1983 Jan Echo Tr
/A- Y
10
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For Office. se
Permit
City of Ea
b I Permit Fee:
3830 Pilot Knob Road
Eagan MN 55122 Date Received: j
Phone: (651) 675-5675 j Staff: I
Fax: (651) 675-5694 I I
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
7 7 f
Date: 7 f! Site Address: 1'779) i 21 1 c 1`t~ I q 94~1 1 n~ e`5/cor~lL ,r ? l r'C!1'
"tenant: Suite
RESIDENT / OWNER Name: Phone:
Address / City / Zip:
Applicant is: Owner Contractor
TYPE OF WORK Description of work: & xeil)
Construction Cost: Lr>C~ Multi-Family Building: (Yes- / No
CONTRACTOR Name: L-2 /,r/ ife. License Z~lb
Address: /G>G~ ~dG1 7YY~zai' 5-xe-1 l e 2'Y,:0
City: State: /1W Zip: -533 . )
Phone: /C-'1 3 (0 b4,0 Contact Person: /`7i p SCf7 _
COMPLETE HI 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 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 Dater Contractor: Phone:
NOTE, Plaits and supporting,da.curments 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 the are trade secrets:
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
occordance with the approved plan in the case of work which requires a review and approval of pla . i
x 'A) V►~ l~Vls C~_ x
Applicant's Printed Name Applica s °gnature
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