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,City of Eapll
Date:
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit #: ‘13 LDS ci
Permit Fee: 2a.15
Date Received:
Staff: 25E>
2013 COMMERCIAL BUILDING PERMIT APPLI9M1Oking,
- 5 - Zol3 Site Address: LI-itti (-Mc) qtgt5, (WO, Lek/ WR
Tenant Name:
(Tenant is: New /
Existing) Suite #:
Former Tenant:
Name: Phone:
Property Owner
Address / City / Zip:
Applicant is: Owner Contractor
,,---1 -,,,- I ;'
Type of Work
Description of work: 1 --*.t: ,24:::&"\--
Coi
Construction Cost: 5 ) 3t
Name: !, A
Address:
State: Zip:
License #: Peg
City:
Phone:
'333-33, 3
Contact:, -1,;_z 7 Email:
Name: Registration #:
Address: City:
ArchitectJEngineer
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.qopherstateonecall.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 re uires a review and approval of plans.
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Applicant's Printed Name
X t
At'i-pr cant's SI na ure
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6
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or`Oftice Use
H. Cityof Eqpt Permit#:
Permit Fee:
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Date Received:
Staff:
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: �— 7 / / Site Address: /! is R24/7171/7 73(2994-X:
Suite #:
Tenant: h/iI V1 O&/'I,.'Sfey
RESIDENT / OWNER
TYPE OF WORK
Name:
/ re y15/z /
Address / City / Zip: '/f 64.7,9
Applicant is: Owner )( Contractor
Description of work:
Construction Cost: Multi -Family Building (Yes / No )
Phone: b3/ g � 2 416
f3/.Pa AU 1474, 5i Z
Cori-(2_,14,E"P . Re-PU9e/
CONTRACTOR
Name: ere, f Fa/' 74c Liz- License #: Ze7412 2'
Address: Z Z3 92- Gi ,/ape -n d,ci /11-7/e
City: /a0Z7/,1? 7z9 s?
Phone: 75/ ' me) 62/ ty/:Contact Person:
State: /I'M/ Zip: 6' c=g./
Ze> M /—t !S,5/S09?1/..5
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Energy Code
Category
(J 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:
Mechanical Contractor:
Sewer & Water Contractor:
NOTE: Plans` and supporting documents that your submit are considered to be public information Portions of
the information may be classified as non-public ►f you. provide specific reasons that would permit the City to
conclude that:they. 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 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
occordance with the approved/�%/plan in the case of work which requires a review and approval of plans.
SGC? iht/C/1
Applicant's Printed Name Applicant's Signature
Phone:
Phone:
Phone:
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