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3705 Burgundy Dr From: Parsons Exteriors Inc Fax: (888) 426-9712 To Fax: +1 (651) 675-5694 Page 10 of 269126/2013 8:24 Use BLUE of BLACK trek y,4 ` l for 61fic-C Ilse { 1 ~ 154 l I -711 Ity of Eap j Permit Pee:. 3VO Pilot Knob Road t I 1 (t! ( IDate Received , Eagan Mtn 55122 l y i. Phone: (01) 6754675 t 1-4 Fax: (56'i) 87"1691$ l Statf I L_ _ i 013-RESIDENTIAL BUILDING PERMIT APPLICATION Unlt # Datet Site Address: 7 ~hlame., Resident/ Address I C+t'Y !i_ Owner P= Applicantis Own ~C7ntraC~or Description of work: Type of Work Construcilon Cast Multi-Family Building: Ns /NO ell' Compsnyr: at I )'1 Z as V C-1 Contact P .1 `-d G Address + ii- G tt ,:-ii city Contractor State: Zip.: Phone; 7 1,1V 7.1 License*: 7b Lee Certificate * - `S-I It the idfQJfiGt is Xq p - ern teat! cerklfJeat6rin, ;please explain why. (see P°age.8 for additional information) VT- COMPLETE THIS A,REA► ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months. has the Citgt of Fagan. issved a permit fora s triilar:plan. based ort a rtiasterplsn? -Yes No If yes, date and address of master plan: Licensed Pi'ulttber: Phone Mechanicai 63e-stractar Phone':" - Sewe=r & Water Contractor.: Phone- NOTE., Plans and suppasfing documents that you submit are considered to be public infer-inatirsn. Ray ions of the information maybe clan slffed as non-public vt you provide specific reasons that wvuld p permit the Cify to conclude that 1heey are frade secrets. , CALL BEFORE YOU MG. caii rapher state one Call at (651) 45"002fur protection against underground utility damage!, gall 48 hours before you intendFo dig to receive locates of tinder-ground uU11fies. I Hereby acknowledge heat t-,ts informal on is v'9mplete and accurale, that the, work will tav jr) contoRnande with the ordinances and ode's of the MY of .Eagan: that i.;udersWnd."th1s is not a permit, but only art ;appllcaltcin fora ermit, and work is not to start mathout n perrnit; that the.. Wont ,x611 be in a=rdancevuith the apprc ed putt ie1 the case of yrnrkwhich i!quires 3 !Viewattd apPi►?val of plans. Exterior waykatithorizad 6ya build nil permit issued in accordance with the Minnesota 5ta#e Building t ade mtast be mlaie#er1 tilritti3ef 984 days.ot perinit l"uance, Applicant's Printed Marne Applicanrs Signature page of 3: Use BLUE or BLACK Ink For Office Use Clt of�a0a� Permit#: /471 Permit Fee: �2 o 3830 Pilot Knob Road , Eagan MN 55122 RE,-n 1;, ,_') Date Received: Lt Phone:(651)675-5675 Fax:(651)675-5694 APR 1 3 2017 Staff: /-1116191 2017 RESIDENTIAL BUILDING PERMIT APPLICATION Date: -i lc/ t Site Address:�"1 O l . �J i O` 3^in S t)r-ya,,, ,f D( Unit#: Name: Phone: Resident/ Owner Address/City/Zip: Applicant is: Owner Contractor Type of Work Description of work: ICD �.-c�bc Construction Cost: Sit,c) Multi-Family Building:(Yes /No ) Company: S)Ckr-SO".1 Cor.S�nfc�4+a� T, , Contact: � � ►- ��nS,tiJa. Contractor Address: {le 011) c-,JA R-C) City: C D v, C State:IVV\ Zip: ScOIZ Phone:tort-1cl - 9'No Email: 34-;•..5 1. Gcv License#: 'I lC.-telt i 1 K Lead Certificate#: rt)/d� If the project is exempt from lead certification, please explain why: 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: Fire Suppression 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 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.gopherstateonecaltorq 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 State Building Code must be completed within 180 days of permit issuance. x J0'Srh ) Applicant's Printed Name pplicant's Signature Page 1 of 3 Exterior work authorized by a building permit Issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. x 5\nr.,,v)6\ Applicant's Printed Name ' ppiicant's Signature Page 1 of 3