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2214 Rocky Rapids WayLaaosi ate9, ;alik aapo, aals, a.ao 'e.oc, 14tv'icis City of Epp 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 r 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 Page 1 of 3 :>peA-(07)3 41/`. City of Eagan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 For Office U_ se / ' Permit #: ( `"" Permit Fee: Date Received: Staff: 2008 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 02" 7 / I/ Site Address: �`) `f O)C jl '''keAs tA)a'y Tenant: 74r)d 'erg / 75 /Name: /lIICI{is /. ,%%'7..5{' /V %4# 84Pf4- 4� 1,1171 Address /City /Zip: }� Applicant is: Owner X Contractor RESIDENT / OWNER Suite #: Phone: �Oft2�l12' TYPE OF WORK CONTRACTOR Description of work: Construction Cost: Multi -Family Building: (Yes-/ No _) Dec‹. lei r=1'Ul/fieri Name: ere,3 f icrl,oc.3 License #: Zoc77` '512"" Address: 2 23 92- CA /fit," --171-444 /t/live City: Ca -7-77.7 % % ,1 State: /Y!/7// Zip: 64 Phone: 1p, / - Z e7/ tg/ i Contact Person: Z e) / `.e 5/ 9061/".5 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Energy Code Category (I submission type) In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? Minnesota Rules 7670 Category 1 • Residential Ventilation Category 1 Worksheet Submitted • Energy Envelope Calculations Submitted Minnesota Rules 7672 • New Energy Code Worksheet Submitted Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE: Plans and supporting documents that you submit are considered toy be public information, Portions of the information may be classified as non-publie if youxprovidtle specific reasons that would permit the City to conclude that are, trade'secrets. 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 1 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 Applicant's Printed Name off /��rn7 x Applicant's Signature Page 1 of 3