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3902 Valley View Dr S'' City of Eaall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 JUN ? 1 CO' Use BLUE or BLACK Ink D Permit*: ( Permit Fee: ` 3�9 354 Date Received: Staff: 2011 COMMERCIAL BUILDING PERMIT APPLICATION Date: v ' s`1' // Site Address:3y0d - 3 !O !' Tenant Name: (Tenant is: New / ..›1" -Existing) Suite #: Former Tenant: PROPERTY OWNER Name: i, Ve Ale e 1�-,/ ...-°¢r, G 4G Phone: 4'51- '9S`f ' 02 / e) ,�,�,, Address / City / Zip: ?S' 7 Y rr>/%,. v.e.-,t, D: c, -..s ,, N04) s~s/� 02 / Applicant is: Owner Contractor TYPE OF WORK Description of work: ',At eve ,,,,,,e;,,):1 v , ,;y % s;',1; ,,,,s >r Trio 4e % ' i' 1^ ,J .5-;41./.....5 Construction Cost: Oce? CONTRACTOR neC, Name: A�%,,, 4.,-A9. Ce,,,si-w 1.cK,, J License#: iP2OC3 4.'5--e, Address: Z7a25 67a•4iy hiIwiy C. City: 'el-/cc,76e State: W'.- Zip: 1-975`5Phone: /02 - 74//- /79/ i g Contact: Det yr 1p 1 Email: d 1 € 1 p aJ/ e B -#i ry , Gd •""'t ARCHITECT / ENGINEER Name: Registration #: City: y: State: Zip: Phone: Contact Person: Email: Licensed plumber installing new sewer/water service: Phone #: NOTE: Plans and supporting documents that you submit are considered lo be public information:- "Portionsof the information may be classifiedas non-public if youprovide 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.gopherstateonecalLorq 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 an •royal of plans. If x PG'h'� C lG,cSi5✓LGc-i, Applicant's Printed Name x Ap, icant's Signature Page 1 of 3 Aug 25 11 02:55p Bruce Nelson Plumbing & H City of Eagan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 41:4.1441 statStaff:PERM 6517312804 p.6 Use BLUE or BLACK Ink ForOffice Use Pe.mIt*: tee 7,5 Permit Fee: Date Received: 2011 COMMERCIAL IT APPLICATION Data B'\,��\ II` --1� Site Address: a 1 �;�\VA\\ v .LU .1 }y �� Tenant Name\ \ JL�1�1`l�(� 1( L (Tenant is: _ New / t/ Existing) Suite #: Former Tenant r PROPERTY OWNER Name Of- f\b \L., IS.Phone: ,.� M 1 /� Address i City / Zip\ 211 k L, (16\ n i � ci � cut f 1 lil I t J J Applicant is: Owner Contractor _ ,L TYPE OF WORK Description of work: (L2 2. 'CO. Jt) ;, k -Y Construction. Cost CONTRACTOR Nam>E: ' . ` (1 P11O1 C c License t Y �r 1 43 _ Address:Gr) .�I) • h ,� �1'O Rt.1%)D lA IG,, ar��. �� 4ilJLS2.` State: , p � c) Z\\ -Q ` one: ) - i �1 `fl \'5 Contact: AC(tO Email: ARCHITECT / ENGINEER Name: Registration #: 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 maybe classified as non-public if you provide sp ecific reasons that would permit the City to conclude that they are trade secrets. CALL BEFORE YOU DIG. Cell 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.aoaherst.teonecall.orc 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 1 understand this is not a permit, but only an application far a p:>.rm, and work is no: to start without a �errnit; that the wort will be in acccrdance with the approved plan in the caseof wort% W TTEg4Ires a review and a.Orovai ot plans. x��,t41C�r1 �Ir0Va Applicant's Printed Name Applicant's Signature Page 1 of 3