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4076 Durham Ct 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 I 1 �------_r.__...____...a 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#: • •• �•�'.:�.-'x '�:f'.:• : .� i ..._:'_.:\:—i�•'' )'���. ,'�"''1'� �;���`c���:"': - Name: yo P2oPe�TY �A-�E ING. Phone: �S!- SS�/- 94�/9 , "�.;`'i,:;�'i:'.r.ti:,..'::i;�'-;;;�':;;, ,�,;;;,.y :�;1'e.>,��,���d�nti,�•., � :;:, ��,:�;;�;,�,�j1� �`�;`' Address/City/Zip: 'R o. 63o x 2�z 5 /NV�x.L�✓�s ���,�r. R� 6s'� 7� �'.;,•.;F': �„1�,. ;:�.�a�! :.���` •';'.t ,;';1�:.,• J'•r, �" ''' ��� '''�'`�`��{� �"' Applfcent is: Owner x Contrector ��:' �9t;;`.� '�?ti'�. 'ir; �:��;�'��'�`':�:.: .:;.... ,:�:,� , . ;:;'r�,�,"��i�'...: � ..,._5.;,;�;;;�;; �;;�.-,:,,,:,:::,,,:;;..�, b2Ltorr� f�iri0 ��GAe�" �iOiN(� � , . �p �;,�,�,��.���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� ..,... ,,.,�, ;�•,,a'��.,,i.,.•':'t: . ., .`�,,;::'. �, � r 1 ,�f �1� , �0> �,. , � !< , Company: �ES �TaNE� RGTO�OA/f- /NG Contect:Csl�¢t s f�-n�D�ZSO,J . � ..�•r��;�; ..�ri.::i.,lr`i�;�:.�;..°t' ;,�,,,_-rs„�.�•..;.y,p;,,��.:';r:,:,i:�'��:`+ r:;, ,:-•,. .,�w<?� ''`� Addrese: 95l/ (A/. d�0� S�"/�-�'�~' Clty: �i,n�2u�r�'b�✓ :'''�µ''�',q�1tl(?'��`,ar' ,n �<;:;�- .,;..;::��� z�y�h;� ;;,,,-�,,:,.;<:;;',�i°;; °���� stete: �1n/ z�p: .f.��2a Phone: 9�5�- 76 7-a8/9 'V:a.:� '2i:a:���:;'e�r;l,�;° ,°j�"�' �:"a '�W"�•. �j j '�,(�) '.''� ..;f.`; ;%��: : ,'���� �- -�" l.lcense#: �vS�� Lead Certlficate�: .UA�T ''f 0� ��-� .•/�.i:' 1'I(..����"'�� __ 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: � .'�,: � . :��:�� � p�: t .���:, _ � i`„ � .� re n t �.,..�p b P,. �R � �,Q� � � t a � / I K � � t �i �� Y ,��/ .:w �,�"`�'l� �=17 K I' `^ 1 ;�� �h�litifo�m$�i,bt���i;i��!'�e�1 s�fl��l����1,c�h'►�,�It r�'yo'N� KttYYd�i� �31f�, r� g�/�:s`�t t���u1�dpQr°iflit,'•��ie}���y�b ,' ^ '.`t...�� . .,.1,. .,a...�^,�. . . J� ! �, i h 'A c,r •.. .6 �3: ! <,;�n,+! �.w�a ��i,,.,... S�g'. �:,. ' , ' ,t .a. �•:4.�y•�yi i.� �.C.; '�L:.� Qi ( �,•. ,�.,� •�. ,,,�,. ,.t,, ra;�'a�'.�5;;;: ;'.,1. � '.�' �. ..�"� r o;:,:s2:'.�lJ�;;�,.s ,.f;. .�_•,'<?,;; :�•� •��.�. i.,(' f �.� � S �", -.r; '..hl:�.`•,; ,ti5. .;t.;�.r ;.. '_v.fFi. ri`' .�..� �� •'t .��• � �� i 'l�..�"a. ,:y::ii..•.' !%'u.;"�a. ,,..' •... :,{C,•,:� � , A �,l ,�,• . �, . " .� � .,,,....: .. <:.: .r:ai:: ^.:..� .,n'.;rr{;,,e.,s,l;1:i.,..\.:)�:1�' '��f.C,Y'.(4M Y r.� S. .n.•��!< ,4... ..t.. Sl�:.L:".r:,..�•.lr•�"7.+'�'. .. .. . ... � .. ,;:a�...:.i . . 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 ;.,..1- � T� �.'.i'. 51 .t{ ��� �1�'�!" �.�r_r. �N a� �� `��'!'�'��1�'�:�r�� ,`;,,� Address/City I Zip: �P-O. �o K 2t 5' /NV�2��t ., .,:. .w�r'- y�:' .; ., .,. � ;1.�':. r,,.��� �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 ' .i. � . ...r,6:, / ''�.,�j`>tij-�•:•'"�":,:t,,`��,� Company: ,�ES �T'aN�3 R[�f�Nlt- /•vG ConEac�t: Cs�ier s fl-�o���/ ���r�� a �° �a �v�' ,'a�� .j��,�;�...,'�k.��� rl � . � ...� ";.. N Q . `�%''� �a ������'s�'?��r�k Address: 9 Y l �l/, 8D� S°!"/LE�T' Clty: piGOA2t�.t2�r7��✓ -`�>�� n�"i��tQr:>�,,, 'E �b•�:. z�r,,.,,�•�,-�t� ♦ 7- 8 9 "^���`4�;y,*� 'r�, ���,���� �� � S�le.^ ��ZIp: .f,fk�2o Phone: �SA 7(0 0? / '�' 1�x ,+�.,� , c�r�'iti i � . i�i.` E�:,..c � g'•>� d +�"' . .�' 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�-. N� �. , �.� ;� , � .; - y�,.^ ;,. qr �;: � � � � ,�. 4,,� �,,.: �;, ,. ,y ��«j'�� �����. ''��k�,.,:�� �������`n ��'���la�;� ��r��v►- � �p��������°�,�. H��%k��►!� ,rR ..,�_...►�;tr;�. '.:r��,��:`` � � �.�. r . �. ,i � �4 � .�F �:�' :., .�,. ..>.+�M.ro x,- �..��'•.r. . ,�; . . , ,., . -� , A - :. ��,k , 9 .. ; � . ��i r„t...F:!'��i��llit al:r. .. I.. .z,. `,..�1.',wc*u. ��' �r. -�ti 4..r.. u.��.� �1� yti"'� ��� .P:,.'��a r,i;�o:� .J _ _, .i . 'C � �� e�R ..• �' ,.,,, =' ' �:. 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