3746 Vermilion Ct S
From:ALLSTAR CONSTRUCTION 19529427464 09/03/2013 10:12 #482 P.014/043
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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.
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Applicant's Printed Name Appli s Signat e
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