4416 Jan Echo Tr
Z, Ify -A
11C,
I For Office. us.e
Permit
C ity o Ea
~ Ij
I Permit Fee:
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff: I
-
2008 RE IDE TI BUILDING PERMIT APP ATION
41
i f /4/ ff ~Q/ qi q4l q #i ~i a 4 G rG J
Date: Site Address: ~}f/J~f 41 /Y,
Tenant: ~ Suite M
RESIDENT" / OWNER Name: Phone:
Address / City / Zip:
Applicant is: Owner Contractor
TYPE OF WORK Description of work: ge- &o g -1,2
Construction Cost: 4`" I- Multi-Family Building: (Yes-- No
CONTRACTOR Name:- T~e°' a C'e:E- License
Address: /Qeq ._:5aH?fi,7e, ' -~5- / ' Y29
-
City: State/)W Zip). ~//,3
Phone: _`P j -2 ,38~/ _ °y Cv/,-- Contact Person:
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 documents than' you stil mit are considered to 69'public information: Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
eonciude thaf.,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 j
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; th work wi a in
accordance with the approved plan in the case of work which requires a review and approval of lans.
x 1y (C-'"-'~ x '
Applicant's Printed Name Applicant's Signature
Page 1 of 3