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
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-711 Ity of Eap
j Permit Pee:.
3VO Pilot Knob Road t I
1 (t! ( IDate Received ,
Eagan Mtn 55122 l y
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Phone: (01) 6754675 t 1-4
Fax: (56'i) 87"1691$ l Statf I
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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