4128 Beaver Dam RdCity of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 4128 Beaver Dam Rd
Lot: 167 Block: 04 Addition: Diffley Commons
PID:10- 20450- 167 -04
Use:
Description:
Sub Type: e- Windows/Doors
Work Type: Windows/Doors - New/Replacement
Description: House
Census Code: 434 -
Zoning:
Square Feet: 0
Comments:
Fee Summary:
Valuation: 3,000.00
Contractor:
Beissel Window Siding
1635 Oakdale Ave
W St Paul MN 55118
(651) 451 -6835
Applicant/Permitee: Signature
PERMIT
City of Eaan
BL - Base Fee $3K
Surcharge - Based on Valuation $3K
- Applicant -
Construction Type:
Occupancy:
Carbon monoxide detectors are required by law in ALL single family homes.
$88.50
$1.50
Total: $90.00
Owner:
Mary J Upson
4128 Beaver Dam Rd
Eagan MN 55122
Permit Type:
Permit Number:
Date Issued:
Permit Category:
Improvements to the home require smoke detectors in all bedrooms. If altering window openings, call for framing
inspection. Call for final inspection after installation.
0801
9001
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply
of Minnesota Statutes and City of Eagan Ordinances.
h all applicable State
Issued By: Signature
Building
EA091669
10/19/2009
ePermit
06/17/2014 15:08 Les Jones Roofing,Inc. ffAX�528817009 P.0201020
Use sL.U�or BLACK Ink
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C��� �� ����� � Pertnit Fee: � � I
3830 Pllot Knob Road I I
Eagan MN 55122 j Date Recelved: j
Pho�e:(s��)sy�-�sy� i �
Fax:(661)675�694 . ' I SIeN: I
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2014 RESIDEN7IAL. BUILDING PERMIT APPLICATION ,
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If the proJect(s exempt from lead certlflcatlon,pieeae explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONL.Y IF CONSTRUCTINO A NEW BUILDING
In the laat 12 monfha,has the Clty of�agan issued a pemlit for�simllar plan based on a master plan9
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Llcensed plumber: Phone:
Mechanical ConEractor. Phone:
Sewer&Water Contractor: phona:
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CAI.�,S��OR�YOU dIG, Call Gophar State Ona Ca11 at ig61)464•0002 for prolecllon against underground utllity damape. Call 48 houre
b0foro you Intend to dlg to recelve locales oi underground utllfUea. w�vw.pooherstateonecaU.om
I heroby acknaMedge that this Iniormetlon Is complete and accurete;that the work will be In coMormance wllh lhe orcllnancea and codeo of(he Clty of
Eegen; lhat 1 understand lhls le not e permlt, but only an appllcaUon for e pertnk,and wofk le nol to etart Without a permit;that the worlc wlll be In
eccordance wllh the approved plan In the caee of wak whlch raqulres a revlew and epprovel of plene.
Exlerior work authorized by a buliding permit 156ued In aecordence with the Mlnne9ota State Buildlne Code muet be completed within 180
aays of permlt issuance.
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Appllcant's Printed Name AppllcanYs 8lgnature
Pege 1 Of 3
02t19/2014 12:38 Les Jones Roofing,Inc. ffA��9528817�9 P.0201020
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�ty Of�a��� ��������� ; � ��-���-�
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3830 Pilot Knob Road
�agan MN 66122 ��� 1 91�t4 � Date Received: i
Phone:(651)675-6676 � S�� I
Fax:(661)676-6694 . � �
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2014 RESIDENTIAL BUIL.DING PERMIT APP ICATION
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If the proJect is exempk from lead certificatlon, please explain why: (see Page 3 for additional Information)
COMPLE'1'E 7HIS AREA ONL.Y 1F CONS7RUCTING A�BUILDING
In the laet 12 months�has the Clty of Eagan issued a permit for a slmllar plan based oh a maeter plan?
�Yes No IF yes,date and address of maeter plan:
L(censed Plumber: Phone:
Mechanlcel Contractor: Phone:
Sewer�Wate�Contractor; Phohe;
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CAI.I. B '�ORE YOU DIG. Call Gophar Stato Ono Cell el(661)464�OOOZ for protection againat underpround utlllty damage. Cell 48 houre
before you Intend to dig to receive(oCetas of undergro�md utlllUee. m�vw.aonherstaleonQ�all.or�
I hereby acknowtedge that thls InformaUon la compiete end accurete;thst the work will be m conforrnance wlth the ordlnences and codes ol the Clly ot
Eepen; thet 1 understend tF�e le not e permit, but onty en eppllCallon fo�a permit, and work le not to efati viAthout a permit;that lhe wortt wlll be In
eccordance wtth the epproved plan In lhe ceae of work wtikh requlrea a rovlew and approval of plens.
Exterlorwork authorized by a buliding pArmlt Isauad In accordance wlth tho Minnosota state Building Code musf ba completed wlthin 18�
days of permlt Issuance.
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Applicant's Printed Name Appilcant's 8lgnature
Pege 7 Of 3
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA139844
Date Issued:11/10/2016
Permit Category:ePermit
Site Address: 4128 Beaver Dam Rd
Lot:167 Block: 04 Addition: Diffley Commons
PID:10-20450-04-167
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace
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 -
Mary J Upson
4128 Beaver Dam Rd
Eagan MN 55122
Haley Comfort Systems
122 3rd St W
Hastings MN 55033
(651) 437-0338
Applicant/Permitee: Signature Issued By: Signature