Loading...
2185 Cool Stream Cir - BL 89377 - - - - - - - - - - - - - - - - - I For Office Use Permit / City of EaV~ d Permit Fee:. ' 3830 Pilot Knob Road f/ Eagan MN 55122 Date Received: Phone: (651) 675-5675 I Fax: (651) 675-5694 Staff: 2008 RESIDENTIAL BUILDING PERMIT APPLICATION Date: _ Site Address: Tenant: Suite RESIDENT/ OWNER Name: Yil _/zqN.I~ Phone: ~S~ ~C Address / City /Zip: 6~r2cA;D AzT- 141 Ste. Si &uL /V, 55 O 7 Applicant is: Owner X Contractor TYPE OF WORK Description of work: RE/UO 4/!ID j2672(, ( 5 c~/4'2 - Construction Cost: Multi-Family Building: (Yes / No CONTRACTOR Name: 7X( t0f /1t,4f1VT C~c /2 License Address:4"Os /1 6c Srii City: _yl11211'Inkloot 15 State: Zip: Phone: 61 Z4 6"? ~3 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 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 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 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 he case of work which requires a review and approval lans. x C%V[ S 1' Applicant's Printed Name Applicant's Signature Page 1 of 3