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1864 Buckley Bay Use BLUE or BLACK Ink (7 ~ For Office Use i x l- Permit#: 'ant- I City of Ea~a~ I Permit Fee: i 3830 Pilot Knob Road ) Eagan MN 55122 Date Received: I Phone: (651) 675-5675 i i I Staff: Fax: (651) 675-5694 ( I 2014 RESIDENTIAL BUILDING PERMIT APPLICATION p~ Site Address kr Unit Date: , Name: Phone: Resident/ Alt 'r Address/ City/ Zip Owner Applicant is: Owner Contractor s Description of work: Type of Work P):.^- _ Construction Cost: Multi- FarniiBuilding: Yes tle /No-) Com P anY, Ci t S fr Jitr t~ P~i'n~'l Contact: Address 2l~a:.:arl', rE~ r l ; City: Contractor - / Phone: / .2 State:tj Zip Lead Certificate _7 C License - e r If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) - - - COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING 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 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 concit/de that they are tracte secrets. CALL BEFORE YOU DIG. Call Gopher State One Cali at (651) 454-0002 for protection against underground utility damage. Call 48 hours t Before you intend 1o dig to rec wh e locates of underground utilities. www.gophym hereby acknowledge that this information is complete and accurate; that the work wiil 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. Exterior work authorized by a building permit Issued in accordance with the Minnesota State Building Code must be completed within 130 days of permit issuance. X x _ Athcant`;; Printed Name a Applicants Sign atui~ Page 1 r , 0Y r------------------`-+ For Office. Use I t I ^oC,~ I ; Permit City of a I I Permit Fee: I 3830 Pilot Knob Road I I Eagan MN 55122 Date Received: Phone: (651) 675-5675 ; Staff: I Fax: (651) 675-5694 I 1 2008 RESIDENTIAL BUILDING PERMIT APPLICATION Late: 5ite Address: - Ci ZcG''' Tenant: Suite RESIDENT / OWNER Name: Phone: Address / City / Zip: Applicant is: Owner Contractor TYPE OF WORK Description of work: / 1~- 7a Construction Cost: Multi-Family Building: (Yes No J ~ CONTRACTOR Name: e) T/ Z°-~~ Xy,1,k-7 ~C License G= 2 ~ ~ Address:q 21z9a -:Y/ /GG1't7f ~ 7u le City: - d/.I f?l?/~. a State: Zip: J:~'1' Phone: 912- t 38"/~ / `~LuG~,G;-~ Contact Person: / COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Category 1 Minnesota Rules 7672 Energy Code Residential Ventilation Category 1 Worksheet New Energy Code Worksheet Category Submitted Submitted (4 submission type) Energy Envelope Calculations Submitted 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: MOTE Plans and supporting documents that you tibmit are considered to he'public information Portions of the information may be classified as non-public ii you provide specific reasons that would permit the City to conclude_that the are trade secrete, 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 i 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 approv x VVIt » Appl cant's Printed Name Applicants Signature Pag 3