4410 Naper Bay
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-o i ,EIr:0Mce: Use I
City of Eap I Permit#: _ I
3830 Pilot Knob Road I Permit Fee:
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff:
I 1
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: !,D"- Site Address: } All/ Tenant:
Suite
RESIDENT / OWNER Name: Phone:
Address / City / Zip:
Applicant is: Owner Contractor
TYPE OF WORK Description of work:
Construction Cost: ZG z3z, Multi-Family Building: (Yes•• / No
CONTRACTOR Name: Z-~ r '17 1e,-7,-,11-7C'tE- License M Z&;7 7-VD
Address _ ? ~ 'GLYt7r ?z_/'' -!5'1 5411 le 2 Y29
City: / Z40egL 1 State: - Zip: J~ I,3
Phone: /a/ Contact Person:
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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 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:
NOTE. Plans and supporting documbrits 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
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 be in
accordance with the approved plan in a case of work which requires a review and approval of pla s•
applicant's Printed Name Applicant's Signature
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