4051 Beaver Dam Rd07/11/2012 10:42 Les Jones Roofing, Inc.
*2.110
City of Eaftafi
Date:
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 6764694
TAX)9528817009
P.004/004
Use BLUE or BLACK Ink
For Office Use /, / }
Permit #: v— __
Permit Fee: ! 4( 7
Date Received: 7'1( /(Z
Staff: 1`)
2012 RESIDENTIAL BUIWMG PERMIT APPLICATION
7/ft f /. Site Address: 1105'5` `1O Sir (3 EILVEl. DAM ROAD Unit #:
J
:RESIDENT /
OWNER
Name: yo Flu) P(a72r'/ Coi-a$ /N4 Phone: &/" -13-2/- 99Y9
Address / City / Zip: PO. 801( 2125 jN vEn. GrPaJ fleit.otr5, IA/ JYio 7 4'
Applicant is: Owner Contractor
TYPE OF WORK
Description of work: 13EVvtoVE RAID R PL -*CC 17EGOR+41n tic al -M P
Construction Cost: i -O ,� Multi -Family Building: (Yes / No
CONTRACT•
OR
�It
Company: L 65 JONES P o0Fm M.i 1 N rr Contact 041/4S,041/4S,
Address: '1'( W. gr City:: &DOMm/brv4✓
592b Phone: f5 a _ �/- 224"
State: MIV 5
/zip:
License #: (PS(ve VII 1 / 111 Lead Certificate #: A/i¢7"-/O372-1 3/48'i i,r
If the project is exempt
from lead certification, please explain why: (see Page 3 for additional Information)
In the last 12 months,
Yes If
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
has the City of Eagan issued a permit fora similar plan based on a master plan?
yes, date and address of master plan:
^No
Licensed Plumber:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
Phone:
. NOTE: Plans and supporting;docun ents that you:submit are considered to i,e:pyblic information: Portions.of
the information maybe classified as non public if you provide specific.readonslhat:would pent:1Me City: to
conclude,thatthey. areitradesecrets.
CALL BEFORE YOUQJG. Cell Gopher State One Call at (861) 464-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.000herstateonecall.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. end 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 Ieauance.
Gt/Rts A-NDERSorJ
Applicant's Printed Name
x
Applicant's Signature
Page 1 of 3
SEWER & WATER PERMIT OFFICE USE ONLY
CITY OF EAGAN # PERMIT DATE 12/04/91
3830 Pilot Knob Rd. 12412
Eagan, MN 55122 -1897 CHIP # PERMIT #
METER SIZE B.P. RECEIPT # C 1 5423
ISSUE DATE - B.P. RECEIPT DATE 09/17 /91
DATE 9 - 18 -91
_ PRV — BOOSTER PUMP
SITE ADDRESS 4051 Reavpr lam R ()a PERMIT REQUESTED
LOT 38 BLOCK 1 SEC /SUB DIFFLEY COMMONS
X SEWER X WATER TAPS
APPLICANT: The Rottlund Co.
ADDRESS: 5201 East River Rd. COMMAND X RESIDENTIAL
CITY, STATE Fridley, MN Zip 55421 X NEW EXISTING
PHONE: ( 612) 571 -0304
Lawn Sprinkler Meters are to be Installed
PLUMBER: Val ley P l nmh i ng • -ad of Domestic Meters on Water Line.
ADDRESS: 610 C:rpPie La nP - • •' WILL NOT be •'ven fSr Deduct Meters.
CITY, STATE Jordan, MN ZIP 55352
PHONE: ( 612) 492 -2121 � - _re- /1 - 4 C
'"
AGREE TO OM LY WITH CITY OF
OWNER: Th e Rott Co. EAGAN OR 1 INANCES
ADDRESS: 5201 East River Rd.
CITY, STATE Fridley, MN zip 55421
PHOII • ( 612 571 – 0304 a SIG GN NATURE WHEN METE ISSUED
j °l --/. G.- 1 a2 - /4 54� 0 F Y � �lcL
PLEAASE ALLOW TWO WORKIN DAYS FOR PROCESSING. CA 5220 R PECTIONS. FOR STORM ,,
SEWER PERMITS, CONTACT ENGINEERING
�� _ Z _ <_ - G DEPT. ^ % - f ' C 4w
6 t 0 !C 'Yt Y'-"
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA106931
Date Issued:09/18/2012
Permit Category:ePermit
Site Address: 4051 Beaver Dam Rd
Lot:38 Block: 01 Addition: Diffley Commons
PID:10-20450-01-380
Use:
Description:
Sub Type:e - Water Heater
Work Type:New
Description:Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Chad Bettin
3208 First Street South
Waite Park, MN 56387
320-251-2505
Fee Summary:PL - Permit Fee (WS &/or WH)$55.00 0801.4087
Surcharge-Fixed $5.00 9001.2195
$60.00 Total:
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.
Contractor:Owner:- Applicant -
Cheryl A Pexa
4051 Beaver Dam Rd
St Paul MN 55122
Ecowater Systems
P.O. Box 428
Waite Park MN 56387
(320) 251-2505
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA121217
Date Issued:03/20/2014
Permit Category:ePermit
Site Address: 4051 Beaver Dam Rd
Lot:38 Block: 01 Addition: Diffley Commons
PID:10-20450-01-380
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Stephanie Vought
3451 W Burnsville Parkway Suite 120
Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088
Surcharge-Fixed $5.00 9001.2195
$60.00 Total:
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.
Contractor:Owner:- Applicant -
Cheryl A Pexa
4051 Beaver Dam Rd
St Paul MN 55122
Burnsville Heating & Air Conditioning
3451 West Burnsville Parkway, Ste. 120
Burnsville MN 55337
(952) 894-0005
Applicant/Permitee: Signature Issued By: Signature
0510612014 09:39 Les Jones Roofing, Inc. TAX)9528817009 P.0021011
Use BLUE or BLACK Ink
For Office Use
City of Ea
Eao I I
; Permit Fee:
3830 Pilot Knob Road I I
Eagan MN 65122 I Date Received: I
Phone: (661) 675-5675 I 1
Fax: (651) 67"694 I Stath I
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: N
Unit 9:
Name: yo P2oP427-Y r 1 Ale- Phone:
,$1
Address I City / ZIP: D. 00 X 21 2 /,V4 XM ('-*=eVd :di7&&M W;/ f S~ 14
.r
r .f Applicant Is: Owner X Contractor
x Descdptlon of work: E /ltA.~D A-Az'fe~ oc'
Tell"
Construction Cost: T' c?~O• g Multi-Family Building: (Yes x / No
A rr
Company: ~f,57 QN, RGtd,F' A-1r-- Contact: Rr a 4ivD&N-sod
Address:/ O City: AL442t g!4 EMAI
.41:1,
wg '.r State: _MAI Zip: Phone 9S,l - 7 7 - a8/9
ti License 'YO H V,? - Lead Certificate f: !!A /
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?
wYes `No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
1
Ilk,
CALL BEFORE YOU Die Call Gopher state one call at (661) 464.0002 for protection against underground utility damage. Call 48 hours
before you Intend to dig to receive locates of underground utilities. www.aooh2Mtateonecali,or[q
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 We 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 plane.
Exterior work authorized by a building permit lesugd In accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
X_ C*eq 44AQ2 AI x
Applicant's Printed Name Applicant's Signature
Pape 1 of 3
05/21/2014 10:19 Les Jones Roofing, Inc. (fAX)9528817009 P.0111011
1111016City otkali
3830 Pilot Knob Road
Eagan MN 55122
Phone: (661) 676-5676
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit #:
Permit Fee:
Date Received;
Staff.
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 0, 9 / Site Address: 4042 1 I1, 'ion/, Y05S SERVER- DIM RAD Unit #:
i''';'!".1',�` �0•iw „
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o 667- Yrz/ f9.4/11
Name: yp PeoPa2ry C�.& 6 /VG. Phone:
,
Address / City / Zip: p D. 6o k 212 5 / v' (0-dv4oh 44' .4.3-2094
Applicant Is: Owner _X__ Contractor
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yP9Y Q „;
(', IiRh �' � �I:
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Description of work: REMoi/ A1VO 4 1 OM E 7.4 -01096 -ED £2M'4'
Construction Cost: *-2°j /34• r Multi -Family Building: (Yes A / No. )
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,;��i'' ' y' , `,-i,":_,,,License
Company: 1J5 17'/63 R 2AAlE- /NC. Contact CWi s �Q-ivDE2sod
i
Address: qv W. 80 rN Ii -5 City: lcoa?t'A6-T0A/
MAIzip: ,r ''2D Phone: 9'5-.1- 76 7 - a8/7
State: }c�i p
#: k_91, D Lead Certificate #: ,v4r LID g 7.? -_1
If the project is exempt
from lead certification, please explain why: (see Page 3 for additional information)
In the last 12 months,
.Yes If
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
has the City of Eagan Issued a permit for a similar plan based on a master plan?
yes, date and address of master plan:
_No
Licensed Plumber:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
Phone:
w /Ofir/ roi.
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Yi1 y. �W,,414�3hKy k**tAigt 4,9 \[Lro, p "fr..v .1" Jsy'::,"N%a.:e,s1 -V'e'•,';n
CALL BEFORE YOU DIG. Call Gopher State One Call at (661) 464.0002 for protection against underground utility damage. Call 48 hours
before you Intend to dig to receive locates of underground utilities. www.aooherstateonecall,org
I hereby acknowledge that this Information Is complete and accurate; that the work will be in conformance with the ordinances end 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.
Exterior work authorized by a building permit Issued In accordance with the Minnesota State Building Code must be completed within 180
days of permit Issuance.
x CN- i. 44/D sa,A/
Applicant's Printed Name
x
Applicant's Signature
Page 1 of 3