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1276 Timbershore LaneRESIDENT /OWNER Narne: ` Jr_ : •�...: h ' Phone: raid ... Address / City J Zip: ' / Applicant is: Owner / tractor _._ TYPE OF WORK Description of work: .! Construction Cost: i 116 Multi - Family Building: (Yes , f No ) CONTRACTOR Name: 'edit rt ..4# IA.. r %1 ;) License #: 4/i `? 9; ,.Li 7 �/'� / � Address: S �J l�IC. sue, L 1 ✓ City: V State: I' /Y Zip: 5:5 Frn KCia -557 4 rt.- 74 _/93 f _ Contact 3 rE (--- 6 ` Email: mi l! t/4 -6'' 7 f7e,� T rj COMPLETE In the last 12 months, has Yes No If yes, THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING the City of Eagan issued a permit for a similar plan based on a master plan? date and address of master plan: Licensed Plumber: Phase: Mechanical Contractor: Sewer & Water Contractor: Phone: 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. Jul 12 10 08:13a Gates General Contractors Cite of Eaaali Tenant: 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675 -5675 Fax: (651) 675 -5694 ( 4 GG J Apple 's Printed Name x Ap . ' nt's Signature (763) 498 -7710 p.1 Use BLUE or BLACK Ink For Office Use (� Permit #: f Permit Fee: 30 e Date Received: Staff: � 2010 RESIDENTIAL BUILDING PERMIT APPLICATION Date: r ( I 2 r � t� Site Address: /2-7g-/r2 Y j I `Z 70 /z-7J I r d"4 541.471 -1- 6 " 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. Iwww_gor herstateonecall.org I I hereby acknowledge that this information is complete and accurate; that the work will be in conforma • with the ordinances 'nd codes of the City of Eagan; tha derstand this is not a permit, but only an application for a permit, and work is o start without a perm' , t the work will be in acco ce w' the approved plan in of work which requires a review and app Page 1 of 2