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Mayo Clinic is providing new details of its planned multibillion-dollar expansion in Rochester, which promises to bring major change to the downtown area over the next few years.

Mayo officials have submitted potential projects in an updated five-year infrastructure plan to the city of Rochester.

That includes two new medical buildings along 3rd Street SW. at the site of the Damon Parking Ramp and the Ozmun Building, as well as underground and skyway connections to those buildings.

"We're looking to create flexible spaces that accommodate the needs of our patients today," said Bridget Avikainen, an associate Mayo administrator, during a planning and zoning commission meeting Wednesday.

The expansion also includes renovations to Mayo's main facilities, the Gonda and Mayo buildings. Both would get upgrades to their east entrances and canopies, along with nearby street improvements.

A mixed-use logistics building could go up at the site of the former Lourdes High School. The clinic plans to add on to the Prospect Utility Plant on 3rd Street NW. and build another utility facility.

Several parking ramps and lots are planned, including an expanded lot and loading dock facility at the site of the 5th Avenue Inns & Suites. The project list also includes an expanded parking lot at 2nd Street and 11th Avenue SW., which Mayo hopes to use as a shuttle bus turnaround as part of a plan to switch its busing routes out of W. Center Street through the Kutzky Park neighborhood.

City Planner Ed Caples said the expansion's potential projects fit with Rochester's downtown master plans.

The city's planning and zoning commission unanimously signed off on the updated plan Wednesday. Mayo will go before the Rochester City Council next month for further approval.

Mayo is actually reducing the amount of parking near its downtown campus through the expansion, said Melanie Baumhover of architecture firm BWBR in St. Paul. Mayo is instead adding more parking west of downtown in a planned transit village along a bus rapid transit line set to start construction in 2026.

It's unclear how many of these projects will be included in Mayo's downtown expansion, however. Mayo officials have yet to finalize the plan it announced in June, though they've said there could be at least seven years of projects starting in 2024.

The medical system's board of trustees are expected to review and approve the expansion by the end of the year.

The expansion cost is said to be more than $4 billion after a Mayo lobbyist emailed Gov. Tim Walz in the spring warning that the yet-to-be-announced project could be in jeopardy if he signed legislation that would regulate hospital nurse staffing and penalize hospitals with excessive cost growth. The lobbyist estimated that Minnesota could lose a privately funded project that quadrupled the $1 billion price tag of U.S. Bank Stadium.

Mayo officials caution a dollar figure isn't finalized as expansion plans aren't yet set, but the project looks to be one of the largest hospital expansions in state history. Aside from community support and city development assistance, Mayo could seek state support if the project includes additions that would trigger a review from the Minnesota Department of Health.

Mayo last updated its five-year infrastructure plan in 2021. The process is part of a decades-old agreement with the city to operate within special development districts where the medical system has a bit more flexibility in the building process.