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4127 Beaver Dam Rd
05/06/2014 09:41 Les Jones Roofing, Inc. 4016 City of Eaaall 3830 Pilot Knob Road Eagan MN 66122 Phone: (651) 676-5676 Fax: (661) 675-5694 42oeir ff AX)9528817009 P.0071011 • Use BLUE or BLACK Ink For Office Use Permit II: ` Permit Fee: 1k'J J50 Date Received: b I I Staff: 2014 RESIDENTIAL BUILDING PERMIT APPLICATION Date: II/471/y Site Address: `fl2 y Yi S D .... Unit #: J c41. __ .. , , ' a ' a ' °��;� o•;� "��7. , `` ,cI'• • • .'"' A ;' , •r' ( Name: yo PYeOPPT`/ G4I?Et I. NC.,, Phone: 657-' Sii/- 99'-/9 Address Applicant / Cit / Zip: 'P O. BO 2 / v v y p: � 12 5 N E�2. �o .x [�t11� /Lli(/ d'� 9 � Is: Owner X Contractor +y„` T. - y -A ,; \i„:�? .. g ",;r I. 'Ate .., 1, 40,0 ',r Description Construction ��pp ,,pp of work: _XF41e) A-4/1"A-4/1"/�0O G6 4 pop Cost: $ 5/4 93$, �� Multi -Family Building: (Yes x / No ) ti” ", :j,, Xa '?NH. by (• • e YI' '"4' ^# i ` ^ 'f'\ `r ; `, J t ��,. yy ' � ' Company: Address: State: SES v6S Roof/fur- //VG Contact: C�,F� s 4 6Fzso tQ Q / W. PO �'l"/L T"' City: ,Bcoe evG-7-,/t/ /(/Irl Zip: ..1./412( Phone: 9'SA Iry 7 w 02811 License #: 4.3-6,o Lead Certificate #: .1.44T °i0 3 7,7 -I If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) In the last 12 months, _Yes _.No If Licensed Plumber: Mechanical Contractor: Sewer & Water Contractor: COMPLETE has the yes, date THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING City of Eagan Issued a permit for a similar plan based on a master plan? and address of master plan: Phone: Phone: Phone: 'll Y i v' 1 ��1r co©I r ) �` 0 0 0 y +9 Y J .I ' ( ���f' 7� I� ,,,'!*-1.''''' . alt i 7 L l .iW 'ji o 64i ° Y%y�, .. r, c ° `rr ° a JI )e eY A1. �L Jjfy){ny 1 .:. T� e�� 6 9�i �/ i� i 1 r 6,�,{,f� I P `Sj )1.: : a Q IYA1 ° ) C a o ° r( ( � ° s ^.0 , r °aY�'� a ° t; sL 1 1, c Airr d, . a % r k_k`.;• `' { 'VI. eY �e f., o W )� ! 1ji., .1 'f 0�i1P.41 �••l 1• %�° ° o/ 1 y' Y:• I I� �1/' r-,u�/ � �^ � Y <, ,'--. ,, �. i. ,1. CALL BEFORE YOU DIG. Cell Gopher State One Call at (651) 464-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.000herstateonecalLorh 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 GthIX CiRIS 4MD6iso, Applicant's Printed Name x rk . I'' Applicant's Signature Page 1 of 3 05/21/2014 10:18 Les Jones Roofing, Inc. (FAX)9528817009 P.0061011 '�"S'11‘" City of Eta] Date: 3830 Pilot Knob Road Eagan MN 56122 Phone: (651) 675.6675 Fax: (651) 676-6694 Use BLUE or BLACK Ink For Office Use Permit 8: 2-151 3 j Permit Fee: Z3L_ Date Received: Staff: 2014 RESIDENTIAL BUILDING PERMIT APPLICATIONcby`>''' 2! 49//r. Site Address: `/123, 4//1.7 '1/3/, v/W Q.,vEx_ 12Q,40 Unit it: • • . ' , ' ; 1 y . -ix, rtT O ner' ,t, f , Sa 'Ya. , v '".. .. ,.��� � Name: 'o PeOPe27-`' GAeE LNr✓. Phone: 457 r$7/- 99470q Address / City / Zip: Bo. Bo3 2 '' 2.5 /�n_GE-o✓d r4h' 1g4/' v' 6 74 Applicant is; Owner X Contractor it 54 L@ � .•o, ,�A r ;;°3 ;. Description of work f MOvE 4i'V AnJo MF s -P 1:i4/4"; Construction Cost: d / r, 2. 6 6 • Multi -Family Building: (Yes A I No. ) ;�;v,,,,• .,' .s,. ,,,, ,. 1 �Era�'� � li' ••r ll. o. r�It I, :,., (f � l+• `gypp:,?' . ,'t"s1(,s" ;gin, ('t'`•''s ,1'; ' . ,' Company: SES ,TaNF.3 RQpori/1t hue_ Contact Gs,424 s 44872s0 77/ Address: /tit 14/ Rd ,fr" t"�' City. JGOGY1cclN6TbA� State: /4/4 Zip: „f,�4r2a Phone: 9'$ - 76 7 - 528/7 License #: ('5752.) Lead Certificate #: 4/A47 4/O 3 9,? - / If the project Is exempt from lead certification, please explain why: (see Page 3 for additional information) In the last 12 months, _Yes _No 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: Licensed Plumber; Mechanical Contractor: Sewer & Water Contractor: Phone: Phone: Phone: ,7-.' hg's :13 OlVi ry "', b`lijit a T,''cbl"t'�sl�°l.nn.a � 6,11 ` 1 11.49J� eiim `f ,f;,‘,,,y,.1 t' f" �7 ^`Y' '', IV q 1.1 cal tR""4r4 e eS'S1fl d,bi tl Ilr' mo b' � � rid „ J �5' ,� tvOo 1:01.�,J� t;"8. % 19-0;t, ' �i 'rr'��CC��C . �A � y��:,R►�R�JIG�,.t� "�R1Qt�i��6 �'"M"�F�� �R 1.+�. , . ,�%i '7, ,• 0 �4, � .- .:�V'r ' ., :' 1;itiil. R'e, .c �/�+ • i� i ..44.. !�s�,r 040, 14 ', � ., „enty t a . _ M_ .,... �: -irS,t , Iy�� 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.gopherstateonecall.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. 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 C/# I& fin/D672s0d Applicant's Printed Name Appllaan at rnuwu IN1anw Applicant's Signature Page 1 of 3 Page 1 of 3 City of Eagan PERMIT EAGAN Permit Type: Mechanical Permit Number: EA153865 Date Issued: 01/29/2019 Permit Category: ePermit Site Address: 4127 Beaver Dam Rd Lot: 20 Block: 01 PID: 10-20450-01-200 Use: Addition: Diffley Commons 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 Surcharge -Fixed $1.00 0801.4088 9001.2195 Total: $60.00 Contractor: Haley Comfort Systems 4320 Hwy 52 N West Frontage Rd Rochester MN 55901 (507) 281-0138 - Applicant - Owner: Dean M Victorson 1438 Kings Wood 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