4147 Beaver Dam Rd05/06/2014 09:41 Les Jones Roofing, Inc. (FAX)9528817009 P.0081011
40* City of Eatan
3830 Pliot Knob Road
Eagan MN 65122
Phone: (661) 675-5675
Pax: (651) 676-5694
2 5-o vr 2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Use BLUE or BLACK Ink
For Office Lisa
Permit #: I f) 9 Off
Permit Fee: (iAg
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Dale Received: 5) R1
Staff:
Date: - /Y Site Address:
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o,aD Unit #:
Name: yo P20p42TV colieer t NG. Phone: 667- 5r'/- 99'vq
Address / City / Zip: 1:1,0 -
Applicant
O.Applicant Is: Owner X Contractor
Description of work /e -g4101/' Ael4' cteoire 00f
Construction Cost: 90 93V,
Company: Ars 122P /6T R •'ffnl/r /.vc.
Address: 9/i W. 7p m "TA e
Multi -Family Building: (Yes X / No )
Contact Cs{2r s -i4-1111272-soA/
State: Mi.) Zip: fr'E20
License #: 45-60
City: ,084Ga -vz 1/
Phone; 9SR — 76 7 - arp/ 7
Lead Certificate #: NAT- `iv 3 9.7 - /
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, hoe the City of Eagan issued a permit for a similar plan based on a master plan?
Yes _No If yes, date end address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
CALL BEFORE YOU DIG. Call Gopher State One call et (651) 464-0002 for protection against underground utility damage. Cal 48 hours
before you intend to dig to receive locates of underground utilities. www.noohers(gteonecaltora
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 end approval of plane.
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.
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Applicant's Printed Name
Applicant's Signature
Page 1 of 3
05/21/2014 10:18 Les Jones Roofing, Inc. (FAX)9528817009 P.005/011
11111/11‘ City of Eapli
3830 Pilot Knob Road
Eagan MN 65122
Phone: (661) 676-6676
Fax: (661) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit #: l 22.1
Permit Fee:
Data Received:
Staff:
2014 RESIDENTIAL BUILDING PERMIT APPLICATION '46 "'
Date: /199 V Site Address: Y'l39,'h`F3, 't/97� H/S/ &4UE72 riM►at— 2 - Unit ft;
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Name: yp P2aPeW1'Y G 4-eEi 6NG.. Phone: 457- 5,-4/- 99yq
Address / City / Zip: 11.0. BD k 212 5 / N 472 CTR -41/4 4 Mt/ 5S -a, 74
Applicant Is: Owner X Contractor
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Description of work: 1EMoM A+ND 1R�pcACE SoM& A'td{ / iAI9
Construction Cost 4 21j 2:27 r Multi -Family Building: (Yes x / No )
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Company: .ht -5'4'63' itaa/Vlr /NG Contact Ci/, 4,v'L
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Address: 9K 1 W. gel ,L City: Aoa.�rrz) t/
State: Nin/ Zip: f,1� '20 Phone: 9'SA - 74, 7 - a2t?/7
License #: 657,4 Lead Certificate #: .U,47 `to S 9R /
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 aimiler plan based on a master plan?
yes, date and address of master plan:
Licensed Plumber:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
Phone:
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(r 1,..t,:.:6, -.,,,,AL e � 5',„‘ a . iAYw%�,�i"3...e�s� ``�,Q�OI!Iil�l�0��..i.. � ..��5��.. ?k4.• ����1 a:6..,�...ro?:,..'i�..;....,rt"'..,..,� , •t,•.� .',
CALL BEFORE YOU DIG. Call Gopher State One Call at (661) 464-0002 for protecUon against underground utility damage. Cell 48 hours
before you intend to dig to receive locates of underground utilities. www.aooheratateonecalkora
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 en 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.
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Applicant's Printed Name
Applicant's Signature
Pagel of 3
City of Eagan
PERMIT
411' City of Eaan
Permit Type: Mechanical
Permit Number: EA141456
Date Issued: 03/14/2017
Permit Category: ePermit
Site Address: 4147 Beaver Dam Rd
Lot: 14 Block: 01
PID: 10-20450-01-140
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.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Fee Summary:
ME - Permit Fee (Replacements) $59.00 0801.4088
Surcharge -Fixed $1.00 9001.2195
Total: $60.00
Contractor:
Haley Comfort Systems
4320 Hwy 52 N
West Frontage Rd
Rochester MN 55901
(507) 281-0138
- Applicant -
Owner:
Bette J Briest
4147 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