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4122 Arbor Lane þýüýû ÿþþ ýüûúûúù øýýþþùúúö ö ñ å ÿ ÿþõ úù ø÷ öý õ ý öø÷ ô ó öý õ ý ò úñ ò ø÷ òýùðýù ú ýôù ï ôù úñ þ î í ï þýüýû ì ëöúêéöõèç æåæå ôø úù ýü ìä çæ ãæã óüòü õñð ÷÷ý á ý÷ù üï ýøú ïæûà ý þýüýòô þýüýòô ë è øýó ü ý ýâ ý ý÷÷ýý ý ý ðý ýýü ÷øó ýý÷÷ý úý ðò ýúýù ýáøðþýüýíý æ ÷÷ýé úüýù ù øúüýù 0512312014 11:27 Les Jones Roofing, Inc. TAX)9528811009 P.0101016 Use SLUE or BLACK Ink ^ y For Office Use I j Permit ~ g` g 3 j City of Eqan ( r 1 Fee: 15-71.-7_45 Perot t 3830 Pilot Knob Road Fagan MN 65122 Date Received: (1 Phone: (651) 675-5675 I I Fax: (661) 67MB94 i Staff: 2014 RESIDENTIAL BUILDING PERMIT APPLICATION Date: S11 Site Address; 4120- q1 Z.'2 - qI2$-q 124 ~ -a LAAi ko""' Unit Name: yo m-E Aizaoas As hoc. ~e-Ar x,A-- #4 hone: to Sj- 4O-S- `a_5' C r.' Address /City IZip! _ H~9RBoQ . Ggf`faF Applicant is: Owner X Contrector Description of work: F-VA-4 b VC AWA /LEDc.3ce Construction Cost: ` 3 -2 Q r X Multi-Family Building: (Yes / No Company: ArS ToNg3 q~ofiallr &mc. Contact: d::'mat r A-NDE72so&/ Address: 9 Y / IN. go"' orAzzm- City: &e416lA61-22A1 r' State: Mn/ Zip: - ,~,f <`2a Phone: 95-A - 74 7 - AW _ License D Lead Certificate .VA-7- qO 3 'PR If the project Is exempt from lead certification, please explain why: (see Page 3 for additional Information) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan Issued a permit for a similar plan based on a master plan? _Yes _No if yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: r CALL BEFORE YOU DIG. Call Gopher State One Call at (661) 464-0002 for protection against underground utility damage. Call 48 hours before you Intend to dig to receive locates of underground uglltles. www ooaherstateonscall.ora 1 hereby acknowtedge that this Information Is complete and accurate; (hat the work will be In conformance with the ordinances and codes of the City of Eagan; that I understand this Is not a permit, but only an application for a permit, and work Is not to start without a permit; that the work VA be In accordance with the approved plan In the case of work which requires a reYlew and approval of plans. Exterior work authorized by a building permit Issued In accordance with the Minnesota State Building Code must be completed within 980 days of permit Issuance. ,Crs AV06I20-t7,J x roz' de, e Applicant's Printed Name Applicant's Signature Page 1 of 3