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827 Wescott Square
Use BLUE or BLACK Ink ------------------ For Office Use /r 1 �U b I City of DPermit ian #: 3830 Pilot Knob Road Permit Fee: © Eagan MN 55122 1 g Date Received: 1 Phone:(651)675-5675 I 1 Fax:(651)675-5694 1 Staff: 1 I 2016 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 5/25/2016 Site Address: rl ( -� 9 Gi/�� Unit#: ( Name: Eagan Oaks Town Home Assn/ ,� t Phone: 952-238-1121 Resident/ c/o Personal Touch PO Box 5233 Hopkins, MN 55343 Owner ' Address/City I Zip: p Applicant is: Owner i Contractor Type of Work Description of work: Garage door replacement Construction Cost: $1,152.64 Multi-Family Building: (Yes V( /No Company: Custom Door Sales, Inc Contact: Amy Egan Contractor Address: 5005 Hillsboro Ave N city: New Hope State: MN zip: 55428 Phone: 763-535-0042 Email: aegan @customdoorsales.com License#: Lead Certificate#: If the project is exempt from lead certification, please explain why: 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: Mechanical Contractor: Phone: Sewer&Water Contractor: Phone: 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 th!Z 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 Buildin ust be completed within 180 days of permit issuance. x rn C4 x Applican s Pri d Name ppli 's Sign ture Page 1 of 3