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4112 Beaver Dam Rd
06/17/2014 15:08 Les Jones Roofing,Inc. �Afl�9528817009 P.0191020 Use BI.U�or gI�ACK ink ' � ForOfflceUOe--^----^^� . ' j Permit#: ����� j �i Gity of �a�an � Permlt Fee: � I 3830 Pllot Knob Road � � Eagan MN 6b122 j Date Received: � Phone:(661�67G-G67G I � Fax:(661)6755694 . i Staff. � �..-.�______________J 2014 RESIDENTIAL. SUILDING PERMIT APP��cATio� y/ov-�f/o� -ylo�-y/a6-yloP- �}�/e �y�i2- 5�// Date: �O � � SlieAddress:y//�¢//8�� �ZD—y/.� $� �t �. Unit#: "' :•�'>.::::::..:... ::1�-� �, 'V . �.'y d��.:1':.�'r.i i.:.:'.'. -_: i`. ;.'�'':',,,;:�`=;c-. �"s� �� Neme: �/o p2a�e�2ry ��-�,E, 6NG. Phone: �si- ss-� 9qvq •.� ��'�,��.:.�;-,:.,,;:,e:,.:::,;; �;,`�;,�?��'s�+d�,j��>.;:;;';.; � ;,.:;,',������";��Vlln�r.';;:;i: ;:,A'..:,- Address/City/Zip: �D• BD u 212 5 /NVEl2�7+�.0✓� z�/1�/ 6Sd� 9(o .. ,.;t::.,: ...,:. ,. ...... .,�,�:'�.•;-;,r',�:'.;��•�:,_;= ;:` �,;� ��' �;, , `',� ;;, � Applicent le: Owner X Contractor �,:...�`,�;,iS,,i• •.��f,;(,.,r.,�..)..',;;7;� (� `E�`a": , +.i,i;�:r.l;. �., . • '. �,;::��;`��:���:�;°" .' .�,,' ,�>�.; Desc►iptionofwork• ��iLfl�_!� f�l1l!) ��pGf!-G� J/L�//✓C7`� '<�'�Yp�Q�of:�l1(,.o'r�_:;;�. _�:, �. � '•<r�'`�� �� :?;'?��,;;;;;; Construction Cost: '2 �� Multi-Femlly Bullding:(Yes x /No_� ��,,:��:;: ..:� .,:,.. :;;. �•� '•i;�,��.`�"��;��;:;� ;�r>��:-�;�,.; / .;a,,,.`',.;,., ` ;?:1 � ":;:: Company: �E',S �ToN63 RaDf<�+//r /�vG Contact:C�.s.a.r s ,4,�0�-so,�/ ,-.� ';c;:''�;: ':,��i"•,�F,?, �� � � �ir' z,' `_ � '`r'' ;,. .1� Address: 9�l l W. �D� S'i"R.�'7'" City: ,BGO�vu,r.v�i-�b�✓ �cb�`k�ai�XAP;;, �;•':;cc,:<:��;.;; :;r%` ::<,;•• .', e.. �'�<c'f .;:s'�;``;;�<;;'';','si:. ''���- State:_ �I�/�Zip: ,�.�'�20 Phone� 9'S.� 7�0 7-�8l9 �;� ,;...,<;;�.,�� �`;;;,::'+'� ��t"'�.��," ` ;�,o, `� ';`�:, License#: �.S7o0 Lead Certlficatell: .UA-T �O 3 7.7 —/ `:�'', ;;-�,���,:: lf the project ls exempt from lead certlflcatlon, please explain why:(see Pege 3 for edditionai informallon) COMPLETE THIS AREA ONI.Y IF CONSTRUCTINC3 A NEW BU���G In the laat 12 months,has the Clty of�agan Issued a permit for a slmllar plan based on a mester plan� _Yes ^,No If yes,date and address of master plan: Llcensed Plumber; Phone: Mechanlcal Conuactor: Phone: Sewer&Water Contractor: phone; �:t. . . .,.,�,�,:.�..., � �,�. � ,.,, ,.,�,. .,�.:- . .,.. ,,.� , �:,,, �� ,;Q •, .::�a.s< �.,.s�,: ,a "�` at'��:,ou:�sub ►fii�" ��ti� 'il'!'e�retl�"a;6'`� t]'G'll w�llf�"o. ��.,.�::,. "►.. '.s3Of1::;: ,::>. , , ., ,!�. ��, ,pl�Q,��i" �FUlty��., �.�, �.►i. �, .�� �., �.,� ,... a. ;�:,.,.i�,,.,,;,:.,�i.1 . ... Y n . /] .,.:••i.. , .. . . �.r .y%•.;,,.t.,.�r.'",� ..,..,.��;•�.�,,.u,r�,..r.,��: ',T..,;^. 7tli.o�r;i;:; �.i,;..,��: -'�it, .`7;��irpr!..� .��.,.....; t . �p., ,. � 4: , ,, � , ,a. ir:�.`^ ,. ;., ' ,.. :,J,;,• �,,..,;i.•n,. ., y „ ... ��;,;.t. �irt,o .�.t�n' � ,� a�'t � e un- .rr�j' :�f: u: vlde;s �QI ��. .ri's?t�':at�. ��l!{'�'�;,.e°- ;t(/e,�►c`�to-';�-:'- .!t�,,..,, .� .�,: ,,,,.!f�.,.Y,!�. .,�;,�t�'..:+�L:�;�. ,� .v,�� ,,,Y::4�,p',. ,.,p. fl.�;�Q ,,�1... ..t�,,., � �1�, .,�.. �: �. n �F.,,� ,.v, ;a;. q g, d:1 a, ,.�t 1_ ��" �. ,;i�,�r.µ;. �., �� ti�a:'�.ra�. ,,1 ,'.�i1r4�. afC+n'.. O.,.r9:;... ,ci7?q:;h: i�i:" '��� 5�1,,.'�.6.�,5'�6:1,`i^� c;*..'i.,, <<�.'�C"�;r'.^..:_ ,n., R�'�' .r�i� ..:1• y�� �1✓..l.`r,.:;r..:J::\;' �:i;.. •!�;.. :,�' :i?'. - ,-i,i U�8'�f ',f,.,�..4•�I �`� ,=5 !�� ,�},.,::.�, �'�.,:?.: .;a ,, ;�.,,.. :_���:. ;�: ._. :.,� pn,� d" , ;.� ., ,. .. ., .. ,.,,, :,:,:-..;,;._:.,:�.„5,.,t,..;,;,,- ,. ���� .,E.� ..,� > . . .. ...., .... �lla�,,..,_. ,. ._�........ .....��.. ..�:.�. CAI.I.B�FOR�YOU pIG, Cpll Goph9r Stete Oee Call at(861)b6�1-0002 for pmtecflan agelnst underground ulllily tlemege. Cel(48 h0ure betore you Inte�d to dlg to recelve locetes of underground u11UUee, uwuw.00aharstateonecall.nra I hero6y acknowledge Ihet thls Informelion Is camplete and accurete;lhet lhe work will be tn conformenCe With the oYdlnences end codeb of the Clty of �epan;that I unde►stand ihls Is not e permR, bul only en appllcetlan for e permlt, end wotk ia not to etert wlUtOUt e pemtll; thel lhe work vulil be In accordance wlth Ihe epproved plan In the case of werk whlch raqulres e revlew end approvel of plens, EXterior work authorhad by a bullding permlt Issuad In accordence wlth the Mlnne9ota 9tate Buliding Code muat be Completed Within 180 day9 of permtt Issuance. X CµQ�s ��u0�2sa�l X ���� G��:��° Applicant's Printed Nama AppllcanYs Slgnature Page 1 of S 02119/2014 12:37 Les Jones Roofing,Inc. �AX�9528817009 P.0191020 Use BLUE or BLACK Ink iFor Offlce Uso---------� . � � ��� Pertnil#: �-r..- ti �. 1 � �I � �ty o a�an �������� � , Pe�«Fea-� �a�� � ����� 3830 P11ot Knob Road � � ' Eagan MN 55122 F�� � 9 Z��(� j Date Recelved: j ' Phone:(851)675»567b I I ' Fax:(6G1)676-6694 , � Stan: i !� �___________^^���J 2014 RESIDENTI/�L BUILDING PERMIT APPLICA71oN y,oo, �.o�,�io y, yiob,y.o 8, �..o ef- �ate: � ` Site Address: �// //f/4// �! 0 S+iaA ���M�Unit#: ,,,,: .; .��..,.., .. ��,,�,,.,�,.. �.. : 4�;, r �1..�. �. .c `7p:r,i'Yi'.•-.'o:Y. ;,�i=�;;:r;qfw:�;u;,�.> .,,:,,;,�,�,�F: c.. Phone: sr�/- 99v� ,,,;;;,,;,,, . ,�;,::��„���,� :�:�° Name: yo P2oP�ry ��rz,E. i n► 6��-» ,� � �:��o -�: ,�; . '''.�I�r.. `,`Y�`Q�.. f Ja ?'<_..,. �v� � ��"'.•'".'. °';;,-��Q;�����,•�%-,;,��, Address/City/Zlp: R O. �o x 2�2 5 /Nv�C�.a✓r �o,�,�rs:_�r/.� _ 5� 9 G� ,�.,, �5,, � ,, :.,>,�� i`'�;r�1�1;r.�r�,'����°' `" ,%"''',: n �d°?� �Y '- �'"'`�"�'-:?%`x-' AppI1C8l1t IS. Owner X Contractor 3�. ,:,.�e;::+a_ �`i�� ��:�'='�a�,.,u. .�, :;� ..;....,;,.;.,,.�,..,'` i��� � . ... ;J 4" :r��'�"r,'�',N�� '1...i;f`C� � �'�'t,":v-!;i!;�i,�."`t+,y ��: <2"�` D68Cf�p�017 Of WOf�C: /6�/�D V�? �'/� �C�'� 00�' y�x'r�(�A�Q�'^ ,.b�`IS�^=; � xry'tl!4YA�r'' i.�:T „j'Jni.'�C�� J '(/ i,� �,^M;,::;� .,<�'`�;`:,;.�, Construction Cosr �y g�3, ✓ Muld-F�mlly 6uilding:(Yes X /No� ?�r� r.: -,,.... . .,..,�;��:�;:....�_-��; .... ��'r`' ,;;��` t �;,' +�, -� � �' �;.`,7.;ti,.,:r: �1`�. �.,,,.�y ,,. , ;>:: 6 • �,� :°x?'� ';y,, Company_ �E',S �TQ�/�' RODfnllr /ivG Contsct:GsrR.�s ,�Nar�-so� �� k�. it;ya� ,�,;�n<�.�. �',�.��:. �.,�i3��;�-,,�>-: Jg;�.,,!` =,s:. ,�;�,.� � �;: A.� ,y �� o� � � / f�i,,r�;St> ,d� j i+ i'e'�;���'�'"? I�I.�Cif98S: 9�� � �d� �'°Tlc.FG/ �:�b/. �GOQ?�L.tA/�b/V ��'�������;�/����a�:�;� - '��,"'•"":'g2pi ,+��S�r�!q••1?u;y ��;: ` `i�z�•�R�!``"`�'. wr'i Stete:�Zip: .�.f^4�20 Phone� 9'SR- 76 7-a?�'!� ;,,�g^`F'`'.�uy;,, . � ..;'�,; ' . f7 :�}..�?' :Y' �.,.,,�,�. '�;,�;; �:. a� ,w.. �t�,.laa f��� �•1�.' dJ'>;'�d��"!F�f l�o: / - h::?js�,,,�r'.:'��:����P�r,�c�a�.:�e� �,�;jsS� LICA1190#: _4P�10� �9dd C.@I't�nCQ��: ��� �O.y 7!r—� If the projecf ie exempt from lead certlflcatlon, please explaln why: (see Pege 3 for edditionel infonnation) COMPI.ETE THIS AREA ONLY IF CONSTRUCTINO A NE1N BUII.DINO In the last 12 months,has the C1ty of�agan Issued a permlt for a elmllar plan based on a master plan? „_,Yee _No If yes,date end eddreas of maeter plan: Llceneed Plumber: Phone: Mechanlcal Contractor: Phone; Sewer&Water Contractor: Phone; �1' 1Pr' 1 V I ' N �� I'G ��t O�r ,:;Py1�11���ea►� 'p'�it""t1�, '�"'d'�'[im r�s "���' �l '"c�'�}p,li � 'I Ir� o aY�l��'P "." { �j� t �,. ,����.,,,��' f�'i%; I� • , . :�' ����' � �t �, , �►�t�`Q'f`' ,;,A�, i � ?! g� ..�1 .�1 'di ,j S�.' r •1. .✓".' ;t r,.r r�� ���"L'C'�'C.,.,j� �.aG:�'�Ai,,.;�:Y�yS��P � •�l rr i �.�!'• �.e i(,�1�12`;�f�y0�I1 lk�}q �l, e�r+.�',.�(l.�?;,�,1?I'5.�1�1 ;,,s��,xri�'l.���. ! ��y���_�:,�SAI�/.11,��,,t�., �(��'�a!''a'�n '��� �°4,t��J^ '"f t :�, ���,.. �� � �. �..� ,,�, � ��.:, ��, , ��1��"!,��:p���� b� ,t ,.fw (��p/�{J� �.! I v � C�. K'M"`� �.n����Y�'.�~.�xl.;E�"�� �Z"'°U, 'rL..1 6''� ,'.4��1i� .��17.� y '��� �, � ��:^. �.p.�: �' '.�.�c-,>..Ix,b?"' .h*y�t:�a�`p�����j��;'"�.(i4� 4n /: �a.Nl. ..(.��1� 7", Y e � ..T.!I:..�� '.i{�.�. �.•�,'4 - �Q4 1�.�.. 11'Yk 7 II:il1L�.LGIa I; L.. ..�.1:.'.���� l�:-.�1. r.I:.��J. �A CALL BEFORE YOU DIG. CaN Gopher 3tete Ono Call at(661)454•0002 tor profecUon agalnet u�derground uUNty demage, Ca1148 hours before you Intend to dla to recefve Ixetes of underpround utllltlea. www ' 1 hereby acknowledae that thle Informeqon(s complete end accu�ate;that the wark wlll be In conPormance uullh lhe ordlnancee and codes of the Clry of E9gen; thet I underetend tNe ia not a permlt, but only en eppllcatlon for e pe�mlt,and wotk 18 not lo etart wllhout e pennit;lhel fhe vuork wlll be In accOrdenee wifh the epproved plan fn lhe case of work whlch requlias a revlew and e�pproV�l of plene. � Exterlor Work authorized by a bullding pa�mlt 19sued In accordance wlth Lha Mlnnesota Stflte 6u11d111�Code It1Uet b6 COtllpleted wlthln 180 days of permlt 19suenco. x Cµ,e�s �4MDEQsa,�/ x��5��� .GG�=� Appllcant's Printed Name Appllcant's Slgnature Page 1 013 !" #$%&'()'*+*, -./$%'"&0-143/7$,+ -./$%'63/7-.189:S@@: =*%-'!>>3-5199?9D?A@9B -./$%'#*%-+(.&1--./$% C$%-'855.->>1''S99A''2-*E-.'=*/'5'' 8"V#$%& ''9")**++, ''7+LL$/1'-II,4 267 89:(9"U9:9":8"V' <4/ =->H.$0%$(,1 =>?'@1A/ \\/4+*/,+3$ C0&'@1A/ \\/A$3%/ 7/4%0+A+, C3/0'Z/3/0 P//0'=+a/P//0'@1A/P3,>L3%>0/0=/0+3$'Y>I?/0\\/I/'Y>I?/0+,/'=+a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c+*+D ;F<-.:&T:: 3 1E@.V:E:+9&&G:&GE:&.:F<*.:&9E%:&)::$.9&*+&-##&=:).E9Q&10&-#:.*+D&S*+)S&@:+*+D9&.&*+9-##*+D&"-?&.&"S& #(//-,%?1 S*+)S9I&$-##&0.&0.-E*+D&*+9@:$*+Q&/-##&0.&0*+-#&*+9@:$*+&-0:.&*+9-##-*+Q /-.=+&E+R*):&)::$.9&-.:&.:F<*.:)&S*G*+&!3&0::&0&-##&9#::@*+D&.E&@:+*+D9&*+&.:9*):+*-#&GE:9&KJ*++:9-&;-:& "&4&"-9:&T::&UO_U!3'QM5&3P3!QO3P5 G--'D6//*.&1 ;<.$G-.D:&4&"-9:)&+&d-#<-*+&UO_UMQ33&L33!QM!L5 d-#<-*+ &&OI333Q33 "(%*41H9=;IA;' #(,%.*2%(.1JK,-.1 4&&(@@#*$-+&&4 ":*99:#&B*+)S&\]&;*)*+D&/2-%-&/<+?&55!MM&O!!M&":V:.&2-E&A) !6'5&W-%)-#:&(V:!L63&/#*00&-%:&A)&;:&!ML4M'! 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