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4150 Beaver Dam Rd ~1~a, ~1~4 ~~tla~, ~14~, g15a, X152 v~rr ~aurn ~ 101 6'7 IZU,6t C,"We BLUE or BLACK Ink I For Office Use Permit GQ n o n J_`6- City Ol EQ Qll Il I S I Permit Fee: 3830 Pilot Knob Road I I Eagan MN 55122 I I I Date Received: I Phone: (651) 675-5675 I Fax: (651) 675-5694 I Staff: I L----------------- 2013 COMMERCIAL BUILDING PERMIT APPLICATION - 12 UY1 t tS Date: '1 d17 Site Address: yv gvCr are. Tenant Name: Coe ftj 0,1 (;,.,1 ko+nt$(Tenant is: New / i`-, Existing) Suite Former Tenant: a Name: D;MtN C.or%ho.,s ;L \j%kk&s ot^j !~gCL,& "S Phone: AS*A- 4 3 a- 817 9 Property Owner Address/ City /Zip: ?b D42X N>3 et ho\)V% (of? Applicant is: Owner Contractor Description ofwork~eac- Oicr Qnc- (,oo~ a!, C1~rar 5 .vh Ct ^'C` Type of Work Construction Cost: b~~q Name: O T License \J .C~ 1 t et a a Address: ~Aojv lee, o•vL City: q 10!5C_ 0jV%A- Contractor State: M ~J Zip: ';J5'0(~sn Phone: !Tcs-l - 21 ;L` ~ 9 (as o~`J . G.of1 ? Contact: LG-► Email: ~f j kd V ek( e, 6 Name: Registration Architect/Engineer Address: City: State: Zip: Phone: a 2 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 y conclude that they are trade secrets. 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.got)herstateonecall.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 Lc~j_ I o V x - r}nu. - Applicant's Printed N e Applicant's Signature Page 1 of 3 PERMIT City of Eagan Permit Type:Building Permit Number:EA131404 Date Issued:06/17/2015 Permit Category:ePermit Site Address: 4150 Beaver Dam Rd Lot:011 Block: 04 Addition: Diffley Commons 2nd PID:10-20451-04-011 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:One Window/Door Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Valuation: 500.00 Fee Summary:BL - Base Fee $500 $40.00 0801.4085 Surcharge - Based on Valuation $500 $0.50 9001.2195 $40.50 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 - Linda J Baker 4150 Beaver Dam Rd Eagan MN 55122 (651) 308-1306 Pella Northland 15300 25th Ave N #100 Plymouth MN 55447 (763) 355-1300 Applicant/Permitee: Signature Issued By: Signature