1949 Ruby Ct N
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1 I , I For Office Use
City of Eajan R, Permit
el I Permit Fee: 1 •~b
3830 Pilot Knob Road I
Eagan MN 55122 I I
Phone: (651) 675-5675 i Date Received:
Fax: (651) 675-5694 Staff:
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2013 COMMERCIAL BUILDING PERMIT APPLICATION
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Date: o1 77 13 Site Address: Z fQ I43 ! 3 <S <
Tenant Name: ~✓~~~r~t'1 comftS ek %i \\&S 0-4 (PQt-\ kov%%(Tenant is: New / 1 Existing) Suite M
Former Tenant:
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Name: Q► Cor~howS X \(M*,S ok^A yacc~4.%~wmS Phone: lJo~- 4-3;L- 89 79
Property Owner Address / City / Zip: P. C2 D&X S N>3C.hnJv~t Au 5-5-0 b$
Applicant is: Owner Contractor
Type of Work Description of workGAC- d - (\ot~~ GK C1ar~r S a ~h Ct
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Construction Cost: too 10.
Name: O_N c.ov,s~c_.,A oti License \J
Contractor Address: ~L~2L C`ojv\dtc- awL, City: OSLP'~~~vt~-
State: M k 1 Zip: '75'C(612 Phone: _ ~T• ( 'es' I - ~z 1 •Z ' 9 ti06
Contact: Le,4• Email: LG✓! 0~ 04 . Lon
s Name: Registration
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Architect/Engineer Address: City:
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State: Zip: Phone:
Contact Person: Email:
Licensed plumber installing new sewer/water service: _ 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.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.
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Applicant's Printed N We Applicant's Signature
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