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2175 Cool Stream Cir - BL 89376 rla~~ 27 For Office Use Permit 74 City of Ea p hermit Fee.. 3830 Pilot Knob Road Eagan MN 55122 Date Received: ~ Phone: (651) 675-5675 I Staff: Fax: (651) 675-5694 1 2008 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Tenant: Suite RESIDENT / OWNER Name: %le 1)V e,0kD 125c)ejRTFS Phone: 6 / 4'51 Z 3C9C) Address / City / Zip: 72 Z 6R It JD I4VE V J S©. Si a O 7S Applicant is: Owner Contractor TYPE OF WORK Description of work: RMOV,:F 4}A Y1 'CI'[-/1z S"/D/std ~ Construction Cost: T Qf2 Multi-Family Building: (Yes No CONTRACTOR Name: 311 E.~ 1 ~1~ t Di M Fr (l I - Col P License 2O2 ///3% Address: qc)5- j,ij 6c)-l", S/ ?EEi City: v'1 l l ____-1 PJi-f5 State: NAI Zip: 5/9 Phone: to / 2 - 6 Z43 Contact Person: Si EVE `Aa[- 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 public information. Portions of the information maybe 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 accordance with the approved plan in the case of work which requires a review and approval of plans. X ~rf2lS AN~'s~rl/ y~r~~~ s Applicant's Printed Name pplicant's Signature Page 1 of 3 (p`~~ t I -7 Use LICE or BLACK Ink cool spa„ i -For --Off-ice--Use Permit#: CRY a I permit Fee: 3830 Pilot Knob Road I I q Eagan MN 55122 I I Phone: (651) 675-5675 i Date Received: Fax: (651) 675-5694 j Staff: j r---- t -----------I 013 COMMERCIAL BUILDING PERMIT APPLICATION Date: 3 Site Address: ? 12-71 t -71, 0-3 Tenant Name: (Tenant is: New / Existing) Suite Former Tenant: E Name: Phone: Property Owner Address /City /Zip: Applicant is: Owner Contractor ell Type of Work Description of work _ td t n Construction Cost 4 Name: ~xlEc g C , -9/ License m/ . Contractor Address: City State: _ Z IV Phone: Contact...,: Email: Name: Registration rchitect/Engineer ' Address: City: State: Zip: Phone: Contact Person: Email: Licensed plumber installing new sewer/water service: Phone NOTE. Plans and supporting documents that you submit are considered to be 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 they are trade secrets. CALL, BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org 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 accordance with the approved plan in the case of work which requires a review and approval of plans. X ( q g ee-b Applicant's Printed Name ApjYt cant's Signature Page 1 of 3