1480 Woodview Ave E
From:ALLSTAR CONSTRUCTION 19529427464 05/07/2014 10:14 #166 P.023/037
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Permit ✓
City of Eaaan
I Permit Fee:
3830 Pilot Knob Road
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Eagan MN 55122 j Date Received: 51-7 Ili
Phone: (651) 675-5675
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Fax: (651) 675-5694 I Staff: I
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2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 5-1-H Site Address: HID, 14195 L40,1 2. %WiVitW E,,i (r('> ynou ~i to". es)
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~..~._~..r. Name: S . r'e' CIU,Phone: ..._Qa...~,_..w.~..~,r..-,,...9,.~
44f Resident/
Owner Address/City/Zip: 16 QJ CI 4 W, Pdlrl~wOl~In I ~Cdtih 9YAirito MN
r Applicant is: Owner Contractor
Description of work: _ lay cif ~f'' R01)f
Type of Work
I Construction Cost:- 4291 I GO .0() Multi-Family Building (Yes X
No Company: LL Contact: tQlhe MtJ4CY(X0in
Address:.51y5ltjftfi Qil St. ' IU?~ City: Mop(f. Pfain
Contractor ~
State: _RN Zip: 553r 3f] - Email: dQ[V1f rta OIIIftV • bL
License t' V VM 515 Lead Certificate N JA T- 21701(0`{ - 0
If the project is exempt from lead certification, lease explain wh see Pace 3 for additional information
P 1 P Y~ (see Page )
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:
t
Mechanical Contractor: Phone:
S
Sewer & Water Contractor: Phone:
NOTE., Plans and supporting documents that you submit are considered to be public information. Portions of
the information maybe classified as non-public if you provide specific reasons that would permit the City to
a~_~= _4r~ .r yR~Ka4x conclude that their are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 4540002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.oooherstateonecall.ora
1 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.
Exteriorwork authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
x C,tkftl, Mc~ermut~ x
Applicant's Printed Name Applicant's Signature
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