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Reliabuilders 952-226-5514 p.3
Use BLUE or BLACK Ink
For Office Use
411' Permit 0: I 13 061
City of Eaau Permit Fee: 3c,
3630 Pilot Knob Road
Eagan MN 55122 Date Received:
Phone:(651)675-5675
Fax:(651)675-5694 Staff:
` J
2017 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 5-31-17site address: 3019, 3021, 3023 & 3025 Timberwood Trail units!:
s Name: Advanced Innovative Management Phone: 651-739-5544 i
E Resident/ a
Owner Address/City/zip:
1303 Geneva Ave. N. Oakdale, MN 55128 i
L--------- I Applicant is: Owner X Contractor
.. i Remove and replace roof
Type of Work j Description of work: 1
i Construction Cost: 35'000.00 Multi-Family Building:(Yes x 1 No )
i; Reliabuilders Construction, Inc. Jason Michels
E Company: Contact
I Address: 3351 Griggs St. S.W. City: Prior Lake
Contractor I
i State: MN Zip: 55372 Phone: 612-581-6255 Email: jason@relia-builders.com
E
BC650191 R-I-30358-13-00160
i License#: Lead Certificate#:
r If the project is exempt from lead certification, please explain why:
N/A
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
i Yes No If yes,date and address of master plan:
i
i Licensed Plumber: Phone: 1
Mechanical Contractor: Phone:
• Sewer&Water Contractor: Phone:
i Fire Suppression Contractor: 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. -.I
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.orq
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 wit 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,
.Eason Michels
x x111'
Applicant's Printed Name Ap Ircant's Signature
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