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3830 Vermilion Ct S From:ALLSTAR CONSTRUCTION 19529427464 09/03/2013 10:09 #482 P.002/043 ft2 i MA t 3$te, ~)Wj H2Di X62?- 8 aIA , 3 82b , 829 , 830, ~j $32 i ?j g + Use BLUE or BLACK ink An. I For Office Use I AML I ; Permit g: t 133 4 City of Eajan . 1 Permit Fee:* 152 P-5- 1 3630 Pilot Knob Road Eagan MN 55122 j Date Received: Phone: (651) 675-5675 I 1 Fax: (651) 675-5694 I Staff:) I I t d 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: v 2 ( 20' Site Address: _MMI - 3 I &640n CDUtt SOL t 1' f Unit ft: Name: Phone: Resident/ Owner Address / City / Zip: Applicant is: Owner Contractor Type of Work Description of work: YOof And YL- sl d(m Construction Cost: tr~ { I Multi-Family Building: (Yes No ) Company: -A&W C 1S IeW MlklAotAft Contact _ A1ft7i1li «i Contractor Address: 5145 Ir1(~LVISIYI A S$. $UTA 103 City: A2011/ P17t i n State: Zip: V3.3 I Phone: tJ2' - f~2 1 ~15~1 License F W31151 Lead Certificate NAT- ICAIDL4-0 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 i 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: I Licensed Plumber: Phone: Mechanical Contractor: Phone: p Sewer $ Water Contractor: _ Phone: E NOTE. Plans and supporting documents that you submit are considered to be public information. PoWonS of the information may be classified as non-public if you provide specific reasons that would permit the City to M^ r s ~rx t M conclude that they are trade secrets.r~~_M_ CALL BEFORE YOU DIG. Calf 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.oooherstateonecall.oro 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 74kSc31 x Applicant's Printed Name Appli a s Signatull e Page 1 of 3