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City of ECG Permit#:
; Permit Fee:
3830 Pilot Knob Road
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff: I
I I
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2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date:_ Site Address:" 19bfr /1/0?1, 1X75 J411y~t'f~%> 1~" '>f
Tenant: Suite
RESIDENT / OWNER Name: Phone:
Address / City / Zip:
Applicant is: Owner Contractor
`HYPE OF WORK Description of work: J1~ e d
Construction Cost: Multi-Family Building: (Yes, / No
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CONTRACTOR Name: License
Address:-2-/z9,0 Yf?~ i' die I 'I 7c
City: /J,-yr7r'-/yn~~~ ~ State: /IIr~/ Zip:
Phone: (<-1/2. 'Contact Person: t`a_
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW SUILDIN
Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672
E-nergy Cade Residential Ventilation Category 1 Worksheet New Energy Code Worksheet
Category Submitted Submitted
submission type) Energy Envelope Calculations Submitted
In the last 'l2 months, has the City of Eagan issued a permit for a similar plan based on a roaster plan's
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
I
Sewer & Water Contractor: Phone:
MOTE: Plans and supporting documents that you submit are considered to he public information Portions of
the information may be classified as norr-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
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
:,ccordanc/enwitth the approved plan in the case of work which requires a review and approval of plans.
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Applicant's Printed Name Applicant's Si nature
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