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4116 Durham Ct 06/17/2014 15:07 Les Jones Roofing,Inc. �AX�528817009 P.016/020 Use BLUE or BLACK Ink r���������������� � For Oilico Use � . ' j Pertnit#: ���� j C�ty of�a�a� � Permlt Fee: ,� � 3830 Ptlot Knob Road I � Eagan MN 55122 � Dale Racelved: � Phone:(651)875-5675 I 1 FBx:(661)676-6694 . � S�� � I I `._.....�..�������������J 2014 RESIDENTIAL BUILDING P�RIWIT APPLICA710N 4i�a-��r� �ii�- yi�' /� � Date: �7 � Slte Address:U/3b��/�S-!�/Yo-�1i�y� ���n�l (.�,a� _Unit#: �.::.:..�.., :;,�;:�;.:4:^;;-i:..,;,: �',' ';, ' ,, 4'',�, '� Name: �lo P2op�+2ry �-a-r�E� 6nlc.. Phone: �a$�- ssy ��yq '�:;;,:E���siaentl�..;,.,,�,;,; 5�ta7 9� ',',;. ;S�i.^Q�tiyv�e� :.'� Addre96/Clty/Zlp: �D• Pp 1C 2l"Z 5 �NV�.?7-��✓�_ o}�'ls /� �����`�C:;:�: .}� �..-.y.;1,..,�'. � ,�'.^::.•.1�:�'�.,.V '':: :��:'(:..,�.: •,�•`. ': '. y'��:"',���j:.�'..: . :- . ,5y�;;,�'�::.�`�'�*�.:,`;�', �'','�"r�- Applicant Is: Owner X Contractor .. .. .��lil,• .."'4'tr:t1(." i. ��Y � � � Descrlptlon of work: ��t4t� �4y✓D �pfift^L� .7�OiN�, ; �pe�°�f����'�,,; Z .'r�, .1' '.:.: .'�.'i"•:'.lY•" �`/ ; �",� ?��" ' `:�" Construction Cost: � y?7. Multi-Family Building:(Yes x /No� :,-,+;;�,;.:"'.:.:,.�. : , , ';',`= ����...,,�;��:. H'.':�i;�"�1 ���. :'�.�::%.: . . ; � t`�,�::"'�.:;1;:�lf',':'.`�."';o��, / " '<r?"`y�'-•.' <���:, � Company; �E,S �oN�3 RGaOFl�t16- /NG. Contact:G�fiPa s r�ivap250�/ .,:-�;, ;...,,;,_,•,.:`:;,;..;,, .� ;��,, :,.,%:'•,�:.::,;. :..a:.,.'.,>, .��..<.�:� ..�., ,..,. ; .. " .4�:��t.�., �. �: -•;;.?:,;+.:;;�.;��:�.,r�;�:,�::°=ti;,.:.�. Addrees: 9Y� �N, 8l)� .�`Ti�� City: ���N�.✓ 'x.�;,:;�a�:iif�'�,�ct�r.;<`';;4:,: t:�; . ,;,.:. .,�'._ �,A�:. ,•:;,r., „,�;,::,;`�%;.� ;:� 'f::,,,: ,,ry_:; � -- State: A ln/ Zlp: .�,�'�2D Phone: 9'S.1- 7G 7-�817 . .�.-.�,;�F M1,i..i��.�.�';i� -'`e'•'. �')���i'.. h. . '�� . ' _�:'�": ,:!.��1�., '..�til`::�}��i'. �'.'''" :�.`,�: i',•h'.�� ;��- � �� Llcense#: lor��o D Lead Cerflficate#: .lJ,4T' `f p 3 7.�-/ 'F:�S..c': If the proJect Is exempt from lead certificatlon,please explaln why:(sea Page 3 for addltiona)informatian) COMpLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 monthe,hae the Clty ot Eagen leeued a pennit for a slmllar plan based on a maste�plan? Yes _No If yes,date and address of master plan: Llcensed Plumber: Phone; Mechenlcal Contractor: Phone: Sewer 8 Water Contractor; Phone: ':"„!IY.�PI�; i�'!�/ �r11 h `� !•L�h bV » Q 4 �ui~ � L.� �*'�� �� � �''(� ��.' ..:. .,��. �, „�:.�f�.,� p{,�., .��►, .l�f»�, t !� ����. ►nt��i'e ±b�►�sl'�'..:�e"'d-�o.��fa�p,;,u�'�I�<,��Qt; 11a,,�fori'i-�� o►'tq s��.'a �i°,��i���/'ttifo�`iti�i�l,ii�1.�'s�:��{�;�i�sl'��^..��%�Qf����►�t��1'rp��'�►/��lf„°`V�oi4�=•;/�!VI`d�b�;su.,l �Iftc�d1`'¢��oit5;� a;trW�r�l`J p1y•�A�����;�%I�%!e>`;�M'; Q�.�.t.:P:,:.4t.i t�i., ,f:" :�r!i•;"('.G, .J�r> ,cp, �n a ,.I, �r�.b�,•i S :d�'Yk...,,y ..1 -� ,�t1'�C, . ,.:,. .. .:,.. ':,, ..7J,,,,.7!'�.�.�,,;,n.;F:;.-,,1�...ti.� ...'y,, ��".�. ;i.,p ,�a._�. •i x` l.r;x�:\P.;.iy.�; .p.:'.>i.. f.�� :_.�;;'? _ �'r:.`P� .c.., k., r��..; :�i;i" r ';1 "c7" .1�: �,.,r..•�. ;;a �..5'�l.:{!:=�i�°'"rats>.;; ;.4, �.r� iQ.,;v1,; :r��� n 4�; t ,�""?i%� n�.... y. y:.;:r" � . . . ,.. ,., ..,, ,,.�,..: ., 7:: �°,' '(,�'y.: ,.. ,,,,...,,. --: ,� ,: � .r�t1A�,C�,� . ., .�. Y=��.� ..S'�:4�'� . , ,..... .... ,a: ,.,..,.,.....�:�......::.. ....� .. �•;..,,.:,,.. . �•�'-2�.,., CALL.S�FOR�YOU DIG, Gell Oopher State One Call at(681)464•000�tor protectlon�galnst underground uUllty damage. Call a8 hou�s before you Inlend lo dlg to recelve locafee of underground ulllltles. www.aoohare�ateonecell.ora I hereby adcnowledge that thle IMonnellon le complels and eccurete;that the work wlll be In confortnance wllh the ordlnances end codea of the City of Eegen;that 1 underetand lhls(e not a nermll,but only en eppllcatlon !o►a permlt, and work Is nat to atart wlthout a permlt;ihal the work w111 be in eccordance with 1he approved plen In the ceee of work whlch roqulros a revlew and approval of plana_ Exterlor Work autho�lzed by e bulldtn8 pemtlt leeu9d In flcCOrdance wllh!ho Mlnnasots Steta Bullding Codo must be complaled wlthln 180 days of permlt 188uanca. x Gµ2rs f�NDE12s'o,✓ x /���� G��=�� AppltcanE's Printed Name Appllcant's Slgnature Pape 1 of 3 02/19/2014 12:36 Les Jones Roofing,Inc. (FAK�528817009 P.0161020 Use BL.UE or BLACK Ir�k � For Offlce U9Q^� � I . ' j Permlt#: ���� I C�ty of �a�aIl , I Pertnil Fee: �l � � 3830 Pllot Knob Road R�C�# J�D � �' � Eagan MN 65122 j Dale Recelved: � Phone:(6g1)676-G676 ��B � � �o�� I i Fax:(651)675-5684 . � S�K� � . I 1 �--------____.__�_�a 2014 RESId�NT1AL gUILDING PERMyAPPLICATION �!//,'j, y//y �!///p, �/i/8 Date: � � Site Addreas: y/ /'1D �/ J Gat�- Unit!!: �'F���< fn� �yJ��i�:"w;;Y_���,:; �� ��r�n��?.���>,;�i^„`' Neme: yQ P20p�T`� GA�'Er 6NG. Phone. /va"'7� S.S�/ p��l�f ,��.:��1� �Itt/'-:a;'` `v�t ?���Q�%���j' ::'� `�� AddreSS/Clly/Zip: �O• 80� 212 5 /NVE)Z.C��ovd � �� 9�0 ���:���V_�i.d'li �.,M �>,`�..�.\i . k" � �' ��.�:•:��a, °'' '���`�`�'�� '�,(�p '��° Appflcant 18: Owner x Contrector :Yi� .�id:...� .�l ./?. :,.... 'e. y. Y W7 � ��1 P) � �.: F^. ,�� -� �...,, ,.},�:., � � p�m /?��� ��F -� L�a���- P� �6 ,� `,�;�;'� � �=,:- Description of work: � �/ � ����ip:���'f'VI�o:C�, '' �.., � ��'���N�;,"` " � r"`��'' 'a ConetructlonCosr � 7�` � y Multi-Famii Bulldin Yes x !No 9 �. ,;A�. �: ,.t:,, ,� �� Y 9� ( � �.y�� ., w.. '.;��G'.,y'..' •5.�...�f.$�� . �u;Y�;1 �,el...v � / ;,.; �j c�' r� ��r y� Compeny: �E5 �ToNb3 RGOf��1/G- /•vG Contec�Csri¢�s ,�-,vDp2so�/ �,��� '�,E:`�,��,r��. (��"? �j���":'ji:ib'T,, a"•l;('� ��5' rL � 4j '� �a ��`��,:T';�� �' Address: K/ W. �D� ��'� Clty: �a�tu.�.✓ .::��i�"�;����r��„� . �y,:;,.�,�, .;"'.` .���;>•. 7- �.,�•� �� ��v' '`�;;; • � State:�2ip: ,�,Sr��O Phone: �5.�- 7(v ab'/9 „���t: , , i�r?�+; :� �; _.�T�,�j�,,r�,;;�`,'�aV� ;;� ���Y"'';.� �,,;,�,.,�;�',,*. Ucense#: lp.��o� Lead Certlflcafe#: .U�T `fo 3' ?.�-/ )f the proJect Is exempt from lead ceKlfication, please explain why: (see Page 3 fo�additio�al i�formation) COMPI,ETE THIS AREA ONLY IF CONSTRUCTING A NEW BUIL�INC In the la9t 12 months,hea the Clty of Eagan Issued a permlt for a almllar plan based on a master plan? � Yes _No If yes,date and eddress of inester plan: Llcensed Plumber: Phone: Mechanlcal Contrector: Phone: Sewer&Water Contractor: Phone: ;��, aX� t� .,l � �o; �.�'h1- ►�{t;�+fh -"G;�. %�iL,S :+'� ��rr '" �} bs`� ibYf'"�r �I'" r� o}�y�t "s"fzt '��� r �i..,p .�y.-�. ,�. .rFSY• ,�, �, T� ���'�.�.�+`��.� �. .���....� .e•"N, �.. ���� � m pp �y,,/� �r ,, ��; .�c,�I�L �„C • f��,t�V � �e. Mf'.��,..a�[��i�.� �;!%{�e,;�/�.�'s�y�c.!�� c��n,,�k�,U��;j.Ili,o� p,/'��.id�s,��Q f/e�e � �ns�Q�a� �d. :r N��e1�/��t�tit# ��'tiC�l�G;�,� „�'t r � .�I i..,��"'�?;�„ a .i �d� �„A,,��`%¢� �'�. .I�fC; .s, � .a. � r„ '�'"h� ��qtii°�'�a 'Y,.�_'„' 4;�, "1� .� .,,, : . .. :.. . , c:.. . '�� � �,�`� �, �u ��y� 'f�, r:. _ ....., ... , , �:"G"�... u:n„�J.:�hr..at.., ..an�� d .fi:�.: ...r���iLM1:'Q'��.Y� ��:s. .�. SRNS4�I���.��.',�1e .,ie.., �b4'°,tl� ...�..+.��r':. !�yil.y�'i: .t9.�� CALL 6� OR�YOU DIG. Cell C3ophar 9tata One Call at(651)4a4-0002 for prolectlon egetnat undarground uUllly damape. Cell 48 houre beforo you Intend to dlg to rocelve iocates M unde�ground uUlllles. www.amohereteteoneceu.oro I heroby ecknowledge that thls InPormallon le complete and eccurate;that lhe u+rork w111 be In conlormance wllh the orcllnences and codes of the Clty of Eapan; lhat I unde�stand thls la not a permlt,but only an appllcadon tor e pe►mtt, and work le not to etart wllhout a permlt; thal the work wlll be In eccordance wlth the approved plen In the caee M work whlch requlree a revtew end approval ot plane. Exterlor work authorized by a bullding permlt Issued In accordance wlth the Mlnne6ota State Bultding Code must be completed wtthln 180 days of permlt Issuance. x Gr�,et5 f��v0�2SO�/ x��k��� .G�s�<-�' -�. Appllcant's Prtnted Name Appllcant's Stgnature ' Page 1 of 8