3901 Valley View Dr S141`b
City of EaQali
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
2 1 2011
Vc
2011 COMMERCIAL BUILDING PERMIT APPLICATION V✓ r„�/_ 1j_��
Date: %✓ ,2/ // Site Address: 70/ — 3 A4 yr w 1. r SS,
(Tenant is: New / Existing) Suite #:
Use BLUE or BLACK Ink
Permit #:
Permit Fee:
9'6
Date Received:
Staff:
Tenant Name:
Former Tenant:
PROPERTY OWNER
Name:
FV,/ P0.1
.n.-1e 4f4(/_/, LLC Phone: £s -/-1;5-v ,2/yc
Address / City / Zip: .$ 9 i• I/04 v:c w Dr 1rkc' cv # / /if Ss /a .Z.
Applicant is: Owner Contractor �l
TYPE OF WORK
Description of work: /r/I r.n•
P( c
Construction Cost: o2Oj 000 •
rid:0
As jC®4cv. (.44k Al a[•.��
CONTRACTOR
Name: /4/1441
Del .4 _/ /r
I„ G
Address: .0267,95 kaiy bw/ 6
State: mei- Zip: sr 97y5--- Pho
�1
Contact: DA vitt, 1 Email:
License#: x7063 yes -0
City: 110 /04•47 h
ne: � /a - 7v/ /7I/
9
do4le 1 pea de, ry i Gg,''t
ARCHITECT /
ENGINEER
Name: Registration #:
Address: City:
State: Zip: Phone:
Contact Person:
Email:
Licensed plumber installing new sewer/water service: Phone #:
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.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 a royal of plans.
x I9a e ( TO itS,S �G -
Applicants Printed Name
x
Ap: iicants Signature
Page 1 of 3
Aug 25 11 02:55p Bruce Nelson Plumbing & H
CityofEaaali
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Ocutibm-,
6517312804 p.4
Use BLUE or BLACK Ink
For Office Ilse
Permit #: /(,la 7`/9�,
Permit Fee: �7-`-�L.!
Dam Received:
Vat
2011 COMMERCIAL�BN PERMITAI
mP'PLICATI4N
I
Date: II I Site Address) J IJ \\11,\\ L I JU�11 v
j (�.
Tenant Nae\\ :�l , .f lJ.)
t
(Tenant is: _ New /y .7 Existing) Suite #:
Former Tenant
PROPERTY OWNER
Nmrne i[L. (` U h -\ Phone:L ) E E - -c-D
City /Tip:\ 0\ 0 (�L l f `l �i , t-)itak_ Y I in ", i
Applicant is: — Owner Contractor
TYPE OF WORK
Description ofworlcQz..- A,‘, VA
Construction Cost
CONTRACTOR
C.
Name z ..U.- t \ r k-�n \ r'\C 4 'C License #: b5 3L?j
AddressYD-')'D-.Q15.1-rt C t �c cj . '-'1 l " 0
U w ZY
State 1 f Zip: T7 1 , t h ne:l..S-_J 1- " ► J''9554
contact ---)c , c (\ Email:
ARCHITECT J
ENGINEER
Name: Regisiratior. #:
Address: City -
State: Zip: Phone:
Contact Person: Email:
Licensed plumber installing
newsewer/water service: Phone #:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information maybe classified as nonpublic 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.Qoaherstateonecall.onq
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 comfit, and work is no: to start without a
permit; that the work will be in accordance with the approved plan ir, the . e.of work .Ch requires a review a( ;d approval Oi' plan.
Applicants Printed Name
Applicants Signature
Page 1 of 3