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1863 Michael Point Dr S For Office U. se City of EaPH I Permit A I I I _ l 3830 Pilot Knob Road Permit Fee: ~ Eagan MN 55122 Date Received: Phone: (651) 675-5675 I I Fax: (651) 675-5694 1 staff: 1 I 1 2008 REST ENT'IA UIL®ING PERMIT APPL ATION-^----- Date: r ! `7' Site Address: fzL`~ _ J o /glc /Z 4 Tenant: Suite: RESIDENT" / OWNER Name: Phone: Address / City / Zip: Applicant is: Owner Contractor TYPE OF WORK Description of work: _ T} xeo 7a Construction Cost: i Multi-Family Building: (Yes- / No CONTRACTOR Name: A ~I ~-5' ~'~Jr7 14 7-5~tr7Ce' License Address: 7 GtYf'7 Z~'!' > r~ ? -Q 1 State: IV41 Zip: , ~-J I13 43 Phone: 82 Contact Person: > > COMPLETE THIS AREA ONLY IF CONSTRUCTING NEW BUILDING ` Minnesota Rules 7670 Category 1 Minnesota Rules 7672 Energy Code Residential Ventilation Category 1 Worksheet New Energy Code Worksheet Category Submitted Submitted N submission type) Energy Envelope Calculations Submitted In the last 12 months, has the City or 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 supposing documents that you subm are considered to be 'public inforrr~afion 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. 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 { agan; 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 ccordance with the approved plan in the case of work which requires a review and approval of p ns. .pplicant's Printed Name Applicant's Signature Pagel of 3 i Ii