3653 Denmark Ave
Jul 10 13 07:32a Gates General Contractors 7634387710 P.1
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(.I ~G 72/ j Permit*:
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City of Ea an Permit Fee: 36
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383D Pilot Knob Road I I
Eagan MN 55122 I Date Received: TI 15 j
Phone: (651) 675-5675 1 1
Fax: (651) 675-5694 1 Staff: 1
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2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: b Site Address: -cc ~ r 3 ~ 5~3; 3L 5-5; 3(,5--7 Name: ! Phone:
Resident
Owner Address / City i Zip:
Applicant is. Owner Contractor
Type of Work : Description of work:
Construction Cost: 3 1 i'CTTU ^ Multi-Family Building; (Yes ✓ / No
Company (Or14r~ ~G,~/~~r~l_7 L`Ohs?ri~ Contact:
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ity:
Contractor Address:
state: /*14"_ Zip: ,S~7 7 Phone: 1-511-72-3'-~ -3
License 17 C Oa G Z 5'3 Lead Certificate lt: Nom- Z 3
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
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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:
NOTE. 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 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 4540002 for rotection against underground utility damage. Cal 48 hours
before you intend to dig to receive locates of underground utilities. ~~dww.aoo`ersiateonecall orm
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 a roved plan in the case of work which requires a review and approval of plans.
Exterior rk author' ed by a building it tss in accordance with the Minnesota State Building Code must be completed within 160
days permit iss nice.
Applic' Printed Name Applicant's Signature
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