1487 Woodview Ave E
From:ALLSTAR CONSTRUCTION 19529427464 05/07/2014 10:16 #166 P.029/037
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Use BLUE or BLACK Ink
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I For Office Use (0]
City j Permit >f: { ZZq' ~
of Eanan Ed1 Permit Fee: a 5-73830 Pilot Knob Road I I
Eagan MN 55122 j Date Received:
Phone: (651) 675-5675
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Fax: (651) 675-5694 1 staff. rJ 1
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2014 RESIDENTIAL BUILDING PERMIT APPLICATION
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Date: Site_Address: I443 WTI IyS~r INra WOOdViQ~W ~CUSt ( ~GtrGIAf Toe►IsfmII UtMGS)
Name.... r~.,.e..,-.,__ Phone:
Resident/ J -J
Owner Address / City / Zip: 443 2; CI 3 W . Parkm'(A I qj,&0 MI'li 1'It M N 5~--1-1
~ m Applicant is: Owner _X_ Contractor
Description of work: I~(/(~( U1l R R0
Type of Work ~ t
Construction Cost:. I3125D.~~ Multi-Family Building: (Yes /No Company:4IIStt►r Wastrydip i M n0I0I Mtn 1 LLIG Contact: b►hC mtUcyaoln
Contractor Address: 5145 IYIG1NSWIXI S-- -4105 City:. Ma l Plain
e State: M N Zip: !55-3(301 Phone: , - Email: nlotm ft1IStOtr -W_
License 1P3I5 J ~m Lead Certificate M N PT- 2(Atoy I -D M.
[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
N
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:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer $ Water Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of I
the information maybe classified as non-public if you provide specific reasons that would permit the City to
conclude that the 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.
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Applicant's Printed Name Applicant's Signature
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