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4086 Beaver Dam Rd SEWER & WATER PERMIT OFFICE USE ONLY Q OF EAGAN MITER # . PEFIMIT DATE 02 3830 Pilot Knob Rd CHIP ,� # t ? 51i 5 Eagan, MN 551 22 -1897 METEI SIZE B.P.I CEIPT# C 01.7372 DATE FEB 18, 1992 ISSUE DATE t# I': RECEIPT DATE 02/19/92' PRV ___ B0OSTER >PUMP r " 4078 401) 4084 4016 4080 VI E - DAN RI) SITE ADDRESS 4145 41 414c 1 0): : : . 41, 4151 4.15rt E'IAf q' PERMIT REQUESTED LOT 8 BLOCK 2 SEC/Stja HIFFLEY - S SEWER _X_ WATER —,TAPS APPLICANT: ADDRESS: COMM /IND ..X_ RESIDENTIAL CITY, STATE F; ZIP X NEW .___ EXISTING PHONE: Lawn Sprirrkler Meters are to be Installed PLUMBER VALLEY :. F 1 . :: s Domestic Meters • on Water Line. ADDRESS: 610, E ' -. *J L NOT be giv -n for T?eciuct Meters. CITY, STATE J :. e ZIP . 55352 492 -2 L21, , PHONE: �,.'. .. �.. - t AGREE < • 0 WITH CITY OF OWNER: THE ;'RI0TTL ,00,:INC EAGAN ORDINANC S ADDRE 4 5201 E RIVER R1 CITY, STATE F'$I E Y Mit ZIP 5 5471 F) st _ r SIGNATURE WHEN METER ISSUED t �� ,ere . ' rir . ?" c f b R P ROCESSING. CALL 454 - 82'211 FOR IN SPECTIONS . ;FOR S�, SEWER PERIINTS, COtflAC‘TEft401141EEIIING DEPT. 06/17/2014 15:05 Les Jones Roofing,Inc. �AX�528817009 P.0091020 Use BL.U�or BLACK Ink ( For OHlce U9e ^ ^� � . ' j Permlt#: ������ I C"�"� o^ ��5�`�^ I permit Fee: l0 �� � 3830 Pilot Knab Road � � Eagan MN 66122 j Dete Recelved: j Phone:(651)6755675 1 I Fax:(661)6rG.6ss4 , � 5��� � I I �____.___�_.__-----., 2014 RESIDENTIAL BUILDING PERMIT APPLICATION yc�8- yo�o-4082-yo8y-yo8��UO&� �� D� �o�-o Date: � �? Slte Address:y/ys-y/'Y�-�//y9-N/r/- y/S3-�//s'� �u.2,�q�t.t, [ozia.7tinTt�: , � , , � :�r'i•�'� j .. � n;,+•,,.,*,.�„>` �r Name: yo P�eold2ry c,�� lntG. Phone: �5!- 5"S7/- 9S'�/� -�,:�;;; � �. ;�:;.��.; � ��>.. ;.���:�d��!�'I,?,;:;,;:; F'" � '.O�y'�'�r;�'''��'� Address/Clty/Zlp: �O. �i0 k 2l 2,$ �NvdYL�xQ.nv� �sLQtJ1!�. /�N b~S�dy 9� ,,,.�;�c'. ,;�.� i'� ; -�.; �1.;: .�^4�. ;;i°�`"•'�, ''r>`' ';:i:;. Applicant fs: 0 X ���;,� .:,; ;.�;;;< wner Cvntractor ' 4'yf��:.i:�,{.,:"I..i:i'11.!•',�r^•::'`:��\ .''t,�,,,;.�'..y.,,�.1^'v,�::f�r,i',r.�l',J^a..^;:��.. d ;:;�;��. {�-� �,',`��,�.,+�;`::<>�`; pescripHon ofwork: I�E�Y101i� fFr✓4 /�CPG.4G� S//Ji�/Lr. �, �1"Y,�e��`��WQ�`It;<; � �r?`;'„� ��%"�;��:?�:� ,��,:�;`; ConstructlonCost: � �O� Multl-FamilyBuilding:(Yea x lNo� �;.,, : :.��:.,� �;; �. r;:,�, . .;:,:� � ._, „ �� � ,�'y°,-j/" �,1�'�:',:;' / � • ��° -4�; ;;;�°v'� Company: �E,S �7'0� RUOFfaIG-_ /NG Contac�C�.er s ,4N042�so�/ `°���'���::.:;',;�':,'<:;`r;�.;:;t.;,,;r;.: � .Ni.,;�� .,,�;,,�,,.,, .,.,.,ar,,,:..:.r. i���:�S.i,i�;nii1;,'iA�;P'�;d.�r��:ri,�-'"."�i; , ,,.t.: ,, ,����,, ... �areea: 9�r �v. 80�` s�a�r c�ry: ,BGa�,�.�/ !;:-;�:�'�ora�r'�a�,tQr;%;;;:: .;�;;•' .: �:l;':, ,.cp �..� ... ��d.;i�: :�,,� !;.y6�.�!„ i4',� C:F��4:. StB�A��„Zlp: .f ��D - 7- 8 9 •! ,�.�.t�' .�49.'�. �.1 : �i?s�`, .f� Phone: 9�5A 76 a / ::;�;;��� ,.,��::. M�;;;;;:;;.�::'.';°:�.,: ,;„,� >;;.; ,:;�;:; ;:;�:�:;���'�,';�+;� %;;";� Llcense#:_ �2�/a� L.ead Certlflcate#: �U�4T `e`O � 7�-/ .,. �>,>� If the proJect Is exempt from lead certification, please explaln why:(see Page 3 for additional information) COMPLETE THfS AREA ONLY IF CONSTRUCTING A NEW BU(LDING in the laet 12 montha�ha9 the Clty of Eagan Iseued a permlt tor a elmllar plan based on a msster plan? � Yes _No If yes,date and eddress of inest�r plan: Llcensed Plumber: Phone: Mechanlcal Contractor: Phone: Sewer 8 Water Contractor: Phone: ,... .. . , .;,,„ . .. ;��,n►,�,7�;�I r��:�n�►,°,'i�- '�rigu"��,��'rir.���i �tr���'.au,�, �,�it��ar�.µ;��i�t��r�d:f.�.,,.'�,a �'��,�.;'�:fa���.ton�JPb fb�i�����„= .. {��:i 1.7,r,';NY,. ; ,:�,. ,��.�. .,;, ,�, ,,t�vp,�,• ,..�T.,.a;:' >�.:F-'T,.�:..�. r.e,�„� r, ,^ � �.o., .F••.�., "•�=��R y�lU.O� ,� S�:h•. _:,V'�1:. +`X� ;�)� 5...•.�.'G..1 ,�.. � �ciy; ��.,�.�._�'� ,=S:ra ��V• i�,... �.c .�,k:.,,,�...... ,►fi florl..�1i�'.�•k; ��'1�ass f'�d�� .n J�� •1�`���}��.�if:�y'_ouy `vid',��s �ee��.c;i'e�s ns� a��,�vt��7'Id= �e rtl�F� <;Oi ;;f�` ,.. A q � �': Y. � .,�.� .� ,.� .�..�., .�., ,:4.:. ,.!a.:^. �. ,.r._.� ..1�� ty�`..�.:,; .F, .1' .���..n. • �r,L.,..�. :�".;: �.r•l�r., n.A. �h. 1 ;.':;s` : � . .. �t:ns, .;,.�^�dr f`. Nrn.�,�.� ,5,..�,,7.. :M .,�� w.� ..v, �� r.<:.�� y i I�� �t,, .��..,�4 ��c ti;�� :::c. l•" .�'1;%i, 1�� ,'r. M%i'r �.1. ��,y''.5:;,� �.•.��r'4. .:,, .p I;'� '.� ''hf �<Lt.��,.1:���: „E� 'i .� �,/ •n't re��:,-..pyr*M ' q�� ' ' � ;�1�� .�i+: �.� :,7rA: ":'i:��v,.. :Jy`i:...;: ;;�.,;.;:.; 't<:, ';,:. ~:,�: ..z. ?.��`n (` �'.�t •th�. d ;� i'e�s�,,;. '�.�; , .. . . .. „ .. .,.. ,,.^:. . , .: ,,,,, r 1,�1 I, X ....,,.::... , ...,. , ..� .:..� ... ,�.,:..:v.. u`..<'.� .. ..�.�F1,Y..:.:'i.4�'..,� 1':..��I .. ...�j....N N,N ,r..[i.��„._... ,.. ; �' .�.... .F.�,..,�lf.... _.... .�� :e.. .rv..x„ CA�L BEFORE YOU DlG. Cell Oophor 9tafo One Cell e1(661)46M0002 for proteCUon agelnst underground utliity damape. C8U 48 houre before you Intend to dlg to receive locat8e M underpround uUlltlee, www.aonhersteteonecau.oro ' i hereby acknowled8e lhat thle Informalton Is comptete and accurate;that the work wtll be In conforrnancs with the orcllnencee end codea of the CUy ot Eegen; that 1 underetand thle le not a permtt,but only an appllcaGon for a permit, and work le not to atan wlthout a permit; chal Ihe work wlll be In accordence with the approved plen In the caae oF work which requlree a revlew and approvel of plane. Exterlor work authorized by e building permit 199uad in accordance with the Mlnnesota 8tate Bu(Iding Code must be completed withln 180 days of permit lesuance. x GtfR15 f�,U0�2�d� � .G�a�-�' x_ __ Appllcant's Printed Name Applicant's Slgnaiure Pege 1 of 3 0211912014 12:34 Les Jones Roofing,Inc. �A�}A528817009 P.0091020 Use BLUE or BLACK Ink � ForOHlceUeeYy__�____i 1 7�'�7�i � Clt� Of ���1�I1 , Pe�,���: . R��,�9°,!��' ► �7 i � Partnit Fee: � 3830 Pilot Knob Road FEB 1 9 2014 � Date Rec�1�d: � I Eegan MN 65122 � I Phone:(661)876-66y6 I Statt: 1 Fax:(661)676-569e1 . � � �----------------� 2014 RESIDENTIAL BUILDING PERMIT APPLICA710N �� Hp'78, 4080, H08Z,ti1t�8�I. �1D8b. SI08$ ,c3�A�V�� �� a'p Date: �I� � Slte Address: `�ISi / D �o� "T"` Unit#; r�„',��p .,. .. ;.i;C:;? ..;..�;,,.�9 ':r; :� ..,:?�::..,:�;,r,�;.r`�,.;�;' ��'r��"��..���A ti�ilti ti.,.,.�,e• � Name: ,1�',Q P�oPa2ry c�.E� �n►�. Phone: �a5�— .�,5�'/ 9�/'�19 . ,.! * _ ?�� i:�'ri` ��.�.�����. ��✓r��7� ;•�;�,�,�yt'���r �:;;,�,r`` Address I Clty/Zip: ��• �OX 2l2 5 �NvE1LC�¢.o✓�r �g-i oi,h�: � 6S� 7� �� ��., ;� �,c'. . ,.. �. ;� ? �� ��"`����<,�'t""((`1� ��� Appilcant Is: Owner X Contractor a.'�t.�.=:r. ,..�....r..•.,�:..,� �`�: `;,tYN J., d'" .' ). 4i.�,,/,..�...; ,� ��r�t 1 �LLO!/� A�V,O 10E�L�..E /� � �� � �" ' '� Description of wo�C:�' G� �i ye,p��'f�.��'��;�a r��,7��,.„�'a.,•• ,a ,,, �:;�� � -�-� } Construction Cost: �S�I 7�I GI. /S Mui�-Family 8ullding:(Yes x �No� � , .;�,-..�,�. �. �.�,:Y.:,,��fi,�,�.;�'!':;r'�;�'� N �� �i'.;'g, °' ��:�,;:' L.4�� Compeny: �ES �T`oN63 RGOFln/lr /.vG ContecL•G's,ri2r s �ivD�2so :�..� ,,...w�;��„.,. ; ,, r ;,.,jf<.N "'"J�." � ',...:,:,C I�1 '°� ' ' `` ` B�oa�.r�iv�✓ .f C Ay ' � � e:L' G:�''"i�.QI��C�t�t r�f£^4,� Address_��/ �1/. SQ� .�°!� � City: . .�:�� .w� ,. M i��;���;;; ��� �� ',� ';�-ti�,�;,,:�tw�;,�;�;;'r, State:�Zlp: .�.��2D Phone: 9� �— 9 7- 8/9 "-x�� ���n ,..v. ,,. ... x�� ,�, �h,;,r:; , . . � �r�.,.. I' ;`�� _ �,��`�t'';�y�:��,;':�"'' Llcen6e#: /05'"�D Lead Certlilcate#.�t/�7'� �f o.� 7�7 -/ If the project is exempt from lead cettificat(on,piease explain why: (see Page 3 for additionel informatfon) COMPLETE THIS AREA ONLY IF CONSTRUCTING A EW BU G (n the Ia$t 12 montha,has the Clty of Eagan lesued a pertnit for a simllat'plan based on a master plan? � ^Yes uNo If yes,date and address of master plan: Licensed Plumber: Phone: Mechanical Coniractor: Phone: Sewer&Water Contractor: phone: G "i ./ V.• q Yi'7 �1 Y PrR"_ ... J �. � 1 r_N,,,�'J,�%. �;�'1: b�. ;,- ;ts,,::a�,' ��u�"r�if�:����,. .t��to;l��9� �'IJ, t.o�, f?o'� ,y�d, ,� ;, ,�.. , �.J ��. �"� ' • i ., r � ss. � • . •' ,.��, �.. .,� ,,tl�eKi./,�f�, ,: .t,�ry � •��r.l��,�:� ���' �p�;�f;►►'�o'�aP�#.�z!t�������rQ.�.��tl��.�,�J,�.tf,�►,$.; '�a.�;�u�9�,;@�'fil�4��;;�., .^�i�,�,. , ��y - {� re� �° :�,_,�,.�.�-:,• .1,--�:� . „:. �;l 5� ��� ,� �t���,��; �f ` ��, ,.,.,�. . �, �+�. �. ,.� ,, �r?�;,.. . , . �,� , -• -- � 'e , � ' 't , .� -M�416w.,L. ....5.'.. .tlF.' „�.. �.. :��.� .� . �'..,.�7. �� .. ..IJ-'-'.l_.. a... �7c,.�c.__. :.�.,�Fe.• %�. .A� Iry�.'TG� �iiii_n�� ...�.. CALL BEFOR�YOD UIG. Cell Gopher State Ona Ca11 at(e61)a64•0002 for proledlon agalnst underground ullNly demege. Ce�ll 48 houre before you Mtend to dlg to recelve Iocates ct unde�gro�d utllidas. I hereby aCknowledge thel thls Intormetlon Is complete and sccutete;thflt the WoAc VNII be In COnfom19nC8 With lhe ordlnences and codes of the Clty of Eagen;that I underaland Ihls le not a permlt,but only an eppllceNon for a permit, and work le not to slart wllhoul e pertrdt;thet lha work wI11 bo In accordence with the epproved plan In the caee olwork whlch requirea e rewew and approvel of plane. Exterlor work uuthoAxed by a building permit issued In accordence wlth the Minneeota State Bullding Code mu6t be completad within 180 days of permit 19eupnCe. x G�f-2ts �4�tD so�tl (����� .G��=��0 x Appllcant's printed Name Applicant's Stenature Page 1 of 3 PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA160816 Date Issued:04/15/2020 Permit Category:ePermit Site Address: 4086 Beaver Dam Rd Lot:071 Block: 04 Addition: Diffley Commons PID:10-20450-04-071 Use: Description: Sub Type:Residential Work Type:Replace Description:Furnace Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088 Surcharge-Fixed $1.00 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 - Joseph H Girtz 4328 Trenton Tr Eagan MN 55123 (612) 968-4415 Dean's Professional Plumbing 7400 Kirkwood Court N Maple Grove MN 55369 (763) 428-1321 Applicant/Permitee: Signature Issued By: Signature