2239 Creekside Ct
Use BLUE or BLACK Ink
I For Office Use 1
1~3~31 I
Permit I
of Eap
City I Permit Fee: 50
3830 Pilot Knob Road I
Eagan MN 55122 I I
Phone: (651) 675-5675 i Date Received: Pax: (651) 675-5694 j Staff: O I 1-7
i-----------------1
2013 COMMERCIAL BUILDING PERMIT APPLICATION
- ~
Date: Site Address: r 22 5-71 21~ Lf Ae CA--
Tenant Game: (Tenant is: New / Existing) Suite
Former Tenant:
Name: Phone:
Property Owner Address /City /Zip:
Applicant is: Owner Contractor
-7
Type of Work Description of work: cl 'n C!
(J g g
Construction Cost:
tt
Name: License .
Contractor Address: City:
-
State: _ Zip: Phone:
Contact: Email.
Name: Registration
Arch itect/Eng►neer Address: City:
State: Zip: Phone:
Contact Person: Email:
Licensed plumber installing new sewer/water service: Phone _
MOTE: 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 DICE. 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.org
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 areview and approval of plans.
X.~
X v-n x r___ 1
Applicant's Printed Name Ap` cant's Signature
_
Page 1 of 3
Use BLUE or BLACK Ink
I For Office Use 1
1~3~31 I
Permit I
of Eap
City I Permit Fee: 50
3830 Pilot Knob Road I
Eagan MN 55122 I I
Phone: (651) 675-5675 i Date Received: Pax: (651) 675-5694 j Staff: O I 1-7
i-----------------1
2013 COMMERCIAL BUILDING PERMIT APPLICATION
- ~
Date: Site Address: r 22 5-71 21~ Lf Ae CA--
Tenant Game: (Tenant is: New / Existing) Suite
Former Tenant:
Name: Phone:
Property Owner Address /City /Zip:
Applicant is: Owner Contractor
-7
Type of Work Description of work: cl 'n C!
(J g g
Construction Cost:
tt
Name: License .
Contractor Address: City:
-
State: _ Zip: Phone:
Contact: Email.
Name: Registration
Arch itect/Eng►neer Address: City:
State: Zip: Phone:
Contact Person: Email:
Licensed plumber installing new sewer/water service: Phone _
MOTE: 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 DICE. 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.org
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 areview and approval of plans.
X.~
X v-n x r___ 1
Applicant's Printed Name Ap` cant's Signature
_
Page 1 of 3