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4413 Naper Bay 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