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1516 Woodview Ave W From:ALLSTAR CONSTRUCTION 19529427464 05/07/2014 10:10 #166 P.014/037 u tn;l , - ~Slg f 5~~ 115 l$, l Sao woodull eu) Rve., W Use BLUE or BLACK Ink F----------------- I For Office Use I j Clt~ Permit I `Tlp j of Eallan ~ Permit Fee: 3830 Pilot Knob Road Eagan MN 55122 Date Received: ry IV Phone: (651) 675-5675 1 I Fax: (651) 675-5694 1 staff: _ I I I 2014 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: _r014,I51U,~rll 152,0 woacrv►twwel+fp3AY010t oW ~amtJ ~..{._._..~..r----..~ Name: T NYr u Ht,,aVri~ h to ftmban a Phone: Resident! ~-%J Owner Address / City / Zip: (H~ CI W~ W, PgrkVVX4 I CWY1 NC rit, M N 5S~`-r Applicant is: Owner Contractor 11 ~ Type of Work Description ofwork: ~:R!_..._ off I iCe. - P-0 Vf I Construction Cost.. 12 t 1 t 2,01) - Olt) Multi Family Building (Yes X I No kny:Allsby ompaUlnst mct on Mahaaeamrxrt, LLL Contact: -bayle MCIhCYaan Contractor ¢ Address: 5195 ~Y oyistrial Sf _ #102 City: ple. Plain State: _MN Zip: 5 Phone: Email: {;IQYtQ ~aIIS~DIY•bL l ~N License tD3I S15 - Lead Certificate* N A T- 21A(P 1- 0 If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) I 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? I _Yes _No If yes, date and address of master plan: I F Licensed Plumber: Phone: (r Mechanical Contractor: Phone: f Sewer & Water Contractor:_ Phone: NOTE., Plans and supporting documents that you submit are considered to be pub/ic 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. 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 ~,~tilleh Mc~e~mulfi x Applicant's Printed Name Applicant's Signature Page 1 of 3