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2218 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 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