4132 Beaver Dam Rd 06/17/2014 15:08 Les Jones Roofing,Inc. ffAX�528817009 P.0201020
Use sL.U�or BLACK Ink
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3830 Pllot Knob Road I I
Eagan MN 55122 j Date Recelved: j
Pho�e:(s��)sy�-�sy� i �
Fax:(661)675�694 . ' I SIeN: I
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2014 RESIDEN7IAL. BUILDING PERMIT APPLICATION ,
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'';;;�-;���:��";�' '' ;;` �onstrucnon�ost: a�3 , d� Multl-Femlly Buliding:(Yes X /No�
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�'i11:..!T.,�H:,I;'`';:;:;: �-,�;:; '::�;;� Licensa#: �S7o� Lead Certiflcate�i: .U.47^ �O 3 9R�-/
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If the proJect(s exempt from lead certlflcatlon,pieeae explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONL.Y IF CONSTRUCTINO A NEW BUILDING
In the laat 12 monfha,has the Clty of�agan issued a pemlit for�simllar plan based on a master plan9
_Yas _No If yes,date and address of inester plan:
Llcensed plumber: Phone:
Mechanical ConEractor. Phone:
Sewer&Water Contractor: phona:
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CAI.�,S��OR�YOU dIG, Call Gophar State Ona Ca11 at ig61)464•0002 for prolecllon against underground utllity damape. Call 48 houre
b0foro you Intend to dlg to recelve locales oi underground utllfUea. w�vw.pooherstateonecaU.om
I heroby acknaMedge that this Iniormetlon Is complete and accurete;that the work will be In coMormance wllh lhe orcllnancea and codeo of(he Clty of
Eegen; lhat 1 understand lhls le not e permlt, but only an appllcaUon for e pertnk,and wofk le nol to etart Without a permit;that the worlc wlll be In
eccordance wllh the approved plan In the caee of wak whlch raqulres a revlew and epprovel of plene.
Exlerior work authorized by a buliding permit 156ued In aecordence with the Mlnne9ota State Buildlne Code muet be completed within 180
aays of permlt issuance.
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Appllcant's Printed Name AppllcanYs 8lgnature
Pege 1 Of 3
02t19/2014 12:38 Les Jones Roofing,Inc. ffA��9528817�9 P.0201020
Use BLUE or BI.ACK Ink
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�ty Of�a��� ��������� ; � ��-���-�
� Pemtll Fee: � �
3830 Pilot Knob Road
�agan MN 66122 ��� 1 91�t4 � Date Received: i
Phone:(651)675-6676 � S�� I
Fax:(661)676-6694 . � �
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2014 RESIDENTIAL BUIL.DING PERMIT APP ICATION
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If the proJect is exempk from lead certificatlon, please explain why: (see Page 3 for additional Information)
COMPLE'1'E 7HIS AREA ONL.Y 1F CONS7RUCTING A�BUILDING
In the laet 12 months�has the Clty of Eagan issued a permit for a slmllar plan based oh a maeter plan?
�Yes No IF yes,date and address of maeter plan:
L(censed Plumber: Phone:
Mechanlcel Contractor: Phone:
Sewer�Wate�Contractor; Phohe;
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CAI.I. B '�ORE YOU DIG. Call Gophar Stato Ono Cell el(661)464�OOOZ for protection againat underpround utlllty damage. Cell 48 houre
before you Intend to dig to receive(oCetas of undergro�md utlllUee. m�vw.aonherstaleonQ�all.or�
I hereby acknowtedge that thls InformaUon la compiete end accurete;thst the work will be m conforrnance wlth the ordlnences and codes ol the Clly ot
Eepen; thet 1 understend tF�e le not e permit, but onty en eppllCallon fo�a permit, and work le not to efati viAthout a permit;that lhe wortt wlll be In
eccordance wtth the epproved plan In lhe ceae of work wtikh requlrea a rovlew and approval of plens.
Exterlorwork authorized by a buliding pArmlt Isauad In accordance wlth tho Minnosota state Building Code musf ba completed wlthin 18�
days of permlt Issuance.
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Applicant's Printed Name Appilcant's 8lgnature
Pege 7 Of 3
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA130913
Date Issued:05/21/2015
Permit Category:ePermit
Site Address: 4132 Beaver Dam Rd
Lot:161 Block: 04 Addition: Diffley Commons
PID:10-20450-04-161
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
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)$55.00 0801.4088
Surcharge-Fixed $5.00 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 -
Michelle L Banta
4132 Beaver Dam Rd
Eagan MN 55122
(612) 636-0534
Air Mechanical
16411 Aberdeen St
Ham Lake MN 55304
(763) 434-7747
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA175260
Date Issued:03/23/2022
Permit Category:ePermit
Site Address: 4132 Beaver Dam Rd
Lot:161 Block: 04 Addition: Diffley Commons
PID:10-20450-04-161
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 - Residential Additions, Alterations
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: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 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 -
John Morgan
4132 Beaver Dam Rd
Eagan MN 55122
Minnesota Rusco
5010 Hwy 169 N
Brooklyn Park MN 55428
(952) 935-9669
Applicant/Permitee: Signature Issued By: Signature