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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
Q�Zn �n5pes+ic�� ��
City of Ea�all
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
;For
ICA ;Use
Permit #: ( 1
Permit Fee:
Date Received:
Staff:
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: r2" .1"/". ill Site Address: o` V '� i'�� /LV5 a
C �l Mc M a ?
Tenant:
Suite #:
RESIDENT / OWNER
Name: it G h el Ce Ma i7/4 in rj Phone:
Address / City / Zip: a / gv / Z)Ze ky i3 y i S " t e y
Applicant is: Owner Y Contractor
TYPE OF WORK
`
Description of work: 674 1P1€- Dom' R'i'p �g� 'rit
k +
Construction Cost: Multi -Family Building: (Yes- / No )
f . , 1
CONTRACTOR
//77
Name: er-e,3 t F,v, /cry ,9,-.3 1-1--� License #: Z 2=)--12--
Address: Z Z3 92 ,%o ' .,/',4 /e iq--e,e
City: /tf/1//fr1C 722 e1 State: /7711/ Zip:
//� / i —5Zo /-gym s>5C 9` e)V
Phone: l��� r �,%l.�C, �/ �% Contact Person:
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"document`s thatyou submit are considered to be public information: Portions of
the information may be classified *as non-public i f ad 'wide' spec fic reasons that would permit the City to
conclude,fl at they are,ttade 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 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
r,ccordance with the approved plan in the case of work which requires a review and approval of plans.
Applicant's Printed Name
x
Applicants Signature
Page 1 of 3