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1507 Central PkwyCity of Eaali 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 qA,3 Use BLUE or BLACK Ink pitiOr Permit #: 2 -50 Permit Fee: 'J' Z Sui2Cht9ie S4C CA/ Date Received: Staff: 2009 COMMERCIAL BUILDING PERMIT APPLICATION Date: 1 DI 2A oc\ Site Address:C SO l N T R. L p P52tw A -`c. Tenant Name: (Ill L of- EA— ,j (Tenant is: New / Existing) Suite #: Former Tenant:' t4f 8L W04ret—Tett PROPERTY OWNER Name: Phone: )( S 3 2c( Address / City / Zip: Applicant is: Owner Contractor TYPE OF WORK Description of work: QE ST /� 00 r" Construction Cost: rIOQ0 P RJB LToAd S -`OA) LTOR £ 2-1 CONTRACTOR Name: GT I" A 0 A -G P-, (Qo ) License #: Address: 35-6 1 Ldp 1 dk"' City: t%A State: M N Zip: 56(T2- Phone: StZZ Phone: C S 2,-`1 Contact Person: T P L 6 Q -A-146 ARCHITECT / ENGINEER pg -M11-1174 I.rb Name: AN o P- L�-i-o��Jie Es Address: jO 1 M MN ITDgA P VE- '5 - Registration #: 14 ft �J City: WM/7_,A-ri1/4 Phone: C 2_ i S - State: M N • Zip: 55311 Contact Person: AIU Licensed plumber installing new sewer/water service: %U 115G14 VIL LE, CO-- Phone #: %%3 " 4q7• 414z- OTE: 142 OTE: Plans and supporting documents that you submit are considered to be publi!cinformation. P he information may be classified as non-public if you provide specific reasons that would permit t conclude that they are trade secrets. 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 underst permit; that the work will be in accordance x i_. C7 ( ikH am Applicant's Printed Name tljizjsA t a permit, but, my an application for a permit, and work is not to start without a rt -e0 jia`n)tll case of whicvires a review and approval of plans. pk OCT 2.1 ietri x Applicant's Signature Page 1 of 3 DO NOT WRITE BELOW THIS LINE SUB TYPES Foundation Apartments Lodging Miscellaneous WORK TYPES ✓ New Addition Alteration Replace Retaining Wall / Public Facility Commercial / Industrial _ Greenhouse / Tent Antennae Interior Improvement Exterior Improvement Repair Water Damage DESCRIPTION Valuation Lube--. f1P-v1 Plan Review tib leo% Census Code # of Units # of Buildings Type of Construction V • P� O REQUIRED INSPECTIONS ✓ Footings (New Building) Footings (Deck) Footings (Addition) Foundation Drain Tile Occupancy Code Edition Zoning Stories Square Feet Length Width Accessory Building Exterior Alteration -Apartments Exterior Alteration -Commercial Exterior Alteration -Public Facility Siding _ Demolish Building* Reroof Demolish Interior Windows Demolish Foundation Fire Repair Salon Owner Change *Demolition of entire building — give PCA handout to applicant ft -3 `''1 2vo7 Nt RG 7Y 1 2`553 / Roof: _Decking ,Insulation i Ice & Water `'Final v Framing Fireplace: _Rough In _Air Test Final VI Insulation Meter Size: Final CIO Inspection: Schedule Fire Marshal to be present: Reviewed By: (.e1144. , Building Inspector MCES System SAC Units City Water Booster Pump PRV Fire Sprinklers Sheetrock Final / C.O. Required Final / No C.O. Required HVAC Other: Pool: _Footings _Air/Gas Tests _Final Siding: _Stucco Lath _Stone Lath _Brick Windows Retaining Wall Erosion Control Yes '/No Reviewed By: kf-.4<fI 1 Planning COMMERCIAL FEES Base Fee Surcharge (37 •SD Plan Review 0 • DO MCES SAC g' a of . e--6 City SAC S&W Permit & Surcharge Treatment Plant Treatment Plant (Irrigation) Park Dedication Trail Dedication 0.DD Water Quality to. e 0 O•SD Water Quality Water Supply & Storage (WAC) Storm Sewer Trunk Sewer Trunk Water Trunk Street Lateral Street Water Lateral Other: TOTAL4 /' Page2of3 Metropolitan Council November 10, 2009 VIM 162009 Dale Schoeppner Building Official City of Eagan 3830 Pilot Knob Road Eagan, MN 55122 Environmental Services Dear Mr. Schoeppner: The Metropolitan Council Environmental Services (MCES) Division has determined SAC for the Central Park building to be located at 1501 Central Pkwy within the City of Eagan. This project should be charged 4 SAC Units, as determined below. SAC Units Charges: Park Building 61 f.u. @ 17 f.u./SAC Unit 3.59 or 4 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. Please keep in mind that on January 1, 2010 our SAC credit rules will change. If you have any questions, call me at 651-602-1118 or email karon.cappaert@metc.state.mn.us. Sincerely, CAA. (IVA /704 Karon Cappaert SAC Technician Environmental Services Division KC:kb: 091110A9 Determination expiration: November 10, 2011 cc: J. Nye, MCES Peggy Fleck, Eagan Paul Graham, Eagan (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 X1 7 303 41,11/ City of kali demo TO: Scott Peterson, Building Inspections Peggy Fleck, Community Development Jon Hohenstein, Community Development Mike Ridley, Planning Dale Wegleitner, Fire Marshal Tom Colbert, Engineering John Gorder, Engineering Dave Westermayer, Engineering Leon Weiland, Engineering Tom Struve, Maintenance Eric Macbeth, Maintenance Gregg Hove, Maintenance Wayne Schwanz, Utilities Jim McDonald, Police Department Mark Anderson, Electrical Inspector FROM: Craig Novaczyk, Senior Building Inspector DATE: 10/29/2009 RE: Plan Review For: Cit roject ('"67 entral Pkwy Restroom/Pavilion Bldg The plans are in our plan review section for your review and comment. # 25 Please return this form to my attention with your signed comments within 7 days. Please indicate any concerns you have with these plans and resolve these issues with the affected parties. If you are requesting that issuance of the building permit be held, please submit the proper "hold request" form to me. Comments: Indicate below any fees that are to be collected with the building permit. Amount ❑ Yes ❑ No ❑ Yes ❑ No O Yes ❑ No ❑ Yes ❑ No O Yes 0 No ❑ Yes 0 No Landscape Security Required Zoning: Water Quality Dedication Meter Size: Park Dedication Trail Dedication Tree Dedication PRV Required Signature Date G:\Building Inspections\FORMS\Commercial Bldgs Final & Plan Review Letters 9a ‘* City of kali MeMo TO: Scott Peterson, Building Inspections Peggy Fleck, Community Development Jon Hohenstein, Community Development Mike Ridley, Planning Dale Wegleitner, Fire Marshal Tom Colbert, Engineering John Gorder, Engineering Dave Westermayer, Engineering Leon Weiland, Engineering Tom Struve, Maintenance Eric Macbeth, Maintenance Gregg Hove, Maintenance Wayne Schwanz, Utilities lectrica sector FROM: Craig Novaczyk, Senior Building Inspector DA RE: Plan Review For: Cit Central Pkwy estroom/Pavilion Bldg 1501 # 25 The plans are in our plan review section for your review and comment. Please return this form to my attention with your signed comments within 7 days. Please indicate any concerns you have with these plans and resolve these issues with the affected parties. If you are requesting that issuance of the building permit be held, please submit the proper "hold request" form to me. Comments: Indicate below any fees that are to be collected with the building permit. Amount ❑ Yes D No D Yes ❑ No ❑ Yes 0 No O Yes 0 No O Yes 0 No ❑ Yes 0 No Landscape Security Required Zoning: Water Quality Dedication Meter Size: Park Dedication Trail Dedication Tree Dedication PRV Required e mai Date G:\Building Inspections\FORMS\Commercial Bldgs Final & Plan Review Letters 411,1/ City of Eagan memo TO: Scott Peterson, Building Inspections Peggy Fleck, Community Development Jon Hohenstein, Community Development Mike Ridley, Planning Dale Wegleitner, Fire Marshal Tom Colbert, Engineering John Gorder, Engineering Dave Westermayer, Engineering Leon Weiland, Engineering Tom Struve, Maintenance Eric Macbeth, Maintenance Gregg Hove, Maintenance Wayne Schwanz, Utilities Jim McDonald, Police Department Mark Anderson, Electrical Inspector FROM: Craig Novaczyk, Senior Building Inspector DATE: 10/29/2009 lSO 1 RE: Plan Review For: C. Pr Central Pkwy estroom/Pavilion Bldg The plans are in our plan review section for your review and comment. # 25 30 Please return this form to my attention with your signed comments within 7 days. Please indicate any concerns you have with these plans and resolve these issues with the affected parties. If you are requesting that issuance of the building permit be held, please submit the proper "hold request" form to me. Comments: 11 5i be r•e./lc l cz,--r 9 Lt / ,[ it t pCs. re -r ker i c % at C ', tr'a c.t ( 9 - 2 3. Indicate below any fees that are to be collected with the building permit. Amount 111 No Landscape Security Required Zoning: ❑ No Water Quality Dedication Meter Size: O No Park Dedication ❑ Yes ❑ Yes ❑ Yes ❑ Yes ❑ Yes ❑ Yes O No Trail Dedication O No Tree Dedication Eallo PRV Required Si nature Date G:\Building Inspections\FORMS\Commercial Bldgs Final & Plan Review Letters City of Eagan TO: Scott Peterson, Building Inspections Peggy Fleck, Community Development Jon Hohenstein, Community Development Mike Ridley, Planning Dale Wegleitner, Fire Marshal Tom Colbert, Engineering John Gorder, Engineering Dave Westermayer, Engineering Leon Weiland, Engineering Tom Struve, Maintenance Eric Macbeth, Maintenance Gregg Hove, Maintenance Wayne Schwanz, Utilities Jim McDonald, Police Department Mark Anderson, Electrical Inspector FROM: Craig Novaczyk, Senior Building Inspector DATE: 10/29/2009 RE: Plan Review For: Cit Pro'e Central Pkwy estroom/Pavilion Bldg The plans are in our plan review section for your review and comment. 1507 # 25 92 Please return this form to my attention with your signed comments within 7 days. Please indicate any concerns you have with these plans and resolve these issues with the affected parties. If you are requesting that issuance of the building permit be held, please submit the proper "hold request" form to me. Comments: Indicate below any fees that are to be collected with the building permit. Amount ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes 0 No ❑ Yes 0 No ❑ Yes No ❑ Yes ❑ No Signature Landscape Security Required Zoning: Water Quality Dedication Meter Size: Park Dedication Trail Dedication Tree Dedication PRV Required il- it -or Date G:\Building Inspections\FORMS\Commercial Bldgs Final & Plan Review Letters i 4 I! ok CityofEa�au TO: Scott Peterson, Building Inspections Peggy Fleck, Community Development Jon Hohenstein, Community Development Mike Ridley, Planning Dale Wegleitner, Fire Marshal Tom Colbert, Engineering John Gorder, Engineering Dave Westermayer, Engineering Leon Weiland, Engineering Tom Struve, Maintenance Eric Macbeth, Maintenance Gregg Hove, Maintenance Wayne Schwanz, Utilities Jim McDonald, Police Department Mark Anderson, Electrical Inspector FROM: Craig Novaczyk, Senior Building Inspector DATE: 10/29/2009 RE: Plan Review For: /501 Central Pkwy Restroom/Pavilion Bldg # 25 q The plans are in our plan review section for your review and comment. Please return this form to my attention with your signed comments within 7 days. Please indicate any concerns you have with these plans and resolve these issues with the affected parties. If you are requesting that issuance of the building permit be held, please submit the proper "hold request" form to me. Comments: Indicate below any fees that are to be collected with the building permit. Amount Landscape Security Required Zoning: Water Quality Dedication Meter Size: Park Dedication ❑ Yes ❑ ,No ❑ Yes No ❑ Yes No ❑ Yes 0 No ❑ ❑ No Yep 0 No Sign -sere Trail Dedication Tree Dedication PRV Req Date IV/ 3 /0 G:\Building Inspections\FORMS\Commercial Bldgs Final & Plan Review Letters 1,/ City of Evan TO: Scott Peterson, Building Inspections Peggy Fleck, Community Development Jon Hohenstein, Community Development Mike Ridley, Planning Dale Wegleitner, Fire Marshal Tom Colbert, Engineering John Gorder, Engineering Dave Westermayer, Engineering Leon Weiland, Engineering Tom Struve, Maintenance Eric Macbeth, Maintenance Gregg Hove, Maintenance Wayne Schwanz, Utilities Jim McDonald, Police Department Mark Anderson, Electrical Inspector FROM: Craig Novaczyk, Senior Building Inspector DATE: 10/29/2009 RE: Plan Review For: Pro' i ► Central Pkwy estroom/Pavilion Bldg f,7 # 25 The plans are in our plan review section for your review and comment. Please return this form to my attention with your signed comments within 7 days. Please indicate any concerns you have with these plans and resolve these issues with the affected parties. If you are requesting that issuance of the building permit be held, please submit the proper "hold request" form to me. Comments: Indicate below any fees that are to be collected with the building permit. Amount ❑ Yes ❑ No Landscape Security Required ❑ Yes ❑ No Water Quality Dedication ❑ Yes 0 No Park Dedication O Yes 0 No Trail Dedication O Yes 0 No Tree Dedication O Yes 0 No PRV Required l Zoning: ID Meter Size: Signature Date • G:\Building Inspections\FORMS\Commercial Bldgs Final & Plan Review Letters 3115 RECEIVED NOV 0 3 2009 1 1 D & S Cement Company, Inc. 8090 Bagley Avenue, Northfield, MN, 55057 Email: dnscement c@earthlink.net Ph. (507) 663-1294 Fax (507) 663-1295 Web: www.DandSCementCompany.com 09/29/2010 To: City of Eagan Attn: Paul Graham 3501 Coachman Point Eagan, MN 55155-1810 (567 al Grounds Pavilion Central Parkway agan, MN The concrete columns installed around the pavilion posts were installed per the structural plans. There are 4- # 6 rebar bent into the footing and # 3 ties at 10" tied to the vertical dowels. Sorry for the mix up, with the anchor bolts already in the footings the guys didn't think about needing an inspection for the piers. Please call with any questions. Mick Scofield D & S Cement Company, Inc. 8091 Bagley Avenue Northfield, MN 55057 507-663-1294 ENGINEERING TESTING, IC; CONSULTANTS * ENVIRONMENTAL • GEOTECFI11CAL • MATERIALS • FORENSICS QT7:l3 REPORT OF SOIL DENSITY TESTING PROJECT: PARK BUILDING C Y CONTRACT No. 09-23 ENTRAL PARKWAY AN, MINNESOTA 507 AET JOB NO: 20-09496 REPORTED TO: CITY OF EAGAN 3830 PILOT KNOB ROAD EAGAN, MN 55122 ATTN: 1 w egenerCdlcityofeagan. com DATE: NOVEMBER 30, 2009 SCOPE This report concerns the aggregate base compaction and moisture testing we performed for the referenced project. The scope of work pertinent to this report was specifically limited to the following: • Perform 4 soil density tests in fill placed below the bike trail and in the park building. • Perform Standard Proctor tests for each type of soil encountered at our test locations. • Determine the compaction level at each test location, and compare the results to the compaction levels required by the project specifications. • Present the results of our services in a formal report. All tests were performed in general accordance with the applicable ASTM methods which are indicated on the attached test data sheets. TEST. RESULTS The results of our tests indicate the specified compaction levels were met or exceeded in the fill within the park building, at the locations and elevations tested. The result of the test below the bike trail did not satisfy project specifications. REMARKS, Our testing was performed on a will -call basis. This level of involvement by AET relies on others to control the filling and compaction processes used. As such, AET cannot comment on the uniformity of the lift thicknesses, the material types used, the moisture conditioning of the till, or the compactive effort used to compact the fill. The tests only provide the compaction and soil type data for the specific locations and elevations tested. 550 Cleveland Avenue North j t. Paul; MN 551141 Phone 651-659-9001 !Toil Free Thi n yczm t sh .i .7. be ,,,protiur. -972-6364 j Fax 651-559-1379 lwww.amen test.co tul , rtr}L:)t written apprQ di tT.. trTIWrIC if":EI', neerrfi7 Te IERICAN ENGINEERING TESTING. INC. REPORT F ENSITY TESTS CONSULTANTS • ENVIRONMENTAL • GEOTECHNICAL • MATERIALS • FORENSICS PROJECT: REPORTED TO: PARK BUILDING CITY OF EAGAN CONTRACT NO. 09-23 3830 PILOT KNOB ROAD ENTRAL PARKWAY EAGAN, MN 55122 GAN, MINNESOTA (5c1 AET PROJECT NO.: 20-09496 FIELD DENSITY TEST DATA ATTN: lwegener(cityofeagan.com DATE: NOVEMBER 25, 2009 Test Depth Below Dry Moist:, Test Test Existing Density Content Proctor Percent No. late Test a 'on •Depth/ Q,rade (pen (*A) MI. Compaction $pees. EIev 1 11/10/09 Watermain backfill under bike 3'z* 'IA' 117'.4 10.6 1 89'%** 95 trail; 20E of water valve 11/10/09 Park building pad fill; ION & 96)/2 W 107 4.3`` 2 95 95 15E of SW building corner 11110!09 Park building pad fill; 5'N & 98 '/z' 108 11,7 2 96 95 20E of SW building corner 11/10/09 Park building pad Fill; 15'S & 981A W 111'4 93 2 99 95 10'W of NE building corner Method: Sand Cone (ASTM D1556, AET #20 -SOI -1) Nuclear (ASTM D2922, AET #20 -SOI -2) 3C *Depth (f) below subgrade elevation **Test result below project specifications. levetand Avenue North 1St. Pa Frye $04-972-53641'Fax 651-659-137 :'a_pr;d icedexcept in full arrtonglt:t.corn IAA/EE0 ^..an Er ine no Testinr1. {iEr.... g? 3o3 AET Project No. 20-09496 Page 2 of 2 LABORATORY MOISTURE -DENSITY RELATIONS OF SOILS (PROCTOR) Soil Description Silty sand with a little gravel, fine to medium grained, brown (SM) Sand, mostly medium grained, brown (SP) Max. Dry Gravel Test Opt. Moisture Density Content (%) Method Content (%) 9.8 131.0 16.6 112.8 Procedure & Method: Standard (ASTM D698, AET #20 -SOI -3) X Modified (ASTM DI 557, AET #20 -SOI -4) To protect the addressee, the public, and ourselves, this report (and all supporting information) is provided for the addressee's own use. No representations are made to parties other than the addressee. Reviewed By: American Engineering Testing, I Mi ' =el P. McCarthy, PE Principal Engineer/Division Man A AMERICAN ENGINEERING TESTING, INC. November 19, 2009 Eagan Parks 3501 Coachman Point Eagan, Minnesota 55122 Attn: Mr. Paul Graham RE: Supplemental Geotechnical Review Park Service Building Eagan, Minnesota AET Project No. 20-09276 Dear Mr. Graham: CONSULTANTS • ENVIRONMENTAL • GEOTECHNICAL • MATERIALS • FORENSICS REVIEWED PLANS MUST REMAIN ON JOB SITE 1507 C i i'CP#L W l EAGAN By. REVIEWED DATE. II/7iYOIBUILDING IN PEONS DIVISIO Following our discussion on November 18, 2009, we have prepared this addendum to our original report dated September 22, 2009 (AET Project No. 20-09276). We are submitting two copies of this report to you and one copy to J. Andre LaTondresse at JAL Architects. Project Information The project consists of a new unheated service building for restrooms and storage. This will be a single story, slab -on -grade structure of masonry construction. The roof will extend out over open-air portions and will be supported on the building and exterior columns. At the time of our original report, the building was planned to be supported on conventional frost footings. You are now planning to support the building on a thickened -edge slab; the exterior columns would still extend to below frost depth. It is our understanding that the building pad area was recently excavated to about 5 feet below grade and backfilled with imported non frost susceptible sand. Although we performed some density testing on the new fill, we did not document the excavation oversize. You indicated that the excavation typically extended about 2 feet outside the perimeter of the building. Supplemental Recommendations In our opinion, the building can be supported on a thickened edge slab provided some additional lateral oversizing is done to replace site soils with non frost susceptible sand. The oversizing should include stripping/subcutting the existing soil to a depth of at least 5 feet below proposed finished floor elevation. The lateral zone of stripping/subcutting should be extended horizontally at least 1 foot from the outside edges of the slab for every foot of fill required below the base of the slab (1:1 lateral oversize). This lateral oversize should be measured at the base of the excavation. 550 Cleveland Avenue North 1St. Paul, MN 55114 Phone 651-659-9001 1 Tolt Free 800-972-6364 Fax 651-659-1379 I www.amengtest.com IAA/EEO This document shall not be reproduced, except in full, without written approval from American Engineering Testing, Inc. G 4,111, "1 Park Service Building AET Project No. 20-09276 November 19, 2009 Page 2 of 2 We recommend using only granular soil with less than 5% passing the No. 200 sieve and less than 40% passing the No. 40 sieve as new fill. The building pad fill should be placed in thin lifts, compacted to at least 95% of the maximum Standard Proctor dry density (ASTM: D698). The fill should be placed in lifts thin enough to attain the specified compaction level throughout the entire lift thickness. We recommend the subcutting be observed by a geotechnical engineer to verify adequate oversizing. Soil density , testing should also be performed on new fill placed at the site to document that our recommendations and the specifications for compaction have been satisfied. We recommend that the ground surface around the building be sloped away from the structures to promote surface runoff and reduce infiltration into the sand fill. The roof drainage system should be designed to discharge away from the building. Limitations Within the limitations of scope, budget, and schedule, we have endeavored to perform our services according to generally accepted geotechnical engineering practices at this time and location. Other than this, no warranty, either express or implied, is intended. Closure If you have questions regarding this addendum, please contact us. Report Prepared by: American Engineering Testing, Inc. y P. Brekke, P.E. Staff Engineer II MN Lic. #25631 jbrekke@amengtest.com Report Reviewed by: American Engineering Testing, Inc. K `L, R. Anderson, P.E. ff Engineer II 9303 A AMERICAN ENGINEERING TESTING, INC. November 20, 2009 Eagan Parks 3501 Coachman Point Eagan, Minnesota 55122 Attn: Mr. Paul Graham RE: Supplemental Geotechnical Review Park Service Building Eagan, Minnesota AET Project No. 20-09276 Dear Mr. Graham: CONSULTANTS • ENVIRONMENTAL • GEOTECHNICAL • MATERIALS • FORENSICS You indicated that there was some concern with differential settlement between the columns and building. For the revised building plans (with the building supported on a thickened -edge slab over compacted sand fill and the exterior columns at frost depth) we estimate differential settlement would not exceed "A inch. We trust this provides you with the information requested. If you have any further questions regarding our services performed at the site, you can contact me at (651) 789-4645. Sincerely, American Engineering Testing, Inc. id4 Jay P. Brekke, P.E. Project Engineer jbrekke@amengtest.com EAGAN E61EWED DATE: -- BUILDING INSPECTIONS DIVISION REVIEWED PLANS MUST REMAIN ON JOB SITE 550 Cleveland Avenue North 1St. Paul, MN 55114 Phone 651-659-9001 IToll Free 800-972-6364 IFax 651-659-1379 Iwww.amengtest.com IAA/EEO This document shall not be reproduced, except in full, without written approval from American Engineering Testing, Inc. ?IV 9? 303 AET Project No. 20-09496 - Page 2 of 2 Our services for this project have been conducted to those standards considered normal for services of this type at this time and location. Other than this, no warranty, either express or implied, is intended. American Engineering Testing, Inc. Cityofaafl 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink Permit #: Permit Fee: Date Received: Staff: 2010 COMMERCIAL PLUMBING PERMIT APPLICATION Date: / — /Q Site Address: /50 / (1,6.411#71- Y Q 3/ p Tenant: �,�A/��P<JL %'.�iP/(' FES'✓"fi L /A F«Y 11`.°4/ Suite #: PROPERTY OWNER Name: err- Otc 6,i 4A/ Phone: CONTRACTOR Name: L✓ef'CL"/'/c v7.3( /7468 LLC cense #: (903:5'5.0914 Address: / 7/0 6h069 J ,A0 City: e, 4761,4A/ State: /14Zip: 65/Z Phone: f e - T/37 Email: C ' c4J &/S' W.°P41,, Co # TYPE OF WORK X New _ Replacement _ Repair _ Rebuild _Modify Space _ Work in R.O.W. Description of work: PERMITCOMMERCIA4, TYPE - jr 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 — //Z 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% = $ Permit Fee Required on ALL new buildings and boulevard irrigation systems 3 = $ Radio Meter Read - If Permit Fee is Tess than $1,000, surcharge is $.50 = $ Meter(s) - If Permit Fee is > $1,000, surcharge increases by $.50 for each $1,000 $1,000 Permit Fee (i.e. a $1,001-$2,000 Permit Fee requires a $1.00 surcharge). = $ State Surcharge Following fees apply when installing a new lawn irrigation system. $ Water Permit Call the City's Engineering Department, (651) 675-5646, for required fee amounts. $ Treatment Plant ECIEVS $ Water Supply & Storage 1 2010 $ State Surcharge FSP 1 3 AR 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.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 per ; that the work will be in accordance with the approved plan in th se of work which requires a review and approval of plans. - X ez /V./de/s Applicants Printed Name FORK OFFICE USE' .equired Inspections r rider Groun• -` ough- nl pprovec x Applicant's Signature est Final PRV Required: Page 1 of 3