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1948 Grant Alcove Use BLUE or BLACK Ink __~--_i-_ e-__-I 1 ~ ' I For Office Use I Zr j Permit It r I City of Eann Permit Fee' I 3830 Pilot Knob Road t i Eagan MN 55122 I Date Received:: I Phone: (651) 675-5675 l I : Fax: (651) 675-5694 I Staff; ! I 1~. w..~. ar ..w e ~ e+. w.._ ~ ~ ter.......... J 2014 RESIDENTIAL BUILDING PERMIT APPLICATION Site Address Unit 'l Date: { Name; E 3 ,r Phone: l~ Resident! , . 2) X AA Address /City / Zip: Owner t Applicant is: Owner Contractor ' Description of work: , f iji L- r' f c a € Type of Work , (5 " ~,w_ p y ~ Construction Cost: Multi-Family Building: (Yes / No ) Z./ TJ ,721 C Company: r~ t'.' z r f rl~rf~✓~fit Contact: Jt ZL r I'~r 1~ lltldrryss. ~~(7DSt~JNl"! r~" ^ t:a r ci c; City: Contractor State: y Zip: G Phone: 461 (mss 2 2 License << Lead Certificate#: _YL__ - 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: t Licensed Plumber: Phone: Mechanical Contractor: Phone: i 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 e011clude 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_g. QPr?+ I hurehy acknowk!dge: 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 tliis 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 c a~ t xnce with thn 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 withill '180 days of permit issuance. F X_\ X Applicant's Printed Name Applicant's, Signature 1 Page 1 of 3 i I ForOffice:Use I City 0 ~ Permit Eali n I D I I Permit Fee: [ 3830 Pilot Knob Road Eagan MN 55122 Date Received: j Phone: (651) 675-5675 I I Fax: (651) 675-5694 I Staff: I I I 200 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: 11410 Iq / 4 Tenant: Suite RESIDENT/ OWNER Name; Phone: Address / City / Zip: Applicant is: Owner Contractor TYPE OF WORK Description of work: I Jc-G~fl -142 Construction Cost: Multi-Family Building: (Yes, /No CONTRACTOR Name:. e) Z--!!5 IVIf CtE License Fes- Zzlz) Address: ? IG~ SLCI '7 i' . w~ z l If 2YO City: Aili7je-/l/a,21",~5 State: ft~/ Zip: J. 11,..._ Phone: 1-a12-,381`,` 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 submission type) Energy Envelope Calculations Submitted In the last 12 months, has 'he 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: Sender & Water Contractor: Phone: NOTE: Plans and supporting documents that you submit are considered to be 'public information. Portiohs 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. 1 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 approval of plans. ^ccordance with the approved plan in the case of work which requi:77X x~VV L. VVL1 Applicant's Printed Name Applicant's Signature Page 1 of 3