3818 Denmark AveRESIDENT OWNER N
Name: I he eas'a.A..sd r alui,cki kT Phone: -fl g V
Address City Zip: Wtt 30� i "r4-k 4Ve Fa 56/ g3
Applicant is: Owner Contractor `J
TYPE OF WORK D
Description of work: i"1 e P POUC
o
Construction Cost: Multi-Family Building: (Yes No
CONTRACTOR N
Name: 1,4 gocc License G900009
Address:
C" 7
(tea C
COMPLETE T
THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes N
Mechanical Contractor: Phone:
Sewer Water Contractor: P
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.
2009 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Address: 31
Tenant: Pr\ e &AJ r Gott (0 C k k1
City otEagau
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
Applicant's Printed Name
eG
x
Applicant's Sign
Use BLUE or BLACK Ink
Permit
Permit Fee:
Date Received:
Staff:
J
Suite
CALL BEFORE YOU DIG. Call', Gopher State One Call at (651) 454 0002 for protection against underground utility damage.
CaII 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecail.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 wi out a permit; that the work will be in
accoOA dance with the approved plan in the case of work which requires a review and approval of plans.
l Nt,lt.
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