2146 Water Lilly Lane
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a ~>A o~-t J (V 1 `t 3 (3, eD- I'q b Use BLUE or BLACK Ink
a I A V~cX t-'11
~19r~ &L` I For Office Use
Permit I L~ ~ 09 j
. ~ _
I t I
City of Eap
I Permit Fee: lQ~~ • 50 I
3630 Pilot Knob Road I I
I Date Received: I
Eagan MN 55122 I ~J ~j I
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 j Staff:
L--------------- - -
BUILDING 2013 COMMERCIAL APPLICATION
" l
Date: 15t 2-01,3 Site Address: I LtZ
~ 1► Q.
Tenant Name: (Tenant is: New / Existing) Suite
Former Tenant:
Name: Phone:
Property Owner Address /City /Zip:
Applicant is: Owner Contractor
Description ofwork: L t - - -
Tye of Work
Construction Cost: 4-9
_ x License '=t
Name:
Address: City:
On
State: Zip: Phone:
Contact:Email
Name: Registration
Address: City:
Arch itectlEngine r
State: Zip: Phone:
Contact Person: Email:
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 may be 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.gopherstateonecall.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 without a
permit; that the work will be in accordance with the approved plan in the case of work which re uires a review and approval of plans.
F ,
H
Applicants Printed Name Ap int's'Situnature
Page 1 of 3
op2,n ;Ln60-10,13416°
City of Eagan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
r )fir Office Use
Permit #:
ID)65--1
Permit Fee:
Date Received:
Staff:
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: (9—.2.5— (- l Site Address: ,:/1--/i4 kti4 /eV / /f i, 4,7 r"
Tenant: .3 i t ' Ft- y C-e'CS Dy-)
Suite #:
RESIDENT / OWNER
Name: -3 i l 1 h \d - -e SO r Phone:
Address / City / Zip: / ‘447/e,,-- /_ `/_ l y Lfr-c
Applicant is: Owner X Contractor
TYPE OF WORK
Description of work: a, aq € city € ,o/ `e ,� n %-
Construction Cost: Multi -Family Building (Yes / No )
, #
CONTRACTOR
Name: r,,—/r5 / 6 7 , /or -r Lee- License #: ‘,34/‘,34/ (52_
Address: 3 .,,), Ch/ � ,..enc/ ale Ave
_.
City: rpeo t t f'7 /-0/11/-0/11State: 1(i'(v,' Zip: 5:5;02
1
Phone: (s1 ¥(006/S / I Contact Person: 5e4/71— 65/ .F2.9 66V—S
COMPLETE
Energy Code
Category
(1 submission type)
In the last 12 months, has
Yes If yes,
THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Category 1 Minnesota Rules 7672
• Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
Submitted Submitted
• Energy Envelope Calculations Submitted
the City of Eagan issued a permit for a similar plan based on a master plan?
date and address of master plan:
_No
Licensed Plumber: Phone:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that they aretrade secrets.
1 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
'ccordance with the approved plan in the case of work which requires a review and approval of plans.
s
x
Applicants Printed Name
x
Applicants Signature
Page 1 of 3
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