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City of Epp
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
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Use BLUE or BLACK Ink
For Office Use
Permit #: 1 13 Co
Permit Fee:
Date Received: 13
Staff: .813
2013 COMMERCIAL BUILDING PERMIT APPLICATION
Date: q-5- Site Address: .3ai)slami3onix,ofia,aitod3lgD
Tenant Name: VZ°C* Eif e- ant is: New / Existing) Suite #:
Name:
Former Tenant:
Phone:
Property Owner
Address / City / Zip:
Applicant is: Owner Contractor
Type of Work Description of work:
Construction Cost: -7/ 53q t
Contractor
Name: L..--Ce...tjt
Ete LI
Address:
State: /fj: Zip:
Contact: „;
Phone:
License #: pfv,
City:
Email: t
Name: Registration #:
Address: City:
ArchitectiEngineer
State:
Contact Person:
Zip: Phone:
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.orq
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and
codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a
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.
1 I UV- V1/7)
Applicant's Printed Name
x
kip ant's Si nature
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4,111' City of Eagan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
ForOff!ca.- Use
Permit # 1
IA
Permit Fee:
Date Received:
Staff:
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
a L�dz) &kt Peds �c>/
Date: 02—-! '" / f Site Address: i,, � 1,
Tenant: 1\\AA-O-NiN
U L
RESIDENT / OWNER
TYPE OF WORK
CONTRACTOR
Name: CA -x - IALtr,e-\
�c +.. _ '
Address /City /Zip: 05 Ss
Applicant is: Owner Contractor
Phone:
Suite #:
Description of work:
CfJ,42f1 �� PGea2. R f' J7 / % 7
r ,
Construction Cost: Multi Family Building: (Yes- / No __J
Name: ere,3 f r i est LL'- License #: Zl3Vh'52
Address: 2 �23 v6'_- G t >fi f c,./' k C 41)
City:
A-K/z%/`'iGr l9 r'1 State: M-71/ Zip: n4JG3�
�1
Phone:
a".5/r o ),f 8%i Contact Person: ce'l`7 5/ 9eD .,5
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Category 1 — Minnesota Rules 7672
Energy Code ® New Energy Code Worksheet Residential Ventilation Category 1 Worksheet Submitted
Category Submitted
(I submission type) • Energy Envelope Calculations Submitted
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
Yes _No If yes, date and address of master plan:
Licensed Plumber:
Mechanical Contractor:
Sewer & Water Contractor:
NOTE: Plans and supporting documents that you submit;ar`e considered to be public information Portiofig 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:secreta.
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
'ccordance with the approved plan in the case of work which requires a review and approval of plans.
d//1Gtn
x
Applicant's Printed Name
x
Applicant's Signature
Phone:
Phone:
Phone:
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