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Permit
City of EavIl I Permit Fee: a5 I
I _ i
3830 Pilot Knob Road I I
Eagan MN 55122 I Date Received: I 1
Phone- (651) 675-5675 L I
t Staff<
Fax: (651) 675-5694 1 f
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit
. -
Name Phone:
Resident/ 2)
Owner Address I City I Zip:
e ~ 3
Applicant is: Owner Contractor
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Description of work: La,
Type of Work,
Construction Cost Multi-Family Building: (Yes No )
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t7S 1i,~~ lr 1,f: r~~ p.~>f £ I Contact: 17l Z~
t Company:
1C7t~ 6t rYh t2 Nr, «2 G1 City:
Address j
Contractor
State: LJ Zip' Phone:
License ~Z(a 2 .Z Lead Certificate
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
E
i
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:
p 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
_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.aoc cal-cfo
I hera'by acknovAoage 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 undefstand 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 180 ~ m
days of permit issuance. -
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App icMit's Printed Nan7e ApplicanVt Sitin:~tuie
Page 1 of 3
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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
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Appl cant's Printed Name Applicants Signature
Pag 3
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