1544 Aspen DrRESIDENT 1 OWNER
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Name: ��'� Phone:
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Address / City / Zip: (r 0, ti '1 [ t'it,LC..
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Applicant is: Owner X Contractor
TYPE OF WORK
Description of work: il l' _ % / � _, 1 1 �, / . !/'. / -/
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Construction Cost 2' t3 _6700 Multi- Family Building: (Ye s �C / No )
CONTRACTOR
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Name; 6604 W Dr/A. 6 Li ce se #: D ! / 05D
Address: r - Li. . I1 sr L C i ty : - La d,c T.1
State: Zip: . Jr Phone: /J — -/q r
Contact: r / V47V V1e'r. -4 arnail: f � / ik 1 4124446.1
COMPLETE
In the last 12 months, has
_ Yes No It yes,
Licensed Plumber:
THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
tha City of Eagan issued a permit for a similar plan based on a master plan?
date and address of master plan: .-
Phone:
Mechanical Contractor.
Sewer & Water Contractor:
Phone:
Phone:
_
NOTE: Plans a 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.
Ju n. 1. 2010 4:00RM SELA ROOFING No. 1929 P. 2
Use BLUE or BLACK ink
4 1111P
City of hp
Date:
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 6755694
2010 RESIDENTIAL BUILDING PERMIT APPLICATION
Tenant:
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Applicant's Printed Name
Site Address: /._.): b ,4
CALL BEFORE YOU DIG. Call Gopher State One Gall 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.aoaherstateonecall,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 1 understand this Is not a permit, but only an application for a permit, and work is not to Start without a peyaai • that the work will be in
accordance with the approved plan in the case of work which requires a review and approv plans. /
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Applicant's Signature
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Permit `7 `t' j `tr
Permit Fee:
Date Received:
Staff;
Suite*:
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