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1334 Windcrest Ave PIONNIT ` } { k 1 c I r ' � a of l r . ,- stea '8�t€ 1 _� 4 Yx t Y ;� � v r CITY R " �` Y ',21f99 a " SIT #104. ..: 8693 -- Vi z' e *ate Ate: 134 . °, at Avenue .I3' "83 Wfndcrt t. rx. .- LW. > , , i l i ' � " .� ; ' Tc ; , o f irmi t ,. Y . 7 . � 9lgitk � � Use or BLACK ink - t For Office Use a 9 t f'ermd 33D3 City of Eap Permit Fee 3_ 3830 Pilot Knob Road ! } Eagan MN 55122 Date Received: awl Phone: 651 675-5675 Fax: (651) 675-5694 t Staff: 3 20'13 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: 3 3 2 ° 3'f - 1~ ~ 3 IS W I,- b CyeS~C AU. - Unit _ Name: Resident! --i f) C YcR 'T1:ZC 3tJ 6~° 13ZGs)11-t!-&')hone_ Z. ~ D Owner Address ; City I Zip: Q- 2 in 1~z f f~a~ MA-) 5- Applicant is: 4::mer Contractor Type of Work Description of%vork: Jae--RQoV Construction Cost. 5-p Multi-Family Building: (Yes ~ t No ) Company: n Ir T)V\0 3 U -H Contact: lh u R, Contractor Address: -I Z-C y Vail 7" i city: 9 Q AN, State: N_ Zip:) L~ Phone- License Lead Certificate:_ j IT cr, I If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING 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: NQTE. 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 speck reasons that would permit the City to conclude that they are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (661) 454-0002 for protection against underground utdty damage. Call 48 hours betwu you ,mend to dig to me eive locates of underground utilitie=s I hereby acknowledge that this informat<on is complete and accurate: that the work will be in conformance with the ordinances and codes of the City of t agan. Thal 1 unde!stand this is nol a permd, brat only an appLcation for a porrrnt, and work is not to start wilhoui a permil treat the work vulf be in accordance with the approved plan in the case of work which requires a review and approval of plans Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. X 11[1 ? L? (sari [1A 92 1 EAZ a~ X Applicant's P ted Name Applicant's ignature