3652 Vermilion Ct N
From:ALLSTAR CONSTRUCTION 19529427464 09/03/2013 10:14 #482 P.020/043
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I For Office Use
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j Permit ✓ I j
City of Eajan I I
Permit Fee: 1 , •
3830 Pilot Knob Road ry
Eagan MN 55122 j Date Received: -1 151 -3 1
Phone: (651) 675-5675 I p,~ 1
Fax: (651) 675-5694 1 Staff: I~ y 1
I I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
3
Date: Site Address:%M=3 LvWp V-rm i Ion Unit
Z'o I _ Ci
-~.,....,,.M,~,... ~ Name: Phone: --~.a... x~.~
Resident/
Owner Address / City / Zip:
Applicant is: Owner Contractor
of Work Description of work. rou A T p A t~- S i o f M
ype
Construction Cost: I OC Multi-Family Building: (Yes No )
Company: N ISt71r C41AJVU&W1 Mav 21 fta nt Contact: _ox h A slt l
Contractor Address: 15145 II 1WV►JI f 1711 St. Mit # 103 City: M-AD►/ KA i n
State: MR Zip: Cl;53_5 I Phone: 952- Om?.- IH5H
License BCAPAI5 15 Lead Certificate l~! V-I1Dy-0
P If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
I
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:
t 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) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.aoaherstateonecall.ora
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 and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota tate Building Code must be completed within 180
days of permit issuance.
x~ lue t~ 74 I s+C31d x
Applicant's Printed Name Appli i's Signatullre
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