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1203 Timbershore Lane
Aug 18 11 01:46p Gates General Contractors 41,11/ City of Eaau 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 7634387710 p.1 Use BLUE or BLACK Ink For Office Use Permit ff: /006 Permit Fee: Date Received: Staff: 2011 RESIDENTIAL BUILDING PERMIT APPLICATION Date: $ / II Site Address: 124/ 2-193j / 2-C/ /l'' l I `°u3t 4' U :e--- Name:C t�11V=P5�7,rr / D• If-• Phone: RESIDENT f OWNER Address / City 1 Zip: Applicant is: Owner K.Contractor� , 71-ee, Description of work: "t`'�-7i" V r1,`7, r`1‘24t447� 7 TYPE OF WORK ` v y - Construction Cost i 2-57.). ©® -�y Multi -Family Building: (Yes `_ / No _ ) r Company. /if1f i 6 - elf- ee1f;1 / Tye' Contact: 'c A CONTRACTOR Address:339)0 fr tip. Li,/ f1i% Ycn ' l City: pf(ik-frtll 4 State: f Y' 1" Zip: >> 7 Phone: 41-2, 2 -7 2- 3 -6, :7 License #: 7 (J Lead Certificate #: If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) 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: 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. CALL BEFORE YOU DIG. Call Gopher State One CaII 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.gooherstateonecall.orc 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 erstand this is not a permit, but only an application for a permit, and wo of to start without • permit; that the work will be in aoco wit he approved plan in the ca of work which requires a review and apt - - of ns. Applicant's Printed Name x Applicant's Signature Page 1 of 3 i• 0 0:0 (0 0 O M (Q @ O • 0, g � too o 3 CL m CD � m N• p C�6 O O0o N. co co o o CDa g. c 0. 3 0 In the last 12 months, has the City of Eagan issued a permit fora 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: 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. 0 O 0 .4 XI '0 Ill 011 XI 73 MI CO m Z z Description of work: /71..,-- I°��LC�n �V/ C� Construction Cost % g / 7 rZ - O3I U Multi -Family Building: (Yes 1! No ) Name: (..;',1"7.413 6-eiV gsel errs 7C�d1�I Licernse #: 6 793 Address: 31.-b e2 1!•l i;FG.-,(,-yl,7 L,4 Ca, Y-00-3c/city: ,i a O u State: /,/ti . Zip: /5/7 Phone: 672 - 6_3 Contact: , a•'---- Email: 'LETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Name:l;-,,r� sL4 /-74-0 4- Phone: G/z-17r %/92 Address / City/Zip: vl/9.71/ 114."( Applicant is: Owner r✓ Contractor 0 :SSW ppb ems omo 2 Y N C. 01471 m7g 0nn N � 13 gi 171 �-4 a Cn01 m C 13 o 2 104 01 :pameoaa area Elul )13Y18 Jo 3618 asfl dOL:90 OL 9l AoN saoloOJTuoO pewee seiee OLLL-86b (£9L)