3806 Vermilion Ct S
From:ALLSTAR CONSTRUCTION 19529427464 09/03/2013 10:10 #482 P.005/043
51(68 l 3710 , 3M, 3-7614 l 3-194;1, 31"IS
<3 116 01D 0 ~1_ ' a 0 , 3 8C)(0 / C) 8 Use BLUE or BLACK Ink
For Office Use
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Clt of Eanon ; Permit
6 i Permit F .
3830 Pilot Knob Road l
Eagan MN 55122 j Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 Staff.
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: N2117-01-3 Site Address: 3Q V 1 VtV Mj 1 j QV1 COO [ L SbL "Unit
Name: Phone:
Resident!
Owner Address / City Zip:
Applicant is: Owner Contractor
Description of work: 1 -f0of And 1 ~ Si tAI M
Type of Work
Construction Cost.* 1 0 0 Multi-Family Building: Yes No
Company: _Why COY►Sfi I&II n M21h7101eXhL1(1't Contact: Wy R-A JSi Q~
Contractor Address: 51 15 w"- tYi Al St. Suite # 103 City: M-Awi P121 in
State: R Zip: CjcJ3SoI Phone: 952- ly5y
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t~ E ~p
License # CCP~ f 'J 15 Lead Certificate _ N 11 T" Z V_t j fly -o
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:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
t NOTE. Plans and supporting documents that you submit are considered to be public information. Portions of
the information maybe classified as non-public if you provide specific reasons that would permit the City to
conclude that the 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.Qopherstateonecall.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 Minneso Late Building Code must be completed within 180
days of permit issuance.
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Applicant's Printed Name Appli a s Signat e
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