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3762 Vermilion Ct S From:ALLSTAR CONSTRUCTION 19529427464 09/03/2013 10:11 #482 P.011/043 3 ~ 4$ , 3-7 S-0 3-75,q , 3`7 5-A 5-7 5 (o 3-15 S 1 '3-7 Qo a 1v-7 ba , ~-7 G A . 3-7 4 (1P Use BLUE or BLACK Ink I For Office Use I I Q, I City of Eajan i Permit ` ?213 477 Permit Fee: 13 Of . 3830 Pilot Knob Road 22 Eagan MN 55122 Date Received: 4A i ~J Phone: (651) 675-5675 1 I I Fax: (651) 675-5694 1 Staff: L 12 2013 - - - - - - - - - - - - - - - d 20113 RESIDENTIAL BUILDING PERMIT APPLICATION Date: v 2i 2oIJ Site Address: _31"49)- 31 DIP V=MDY1 sWlkJ12 Unit#: Name: .n,..-:...~~.. Phone: Resident/ Owner Address / City / Zip: Applicant is: Owner Contractor ' of Work Description of work: roof -A Type Construction Cost:* I , ~0fZ_ Mufti-Family Building: (Yes / No ) Company: /11I Y cAY1SjVUchm MaMexvtunt Contact: JX A sftcl Address: 5145 IM A A St. S%Ai* # 103 City: I ( h Contractor State: Zip: CJcJ3SoI Phone: a -151-0141- 11-, 15H License M -BCA 10J 7cJ' Lead Certificate M N AT" 2U°II-011-4 -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: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: i NOTE. Plans and supporting documents that you submit are considered to be public information. Portions of i the information maybe classified as non-public if you provide specific reasons that would permit the City to conclude that the are trade 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.clopherstateonecall.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 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, x lot, 74 1 e%-L--ad x Appricant's Printed Name Appli s Signat e Page 1 of 3