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4139 Ruby Lane î ÿ þýý üûúüùû øýýÿûú ë ßéé úòôô ß þýö þýüûúù ø ÷ ò ýûúù ûúù ø ÷ ö ø÷õ ù ô ùóý ò ý ò ñíýùú ð þïý î ôùì ô ë ëô ïý ô ü ô ê é øøù ÿééô ý ù êòéé ù é ê òüôè ïý üúø éôúëô ê î æñåæêê õø þýë çýæñåæêäêä çýñÿê ôó öòñ ùù ç ë ñëì öáñäõýüú ãö àßñÞß ë üúø ë ëì ë ùù ëë éô ôùúøëùùü þ éã þý òúé í ê ùù÷ ý úþ ý Use BLUE or BLACK Ink JAI I For Office Use Permit#: k-1S of I Permit Fee: 1E2~ City Ea~d 3830 Pilot Knob Road I Eagan MN 55122 t Phone: (651) 675-5675 i Date Received: 1 3 Fax: (651) 675-5694 j Staff: I L-----------------I 2013 COMMERCIAL BUILDING ERMIT APPLICATION S u.~ I Date: 1 27 1-75 Site Address: YGIV Tenant Name: 0-,,VR j convoy", a.~►\\S ®4,.~ ~ar~cn kor&'*(Tenant is: -New/ Existing) Suite Former Tenant: Q Name: ~tN Z.oeUne. S V~~~a.5 w~~ d1aC~,n IwncS Phone: lJo- 4 3 a• 87 9 Property Owner Address / City / Zip: P~~ok J N>3e_ o n~ n m 5,5-0 (0 Applicant is: Owner Contractor Description of work ~GwC O~F on-\C- Govt GK~► 5"A1^h Ct~ai~ Type of Work Construction Cost- 155 1 3 11 Name: O ~ (_0V%5. ('QC1i o License V5 L Z2 t a Contractor Address: kouvtd{ lc_ ayL City: 1~5L ~yJ~'1 T State: M 1 Zip: J~t~( Q Phone:G S- I" 2 k;L f Contact: LC4. Email: Name: Registration Architect/Engineer Address: City: State: Zip: Phone: Contact Person: Email: Licensed plumber installing new sewer/water service: 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. - . n..,........ r..... m_t 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.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. x x D -qm. wi Applicant's Printed N We Applicant's Signature Page 1 of 3