4414 Fremont Alcove
\'J r-----------------
, l ;For'Office.Use 1
3 1~ I
0 Q Qp ~ Permit
City I
I Permit Fee:
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I 1
Fax: (651) 675-5694 i Staff: I
1
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: •J / ! Site Address: r,. , / " ✓ ` " ,J Gl~'r` r,lr d'
Tenant: Suite M
RESILIENT / OWNER Name: Phone:
Address / City / Zip:
Applicant is: Owner Contractor
TYPE OF WORK Description of work: & -/9
Construction Cost: Multi-Family Building: (Yes, / No
CONTRACTOR Name: ) /z_:: License M.
Address: -5-
City: ~/J:7t?P/ /,J /1 State: 1,1141 ~Z/ip:
Phone: 2-3 / ; ~o%~(> ( Contact Person: BI sc~
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Category 1 Minnesota Rules 7672
Energy Cade 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 fora 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 that you sLibinit arc considered to he'public in/brmation. 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 in i
accordance with the approved plan in the case of work which requires a review and approval of pl ns.
App"licant's Printed Name ApPlica is Signature
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