1853 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
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