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3634 Vermilion Ct N From:ALLSTAR CONSTRUCTION 19529427464 09/03/2013 10:15 #482 P.023/043 3 1 3La22-1 3(o a~ co 2~ , 3"02c6 . 3(030 J 3 a. r 3 (oA I -3 63(6' -3 (o Co 4 O 1 ~(to 4, Use BLUE or BLACK Ink I For Office Use I 2 I City of Eapn Permit Permit Fee: J ac a S 3830 Pilot Knob Road 2 Eagan MN 55122 j Date Received: J j Phone: (651) 675-5675 I I Fax: (651) 675-5694 1 Staff: I I 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 2 20 Site Address: (Q n,0-3(0`42 Vef rn 1 I 1 O VI C+ Unit ...~--..-,..,...w..-.. ~ Name: Phone: Resident/ Owner Address / City / zip: Applicant is Owner Contractor Type of Work Description of work: rtr f00+ AMA Y L Si dl Construction Cost: D1 r O 00 Multi-Family Building: (Yes 1 No ) G D Company: /7II~~( UlX ►Sfi(1~ ,~~(1 IY► e,~,(~ Contact: ~ I I~~~7i1~ Contractor ! Address: rJI~S Ina"--ft-Al St. Wit ~ 103 City: M-lDIG PI-1 l n State: MR Zip: CJOJ 3501 Phone: 951- CHI- 195H License _aCAP~1515 Lead Certificate N AT 209 Jpy'0 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: 1 Licensed Plumber: Phone: s Mechanical Contractor: Phone: I 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 rf 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.aooherstateonecall.orci 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 Late Building Code must be completed within 180 days of permit issuance. x tluc d x Applicant's Printed Name Appli s Signat e Page 1 of 3