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4119 Beaver Dam Rd
CityOfEaaali 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Date: (ice l Tenant: Use BLUE or BLACK Ink Permit #: 7.e, 2 Permit Fee: Date Received: Staff: 2011 MECHANICAL PERMIT APPLICATION Site Address: 1-1- 1 I ��'Cl v rr ({ Suite #: J RESIDENT / OWNER Name: C1_. ci Phone 1- 3c Address / C4-, , :... 4 1 Iq l € 1\icir -Dam 1 n I�, 7J 4c;', R\LT.Lb StA%g8% CONTRACTOR Name: Address: _ State: Contact: T t 16\ r Dan Wohlers Southside Htg. & A/C 6950 W. 146th St., #106 Apple Valley, MN 55124 (952) 431-7099 City: Email: LOOil1er5 ► 6 de C- Mler TYPE OF WORK New K Replacement Additional Alteration Demolition Description of work:i` e -` urr\ac_a'>_ PERMIT TYPE RESIDENTIAL }( Furnace Air Conditioner Air Exchanger Heat Pump Other COMMERCIAL New Construction Interior Improvement Install Piping Processed Exterior HVAC Unit Gas Under / Above ground Tank ( Install / _ Remove) ** When installing/removing tank(s), call for inspection by Fire Marshal and Plumbing Inspector RESIDENTIAL FEES: $55.00 Minimum Add-on or alteration to an existing unit (includes $5.00 State Surcharge) $95.00 Fire repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) $ TOTAL FEE COMMERCIAL FEES: $75.00 Underground tank installation/removal OR Contract Value $ x 1% $55.00 Minimum (includes State Surcharge) = $ Permit Fee - If the Permit Fee is Tess than $10,010, surcharge is $ 5.00 Surcharge - If the Permit Fee is > $10,010, surcharge increases by $.50 for each $1,000 Permit Fee = $ (i.e. a $10,010-$11,010 Permit Fee requires a $ 5.50 surcharge) _ $ TOTAL FEE 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.raoaherstateonecall.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 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. C11GC Liii0h5 x Applicant's Printed Name Applicant's Signature Y. Under Ground Rough°ln Air Test Gas Service Test _In -flood Exterior HVAC Scr tin :; It ©n SEWER & WATER PEFINI1T CITY OF EAGAN .3830 Pik4 Knob Rd. fagan, MN 55122-1897 DATE :4-4-41 ETERI aeP# METER SIZE ISSUE DATE —.PRV BOOSTER PUMP PFICE 0SE IDNLY , PERma DATE 03t13192 PERMIT # 12604., B.P. RECEIPT # C017717 S.P. RECEIPTDATE 03/10192 SITE ADDRESS 4119 Beaver Dam ‘4R011_ LOT ___ZLELOCK 1 SEC/SUB DSZ34tv commons AppuGANT: The Rottlund ADDRESS: 5241 E., River &bed CITY, STATE Mn. PHONE 5 PHONE. 571-0304 PLUMBER: Valley Plumbi ADDRESS: 639 Creek Lane CITY, STATE PHONE JOdarl MTh* 492*a IP 55352 OWNER: 11 Rott1iincl Co. , ADDRESS. River, Rc CITY, STATE ;:Jr 111' zjp 5421 , CONTACT PERMIT REQUESTED SEWER WATER TAPS CQMIWIND IRESIDENTIAL __X_ NEW -,—._ EXISTING Lawn Sprinkler Meters are to be Installed • ;ef Domestic Meters on Water Line. LL NOT be Meters. - EA 0 DINA CITY F SIGNATURE ;CALL 454-5220 FOR R ISSUED S. FOR ST City of Eagan PERMIT City of Eaan Permit Type: Building Permit Number: EA108209 Date Issued: 11/26/2012 Permit Category: ePermit Site Address: 4119 Beaver Dam Rd Lot: 21 Block: 01 Addition: Diffley Commons PID: 10-20450-01-210 Use: Description: Sub Type: e-Windows/Doors Work Type: Windows/Doors Description: House Census Code: 434 - Zoning: Square Feet: 0 Construction Type: Occupancy: Comments: Improvements to the home require smoke detectors in all bedrooms. If altering window openings, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required by law in ALL single family homes. Fee Summary: Valuation: 4,000.00 BL - Base Fee $4K $103.25 Surcharge - Based on Valuation $4K $2.00 0801.4085 9001.2195 Total: $105.25 Contractor: Renewal Andersen 1920 County Road C West Roseville MN 55113 (651) 264-4777 - Applicant - Owner: Laura M Molitor 4119 Beaver Dam Rd Eagan MN 55122 I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Applicant/Permitee: Signature Issued By: Signature 05/06/2014 09:40 Les Jones Roofing, Inc. 416* City of Eapli 3830 Pilot Knob Road Eagan MN 55122 Phone: (661) 676-6675 Fax: (661) 676-6694 2S V3 2014 RESIDENTIAL BUILDING PERMIT APPLICATION (FAX)9528817009 P.0061011 Use BLUE or BLACK Ink For Office Use Permit #: Permit Fee: Date Received: Staff: Date; z//c'//y Site Address: 410 j `1/r/, W1 YU 9 BE»v6J _ O.., 20 ,4 p Unit #: t ` %. ' a1 ` rl 1' $ , ° ti :4 `.. A...0", �t.. `+'Y'' ' , 'l1 'k7 Name: r90 PeoPd r/ G /'.e l 4... Phone: 65w' -- FS-?/- ?7,-/I t Address / City / Zip: RID- Bost 21,2 5 04/1,672C_Ovz 26 /lam/ 6Y`' 94 Applicant is: Owner X Contractor ' ) .. y°� ,; a. Description of workiGffJliE /�..1/ F 64, Construction Cost $ W, 1, 4/.J Multi -Family Building: (Yee x / No ) fir, °`�' .' 4 Ir. B 3, u `°:1 , 6' � 4'n ' � J "" t : Company: A1-5 ,7 t/63 ,Ri F,V6- /Air -Contact: Chiles s ii-vDE72so,J Address: 1 Clt Go a�r�� 7 � W, gelThi "r ��%� y: f_ _i__ State: Mi) zip: f e2O Phone: 9'SA Ira 7 — c?819 License #: 65-6P Lead Certificate #: ,f),4T LI0 3 ? — / If the protect 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: ... c. �-+c yvl Cirf'.. ' .n 1, h �. � 1 �.7.•� . *cC'h � - her f, r '.y : `r 1 7i.m'T 'T "F q°!' ,' 'y h ' e� i i y��� 1 !7, c o�oiv l o . o s ��r� '''i_ i l ^ r ale si r, -- 3 � ro ; zo�/ o a o 1.']'; of - T.,;) -r1 e d�,.TZ.4- -, { � L �.T �,.A _� l�, � � �'I, ). 1 (1 1y 1� la �� Y t �i�Y{f.. I BZ= °�QI i "�4 �1 ,ol e ` o p : Y o l' o o el a 1 ���a�':r j a,; • . y T i cY of 1,6 111 -���� ��jj � t� I��, it' �'� i �- �` A �'�'4. � �� /Ps 9 . 10 I , 1!c,,,r 1- rtT:, l- < ,M. ,t� . 1.ea : f 1* , ?c am CALL BEFORE YOU DIG. Call Gopher State One Catl at (661) 464-0002 for protecUon against underground utility damage. Call 48 hours before you Intend to dig to receive locates of underground utilities. www.00raherstaleonecall.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 1 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. Exterior work authorized by a building permit issued in accordance with the Minnesota state Building Code must be completed within 180 days of permit leeuance. x Cimis 441D6720N' Applicant's Printed Name Applicant's Signature Page 1 of 3 05/21/2014 10:18 Les Jones Roofing, Inc. TA)!)9528817009 P.007/011 44,111'`City otPaaau Date: 3830 Pilot Knob Road Eagan MN 55122 Phone; (661) 676-5675 Fax: (651) 675-5694 Use BLUE or BLACK kik For Office Use Permit ft: Permit Fee: Date Received: Staff: 2014 RESIDENTIAL BUILDING PERMIT APPLICATION Site Address:41/1l fl 7Jv Wh < Eq+�6d 120.E Unit#: Nems: y0 i° CPe2TY -4-t? E WC - Address / City / Zip: C - Address/City/Zip: 'Rd. Bok 2125 Applicant is: Owner X Contractor Phone: $,s -ll. ?. 'q grs-/kit/ 6T'24 Description of work: Sem our- Awe Al) Construction Cost 23i.-153, gritIng 12441446e7) S30/Alb'' Multi -Family Building: (Yes / No ) Company:.ES 172,4/63'RGIOFsAUT; /AJG Contact Ciwats 4s iso Address: 9 1 W 8d 7 Srizr City: 14A h State: MA/ Zip: .1.5-4120 Phone: 95A - 0?8/7 License #: 4.5701) Lead Certificate #: _&41 yes g 7? - / If the project is exempt from lead certification, please explain why: (see Page 3 fof 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 Ryes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor Phone: Sewer & Water Contractor: Phone: 41.4004:-.. la -WA; 440#604041Mildit BellO,.�i/Stela,�vlESO Siff fa tiO►(l� ' rill y rti.. � ��t�if/ O@ i 0.0471-PWORIO"hair10;'? CALL BEFORE YOU DIG. Cali Gopher State Ono Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you Intend to dig to receive locates of underground uUlitles• www.aooherstateonecall.orq 1 hereby acknowledge that this Information Is complete and accurate; that the work will be In conformance with the ordinances and codas 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 end approval of plans. Exterior work authorized by a building permit issued In accordance with the Minnesota State Building Code must bo completed within 180 days of permit Issuance. x diets ANDERsd,A/ Applicant's Printed Name Applicant's Signature Page 1 of 3 City of Eagan PERMIT City of Eaan Permit Type: Plumbing Permit Number: EA142405 Date Issued: 05/02/2017 Permit Category: ePermit Site Address: 4119 Beaver Dam Rd Lot: 21 Block: 01 Addition: Diffley Commons PID: 10-20450-01-210 Use: Description: Sub Type: Residential Work Type: Replace Description: Water Softener Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments: Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Fee Summary: PL - Permit Fee (WS &/or WH) $59.00 Surcharge -Fixed $1.00 0801.4087 9001.2195 Total: $60.00 Contractor: Blue Sky Mechanical Llc 41531 237th Ave Le Center MN 56057 (612) 756-2255 - Applicant - Owner: Laura M Molitor 4119 Beaver Dam Rd Eagan MN 55122 (651) 688-3061 I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Applicant/Permitee: Signature Issued By: Signature