1912 Glenfield CtDate:
City of Evan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
/00/641
Use BLUE or BLACK Ink
ce`
Permit #:
Permit Fee:
Date Received:
Staff
2010 RESIDENTIAL BUILDING PERMIT APPLICATION
4051/ yos4 4.951 1106o 8f.vft DA -4i /Lobo
l0/20 �Q Site Address: /910 / 9/01 /9/y ti -/9/6 G'teNFIG`ZQ Coi,ir-
Tenant:
Suite #:
RESIDENT / OWNER
Name: 0 PRO PC3TI CARE 1N C. • Phone: (o Si- 5-S`/^ 99V9
Address / City / Zip: Po. BOX Zi z 5 (Nve-g 6/Love 7/E76Hrs1 /1.10 55026
Applicant is: Owner X Contractor
TYPE OF WORK
Description of work: REMOVE .4A/D //Ep4R - SN/N( tp ,t.0p0e7
Construction Cost: i$ .21 O 60 Multi-FamilyBuilding: (Yes / No )
CONTRACTOR
Name: BFI fXTER-IO[? MSFINT: CoeP License#: o2001g1//3/
Address: q05 14. 60th STfZE Y City: Ail INIibW'au.s
State: M w' Zip: 5-sqo Phone: 6/ 2 - 8(01- 6g1/3
Contact: PAI4L- M • Email: /h -r > t bei X -M . 601
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.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities. www.00pherstateonecall.orq
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
accordanceor�n"with the approved plan in the case of ork which requires a review and approval of
X GMe r s a72 So
Applicant's Printed Name
Applicant's Signature
Page 1 of 2
City of Eaaall
3830 Pilot Knob Road6�, D
Eagan MN 55122 ��
Phone: (651) 675-5675 i1 t� ia�i
Fax: (651) 675-5694 \30-
Use BLUE or BLACK Ink
;Office Use
Permit #: /, o c337
0 0,
Permit Fee:
Date Received:
Staff:
1 2010 MECHANICALPERMIT APPLICATION
Date: 7 -6 - i d , Site Address: / 7/ 2 ' 6 (ei' F-7:Gf(
Tenant: t i iTc:'CTO Weet--4l�,
Suite #:
J
RESIDENT / OWNER
""' =�" --tet
Name: =" t' Phone: �!o y/d, voY4ej
Address / Cit / Zi -- = _
-- ii..rwiiv..�— -
CONTRACTOR
Name: I 'CCC \5', C."/�� '� � License #:
Address: 3(a5% Clle5 1AL 'S\ City: �Jk2,
State: ip
, Phone: 9-3 o `4//c 9104S
Contact: Email:
TYPE OF WORK
New Replacement Additional Alteration Demolition
Description of work:
NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened by City
Code. Please contact the Mechanical Inspector for information on permitted screening methods.
PERMIT TYPE
RESIDENTIAL
X Furnace
COMMERCIAL
_ New Construction Interior Improvement
Air Conditioner
_
Install Piping Processed
_
Air Exchanger
_
Gas Exterior HVAC Unit
Heat Pump
Under / Above ground Tank (_ Install / Remove)
_
Other
_
** When installing/removing tank(s), call for inspection by Fire
Marshal and Plumbing Inspector
RESIDENTIAL FEES:
$55.00 Minimum Add-on
or alteration to an existing unit (includes $5.00 State Surcharge)
burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) $ TOTAL FEE
$95.00 Fire repair (replace
COMMERCIAL FEES:
$75.00 Underground tank
$55.00 Minimum (includes
installation/removal OR
State Surcharge)
$10,010, surcharge is $ 5.00
surcharge increases by $.50 for each $1,000 Permit
Fee requires a $ 5.50 surcharge)
Contract Value $ x 1%
= $ Permit Fee
- If the Permit Fee is less than
Fee = $ o e Surcharge
- If the Permit Fee is > $10,010,
(i.e. a $10,010-$11,010 Permit
_ $ ,• ® • —
TOTAL FEE
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection agejp
before you intend to dig to receive locates of underground utilities. www.gopherstateonec orq
I hereby acknowledge that this information is complete and accurate; that the work willt; iern co
Eagan; that I understand this is not a permit, but only an application for a permit, and wo {(is not
with the appy ved plan in the case of work which requires a review and approval of pl
'efe
Applicant's P
FOR OFFICE USE
er• ound utility damage. Call 48 hours
ce with the ordinances and codes of the City of
witho t a permit; that the work will be in accordance
eviewed By: Date:
Required Inspections:Under Ground Rough In Air Test Gas Service Test In -floor Heat Final
Exterior HVAC Screening Inspection
SEWER & WATER PERMIT
CITY OF EAGAN
3830 Pilot Knob Rd.
Eagan, MN 55122-1897
DATE 9-18-91
OFFICE USE ONLY
METER # PERMIT DATE 12/04/91
CHIP #
METER SIZE
ISSUE DATE
PERMIT # 12415
B.P. RECEIPT # C 15423
B.P. RECEIPT DATE 09/17/91
PRV BOOSTER PUMP
4054 4056 4058 4060 BEAVER DAM RD
SITE ADDRESS Jacitgrxmlba. 1910 19121914 1916 CEFNFTFTn CT
LOT 1 BLOCK 2 SEC/SUB DIFFLEY COMMONS
SEWER
APPLICANT:
ADDRESS:
CITY, STATE
PHONE:
PLUMBER:
ADDRESS:
CITY, STATE
PHONE
The Rottlund Co.
5201 East River Rd.
Fridley, MN ZIP
(612) 571-0304
Valley Plumbing
610 Creek Lane
55421
Jordan, MN
(612) 492-2121
ZIP
55352
OWNER: The Rottlund Co.
ADDRESS: 5201 East River Rd.
CITY, STATE Fridley, MN ZIP 55352
PHO E- ( 612) 571-0304
� W SFa PROCESSI
PL AS LLOW O ORICING DAY FOR R CESSING. CALL 454- 220 FOR INSPECT ONS. FOR STORM
SEWER PERMITS, CONTACT ENGINEERING DEPT. � t ret4) e r 1 r
PERMIT REQUESTED
WATER TAPS
COMM/IND RESIDENTIAL
X NEW
EXISTING
Lawn Sprinkler Meters are to be Installed
d of Domestic Meters on Water Line.
t WILL NOT - gken for Deduct Meters.
I AGREE T
EAGAN 0
CI MPLY WITH CITY OF
INANCES
SIGNATURE WHEN METER ISSUED
06/17/2014 15:04 Les Jones Roofing, Inc. (FAX)9528817009 P.002/020
City of Eagan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (661) 676-6675
Fax: (651)675-5694
Use BLUE or BLACK Ink
For Office Use
fZ3'33
ziK51).
Permit #:
Permit Fee:
Date Received:
Staff:
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
I1 t0- 1912- /9I4- /9/4 Leta -WI exa G60J0-1-
Date: /a/!ill Site Address: 90 S-4/ 4e - - 4ps8- yo, /3E,sv Aam 12emte
Unit #:
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1, t, ;
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Name: Flo Peof 7'V C.4i?.E t:NC-- P 4S7-
hone: S,f"4l 99Y9
r
Address / Cit / Zip: ' o• $O k 2 v / vd 464,E , 4' o to
Applicant Is: Owner x Contractor
'' .. '
` 1,s"=1,�
�.::, iil� v JI1I:• .� Via'`',; j:
, sur ;'.; ?'-: :, ,, :
Description of work: Q6ittO � .f-o£$oGAG 51.9m/b.
Construction Cost: $ 2g 449. 15 Multi -Family Building: (Yes x / No __,
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Company: 5 tTpN63 ApoF/it/� / Contact C'�,12.r s
Address: 9 `l / IN. d'0 T S'Ri'
i7"' City: Je4 a u-N�A/
State: /'W Zip: ,ffVV 2D Phone: 9S2 - 74 7 - 018/9
License #: ���0 Lead Certificate #: .UA -7— YD 3 9R -/
If the project is exempt from lead certification, please explain why: (see Page 3 for additional Information)
In the last 12 months,
Yea No If
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
has the City of Eagan Issued a permit for a similar plan based on a master plan?
yes, date and address of master plan:
Licensed Plumber:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
Phone:
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1.,
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\..{.� s, :'.... .A 0, : i 4 rr,..e♦ .,Y,y:.i �i`Wq.0:'Tadto#k. l..cr� y.�'" 4.. �. :.�n..F,i..j..,r 1y {'.
n.t,;:!. _o.i.ir:ia;`u. ti.,t1^>.i: \rl',C.c;,.::�4.0%� d��..�C. ?Qv.@�;_Mir.`.,•:FhiY'a.!!ra:�;!...;h'.n:
�,.
'
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 utilities. www.aonherstateonecall.org
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, end work is not to start without a permit that the work will be In
accordance with the approved plan In the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit Issuance.
x Cikis I10672.5dA/
Applicant's Printed Name
Applicant's Signature
Page 1 of 3
02/19/2014 12:31 Les Jones Roofing, Inc. AK)9528817009 P.0021020
Date:
City of Eaaali
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675.5675
Fax: (651) 676.6694
RECEIVED
FEB 1 9 20V4
Use BLUE or BLACK Ink
For Office Use
Permit #:
Permit Fee:
Date Received: _
Staff:
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
1110, tgi2, /9iy, 0/4GLeA.Fi� GvL�er
494/9 Site Address: 40.514NDSAe 4ion* 4/ 040 BeAveR . ROAD
Unit #:
jJ
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;�� ;>. i i; s. �:►'y
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t
Name: yo PleoP 2rV C.46, l NG. Phone: 457— SSS 94`/9
Address / City / Zip: Bo. Bok 212 5 /NVA72_ u.eve M 6"rao 76
Applicant Is: Owner X Contractor
/ , -� �,.;4
. 0 v4', ,,QIij p,;,
,,.a. s• 'i .,,
'. '`.'�r��...,,:" t,.. ;
Description of work: Rt`/11,p l�� ft/.12 /� �Y� L04 -e- oOJ�
Construction Cost: * 38 .5-6 3. .. Multi-FamilyBuilding:(Yes X / No
/
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Company: hes zw63— Aa.9,' i/6- hue -G Ai t.$0 /
p y_ Contact Ni2r s � �/
Address: 9/ / W. b'd TH R- (47 City: 10 c terMPgA/
State: MA/ Zip: 8-020 Phone: 9512 - 760 7 - 078/9
License #: 6s�� Lead Certificate #: Al/A-7— �Q $ %R - /
if the project is exempt
from lead certification, please explain why: (see Page 3 for additional Information)
In the last 12 months,
_Yes No If
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
has the City of Eagan Issued a permit for a similar plan based on a master plan?
yes, date and address of master plan:
Licensed Plumber:
Mechanical Contractor:
Sewer&Waterontractor:
Phone:
Phone:
Phone:
'•,,,,,9}+tIugPN 6#5ii#It y etiMyY p8 :` ijdy 0 5,49 +pUr•./ifth�n t """ ".
or
-$ 04.10. afru+1;y0171f4^01Itelai.tev P,A' `eo . �.I-tow 1,d� (4 . -4
'�,�.. M_hJkR:14 ,!�. 4 .ayih .l,;4'er06�/�, A 4_�Jr;7,p444,0�, lAs• :� ��Y4n.. :I�;4Nxfy4.5
CALL BEFORE YOU DIG. Call Gopher State One Cell at (661) 464-0002 for protection against underground utility damage. Call 48 hours
before you Intend to dig to receive locates of underground utilities. yvww aooherstateonecalLorn
I hereby acknowledge that this information le complete and accurate; that the work will be In conformance with the ordinances and codes of the City of
Eagan; that I understand this la not a permit, but only an application for a permit, and work Is not to start without a permit; that the work will be In
accordance with the approved plan In the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota Slate Building Code must be completed within 180
days of permit issuance.
x C ll-A1S 4#0672SO4/
Applicant's Printed Name
Applicant's Signature
Page 1.of 3