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1592 Sherwood Ct�City afEaQan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink Permit #: 4q66 0 Permit Fee: f Date Received: Staff: 2009 MECHANICAL NI CALPERMIT�APPLICATION Date: 5,-/q--10 Site Address: p;/ �59 9 Sherwood d - Tenant: A!€x TSor(�/1rc�l(.tsK Suite #: RESIDENT / OWNER Name: i lL � �e:�! f�(s(s Phone: (SSI' 14/I6)-0 0 1 Address/City/Zip: J5dd Sherwood c 1aai , 61,v 66S) a CONTRACTOR /S�t�e J* +/- 5 e 71- L Name: Th' l o f P lt-f kt(%v License #: v3 `7 Address: ./ D Mem ori 41 0 s�s-s ' City: &I{waCr State: ( Zip: 66Ogd Phone:66)4i 3t- 5770 Contact Person: .1 iti/vY\ a JOK 11SCNn ) TYPE OF WORK New yl Replacement Additional Alteration Demolition U1sf atU Lennoy air ctit -oncr �se'P 3 . F E d _' -� •! "s 0 8 B a, ca t 1 ®' 6 Y 4 OA A 8,�.?S i .• 11 r•rma fnp _. ff r PERMIT TYPE RESIDENTIAL Furnace COMMERCIAL New Construction Interior Improvement XAir Conditioner _ Install Piping Processed Air Exchanger _ Gas Exterior HVAC Unit Heat Pump Other Under / Above ground Tank ( Install / Remove) ** When installing/removing tank(s), call for inspection by Fire Marshal and Plumbing Inspector RESIDENTIAL FEES: $50.50 Minimum Add-on or alteration to an existing unit (includes $.50 State Surcharge) 50' O S $90.50 Fire repair (replace bumed out appliances, ductwork, etc.) (includes $.50 State Surcharge) $ V TOTAL FEE COMMERCIAL FEES: $70.50 Underground tank installation/removal OR Contract Value $ x 1% $50.50 Minimum (includes State Surcharge) = $ Permit Fee - If Permit Fee is less than $1,000, surcharge is $.50. - If Permit Fee is > $1,000, surcharge increases by $.50 for each = $ Surcharge $1,000 Permit Fee (i.e. a $1,001-$2,000 Permit Fee requires a $1.00 surcharge). = $ TOTAL FEE 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.aooherstateonecall.orq 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 Applicant's Printed Name x Applicant's Signature ?asu Pilot Knob Road SEM/ER SERVICE PERMIT P. O. Box 21199 Eagan, MN 55121 PERMIT NO.: l Zoning; (? DATE: Owner. `o fs No. of Units: i Address: Site Address: 7:92 Sherwood Court Ll of ?ritt.?r,V r:«? Plumber. Cenz I "ree to oom* W" Oraooaos Ow 017 of Boom L. 0 0 Connection C NM),: 425 . 00 r)d Account Deposit: Olt Permit Fee: BY Surcharge. P4 Date of Insp.: Misc. Charges; Insp.: Total: Doh Paid: CITY OF EAGAN WATER SERVICE PER 3830 Pill' Knob Road MIT P. 7. Box 21199 PERMIT NO.: Eagan, MN 55121 DATE: Zoning: :Z 1 No. of Units: Owner iildrs Address: Site Address: i. Sherwood roust L.i '. - ?; : v Uth Plumber: Benz R4,e,n Meter No.: Connection Charge- 3 t1 Size: Account Deposit: Reader No.: Permit Fee: 1 some to oon@* W" the City of Eager Surcharge: . S sou ordlaoaco& Misc. Charges 3 • ?;? pd net_cr Total: By D d P ate ai : Date of Insp.: Insp.: CITY OF EAGAN 3830 Pilot Knob Road P. O. Box 21199- Eagan, MN 55121 Zoning: " Owner. Address: %ddress:: ? to 60044 akb tbo City of to" WATER SERVICE PERMR 7 j PERMIT NO.: _ DATE: 1 No. of Units: 1 o . or) nd ,Accour* Deposit: 1 .00 pd =Pemit " Fee: , 5 0 d Surcharge: ?? • :, p ? d st t car Misc. Charges: - Total: Date Paid: Date of Insp.: CASH RECEIPT CITY OF EAGAN P. O, BOX 21-199 EAGAN, MINNESOTA 55121 DATE 19 REC61Yfi0 FROM AMOUNT $ CASH 0 CHECK DOLLARS 100 FOR White-Payers Copy Yellow-Posting Copy Pink-File Copy Thank ou / ,., ' BY CITY OF EAGAN NO 8885 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 4548100 // BUILDING PERMIT Receipt ?; ?- / * HF DVx'/Q7 R ? 10 3 , 0 0 0 MARC i 13 3 4 To be used for Est. Value Date , 19 1592 SF'FRP700D COURT R3 Site Address Erect IN Occupancy Lot 1 Block 1 Sec/Sub. BRITTANY 6TH Alter ? Zoning c Parcel No. 10-15005-010-0 1 Repair Q Fire Zone ` W Name _ Z Address City - O Name _ 6L) Address F- City _ W Name _ _? Address GO City _ I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Permittee A Building Permit Is issued to: all work shall be done in accordance "v!o all Building Official ?'? Enlarge ? Type of Const. Move ? * Storte Demolish ? Length - - Grade c] Depth Sq. Ft. Approvals Fees Assessment _ Water 8 Sew. Police Fire Eng. Planner Council Bldg. Off. _ APC Permit ' r 0 Surcharge 5' • 00 Plan check----72-6-.50 0SAC -? 0 O Water Conn. ' G 0 Water Meter ? ? 0 Road Unit Total • 0.5 • 50 on the express condition that Minnesota Statutes and City of Eagan Ordinances. it No. Permit Holder Misc. Permit No. Holder 7 !, J r 4 2 er `? --36 4?.yv Inspection Date Insp. Other Footings Foundation Framing S Rough Plbg. _ Q g d Rough HVA _? _ Insulation Final Plbg. D Final HVAC Final ] C Q Water Describe Location: Well Well 'rl Py -;/V Sewer Pr. Disp. Receipt MECHANICAL PERMIT Permit No. CITY OF EAGAN Fee Fill in numbered spaces S/C Type or Print legibly Tot. 1. Date 2. Installation Cost 3. Job Address Lot Blk. Tract 4. Owner 5. Contractor Phone 6. Address 7. City State Zip 8. Building Type: Residential ? Commercial ? Institutional ? 9. Work Description: New ? Add ? Alter ? Repair ? 10. Describe 11. Type No, Equipment STU - M. Ea. Forced Air No. Equipment CFM Mfg. Air Handling: Boilers Mfg. Mech. Exhaust Unit Heater Mfg. Other Air Cond. Mfg. Gas, Piping Outlets 12. 1 hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed : for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454.8100 Receipt PLUMBING PERMIT CITY OF EAGAN Fill in numbered spaces Type or Print legibly 1. Date L 2. Installation Cost 3. Job Address Lot ? Blk. i, Permit No. ` Fee S/C v T Tot. 5o Tract 77- 4. Owner 5. Contractor Phone 6. Address 7. City - State Zip 8. Building Type: Residential ? Commercial ? Institutional ? 9. Work Description: New [} Add ? Alter ? Repair ? 10. Describe 11. No. -- Fixtures Water Closet No. Fixtures Cesspool /Drainfield Bath tubs Septic Tank Lavatory Softner Shower Well Kitchen Sink Urinal/Bidet ther Laundry Tray Floor Drains Drinking Ftn. Slop Sink Gas Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed : for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-6100 CITY OF EAGAN Addition Brit Y) , % i ? It)(- 1!!, x '/If, Lot 1 Rik Improvement Date A ount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK 3Q 1976 130.10 8.67 15 52.07 014450 8-17-84 SEWER LATERAL WATERMAIN WATER LATERAL WATER AREA (P ? 1992 269.93 .99 5 107.99 A014450 8-17-84 STORM SEW TRK 1982 571.13 114.23 3 228.47 A014450 8-17-84 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT ROAD TINIT - -no -Z60; #'41924 -3--13-04 WATER CONN. ?t7 n n BUILDING PER. SAC 5.00 n tt PARK CITY OF EAGAN 1?T0 3830 Pilot Knob Road, P.O. Box 21.199, Eagan, MN 55121 N? 8885 PHONE: 454.8100 BUILDING PERMIT Receipt # To be used for SF DM/GAR Est. Value $108.000 Date MARCH 13 Iq 84 Site Address 1592 SHERWOOD COURT Erect M Occupancy R3 Lot 1 Block 1 sec/Sub. BRITTANY 6TH Alter ? Zoning R1 Parcel No. 10-15005-010-01 Repair ? Fire Zone N/A W Name TOLLEFSON BLDRS. z Address 1655 NORWOOD DR. City EAGAN Phone 454-6873 Enlarge ? Move ? Demolish ? Grade ? Type of Const. V # Stories Length 60 Depth 56 Sg. Ft. SAME Approvals Fees o Name ou Address Assessment Permit .00 u? City Phone Water & Sew. Surcharge 54.00 Police Plan check 226.50 VW Name Fire SAC 525.00 uZU, Address Eng. Water Conn. 470.00 <W City Phone Planner Water Meter 63.00 Council Road Unit 260-00 1 hereby acknowledge that I hove read this application and state that Bldg. Off. the information is correct and agree to comply with all applicable $2 051 50 State of Minnesota Statutes and City of Eagan Ordinances. APC • • Total Signature of Permittee ??QQ A Building Permit Is issued to: at-1-L/-f? - on the express condition that all work shall be done in accordance wo all appli to of Minnesota Statutes and City of Eagan Ordinances. Building Official This request void 8 months froma '15 A 9AgR91--1 ,P1? (n 4`-3O-kq 1? Rj;6 Request U to ?? _ F - (/ Fire No. Roug_ Inspection Requ? d7 es ? No ,.?/? ?Ready Now IpcW ill Neu Inspec- r Por When Ready ? i.eased Electrical Contractor I hereby request inspection of above Owner: electrical work installed et: Street (Address, 00. or Route No. f / Z-- G ib""f UbY ??t City E v0,z') 1 ecuon No. Township Name or No. ange No. County Oceu/p/ (PP?RRI/NT)). f(` I Phone No. Power tier ///?C n 14 x&114 iF--C L?" Address Electr'c ontractor (Compan ame) Contractor's License No. 6-00 k' At,? I 3S- Mailing Ad res. (Con 162, actor or Owner Making,n.tailatioul y l_? //Ccldt« /U s ?G 3 Authorized Si n ure ( ntractor/ wn er Making Installation) Phone Number n (//./fry ;%'/- 3 ?y Z / MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION BEQUEST WILL NOT Origg.-Midway Bldg. - Room N•191 BE ACCEPTED BY THE STATE BOARD 1821 University Ave.. St. Paul. MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (612) 297-2111 ENCLOSED. y,' a 15 REQUEST FOR ELECTRI C"p?A ' INSPECTION I'FB-oooot °° ./ , See instructions for completinjithi s form on beck of yellow copy. ^ r . . "'X" Below Work Covered by This Request kAvA Add Rep. Type of Building Appliances Wired Equipment Wired Home Range Temporary Service Duplex Water Heater Lighting Fixtures Apt. Building Dryer Electric Heating I Commercial Bldg. Furnace Silo Unloader Industrial Bldg. Air Conditioner Bulk Milk Tank Farm Other Spec v the, l5 ned fvl t m Sued ry Other Other Compute Inspection Fee Below # Fee Service Entrance Size # Fee _ Feedars/Subfpeders # Fee Circuits O U 1o20 0 Am s 0 to 30 Amps 0 to 30 Am Above 200 Arnps 31 to 100 Amps 31 to 100 A s Swimming Pool Above 100-Amp; Above 100_Am s Transformers Irrigation Booms Partial:Other Fee I I I Signs I (Special Inspection s? CAS I Remarks TOTAL F / / t?yl ......e. -... / .i /?? /ly -_..? "the Electra fMJ p' •'C/? i _ Inspector" hereby certify that the above Final n/ f Date7,? inspection has been _.L 1 1-1 j mad&. This request void CITY Or L?AGAN Lei U BUILDING., PEMIT APPLICATION To Be Used For Valuation 0g ?? -"3z 1 ' Site Address ?wd ('61A Lot Bloch ?_?Sec?. Sub. 61- Pasoel i s /D I, /? U Queers X,& VJ",6) Address. City/Zip Code: Mwns !: Omtractors jgl yS V, Addzess: J 5 /JDYWDD(_ F IV-6 City/up Ocdes _ Ptvxw #: - Address: • City/Zip Code: Phone #: n/ 3113 Include 2 sets of plans, 1 site plan w/elevations L 1 set of energy caloslAtlians. _ Date ?p ?f Ll ! f ?l??l OFFICE USE. ONLY Erect r,,l_ occupancy Alter Zoning Hair Fire Zone Enlarge _ `type of Const. hove M Stories Demolish _ Front !00 ft. Grade Depth ?y ft. r APPRVAIS FEES Assessments Pernut3 Water/Sewer Surd"rge Police Plan ChwA ai Fire SAC 4:- ?2g- EM. water Conn, PLjuvrar Water meter Council ' wwad Unit ? 6 Bldg. Off. AM ?MAL c2i ? 5j• 57 ? W ?? ? ? ? ??C? ? ? s ? a ,? Tollefson Builders Inc. JACKSON - SURVEYORS sacle: 1° 30, RROIRTERED UNDER LAWS O/ VTATR OF mINNUCTA a Denotes Iran 000.0: Existing Bia -?=Drainage ! 8616 EAST 554S :Drainage 6 f ??C Utility Easement T "v D MINNEAPOLIS. MN SH17 7273111 Ourbcpor's 6trUfa tc n lti r '?1 > > Io° ° !/ /? i3 A ?l 1 D ?° r \ LJ N Or. 11494 188-5 i f 1 S' Proposed Garage Floor Elev. ? Proposed First Floor Elev. Proposed Basement Floor Elev. \/ - pra( ?"? f 1 HERESY CERTIFY THAT THR ABOVE IE A TRUE AND CORRECT PLAT OF A SUIIVEV OF L S Lot i,glock 1,Brittany 6th. Addition, Dakota couaty,Minnesota. N I IS AS ?URv EYED BY MR THIS let. DAY OF March ••D.- ?.+.#???kk<Yd%kM?i1F??iYF°dXiik?k>'n?XM?,:WM?H;7.&:ikY,ek:k1;<YFM?IXCXcYF.R(Re?K CITY OF EACAN CA:ifl]:ER- JS Tu'RMINAL. NO, 760 DATE,. 08/24/99 TIME. 07:34e55 M., NAME. SEI A ROOFING & REMODELuNG WC 32iO 91.109. i5cJ2 SHF*PNOOD C 195.125 2155 9001. 1592 SHE:RNOOD C 5. 50 'io t at Receipt Amount, 200.75 Mli58(i9. USER IM., ..3AN >k%dM?iX?kY,Uk?X?k?k?X#?k?7,i>r7:t9i'$i?$Yn M?F?FitMd'irit?YYnh"?k>?:X(?k'F;'kM 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL) a G b S CITY OF EAGAN 3830 PILOT KNOB RD - 55122 ?3 ql / 651-681.4675 ew Construction Reaulrem D 3 registered site surveys showing sq. ff. of lot, sq. H. of house and gll roofed areas (20% maximum lot coverage allowed) ? 2 copies of plans (show beam 8 window sizes. poured fnd. design; etc.) ? 1 set of energy calculations ? 3 copies of tree preservation plan R lot platted after 7/1/93 DATE: b c9-3-'?1 DESCRIPTION OF WORK: - P&Vz0% p kelzoo STREET ADDRESS: lJ??a-- 5 ?er2)N0f)d V'/X C? Remodel/Repair ReauiremeMs 2 copies of plan 1 set of energy calculations for heated additions 1 site survey for exterior additions a decks ll, ? CONSTRUCTION COST: ot..Aff-jo . fto G1 k1 C'4'u e 'y a?1 /mom fio cg LOT' , BLOCK: SUBD./P.I.D. Vl- N`'rsav?hra?sl T 65 Name: I S o N f k (' a?c15 / NC PxatiCb'? Phone #: PROPERTY Last First OWNER st.?Vt'L C- Street Address: City State: Zip: SELA ROOFING & REMODELING, INC. Company 4100 EXCELSIOR BLVD. Phone #: G f a- ?? 3 8 f ST. LOUIS PARK, MN 55416 (area code) CONTRACTOR ID #0001050 Street Address: License# f195'-0 Exp. 3 aD City State: ARCHITECT/ ENGINEER Company: Name: Teiephone #: area code ( j Street City State: Sewer & water licensed plumber (required for new construction only): Penalty applies when address change and lot change is requested once permit is Issued. Zip: Zip: ' I hereby acknowledge that I have read this application, state that the Information Is correct, and agree to ompiy with all applicabl State of Minnesota Statutes and City of Eagan Ordinances. ' Signature of Applicant: OFFICE USE ONLY Registration #: Certificates of Survey Received Yes No Tree Preservation Plan Received Yes No Not Required OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation 13 06 4-plex ? 11 10-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 02 SF Dwelling ? 07 5-plex ? 12 12-plex ? 17 Garage ? 22 Porch/Addn. (4-sea. ? 03 1 of _ plex ? 08 6-plex ? 13 16-plex ? 18 Deck ? 23 Porch (screened) ? 04 2-plex ? 09 7-plex ? 14 Apartments ? 19 Lower Level ? 24 Storm Damage ? 05 3-plex ? 10 8-plex ? 15 Lodging ? 20 Pool ? 25 Miscellaneous WORK TYPE ? 31 New ? 35 Tenant Impr ? 39 Gas Line Only ? 43 Siding/Soffits/Fascia ? 32 Addition ? 36 Move Bldg. ? 40 Gas Insert ? 44 Windows/Doors ? 33 Alteration ? 37 Demolish Bldg.* ? 41 Wood Stove ? 45 Fire Repair ? 34 Repeii ? 38 Demolish (Interior) ? 42 Reroof * Give PCA handout to applicant for demolition permit GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Width APPROVALS Planning Basement sq. ft. Main level sq. ft. sq. ft. sq. ft. sq. ft. sq. ft. Footprint sq. ft. Building Engineering Census Code SAC Code No. of Units No. of Bldgs MC/ES System City Water Booster Pump PRV Fire Sprinklered Variance Permit Fee S aS Surcharge S- 5 (? Plan Review License MC/ES SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment PI. Park Ded. Trails Ded. Other Copies Total: Valuation: $ SAC Units % SAC 2/84 CITY OF EAGAN APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION (PLEASE PRINT) 1) PROPERTY ADDRESS: LEGAL DE.RIPTICN: I EXIS_-:G STRUCTURE, DATE OF ORIGINAL EUILDDNG P? -1T T_SSL;ANC_E: PP 5E - S^`Ti T %? PCS ,S--:-1 SD-,= FAMILY ? R-2 DUPLEX M'--O UNITS) ? R-3 TCSvNHCUSE (THREE + UNITS) ( UNITS) ? R-4 APART!, T/C Z)allMNIU i ( CHITS) ? CUML=TAL/RETAIL/OFFICE ? n\DUSTRLAL ? INSTITUTIONAL/COVE,RNL= 2) APPLIC-AN7 (PLEASE PRINT TOLLEFSON BUILDERS, IN NAME ADDRESS: 1655 Norwood Drive CITY, STATE, ZIP: Fagan, MN 55,122) PHONE: (612) 454 - 6873 3) PLUMBER ME ^ ' IPLLASL PHINI) % FOR CITY USE ONLY lU1 W C.r . ? - ADDRESS: PLUMBERS LICENSE: Active CITY, STATE, ZIP: S?MOr / ?r- IKrNN ? ?Q?? Expired . PHONE: ?3- r 44 _ AIL: PLUMBER LICENSE /f )t9Aq Not of Record < ir SEarr Inlti?(- 4) OCCLT'ANr/CUvNER N*fE: (PLEASE PRINT) - ADDRESS: CITY, STATE, ZIP: SAME AS 4PPI TCANT PHONE: 5) INDICATE WHICH PEP.= IS BEING REQUESTED: CO„TTECPION TO CITY SEVER CONNECTION TO CITY WATER -- ? OTHER (PLEASE DESCRIBE) 6) r;DIC E 0:JE: ? PLEASE HOLD APPROVED PERvTIT FOR PICK-UP BY-ONE OF ABOVE PLEASE.;IAIL APPROVED PER.%UT TO 1, 23 4 ABOVE. (Circ one) 7) SICLv1TLRE. DATE. L-- r6 ) - ?! 6! Cl.? ?1lA ? i ?! a i?_ sa ve a rt a-aii.O ?f of a ®: RS m:a :m sa fm[ w? cF.mF:sa!-m:fY ? aal !~a! ac¢?iLG• ee F O R C I T Y U S E O N L Y PERMIT y ISSUED FEES: $ ie-moo $ $ / e $ L?7d. a? S $ $ " SE.^:E°, PER-11T_T (I T- DE SURCH?.. GE) WATER PERMIT (INCLUDE SURCHARGE) WATER METER/COPPERHORN/OUTSIDE READER WATER TAP (INCLUDE CORPORATION STOP) SE14E_R TAP ACCOUNT DEPOSIT - SEWER ACCOUNT DEPOSIT - WATER WAC SAC TRUNK WATER ASSESSMENT TRUNK SEWER ASSESSMENT LATERAL BENEFIT/TRUNK SE1•7ER LATERAL BENEFIT/TRUNK WATER OTHER $ TOTAL AMOUNT PAID/RECEIPT 4 417 z---l DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? YES IF YES, THEN A "PERMIT FOR WORK WITHIN PUBLIC ROADWAY" MUST BE ISSUED BY THE NO ENGINEERING DIVISION. LIST AS A CONDI- TION. SUBJECT TO THE FOLLOWING CONDITIONS: APPROVED BY: TITLE: DATE: . ; sw w W :m aw M m w jmcw MUM w M w eRyu s+1+ ao--m Rm w W fl wpm R# ¦e W se sr wt?w Pkew w sre w r----------------- ?l;?;gO/ / -7 I i Permit #: I Permit Fee: ---- I I Date Received: I I I Staff: I I Date: Tenant: RESIDENT / OWNER Name: x / { IF', G1? S Phone: z 54 l ? ?f 7 r/ Address/City/Zip: Applicant is: Owner Contractor TYPE OF WORK / Description of work: i<-P r04 l i F il B ildi Y N 16 7n M - y ng: ( es o u t am u Construction Cost: . CONTRACTOR Name: ! ak? .14A License 0: ? O/ -?U3 9/ Address:: I7r t,, e /W Zip: Sta te: City: La (A , / ` Phone: 6/ z Sr'7 36 0 Contact Person: ta? VUt COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING _ Minnesota Rules 7670 Cateoorv 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 Citk 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 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 T / Q ^ 141 tlf , 21 X Applicants Printed Name icanfs Signature Page 1 of 3 2008 RESIDENTIAL BUILDING PERMIT APPLICATION