1866 Casey Tr
Use BLUE or BLACK Ink
For Office Use
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Permit # I I " i
City of Eakan
1
w I Permit Fee:
3830 Pilot Knob Road l 3
Eagan MN 55122 t' Date Received:
Phone: (651) 675-5675 1
Fax: (651) 675-5694 1 Staff: 1
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address Unit
Name: 6 41` 1~11.' Phone: !l!~'~t C%
Resident/
A0 S'4 ~kytk r4
Owner Address / City / Zip: r r ~
Applicant is: Owner Contractor r
Description of work:
Type of Work
L3uiltiinci-(Yes / No
_ D Multi-Family
Construction Cost: ~
"
C
Company: Contact:
/13 City: 1~'~'> f
Contractor AddressZiy~sNt~
3 +
~ /.2
State: Zip Phone: ,
License M _ 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
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:
j 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 secret,.
m _ _ 1 -1 ___111 I
CALL BEFORE YOU DIG. Call Gopher State One Call at i651i 454-0002 for wotectiori against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities r -;,rir i l it r t,tc r,c~ati.
I hereby :fcknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
1:a9an: 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
accordancc. with the apgrovi=d 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 cornplcted within 180
days of permit issuance.
i'
Applrcant's I'rinted Name Applicant's Signatu-~u te~
Page 'l of 3
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For Office U. se
City of EaPH I Permit A
I
I I
_ l
3830 Pilot Knob Road Permit Fee: ~
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 1 staff: 1
I 1
2008 REST ENT'IA UIL®ING PERMIT APPL ATION-^-----
Date: r ! `7' Site Address: fzL`~ _ J o /glc /Z
4
Tenant:
Suite:
RESIDENT" / OWNER Name: Phone:
Address / City / Zip:
Applicant is: Owner Contractor
TYPE OF WORK Description of work: _ T} xeo 7a
Construction Cost:
i Multi-Family Building: (Yes- / No
CONTRACTOR Name: A ~I ~-5' ~'~Jr7 14 7-5~tr7Ce' License
Address: 7 GtYf'7 Z~'!' > r~ ? -Q 1
State: IV41 Zip: , ~-J I13
43
Phone: 82 Contact Person: > >
COMPLETE THIS AREA ONLY IF CONSTRUCTING NEW BUILDING
` Minnesota Rules 7670 Category 1 Minnesota Rules 7672
Energy Code Residential Ventilation Category 1 Worksheet New Energy Code Worksheet
Category Submitted Submitted
N submission type) Energy Envelope Calculations Submitted
In the last 12 months, has the City or 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 supposing documents that you subm are considered to be 'public inforrr~afion Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that the are. trade .secrets.
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 {
agan; 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 p ns.
.pplicant's Printed Name Applicant's Signature
Pagel of 3
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