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4134 Durham Ct 06/17/2014 15:07 Les Jones Roofing,Inc. �AX�518817009 P.017/020 Use �LU�or BI.ACK Ink � ForOffICeU9e`� ` ^'^f—^� . . ' j Permit#: �✓� ` � 1 C�ty of�a�a� � Pertnit Fee: � . � � 3830 Pllot Knob Road � � Eagan MN 65122 j Da1e Recelved: � Phone:(651)675-6675 I 1 Fax:(6G1)675-6694 , � S��: � `���������������_J 2014 RESIDENTIAL BUILDING PERMIT APPLICATION �iza- y��� � y�ay�c/iab— cf�28' nete: I? / srte AadreS$; y13D-��3� - 4��,��1 l'�v�2�,� Co�,� un�t�: .:,:, ..,.. ;:,,�..;.,:: ,..�;r`:';'r'fl'.t:'.,���'��/�.!��'�',ic��:�`� Name. �0 P�eopd2ry �R�Ei � �y "i,...�;•r .�,�,: �'�, •., NG. phone: /oSl� S� 7�yq �,a:;`;:"�;J,��:S'ISI.s,I1�/;;��'�`'�;; `�;��i,>`'::���.�W`f��l'';;,' '<��'- Address/Clty/Zip: 'P o. 6o x 2�2 5 /Nv�Cx,e.ov� �ZlQ,�►� lt� a�'�' 7� ;c. .,,..,;�;: T i�`;.i,-�.��;?i��-;?t:.H1,:'.': -;.`�''1`�'. ;'�, �?,f, ���' �,n` .�c,�,�`,;? AppUcant is: Ow�er x Contractor , . . ;.",'i� �;,�,.��,..,\r.,�c::c Y� 4 � i �; �7.�."' .t � `�,� s;t�; � ,; Descrlpdon�fwork: �C�Lt012r/�D ��P�,�t.� �/D!./V� ., ���;���'``W'��'.1�;:..; 8�/ :�.> : :.;,.. :,; ;, �:A;. ',J=:`�''�:,;;,�` :��;;;; --<> Conetructlon�oet: ��0. Multi-Family Bullding;(Yas x i No`) ;:;,;, ";;;:'::.. .,:.:;�::: ;,.:::;'. �,, �,,��.;;:;; . ,.,: `.�,,,.,:%r,. .?,�,:.�;;:;�,:;?;`�,.,,;;;:. / + ; � ;� , s Company:__�ES �7'oN6S RaO��//r /NC. Contact C�iea s ,�a�so�/ ., :� � � .... ,,-..;:�;:,,•:;t..�;.,,:;;ir.;,..:..i �`�iN,'�I'�,N),,,.r.li�,\�.�:�_.;;•��:1_,.�s,4��`. � `�"` "�'� Address: 9Y l (N, g4� 9Y�� Clty: �GOt�a� ;,;,,,Cx0,11t,����.r-�•;.� � -- ,,..;::,;�E; , �;�' �;,:;;:,: �;,r�;,` c��::�°��;;;:.`;�::;;;,;�� State:,�_Zlp: ,f,f�k�?D Phone: 95�- 76 7•e78/9 , ;� ,�y;f<:i,.���.,;_;::{; vril� ,^�^/�:� ..'�'tf!.1��.��•,1�' �'�.� �;��;�i,,::�� Ucense#: /��o� l.ead Certlflcate#: .U,4T `f 0 � ��—/ ;;�-^ - If the proJect Is exempt from lead certification,please explaln why: (see Page 3 for addltlonal informatlon) COMPI.ETE THIS AR�A ONLY I�CONSTRUCTING A NEW BUILDING In the laet 12 monthe, has the City of Eagan Issued a permlt for a elm)lar plan baeed on a maeter plan? �Yes __ IVo If yes,de6�end address of inester plan, Licensed Plumber: Phone: Mechanlcal Contractor: Phone: Sewer&Water Cohtractor: Phona: :;;,�N��T ��PI n� "�l;�u �..o' ii ;.b"�. .��i ;f �f;�:o��,; f°"r�;�:°h •s.. .:,• .r.���� p��c;r`°�...,��a l� :::. �:Ytl3 s=.��. T, ;. ,,���„ ;��_�,�,, ;�;,��;�,�•�:��� -,:�'�!,� ..;��F ��;��', .;►,;�`,k,ijiil�, ,,��,�:,,;F>�l,-,:-.;,��: ;�;;�'.,.Mn.or.r� ��t�, .��, � �.�F F '�he�nf.��ii�a�i�nr�►'��y!��q`a(a��l�;�d'�;3!►,�ny,R„u��ia��f;�/.ou�':F�,���tsl�.t��fru;�l;e��a�,¢h�;rt��t l�/��/,��,$�1/�-t��'�C(fj�`ti�b -���� : ��7:'C i� (�!� � �•�ti.�r� e,� 1 t< <1�� ' c �y.,y ��i Mi�i 11�`�,; y� � �e�y �` s4t( y, �yw� j a •: ''�� ,�..t. �a e i.. ��Y:�.. � ` '� ' : :�..v ... ';'' .0�.{1Q�F/4�!.�,i,4��N!� .';�.�:�T/'A�I�'��i.k��.r� �"( .� �41 i: �lM1.: �� .�� +r�'�t�,�,�Y� � I ..�.. � x1` a �, ,� �, .S. r, CALL BEFORE YOU DIG. Cell Oophor Steto Ono Call et(661)464-0002 for pro►ecllon ageinet untlergrountl uGlity dama8e. Call 48 houre before you Intend lo dip to recelve locatee of underground ut�lltlee, www.aoohereteteonecell.ora I hereby acknowledae lhat thie Informedon le complete and accurate;lhal Ihe work wlll be In vonformence wllh lhe ordlnences and codes of tAe Clty ot Eagen;thet I underetend thle le not a pemntl, but only an eppllcation for a permit, end work le no1 to atart without e pe�mlt; that Ihe work wNi be In accarcfencewllh the epproved plen in the cese ofworkwhich reputree a review and approval of plene. Exterlor work author►zed by a bullding parmtt Issued In accordance with the Mlnnesota State gulidlne Code must be completed withln 180 days of permlt Issuance. x G<F2rs f�M0�2s'd�/ 1�"�.s� G�s.�-��-�° x Appllcant's Printed Name Applicant's Sia�ature Page 1 Of 9 02/1912014 12:37 Les Jones Roofing,Inc. �A�9528817009 P.0171020 Use BLUE or BLACK IHk •----------------- � For omce Uso � • j Pamtit#: ' ����I City of Ea�aIl � '- � � Permlt Fee:,_,��— i ��..C����CQ 3830 Pllot Knob Road Eagan MN 6b122 j Date Recelved: j i'hone:(651)6yG-G67G FEB 1 � �Si�I� i s�a�: i Fax:(657)675�694 . � � `����.�____---___—J 2014 RESIDENTIAL BUILDING PERMI�PPL,ICATION ti�ao, y�aa, v�ay, y�a� Date: l� ` Site Address: Yia�� yi3o, yi��, H/ f /,�U.2HrPsrt Cod.C7'' Unit#: a�.;.' � , ,.�>,..; ,�;<,:..,`. r��;,�;;; ,;� �. .. �:D�� ���NI�`'•I'f�/�N'y:�•�l�;�w;: Name: �10 P�eoPr�2ry c�.��NG• Phone: �sr- ss+� �'9yy �` ;i y' ) � 'f� i�� e� �AV , �/�� �^� /� .J7.'l •��"y,��K�.,. �/!/S. /�'NV r7 �P .>yiv���l•h�� �fp ` '�:� Address/Clty/Zip: �D• �OK 2l 2 ✓� /NVE12.�-0✓1 �_ � 9 :. M�.:.�. ���„�-��,�,.; ...:; •�,. �. ,'�'; '� " ',ti�Y^�' a'r , N,����;�"�''.,�:,:'�'���.,;.:�a����t ApplicanE is: Owner x ConU'actor yr,�; ��� ;.w,.q`,`,'.'z Fi �✓ �o i� m'.�'�� �9.,; v�y:'r,.(;, •':� A'�/i�'' �.5 �� ,�. ��r. Description of work: ��M� � ��%�'� � { � � ����/yps���1tl��i'��;?• p��Y�r ��'��'`�,;.' �' � '�'� Constructlon Cost: �f ��D� � Multl-Famlly Bullding: (Yes x /No� ,:2'' � ':.. �'�*.�:it'1� '�r;�' I'N ��,�y �,t � ;.�r �+��,� r �`..�,�,.�,N,'��'�; Compeny: �ES �TaNE3 Rao,�ln/fr /NG Contact:Ca�e�r� �Dr�2so .. � ,a:: ... ° ,,fj..��,, ;�� !Yt� I'. �J � 1�` ••1 ' `:� ,;, <�r:..r, r,.;, •. : � � �D� '�'� Clty: ,BG�A?�G�.t�IrTT�i✓ � A- r�' �,� address:.9�! IN. � .�.>���,�i.X��I1a; tQn-,, v,rP:1. ...: " ��.� r :"� 4.. �,p�s.,�"�'��i°�;,iJy`� state:�Zlp: .�.f��fE2o Phone: 9�SA- 76 7-a8/� E.�, r.;� ., ..: �� �. :�' ";ry' �'• y ;;�A� ;,.,F`e' ,^; ,��,;�,.,� 6��'; �f O 3 �� y;,`,. ��;1y�- �:�,.:�, Ucense#: ���o� Lead Certlflcate#: .U.47- -/ (f tha project is exempt from lead certlflcatlon, please explain why:(see Page 3 for addltlonal Information) , I COIVIpLETE 1'HIS AREA ONI,Y IF CONSTRUCTING A NEW BUILDING In the last 12 monthe�hae the Clty o(Eagan(ssued a permlt for a almllar plan baeed on a master plan? � _Yea No If yes,date and address of master plan: Llcensed Plumber: Phone: Mechanlcal Contractor: Phone: 8ewer&Water Contractor: Phone: i �+� `� ! - c y� .pr. �' :� w � �r 1. w qu, �y. 7f.�J��aFr��c;�:.� �.�d�..a, �A�.�'- � �y` ��.����'�34n��U''�N� Gi� ,r' �i�. ,i��0 .,.ep, i �/,Ot ,���P��l fy,�`i 'i Y•����� ^��f��i"'�'Ir.y��� {���RI�� ua 1 �.�a�4�ikl�vj��blrqd��� �`Gc��r�o�1�Y�� f�� ���n5,,����y��y�t7/������(�e;��'t'y�p`�:�,� � .�P.��'-,�.,iia��1�. '•` ��'";� .,.i.�i i. �r O�ll]!4�?�ti .�t��. ��� .�. i,. 1„.. S,r,'i. �7�e�'�....,M .:E,,,�!'��� d�'.�� s�� .:a t CALL BEFOR�YOU pIG. Call Gopher Stale Ono Call at(661)464•0002 for proleGlon agalnst undetground uQllty damege. Catl 48 houre before you Inlend lo dlg to recelve locates of underground utUltlee. www.aaohereteleonecall.oro I hereby acknowledge(het thls[nformatlen Is complete and aocurate;thet the wo�k wlll be In contortnance wllh the ordlnancee end codee of the Clty oF Eegen;thet I understand thls la nol a permlb bul oNy en eppltcetlon for a permlt,and work Is not to atan wlthout a permlt;that lhe work wtll be In accardance wtth the approved plan In Ihe caee of work whlch requlree a revlew and approval of plans. Exterlar wark fluthortzed by a butlding parmlt lssued In accordence wlth the Mlnneaofe Steta Bullding Coda must ba completed wlthln 180 days of parmlt 199uance. X Gµ�e�s �4�r0�2sa�l x � Appllcant's t'rinted Name � Appticant's Slgnature Page 1 of 3