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1915 Jan Echo Tr Is- 1 f ( Ill(`' X17 C l~'`~ %1, /111- IV - - - - - - - - - - - - - - - - - J I ,For Office:Use I r , o~ I C.(~ It Of E a i Permit I RdI 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 Page 1 of 3