4427 Sleepy Hollow
For Office. Use I
city Of Eapfl I Permit /
I a ~ I
3830 Pilot Knob Road I Permit Fee: I
i I
Eagan IVIN 55122 Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 1 Staff: 1
I 1
2008 RESIDENTIAL 9UILDING PERMIT AP LI~AT N
~l2 1, ~~z~ 5° r
Date: Site Address: L 72-
y X1,7 /
Tenant:
Suite
RESIDENT / OWNER Name; Phone:
Address / City / Zip:
Applicant is; Owner Contractor
TYPE OF WORK Description of work:
Construction Cost:! G Multi-Family i
CONTRACTOR Name: ZZ5 jy,/, License
Address: r f~ 292)
City: State: hw Zip: JJ%,l~_
r
Phone: _4)12-3,
_2,y 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 I
subi-nission 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:
Wechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
IUOTE: Plar►s and su ~
ppo►iirr documents thaf you su,~rrrlt are cc~nsidei°r~d to be public ir►~®r~ratior~: Poriioirs o~ i
the ir►formation Wray k~e classified as nr~~7~puJ~lic if you provide specific reasons that t~rduld permit the City to
.conclude that the are trade secrets:
iereby 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
3gan; 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
:cordance with the approved plan in the case o work which requires a review and approval o 1
)plicant's Printed Name Applicant' Signature
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