4058 Beaver Dam RdRESIDENT / OWNER
Name: /0 P2o PET. CA RE 1/.3c. Phone: (2S I- CS -• 9949
Address / City / Zip: P 0- BOX 212 5 ( VE'E 6aov6 ?'h7G HTS NA/ S50 6
Applicant is: Owner X Contractor
TYPE OF WORK
Description of work: REMOVE .-CVD /16 5�/N6Gel? )e00 A:"
Construction Cost 1$ Z/ 0 00 Multi- Family Building: (Yes / No )
CONTRACTOR
Name: BEI EXTEf -IQg, M 4l/UT: CO,ry p. License #: o2 W /3/
7 City: lNN("frJ
Address: liar W. 6 sTI2t N(
State: M ft/ Zip: 55 q (' Q Phone: (D! 2 - n 1' 6 a I / 3
Contact: P L (4 - Email: /Jo t bet KM • (AM
COMPLETE
In the last 12 months, has
Yes No If yes,
THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
the City of Eagan issued a permit for a similar plan based on a master plan?
date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor:
Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that they are trade secrets.
City of Eaaall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
Applicant's Printed Name
Applicant's Signature
L
F;.or Offir�e 1-
Permit #:
Permit Fee:
Date Received:
Staff:
/LID /l 13
Use BLUE or BLACK Ink
2010 RESIDENTIAL BUILDING PERMIT APPLICATION
1 1.05V, *so, 4058 1 /0440 8E4vEa2 n444 404
Date: l0/20 /PO Site Address: l /O, / 9 /0 7 ; /9 /9 * aLE JI 5Zp Coo le,7
CALL BEFORE YOU DIG. Call Gopher State One CaII at (651) 454 -0002 for protection against underground utility damage.
CaII 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.orq
e
qe,
Tenant: Suite #:
I hereby acknowledge that this information is complete and accurate; that 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 . __, without a permit; that the work will be in
accordance with the approved plan in the case of<Nork which requires a review and approval of
x r Res ,4,O72 So
Page 1 of 2
SUB TYPES
Foundation
_
Single Family
Multi
01 of Plex
_ Accessory Building
WORK TYPES
New
Addition
Alteration
_ Replace
_ Retaining Wall
DESCRIPTION
Valuation
Plan Review
(25%
Census Code
# of Units
# of Buildings
Type of Construction
REQUIRED INSPECTIONS
Footings (New Budding)
Footings (Deck)
Footings (Addition)
Foundation
Drain Tile
Roof: Ice & Water Final
_ Framing
Fireplace: _Rough In Air Test Final
Insulation
Meter Size:
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
_ Fireplace
_ Garage
Deck
Lower Level
Interior Improvement
Move Building
— Fire Repair
4 Repair
TOTAL
DO NOT WRITE BELOW THIS LINE
_ Porch (3- Season)
_ Porch (4- Season)
_ Porch (Screen/Gazebo /Pergola)
Pool
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
_ Siding
Reroof
Windows
Egress Window
Reviewed By: , Building Inspector
— Storm Damage
Exterior Alteration (Single Family)
_ Exterior Alteration (Multi)
Miscellaneous
_ Demolish Building*
Demolish Interior
Demolish Foundation
Water Damage
*Demolition of entire building — give PCA handout to applicant
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Sprinklers
Sheetrock
Final / C.O. Required
Final / No C.O. Required
HVAC
Other:
Pool: Footings __Air /Gas Tests _Final
Siding: Stucco Lath _Stone Lath _Brick
Windows
Retaining Wall: — Footings Backfill — Final
Radon Control
Erosion Control
Page 2 of 2
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SEWER & WATER PERMIT OFFICE USE ONLY
CITY OF EAGAN METER # PERMIT DATE 12/04/91
3830 Pilot Knob Rd.
Eagan, MN 55122 -1897 CHIP # PERMIT # 12415
METER SIZE B.P. RECEIPT # C 15423
DATE 9 - - ISSUE DATE B.P. RECEIPT DATE 09/17/91
PRV BOOSTER PUMP
4054 4056 4058 4960 BEAVER DAM RD
SITE ADDRESS Zigigxxiibi 1910 1912 1914 1916 GIFNFIETI) CT PERMIT REQUESTED
LOT 1 BLOCK 2 SEC /SUB DIFFLEY COMMONS
SEWER _X__ WATER TAPS
APPLICANT: The Rottlund Co.
ADDRESS:
5201 East River Rd COMM /IND _X_ RESIDENTIAL
CITY, STATE Fridley, MN ZIP 55421 X NEW EXISTING
PHONE: ( 612) 571-0304
Lawn Sprinkler Meters are to be Installed
PLUMBER: Valley Plumbing :.d of Domestic Meters on Water Line.
ADDRESS: 610 Creek Lane : •t WILL NOT • gken for Deduct Meters.
CITY, STATE Jordan, MN zip 55352 . !
PHONE: (612) 492 -2121 ■
1 AGREE T C • MPLY WITH CITY OF
OWNER: The Rntt1und Co. EAGAN 0" IINANCES
ADDRESS: 5201 East River Rd.
CITY, STATE Fridley, MN Zip 55352
PHO E: (612) 571 - 0304 SIGNATURE WHEN METER ISSUED
PL S LLOW Q WORKING DAYS FOR PROCESSING. CALL 454-5220 FOR INSPECT ONS. FOR STORM
SEWER PERMITS, CONTACT ENGINEERING DEPT. S' c;a e r '` /
06117/2014 15:04 Les Jones Roofing,Inc. �AX�528817009 P.002t020
Use BLUE or BLACK(nk
�---------�-------_�
� �or Offlce Usa �
, ' j Permlt#: � v�� ✓ _ j
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C��� 0 ���� � Permlt Fee: �J °� I
3830 Pllot Knob Roed � �
�agan MN 55122 � Dele Received: �
Phone:(661)6yG-6676 I I
Fax:(651)676-669a I Staff: I
' � I
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2014 RESIDENTIAL BUILDING P�RMIT APPLICATION
i 9�0-i R/Z-/9�y-/91G �r.suF�a�0 Gat��T
Date: �/!7� ��( SlteAddress: tiuSH-4osG- 4ass- yoEr, l3�,su� oaa, ►�os►� Unit#:
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,`"';�,�"; „ `, �'"`:,• Appllcant Is: Owner X Contractor
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' �:,� s i�'� Descrlpdon oiwork: /QFitlov� ,¢,yo �6o�AC� ��Dii✓h,
,±�r �'�o.�:�,1�s�lr�,�;
,���i�µ .4��f1�..•(,;,.`,1'.
'.!rs;:`��>�°-;��'=;:;�����;�,;;�<<y Const�uction Cost: �2W 449��s Multl-Family Building: (Yes x /No�,
:I"'.^�f/:;4J..'.,K.."•);�\�.. •.�Yhr.'.
;'� �'° •�!��,� `���1,:� Company: �E5 �T'an/63 R�FI.✓lr /�vG Conteck Gs�i2�r s f�-�vo�2.so�/
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'`���;s:��;`;r�';::;"=�r;�' �;ia� L1ce�se#; �.��oD Lead Certlflcate#: .U.4T YD 3 9�--/
If the project is exempf from lead certiflcatlon, please explain why: (see page 3 for addltional information)
COMPLET�THIS AREA ONLY 1F CONSTRUCTING A NEW BUILDING
(n the(ast 12 months,has the Cl�y of Eagan leeued a permlt for a sim(lar plan based on a master plan?
�Yea �No If yes,date and address of masher plan:
Llcensed Plumbe�: Phvne:
Mechanlcai Contractor: Phone:
8ewer&Water Contractor: Phone:
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CALL BEFOR�YOD UIG. Call(3opher 3tate One Call et(661)464-0002 for protectlon agalnst underoround utlllly damage. Call 48 hoerre
before you intend to dig to recelve lOCales ot underpround uillltlee. www.aaoherslstaonecall.org
I hereby acknowledge lhet lhlc IMormallon le compl6te end ECCUrete;fhat the wOrk wil►be In conformance with lhe ardlnanaas and codes of lhe Clty ol
Eagan;thet 1 undarstend lhls Is not e pemtil, but only en 6pplicetlon for e permlt, end work Is not lo start wllhout o potmlt;that Ihe wotk wlll be I�
accordance with the approved plan in►he ceae of worh wl,lch requires e review and epprovel of plans.
Exlarlor work authorizad by a butlding permlt laeued ln eCCOrdance wlth the Mlnnesota 3tata eutiding Codo must ba complotad wlthln 180
days oi parmit 186udnCe.
x G/�Rrs l�MD6T25'O,V x ����` .G���c�-�r
Applicant's Printed Name Appiicant's Signature
Pege 1 of 8
02/19/2014 12:31 Les Jones Roofing,Inc. �A�9528817009 P.0021020
� Use BIUE or BLACK Ink
� i Forofflcouse---------�
. ' � j Pemtit#: ����� j
C�ty of�a�a� � Pertnit Fee: ���- �
R�cEivEa �
3830 Pllot Knvb Road � ' �
Eagan MN 56122 � oete Received: �
Pt►one:css��s�s.�e7s �'E81 9 20i�
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2014 RESIDENTIAL BUILDING PERMIT APPLICATION �
/� 19 io, �q�2, �9�y, r9�6 ��✓�i� Gv��er
Date: � % � Slte Addres9:tiOS�NDS� OS8 4/Obo E 1� Q Unit it:
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'� ��� � ' �' a��s� ��; 'a� Construction Cost: 38 ,5—' 3. Multi-Family Bullding:(Yes x /No�
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If the project is exempf from lead certlflcatlon,please explain why:(see Page 3 for addltlonal Ir�formation)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 manths,has the Clty of�agan Issued a penntt fvr a slmlla�plan based on a master plan?
� _Yes tVo If yea,date and eddress of maeter ptan:
Ltceneed Plumber: Phone:
Mechanlcal Contractor: Phone:
� ,
SeWer&Water Contracto�: Phone:
`' "?'�' �������Pb`�' 'op[� X�l� t�, �' '.s;i�' i�;a R"' ��,'e�'a1'' �.: e�•,. '�"�;a � �id�i' :P'"�,. ���
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CALL BEFORE YOU DIG. Call Gophcr 9tete Ono Call at(661)A64-0002 for protecllon egalnst unde�ound uU�ty demage. Cell 48 hours
before you In►end to dIp to recelve locetes of underpround uGlltlee.
1 hereby acknowledae that thle Informetlon le complete end accurate;that 1he work wlll be In conformance wl�the ord�nences end codes of the Clty of
Eegan;that I underetand tnle Is not a permlt,but only an appllcat�on for e permll, and work Ie not to start wilhout a permlt; that the woric wlll ba In
eccofdenCe wllh Ute epproved plen In lhe csae of wortc whlCh requlre9 a rBWew e�d�pprovel of plens.
Exterlorwork authortzed by e bullding pennit Isaued 1n accordence wlth the Mlnneaota Stete Bullding Code must ba completed wlthln 180
deys of permlt 19sua�ca.
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Appllcant's Printed Name Appllcant's Slgnature
� Page 1.of 3