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101 6'7 IZU,6t C,"We BLUE or BLACK Ink
I For Office Use
Permit GQ
n o n
J_`6- City Ol EQ
Qll Il I S
I Permit Fee:
3830 Pilot Knob Road I I
Eagan MN 55122 I I
I Date Received: I
Phone: (651) 675-5675 I
Fax: (651) 675-5694 I Staff: I
L-----------------
2013 COMMERCIAL BUILDING PERMIT APPLICATION - 12 UY1 t tS
Date: '1 d17 Site Address: yv
gvCr are.
Tenant Name: Coe ftj 0,1 (;,.,1 ko+nt$(Tenant is: New / i`-, Existing) Suite
Former Tenant:
a
Name: D;MtN C.or%ho.,s ;L \j%kk&s ot^j !~gCL,& "S Phone: AS*A- 4 3 a- 817 9
Property Owner Address/ City /Zip: ?b D42X N>3 et ho\)V% (of?
Applicant is: Owner Contractor
Description ofwork~eac- Oicr Qnc- (,oo~ a!, C1~rar 5 .vh Ct ^'C`
Type of Work
Construction Cost: b~~q
Name: O T License \J .C~ 1 t et
a a Address: ~Aojv lee, o•vL City: q 10!5C_ 0jV%A-
Contractor
State: M ~J Zip: ';J5'0(~sn Phone: !Tcs-l - 21 ;L` ~ 9 (as
o~`J . G.of1
? Contact: LG-► Email: ~f j kd V ek( e, 6
Name: Registration
Architect/Engineer Address: City:
State: Zip: Phone:
a 2
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 y
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.got)herstateonecall.org
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.
x Lc~j_ I o V x - r}nu. -
Applicant's Printed N e Applicant's Signature
Page 1 of 3
---Use—B_L_U_E_or_BL_AC_K_Ink
For Office Use I
'4001ity Of Eapn Permit#:
E � I
I
3830 Pilot Knob Road Permit Fee:I �
Eagan MN 55122
Phone:(651)675-5675 I Date Received:
Fax:(651)675-5694 I I
I Staff:
L----------------�
2016 MECHANICAL PERMIT APPLICATION
❑ Please submit two (2)sets of plans with all commercial applications.
Date: 2 � ' f Site Address:_ 11$ I North &N CT E0 qa n ,lYN 551 Z Z
Ll
Tenant: Suite#:
Resider f l trlllter. Name: brow n Phone: 95Z- 393' 9 O 2
Address/City/Zip: D r�`1 K �J( Cl �� (Zl') �j Z Z
Name: License#:
y90 d/V 0Wrnz-
Address: 300 City: 1�OuI h El• 1pC(CL
2
State: M V Zip: 6 07`5 Phone: 0 p0 JH�"1)
Contact: ��r a Email: �rQY I l��G (OM I7 S a a m
New Replacement Additional Alteration Demolition
Type of W0►II r Description of work: la C e Tll r n a Pi�i
fl
a.091+ ,
4
R-15-1.91
RESIDENTIAL COMMERCIAL
Furnace New Construction Interior Improvement
P @CC111Jt- _Air Conditioner Install Piping Processed
Air Exchanger Gas Exterior HVAC Unit
_Heat Pump _Under/Above ground Tank (—Install/_Remove)
Other
RESIDENTIAL FEES
$60.00 Minimum Add or alteration to an existing unit, includes State Surcharge //��
$100.00 Residential New, includes State Surcharge =$ lJJ0, DU TOTAL FEE
COMMERCIAL FEES Contract Value$ X.011
$60.00 Permit Fee Minimum
$70.00 Underground tank installation/removal =$ Permit Fee
Surcharge=Contract Value x$0.0005
=$ Surcharge
If the project valuation is over$1 million, please call for Surcharge =$ TOTAL FEE
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.
x La o,kl 6 t,, D(V x t da4,d_,� &-aA
Applicant's Printed Name App Want's Signature
FOR OFFI�'USilr #I I „f 3
I
Required Mspeor�s,. t#
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