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1020 Diffley RdCity of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675-5675 www.ci.eagan.mn.us PERMIT Permit Type: Fireworks 411!Ilib Permit Number: EA099188 City of Elpil Date Issued: 05/24/2011 Site Address: 1020 Diffley Rd Lot: 010 Block: 01 Addition: Diffley Marketplace 2nd PID: 10-20476-01-010 Use: Cub Foods Description: Sub Type: Indoor Retail Sales Sign Permit Required: N Work Type: Legal Consumer Fireworks Tent Permit Required: N Description: Temporary Event: N Sales Dates: 05/24/2011 to 11/01/2011 Number of Days: 0 to to Comments: Fee Summary: Indoor Sales Surcharge -Fixed $100.00 $5.00 0801.4097 9001.2195 Total: $105.00 Contractor: Owner: Inland Diffley Marketplace LLC % Investors Property Tax Service PO Box 9275 Oak Brook IL 60522 - Applicant - 1 hereby acknowledge that 1 have read this application and state that the 'nformation is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. 40111 City of Eaau 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink cuo ygi8r 2011 FIREWORKS SALES AND STORAGE APPLICATION Applicant requirements 1. An application must be completed and returned at least 30 days prior to outdoor sales and/or storage of fireworks. 2. An applications for indoor sales of fireworks must be submitted between April 1st and June 1st to obtain a permit. 2. A letter from the property owner granting permission to the applicant to sell and/or store fireworks on the property shall accompany the application. 3. A floor plan designating the area where the fireworks will be sold and/or stored shall accompany the application. 4. A list of the fireworks that will be sold and/or stored along with the name, weight, quantity, and material safety data sheets (MSDS) shall be included. 5. A copy of the certificate of insurance coverage as per City of Eagan City Ordinance No. 387, Chapter 6, Section 6.53 Fireworks is required. 6 The Fire Marshal or his/her designee will inspect the proposed location for selling and/or storing fireworks to determine if it is a suitable location. 7 A criminal record check will be done on all applicants. 8. A copy of the City of Eagan license (permit) shall be displayed by the register. Date: 4- (9F5- \\ Business Name: CUB FOODS Telephone#: ( 651 ) 452-1811 Display Address: 1020 Diffley Road Applicant Name: CUB FOODS / Street Address: i C-�p (ita State:, t Zip: � j t c3 Telephone #: Retail seller selling exclusively consumer fireworks: City: yfri *51) Asa.- «11 YesNo x Indoor Sales Dates: 05/2011 to 07/07/2011 and New Years Season Outdoor Sales Dates: to to Please check the selections that apply to this permit to Outdoor Sales $415.00 X All other retail sellers $105.00 (includes: $280.00 Fireworks Permit; $128.50 Tent Permit; $6.50 State Surcharge) Sign Permit $ 25.00 Temporary outdoor event means an exhibition or sale with a duration of 10 or less continuous days which does not occur more than once every 30 days and more than three times per year or a combination of 20 days total in a calendar year. (See Outdoor Sales of Fireworks). Fireworks are regulated by MN Statutes 624.20-624.25. In addition to these state laws, all displays, sales, storage and use of fireworks shall comply with City of Eagan Ordinance No. 387, Section 6.53 Fireworks and NFPA 1124 Standards. I understand and agree to comply with all the provisions of this application and 'e - • 1,e is of the issuing authority. Applic-r ° e gna Indoor Fireworks Sales 2011 Applicant: I PF 0' FE_ Phone: (051- - l8 I 1 Sales Location Name & Address: e u B FOPJDS - 10 a0 A/FFLE Y P IJ Location within store: 99IFF X Clear background check from PD "No sales to under 18" form posted 2 ea 2-1/2 gallon pressurized fire extinguishers Two exits to the outside when required 48" minimum width display aisles 6' maximum height display of product Fireworks fuses covered or arranged out of touch X Posted list of consumer fireworks (MSDS, name, weight & quantity of fireworks)attltd4 )( Certificate of Insurance provided (minimum of $1M per claim per incident; City named as add'l insured; gen liability, property damage, bodily injury) Application Approved: Inspection Approved: Date: 65;)q- Date: ZONING: Property is zoned: Po (Allowed in: GB (retail sales), NB, CSC, PD (retail sales). No sales on R or mixed with R. SALES ONLY ON PREMISES: Retail sale of consumer fireworks shall occur only on the premises for which the permit is issued. SMOKING WITHIN 50' OF BUILDING: Smoking within 50 feet of the retail consumer fireworks sale and storage areas is prohibited. USE OF FIREWORKS WITHIN 100' OF BUILDING: No consumer fireworks shall be discharged, exploded or used within 100 feet of the building in which the consumer fireworks are being sold or stored. FIRE EXTINGUISHERS: The building in which the consumer fireworks are sold shall have at least two, 2- 1/2 gallon pressurized fire extinguishers in the area where the consumer fireworks are sold or stored in accordance with the 2000 International Fire Code. EXITS, AISLE WIDTH, PRODUCT HEIGHT: The building in which the consumer fireworks are being sold or stored shall have at least two exits to the outside and all consumer fireworks display aisles shall be a minimum width of 48 inches. The height of the consumer fireworks display shall not exceed six feet. COVERED FUSES AND PACKAGING: All consumer fireworks fuses shall be covered or arranged so fuses cannot be touched directly by a person handling the consumer fireworks without that person puncturing or tearing the package. SPRINKLER SYSTEMS & PYROTECHNIC COMPOSITION: In buildings in which consumer fireworks are sold or stored, and do not have an approved automatic sprinkler system,consumer fireworks 'sales, displays or storage shall be limited to 50 pounds net pyrotechnic composition or 200 pounds gross weight, if the pyrotechnic composition weight is unknown. In buildings with an approved automatic sprinkler system, fireworks sales, displays and storage shall be limited to 100 pounds net pyrotechnic composition or 400 pounds gross weight, if the pyrotechnic composition weight is not known. LIST OF SALES PRODUCT & MSDS: A list of all consumer fireworks displayed for sale or stored on the permitted property shall be posted in a conspicuous location near the display and storage areas. The list shall contain the name, weight and quantity of the consumer fireworks and shall be accompanied by the material safety data sheets. Upon request, samples of the consumer fireworks shall be made available to the fire chief or his/her designee for testing. NOT TRANSFERABLE: A permit granted under this subdivision shall not be transferable. BUILDING AND FIRE CODE REQUIREMENTS: The building in which retail sale consumer fireworks are permitted hereunder shall meet all applicable provisions of the State Building Code and Fire Code. EMPLOYEE ACTIONS: The permit holder shall be responsible for the actions of its employees or agents with regard to the sale of consumer fireworks on the licensed premises and for purposes of this provision, the sale of consumer fireworks by an employee or agent will be considered a sale by the permit holder. INSURANCE COVERAGE: The permit holder shall maintain at all times during the duration of the permit and as a condition thereof, general liability, bodily injury and property damage insurance approved by the city in a minimum amount of $1,000,000.00 per claim and for each incident. The city shall be named as an additional insured and the permit holder shall provide to the city clerk a current certificate of insurance. The permit holder shall notify the city clerk at least 30 days in advance of any insurance cancellation or threat of cancellation of insurance. EFFECTIVE PERMIT DATES: The permit shall be effective for a period of 12 months, expiring March 31st of each year. SUSPENSION OR REVOCATION OF PERMIT: Suspension or Revocation of Consumer Fireworks Permit. The city fire marshal shall have the authority to immediately suspend or revoke any consumer fireworks permit for any violation of this Section, or any other provision of the City Code or state statutes. The permit holder has a right to appeal the suspension or revocation of the permit upon filing a request for hearing with the city clerk. The hearing shall be held before the city council at its next regular meeting after the filing of the request for hearing, but in no case less than five days from the date of the request. The suspension or revocation of the permit by the city fire marshal shall remain in effect pending the hearing, if any, before the city council. Fireworks Application Page 2 of 9 Tennessen Warning License Application gqiff Minnesota law requires that you be informed of the purposes and intended uses of the information you provide to the City of Eagan (the City) during the license application process. Any information about yourself that you provide to the City during the license application process will be used to identify you as an applicant and to assess your qualifications for selling fireworks within the City. If you wish to be considered for a permit to sell fireworks, you are required to provide the information requested in the permit application. If you refuse to supply information requested by the City, it may mean that your application will not be considered. All individuals in the City who need to know information will have access. A -d3 it Date Authorization and Consent for Release of Information Name of individual authorizing release , freely and voluntarily authorize the City of Eagan to conduct an investigation to obtain the following information for the purpose of determining my eligibility for a permit to sell fireworks: Name: 67/211/1 ,JC`bL La t //_ /Fiirstt /_ Middle frisk) Date of Birth: /5 5(P Driver's License #: �✓ ✓r �A23�'00`f' State I also release the City of Eagan from any and all liability for its receipt and use of information and records received pursuant to this consent. I further acknowledge that I have carefully read this release, fully understand its terms and legal significance, and execute it voluntarily. Executed this 9 day of /" 'ic( Fireworks Application Page 3 of 9 ,2011. q9/R- The Police Department has conducted a criminal background check on the aforementioned applicant. Comments: Pol" e Department Representative Date Conditions of Issuance: ------'_,. Background check completed and approved by EPD: X Yes No Zoning approval Yes No Facility inspection complete and all violations corrected Yes No Insurance policy approved JL Yes No Need Site plan, n • - • -- - • • • • - • - = x. Yes No Building Permit Application for Tent Yes No License approved by Date approved: Fireworks Application Page 4 of 9 99 / ACORE) CERTIFICATE OF LIABILITY INSURANCE TE DA04/25/201 ) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER MCGRIFF, SEIBELS & WILLIAMS, INC. P.O. Box 10265 Birmingham, AL 35202 CONTACT NAME: (A/CNI o, Ext: 800-476-2211 (NC, No): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A :Liberty Surplus Insurance Corporation 10725 INSURED AmericanB American Promotional Events, Inc. dba TNT FireworksINSURER P.O. Box 1318 Florence, AL 35631 :Ironshore Specialty Insurance Company 25445 C :Lexington Insurance Company 19437 INSURER D : $ 1,000,000 INSURER E : $ 200,000 INSURER F : COVERAGES CERTIFICATE NUMBER:ZX4ZBCY5 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY DGLB00810581 11/01/2010 11/01/2011 EACH OCCURRENCE $ 1,000,000 DAMAGE 10 RENTED PREMISES (Ea occurrence) $ 200,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $ EXCLUDED PERSONAL & AIT/ INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: —1 POLICY n JECOT n LOC PRODUCTS -COMP/OP AGG $ 2,000,000 $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS_ HIRED AUTOS SCHEDULED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE 000788300 11/01/2010 11/01/2011 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 DED RETENTION $10,000 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITYY / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A WC STATU- OTH- TORY LIMITS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ C EXCESS UMBRELLA POLICY Per Occurrence 013136604 11/01/2010 11/01/2011 XS of Primary $5,Mil $ 5,000,000 $ $ $ $ DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) This certificate only applies to INSIDE THE STORE SALES OF MINNESOTA APPROVED FIREWORKS @ CUB FOODS WEST #31794, 11020 Diffley Road, EAGAN, MN, 55123. The Certificate Holders are Additional Insureds under General Liability as required by written contract subject to policy terms, conditions, and exclusions. CERTIFICATE HOLDER CANCELLATION CITY OF EAGAN 3830 PILOT KNOB ROAD EAGAN, MN 55122 USA ACORD 25 (2010/05) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Page 1 of 1 © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ""S3-01181707 - REPRINT 21369 Chain Store Sales -Wisconsin Terms: Net 30 Days Sold To: 1356949 SUPERVALU - CUB FOODS PO BOX 125 MINNEAPOLIS, MN 55440 Desc/Case Packing - PACK LIST Item CP # Ship To: 9q/sr - REPRINT - Order #: 1181707-53-00002 Order Date: 3/31/11 CUST PO: SLSMN: Chain Stores - East 2168975 - CB131794 CUB FOODS 31794 ie 1020 Diffley Road v EAGAN, MN 55123 Quantity Ordered Selling Suggested Units Sell Price *************************** 2 PAK SNAP 225 FDP J09 225/2/50 *************************** #8 SPRKLERS ASST BOX FDP 120/6/5 *************************** Novelties 320514 27736022922 Sparklers JO 380236 27736022755 Counter Cases FDP 50(FR,SS,RK,DNO) SS V2 J1 1/1 Containing: STARS AND STRIPES SS J09 2/12 MINI CALIFORNIA RKT FTN J 4/36/4 DINOSAURS FTN 3 PAK PDQ J 72/3 FREEDOM RINGS SS USA J09 16/1 FDP 50(SHOW,FRDRNGS) SS V1 J1 1/1 Containing: SHOW OF FREEDOM USA SS J09 10/1 FREEDOM RINGS SS USA J09 16/1 DECLARATION OF COMPLIANCE 671567 101833 27736022106 200743 27736019908 200816 27736002177 101832A 27736022090 671568 101831A 27736022083 101832A 27736022090 Case Totals: Total Pallets: Total Repack Cases: 1 CS 1 CS 1 CS 14 EA 39 EA 52 EA 7 EA 1 CS 6 EA 8 EA *********************** 225 EA 1.00 *********************** 120 EA 2.00 *********************** 4 CS PL CS 1 CS 14 EA 39 EA 52 EA 7 EA 1 CS 6 EA 8 EA 535.40 9.99 2.99 2.00 24.99 439.86 39.99 24.99 Page No 1 ""S3-01181707 Bill Shipper: 22069 TNT WAREHOUSE - WISCONSIN 223 COUNTY HIGHWAY A BLACK RIVER FALLS, WI 54615 WLSL Lic #: Vendor #: 5649728 Sold To: 1356949 SUPERVALU - CUB FOODS PO BOX 125 MINNEAPOLIS, MN 55440 SFM #: 9.9/SF Put Pro Number Sticker Here TNT Fireworks of Lading - REPRINT Sales Assoc: CUST PO #: Order #: Route: Zone: Freight Code: Chain Stores - East 1181707-S3-00002 Stop: Ship To: 2168975 CUB FOODS 31794 1020 Diffley Road EAGAN, MN 55123 SFM #: Phone #: 651-452-1811 ******************************************************************************** Emergency Response Nbr: (800)255-3924 Payment Terms: Net 30 Days Contract Number: MIS0006877 ******************************************************************************** HM Description of Articles Weight Shipping # of Cases Class Pieces X UN 0336, FIREWORKS 1.4G, PG II NOVELTIES - NMFC 56290-4 Totals: 121 LBS 85 62 LBS 150 183 LBS 2 [X] 2 [X] 4 ******************************************************************************** Net Explosive Mass: 30 LBS ******************************************************************************** Checked By: Received By: Delivered By: Order: Ship To: Sold To: Received Date: Placards Tendered By: Delivery Instructions Page No 1 MATERIAL SAFETY DATA SHEET — Consumer Fireworks SECTION 1— IDENTITY: Consumer Fireworks at Retail Locations Importer's Name American Promotional Events/TNT Fireworks Emergency Telephone Number Normal Business Hours — 800-243-1189 After Hours — ChemTel — 800-255-3924 Address Corporate Office 4511 Helton Dr. Florence, AL 35630 SECTION 2 - Hazardous Ingredients/Identity Information Consumer fireworks contain various mixtures of oxidizers and fuels, and are designed to burn and produce visible and audible effects when they are caused to ignite by a user. The oxidizers include potassium nitrate, strontium nitrate and potassium perchlorate. Fuels include charcoal, sulfur, starch, and aluminum. All chemical composition is contained within the device, and there should be minimal -to -no exposure to the chemicals under normal conditions of handling of the type typically involved in retail sales operations. The chemical mixtures are stable to temperatures up to at least 250°F, and no ignition of these devices should occur during normal handling, transportation, movement, and storage. A match or other flame or heat source is required to ignite the fuse on the devices in order to cause the devices to operate. SECTION 3- PHYSICAL/CHEMICAL CHARACTERISTICS Boiling Point N/A Specific Gravity (H20=1) N/A Vapor Pressure (mm Hg) N/A Melting Point N/A Vapor Density (AIR=1) N/A Evaporation Rate (Butyl Acetate = 1) N/A - All solids Solubility in Water: slight Appearance and Odor: All chemical composition is contained inside a cardboard or other container SECTION 4- FIRE AND EXPLOSION HAZARD DATA Flash Point (Method Used) Ignition temperature exceeds 250°F Flammable Limits N/A — no vapor present LEL N/A UEL N/A Extinguishing Media Water Special Fire Fighting Procedures: Evacuate the area if a fire reaches the fireworks and they begin to burn vigorously. Allow sprinklers to function, if present — they should control the fire. Otherwise, evacuate the area and await arrival of fire fighters. Unusual Fire and Explosion Hazards — Suffocation methods should not be used — the devices contain their own oxygen. Use a strong water flow instead. A fire that has reached consumer fireworks may produce substantial smoke as well as flame, sparks, and burning projectiles. Once consumer fireworks begin burning, all persons must immediately evacuate the area. Only fire fighters wearing appropriate safety equipment should ever consider approaching an area where consumer fireworks are on fire. Remote firefighting methods should be use whenever possible. Where conditions permit, it may be advisable to allow the fireworks to burn to completion — this will greatly simplify clean-up efforts. SECTION 5- REACTIVITY DATA Stability Unstable Health Hazards (Acute and Chronic) Conditions to Avoid: Open flames, hot surfaces, rough handling Stable X Incompatibility (Materials to Avoid) none Hazardous Decomposition or Byproducts Considerable smoke may be produced in a fire Hazardous Polymerization May Occur Conditions to Avoid: N/A Will Not Occur X SECTION 6 - HEALTH HAZARD DATA Routes of Entry Inhalation N Skin N Ingestion N Health Hazards (Acute and Chronic) Health hazards should be minimal — all chemical composition is contained inside sealed devices. If leakage occurs and contact with skin occurs, be sure to wash hands promptly, and before eating or drinking. Carcinogenicity NTP N/A IARC Monographs N/A OSHA Regulated N/A Signs and Symptoms of Exposure N/A Medical Conditions Generally Aggravated by Exposure None, except in case of fire. Smoke exposure is then the greatest possible concern (in addition to fire). Emergency and First Aid Procedures Evacuate area if a fire reaches the fireworks. If smoke inhalation occurs, remove persons to fresh air and contact emergency medical services SECTION 7 - PRECAUTIONS FOR SAFE HANDLING AND USE Steps to Be Taken in Case Material is Released or Spilled Cautiously pick up the spilled devices and place them in a marked container. Contact your American Promotional/TNT representative for removal instructions. Waste Disposal Method Contact your American Promotional/TNT representative for disposal information. Precautions to Be Taken in Handling and Storing Avoid extreme temperatures, open flame and sparks, and rough handling Other Precautions Intentional misuse/mischief poses the greatest concern with these devices in a retail setting. Monitor the fireworks display area on an ongoing basis, and keep young children, intoxicated persons, and any time of open flame out of the fireworks area. No smoking is ever permitted near fireworks. SECTION 8 - CONTROL MEASURES Respiratory Protection (Specify Type) N/A — no vapor or dust exposure with intact items Ventilation Local Exhaust N/A Special N/A Mechanical (General) N/A Other N/A Protective Gloves — not required for retail sales Eye Protection N/A Other Protective Clothing/Equipment — none required for retail sales Work/Hygienic Practices — wash hands after handling fireworks and before eating or drinking 2 ADDRESS I D7-0 D +Hat, Yd TNT® FIREWORKS Site Plan Worksheet CITY ta9cun STATE IV 1 Y V ZIP 55122 PHONE tp 5 I' 4' 2 10 E 1 STORE NAME / LOCATION # G(X\ C,L'Lb i -cocK TYPE OF EVENT: In-store retail sales of state -approved fireworks NORTH • s -e -e stcre p (P -ea SOUTH SPECIAL INSTURCTIONS SIGNATURE DATE STORE MANAGER / TNT® Representative Greeting Cards Wall of Value M X 'cf. T O LC) CO X X CD T 00 X CO LC) N N N CD 0) T M N O CO CC CC CC CC T W w = CL cn 0 0 0 2 Y us 0 N cn O. N C17 y 0 0 /) N a) E _ as O 0 a) •p_ CO L) CL z a 0 ccS U TL 0 Cn O 2Z0 0)'C C) Cl)ac_=tinE0c0"=ca0 E5tocn = = C: O ca Ca 0 0 0 Ca Ca U Ca Ca Ca U U 0 ... L C C 0 Cr) Cr) en N Cn Cn M N C/) Cn C/) LI) Cn M - CS) 0 ) cn 0 cats 0) 0)cN aa) 0 O a 0 ca V 0 a 0 0000_0_5_0_ Ci) Cn Cn Cf) Cn Ci) N Ci) Ci) C/) NCD CD CO C. LC) C0) a) Cn 0 E 0 0 =co � co 0 i m 0 N 0 O_ O CCI a) E CD 8 OV ca 1:3 0 0 0 .Q V)C/)C/)UO) F'FC=FEFLDHFEFEFE C) CAOMNX00"Cr T = T T F— C—X O O O — N ,— — CD O)0) M co 00 OCA0000 C- m v N M CO 00 M CO W W W CC OC = CsJ M = CO 0 CO C CL) mca c a) al a) C7) a) a) y00 a Ca fa >»>''3g X N LC)CDO MMS 0000 L0 CC h 0) i 0 Y Cl- C d'X a Cy Y N m a)y�Y�C-7ZFE_0 YC U U .�C'..' 0) 0) 0) 0 0 .— C 0 C 0. Q Q Q Ca Ca 0 as as Ca 0 0 as 0) 0 0 o m 0 0 O cn cc)CCO 00) N U 0 D. N C 0 0 0) LL 0. a-+ O 0 C,) 0 C C i 0 L C -= c a i 'y�' CO Vc. t d 0 y iT 0 0 — C a~�aaa-a =a 0 . 0 0 0 0 0 0 0 0 O i i 3 0) U c a) N 0 O Cn O co V 0 Ca = aid Products CO Ca Ca Ca CC) Ca • i O 2 w Hw MEM irs 0 ® .w Y o ,w 0 O o Y/� • 0 ,rC c L WL City of Eakaa 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use Permit #: "=1‘pko 2-c0 Permit Fee: ''S Date Received: Staff: .' 1� 2010 MECHANICAL PERMIT APPLICATION /� Date: I • Site Address: TLC, PI•e\.1 ic>1 • Tenant: �'J CLIA Suite #: RESIDENT / OWNER 1 Name: Phone: Address / City / Zip: CONTRACTOR n Name: ' OL iCI �''P 1 /y / j �/� /, ,rc 1J �G License #: 1-' �t' 60/ Address:t! '5 Ate/ t bI .Y City:rlf (,(/ In ! V' / Phone: 951 V '�,2+t)Q v�J Stateall_ Zip: ZL� / ContactaJ 1. 6 ,*)5 Email:5t2 t y Q soli`/�' i TYPE OF WORK 10 �,.� J c� '�j�`y:�P C. New Replacement Additional Alteration Demolition "�'v�1 `� ` c� C- Description of work c\\ „ NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened by City Code. Please contact tha Mechanicat inspector for information on permitted screening methods.. PERMIT TYPE RESIDENTIAL Furnace COMMERCIAL _ New Construction Interior Improvement 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: $55.00 Minimum Add-on or alteration to an existing unit (includes burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) $5.00 State Surcharge) $ TOTAL FEE $95.00 Fire repair (replace COMMERCIAL FEES: $75.00 Underground tank $55.00 Minimum (includes installation/removal OR State Surcharge) $10,010, surcharge is $ 5.00 surcharge increases by $.50 for each $1,000 Permit Fee requires a $ 5.50 surcharge) 0, A00 Contract Value $ 50 V � x 1% _ $- DC) Permit Fee - If the Permit Fee is less than Fee = $ 5'Vbh/, Surcharge - If the Permit Fee is > $10,010, (i.e. a $10,010-$11,010 Permit =$ S 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.gopherstateonecail.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 with.. a permit; that th- ork will be in accordance wit the approve Ian in the case of work which requires a review and approval of plans. �, / Applicant' Appl Printed Name App icant's ure FOR OFFICE USE Required Inspection: Reviewed By: Rough In Air Test Gas Service Te _ Exterior HVAC Screening Inspection In -floor Heat Date: Final --------- , ,-. - ---- I Permit7k: j PermitFee: I ? ? Date Received: I ? I C ? Staff: -----------------? C'_ GGze"CJ ?,-/J 2008 COMMERCIAL BUILDING PERMIT APPLICATION Date: q 7 boo Site Address: F 'f Tl C TenantName: TGF FRw? ('iub ti-?nrt ? (Tenant is: K New /_ Existing) Sulte #: PROPERTYOWNER Name: fLNhLE VC?l2??PMi? (?•,LG? Phone: 012'330-01'6 Address/ City/ Zip: lDD, fZG) 'rilNw' 57-7 /14r$YcAG ??F. 5•, ?I?KC?9T A li t i / O pp can s _ wner Contractor TYPEOFWORK Description of work: tP11Qaf ?P?OVeN'eGk4 Construction Cost: (fRS. DoO `06 ? CONTRACTOR Name: I• L• 641;ViM ?4 S'fr4 ?:° ti License #: Address: 415LU W- 7744 vl • , r7TL . 200 ciry:State: MN zp: 5'S?3S Phone: RSZ"?3S-2S'L?( ContactPerson: ?c? D ?4 ARCHITECT / Name: L7i1 e 4 Registration #: ENGINEER qddress: (d0 N 644 4-4. , 7rC • 6 54 li City: M,-i,ye.pQftS State: l'l1", Zip: 5S403 Phone: ??Z??i3Q ? ?2 S7 Contacl Person: ?G'?'C ? "Jd e, Licensed plumber installing new sewer/water service: Phone #: NOTE: Pians and supporting documents" that, you submit are considered to be public information.: Portions ol = _ ,. _ 'the fiforinatlon`may7ie ciessifred as t?on-pubUC'it you'?providei`specllic`i?easons that would petmlt fhe C7ty ` coriclude,thatthe :are,tradesecrets., L 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 ihis is not a permit, but only an application for a permit, and work is not to start without a permit; that ihe work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. _ ?\ x WP ?<r x ApplicanYs Printed Name . ApplicanYs Signature ?G???%P1 E 0 sFP 0 3 2008 Page 1 of 3 DO NOT WRITE BELOW THIS LINE SUB TYPES; ? Foundatfon ? Apartments ? Lodging ? Miscellaneous WORK TYPES: ? New ? Addition ? Alteretlon ? Replacement Valuation ?IS Plan Review ?;.t: 5 ? (25%,_ 10 0% Census Code ? # of Units # of Bulldings -- Type of Const. ? ? Public Facllity ? Accessory Bullding Q ' Commercial f Industrial ? Ext. Alteration-Apartments ? Greenhouse ? Ext. Alteratlon-Commercial ? Antennae ? Ext. Alteretion-Public Facility ? Nall Salon [ay Interior Improvement ? Siding ? Demolish Bullding• ? Move Building ? Reroof ? Demolfsh Interior ? Fire Repair ? Demolish Foundatlon O Windows ? Water Damage " Demolition (entire building) - give PCA handout to applicant Occupancy ?J MCESSystem ?-s CodeEdition _Je0 7 /"SBL SACUnits Zoning City Water e.S Stories Booster Pump • Square Feet PRV Length Fire Sprinklers ? r'S Width REQUIRED INSPECTIONS Footings (new bldg) Footings(deck) Footings (addition) Foundation Draln Tile Roof: _ Decking _ Insulation _ Final IceM/ater ? Freming Fireplace:_R.I. _Air Tes[ _Final Insulatlon Sheetrock Meter Size: ? FinaI/C.O. ' Final/No C.O. HVAC Other: Pool: _Footings _AidGas Tests _Final Siding: _Stucco Lath _Stone Lath _Brick Wfndows Retaining Wall Final C/O Inspection: Schedule Fire Marshal to be present. _ Yes ? No Reviewed By: Iv . Building Inspector Reviewed By: COMMERCIAL FEES: Base Fee 10 1, Surcharge 4f1.50 Plan Review SAC-MCES SAC-City SM/ Permit S/W Surcharge Treatment Plant Treatment Plant (Irrigation) Park Dedication Trail Dedication Water Quality Water Supply 8 Storage (WAC) Financial Guarantee Storm Sewer Trunk Sewer Lateral Street Water Lateral Other Total ? / , ) Sewer Trunk Water Trunk Planning Page 2 of 3 Page 1 of 1 Mike Lence From: Dale Schoeppner Sent: Friday, September 12, 2008 7:02 AM To: Craig Novaczyk; Mike Lence; Sarah Brandel; Peggy Fleck Su6ject: FW: SAC Determination - TCF Bank - Eagan From: Cappaert, Karon [mailto:Karon.Cappaert@metc.state.mn.us] Sent: Thursday, September 11, 2008 12:07 PM To: 'Steve Day' Cc: Dale Schoeppner Subject: RE: SAC Determination - TCF Bank - Eagan Steve: I just started the review of the TCF Bank and our database shows a determination was done for a bank when the Cub was built (3/08) and it has already been paid (4/08). There is no need for you to have a determination done. Karon Cappaert SAC Administrative Technician MCES - Finance 390 N Robert St St Paul, MN 55701 k2[on caooaertOmetc state.mn.us Phone 651-802-1118 Faz 651-602•1030 http://www.metrocouncil.org/environment/RatesBillina/SAC Program.htm From: Steve Day [mailto:sday@jlsullivan.com] Sent: Tuesday, September 02, 2008 4:55 PM To: Cappaert, Karon Subject: SAC Determination - TCF Bank - Eagan Hi: Please see attached the SAC Determination request for the TCF Bank branch that is going in the new Cub Food Store at the Diffley Marketplace. Let me know if you have any questions. Thanks. Steve Day, LEED AP Vice President ).I..SUW VAN C0145TRUCTtON 4510 Wes[ 77th Street, Suite 200 Edina, Minnesota 55435 Office: 952-835-2529 Cell: 612-750-3994 Fax: 952-835-1164 sdav(n%ilsullivan.com I www jlsullivan.com 9/13/2008 City of Eapn 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax:(657)675-5694 2008 FIRE Date: q - a. ''( - 06 Site Address: Tenant: D ----, ? F&r_0_ff_16e0 se ? ? Permit #: ?,&,52 I ? I j Permit Fee: co j ? DateReceived: ? Staff: J APPLICATION* $Uite' #: Le["n yon /(,^C PROPERTY OWNER Name: N/ A Phone: Address / City / Zip: Applicant is _ Owner _ Contractor TYPE OF WORK Description of work: ZVlStc ? ? 1-< 'clJ e Construction Cost: 7 Dqf" Estimated Completion Date: /(t) 13 D?Ds CONTRACTOR Name: Nardini Fire Equipment License #: TS00686 Address: 405 County Road E W City: Shoreview State: N4N Zip: 55126 Phone: (651) 483-6631 Contact Person: v r? FIRE PERMIT TYPE WORK TYPE _ Sprinkler System (# of heads ? xNew Fire Pump _ Addition - Standpipe _ Alterations ? other. L;a J-2 11/e -/ Remodel other: DESCRIPTION OF WORK: X Commercial _ Residential _ Educational FEES $50.50 Minimum (includes State Surcharge) OR Contract Value $-5 O D x 1°k 0 ? 7 ?b Permit Fee _ $ O - If P rmi Fee is less than $1,000, surcharge is $.50. ?? - If Pertni Fig is> $1,000, surcharge increases by $.50 for each =$ J?'`' State Surcharge $1,000 Permit Fee (i.e. a$1,001-$2,000 Permit Fe IT,equim ?.?a.00.sqr?ar?e), ?? $ ?R TOTAL FEE u u v L 3/4" Displacement Fire Meter -$183.00 ? SEP 2 5 2008 $ Fire Meter C C? $ TOTAL FEE *Requlrements: 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 [he information is complete and accurate; that Ihe work will be in conformance with the ordinances and codes of the City of Eagan and vrith the Minnesota BuildinglFire 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. xl1 cl5 x AppTicanYs Printed Name App icanYs Signature . FOR OFFICE USE REQUIRED INSPECTIONS _ Hydrostatic _ Flow Alarm _ Drain Test ? Rough In 4 Trip _ Pump Test _ Central Station ? Final Conditions of Issuance: Pertnit Reviewed b: Date: I\ l 0 I l V d 2008 COMMERCIAL PLUMBING PERMIT Date: ? Site Address: 1d.G0 f-?? Tenant: / ; (w ? FarQf_fice Use -?? `1'8 ??w ? Peimit#: 86L4 I /' ?-y I i Permit Fee: CO I ?_ I I Date Received: 1 ?? I j Staff: j L -----------------? PLICATION Ck..:._ «. PROPERTY OWNER Name: rp c titTUP Phone: CONTRACTOR Name: 416PLA+t/O j?fvit()&![{. ?iylP Licen e # Address: City: ?PClF'(1AZr1'QA.f State: ?"!Iv Zip: 5:5y37 Phon'?'9$` 32-53u2 ContactPerson: TYPE OF WORK K New _ Replacement -Repair _ Rebuiid _ Modify Space -Work in R.O.W. 7? Description of work: 1/5j?4A7jQ1J 3 f'5 fFdy - PERMIT TYPE COMMERC/AL _X_ New Construction Modify Space . ? Irrigation System (-Y- yes!_ no) (_V RPZ PVB) • Rain sensors required on inigation systems • Avg. GPM _(2" turbo required unless smaller size allowed by Public Works) ? Meters Call (651) 675-5646 to verity that tests passed prior to oickina uo meter. ??, ?t Domestic: Size 8 Type ?L6 -1Fi i " re: S ze & Price 3!4 meter 1$ 83.00 Avg. GPM13-L HigFi demand devices? _Yes 9 No Flushometers i Yes No PRV Required _Yes e _&No COMMERC/AL FEES: $50.50 Minimum (includes State Surcharge) OR contrect vaiue E? x 7°, _ $ ?noaermit Fee Required on ALL new buildings and boulevard irrigation systems ?= 3 Radio Meter-Read h/ k? - If Permit Fee is Iess than $1,000, surcharge is $.50 =$ 6 f/ LC o !J0 :(er(s) - If Perrnit Fee is >$1,OD0, surcharge increases by $.50 for each $1,000 /'? $1,000 Pertnit Fee (i.e. a$1,007-$2,000 Permit Fee requires a $1 00 surchar _ 6( . ge). $ . ?$tate Surcharge Following fees appty when installing a new lawn irrigation system. - $ Tj b, f.D Water Permit ' Call the City s Engineenng Department, (651) 675-5646, tor requiretl tee amounis. -O- TreatmentPlant pro '! ` -O - $ Water Supply & Storage $ y tate Surcharge TOTAL FEES S_fo97, t 00 ereby acknowledge that this information is complete and accurat ' ih onformance wilh the ortlinances and codes ot the City o( Eagan; that I untlersWntl this is not a pertnR, but only an applicatwn for a pertnrt, a 6T ? it t that the work will be in accortlance wiN Ihe approved plan in Ihe case ot work which requires a review and app¢val oi !?,., n l i -?-?ApplicanYs Printed Name Applic?bn[s .,,y„awre / ? FOR OFFICE USE - Approved By Date: t i ,R@QlllnBd'IOSD@Ct10I15. • llnflarC:rnnnrl.?'?? . R.,j,..1, I.. ??=e?.-re?? . . n.....T._.,a , ?r.__?. Page 1 of 3 ? City of Earn 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 EcEry7, u \I NOV 0 2 2009 -01/19-fi s ClyEc, Permit #:/ .e,`J Permit Fee: 1/4.37J- Date V - Date Received: /1 — Staff: 1— Staff: 2009 COMMERCIAL PLUMBING PERMIT APPLICATION Date: s () 1)0\O`1 Site Address: 1D 0 \ Tenant: Suite #: PROPERTY OWNER Name: Phone: CONTRACTOR Name: ( ) C — M S- k. C x CLa aCNcense #: orsg-z, •Pt'V1 Address: °I [03 ca. : 'v\ppc. SAO tty: 'P-A.c1, a State: (Vl % Zip: 554 q c Phone: 7(r,,37S-1O- Rio 17 Contact Person: 7'3 7 t & EL0 ci( TYPE OFNew WORK Replacement X � Rebuild Modify Space _ Work in R.O.W. _ Description of work: PCC) i C Ai cR.: - S 0 p pit - .4 \ \ O1< -CO -Ca Q PERMIT TYPE /S� 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: Size & Price 3/4" meter $203.00 Avg. GPM High demand devices? _Yes _No Flushometers _Yes _No i I MERCIAL FEES: 50.50 I inimum (includes State Surcharge) OR Contract Value $ I OOa . 00 x 1% = $ 1 ? 0-0 Permit Fee Required - If Permit Fee is less than on ALL new buildings and boulevard irrigation systems -> = $ 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). = $ 1 `01) 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 $ (3 . t ''() 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 - mit; 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 0��SL_� Applicant's Printed Name ant's Sign ture Page 1 of 3 2200 Food Generator - Plumbing Guide 0001-0398.doc page 4 of 13 4,11/ City of Eaali 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For OfficeOfficPermit#: Permit Fee: 3D1.3'71 Date Received: Staff: 2009 COMMERCIAL BUILDING PERMIT APPLICATIO Date: I A 2 ` 0 Site Address: l O 'Z- o I A19 Tenant Name: C kQ rO (ID s Acta' r (Tenant is: New / X Existing) Suite #: Former Tenant: PROPERTY OWNER Name: pi f FL, roi`` t \ Phone: COL. 3. 1" I 0 4 4 Address / City / Zip: 1 rttite01400 V . Applicant is: Owner X Contractor TYPE OF WORK Description of work: AT (z --EM 0 F S TO Iti-i"c. Construction Cost: ! rpt 000 CONTRACTOR Name: 61.- b 0 CLoA i .:# Fla ''License #: Address: i.0, 300 ;i a ►' . - City: "LUOPLINlC 1-0 4 State: MR. Zip: S'S.437 Phone: q S l — $ 31- - s -341 -Contact Person: IS o 3 CO P C.-4.0414 WO ARCHITECT / ENGINEER Name: P t--14-14Lu (.lam M.4. Registration #: Address: (,:)S—.3 3 P L 4 OK. Ct. tb v.O Oa -,•#-.10Q City: Prip.D 14 P NA' fires t State: %Ntkl Zip: ) 3 4+ Phone: ! S 2-—elt 4— 580 O Contact Person: AAS ss'14. TO Nr4 S 0 Licensed plumber installing new sewer/water service: Phone #: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information maybe classified as non-public if you provide specific reasons that would permit the City to 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.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 inaccordance with the approved plan in the case of work which regy'res a review and approval of plans. x fl-d�t ter+ ClC . (a L ct Applicant's Printed Name --D)EZE nu 302009 cant's Signature Page 1 of 3 JD c;b tcE(c DO NOT WRITE BELOW THIS LINE &/7,o6-6 SUB TYPES Foundation Apartments Lodging Miscellaneous WORK TYPES New X Addition Alteration Replace Retaining Wall DESCRIPTION Valuation Plan Review (25%_ 100% 1) Census Code # of Units # of Buildings Type of Construction _ Public Facility X Commercial / Industrial Greenhouse / Tent Antennae Interior Improvement Exterior Improvement Repair Water Damage 1b1000 REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) AFoundation Drain Tile Roof: _Decking _Insulation Framing Fireplace: _Rough In _Air Test _Final Insulation Meter Size: Occupancy Code Edition Zoning Stories Square Feet Length Width Ice & Water Final 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 2GC'7PA SSL MCES System SAC Units City Water Booster Pump PRV Fire Sprinklers 1 / Err. Egos u 2.;E fog. y'L>ss ST?Rc as Sheetrock Final / C.O. Required Final / No C.O. Required HVAC Other: Pool: _Footings Siding: Stucco Windows Retaining Wall Erosion Control Air/Gas Tests Final Lath Stone Lath Brick Final CIO Inspection: Schedule Fire Marshal to be present: Yes _No Reviewed By: C.� , Building Inspector Reviewed By: Ply P , Planning COMMERCIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC S&W Permit & Surcharge Treatment Plant Treatment Plant (Irrigation) Park Dedication Trail Dedication Water Quality 6. ea Water Quality Water Supply & Storage (WAC) Storm Sewer Trunk Sewer Trunk Water Trunk Street Lateral Street Water Lateral Other: TOTALO w3ZI 2"! Page 2 of 3 1 F-fG f foa,vn,r77onl PeeMlr aN" -=n=- -?-- ?? City of EaVan 3830 Pilot Knob Road Eagan MN 55122 Phone: (657) 675-5675 Fax: (651) 6755694 ,. '1?1, a, ---------i i-------- ? For Office Use I I ? Permit#: 67462-1? I 7 ? Permit Fee: . j-D • 11 I l ?. ? Date Received: ? I ? i Shaff: 1 ----------------- CA llG?( /-/- '?21 -0 ?'? 2008 COMMERCIAL BUILDING PERMIT APPLICATION /020 DIGGL? ?D - Date: 3" ?° ?9 Site Address: 5.?' , Gp ?F N?. R- tS F (J I Fr-tkr'°t }'i,.o ? iiAbJi a-L il it. P s" d?- Tenant Name: G(,i r5 pU: 0k) (Tenant is: X New / E)isting) Suite #: PROPERTYOWNER Name: (LS L/hNGf£ D 9- U%;(.OYWL?? I`i° i Phone: 6tL' 33$ "?OU 0 Address / City / Zip: 10 V 6 2.ktqQTtl W !st? S 27 MA? kx ?'iH ?.` "r'1" - a V ES. - - ' 1 /..+I n-"4 L:.a;4r:415 , ttN sa 40 ti Applicant is: _ Owner Contractor TYPE OF WORK Description of work: 4' ¢ r do0 5 FN eW (? ?l M S T"0 rl-AL Construction Cost: ??-i G50? 42v0. 0? b o o•=` fv 9- t-? , fo o?. a. P?u,w vtqX rls--2 * ' CONTRACTOR Name: ? r) 40 1 -t-00t 10 ( j u 14 10 114 ? G?4-1fO License #: s ?I ' Address: 5` IQ 0 17 R. .;:1- Ltl r) City: 13Ll7oM.IN6°YOtv state: MN zip: 7S4-37 G?5 Q?.Ldc<1 d? Phone: Z"S' 3 0 2Contact Person: 900 ARCHITECT / Name: twtLbE. Registration #: ENGINEER pddress: ?DS 3 3 r 1?`? I tW? C,,. l.-D la:1S D Y1 ,. tt 10(3 City: ? d &iy 12tVA 1 1"t b tit- State: /-I? 14 Zp: 5 ?3 4 4- Phone: f{ S°1. P914: S BE} U Contact Person: GCLk6fe Ia Ns V 1 SS f. N To B ? DE7EiZllluh.a Licensed plum r installing new sewer/water service: _. , Phone #: e, L ,c- i .c-?u?; ?r?-- NOTE: Plans and su porting documents that yoti submit are considere to be pu6lic infonnation. Portions of the informatlon may be classified as non-public if you prov/de specific reasons that would permit fhe City to conclude that the are irade secrets. ? I hereby acknowledge that this informalion is complete and accurete; that the work will he in conformance with the ordinances and codes of the CiTy of Eagan; that I understand this is not a permit, but only an applicatlon for a permit, and work is not to start without a pertnit; that the vrork will be in accordance with the approved plan in the case of work which requires a review and approval of plans. xpobe?T , l? o lOG L Z L,..d ??IS? Vx Ap ?canYs PrlMed Name D anYs Signature f? Iv,Art j j 2008 Page 1 of 3 ?•'?'. ? DO NOT WRITE BELOW THIS LINE SUB TYPES: ? Foundation ? Public Facilky ? Accessory 8uilding ? Apartments 0 Commercial ! Industrial ? Ext. Alteration-Apardnents ? Lodging ? Greenhouse ? Ext. Atteration-Commerdal ? Miscellaneous ? Antennae ? 6ct• Afleratlon-Public Facility ? Nail Salon WORK TYPES: ?d New ? Interior Improvement ? Siding ? Demolish Bullding' ? Addition ? Move Building ? Reroof ? Demolish InteHor ? Afteretion ? Fire Repair ? Demolish Foundation ? Replacement ? Windows ? Water Damage ' Demditlon (endre building) -give PCA hantlout to appifcant DESCRIPTION: ? Valuation /0j OOO r pccupency M MCESSystem Plan Review ? Code Edition 200 6 SAC Units / 7, (25%_ 100%!? ) Zoning City Water V/ Census Code Stories ! Boaster Pump #oi Units ? Square Peet a2o//iO PRV ? # of Buildings ? Lenglh Fre Sprinklers Type of Const. Width REQUIRED INSPECTIONS Footings (new bldg) Sheetrock Footings (deck) Final/C.O. Footings (additlon) FinaUNo C.O. Foundation HVAC - orain Tile - aner: . Roof: _Ice & Water _Finai Pool: _Footings _Air/Gas Tests Final Framing Siding: _Stucco Lath _Stone Lath _Bridc Fireplace:_R.I. _AirTest _Final Windows Insulation Retaining Wall Final C/O Inspection: Schedule Fire Marshal to be present. _ Yes _ No Reviewed By: Building Inspector Reviewed By: PA . Planning -------------- --------- ------------------------------------------------------------------------- -------------------------------------- ----------------------- COMMERCIAL FEES: ?? Base Fee / 9/• 7s- " C Surcharge ?? ? ? L? ?n Ct/7 Plan Review /Z 1 I I 7" ?? 1 SAGMCES - 21?9A?.so-' C7 I SAGCity / ZOO. S/W Permit ? p p, t+ve Financial Guarantee S/W Surcharge 0, r0- Storm Sewer Trunk - TreatmentPlant $ Z$O.ed- SewerLateral },Z 217. Treatment Plant (Irrigation) ?&..2 ...Street - Sewer Trunk 4//70 7, ` Park Dedication SBS, .-v-Water Lateral 4 20 612 98 - Trail Dedication I ?J- 3 py- Other(Sew., ! 4, " Water Trunk # 12 3N7. " Water Quality Wd? 5'b'6s) Water Supply & Storage (WAC) Tptal . \ / Page 2 of 3 ?/ ?, ? S? --? , -- -;?' - f `Al y'A u Council /azo D/r-r? AD. Environmental Services Mazch 12, 2008 Dale Schoeppner Building Official City of Eagan 3830 Pilot Knob Road Eagan, MN 55122 Dear Mr. Schoeppner: The Metropolitan Council Environmental Services (MCES) Division has determined SAC for the Cub Foods to be located at Lexington Avenue and Diffley within the City of Eagan. This project should be charged 12 SAC Units, as determined below. Charges: Office 880 sq. ft. @ 2400 sq. ft./SAC Unit Warehouse/Production 2276 sq. ft. @ 7000 sq. ft./SAC Unit Retail 32,818 sq. ft. @ 3000 sq. ftJSAC Unit Bank 405 sq. ft. @ 2400 sq. ft./SAC Unit SAC Units 0.37 0.33 10.94 0.17 Total Charge: l 1.81 or 12 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 questions, call me at 651- 602-1378. Sincereiy, _ Jessie Nye ? SAC Coordinator Environmental Services Division JN:kb: 080312A5 n EOE?vEl cc: File, MCES Peggy Fleck, Eagan ? I ML1R 1?i 21108 Bob Copeland, Copeland Building www.metrowuncil.org 390 Robert Street North • St. Paul, MN 55101-1805 •(651) 602-1005 . Fax (651) 602-1477 . 7"PY (651) 291-0904 An Equa! Oyyonimity Employer Avenue and (1) a non-signalized, three-quartet access (eastbound and westbound entrances and eastbound exits permitted; westbound exits prohibited) &om Diffley Road to the north; and (2) an entrance-only access (all exits prolubited) from Daniel Drive on 4he east (the "North and East Accesses'l. The North and East Accesses require approval by the Dakota County Board and the parties agree that the City and Diffley will apply to Dakota Cotmty for fhe North and East Accesses. Tlus Settlement Agreement is contingent on approval by Dakota County of the North and East Accesses as herein descn'bed. 4. Mitigation of Traffic Safety Concerns. In order to account for and alleviate traffic safety concerns raised by the Development, Diffley agrees to pay the sum of $20,000.00 to the City within ten days of County approval of the North and East Accesses ("Traflic Safety Mifigation Funds"). The Traffic Safety Mitigation Funds shall be retained by the City for use for safety mitigation measures related to the Development and expended according to the City's sole discretion. If, after a period of three years following the date of the first Certificate of Occupancy issued for the Development, the City has not approved a plan for safety mitigation measutes related to the Development, the Traffic Safety Mifigation Funds or portion thereof that has not becn expendei shall be refunded to Diffiey. 5. No Admissioa of Liability; Noa-disparagement. Diffiey and the City aze hereby agreeing to an amicable setklement in tlris matter. Neither the willingness to entei into this Settlement Agreement, nor any tecros hereof, shall be regarded or construed to be an admission of liability or an admission of inerit regarding any actual or potential claims or allegations made by or against any of the Parties, both of whom expressly deny the same. In that spirit, Diffiey agees to refrain from any public comment related to this lawsuit, the City or its staff, the Property, or the Development wluch in any way assigns need or fault for the AM6 qTolo Clty of EapiIl FAX TRANSMITTAL T0: ATTENTION: , pnpdanj FAXNO.: 9S? 16--56 I COMPANY: /1 l nD( I,4/1 t( ?ICE G. CD2 P• ?7 I FROM: ?EIo?Y ?LEGK- COMDENTS: 3830 PILOT KNOB ROAD EAGAN, NIN 55122 FAX NO. (651) 675-5694 DATE: ?Z- 0I -D 6 TIIvfE: NO.OF PAGES TO FOLLOW: SUBJECT: -466-?, PX14 These are being transmitted as checked below: S For Approval High Priority Originals Forwarded By Mail For Publication For Your Information Originals Not Forwazded As Requested For Review and Comment Note to Facsimile Operator: Please deliver this fax transmission to the above addressee. If you did not receive all the pages in good condition, please coniact us at 651-675-5646 - Engineering; 651-675-5675 - Building Inspections; 651-675-5685 - Community Development. THE LONE OAK TREE... TIiE SYMBOL OF STRENGTH AND GROWTH IN OUR COMMUNITY Equal Opportunity/Affirmative Action Employer GFORMS/FaxForm - General PERMIT Clty Of Eagan Permit Type: Building 3830 Pilo[ Knob Rd Permit Number: Eagan, MN 55122 Mv Date Issued: (651) 675-5675 of ERvaR www.ci.eagan.mn.us Site Address: 1020 Diffley Rd Lot: 1 Block: 1 Addition: Diftley Mazketplace PID: 10-20475-010-01 Use: Cub Foods Description: Sub Type: CommerciaVlndusRial Construction Type: 11-B Work Type: New Description: Foundation Census Code: - Oceupancy: M Zoning: Square Feet: 42,110 COlI11i1CIltS: Planmark 6533 Flying Cloud Dr, #lOq Eden Prairie, MN 55344 952-9145800 Fee Summary: BL - Base Fee $191.75 0801.4085 City SAC $1,200.00 9379.4681 Valuation: I0,000.00 Plan Review $124.64 0720.4222 Sewer Permit $50.00 6201.4532 Surcharge- Based on Valuation $5.00 9001.2195 Surchazge-Fixed $0.50 9001.2195 Trealment Plant $8,280.00 6101.4685 Treatment Plant (Irrigation) $690.00 6101.4685 Wa[er Permit $50.00 6101.4507 SAC - CommerciaUlndustrial $21,900.00 9220.2275 Pazk Dedication $36,585.00 9328.4670 Trail Dedication $13,686.00 9375.4671 Water Suppty & Storage $19,434.00 6101.4680 Sewer lateral charge $21,217.14 9379.4611 Water lateral charge $20,612.98 9378.4611 SewerTrunk $11,707.80 9379.4611 WaterTrunk $12,347.70 9378.4611 Total: $168,082.51 Contractor: - Applicant - Ow'ner: Copeland Building Cocp. Diftley Ventures LLC 5300 Hyland Greens Dr. Reliance Development Compuny Suite 200 Minneapolis MN 55402 Bloomington MIJ 55437 (995) 832-5302 I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. ApplicanVPermitee: Signature Issued By: Signature MESSAGE CONFIRMATION 04.21,2e08 10:05 ID=ERGRN ENG+COM DEV DATE S,R-TIME DISTRNT STRTION ID MODE PRGES RESULT 04121 00'43" 952 345 0949 CALLING 02 OK 0000 04i21i2008 10:03 EAGAN ENG+COM DEU 4 99528325301 City of EakaIl N0.511 D01 FAX T1tAN5MITTAL 3830 PzI.OT IdVOB ROAD EAGAN, MPT 55122 FAX NO. (6511675-5694 TO- ATTENTION: al?k 4 DATE: FAX NO.: L3--2 - s36 ! TIIVM: COMPANY: -j I{?,. ,C„01P, NO.OF PAGES TO FOLLOW: ? FRQM: LEGIG- I SUBJECT: COMMENTS: "E110 bOb ,(t's (je IaJ/I/ n„ L r?Z_ J_ TG , 1. /? ,, nT,- ,l -) /,L ,..d, /'.,, l.u. . T -?? City of Ea?an 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 -_-'_____'7 I FOf OffiCe USB I j Permitli: ? Permit Fee: Z / 7 7`? I I ? i ? Date Received: ? I ? ? I ? Staff: -----------------? 2008 COMMERCIAL BUILDING PERMIT APPLICATION uate: ?° 0 3 Site Address: s, ?' , Ga l:.N ? rx.. vr` fJ tP ?(,??^?s V„y} ? f???,J???L 3 ` Tenant Name: G ur,? F- U- 0o (Tenant is: _X New / _ Existing) Suite #: PROPERTY OWNER Name: R- ??-! h M G(£ Dr-1.0Y V4 1& CF' i Phone: 617-' D8 "l[U d u y 2'7 M It k'tf2k 1" - A US C, Address / Ciry / zip: I U? U Q-ktII17 'i-n W t? C? t ?-% I r'- k?i ?:.c, ;irC L 15 ?. ya(4 J`.? CF o'L Applicant is: _ Owner -4- Contractor TYPE OF WORK Descrip6on of work: 4-4-i Oa p S F /J F-1.J C, t.t Cy STO r4-A o ao °"' Construction Cost:' 2G 400 CONTRACTOR Name: (' t'? t? ?%?AL? ?0 (3 U I l. 101lH ` FO -X19, License #: Address: S? b 0 1-? 4 I.,. k bJ v' fn Z. a F- d`'? ? ?? -#?"' 2- Gr) Ciry: 13 ?-Q? Fti l t?G °T o ?v State: M N zip: c'S' ¢ 3 7 Phone: ?I S?- ' P? 3 Z° S 3 d 2Contact Person: 900 C.a j?,LA-l 0 ARCHITECT/ Name: t.A +kt+'k(- Registra4on#: ENGINEER qddress: i-IC* Q N prL i:t, `Q O City: 9; b# 12 a w. k, 1 i"&. F P State: l?^i-Ft Zip: ?1 3 4- 4^ Phone: °ofi 4• - 5 coi0 U Contad Person: C R-F. 1 f2 ?y h=V 1 SS F_ h1 TU PC- DG1c..lLFa114hs.0 Licensed piumber installing new sewedwater service: Phone #: NOTE: Plans and supporting documenfs that you submit are considered to be public information. Portions of the Information may be classified as r+on-public if you provide specific reasons that would permlt the City to conclude that the are trade secrets. I hereby acknowledge that this iMormation is complete and accurate; ihat the vrork will be im mnformance with the adinances and codes of the City of Eagan; that I understand this is not a permit, 6ut only an appGcaGon for a pertnit, and work is not to start without a permit; that the work will be in accordance with tha approved plan in the case of work which requires a review and approval of plans. X obe?T I. C O pt t a?,,d '? ( IS ? V x App caM's PriMed Name D anYs Signature - 1 3. 2008 Page t of 3 DO NOT WRITE BELOW THIS LINE . SUB TYPES: ? Foundation ? Public Facility ? Accessory Building ? Apartments ? Commercial / Industrial ? Ext. Alteration-Apartments ? Lodgfng ? Greenhouse ? Ext. Alteratfon-Commercial ? Miscellaneous ? Antennae ? Ext. Alteratlon-Public Facility ? Nail Salon WORK TYPES: ? New ? Interior Improvement ? Slding ? Demolish Building" ? Additfon ? Move Building ? Reroof ? Demolish Interior ? Alteretion ? Fire Repair ? Demolish Foundation ? Replacement ? Windows ? WaterDamage ' Demolition (entire building) - give PCA handout to applicant DESCRIPTION: GAfQ ?, ? ES S M f Valuation Zr 000 Occupancy ystem MC Plan Review ? Code Edition 2-40 C. SAC Units / Z- (25%_ 100% ? Zoning City Water ? Census Code Stories ? Booster Pump # of Units v Square Feet q' Z1110 PRV # of Buildings ? Length Fire Sprinklers ? Type of Const. ? Width REQUIRED INSPECTIONS Footings (new bldg) Sheetrock Footings (deck) ? FinaUC.O. Footings (addition) Final/No C.O. Foundatfon HVAC Drain Tile Other: V Roof: _ Decking ?nsuiation ?Final _ IceMater Pool: _Footlngs _AidGas Tests Final ? Framing Siding: _Stucco Lath _Stone Lath _Brick Fireplace:_R.I. ._AirTest _Final Windows ' ? Insulation Retaining Wall Final C/O Inspection: Schedul e Fire Marshal to be present . %/ Yes _ No Reviewed By: OR4'f?/ , Buiiding Inspector Reviewed By: T• p• , Planning ---------------------------------------------- COMMERCIAL FEES: Base Fee Surcharge Plan Review SAC-MCES SAC-City SNV Permit S/W Surcharge Treatment Plant Treatment Plant (Irrigation) Park Dedication Trail Dedication Water Quality Water Supply 8 Storage (WAC) ?V A'LL. 07fiIE4 r'£S-`?L S? L10LL.£7p Us/fJt /2R 5/G.7? ,?y'??rPOfNiMT7? PEZMfT # Bl?Z'? 092.00 ? S??f s9 Financial Guarantee Storm Sewer Trunk Sewer Lateral Street Water Lateral Other Sewer Trunk Water Trunk Total J-4-2&G v- Page 2 of 3 Mike Maguire MafCh 27, 2008 MAVOfl Robert R. Copeland Paul Bakken Copeland Building Corp. Peggy Carlson 5300 Hyland Greens Drive, #200 Cyndee Fieids Bloomington, MN 55437 Meg Tilley . COUNCIL MEMBEqS Dear Robert: Thomas Hedges We have started our review of the construction documents submitted in pursuit of CIN AOMINISTRATOFl obtaining a building permit for the above-referenced project. This review is not intended to be an exhaustive and comprehensive report. Unless otherwise noted, all references are to the 2006 I.B.C. It is our goal that this review will help you in complying with the applicable codes and we are, therefore, requesting that the following items be addressed: 1. Soils Report. MUNICIPAL CENTER z. Special Structural Testing and Inspection Program Summary Schedule (form 3830 Pilot Knob Road enclosed). Eagan, MN 55122-1810 3. Energy Calculations. 651.675.5000 phone 4. Fire Protection System Plan Review Information (form enclosed). 651.675.5072 fax 651.454.8535TDD If you have any questions concerning this letter, please call me at (651) 675-5683. MAIMENANCE FAGLITY SIf1Ce •I 3501 Coachman Point / ?^??Z? Eagan, MN 55122 Craig Novaczyk 651.675.5300 phone Senior Building Inspector 651.675.5360 fau 651.454.8535 TDD Cc: Greg Thompsen, Planmark 6533 Flying Cloud Dr, #100 Eden Prairie, MN 55344 www.cityofeagan.com THE LONE OAK TREE The symbol of strengih and growth in our community. City of EapIl Ma TO: Scott Peterson, Building Inspections #_29_ 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 Jim McDonald, Police Department Mark Anderson, Electrical Inspector Sarah Brandel, Community Development FROM: ? Craig Novaczyk, Inspector DATE: March 18, 2008 RE: Plan Review For: Cub Foods at 1020 Diffley Road 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 requesY" form to me. Comments: Indicate below any fees that are to be collected with the building permit. ? Yes ? No landscape security required ? Yes C No water quality dedication ? Yes ? No park dedication ? Yes ? No trail dedication ? Yes ? No tree dedication ? Yes n No PRV Required Amount Z o n i n g ? Meter Size Signature CD/Bldg [nsp/FOrms//Plan Review For REVISED 2-07 City of Eapn In TO: Scott Peterson, Building Inspections #_29_ Mike Ridley, Planning - Dale Wegleitner, Fire Marshal Fx°"e_6.1 Tom Colbert, Engineering 511, 2y P#'. ? John Gorder, Engineering Dave Westermayer, Engineering Leon Weiland, Engineering Tom Struve, Maintenance Eric Macbeth, Maintenance WkC y i??jG? = g?9, y3y ? Gregg Hove, Maintenance 53 4206(2. 96 Jim McDonald, Police Department 37 x 3HY.?y . MarkAnderson, Electrical Inspector $36, v1 ?5y??y ? 2?? ?y Sarah Brandel, Community Development Y5h+6 FROM: Craig Novaczyk, Inspector o0 W?f? S?r?tae ? 2 773. - DATE: March 18, 2008 5f`? RE: Plan Review For: Cub Foods at 1020 Diffley Road 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 requesY" form to me. Comments J<-???h?it?c. 5?e re?,?? ???-? - ?n?. ???? OE?-vP-G' ?{'?v??'? r ?D ??• i,???.?t i'i?viTcrul o6/r«af?v?.s a5 5/?owc. oz, 6u?%?/?.?er?n?t ? ? > > ? Indicate below any fees that are to be collected with the building permit. ? Yes ? No ? Yes ? No ? Yes ? No ? Yes ? No ? Yes ? No ? Yes ? No ?;4 ignature landscape security required water quality dedication park dedication trail dedication tree dedication PRV Required / .? Amount Y-/6 - o ig Date Zoning? Meter Size CD/Bldg Insp/FOrms//Plan Review Por - REV ISED 2-07 City of Eapn Meo TO: Scott Peterson, Building Inspections 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 Jim McDonald, Police Department Mark Anderson, Electrical Inspector Sarah Brandel, Community Development FROM: Craig Novaczyk, Inspector DATE: March 18, 2008 RE: Plan Review For: Cub Foods at 1020 Diffley Road 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 requesY"form to me. Camments: # _29_ Indicate below any fees that are to be collected with the building permit. ? Yes ? No landscape security required ? Yes ? No water quality dedication ? Yes ? No park dedication ? Yes ? No trail dedication ? Yes ? No tree dedication ? Yes ? No PRV Required Amount Zoning? Meter Size ? Signature !`"I 1 ?il0 Date -r CD/Bldg Insp/Forms//Commercial Bldgs Final & Plan Review For - REVISED 2-07 ? C-e-- Jen'thg: Fence Designs: Aluminum: 200 Series Fence Styles QAS Ornamenta! Fences n/ Dis[inclinn 1-500-344-2242 FENCE DESIGNS - PRODUCT FEATURES ABOUT US LITERATURE CONTACT FAQsAluminum I???,ei?? `y y'`Sy,•? Industrial 100 200 Series Fence Styles 200 400 ....?..,_,., <.......,.,?_.:.__ '..,......._ ._._ _.'.___. Concord Encore Ovation Regenty ? Acce55ories Gates General Info i pw+1 INr .. ?• of 1O??? 1 Specifications ??? ' Patrfot Ornamental W?e \ Click here for larger image. Qlick he,re for larger ima?]ce._ Style #202 is a more modem design with a smooth rail on top rather than ezposed picket points. S1YlE Click herefor larger Click here_for larger image_ image. Sryle #200 is a modifcation of #202 which combines the safety of a top rail with fhe traditional look of pointed pickets below the rail. Style #217 uses finials underneath the top rail rather than standard pointed pickets for a refined, elegant appearence. Modtiled SMe M0. 5202 and #211 Modified Sryle #200, #202, or #211 are variations of the above. They are only available in a 54" height and are designed to meet sVingent pool enGosure codes [hat require a 45" spacing behveen horizontal mils. These fences are modifed so that they do not have the pickets extentling below the bottom rail. Page 1 of 2 http://www.jerith.com/200.htm 5/2/2008 Click here for larger Imoge.. Jerith& Fence Designs: Aluminum: 200 Series Fence Styles FENCE DESIGNS PRODUCTFEATURES ABOUT US LITERATURE CONTACT FNQS HOME Copyright 2005 ]erith ManufacNring Inc Page 2 of 2 http://www.jerith.com/200.htm 5/2/2008 Click hece for larger image. City of Eapn Ma TO: Scott Peterson, Building Inspections 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 Jim McDonald, Police Department Mark Anderson, Electrical Inspector Sarah Brandel, Community Development FROM: Craig Novaczyk, Inspector DATE: March 18. 2008 RE: Plan Review For: Cub Foods at 1020 Diffley Road 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 requesY' form to me. Comments: # 29 Indicate below any fees that are to be collected with the building permit. n Yes ? No landscape security required ? Yes ? No water quality dedication ? Yes ? No park dedication ? Yes ? No trail dedication ? Yes ? No tree dedication ? Yes ? No4 PRV Reguired ?" 1 Amount Zoning? Meter Size Siature "- cIDvdg [nsp/FOrms//Plan Review For Date REVISEU 2-07 City of EapIl In TO: 5cott Peterson, Building Inspections 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 Jim McDonald, Police Department Mark Anderson, Electrical Inspector Sarah Brandel, Community Development FROM: Craig Novaczyk, Inspector DATE: March 18, 2008 RE: Plan Review For: Cub Foods at 1020 Diffley Road The plans are in our plan review section for your review and comment. # _29_ 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 requesY" form to me. Comments: Indicate below any fees that are to be collected with the building permit. Cl Yes ? No landscape security required ? Yes ?( No water quality dedication ? Yes ? No park dedication ? Yes ? No trail dedication ? Ye ? No tree dedication ? e F? 4 N P V uired Signatu Amount 3f /Q?08 Date Zoning? Meter Size CD/Bldg Insp/Fomu//Plan Review For - REVISED 2-07 City of EaiaIl Iemo TO: Scott Peterson, Building Inspections 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 Jim McDonald, Police Department Mark Anderson, Electrical Inspector Sarah Brandel, Community Development FROM: Craig Novaczyk, Inspector DATE: March 18, 2008 RE: Plan Review For: Cub Foods at 1020 Diffley Road 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 requesY" form to me. Comments: # _29_ Indicate below any fees that are to be collected with the building permit. ? Yes ? No landscape security required ? Yes ? No water quality dedication 0 Yes ? No park dedication Amount Z o n i n g ? Meter Size ? Yes ? No trail dedication ? Yes No tree dedication ? Yes No PRV Required Signature CD/Bldg Insp/FOrms// lan Review For !(l-0 Date REVISPD 2-07 Clty of EapIl In TO: Dale Schoeppner, Building Inspections Scott Peterson, Building Inspections ,/Craig Novacryk or Mike Lence, Building Inspections Mike Ridley, Planning Carol Tumini, Utility Billing Dale Wegleitner, Fire Department Tom Colbert, Engineering John Gorder, Engineering Leon Weiland, Engineering Tim Pahr, Engineering Paul Olson, Maintenance Tom Struve, Maintenance Eric Macbeth, Maintenance Mark Anderson, Electrical Inspector FROM: Terry Zelenka, Building Inspector DATE: August 27, 2008 SUBJECT: Final Inspection for Cub Foods - 1020 Diffley Road The Protective Inspections Division will be performing a final inspection at the above referenced property on October 1, 2008. If you have cause for not granting the Certificate of Occupancy, please submit a"hold requesY' to my attention. The person/department requesting a hold is responsible for notifying and resolving problems with the affected parties. CD/Bldg Insp//Forms/Comm Bldg//Final Inspection For_ Apr.-8. 2008 4:21PM Copeland Building 952 832 5301 Na.9581 P. 2 04/08/2008 10:05 FAl( 651 487 1812 BRAUN INTERTEC Q002/002 Apr. S. 2008 11:14hM Coaelan4 Buildin8 952 832 5301 40, 9501 F. 2 c) O SPeQial M-r.uC't1lYitl Te'stlpg•n1id:Inspection 1+r.ogram Sumynaryl5clxedtil4 Pro1'oottJntnu Y,OGAtI611' •????? (?`, (),,?' TypE of SpeclRr. RePoi1 AdafCned Scct 'n /?dIcIM ' D@sctlYifmi(3)- Ins ecto? A) p?c umu S L? 2 ..e?_... v 4p .,..?1? ,•???: ?maaa,cuuIeannuycrmsu `AenmUlo le A _.__..' "_""'?,:....__...??...?...._v.?..., !nr•Specltll7iiepdelim? &'Tesf h?r;" oe:-cuntalncd fo.ihe,Stdi? 4k'iAdrtnte adspted IDL`.) I pr6ACOn`f y@n Gu •ddW??'srttloi181rtlcliy by w{altlnp;GA13D/MN'.M wtv(v;cecm':m•8° U ,rcnn;iAfu, la•bnpy.ovl'deQby.ihe•vuilalugdrrc(a). 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A Structural Steel Special Inspection Final Report Cub Foods Store 1020 Diffley Road Eagan, Minnesota Prepared for Planmark Project AV-04-06040A 11 ??(c LS J T I August 5, 2008 P AUr, o $ 2008 Braun Intertec Corporation 5 : 1 n a u FIFTY YEARS BRIWUtl9 INTERTEC August 5, 2008 Tom Peterson, PE Planmark 6533 Flying Cloud Drive, Suite 100 Eden Prairie, Minnesota 55344 Braun Infene< Corporation 11001 Hompshkc Avenue $ Minneapolls, NiN 55438 Project AV-04-06040A Re: Structural Steel Special Inspection Procedural and Final Report Submittal Cub Foods Store 1020 Diffley Road Eagan, Minnesota Dear Mr. Peterson: Phone: 9;i29952000 r? 952.995 2020 Web: 6rouNmene<.mm Please find attached to this procedurel report the Structural Steel Special Inspection Final Report for the Eagan Cub Foods Store and the supporting Special Inspection Daily Reports. Special Inspection and Testing Procedures The special inspection services were periodically provided by International Code Council (ICC) certified special inspectors in accordance with the requirements of the Minnesota State Building Code, Chapter 1700 of the International Building Code (IBC) and the project plans and specifications. The purpose of special inspections is to provide a review of the contractors work designated by the project structural engineer as needing special inspection under the guidelines of the IBC to determine compliance with the approved construction documents. The special inspector does not have the responsibility or authority to, nor is it the intent of special inspections to have them, judge, or modify the construction documents. Only the structural engineer of record can do this. As the special inspections were completed, a Special Inspection Daily Report was prepared to summarize the results of our inspections and testing. A copy of this report was provided to the contractor's site representative for their review and records. As part of this report, items needing correction or discrepancies observed from the approved construction documents were noted. Plans and Specifications The plans and project documents available at the site were used for our inspections. Visual Examination of Field Welds Visual examination of the field welds was conducted in general accordance with American Welding Society (AWS) D1.1-2006, Figure 5.4 and Table 6.1 requirements and the requirements of the project plans and specifications. -- --------- - ------- --- -< Celebraring 50 ycnrs of grnuah thruugh service nnd nust Planmark Project AV-04-06040A August 5, 2008 Page 2 Bolted Connection Observations Bolted connection observations were conducted to determine if the bolt holes were filled and if the splined end of the tension control bolts had separated from the body of the 6olt. Removal of the splined end is a direct indicatorthe bolt has been torqued to the minimum snap-off Ioad. At connections where the splined ends were not, or could not be removed, the torque applied to the bolt by the contrector was determined using a hand-held torque wrench. In addition, each connection was observed for fit-up and to determine if the various plies were in contact with one another. Deck Weld Observations Deck weld observations were conducted in generel accordance with AWS D1.3-1998, Section 6.0 requirements and the requirements of the project plans and specifications. In addition, the location and the completeness of the side lap fasteners were observed and evaluated. Anchor Bolt Observations The anchor bolts were observed to determine if they were in place, and if the nuts were installed, fully engaged and snug tight. If required by the construction documents, we also observed if the plate washers were installed. General In performing its services, Braun Intertec used that level of care and skill ordinarily exercised by reputable members of its profession currently practicing in the same locality. No warranty, express or implied, is made. Thank you for the opportunity to provide the special inspection and testing services for this project. After review of the attached Special Inspection Final Report, if you have any questions or require additional information, please call Len Vos at 952.995.2514 or Marv Denne at 952.995.2510. Sincerely, BRAUN INTERTEC CORPORATION / Leonard T. Vos ICC Certified Special I spector-S ctural Steel and Welding . euer, PE Vice Pres' ent-Principal Engineer Attachment: Structural Steel Special Inspection Final Report c: Mr. Dale Schoeppner; City of Eagan Inspections Department Mr. Rob Golish; Braun Intertec Struc[Steel Final Report ? t (NTERTEC I •l? FIPTY YEAKS BRAUN INTERTEC 8raun Intertec Corpomtion I'hone -. 952 9952000 11001 Hnmpshue Av=noe S Fax: ^>52.99i"020 Minnuapolis, MN 55438 We6bmun'mteiiecmm Structural Steel Special Inspection Final Report City of: Eagan, Minnesota Date: August S, 2008 Attention: Mr. Tom Peterson Project: Cub Foods Store 1020 Difflev Road Minnesota Braun Intertec Project: AV-04-06040A In accordance with Section 1704 of the International Building Code and the agreed upon scope of services, the required special inspections and testing have been provided for the following items: Bolting. The bolted connections detailed in the attached Special Inspection Daily Reports were observed in general accordance with the requirements of the plans and specifications. There are currently no outstanding or unresolved bolted connection related issues. Structural Welding. The welded connections detailed in the attached Special Inspection Daily Reports were observed in general accordance with the requirements of the project plans and specifications. There are currently no outstanding or unresolved structural welding related issues. The deck welding and side-lap fasteners detailed in the attached Special Inspection Daily Reports were observed in general accordance with the requirements ofthe project plans and specifications. There are currently no outstanding or unresolved decking-related issues. Conclusion Based upon the inspections performed and the attached reports, it is our professional judgment that, to the 6est of our knowledge, the inspected work was performed and completed in accordance with the approved plans, specifications and applicable workmanship provisions of the International 8uilding Code. Inspecting Firm: Braun Intertec Corporation I hereby certify that this plan, specification or report was prepared by me or under my direct supervision and that I am a duly Licensed Professi4 Engineer under the laws of the State of Nkp1????;Q?! ? ic ael M_ euer, =G; ' Vice Pre?6ent-Principal Eng??'r, ?? License'Number: 15571 ?`ti'•.,, ,,.August 5, 2008 bq0? Attachments: Special Inspection Daily Reports 1 through 6 --- ---_? Celebrating 50 yezrrs of grnwth thromgh service and erust Poge I of / sRauN INTERTEC SIDRPT Special Inspection Daily Report ciry of A?apLe va11e-r Report No.: S?Toi(-{u(cK DateoFThisReport: :.?OOu Project Name: C" t S F=, =A S Project No.: FT I?- O?- O Project Address: ?!2 ),C lj? : t'7 ?? ClienF. ? (4, kvlc-r (L Client Projecf No.: Weather: Su,,.., -, Temperature: Type of Inspedion: Inspetiion Coverage: ? Continuous ? Masonry ? Rebar Placement ? Foundafions ? Special Cases E?' Periodic 8B-Welding & Bol}ing ? Concrete Placemenf ? Fireproofing ? Piles & Piers ? Tendon Placement ? $oils Did the architect or engineer authorize changes To city a pproved plans? Yes ? (Lisfed Below) No ? Description and location of work completed: o C ? q 6 / -Af Q -F / 5 ;?Z.. - /?c ?-l.'ac1^o?? 41e?' e-?/c.-?..s 4A' .Fln X',F-1 ' t ce s< (k dv 6Gi' LtlPi/e?? /'/' F? I" T '/?O Cl J(.^ , 3, ??, r f 4:cfar- ta l'e /? ?/Ce?f w@ /? .? F/ ?..s? a, 3 N L ,?o..? Cc.•.. lf''? ' NC ?I C.^e. ? no Lis} fests performed: • Are }here any discrepancies noted from ihis day's o6servations? Yes ? Na? • Are }here ony outstanding discrepancies on this projecT? Yes ? No • If yes, see aHached $ummary $heet. To the best of our knowledge, work inspected was done in accordance with ihe opproved plans, specificafions and applicable workmanship provisions of }he current IBC/UBC, except as noted above. Signed: T?" 3 -?-UO Date: PrinT Full Name: I.D. No,. (D ?? ?,-,) -[>5? White copy to Braun Intertec file. 81ue copy fo Projed Site Representafive. Prwriding engineering und environmental salutimu aince 1957 sRauN Page ( of ( SIDRPT I NTE RTEC Special Inspection Daily Report Report No.: Projed Name: Project Address: Clienf: Weather: City of ?DDIiZ ? zl??, _ -?'?''?^C L •c.? ,S y 26 3 Date of This Report: ^ ? .-c S rA,: ?c ^ Project No.: ."'1 /`- 04(-- d ? C) y U - ? F/??n Client Project No.: 414 ?e. rF TemperaNre: - 75 %° Type oflnspedion: Inspection Coverage: ? Con}inuous ?- Mason ? Rebar Placement ? Foundafions ? Special Cases Periodic W ' g?BnlTing ? Concrete Plocement ? Pireproofing ? Piles & Piers ? Tendon Placement ? Soils Did the archiTecf or engineer authorize changes to cify approved plans? Yes ?(Listed Below) No ? Description and location of work complefed: ee?Qy,?_? ??- r (;? -2 a)?ene L ? -n/o c%•rc.ti./Jc,.? e?Co? 612 5t ltCh e?"4?Ee4? AQ /v4e,-?, ?o KG ??O hS ?C ?JCr,2?4 c..i vw?e' ?-? '-N¢ ?F".T q.,cla. '!?, ?'ol c, u?? anr ? r ?'?+ F'sz. f3F?Y /?...? f}? F - i?o G?` s o ?'?G? c?, tqo +?d ?l Y^-t ? I?G ?? /O ?•? O D/? ? hsme-4t-p?d: 14GK v.JQ?e?:.S C, JP?d r??erv? Carrc1-?? ?> 'S[?.•t?r'/iy 4C?90(R- ? li'.1Y?c .?a f)roCY`Cts • Are ihere any discrepancies noted from ihis day's observations? Yes ? No • Are there any outstanding discrepancies on ihis project? Yes ? No • If yes, see attached Summary Sheet. To the besi of our knowledge, work inspecfed was done in accordance wi}h ihe approved plans, specifications and applicable workmanship provisions of the current IBC/UBC, excepf as noted a6ove. Signed: ?i-sDate: C`??^ Print Full Name: LG„ ? S I.D. No.: White copy fo Braun Inlertec file. Blve copy to Project Site Representative. Prmating e'tgineering and envirmimentul solutirnis since 1957 * Page ? of r sRauN SIDRPT INTERTEC Special Inspection DailyReport ciry ct ?-, Reporf No.: g5!? afe of This Report: Projecf Name: r"S F? c(S Project No.: U`14 ' O G 0 Project Address: Clienf: Clienf Projecf No.: Weather. ??. Temperature: ?V Type oflnspedion: Inspedion Coverage; ? Continuous ? Masonry ? Rebar Placemeni ? foundations ? Special Cases 59" Periodic ? Welding & BolTing ? Concrete Placement ? Fireproofing ? Piles & Piers ? Tendon Placemenf ? $oils Did the archi}ect or engineer authorize changes to city approved plans? Yes ? (Lisfed Below) No ? Description and lomtion of work completed: SG"ez "J"CR I?.?, rk9?/ 5e 1 fta?? ?-E ? . ? . s -r- ?e l?, - ,?a n! D)'7FH.? fa •f 5'? ?i?aa.,...hr ?`-, ??2????lri° hP,+l ?l' (?elJS - 1'f4 F ? ?.D ?-?de - ?o ?•S C 3 ??oo.? I?ZG/c wt?l?J ?` ,S.'1-k 111.2 c -f. /- 7 - ,?? ?-(,ic_,?nc_r. Lisf tests performed: • Are ihere any discrepancies noted from this days observations2 Yes ? No • Are fhere any oufsfanding discrepancies on this projed2 Yes ? No . If yes, see attached Summary Sheei. To the besi of our knowledge, work inspected was done in accordance with the appraved plans, specifications and applicable workmanship provisions of the current IBCNBC, except as noted above. Signed: DaTe: PrinT Full Name: ?6?-' (??S I.D. No.: Whife copy to Braun Intertec file. Blue copy fo Projecf Site Representative. Providiry engineering and etwirvnmental solucions since 1957 sRauN Page ( of / SIDRPT INTERTEC Special inspection Daily Report City of Report No.: O 'fY?. L`f Lt -? S ??. ?~ Date of This Reporf: Project Name: 5 F??/s" Project Na.: Project Address: / Client: a Client Project No.: Weafher: H Temperature: -7, 2 - 0 e .? !?' O '?/ ? L C O ?Fv -4 Type oflnspection: Inspection Coverage: ? Continuous ? Masonry ? Rebar Placement ? Foundations Eg Periodic Eg Welding 6 Bolting ? Concreie Plocement ? Fireproofing ? Piles & Piers ? Tendon Placement ? Soils Did the archi}ect or engineer authorize changes }o city approved plons$ Yes ?(LisTed Below) No ? ? Special Cases Descripfion and lomtion of work tompleted: l? ?`? , W,26 /c C-?lds /,j/ - .._ .?_???_ Scncf. n? Q4? , List tesis perFormed: • Are there any distrepancies noTed from This day's abservations$ Yes ? No • Are There any ou}sfanding discrepancies on this projecf? Yes ? No • If yes, see attached Summary Sheet. To the best of our knowledge, work inspecFed was done in accordance with the approved plans, specifications and applicable workmanship provisions of the current IBC/UBC, except as noted above. Signed: Date: 7- Print FuII Name: xe? G/JS I.D. No.: CJ 7 White copyTo Braun Infertec file. Blue copy to Projed Site Represeniafive. Praoidirig engineering and enviremmental solutions since 1957 Page r of SIDRPT BRAUN INTERTEC Special Inspection Daily Report ciry of ,vl? 6e- v? ? Report No.: 2n?c d?,X ?i? Date oF This Report Project Name: -<? ? s Foc4 J Project No.: Project Address: /a 4-? ?- Ac` Client: PlG- 0',Client Project No.: Weafher: S u ?.. Temperature: Type of Inspection: Inspedion Coverage: ? Continuous ? Masonry ? Rebar Placemen} ? Foundations ? Special Cases 4E? Periodic ? Welding & Bolting ? Concrete Placemen} ? Fireproofing ? Piles & Piers ? Tendon Platemeni ? Soils Did the architect or engi neer authorize changes to city approved plans? Yes ? (Lisied Below) No ? Description and lomtion of work completed: ?„ /?., c.e fL_, ??-f-g? .":-?sr ?'? 7-4 - b, 7 ? fJGr 1?..y •F d,-?GC-?' /,?te'/Cf v' CL A./o orme: ?•3?? 6?li?t C's 2_ tY- SC - e,.>l''- • Are there any discrepancies noted from ihis day's observations? Yes ? No • Are there any outsianding discrepancies on this projed? Yes ? No • If yes, see attached Summary Sheet. To ihe best of our knowledge, work inspected was done in accordance wiih ihe approved plans, specifications and applica6le workmanship provisions of the current IBC/UBC, except as noted above. Signed: Prini Full Name: vv 3 Date: -7 /6 , :? o o rf` I.D. No.: - &E- Whi/e copy to Braun Interfec f'rle. Blue copy to Project Sile Represeniaiive. Praviding engineenng and environmental solutioru since 1957 4,? n N , Page e' of ? s Rau N SIDRPT INTERTEC Special Inspection Daily Report ciry of ////G? , Report No.: ?1 ?J ??C ?t afe of This Reporf: 'p/?Q Zj ? Project Name: L i.+4c Project No.: A V- b4O/y ProjecfAddress: fDc;?O ?.'??lcy Ad Client P/4', Aqr tc Client Project No.: Weather: .f nn c. Temperahire: Type oflnspection: Inspection Coverage: ? Continuous ? Masonry ? Rebor Placement ? Foundotions ? Special Cases gk Periodic Welding & Boliing ? Concrefe Placemenf ? Fireproofing ? Piles & Piers ? Tendon Placement ? Soils Did fhe archiTed or engineer authorize changes to ciiy approved plans? Yes ? (Listed Below) No ? - DescripTion and bcation of work complefed: i64 4y,,, A QkCZ„ 6a ?4- ?-,.. h6 y??•F iI A-aorrl f 3) Lisf tests performed: • Are there any discrepancies noted from ihis days observations? Yes ? No ? • Are there ony ouisfanding discrepancies on ihis projed? Yes ? No • If yes, see attached Summory Shee}. To the best of our knowledge, work inspecfed was done in accordance with ihe approved plans, specifications and applicable workmanship provisions of ihe current IBC/UBC, except as noted above. Signed: vU DaTe: Print Full Name: Zi., ("t" S I.D. No.: -'?? S- White copy to Braun Intertec file. Blue copy to Projed Site Representative. Prouiding engineeririg and enviranmrntal mlutimu since 1957 10-06-2008 02:41PM fROki-FORE hECHANICAL +7637866545 T-487 P.002/002 P-939 y, . MECHANIGAL CONTRACTOFiS .. . .----...... _...___... ....---? . .. ... .. .. .. . ....... FORE MECHANlCAL, lNC. • 3102 703rd Lane NE • 8laine, MN 55449 Phone: 7631786-6500 • Fax 7631786-6545 • wuvw.foremechanical.com pctober 6, 2068 City of Eagan 3830 Pilot Knob Road Eagan, MN. 55122 RE: Cub Foods 1020 Diffley Road Eagan, MN. 55123 Scott Peterson: lZegarding the grease ductwork, Fore Mechanical performed a light test to ensure ihere were no welding deficiencies. Tf you have any questions please feel free to conract me. Sincerely, Kevin Grell Vice Presici? A I, AIR OUTLET TEST REPORT (Flow Hood) PROJECT C SYSTEM TEST APPARATUS Flow Hoad OUTLET DESIGN ARY R E FINAL PERCENT REA SERVED A NO, iYPE SiZE AIRFLOW CFM M ? W AIRFLOW CFM OF DESIGN 37? ! 37 r32/ U ra l ,,,1 g z?o ??3' 167 ? Z /Y. , 703 E<<g&s 3 307 / 78 Z'f7 /qa i eo I Dy'?rcE ? ?6f zol ?-r"GEC, 7 - ? REMARKS: Design 0 Final 0 TEST DATc /o"D8 READINGS BY ?? . p' . Paae ? MINNCSOTA OEPARTMENT OF September 24, 2008 A.?,GRICULTURE FAOM THE FARM TO YOVR FAMILY Scott Reinke Supervalu 6533 Flying Cloud Drive Ste 100 Eden Prairie, MN 55344 D7ICOY2 CO T, 9 ? H L'J ? LicenseP 4 SEP 2 9 2008 Deaz Mr. Reinke: This office has completed a preliminary plan review for the Cub Foods store located at Diffley Road and Lexington in Eagan, Minnesota. The plan review was conducted as required by Minnesota Statute Chapter 28A and the Minnesota Food Code Chapter 4626. The Minnesota food code is the primary goveming document for this review and may be found on line at nww.le¢state.mn.us/leg/statutes.asp by requesting Minnesota Rule Chapter 4626. All appropriate permits from the local authorities shall be applied for and issued prior to starting any work on the site. Failure to comply with this may result in a delay or this of'Yice not issuiog your retail Food Handlers license until the proper permits are issued. In addition if your water is supplied from a well you will be required to provide a curren[ proof of water potability. Our inspector will verify that the permits 6ave beeo obtained. The Minnesota Department of Agriculture grants preliminary plan approval to the plans for this proposed food establishment. Upon tlus agency certifying that all items in tlus review have been addressed, final plan approval will be a'dllted. This preliminary plan approval is based upon the supposition that construction and equipment plans submitted to this office do not change. Anv deviation from the approved plans and soecifications must have prior approval from this aeencK Preliminary approval of the plans and specifications does not constiwte endorsement or acceptance af the completed establishment. Periodic on-site inspections may be made during construction. A final inspection of the comple[ed establishment, with equipment installed, must be conducted to determine if it complies with the requirements of the Minnesota Food Code. Contact Food Inspector Stephen Clsncy at 651-552-5062 to arrange for a final inspection. You are listed as the contact for this project at 952-914-5503. General Comments This review was for the uew wnstruction of a 44,985 square foot grocery store with deli, meat, bakery and produce departments. At this time, a HACCP plan has not been sobmitted for review. In addition, I have found nothing within the plans or application to indicate a HACCP plan review is necessary. Licensing of your 6rm is dependent upon proper installation of an approved water supply, pWmbing and waste system. Our inspector will review your approval letters from the appropriate authorities to insure these requirements are met Pursuant to MS 31175 a license shall oot be issued or renewed without approved plumbing, water and waste systems. (4626.0980, 4626.1030) (5-101.11, 5-401.11) Also our inspector will review approvals from building and fire officials before granting final approval. Please provide copies of approvals for review at the final inspection. Minnesota reauires that all eauipment be Certi6ed to the National Sanitation Foundation Standards foY clean abilitv durabilitv and nerformance New or used equipment not meetinll these standards is prohibited. Anv eauioment installed that does not meet these standards mav be ordered removed. As submitted vour food eauioment anaears to meet the anolicable NSF standard Bakerv equioment anuears to meet the aonlicable NSF or BISSC standard The plans indicate a Tvne I hood with a wet chemical fire suporession svstem will be installed above the donut frver in the bakerv and above the rotisserie, warmer, combi oven and frvers_ in the deli. 625 Robert 5treet North • St. Paul, MN 55755-2538 • 651-207-6000 • 1-800-967-AGRI • www.mda.state.mn.us An Equal Opportunity Employer And Provider • TTY: 1-800-627-3529 Page 2 As submitted the room finishes appear satisfactorv The room fnish schedule indicates a resinous floorin2 svstem and resinous base will be installed in the followin2 areas• deli deli prep bakerv prep produce preo meaUseafood prep aud meat cooler. A resinous tloorinQ svstem and stainless steel base will be installed in the deli walk-in coot?_r, have a sealed concrete floor with a stainless steel base. The wall £mishes include• porcelain wall tile in the deli and deli prep areas porcelain wall tile and fiberzlass reinforced panelina in the bakerv prep area and 6ber¢lass reinforced aanelina in the aroduce prep and meaUseafood prep areas. The plans submitted indicate vinvl covered ¢vosum ceilinQ tiles will be installed in the followin¢ areas: deli prep, deli bakerv oreo oroduce prep and restrooms The meat prep room will have insulated cooler panels as the ceilinp. ianitor area in the back of the store. Concerns A three compartment utensil washin¢ sink is not comenientlv located in the deli It apuears the deli will use the three compartment utensil washine sink in the bakerv Proper procedures roust be in place to ensure deli utensils are properlv washed and sanitized in a timelv manner. An adequate number of u[ensil racks, tables, carts, etc. shall Eauipment Food equipment shall meet the applicable Nationa] Sanitation Foundation (NSF) Intemational food service standards. I'he equipment shall be determined by NSF Intemational or an American Nauonal Standazds Institute (ANSI) Z341 accredited independent entity, includin-, Underwriters Laboratory or the Edison Testing Laboratory, to be equivalent to the NSF Intemational Standard. The use of equipmeut, that does not meet the NSF standards, prohibited. Bakery equipment must comply with the Bakery Indushy Sanitation Standazds Committee (BISSC). (4626.0505)(4-201.11) Custom fabricated or modi6ed equipment must be constructed by a contractor listed by NSFlnternatiorzal. T6e name and address of the fabricator for custom fabricated equipment must be identifed: (4626.0505)(4-201.11) All service counters and other millwo;k surfaces shall be protected with stainless steel, plastic laminafe, or equivalent, coveruig all exposed wood. In areas where food equipment involves heat or moisture, or where food comes in contact with the surface, a stainless steel fuush or approved equivalent material is required. Solid surfaces for food contact, such Corian or Gibraltor shall be conshvcted by a fabricator listed by an approved th'vd-party testing agency. They are required to be installed on six-inch legs ar a solid base. All azeas of the custom fabricated counters shall meet the requirements of NSF International Standard No. 35. All hard grain decor wood (e.g. oak) shall be properly sealed with a polyurethane or varnish-like materiaL (4626.0505)(4-201.11) Used equipment meeting NSF Intemational, NAMA, or BISSC standards, specified at the time of installation is percnitted if it: met the NSF Tnternational, NAMA, or BISSC standazds, in effect at the time it was manufactured, remains in good repair, is capable of being maintained in a sanitary condition, and is approved by the regulatory authority. Your inspector will evaluate any used equipment to determine if it is acceptable. (4626. OSOS) (4-20111) Provide multi-use equipment, utensils, and food storage containers that aze smooth, easily cleanable, and resistant to pitting, chipping, or scratching. All food equipment in a retail food store must be designed as to be easily cleanable, durable and be r Page 3 adequate for its intended use. Household utensils or equipment is prohibited. Retail'shelving and refrigeration and freezer display cases shall be designed and constructed to be durable and to retain their chazacterisric qualities under normal use. (4626.0505)(4-20111) Provide sufficient refrigeration to hold all readily perishable food products at 41°F or less. Provide sufficient ventilation (e.g. louvers, etc.) for the compressor unit to evacuate any buIldup of heat at the underside of the cold pans in and about the compressor azea. (4626.0675.) (4-30111) If an ice machine or bulk water unit is to be installed, the waste drain must be properly plumbed and divert to an indirect waste (air break) floor drain: *(4626.1045 A.) (5-201.11) Food Protection Provida a food thermometer for checking the intemal temperatures of potentially hazazdous foods. Thermometers must be provided in all coolers, freezers, and hot holding uniu where potentially hazardous food is stored, and must be located in an area that is representative of the hve air temperature. (4626.0705)(4-302.11) The intemal temperature of potentially hazardous food must be maintained at 41 °F or below, or 140°F or above, except during preparation. *(4626.0395(3-501.16) All freezer uniu shall hold food frozen (4626.0370)(3-50I.1I) Food on display must be protected from potential contamination from coughs, sneezes and improper handling by installing properly constructed food shields, the use of packaged food items or other effective means of protecrion. (4626.0320)(3- 30611) Provide tongs, ladles, spanilas, scoops, single-service papers, etc, to avoid unnecessary manual handling of dispensed food items. (4626.0330 A.) or *(4G26.0330 B.) (3-306.13) Utensils must be stored in an appropriate manner between usea (4626.0275) (3-304:12) Installations Seal (caullc) a11 annulaz openings around pipes and other conduits, where they pass through walls and floors. Seal all junctures beriveen the wall surface and the edges of attached equipment with approved caulldsealing compound. (4626.1395A. (I) (6-102.15) If conduit pipes are provided for beverage lines they must extend at leasf t6ree to four inches above the finished floor elevation at both ends. The annular opening between the beverage lines and the conduit pipe must be sealed with a hazd material and piovide a cleanable finish. (4626.1395 A. (I))(6-20215) All doors to the outside of the establishment must be self-closing and vermin proo£ (4626.1395A. (3.))(6-202.I5) Li tin Provide at ]east 10-foot candles (110 LUX) of light intensiry, at a distance of 30 inches from the floor, in the wallc-in refrigeration units, dry food storage areas, aud during periods of cleaning. Provide at least 20-foot candles (220 LiJX) of light intensity, at a distance of 30 inches from the floor, For azeas where food is provided for consumer self-service, including buffe[s and salad bars, or where fresh produce or packaged foods are sold or offered for consumption,.inside equipment including reach-in and under counter refrigerators, in utensil storage areas, in areas behind a baz used for waze washing, and in toilet rooms. (46261470)(6-303.11) Provide at least 50-foot candles (540 LUX) of light intensity for areas where food employees aze working with utensils and equipment where safety is a factor and areas used for waze washing. (4626.I470)(6-30111) Page 4 Install effective shielding or shatter-resistant bulbs for all light fixtures over exposed food storage, food prepararion, food display facilities, clean equipment, utensils and ]inens, and unw7apped single-service or single-use articles. (46261375)(6- 303.I1) Plumbine At least one toilet facility and not fewer than the number requued by law shall be provided. *(4626.I075)(5-203.110) These facilities must be conveniendy located and accessible to employees at all times. *(46161095)(5-204.11) Toilet rooms must be provided with adequate ventilation, hand cleanser, single-use towels or hand drying devices, tissue paper and waste paper receptacles. Toilet rooms shall have at least one covered waste receptacle for sanitary napkins, paper towels or diapers. (4626.1260)(5-501.17) Plumbing plans must be submitted to the Minnesota Department Labor and Indushy, Engineering Unit, or delegated authoriry for review and approval prior to installation. All plumbing must be installed according to the Minnesota Plumbing Code, including current amendmenrs. *(4626.1045) (5-202.11) Equipment connected to the potable water supply shall be protected from back-siphoning and back flow. Equipment with submerged inlet lines (dish machine, garbage disposal, steam table, urinal, etc.) shall be equipped with an approved backflow preventor, this includes all threaded hose bib connections. *(4626.1085) (5-203.14) If a post-mix beverage system is provided, an approved pressure-type, back-flow preventor upstream from the control valve on the carbonator (water ]ine to the carbonator) is requ'ved. (Toilets shall be equipped with an anti-siphonage ball cock assembly. The water ]ine serving a dipper well shall be permanently installed with an air gap on the water line entering the fixhire. *(4626.I055) (5-202.13) Please contact a licensed plumber or refer to the Minnesota plumbing code. Install a hot water heater in accordance with NSF Standazd 45. (4626.0505) (4-201.11) It must be of adequate size and recovery rate to provide hot water to all taps during peak water usage. Lack of hot water will require the installarion of additional hot water capacity. (4616.I015) (5-101.13) If a grease interceptor or gease trap is required by the city building official, it shall be mounted flush with the floor in an accessible location for maintenance. The lid shall be water-tight and securely fastened in place. Under no circumstances shall a grease removal device be installed above the floor. (4626.1195)(5-402.13) If soap and chemical dispensing devices are installed on potable wa[er lines, they shall be listed to ASSE plumbing standard 1055. (4526.1260) (5-50117) Sinks Install hand washina sinks in all food prepazation, food dispensing, toilet rooms and utensil washing areas. Generally this is within 20 feet as a person walks. *(4626. 1095) (5--204.11) Provide hand cleanser, single-use [owels,-and a fingernail brush at the hand•wash sink located in the food preparation, and ware washing azeas. Install a NSF three compartment, utensil-washing sink (4626.0680) (4-301:12) with integal drain boards, racks or tables, (4626.0685) (4-301.13) for the proper cleaning and sanitizing of all multi-use equipment and utensils. The size of the sink compartment must be large enou.gh to accommodate the lazgest utensiUequipment, which is to be cleaned and sanitized_ Provide and use an appropriate chemical test kit to determine the strena h ofthe sanitizing agent in the final rinse water of the three-comparhnent sink. ( 4626.0715) (4-302.14). Install a separate food prepazarion sink if raw food will be cut or combined with other ingredients, or otherwise processed. (4626.0780) Install at least one service sink or curbed unit with a floor drain for disposal of mop water and similaz liquid waste. (4626.1080)(5-203.13) Provide hooks or hang-up brackets at the utility sink for storage of mops and brooms. ptensil washing and hand washing sinks are designed and approved only for their intended use. Page 5 storaee Piovide adequate shelving covering the food operarion to ensure that food products, utensils or single-service articles are stored at least six inches off the floor. (4626.0730 A.) Food storage shelving used in walk-in refrigerators must be in conformance with.NSF standazd 92. Chrome or zinc-plated shelving without an approved factory applied hazd-baked protective wating is not approved for this purpose. (4626.0505 B) Retail shelving shall be designed and constructed to be dwable and to retain their cliancteristic qualities under normal use conditions. (4626.0505A.) Provide an area for storage of employee's personal belongings that is sepazate from food, clean equipment, and single service supplies. (46261560) Erovide an approved azea for storage of chemicals, which is sepazate from food, food equipment, and single service articles. (4626.I600) Room Finishes The floors, floor coverings, walls, wall coverings, and ceiling surfaces shall be designed, constructed, and installed so they are: a) smooth, durable and easily cleanable where food operations are conducted; b) nonabsorbent, for food.prepazarion azeas, walk-in refrigerators, waze washing azeas, toilet rooms, janitorial azeas, laundry areas, interior ?azbage, refuse storage rooms, and azeas subject to flushing or spray-cleaning methods, or other areas subject to moisture. (46261325) Polvmer flooring,s,vstems: Ifpn(ymerjlooring such as an epn.iy or urethane systems are installed they must be 118 inch minin:um in thickiaess in snack bars and sar:dwich preparation areas and 3116 inch mirrimum in Uiickness in areas where ovens, fryers and other heavy kitcken operations take place and contains a ground aggregate to refusaL The finish coat musl rertder theJlnor surface smooth to the extent th¢t it can be cleaned with available cleanisag equipmeni. . A test area sl:nu[d be provided so that our inspectm can verify the flooring dvickness. Concrete, sealed or unsealed, is arohibited: a) where food product packages, containers, or cases in those areas aze opened. b) Under equipment in food prepazation and service areas including under service cases. c) in walk-in refrigerators or freezers, waze washing areas, toilet rooms, mobile food establishment servicing azeas, hand wash azeas, janitorial, laundry areas, interior garbagge and refuse storage rooms, areas subject to flushing or spny-cleaning methods and azeas subject to moisture. (4626.1335 D.) Unsealed concrete is aermitted: For use where ouuide gazbage and refuse containers are placed, including compactors stored on a smooth and nonabsorbent surface. (46261230) Vinvl floorin¢ is orohibited: In a walk-in cooler or freezec (4626.1335 C.) vlnyl flooring is not allowed in kitchens, delt areas, behind fast food or service couuter areas unless the manufacturer reconunends itfor this use. It is allowed in storage rooms and retail areas including under food and beverage counters. Proof of recommended use wi/l be required in tleeforin ofsales material or a letler from tlte manufacturer specifcally showiug tlte recommended use before apptoval of this floaring will be granted. Floor and wall iunetures: Shall be coved and closed to no larger than one millimeter (1/32 inch) when cleaning methods other than water flushing aze used for cleaning floors. At the floor wall juncture where the fiberglass panel meets the floor an acceptable base coving such as stainless, quarry or other pre-approved materials must be installed. (4626.1345A.) Where water flushing is used coving shall be sealed. (4616.13458.) Glued rubber wving may not be acceptable on fiberglass panels, as it may nat bond to the fiberglass material. Floor surFaces: Shall in tfie food prepazation, food storage, and utensil washing areas be conswcted of smooth, durable, nonabsorbent, easily cleanable materials, which resist the weaz, and abuse to which they aze subjected. The walls and ceiling in the food preparation, utensil washing and toilet room azeas shall be smooth, non-absorbent, and easily cleanable. (46261335A) Ceilin¢s: Perforated or fissured drop lay-in ceiling panels aze prohibited in food preparation, food service, and utensil washing or toilet room azeas. (4626.7360B.) Page 6 Venrilation All heating appliances which generate either excessive heat, vapors, condensation, geases, odors or fumes, must Ue properly situated beneath a mechanical exhaust canopy. The canopy and hood construction must meet the applicable standards of the NSF. (4626.0505) In addition, the requirements of the 2001 Uniform Mechanical Code and the 2001 amended Minnesota Building Code covering commercial kifchen ventilation systems must be met Additionalty vent less systems requiring alterna[ive methods shall meet standards UL 710B, (incorporating EPA 202, UL 197), NFPA 96 chap[er 13 and have the local building and fire officiaPs approvaL (46261380) (4626.1475) Miscellaneous In accordance witfi the Minvesota Clean Indoor Air Act, tlils establishment shall be posted as NO SMOKING ALLOWED. Post signs at all public entrances. This facility may not be constructed, remodeled or wnverted, escept iu accordance with the plans and specifications as approved by [his department. Please contact me Tor approval of any propased changes or additions. (4626.1720) Thank you for your cooperation in addressingg the items outlined in this letter. I shall remain available for consultation and review of your faciliry's construction progress. Should you encounter any problems through the course of your construction or equipment installation activities, please call me at 651-20I-6214. Sincerely, Rick Brvecker Food Standards Compliance Officer Dairy and Food Inspection Division RPB:dg C: Steve Clancy, Food Inspector Lorna Girard, Supervisor Ciry Building Official Daren Johnson; Design Services Group; 6533 Flying Cloud Dr.; Ste 100; Eden Prairie, MN October 17, 2008 Mike Maguire Maroa PaulBakken Cyndee Fields Meg Tilley COUNCIL MEMBERS Thomas Hedges CrtV ADMINISTRATOR MUNICIPAL CENTEq 3830 Pilot Knob Road Eagan, MN 55122-1810 551.675.5000 phone 651.675.5012fax 657.454.8535 TDD MAINTENANCE FACILITY 3501 Coachman Point Eagan, MN 55722 651.675.5300 phone 651.675.5360fax 657.454.8535 TDD www.cityofeagan.com THE LONE OAK TREE The symbol of strength and growth in our community. Excel Title LLC 118W6`hSt Monticello, MN 55362 Re: Landscape Inspection 1020 Diffley Rd, Eagan, MN 55123 In February of 2004 a$S,OOO landscape security deposit was submitted to the City of Eagan in conjunction with issuance of the building permit for construction of the building at the above referenced location. These funds aze eligible for release to the depositor at this time. Please note that the property owner continues to be responsible for maintaining the health of all plantings on the property. In accordance with section 11.70 of the Eagan City Code, the property owner must maintain.all landscaped areas, and install healthy repiacement plants for any plants that die or are removed due to disease. Maintenance shall include removal of litter, dead plant materials, unhealthy or diseased trees, and necessary pruning. An inspection will be conducted by city staff next spring/summer to verify that the condition of the landscaping is acceptable under city code. Thank you for your attention to tlus matter. If you have any questions, please call me at 651-675-5684 or Planner Sarah Thomas at 651-675-5696. Sincerely, Fran Doherty ? Planning Deparhnent cc: Sazah Thomas, City Planner 411? City of Eaian 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 ? ?c???rvL D JUN 0 3 2008 D 2008 MECHANICAL PERMIT Site Address: `0 Tenam: LO-b (S,14)-F_2 VA I u --------------, ? Foc Office.Gse I I j PertnitM: ? ? Permit Fee: ? Date Received: . ?C'i I ? ? Staff: ?-----------------? TION Suite #: RESIDENT / OWNER Name: Phone: Address / City / Zip: CONTRACTOR Name: lbd F-t?tY I Clf_r(? 17n License #: N L?'??5 g 5 / Address:l 12-15 /7Y1'}ev I [ dLr, bv(J G Ciry: \1"Nn tn-Y\ State: 0 ?j_ ZiP: Phoneq5L4??t2?'S0 ContactPerson:vQ b 5 TYPE OF WORK XNew _ Replacement _ Add'Rional _ Alteration _ Demolition Description of work: '_1 AtA i E'T w 65 `!` NOTE: Both rooimounted and'ground mounfed mechanical equipment is required to a' be screened by City Eode. Please contaet the Mechanical lnspector ortne?oithe Planners tor informafion on ermitted screenfn mefhods. ' RESlDENTIAL COMMERCIAL PERMIT TYPE Interior Improvement ? New Construc[ion Fumace _ Air Condilioner _ Install Piping _ Processed Air Exchanger _ Gas _ Exterior HVAC Unit ' _ HVAC units must be screened _ Heat Pump Under / Above ground Tank L Install /_ Remove) Other " When installinq/removing tank(s), call for inspection by Fire Marshal and Plumbin Ins tor RESIDENTIAL FEES: $50.50 Minimum Add-on or alteration to an existing unit (includes $.50 State Surcharge) $90.50 FifB f2p81f (replace burned out appliances, tlucrivork, etc.) (includeS $.50 State Surcharge) $ TOTALFEE COMMERCIAL FEES: $70.50 Underground tank installation/removal OR Contract Value $??Q . em x t°k $50.50 Minimum (includes State Surcharge) _$ 3`a I1.5D Permit Fee - If Pemiit Fee is less than $7,000, surcharge is $.50. Oj? ? - If Pertni Fg is >$1,000, surcharge increases by $.50 for each =$ . State SurCharge $1,000 Pertnit Fee (i.e. a$1,001-$2,000 PertnN Fee requires a$1.00 surcharge). O S? TOTAL FEE $ o+IK (Iris I hereby acknowledge ihal [his intortnation is complete antl accurate; that the vrork will be in conformance with [he ordinances and codes ol the City of Eagan; that I understantl this is not a pemil, bu[ only an application tor a permit, and work is not to start without a permit; Mat the vrork will be in accordence with ihe apprrnetl plan in the case ol work which requires a review and approval of plans. ? ? x?lYL1 ?J-ob? x_!?irs4--?1? Applicant% Printed Name Applicant's Si re n FOR OFFICE USE ' Reviewed By: ?-2 ? Date: V _. - .:. - Required Inspeatwn?3: ' Y Urlder Grourid I Roagh In ?_AirTest _Gas Service Test _In-floor Heat ?Final Affih? City of Eaian 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675.5675 Fau: (651) 675-5694 j - Ftir'OfliceUse --?---?----? I Permif B: I ? -? 28Jr'q?5v 1 ? PermR fee: ? I t ? Date Received: I ? Stafl: ? 2008 COMMERCIAL PLUMBING PERMIT APPLICATION Date: ?/ - 2 9- O R Sfte Address: / a 2 D J-)t i',P4'jr? ? ?l mZ-Ilr#ere, ?\p Tenant• _ G v b Foo?? c Suite #- POWNER? Name: Phone: ? CONTRACTOR Name: 213rv;11e PI,,,,,(?ha L;ce,uep: Address: (oS S D") cc, Qlvd C;Ty: s?. Po?I State: f71a Zip: SSl1? Phone: (pSl-484-VoS(a ContactPerson: 7YPE OF WORK New Replacement Repair Rebuild Modify Space WoAc in R.O.W. - - - - - - Descriptlon of work: PERMITTYPE COMMERCIAL Y New Construction _ Modify Space _ Irtigation SYstem LXYes !_ no) (_ RPZ /_ PVB) • Rain sensors required on irrigatlon systems • Avg. GPM yo 0 (2" turbo required unless smaller size allowed by Public Works) _ Meters Call (651) 675-5646 to verity that tesLS p2ssed pria to oidcirq uo me[er. Domestic: Size & Type I?IZ Fl Si & Pri 14" ze re: ce 3 meter 183.00 Avg. GPM High demarW devices? Yes _y No Flushometers_A_Yes_ryo ppyqeyulred Yes_No COMMERGAL FEES: $50.50 Minimum (inciudes State Surcharge) OR Contract vaiuei 2 20. noo x t% _$ `ZOO. °-° Pertnit Fee ' Required on ALL new buildings and 6oulevard irrigation systems ?_$ 153 ?? Hadio Meter Read - If Perrnk Fee is less [han 51,000, surcharge is y.50 =$ Meter(5) - N Perrnit Fee s> S1AM, surcharge increase.s by E.50 tor each E1.000 G $1 000 Pertni[ F i ? , ee ( .e. a$1,001-52,000 Pertnit Fee requires a$1.00 surUarge). _$? J State SLroharge Following fees apply when installirg a new lawn irrigation system. $ water Permit call the Citys Ergineemg Deparlment, (651) 675-5646. ror required tee arrroums. $ Treatrnent PIaM $ Wa1er Supply & Stmage $ State Smcharge TOTAL FEES S liereby ackrwwledg¢ ihal this intormation ia complete end accurate; thai ttre wotic will Da in coMOrtnance with the 9rdinancesank Codes of the Ci ol E ihat I unders thi i is not a parmit, but only an appll M1on br a permit, antl worlc is ?qt to start xithou[ a ty ?? ?? 5 requires aj ?review antl approval af s. P"H; that the xroric wlll be in afin e'th the a roved plan In the case ot rrork which x .Uo?? o? Q/ih x Applicant's Printed Name qP M,s ?ture FOR OFFlCE USE ,qPpro„ed gy; pate,, . o Required Inspections: Under Ground Rough-In jf:?Air Test Gas Test _,&inel Page 1 of 3 City of Eap 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 ? - - For;Offic¢?Use ---___- ? j Pertnil #:-- ? on?1 ? PermitFee: ??51 i ? Date Received: ? i ? f Statf: 1 I ----------------? 2008 MECHANICAL PERMIT APPLICATION Date: ?^I -`J y- O6 SRe Address: / 0 20 TenanF - . ' RESIDENT / OWNER Na'"e: Phone: Address / City / Zp: CONTRACTOR Narne: R„s yl'dP (?),;,..6,;.,? Licenseu: Address: (sS So• Owcs Se 12IVo1 City: r,4. State: myt, . Zip: Ss!/ 7 Phone:?5h k84-#4o86 ContactPerson: i r 14 TYPE OF WORK ? New _ Replacement _ Additional _Alteration _ Demolition Description of work: NOTE: Both roof mounted and ground mounted mechanical eqyipmenf fs requlred to ` , be sc?eened by City Code.. Please contact the Mechanica/ Inspector or ate o/ the Planners /or information on meitted screentn methods. , PERMIT TYPE RES/DENTlAL COMMERqAL Fumace ? New Construction _ InDerror Improvement Air Conditloner _ Install Piping _ Processed Air Exchanger ?.Gas EMerior HVAC Uni[ _ Heat Pump FIVAC unils must be screened . Umkr / Above grourd Tank L Install /_ Remrne) _ Other ^ When instailirglremovirq? tank(s), call for inspeclion by Fre Marshal and Plwnd I or RESIDENTIAL FEES: $50.50 Minimum Add-on or alteration to an existing unit (includes $50 State Surcharge) $90.50 Fire repair (replace bumed out appliances, auctwork, etc.) (includes $.50 State Surcharge) $ TOTALFEE COMMERCIAL FEES: $70.50 Underground tank installatioNremoval OR Contract Value $ i S poo x 1% , $50.50 Minimum (includes State Surcharge) - If Pemi_Fce is less than $1,000, surcharge is $.50. L? I? -$ ? SD •? Pertnit Fee - If Perrnit Fee is > j1,000, surcharge increases by $.50 tar? ?? I I I? _$ . So State Surcharge $1,000 Pertnit Fee (i.e. a$1.001-$2.W0 Pemid Fee req ,;mi a gs pp urch y s ar G 4 $ 1 SD . TOTAL FEE 1 hereby acknowledge ttiat this infwmation is complete and accurate; that the xrork will be in coMOrtnance wilh the ordinarices arM codes of ihe Ciry ol Eaqan; that I urderstaM this is not a pemiit, hut only an application for a pelmit, aM work is rqt to start hithou[ a permd; ihat the xrorlc will 6e in acoordaxe with the approved plan in the case of work wnhich requires a review arM approval of piyns. ,/] X ?oVI d YrsY/N x ?n.?.l/ ?«.,..? ApplicanYs Printed Na 6nnlicanYc 4Zinn9Msw Rev'rewed ey: 5 i- Date: Inspections: Under Ground 't' Rough In _Air Test _YGas:Service Test _In-floorHeat _Y FI ^07/10/2008 09:12 FAX 8517459143 S D F 10001 4000 a City of Eapn 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (esy ) 675-5894 S51 T) 2008 FIRE SUPPI Date: Site Address: I W3e ___'__- _-1 I i P,:rmit tt: Lf,- 4 a j Parmitf'ee: ? Date Re:ceived: r7 -_? ? i i ? s:aRr_ ? I ' - J SYSTEMS PERMIT APPLICATION* -, Y 2.1n) I02O Tenant: jfq& F'(te D sulte #: PROPERTY OWNER Name: . Phon=: Address / City / Zip, _ Applicant is: _ Owner _ Contractor TYPE OF WORK Descriptian ot work: Ir4Y7^ti QanP(G-rc ,aLn 4 Pi--?!i 3'cioCt Construction Cost: Estimated Completion Date: CONTRACTOR Nani rrnw„r nAx: A?rrr¢.roN _ Llcense #: _ Co-i T Address: S'1?C' m?NNErIr ?.+w w.tc W _ City: S-r. State: -i.-! Zip:5'y-rQ3 Phone: 65 t- 2Si - r 88p Contact Person: _Z"_ NASAttp FIRE PERMIT TYPE WORK TYPE XSprinkler System (# of heads New Fire Pump _ Addition Alterations _ Standpipe Remodel Other: Other: DESCRIPTION OF WORK: ? Commercial _ Residential Educational FEES $50.50 Minimum (includes 5tate Surcharge) OR Contract Vaiue S--fL29_ oo x 1% Permit Fee - If Permi[ Fee is less than $1,000, suroharge is $50. 6p - If Per t Feg is > 51,000, surcharge increases by $.50 for each , =$_ _ St6t8 SufCharge $7,000 Permit Fee (i.e. a$1,007-$2,000 Permi; Fee requires a$1.00 surcharge). ? SO TOTAL FEE 3/4" Displacement Fire Meter -$183.00 $_ Fire PAeter $_LQ62. ? sU TOTAL FEE •Requiraments: 2 eomplete sets of drawings and speclfications, cut sheets on materials and compments to be u5ed I hereby apply for a Fire Suppression System permit and acknowled9e that the inforcn ' is com te a cur.3te; that the work will be in conformance wilh the ordinances and codes ot the City of Eagan and with the Minn ota Building/Fi e es; thet I}+nclerstand this is not a permit, but only an apolicatlon for a pertnit, and work is not to start witneut a permit; ihat fhe ork will be in r c wfth rk pprov90 plan in thc? case of work which requires a review and approval of plar.s. / ?-? X Z?I?iIJ ?4g ApplfcanYS Printed Isa&me RM '011/10/2008 09:12 FAX 6517489143 s S D F 10002 FOR OFFICE USE REQUIRED INSPECTIONS Hydrostatic _ Trip Conditions of issuance: ? Flow Alarm _ Pump Test ? Drain Test _ Central Station 'T Rough In Final ?T Pervnlt Beviewed by: ? Date: Page I of 1 '4 John Gorder From: Nathan Wallerstedt [nwallerstedt@landform.net] Sent: Monday, March 10, 2008 11:28 AM To: John Gorder Cc: Matt Swenson Subject: Diffley Marketplace Sanitary Sewer Extension Attachments: Diffley Marketplace Sanitary Sewer Extenstion.pdf Hi John, Attached is a pdf of the MPCA Sanitary Extension Permit Application for Diffley Marketplace. We need some information from the city to complete this application along with City Representative's signature. The information we need from you are item numbers 3 and 4 on the first page and a City Representative's signature on the second page. If you could fill out this information and send it back to me that would be great. If you have any questions or need more information please feel free to contact me. Thanks for your help. Nathan H Wallerstedt, EIT 03 LANDFORM, Designer ? Tel: 612-252-9070 a o a o L A N D F O R M kum Site m Fn6h 0 0 • • 800c Butler Square Tel: 612-252-9070 100 North Sixth Street Fax: 612-252-9077 Minneapolis, MN 55403 Web: www,landform.net NOTICE: All drawings, specifications, insiruments of service, and other documenGs, data, or information of any kind, inclutling all electronic files and data ('Documents') attached to or "linked" from [his E-mail are protected by copyright pursuant to U.S. and intemational copyright laws. Your use of the DocumenGS is controtied and restricted by ihe terms of use .. By downloadirg the attached fles or by accessing the links conNained in ihis E-mail message, you are agreeing to the terms of use.. COPYRIGHT 8 1994-2008 LANDFORM. ALL RIGHTS RESERVED. NOTICE: Indirated professional registrations are for the state in which the oKce is located; to obtain infortnation about other state licenses, please conWct Human Resources at612-252-9070. 3/11/2008 ? PERMIT APPLICATION and TRANSMITTAL FORM for v- Minnesota Pollution SANITARY SEWER EXTENSIONS control Agency AND/OR CHANGES NEW nrocess for 2002! COMPL&TEAPPUCATION RYPRINTING OR TYPING. PLLASE MAXE A PHOTOCOPY FOR YOUR RBCORDS. 1. Tide of Project (Plans and Specs): „D! ff e y /4t.1rte'/ MPCA USE ONLY A lication Number Date Received Month Da Year Check # Fast Track? ? Yes ? No DevelopcrlOwner: CIIG/JCe l 2velo +mtnT" iri " c,q Developer/Owner Address: lO?C7 c? n p t,?Cr' ?.$ o? i.?q HC C AUe,7te soc.'735 City: Ahn*C?aol/S Statc: /l/ Zip: ? d- Phone: ( lA ) 3 5 "IbOC3 2. Permittee: &7PelCnL p?il??/nc ?or?Jbr.:,&U7 County: r!C'17 /1 Contact person: qqd- '1'itle: '-? 7 1 Phone: (9$"„1) 93„l- 3. WastewaterTreaGnentFacitity(WWTF): >enenGct Is the proposed sewer project in accord with the City or Distric[ Comprehensive Sewer Plan? Q'S'es ? No 4. SpecificationoPCurrentWWTF 1) Average wet weather design flow (AW W) MGD 2) Annual average daily flow (pas[ 12 months) MGD 3) Average design flow (if AW W not available) MGD 4) Annual average influenl CSODS (past 12 months) mg/L 5. Estimated Flow Increase Initial Project: .029 MGD Ultima[e: •02 8 MGD Basisforestima[e: t nrUer0- o? i/,ML'of4 01}9I?K 6P6J' %- ('le<-1rnar/ MGn;,,ti / va F, cl-tij j? 6. Es6mated BOD S Increase Initial Project: 'I 7? #/day Ultimate: ? E #/day Rasis forestimate: , 17d-1100 ?,.1 7t '2`djo'rt5i 4,4 /dcr6 1b$Le`4 7. Location of Proposed Project : Facility is bca[ed in the V F qunarter of the NG? quar[er of section Township r p,!? c?o of fc? County Township Range #: .Z 8ast or Westr Ly?e fi City: E?cnn I7 State: Zip: ? I Address (or nearest in[e rsee;tion): Djfv y vc- Q, J_e X/Aq ui! AV e- 8. NaWre of Area w be Served by the Proposed Project Reside ial: Number of New Homes: Number of Existin Homes: ia ndustrial(Describe): ?jrOC.?tN 6v?C oZ +Qe'?y4? ?uFldincjs Other (Describe): J 1 9. Technical Agent or ConsulHng Engineer: .off St+eRSa,,L_ Tide: !-f 0 fe L/°lco °` e_ Name of firm or organization: Lc:nd,,Fv,M 6or'+g2c`+Y V Mailing Address: 100 /?d ,fh 6"S°ef/ $wt e$UU 6,14m4e 4n0 /$" Nl iL , SS- VV 3 Phone: (GI;L ) `I 070 Fax: (!Sf et ) LSX-9077 10. Has the project been reviewed in a previous Environmental Assessment Worksheet (EAW)? ? Yes ONo If yes, note the name of the project reviewed in the EAW, the responsi6le governmental unit, and the date of the nega[ive declaration: Name of [he Project Reviewed in EAW: Date: Responsible Governmental Unit: Date: Date of the negative declaration: 11. Determination for the need of an EAW: is [he ultima[e design flow for tlhe proposed projec[ greater than 1,000,000 gpd? ? Yes UrNo If yes, the preparation of an EAW is mandatory for [his project. Permit Application and Trensmittal Form for Page i af 2 MAV 03 Sanitary Sewer Extensions antl/or Changes (wq-wwprm7-15) CERTIFICATION AND SIGNATURE Federal ragulations (Section 309(c)(2) of the Cleen Water Aet and State regulations (Minn. R. 7001.0070) require the authorized signer to be one of the following: A. For corporation, a principalexecutive officer of at least the level of vice president; B. For a partnership or sole proprietorship, a general partner or the proprietor, respectively; or C. For a municipality, State, Federal, or other publie facility, either a principal executive officer or ranking exeeutive official. D. H the operator of the facility is ditferent than the owner, both the operator and the owner according to items A to C. "I certi(y under penalty ot law that this document and all applicable design documents were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted. Based on my inquiry of the person, or persons, who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penakies for submitting false information, including the passibility of fine and imprisonment." . PRINTED NAME TITLE AUTHORIZED SIGNATURB DATE PRQJTEDNAMF. ffpA n TITLL A-j5 ? ?fi/?14.ar AUTHORfLEDSIGNATURE e DATB 3?? ? /?(3 (AUTHORTLF.D CITY RF.PRESENTATNE) PRMTED NAME J ?? ?V[f G Reg No. y/ / qO AUTHOftIZED SIGNATURE DATB J" I0_ OO ( G R) STATETAX I.D. N REMEMBER! I qL( 3 C1 SO FEDERALTAXI.U.# NJ'y 1772?02,3 • DO NOT submit plaos and specifications with this appGcation unless required! You mus[ first complete the form and ehecklis[ [i[led: Design Cer[ifica[ion for Sani[ary Sewer Extension Plans and Specifications [o detetmine if plans and specificadons need [o be submitted. • No project consVUCtion may begin until you are in receipt of Ihe required permit(s) issued by the MPCA and as defined by law under Minn. Stal. § 115.07, subd.3. • The project information packet you submit must contain ALL of the following i[ems or it will be immedia[e(y returned: 1. This completed and propedy signed Application Form. 2. The completed form and checklist tided: Desien Certification for Sani[arv Sewer Extension Plans and Specifications. 3. Plans and specifications (ONLY if required). 4. The required application fee ($240). Please make your check payable to [he Minnesota Pollution Control Agency. • Forms are availaNle on the MPCA's web site at: - http:/lwww.pca.state.mn.us. You can also contact the MPCA's Cus[omer Assistance Center at (651) 297-2274 (Me[ro or outsidc MN) or toll free at (800) 646-6747 to request forms or ask questions. • Scnd [he project informa[ion packet ro: Minnesota Pollution Control Agency, 520 Lafayette Road, St. Paul, Minnesota, 55155-4194 ATTN: Sanitary Sewer Extensions, REM, Metro. Permit Application and Transmittal Form for Page 2 of 2 MAY 03 Sanitary Sewer Extenslons and/or Changes (wq-wwprm7-15) City of ?apIl 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 I _' _ _ _ _ __ _ _ _ _ _ _ _ _ _I I FOf OIflCC US6 ? ? Pertnit#: ? ?"?? j U ; ? Pertnit Fee: I ? ? Dafe Received: I I ? 1 Staff: ? L________________ - I 2008 MECHAPIiCAL PERMIT APPLICATION j u{(/ oate: sne aaaress: Teoant: &?b Eod? Suite#• RESIDENT / OWNER Name: Phone: Address / City / Z'ip: CONTRACTOR Name: ?orY Licsnse #: Address: 3/ n?. lD ? rd ?r2G ?C Ciry: State: MdJ Zp: ?9'lq Phone: 7Y?3-726, 'G'So?:) ContactPerson: /?ren7 TYPE OF WORK X New _ Replacement _ Addi6onal _ Alteration _ Demolition Descripqon of work: NOTE: Both roof nrounted and grourtd mourtted mechanical equipment is required to be scmened by City Code. Plesse cantsct the ARecbanical Inspecior or ane of the Plenners far Mfortnatf»n on rmifterf screanin methods. RESIDENTIAL COMA?fERC1AL PERMIT TYPE Interia Improvament New Construclion Fumace _ _ Air Conditioner _ Install Piping _ Processed Gas ? Exterior HVAC Unit _ Air Exchanger - " HVAC units must be screened _ Hea1 Pump Under / pboye ground Tank L-- Ins[ail /_ Remove) Other " When instatling/removing lank(s), call for inspection by Fire Marshal arttl Plumbi Ins or RES/DENTIAL FEES: $50.50 Minimum Add-on or alteration to an existing unit (includes $.50 State Surcharge) $90.50 Fire repair (replace bumed out apaiances, ductwork, eic.) (includes $.50 State Surcharge) $ TOTAL FEE COMMERCE4L FEES: $70.50 Underground iank installation/removal OR Conhact Value ?'35U,,- aD0 x t% $50.50 Minimum (includes State Surcharge) n ?f] fJP i F ? J erm $ t ee n ?b - If Permit Fee is less tAan $1 e i 000 s rchai 50 S , , u . ` g s . h I ZJ S ' Fii ? -? State urc - If Pertnit . is >$1,000; surcharge increases by $50 For ea hu l jL P y L(]Qg =$ arge $1 000 P i F i 1 1 P i F h g ? `- = ?? , erm .e. a$ t ee ( ,00 -$2,000 erm ee requires a$1. ar t surc e). - 7 $ TOTAL FEE I hereby acknowledge that this information i6 cOmplete and exurate; that the xark wiil be in corrformance with the orifinences and codes of tha City oi Eapan; thet I undarstand this is not a permtt, but only an application for a permit, anf work i5 not to start wlihnut a permit; Mat the wurk wiN be in aceordance with the apprwetl plan in the case of work which requhes a reviBw ared approval ot plare. X X ApplicanYs Printed Neme Applicant's Sigsiature FOR OFFICE USE peviewed 8y: Date: -t ' D Required InspecUons: Under Ground )( Rough In _Air Test )L-Gas Service Test In-floor Heat Y Final 411? City of EapIl 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 SEP 1 7 ?Opg ' ?c ? K C: LAlq ( 0 4` ?i3 ?y3 `ez >P SO , SO ---------, ? For Office Use I ? 9 1D /?-l?/' ? I Pertnit #: ? ' ? Permit Fee: i ? ? Daie Received: ? Staff: ? -----------------? 2008 MECHANICAL PERMIT APPLICATION Date: -37/4/67 Site Address: /0 2 O In '1CA ? n0 a4 Tenant: TCF 11412 /? / 6 p j?& d S SWte #: RESIDENT / OWNER Name: - Phone: Address / City / Zip: CONTRACTOR Name: Ma6LV" ¢ C License #: Address: Z 3/8 Fjys t S?"1'en f A/E City: %s,,,.a?.o ?s State:?Zip: SS/Z3 Phone: .?359 Contact Person: h?^ .@ TYPE OF WORK - New _ Replacement _ Additional X- Alteration Demolition Description of work: --4hsQ/ t ! v S/ h NOTE: 8oth roo/ mounted and ground mounted mechanical equlpment is r uired to be screened by City Code. Please contact the Mechanical Inspector or one of the Planners for Information on ermifted screenin methods. PERMIT TYPE RESIDENTIAL COMMEIjCIAL Furnace - New Construction Interior Improvement Air Conditioner _ Install Piping _ Processed Air Ezchanger _ Gas _ Exterior HVAC Unit _ ' HVAC units must be screened _ Heat Pump Under / A6ove ground Tank L Install /_ Remove) Other " W hen installing/removing tank(s), call for inspection 6y Fire Marshal and Plumbin Ins ector RESIDENTIAL FEES: $50.50 Minimum Add-on or alteration to an existing unit (includes $.50 State Surcharge) $90.50 Fif2 f@P8if (replace bumed out appliances, duchvork, etc.) (inCludeS $.50 State SUrCharge) $ TOTALFEE COMMERClAL FEES: $70.50 Underground tank installation/removal OR Contract Value $//.S x i°k $50.50 Minimum (includes State Surcharge) _ $ Permit Fee - If Permit Fee is less than $7,000, surcharge is $.50. - If Perrnit Fee is >$1,000, surcharge increases by $.50 for each =$ State SurChafge $1,000 Pertnit Fee (i.e. a$1,001-$2,000 Permit Fee requires a$1.00 surcharge). $ SD. SD TOTAL FEE I hereby acknovAedge that this intortnation is complete and accurate; that ihe work wiil 6e in conformance with the ordinances antl codes of the Ciry W Eagan; that I untlerstand this is not a permit, but only an appliration for a pertnit, and work is not to staA without a peimit; ihat the work will be in accordance with the approved plan in the case of work which raquires a review and approval of plans. /) x x ApplicanYs Printed Name ?- App' anYs nature FOR OFFICE USE Reviewe By: '"5 P Date: -/ -d Required Inspections: _Under Ground zFough In _AirTest _GasService Test_In-floor Heai )J?Final Use BLUE or BLACK Ink r gg c� For Office Ude r Citof Ea Un Permit#: (//�G/ 4, y L+ ll Permit Fee: 3830 Pilot Knob Road Eagan MN 55122 Date Received: (651)675-5675 buildinqinspections(cacityofeagan.com Staff: J 2017 COMMERCIAL PLUMBING PERMIT APPLICATION ❑ Please submit two (2)sets of plans with all commercial applications. Date://$* -f,-/7 Site Address: /OZf. 7ic,72`� <f Tenant: 1!2 �o,pI / Suite#: Property ,...�. , Owner ' Name: 2u'✓ -k 174'L 1" Phone: 4 I Name: Cel"9ciZe(. -(/"a /% �" License#: Contractor Address: , i � U�2T r ,¢y 6It : �� i�� State:��/Zip: .S©� j Phone I51'7P7 2-11‘ Email: i s Type of Work New _Replacement _Repair _Rebuild _Modify Space _Work in R.O.W. I Description of work: "(PO otiCk-r/ci,! P dr64 flb'', 'moi ci.�+'S eriblz) g ee ' i COMMERCIAL New Construction Modify Space Irrigation System( yes/ no)( V'RPZ/ v/PVB) -. / • Rain sensors required on irrigation systems Permit Type i . Avg.GPM (2"turbo required unless smaller size allowed by Public Works) Meters Call(651)675-5646 to verity that tests passed prior to picking up meter. Domestic:Size&Type Fire: 1 n�V Avg.GPM High demand devices? Yes_No Flushometers Yes Npy No COMMERCIAL FEESContract Value$ 9OO � x.01 ' I $60.00 Permit Fee Minimum $60.00 PVB/RPZ Permit(includes State Surcharge) _$ Permit Fee _$ Surcharge a Surcharge=Contract Value x$0.0005 If the project valuation is over$1 million, please call for Surcharge =$„ TOTAL FEE r 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 I I $ Water Supply&Storage $ State Surcharge k I _$ TOTAL FEE You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeanan.com/subscribe. CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. I hereby acknowledge that this information is complete and accurate;that the work will be in conform- ce 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 . permit;tha he work will be in accordance with the approved plan in thecaseof work which requires a review and approval of plans. p x �ll 6 CG 5o140 / x F f Applicant's Printed Name • Applicant's Signature • FOR OFFICE USE Approved By: Date: Required Inspections: ; Under Ground Rough-In _Air Test Gas Test Final PRV Required: Yes No Meter Related Items: Meter Size Radio Read Manometer Staff: Page 1 of 3 Use BLUE or BLACK Ink O F ::::„Er”, __ , , r For Office Use` o, '� + ` ' � Permit#: G L _ ,,, ._ _,, >- . NOVq Permit Fee: inn Db a " NO �+ LU1 C Date Received: 1–I 144"fso Staff: 3830 Pilot Knob Road I Eagan MN 55122 J Phone:(651)675-5675 I buildinginspections@cityofeagan.com 2017 COMMERCIAL PLUMBING PERMIT APPLICATION ❑ Please submit two(2)sets of plans with all commercial applications. Date: \\ \\G-n\ f ^Site Address: \(-NG() �A \f k.J 1 3„ 31 C. - Tenant: L��'f > `�""l-'- ___ 4 Suite#: , Prop ty - Owner Name: �� Q .�C',r �Y�� c. Phone: iQ Q.e�..t lY -t'\C•- • ,(� , 4 .�� Name: C � '� 1 .,.; icense#:� C c_‘OL� h 4111 ,Contractor; Address:1,444- j � c�F'4 t t p `' tate: i Sty Phone: k) )\ ' )E mail: tx11i '‘.., 1_7:12-11(k/L -C, 0 t ° ' New Replacement —Repair Rebuild __Modify Space Work in R.O.W. eo Typf_WorK — — ' Description of work: COMMERCIAL New Construction Modify Space irrigation System(_yes/ no)(_�PZ/ PVB) 1.' . Rain sensors required on irrigation systems Permit Type . 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 Contract Value$ x.01 $60.00 Permit Fee Minimum ``�� $60.00 PVB/RPZ Permit(includes State Surcharge) =$ �� `�LJ Permit Fee Surcharge=Contract Value x$0.0005 =$ Surcharge 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 You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeagan.com/subscri be. CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. 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 IV\\V-e r-r-z t '1-: ("\ x j-\fL.L - VL± J Applicant's Printed Name Applicant's Signature y4. am' � � ic 4 FO, OFFICE BSS tt� , ` Approved By Date �� Required Inspections: . der Ground Hugh In este Cas Test _Fi al V Re d nito i! :. ,.,'3TC ti . 3+` : t.t # iii a a -`' e a :4 ' r c M41:4 3.1:41'd ItetP s. .: ,I�rleter$I4o. ' ..., Radio' . <` 40:01101T-,A,0:4 . ,.,tliaf' >: .< Page 1 of 3 ` ,iLQ__l✓� vac I J '✓ C CvL.,—.- For Office Use I /:N, ° i i r 4 Permit#: / eC-1(DS S 1 l' E A N Permit Fee: 3 a/ T 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810Date Received: !i–7 l / (651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 N 0 V 0 '7 2019 Staff: buildinoinspections(5 cityofeagan.com L 7___. 2018 MECHANICAL PERMIT APPLICATION Ir/ -\� ElPlease submit two(2)sets of plans with all commercial applications. 1, ` 1 Date: 10/28/2019 Site Address: 1020 Diffley Rd Tenant: Cub Foods Suite#: Resident/Owner Name: Phone: Address/City/Zip: Name: Yale Mechanical License#: MB004822 Contractor Address: 220-w- 81st St. City: Bloomington State: MN Zip: 55420 Phone: 952-884-1661 Contact: Steve Miller Email: smiller@yalemech.com New X Replacement Additional Alteration Demolition Type of Work Description of work: replace(2) 175,000 BTU gas unit heaters 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. RESIDENTIAL COMMERCIAL Fumace New Construction Interior Improvement Air Conditioner Install Piping Processed Permit Type — — Air Exchanger X Gas Exterior HVAC Unit — Heat Pump _Under/Above ground Tank ( Install/_Remove) Other RESIDENTIAL FEES $60.00 Minimum Add or alteration to an existing unit, includes State Surcharge $100.00 Residential New, includes State Surcharge =$ TOTAL FEE COMMERCIAL FEES5 366.00 $60.00 Permit Fee Minimum Contract ValueeV $ /7/ x.01 $75.00 Underground tank installation/removal, includes State Surcharge =$. U©- I Permit Fee _$ 2.68 Surcharge Surcharge=Contract Value x$0.0005 �} If the project valuation is over$1 million, please call for Surcharge =$_6248_ 7� 3 /7 TOTAL FEE You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeagan.com/subscribe. I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with t.e 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.start wit ou . . rmit;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 Steve Miller Applicant's Printed Name A . icant ig at re i' FOR OFFICE USE Required Inspections: Reviewed By: Date:...e t f (� Underground Rough In Air Test Gas Service Test In-floor Heat Final HVAC screening kdPqTc For Office Use i " (ICi i + , Permit#: (. "1 17 %,, (.00 AL Permit Fee: Staff: 3830 PILOT KNOB ROAD I EAGAN,MN 55122-1810 Payment Recvd: Yes _No (651)675-5675 I TDD:(651)454-8535 I FAX: (651)675-5694 I Email:buildinginspectionsCDcitvofeagan.com Plans:_Electronic _Paper Plan Submittal:eDlans(cD.citvofeaaan.can't 2020 COMMERCIAL PLUMBING PERMIT APPLICATION 7)0 ❑ Please submit two(2)sets of paper plans with all commercial applications as well as an electronic set of the submittal, \p' , submitted via email,CD or flash drive r ,Y'� 1 Date: \�.>\ '\\' -C) Site Address: 1 „� -fi-' e j. lY Tenant: . (^ `[ Suite#: Property Owner Name:S 4Ye..-Ar v C..t % Phone: t-. Name: ,Y` c'Y"NeYjlk.AYN,k),1Y F #: (. k i--6 \fl ContractorAddress:5- < (J 61 rf'yY t,L { y' ",1 ti State: \i\, rZip: t Phone: 4-, )\- t--1r A'"" 'i Email: A (As �_ s. • A • ire New Construction Addition Modify Space ')( Replacement Repair Rebuild Work in Right-Of-Way Description of work: Type of Work Irrigation System( yes/_no)( RPZ/ X PVB) • Rain sensors required on irrigation systems • Avg.GPM (2"turbo required unless smaller size allowed by Public Works) Meter Required-Call Utilities at(651)675-5200 to verity tests passed prior to picking up meter. Domestic:Size&Type Fire: 1 Average GPM High demand devices?_Yes_No Flushometers Yes_No COMMERCIAL FEES Contract Value$ x.015 $60.00 Permit Fee Minimum $ 1--41). (--)() Permit Fee $60.00 PVB/RPZ Permit nci Kies State Surcharge) Surcharge=Contract Value x$0.0005 $ Surcharge If the project valuation is over$1 million,please call City for Surcharge $ t C . TOTAL FEE The following fees may apply when Installing a new lawn irrigation system or $ Water Permit connecting a new water service. $ Treatment Plant Contact the City's Engineering Department,(651)675-5646,for required fee amounts. Meter Fee $ Radio Read $ State Surcharge =$ ,[`� . CY) TOTAL FEE You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeagan.com/s ubscribe. CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. 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 G alt t_ .-'i i'"'r1 -,Cr x f"\-r--\-1._ *,\ Applicant's Printed Name Appli nt's Signature Page 1 of 4 City of kali d� 0 Ck6-c--- ECEIVE' JUL 2 3 2O2 2017 MECHANICCC71 IT APPLICATION ❑ Please submit two (2) sets of plans with all commercial applications. �� Date: 7— 23- 20x0 Site Address: I D 2-0 P i TT tett tc� 0l�� Use BLUE or BLACK Inli t yv For Office Use Permit #: /6? 6 q Permit Fee: Tenant: 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Date Received: L Staff: Suite #: J i�esi4�ent/t�wn4±r t Name: 1. NO S 3 Phone: Address / City / Zip: c ;t .. at •• : blltl?> o ^ ` Name: CrvnecteAle. ii,PiY' 1to/ License #: it'9 6, Ob) Z3 1 Address: S / I q 1-4t l b aoio LA) City: /(.k u ilibi.0 State: 04/t) Zip: c541 B Phone: to ‘a., 3 64 ' f32g Sr Contact: 1.45►1 l Vt• A. Email: 'Type ,Of Work New Replacement Additional A Alteration Demolition Qr.rc Description of work: AYIt V e,x.\t1.4$+ 5 - & .iC.N3110.4 NOTE oof mou to ka 'dg r ,. dttito ( l g l al e l ` is4`r •" ' G tle Pease orjtaat t l c�ha l In f r#fair COa � , d it iii ti„lag'T+ ireed,to e ass, r '. s •, F�ermit Tyke _ RESIDENTIAL _ Furnace COMMERCIAL New Construction Interior Improvement HVAC Unit / _ Remove) Air Conditioner —' — stall Piping Processed Air Exchanger — Gas Exterior Heat Pump _ _ Under/Above ground Tank (__ Install Other _ RESIDENTIAL FEES $60.00 Minimum Add or alteration to an existing unit, includes State includes State Surcharge Surcharge = $ TOTAL FEE $100.00 Residential New, COMMERCIAL FEES $60.00 Permit Fee Minimum Contract Value = $ $ /3;000 x .01 Permit Fee FEE $75.00 Underground tank Installation/removal, includes State Surcharge • Surcharge = Contract Value x $0.0005 If the project valuation is over $1 million, please call for Surcharge = $ Surcharge = $ TOTAL I hereby acknowledge that thls 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. Applica tilrinted Name FOR OFFICE USE Required Inspections: Underground Rough ._In x Applican's • gnature