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3740 Vermilion Ct S From:ALLSTAR CONSTRUCTION 19529427464 09/03/2013 10:12 #482 P.014/043 `3704 1 31 a to, 3 "l R S v7 3o , 37 3 0 , 3'-7 3 J 37 3 to f 313 Q ( 3`74 0 f 3~ a t 3-744 r 3-74 to Use BLUE or BLACK Ink mln~ For Office Use _ T 1 j Permit ' t rJ 7 "1 j City of Eap I Permit Fee 5 a • as 3830 Pilot Knob Road p, Eagan MN 55122 Date Received: -1 Phone: (651) 675-5675 I I Fax: (651) 675-5694 1 Staff. I I I 2013 RESIDENTIAL 2BUILDING PERMIT APPLICATION Date: 017-112,015 Site Address: 31 24 J1 L11 V 'p VI m Wun WA Vi Sb%ftUnit W Name: Phone: Resident/ Owner Address / City / Zip: Applicant is: Owner Contractor Description of work: t -Vou+ Y Type of Work Construction Cost: ooo Multi-Family Building: (Yes / No ) Company: trip ~ lA)f 1S~1'U ~ I lWffh&ft Contact: _OX h AI Sbt=t Address: 51 45 I SM-AO St. i # 103 City: ftbtb PI-Ain t Contractor I Stater lR Zip: (5$3501 Phone: 951 - c1-12- Iy5H License 13C 4161- Lead Certificate NIT . 2091.Py-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 T 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: 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 pennit 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,gopherstateonecall.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 Minnesota late Building Code must be completed within 180 days of permit issuance. x~olue 741 s+eZld x Applicant's Printed Name Appli s Signat e Page 1 of 3