1759 Walnut Lane
nLuae oF E?cAN WATER SERVICE PERMIT
3793 Pilot Kwob Rosd PERMIT NO.: II09-
Eoyoe, MN 55122 DATE: 4/9/75
Zoning: PUD No. of Units:
Owner: New Horizon Homes Wood ate II
Addreas:
Sice Address: 1759 Walnut Lane
Plumber: 'I'hompson Plumbing Co.
~er No--~ >~~G Connection Charge:140.00 pd
~lZe: `""y~ Account Deposit:
Reader Ne.: G=L- 59' ? Permit Fee: 10. 00 F*d_
q ~ eornpir wifl~ NN Villo~ of Eagoe Surcharge: . 50
D`~ d Miac. Charges: =
Total:
gy 1/11/1 Date Paid: .
Date of Insp.: Insp.:
riLuoE oF UsnN SEWER SERVICE PERMIT
37lS ribl Knor Read PERMIT NO.: 2469
Ea4en, MN 55121 DATE: 4f 9/5
Zoning; PUD No. of Units:
Qwner; New HOri2on Homes - I•7oodqate II
Addrese:
Site Address: 1759 Walnut Lane
Plumber: Thompson PlumbinQ Oo.
1 epw to ee~rlp wMh tl» VNI"o of Eaoow Connecdon Charge: 425.00 Dd
0f /iweRoa. Account Depodt:
Permit Fee: 10.00 air pd
Surcharge: •50 PG1-pd
By: Mirc. Charges:
Daa of Inip.: Total:
:mR: Date Paid:
' CITY OF EAGAN
3795 Pikf Knob Rood Eayaa, MN 55122 N! 5991
' PHONE: 4544100
BUILDING PERMIT ReceiPt #
TO M uNd hr , Vclue Date 'J19
5ite Address ~759 S'lalnut Lane Erecr IZ] occuponcy
l.ot - Block Sec/Sub. '''ood ~'rate 'nd Alter ? Za,irg rl
Parcel Repair p Firo Zone
Enlarge Q Type of Const.
oc Name Ik~;ir~ Move ? # Stories
~ Address Demolish ~ Front ft.
, '1~ • -r
G Phcne Gmde ? Depth ft.
~
Name r .a APProvals Fees
~OIII }~OOZS
o~ Address ''xc~Pl ;i n,• t zr~, Assessment 24 Permit ~'y • ~U,~~ ; ~~5r~ Water&Sew. Surcharge 1•.'7~''
CI t "
Phone Poliu Plan thecl~ 3• ~'n
Name Fire SAC
Address Eny. Woter Conn. ~W Ci phone Plcnner Wnter Meter
Council Road Unit
I hereby ucknowledpe that I have read this opplication end stote thot Bldg. Off.
the Information is corred ond agree to oomply with all applicable APC Total
Stote of Minnesota Statutes und Ciry of Eagan Ordinonces.
Signature af Permittee
Ci1~tCi''. '~nOI ;
A Buildinfl Permit is iswed to: on the exPress condition that
ell work sholl be dona in acwrdance with all applicoble Stme of Minnesota Statutes and Ciry of Eugan Ordinonces.
Building Otficlol
.
Plumbing
Mechanioai
INSPEGTIONS DI1TE INSP. Rough-In Finol
Footings Dofa Inso. Oata I?uP.
Foundetion Plumbinp ~
Frome/ins. Mechonical
Final
Remarks:
~
' cirY oF EA"N
' 3795 PiW Kneb Reod Eeges, MN 55122 Ng 5482
' M10NE: 454.8100
BUILDING PERMIT Receipt #
Te 6e aed M. Est. Vclue Date , 19
Site Address Erect ? Occuponry
Lot Btock Sec/Sub. Alter Q Zoning
Parcel # Repair ? Ftn Zone
Enlorge Type of Const.
oWr Name Move 0 # Stories
~ Addross , Demollsh Q Front ft.
G Phone ~ Grods ? Depth ft.
~ Name - ~?Ppeovals Feas
/lssessment Permit
Ci phane r Woter 8~ Sew. Surchorgo
Police Plan theck
ce
Name Firo SAC
/Wdross Enp. Woter Conn.
ceW C~ p"-e Planner Woter Meter ~
Councll
1 hereby ncknowledfle thct I hcve ?eod this application and state that gldg. Off.r~ I
the infortnation is corced and agree to comply with all applicable ^PC Totol
State of Minnesota Statutes and City of Eagan Ordinonus.
Siflnoturo of Permittee
A Building Permit is issued to: on the express condition thot
nll work shall be done in accordance with oll applicable State of Minnesoto Stotutes ond City of Eagan Ordinances.
Buildirg Official - -
h~tr # o.b I~.d fwwM1M
Plumbing
Mechonicol
INSPECTIONS DATE INSP.
RoupMln Final
Footinps 1l• 2!7 OaRo Irup. Doft Imp.
Foundotion Plumbfnp
Frcme/ins. i Mechanicol
Final
Remarks:
I INSPECTION RECURD c°ntr°' "o.
I CITY OF EAGAN PERMiT TYPE: °l' I t I" 1491
I 3830 Piloi Knob Roed Perrnlt Number. 641114
! Eagan, Minnesota 55123 Date Issued: 4~/29!92
I (612) 681-4675
SITE ADDRESS: APPLICANT:
1 7 G 9 wAt"ur ~-10r1r101ap RnurtNu iar_
w~ut~s~tt :~n E~si.~? x:~-~~~e~
~
PERM1T ~VqTYPF: T1fPE OF WORK: vf:
r?f`. 1 1 1 1 li 1i II f: 041L1 f' tI1 li
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CITY OF EAGAN Remarks
aaditjoJ oo ate 2nd Lot 13 4 pa,ce~ ~ 84601 130 04
Owner e"4 reet 1759 Wa1nut Lane State Eagan.,MN 55122
/
' Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. 12-33 197 8.52 1.70 5 Pa.td
STREET Mz, 1976 1034.75 3.92 3 Paid
GRADIMG
SAN SEW TRUNK ~ 114.72 7.6 1 Paid
#SEWER LATERAL ?j ~ Ej 3068,71 1022.90 3 1 P3id
WATERMAIN
~,9NATER LATERAL ~ 3
jQNATER AREA ~ 6
~STORM SEW TRK ~ 97~ 3
.~STORM SEW LAT fj 3
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 1 O.00 13094 -2•-7
BUILDING PER. 7 13094
SAC 425.00 ' -
PARK 3 37 20.00 -
~
Minnesota State Board of Electricity
, 1959,-1niversity Ave., St. Paul, Minn. 55104-Phone 645-7703 ~ 7 V
. REQUEST FOR ELECTRICAL INSPECTION
Cfl'ECK BELOW WORK COVERED BY THIS REQUEST
Type of Building New Add. Rep. Chmr pppliancq Wired For Check Equipment W'ved For
Home ? ? Range ? Temporary Wving ?
Dupiex Water Heater ? Lighting Fixtuces ?
Apt. Bldg. ? 0 ? Dryec ? Eleciric Heating ?
Commercial Bldg. Furnace ? Silo Unloader ?
Industrial Bldg. ? 0 ? Av Conditioner ? Bulk Milk Tank ?
Farm pList pList
Other 1y
? ~ ? Hehers) Hehersl
COMPUTE INSPECTION FEE BELOW '
Service Entiance Size: # Fee Feeders&Subfeeders: # Fee Cixcuits: # Fee
0 to 100 Am s. 0 to 30 Am res 0 to 30 Am eres
101 to 200 Amps. 31 to 100 Amperes 31 to 100 Am ies
Above 200_Amps. Above 100 Amps. Above 100 Amps.
Transformers Remole Conttol Circ. Paitial or other fee Sa
Signs Special Ins ection Minunum fee 55.00 a
Remacks 'IOTAL FEE
I, the Electrical Inspector, hereby certifj j~ the,Qo}~ ' specti has been made. o
(Rough-in) Date FS'
(Final) a t e This request void 18 months from " •
This reest void 18 months from /7
/
Date of this Request --s?
1, as 01-icensed Electrical ContractorROwner, do hereby request inspection of the above electri-
cal wiring installed a[: a /,3 B J(
Street Address or Route No. Cit
Section Townslup Range County~45-~,J
Which is occupied by
(Nama of~ccupant)
Is a roughin inspection required on this job? No ? Yesgl Ready Now'A-&l Will Ca4U
' -G~o a ji:z
Power Supplie~
l~
Electrical Cont to Contwctor's License No. _
(COmDany Name)
Mailing Address
(E triwl Co t or or Ownar Making This InStallatlon ~
Authorized Sig ur ' Phone No. lo ~
( I trical ant, r o Owne,Making ThIS allatlan)
This inspection request will not be accepted 6y the
Stafe Board unless proper inspection fee is enclosed.
This reqaest qoid
IS months from
Date of this Reques[ Fire No.
I, as ? Licensed Electrical oOwner, do hereby request inspection of the above electri-
cal wiring installed at:
Street Address or Route No. CitygL,~_
Section Township Range County
Whlch is occupied by % nt~~ V1+141~
(Name ot Octupan[)
Is a mughin inspection required on this job? No ? Yesl~( Ready Now ? Will Call ?
Power Supplier - Address
Electrical Contractor v~ W!1!~ 1~~.~ Contracior's License N3-0"
(COm ny Nama)
Mailing Address _ ~ ~t„~
}Elacttlc1 CO <to~ of Owne~ Mak109 Thls IOStallatlon) p
Authorized Signature Phone No. 6 QD'774
(Elactrical Contractor ar Owner Making This Inztalletlon)
This impecaon request will not be accepted by the
f~„ State Board unless proper inspection fee is enclosed.
minnesoca acace ooara ot uecvIciry
Griggs Midway Bldg. - Room N191 EB-00001.02
*"1321 jInjversity Ave., St. Paul. Minn. 55104 - Phone 297-2711 G d
REQUEST FOR ELECTRICAL INSPECTION ~d - -
CHECiC BELOW WOAK COVERED BY THIS REQUEST
Type of Building New Add. Rep. Check Appliances Wired For Check EquWment Wiied Fot J
Home ? ? El Range ? Temporary Winng ?
Duplex ? ? ? Watet Heatei ? LighLng Fixtuies ?
Apt. Bldg. ? 0 C3 Dryer ? Electric Hea[ing ?
Commercial Bldg. ? ? ? Purnace ? Silo Unloader ?
Industrial Bldg. ? 0 ? Air Cond' er ? Bulk Milk Tank ?
Faz!n ? ? ? List List
Other ? ~ ? ? Heiet) s~ Qt~h~ers~
n
C(~yMPUTE INSPECTION FEE BELOW
Service Entrance Size: t Fee Fceders&Subfeeders: # Fee Circuita: # Fee
0[0 100 Am s. 0 to 30 Am res 0 to 30 Amoeres
101 to 200 Amps. 31 to 100 Amperes 31 to 100 Am eres
Above 200_Amps. Above 100 Amps. Above 100 Amps.
Transformers RemoteCon4olCiic. Partialotothetfee
Si ns Special lns ection Mmimum fee E5.00
Remarks
TOTALFEE 24
I, the Electrical lnspector, hereby certify t y}r~e(~~ e ~ms ection has been de.
(Rough-in) Date ~ a
(Final) _ Date C'/
This request void
I Q months from
! zl~
CITY of EAGAN N-0. 3537
BUILDING PERMIT
Owne: 3795 Pilof Knob Road
. G-.i/ ^'a^1'-L/
~ r Eagan. Minaeaofa 55122
Addrex lPrs~enl) x..`.`:: ~"-'~-"J 7'N~-? .SS:~~/3
454-8100
Bufldes /
Address Dale .......T , . 7
DESCAIPTION
8torioi To Be Usad Fos Fson! D11plh H~iph1 Esl. Co~! ~rmtt F~a Romuks
LOCATION
Sireet, Road or other Daser(ption ot Loceifon ~-Lo! Bloclc Add[llon or Trac!
~-w~.Cc~~Q - /7
_7r
This permit does not aulhorize the use oi clraefa, roeds, elleye or eidewalks nor does it give 26e owner or Lis aqent
~ the right to creale eny situeiion which is e auisanea or which presants a ha:ard !o the hsslfh, selstp, eoavenlonn end
general walfare !o anyone in the eommunifp.
THIS PEAMIT MUST BE KEPT ON THE PREMISE WHILE THE WORK IS IN PROGAESS.
Thk it fa carlifp. !hal......
. ....r..:...............has permiesioa !o erset a...L/......~................ _upon
the above described premise subjec! 20 !he p ovisions of all applicable Ordinancea for the Cilp of agan.
L "..""...'Y...n-f... ...._r................... Per f',~^~~t
~
ayor ~ SutidinQ Imp9 elor ~3
czTr o: E„Gara
3795 Pilot Knob Road
Eagan, P?innesota 55122
PERMIT NO.: 5s4
The City of Eacan hereby grants to Thempson plvmbing Co.
Ninnet_on1<a
a PI,Un[elt;:: Permit for: (Owner) Nei•, NOrizolh - Woodgate II
1755, 1753, 1760, 1763, 1759 13ir.korv Hill and 1755, 1757, 175?,i1761, 1763,
at~7(5 W81nut Lane f, pursuant to application dated 4/1,,75
Fee Paid: S22Q,00 dated this 9.*_h day of nPr4 l , 19 75
S.S~i s/c
Building Inspector
Mechanical Permits:
Aid Tota].:
..y~
CITY OF EAGAN
3795 Pilot Knob Road x : ' J ~
Eagan, Minnesota 55122
' YERMIT NO.:
5d9
Tt.e City of Ragan h2reby grants to
op r^^, Sed9wick Heatinq
i
` Permit for: (0wr:er) ".07i-`i 11ve.
•
IiEATING
11'16`1.-1Z5S~.1Z:iL,.._and t 745 r '•O r. i.?on - V;oodgate
1761 walnut Lane i~l~#1t9rrc~PQ~~?t~jo~xlatle~~a~9 ~
Fee 'air~: _ dated this 3/10 /75
day of , ; 9
$160.00 - -
4.00 s/c 13 Ptar. 75
Building In3pector
''"`•clc;:l Permiis:
~~.c: Tota1;
ciTr oF EAcaN
379$ Pitoe Kaob Roed Eagan, MN 55122 N2 5482
PHONE: 4548100
BUILDING PERMIT APPLICATION Receipt
to be usea fer SLmporch & Worksh(EP, vaiue 5,000. p,re 10-30 1979
Site Address 1759 Walnut Iane Erecr ? Occupar+cy R3
Lot 13 BI«k 4 sec/sub. Woodgate II Alter ? Zoninq PD-Rl
Parcel # Repair ? Fire Zone
Enlorge Type of Const. v
W Nome ~Ugla'' ~ ~'~n'' Move ? # Srories
z Add 1759 Walnut Lane perrwlish ? Front 38 fr.
; ress ° Ci K~! an 55122 phone 454-8627 Gmde ? oepth 16 ft.
p Name SdWt10rS2 IT1C. ApDroralt Fees
o" Address 6325 Welcoire Aven~ Assessment Permit 18.00
Ci Mpls 55429 phone 533-0352 WaterBSew. Surcharge 2-00
Police Pian check
FW Name Fire SAC
Address Eng. Water Conn.
<W Ci Phone Planner Water Meter
Council
I hereby acknowledge thot I hwe read this nppiication and state that Bldg. Off. lO 30/79
the infortnation is correct and agree to wmply with all applicabie
$tote of Minnesota $mtutes and City of Eagon Ordinances. APC Total ~
Signoture of Permittee
A Building Permit is iuued to: Sm]hOTS2 I:1C. on the express condition thot
oll work sholl be done in accordanc ivith all opplic ~le St e of Minnesota utes ond Ciry of Eagon Ordirwnces.
Buildirg Officiol ?
- CITY OF EAGANNL~ Include 2 sets of plans,
1 site plan w/elevations &
BUILDING PEMIT APPLICATION 1 set of energy calculations.
SiJ1J I)02c43
'Ib Be Used For WO(Z L.5WaP Valuation 9(13000 Date ~(D 7
Site Pddress 1759 W A LNU7 L R&.q- OFFICE USE ONLY
Int Bloclc Sec./Sub. Fxect Occupancy
Parcel Alter Zoning
Repair Fire Zone
Owner: DaL)loL}15 Cc.r-nMttiS Ehlarge _'Iype of Const.
Address: )75- 1.,.Jf}.L.utJz7' k1t- M°"z # Stories
Dacalish Fivnt ft.
City/Zip Code: Grade Depth ft.
Phone 4- 5-4-' 86 z 7 1
APPROVALS FEES
Contractor: Assessments Permit
Aaaress: ~325 ,q u~ ?"~ate'r/Se~aer surcr~an3e
Police Plan Check
city/zip c«ie: f-j p LS f''r 1 n,) AJ SS4~ 9 Fire sAc
Phone ~J' Water Conn.
Planner Water Meter
Council l~ad Unit
~~•~g•~ Bldg. Off.
Address: APC
City/Zip Code:
Phone # : TOTAL
,
ADD177bIJ
/
r.~A P- , ~lOU ~
~
tv~
t,Op wc7 k-AR
CITY OF EAGAN
, 3795 Pi1M Kno6 Raad Eegun, MN 55122 N~ 5 9 91
PHONE: 454-8100 7 /
BUILDING PERMIT APPLICATION ReceiPr # 01 01
7o be used for SWIItM2ING POOL/FEN13. Value 5,000.00 Dote 7-25 , 19-w_
$ite Addreu 1759 Walnut Lane EreU FL] Occuponcy R3
Lor 13 eiook 4 5ec/s,b. Wood Gate 2nd Aire. ? zon;o9 Rl
Porcel # 10 84601 130 04 Repair ? Fire Zone 3 _
Enlorge ? Type of Const. V
Do Clemens
W Name ~ Move ? # Stories
Z Addrea 1759 Walnut Lane pemolish ? Front 44 ft.
o agan , mn. - Grade ? Depth 20 ft.
Ci Phone
~ Nome Custom Pools ADProrals Fees
Z~ AssessmentIGU2-4,L8 Permit 27.00
ou Address 7Ql F Fv l' Alra
V~ Ci FIOAk1Tls, IVS[l , phone 933-2255 Weter&Sew. Surcharge ~-00
Police Plan checka 3. SO
~
~w Name Fire SAG
i-Z
~o Address Eng. Water Conn.
aW Ci phom Planner WaterMeter
Council Road Unit
I hereby acknowledga that I have read this aDPliwtion and state fhat Bldg. Off. -
the information is correct and agree to tom ly with oll opPlicable AP~ Totol ~++.5~
State of Minnesota Stotute~s /pCity of o an Ordin nces.
Signoture of Permittee~~
A Building Permit is issued to: CllSt ID Poo S on the express condition thot
olI work shoil be done in a on•rd nce withlyll opplicoble State of innesota Statutes and Gity of Eagan Ordinances.
C%~ ~
Building Offidai
CITY OF EAGAN Include 2 sets of plans,
Ih ~ 1 site plan w/elevations &
BUILDING PERMIT APPLICATIODI 1 set of energy calculations.
"`I A„`'-
g
2b Be Used For SI ~v^"k c c5o Valuation 000- U 0 Date 7 4>-3 ( 5!'
Site Address: I'75 q (,k)/ ,Q Itu{Lne OFFI(E USE ONLY
Lot i~ Bloc]c -~7- Sec./Sub.",4&" Erect Occupancy ?2 3 -
Parcel /~O Oy Alter Zoning 77 i
, Repair Fire Zone ~
Enlarge 'Iype of Const. y_
Owner: p VY~P J1S Move # Stories
Address: ~~i~- QnC' Demolish Front V y r ft.
City/Zip Code: L ~ Grade Depth -161 ft.
Phone U- ~ a APPROUAis FEf'S
Contractor: EU-<'~B}y\ 4t5 Assessments ,~y80 Permit m O
Address: `701 c- CCISroI(1~uP. Water/Sewer Surcharge
Police Plan Check
City/Zip Code: Y1 Fire SAC
Phone E"g' Water Conn.
~ Planner Water.Meter
~h ~g : Council Road Unit
Bldg. Off.
Address: AFC
City/Zip Code:
Phone TICTAL
h"~~ 5 n
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INSPECTION RECORD Control No.
CITY OF EAGAN PERMIT TYPE: eurLozNc
3830 Pilot Knob Road Permit Number: 001174
Eagan, Minnesota 55123 Date Issued: 6 7/z 9 I 9 2
(612) 681-4675
SITEADDRESS: Lor: is eLocK: a APPLICANT:
1759 WALNUT IANE SUPERZOR ROOFING INC
WOODGATE 2ND (612) 729-8375
PERMIT SUBTYPE: TYPE OF WORK:
SF (MISC.) REPAIR
DESCRIPTIDN RE-ROOFING
INSPECTION .
FTNAL
F - - -
L
- - - -
PER* N CITY OF EAGAN
aEAL7tvaiE _ 1992 BUILDIhG PERMIT APPLICATION
681-4675
SINGLE 8 MULTI-FAMILV 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, i set of
specifications, 1 copy of energy calcs.
Penal_ty applies when typing of permit is requested, but not picked up by last working day
of month in which re uest is made or lot chan e is re uested once ermit is issued.
Date 25 ~ 72 Valuation of work
Site Address:_175f
,fct72~~ •
, STREET SUITE N
Tenant Name: (coffnercial only) _
IAT SUBG. r,.y^ -7A~ Z/ P.I.D. 1f
Descri tion of work:
The applicant is: ? Owner M-Contractor ? Other coes«tee>
Name ~
Phone
Pfoperty iAsT FIRST
Owner Address (7 S q ~i`r~.lihG•~C ,~~jy,~
STREET STE N
City State Zip
U
CompanY 7yr~~hone 7
C011tf8Ct0r Address 2747 ~i. :?2 r:/ S License p,~ Exp._i :3l-~l3
City 97. ~ State 9Iz~~ Zip 1--?
.
Company Phone
Architect/
Engineer Name Registration #
Address
City State Z;p
Sewer 3 water licensed plumber Processing time for
sewer & water permits is two days once area has been approved.
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 Applicant:
~ ~
8~5 / f zoob RESIDENTIAL BUILDING PExMrr nrrLIcnTtorr /g~ ~
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Cominiction Reauiremerils RemodeUftenair Reauirements Ofice Use OnM
3 registend site surveys showing sq. N. of bt, sq, fl. oT house, and ~II roofed areas 2 copies of plan shwring footircJs, beams, jasls Cert of Survey Reod _ Y_ N
(2(I% mazimum lot caerage allov,ed) 1 xt of Energy Calculetiars for healed add4ons Tree Pres Plan Recd _ Y_ N.
2 wpies of plan slawing beam 6 mMvx s¢es: poured found desgq et. 1 ste survey for additiuis 8 dedcs Tree Pres Required _ Y_ N
7 set of Energy Calalations Add/b'on - mdiwro 'rfon-sile asptic system On-site Sep6c Syskm _ Y_ N
3 oopces of Tree Preservation plan ifbt platled afta 711f93
Rim Joist Detail Opfiais selection sheet (buildings with 3 or less unils)
Minnegasco mechanical ventilation fortn
Date I Z / 18/ C) 7 Construction Coat 3 Ot Ooo, o0
SiteAddress 17Sq Wa~Tv-h(.IV. UoiUSte#
DescripHonofWork -/~oF - PC -5f~~ - ee-P/4cGWc.0f"' (,V++tAdOw
Multi-Family Bldg _ Y_ N Itireplace(s) _ 0 _ 1 _ 2
Property Owner /VA/(,) i 3"eFG COCK Telephone#(6S/ ) y~$ -joSO
Contractor 77_,_,~tbr/-Z4.1-L ~.I~~mibrS'
Address ~07 gpf le- ,er' C;ty Sr4llwe.~ei-
State Zep SS Z Telephone #(6S/ )Y3 g- / 740
COMPLETE THIS AREA ONLY IF CONSTRUCTIN6 A NEW BUILDING
I
Energy Code Category - Mm°esom Rules 7670 Cateeorv I _ Minnesota Rules 7672
(J submission type) • Residential Ventiladon Category' 7 Worksheet . New Energy Code Worksheet
Submitted ~ Submitted
• Energy Envebpe Calculations SubmHted
In the last 12 monlhs, has the Cify of Eagan issued a permit for a similar plan based on a master plan2
_ Y _ N If yes, date and address of master plan:
L'icensed Plumber Telephone ~
Mechanical Contractor Telephone # ( )
Sewer/Water Contractor Telephone # f )
I hereby apply for a Residential Building PeRnit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the Staie of MN
Statutes; 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.
Afte*_ Toff+uSan
ApplicanYs Printed Name Applicant's Signature