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1849 Sleepy Hollow F.: Eoice Use City of Ea i ~ Permit Permit Fee: 3830 Pilot Knob Road Eagan MN 55122 Date Received: Phone: (651) 675-5675 I I Fax: (651) 675-5694 I Staff: I I 1 2008 RESIDENTIAL BUILDING PERMIT APPLI AT O Date: Site Address: Tenant: Suite RESIDENT / OWNER Name: Phone: Address / City / Zip: Applicant is: Owner Contractor TYPE OF WORK Description of work: ~CjC!-112 Construction Cost:c 2 i Multi-Family Building: (Yes, / No CONTRACTOR Name:_ 6 ! f Z'- /Vif 1;,7 1e,17 v7Cf~ License Address: _21Z)0 GGY1? l 2Y~O City: Ajiliz6wl State: ~'d771r7 Zip: -55,1,3 Phone: !C>1.- 3 ,~0 3 fPZ,-0 Contact Person: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Category 1 Minnesota Rules 7672 Energy Code Residential Ventilation Category'l Worksheet New Energy Code Worksheet Category Submitted Submitted (4 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 suppdrting documents that you submit are considered to' h - public information. 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 1 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 ,ccordance with the approved plan in the case of work which requires a review and approval of plans. Applicant's Printed Name C Applic is ignature Page f 3