1666 Hickory Lane
- - - - - - - - - - - - - - - - -
f I For Office Use
Permit
City of Eaaall Permit Fee:
3830 Pilot Knob Road I L-'r
Eagan MN 55122 Date Received: I
Phone: (651) 675-5675 Fax: (651) 675-5694 Staff:
2009 RESIDENTIAL BUILDING PERMIT APPLICATION
Date:// 13 - O Site Address:
Tenant: Suite
RESIDENT / OWNER Name: "/a-,Qk1 T"°I jj'4 i Phone:
Address / City / Zip: ,arc r 2~
Applicant is: Owner x` Contractor
TYPE OF WORK Description of work: c- v- - P,.C-,C
Construction Cost: Multi-Family Building: (Yes / No
CONTRACTOR Name: C d ~c _f f • License 22
Address: 7 % l~'~1 l T ~C1 E;l~
City: _ __i-%S t,1 f Lt-_ State: /u/ Zip:
Phone: ! _ - 199/ 7 Contact Person: 1411je
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
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 supporting documents that you submit are considered to be publik'information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that they 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
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
accordan e with the approved plan in the case e of work which requires a review and approval of plans.
X jAdzW 1461M e c
A260
Applic nt's Pn ted Name Appli ant's Sign re
Page 1 of 3
VILLAGE OF EAGAN WATER SERVICCE PERMIT
3795 +11ot Knob Rood PERMIT NO.:
E6gue; MN 55122 DATE: 4/26/74
Zi
Zoning: pup No. of Units:
Owner Woodgate, Nev HOriZOA d
Address:
Site Address1.660- 62 -6$ -66 Hickory Lane
Plumber: Thompson P1UM inq Co.
Meter No.: Connection Charge:
Size: Account Deposit:
Permit Fee: 10.00 pd
Reader No.• .50 Pd
1 agree to comply with the Village of Eagan Surcharge:
Ordinances. Misc. Charges:
Total:
By Date Paid:
Date of Insp.: Insp.:
VILLAGE Qf EAGAN SEWER SERVICE PERMIT
3795 Pilot Knob Road PERMIT NO.: 2207
Eagany MN 55122 DATE: 4/26/74
Zoning: PUD • No. of Units: .
Owner: _ Woodgate r New Horizon Homes
Address:
Site Address: 660 62 - - Hickory Lane
Plumber: ThoRIpSOn Plumbing co.
1 agree to comply with the Village of Eagon Connection Charge:
Ordinances. Account Deposit:
10.00 pd
Permit Fee: .50 pd
Surcharge:
B Misc. Charges:
Date of Insp.• Total:
Insp.: Date Paid: