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J I ,For Office:Use I
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It Of E a i Permit
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I Permit Fee:
3830 Pilot: Knob Road I I
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I I
Pax: (651) 675-5694 I Staff: I
I
2008 RESIDENT L IL ING PE T APPLICATION
19,1q rs/7
Date: J" w 7 Site Address: 171" 26
I
Tenant: Suite
RESIDENT / OWNER Name: Phone:
Address / City / Zip:
Applicant is: Owner Contractor
TYPE OF WORK Description of work: -19
Construction Cost: Multi-Family Building: (Yes, / No
CONTRACTOR Name: 17 l e-. 1Vjf /,V7 1' e17zt,7C6! License
Address:
J4-2 r/
City:
State: l / Zip:
v
Phone: I
u ~aGl~ Contact Person i
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Category 1 Minnesota Rules 7672
Energy Code 9 Residential Ventilation Category 1 Worksheet Kew 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:
i NOTE:* Plans and supporting d6cuMbnts than yoer submit are considered to bp_'puhlic inforfilation. 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
:accordance with the approved plan in the case of work which requires a review and approval of pi
Applicant's Printed Name Applicant's Signature
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