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
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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)
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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/
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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
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Applicant's Printed Name
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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