4094 Durham Ct 0611712014 15:07 Les Jones Roofing,Inc. ffAX�528817009 P.014/020
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( Forofficeu9e^-----------.)
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� C�ty of Ea�an � Pe�"#: . ,
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� Pertnit Fee: �
3830 Pilot Knob Road
Eegan MN 66122 j Date Recelved: j
phones(651)675-6675 I I
Fax:(6g1)676-6694 . � S�� �
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2014 RESIDENTIAL BUIL.QING PERiVI�T APPLICATION
HO8�1- �108�- �0�8-WO 4v- yo�y�
Date: ���7 � siteAddress: �,/v9y-�/096- �/09�' C�r2►�+�►� Gou;�r' un�t#:
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�: :.���.;`..,' ,��;`�-�����;;':� Name:you P�eoPe�2rY c,a-�.E �n�c.. Phone: �057- �.��/- 99�1�p
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��w��f+;;w,;;;;!��'�;-"'.�?''" � '�y_`;��, Applicant is: Owner X ConUacto�
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; ,4 �• `' � ��' '�', Description of work: [��MD!/ i9yt/O !l-E�L�-� /`/D/it/�
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r;';'-» ;;�a;.,;; ;,,�': -`•;,: Constructlon Cost: , � Multi-Femily Building:(Yea x /No�
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`t,.; `��:;;%� L►cenee#, ���o� Lead Certificate#: .v,4T `f 0 3 7.?-/
If the proJect!s exampt from lead certlflcaflon, please explain why: (see Page 3 for addltional fnformatlon)
COMPI,ETE THIS AREA ONI.Y 1F CONSTRUCTING A N�W BUILDING
In the last 12 months,has the City of Eagan Issued a pe►mtt for a similar pla�based on a maeter plan7
_Yes _No If yes,da6e end addrese cf maeter plan:
Llcensed Plumber: Phone:
Mechanlcal Contractor: Phone:
Sewer 8�Water Contractor: Phone:
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CALI,BEFORE YOU DIG. Cell Gophor Steta Ona Call at(661)46d-0002 tor protecllon apalnst underground udllty damape. Ce1148 hours
befora you Intend lo dlp lo receive locatea ot underground utlqtlea. www.aooherslateonecall.ora
I hereby acknouwedae thet thle Informetlon le complete end accurete;lhat the worlc wlll be In conformance vullh the orcllnancea end cod88 ot the Clly of
Eapan; lhat I understand thle Is not s permlt, but only sn appltcatlon for a pertnit,and work Is no!lo slart wlthout e permll;l�at Ihe work w111 be In
eCCOf�d�nCe with lhe epproved plan In the case of work whlch requlres a revlew and approval ol plane.
�Xterlor work authorizad by a bul►ding psrmlf Issuod In eccordance w[th the Mtnnasota 3tate Bullding Code must be Completed wlthln 180
daya of permlt leeuenca.
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Appllcant's Prl�ted Name Appllcant's Slgnature
Page 1 of 3
06/1712014 15:08 Les Jones Roofing,Inc. �AX�528817009 P.0181020
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� For OfflCe U6e �
, • j Permlt#: ` � I
Clt� of�a�aIl � � �
� Permlt Fee: � �
3830 Pitot Knoh Road
Eagen MN 65122 j pele Recelved: j
Phone:(861)675-6876 � �
�ax:�ss��sy�-�s9a . � s��: �
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2014 RESIDENTIAL BUILDING PERMIT APPLICATION
y/y�!—S//�f6���-y/.S?3 un�t#:
Date: �7 &Ite Address: �l 0 9�- yo 9 �ro9� --yo 9P p�a�r �
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::.;;,;.�,,.�::� ,... .. .� -� Name: yo p�eoPe�2rY Ga-�E �e►c.. Phone: 6s�� �.��
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':E-�:;;'���•'ry�';a�;;f�:;; '',;�����;� Appllcant Is: Owner X Contractor
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;�' � �'"� �'� Construction Cost: � �S Multi-Femily Building:(Yes x /N4�
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�;;z'��'-;�i,`;`i�;��`;;.c'`;.: Llcense#: 6.�(0� Lead CerNflcate#: .U�4r '�O 3 9�—/
If the proJect Is exempt from lead certlflcatlon,please explain why: (see Page 3 for addltlonal Information)
COMPLETE THIS AR�A ONt,Y IF CONSTRUCTING A NEW BUILDING
In the laat 12 months,has the Clty of Eagan(ssued a permlt for a almllar plan baeed on a maeter plan?
Yes _No If yes,date and address of maeter plen:
Llcensed Plumber: Phone:
Mechenlcal Contractor: Phone:
Sewer&Weter Contractor: Phone:
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CALL B�FOR�YOU DIG. Call Gophar Stale Ona Call at(66t)A64-0002 for protecUon agelnst underground utlllly demage. Ca1148 hou�s
befora you Intend to dlg to recelve locates of underground u�lllles.
I hereby acknowledge thet thls Intortnatlon Is camplete and accurate;thet lhe Work wlll be ln Conformence wllh the ordlnances and codes of the City of
Eepan;that I underelend lhle le not e permlt, but only en appllceUOn for a permlt, and work le not t0 atart wUhout e parmlh lhal the woric wUl be In
accordanee wlth the approved plan In the ease of wo�k whlch requlres e revlew entl approvel of nlane.
Exterlor work autho�lzed by d bullding permlt Issuod In eccordance wlth the MlnneeotH State�ullding Code must be compleled wlthln 980
deys of permlt leeuance.
.
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AppltcanYs I'rinted Wame Appllcant's Slgnature
Page 1 of a
02/1912014 12:37 Les Jones Roofing, Inc. �N{�528817009 P.0181020
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� For OHlce Uso �
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, • j Permil#: `°� �� I
C�t� of ���an �i l.i�°��� ' �
� Pertnlf Fee: �
3830 Pllot Knob I�oad � Date Recelved: �
�agan MN 66122 F�B � � 2�')j� � I
Phone:(651)676.6676 I steff: I
Fax:(651�676-5694 . � �
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20�4 RESIDENTIAL BUILDING p�RMI�P�ICAT�ON
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pate: �Cl Site Addr�e: S/D� O �! Unit#:
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'��:•�+��9�b,t�°"��• '�¢`�`a�'���?'�� Applicant Is: Owner /� CrOflli'OCtOf
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'�;,:.;�, „�:,. ';;; -_;�, Consvuction Cost: 3� �9 �r Mulq-Famlly Bullding: (Yas x J No�
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s � ,1����.�r r. LlGPQZG! _ �
�ti;�r� �' '' �'�^�r:� Address: 9�/ W. �d S°lR�T' Clty:
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�a„r� �l d'��.:A�a pL'11,j�� y(��'sI,� ' �/` ' �1 ^
a`,if,1u'1�Jfi3y.� 7i��.r,.:r,,G..`o3('.��° J^tfltA:� �t�zlP: .7J �.C� Phone: .9�5.�� 7�0 �"01��7
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':?;'7�'�;.:i;;;tt'a;��'s;�;,�,a�...a;�'�> Llcense#: �Sr(o� Lead CerUflcate tF: .UA�T �f0 3 7.7—/
If the proJect is exempt from lead certiflcatlon, please explein why: (see Page 3 for addltional Information)
COMPLETE THIS AR�A�NI.Y IF CONSTRUCTING A�IEW BUILDING
In the laet 12 months,has the Clty of Eagan tssuad a permlt for a sfmllar plan baaed on a master plan? ',
��
_Yes _No If yes,dete end eddress of master plan: I
I.fcensed Plumbe�: Phone: �
Mechanlca(Contractor: Phone:
Sewer&Water Contractor: Phone:
,� . ! ( ''u . � �:A' �wtuatil�ai D� �w i� .V^..
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CAI,�,B�FORE YOU DIG. Cell Oopher 9tate One Cell et(661)464-0002 tor proteCGon daainet underground utlllty damage. Call48 houra
bAfOre you Intend lo dlg to recelva IoCelee Ot tN1d81'�rO11114 Ulllples. www.aooheratsteonecall.om
I hereby aaknowledge thet thie Informellon le complele anQ pccurele;lhat the work wlll be In con/orrnence wilh the obinenCes end codee Of the Clty of
Eagen; (hat I underatand thle le not e permlt,but only an appllcaUon(or a pennll,and work le not to start vulthout e permit;thel the work will be in
accordance wilh the approved plan in the ceee of work whlch repuiree a roview and approval of plane.
�Xterlorwork authorized by e bullding permit 186Ued(n ecCOl'danCe With the M1111196otA&lale Bullding Code must be completed w(fhln 180
dey5 of pArmit lasuanco.
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Applicant'e Printed Name Applicant's Signature
Page 1 of a
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA161573
Date Issued:06/03/2020
Permit Category:ePermit
Site Address: 4094 Durham Ct
Lot:110 Block: 04 Addition: Diffley Commons
PID:10-20450-04-110
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 -
Angela C Engelhardt
4094 Durham Ct
Eagan MN 55122--213
(612) 703-7223
Southside Heating & Air Conditioning
10808 Normandale Blvd
Bloomington MN 55437
(952) 884-2453
Applicant/Permitee: Signature Issued By: Signature