CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. 1
I hereby acknowledge that this information is complete and accurate; that the work wi�l 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 permft, 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 plan
x �'1`t'.1��C.n IV-�/���w x " ......,.
Applicant s Printed Name Applica s Signature
: „ � ��
;:
� �
FUf����)� l�.�� Af�p��d�` _
� .. �°��' I��e �
Required'lns�aec�tsn�: '�,,,,U�s��r�ruurid:,_,.,^Rpu�t�yl�,•,,�„�„Arr�'�s# ,,,,,,,_��r�Tss� �,.,,,.���I ' P�Y�i�uired -:�'��_.hlc� . :
Mete�r Rela�ed lterr�s: M�t�r Size� �. F�ad�t� R�d , �l�n��t�r : :��... '
Page 1 of 3