4100 Durham Ct '� �_.s*�
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' I V 14 O1 1J� 1.111 : � Permit#: �
Y � JUL 2 8 2014 � (D . � �
� Permit Fee:
3830 Pilot Knob Road � „ � Q�l�
Eagan MN 55122 sY, _ I Date Received: �' �
Phone: (651)675-5675 ''—`�'" �� � �
Fax: (651).675-5694 . � Staff:_ /� i
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2014�RESIDENTIAL PLUMBING PERMIT APPLI�CATION
Date:� �� b !1� Site Address• �'�Ov ��" � � 1' °/V �
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rRe�siti�� °�"���� �� Name: � ,� —� �
;� � �nfJC7w�n�f`� Phone:
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::�����cs �k��,� Address+'City/2ip: �. � �
Y�������� '��'��,�'�' Milbert _ompany Inc dba Cullign Wat
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fi������� ;� �1� Name: t �icense#: WC643176
k��`�� '�`�� � ��'� 180150 Street East
il��,�� �: �.�� f �'' AadresS: c;ty: Inver Grove Hgts.
����Contractor
��=��'�`�'� ° �� � � 55077 651-451-2241
" -��'� `' � �' State;
� k',��zr;`,�, :Y���� " � —M N zip: Phone:
43tA~�R�t � `�'�Su'�.��
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.��"' . �a�� '�+�r �• .Contact:WIIIIa111',.R_'MIIIJC'I"t. Email:
J�>'.'�'F C y wd F L„1 � � �" . . .. .
�£����`��}£��~
��b��-� "°��'�� _Mew �Re lacement Re air Rebuild odi S ace Work in R.O.W.
� s��T e of Wor � p — p — ry P —
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„�� ��s .:, t .r_,�� , Descrfption of work:
;�;���Sh '°`��� ���L� RESIDENTIAL
�,�3�4f�1Fa�r.�'�- g�� � . .
?;2�"a�°�''�''�''iF,�.p�,�* �s.� .
�;k��aL� � { ,,,� ;�• Water Heater
:��x�� ��� �'� �Water Softener
`��=� ���`� ����.� x��; Lawn Irrigation�RPZ/ PVB)
� Permit"fy —
�'�-*��„�"�r" �� f p Add Plumbing Fixtures�Main/ Lower Level)
�r�,���?����,��$`� Septic System —
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k� r���� ��� � �Z�VV 1�1�2!?f TLC!!a_►Ln,�ny!
�.-r.«G��',�«�i.�s� l�'�+¢ -
�kr�,�` � � ��,'� Abandonment
RESIDENTIAC FEES: "
$60:00 Water Heater;;1Nater Softener, or Water Heater and Softener(includes$5.00 State Suroharge) �
$60:00 Cawn`�Irrigafion:(includes$5.00 minimum State Surcharge)
$60.00 Add Flumbing Fixtures, Septic System Abandonment,Water Turnaround*(includes$5.00 State Surcharge)
, , ..''Water Turnaround(add$200.00 if a 5/8"meter is required)
$115 00;Septic Svstem New($10.00 per as built)Cncludes County fee and$5.00 State Su�charge) (�
' TOTAL FEES�
C�LL:BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage.
Ca11.48 hours'before you intend to dig to receive'locates of underground utilities. www.goaherstateonecall.ora
I hereby acknowledge ftiat this(nforma:ion is complete and accurate;that the work will be in conformance with the ordinances and codes of the Clty of �
Eagart;:fhat I understand this is not a permit but only an application for a permit, and work is not to start wi o t 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.
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Applican.t s Printed Name Appli an s Slgnature
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{F��R O �I� YUS ;;� � Re. $�.: �'�Date� ��� a�rN�` ,
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06/17/2014 15:07 Les Jones Roofing,Inc. �AX�528817009 P.015/020
Use BLUE or BLACK lnk
--------------------
� For Office Use �
. ' j Pemtit#: I ��� 1. y� j
C'""� O������ I Pertnit Fee: �� ,�' I
3830 Pilot Knob Road
Eagan MN 55122 � Dale Received; j
Phone:(851)675-5875 1 I
Fax:(661)67'6-6694 . i Sta(f: I
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2014 RESIDENTIAL BUILDING PERMIT APPt�ICATION
�av�a- vv�y- yo76-�07�-�o�o- �108.� f�U,2�frq-/N CDU.�.�
Dete: �/�� � Slte Address: 4/DO��fle2-y/p S/-�+lob-�l/0�= Y//O Ualt#:
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,'�"''1'� �;���`c���:"': - Name: yo P2oPe�TY �A-�E ING. Phone: �S!- SS�/- 94�/9
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:;:, ��,:�;;�;,�,�j1� �`�;`' Address/City/Zip: 'R o. 63o x 2�z 5 /NV�x.L�✓�s ���,�r. R� 6s'� 7�
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�" ''' ��� '''�'`�`��{� �"' Applfcent is: Owner x Contrector
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�;,�,�,��.���Q�k��.� Desc�iptlon oiwork: F
.`�,'�r>n''i�Y•�Y'0�S`,�4,N Construction Cost 2 �Lf �� Multl-Famlly Bullding:(Yee x /No�
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r:;, ,:-•,. .,�w<?� ''`� Addrese: 95l/ (A/. d�0� S�"/�-�'�~' Clty: �i,n�2u�r�'b�✓
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z�y�h;� ;;,,,-�,,:,.;<:;;',�i°;; °���� stete: �1n/ z�p: .f.��2a Phone: 9�5�- 76 7-a8/9
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,'���� �- -�" l.lcense#: �vS�� Lead Certlficate�: .UA�T ''f 0� ��-�
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If the proJect Is exempt from lead cerNflcatlon,please explain why: (see page 8 for additionel information)
COMPLE7E THIS AREA ONLY 1F CONSTRUCTING A NEW BUI�.DIN�
In the laet 12 monEhe,hae the Clty ot Eagan Issued a permlt for a simllar plan based.on a master plan?
_Yes _No if yes,daE�and address of master plan:
Llcensed Plumber: Phone:
Mechanlcel Contractor: F'hona:
Sewer&Water Contractor: Phone:
��,��NOT ;,Rl' .'� t(.. ;�l'.,.°� ' .�� � ,Y� �!�ili�„,�It�a"';�oo �de►i�d'.-to� Q; r�b.���'r�fol,7i�br l ifT'P�'tt! `°.,,ti:
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CALL B�FORE YOU DIG. Cell(3opher 5tate One Call�t(651)d64-0002 for protectlon aealnst u�erground utlaty damage. Cel(48 houre
bekre you Intencl to dlg to recelve loceles of underground utll(tles. www.aoohe�tateonecall.or�
I hereby acknowledge Ihat lhls Inlormellon Is complele and accurate;that lhe woric vulll be in conformence with the ordinancea end codea of Ihe Clty ot
Eegan; thet 1 underetand thie Is not a permlt, but only an appllcatlon for a permlt, and wo�k Is not to etert wlthout e pertnic; that Ihe work HAII be In
accortlan�rvith the approved plan In the caee of work whlch requlros a revlew and approval of plans.
Exterlor work euthoNzed by�bulldlnp permlt 186ued In accordanco with the Mlnnosota Stete Bullding Code must ba completed witbin 180
deys of pormit Igguance.
x GH�RIS f�NDERs'd�✓ x ���� G��=�-�
Applicant's Printed Name Applicant's Slgnature
Page 1 of 3
02119l2014 12:36 Les Jones Roofing,Inc. �AK�528817009 P.0151020
Use BLUE or BLACK ink
�-----------------
i For O(Itce Uso �
• j Permit#: �� j
Clty of �a�a� •— �f � Pertnit Fee: � �� " '
3830 Pllot Knob Ftoad ��C�����
Eagan MN 66122 6 � 9 2Q�� � Data Recelved: i
Phonec(651)67B-5676 FE i Steff; �
Fex:(661)675-5684 . � �
��������..^�.—______J
2�14 RESIDENTIAL BUILDING PERMIT APPI,ICATION
p��.., yo7�, �f o7�.�IoTS, �fo8`o, �f08'2- '��
Date: � f 9 / Slte Address: �� �� I �z� !�� v Du ccuR'L"'Unit�:
i_;:;:• •u .'..� ;.;..����,;;:��:�•�, (� , G
;�wl';..=''��rj;;'.��;�;�.,�;;,��; "8' Neme: yo P�oPa2rY ��6 l nt�.. Phone: �vs�- SS"�/- Y��1y
4 .i�^�"�� .�': ��a r'�tl
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�y,�:.��,'.LL`�'' �M"" � ° :��' Applicant is: Owner x Contrector
:<y ��`���>+' r...:,r,..��. 'aa,!F / ,�n'^�' Q ,. ^ ^'�
��„ ;�:::�i>'s. ���.,�5 �..�';�..�,,�rf �G Q �6� 4460� � ��'W�ti�_. �OG7�l�rs
``�' ,���� .,,� Descriptlon of work:�D R�
��,t��01f W,�l��i��.
�;.,;�t-: ��;� .v� ,�. ;�:; 2 ODS, ��' X
�:. � ;�,.,.,�;,�, .�:,;; .;�� Conetructlon Cost: Multl-Femlly Bullding:(Yes !No�
,�....� ..,. :r :Y t„�:�C�S
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''�.,�j`>tij-�•:•'"�":,:t,,`��,� Company: ,�ES �T'aN�3 R[�f�Nlt- /•vG ConEac�t: Cs�ier s fl-�o���/
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. `�%''� �a ������'s�'?��r�k Address: 9 Y l �l/, 8D� S°!"/LE�T' Clty: piGOA2t�.t2�r7��✓
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"^���`4�;y,*� 'r�, ���,���� �� � S�le.^ ��ZIp: .f,fk�2o Phone: �SA 7(0 0? /
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.�' t '`�,��'���'r�� Llcense#: ro.��o� Lead Certiflcate#: AJ�4T h`O 3 7.7�-/
s '�2.,-�u','�_.
If the project is exempt from lead certiflcatlon, please explein why: (see Page 3 for additional information)
COMPLETE THIS AREA ONI.Y IF CQNSTRUCTING A NEW BUILDING
In the(ast 12 months,hae the Clty of Eagan Issued a peRnit for a slmilar plan based on a master plan?
� Yee ,�No If yes,da0e a�d address of ineeter plan:
Liceneed Plumber: Phone:
Mechanlcal Contractor: Phone:
8ewer 8 Water Contractor: Phone:
"i a �w� -a, ti c c-• .� ,1, N ..
? �,r r .�;:1�( ;�i 4..;�`b;�i .�i�� �a` �F�,�� �:,,.tY ;'"� �I , ,�t�;�.� �N�F��';fi.t�i' to :�P �fi ,',.�d�i�-.
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CALL BEFORE YOU DIG. Cell Gophe�Stata One Call at(661)464-0002 for protectlon agalnet tmderground ulillly damege. Call 48 hou�a
before you intend to dig lo rocelva locates of underground uUliliee. www.aoohereteteonecall.ora
I hereby acknowledge lhal thls InMrmatlon is complete end accurate;that the work wll)be In con(ormance with the ord�nencea and codea of the Clty of
Eaeen;that I understand thls la not a permlt, but only en eppllcatlon tor e permit,end work Is net to slart wlthout e permlt;thal ine work wlll be In
accordence w�th 1he epproved plan In lhe caae oFwork which requlres a reWew anC approval of plans.
Extarlor work authorized by a bullding parmit Issusd In eccordence wlth the Minnasote Slala Bullding Code muat ba completad wlthln 180
dsys of permit leeuenCe.
x GM-�ers �4�rD�nsa^/ X �:�� G���
Applicant's Printed Name Applicant's Slgneture
Page 1 of 3
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA156702
Date Issued:07/15/2019
Permit Category:ePermit
Site Address: 4100 Durham Ct
Lot:119 Block: 04 Addition: Diffley Commons
PID:10-20450-04-119
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description: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)$59.00 0801.4088
Surcharge-Fixed $1.00 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 -
Kristen C Shell
4100 Durham Ct
Eagan MN 55122
Haley Comfort Systems
4320 Hwy 52 N
West Frontage Rd
Rochester MN 55901
(507) 281-0138
Applicant/Permitee: Signature Issued By: Signature