1497 Woodview Ave E
From:ALLSTAR CONSTRUCTION 19529427464 05/07/2014 10:18 #166 P.032/037
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Use BLUE or BLACK Ink
I For Office Usen r^ I
; Permit
City of Eatan I o a
Permit Fee: _ I
3830 Pilot Knob Road
Eagan MN 55122 ; Date Received: -7114
;
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff: t
I
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2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 5"1-1y Site Address: 1`iq( W°I3 ,1yg5 yq~1 W4odVifiW i✓ffs-t I(AOIP uhume~
Name: S C CjO; Phone:
Resident/ -T
Owner Address /City / Zip: 1 M4 W, PaftkO A I q&n fti riti MN GC -3-3L I
J 11
Applicant is: Owner _)L Contractor
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Type of Work Description of work. JtQ[V Ofd RP.- R~Uf-
Construction Cost 4 Z(Cl )0 wU Multi-Family Building: (Yes X / No
t Company: Alfty C01nsftr%ACtlnn MA Mtrlf LAG Contact: ~G11(1~ Mty CY(XOI n
Contractor Address: 51y5InMMAI &i- -vim City: aPit PloM
j State: _MNZip: '55351 Phone:~)19Lit-7I4?J Email ClOlY1 I~/ OIIICtDIY • bL
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t ~ ffi License r~~
L V25,1615 Lead Certificate M N A`T' 24A 111 - 0 -
hl-ftlh-e project is exempt from lead certification, please explain why: (see Page 3 for additional information)
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:
E
Mechanical Contractor: Phone: c
Sewer $ Water Contractor: Phone:
OTE: Plans and supporting documents that you submit are considered to be public infonmation. Portions of
I the information maybe classified as non-public if you provide specific reasons that would permit the City to t
l 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.aopherstateonecall.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.
x11A,ilea Mc~e~-mu1~' x
Applicant's Printed Name Applicant's Signature
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