3674 Vermilion Ct N
Fram:ALLSTAR CONSTRUCTION 19529427464 09/03/2013 10:18 #482 P.035/043
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For Office Use /
APer
Clt o f EaEd
mits/: rllll Permit Fee: ✓ a ' a✓~ I
3830 Pilot Knob Road
Eagan MN 55122 j Date Received:. 1-3 11
Phone: (651) 675-5675 I I
Fax: (651) 675.5694 1 Staff. I
I I
n 2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: v 21 20 3 Site Address: S60b -36qb.UeVlMi0V1 COW Nort l Unit#:
24 f
i Name: Phone:
Resident/
Owner Address / City / Zip:
Applicant is: Owner Contractor
Type of Work Description of work. -roof 74 yo Y L- 51rAi Ia
Construction Cost: 01, L 0 c Multi-Family Building: (Yes / No )
Company: 81ftIr UMIAChIX 1 MIIV1710Aeffi t Contact: 00e, R71I&A"01 F
Contractor. ; Address: 511-15 IVW"_ Al St. Sine ~ 103 City: M-ADIti PI'Ai n
State: M R Zip: &353501 Phone: 952." C142" 195"1
License U Lead Certificate NAT 7-(AIPL4 -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:
i
Sewer & Water Contractor: Phone: i
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 permit 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.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.
lot ~ x at S4leZt x
Applicant's Printed Name Appli r s Signat e
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