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For Office Use
Date:
Use BLUE or BLACK Ink
City of Eapll
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Permit #: 13 to 0 9
Permit Fee: (06115 • 5o
Date Received: 9 /5 /
Staff: 8T5
2013 COMMERCIAL BUILDING PERMIT APPLICATION
Tenant Name:
Site Address: 34, .13
tApalic th
Property Owner
Type of Work
Contractor
7Igto 2 4
(Tenant is: New / Existing) Suite #:
Former Tenant:
Name: Phone:
Address / City / Zip:
Applicant is: Owner Contractor
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r:
Description of work: 9...e..) 'k- ,, ----, g..c.k.4 t '1-1 C.' C C- -• N f '
Construction Cost:
Name L k 1„,4
7
2 6e uity:
License #: !Alt
Address: L7:,..-.):::),))) (,) fr;
State: iiqfk, Zip
ett ittt
Contact:
Phone:
Email: 72-2'21
Name: Registration #:
Address: City:
ArchitectiEngineer
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 aretrade 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.popherstateonecall.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 ofysgc which re uires a review and approval of plans.
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Applicants Printed Name Ap nature
Pagel of 3
44111 City of Eaall
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r
ForOffice Use
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Permit #:
Permit Fee:
Date Received:
Staff:
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 02"- a7 / / Site Address: .913 4, L4 eckf /, ! /'y /4-4e_
Tenant:
4 4i -
Tenant: 77>e rr' 14'),//,.3
RESIDENT / OWNER
Name: Terry S
Address / City / Zip: 6:7 (r) cd erf 1 ` 1y
Applicant is: Owner )( Contractor
TYPE OF WORK
Phone:
/1yie_
Suite #:
b / 4/20574
Description of work:
PE" Rep�G61 / lei`/
t , .
Construction Cost: Multi -Family Building: (Yes- / No
CONTRACTOR
Name: Cre,3 f FjLicense #: A2::dz--
Address: <52 C1 i'p d'/e
City: Fa -/-/ T1 71917 State: Zip: 64
Phone: 5/ " 46'‘) 6)/ coli { Contact Person: e /4&7 5 c 29 ).6 �.
COMPLETE 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
Energy Code
Category
(-4 submission type)
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: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents that you submitare to be: public information: Portions of
the information may be classified as non-publicif you provide specific reasons that would permit the City to
conclude thatthey 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
'ccordance with the approved plan in the case of work which requires a review and approval of plans.
X e- ihticr17 x • " �� A''
Applicant's Signature
Applicant's Printed Name
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