4111 Beaver Dam RdCity of Eagan
Eagan,
PERMIT
City of Eaan
Permit Type: Building
Permit Number: EA097321
Date Issued: 12/08/2010
Permit Category: ePermit
Site Address: 4111 Beaver Dam Rd
Lot: 24 Block: 01 Addition: Diffley Commons
PID: 10-20450-240-01
Use:
Description:
Sub Type: e-Windows/Doors
Work Type: Windows/Doors-New/Replacement
Description: House
Census Code: 434 -
Zoning:
Square Feet: 0
Construction Type:
Occupancy:
Comments:
Improvements to the home require smoke detectors in all bedrooms. If altering window openings, call for framing
inspection. Call for final inspection after installation.
Carbon monoxide detectors are required by law in ALL single family homes.
Fee Summary:
Valuation: 3,000.00
BL - Base Fee $3K
$88.50
Surcharge - Based on Valuation $3K $1.50
0801.4085
9001.2195
Total: $90.00
Contractor:
Crew2 Inc
2650 Minnehaha Ave
Minneapolis MN 55406
(612) 276-1680
- Applicant -
Owner:
Thedens Linda G Revocable Family Trust
4111 Beaver Dam Rd
Eagan MN 55122
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.
Applicant/Permitee: Signature
Issued By: Signature
ER & WATER PERMIT
F`EAGAN
PilotKrtob Rd.
,'MN 6 122-1897
METER.::# ' PEtrt
CFitP #"' PERMIT.
B.P. RECEIPT # G`' 017717
BP RECEIPT DATE '03/10/42
SITE ADDRESS 41.1 `' Dam c s►
`L®7 4 �•ALOCK 1 SE uB D-ifQ].eY
APPLICANT: Th., 8ott Co
ADDRESS: 1 PL..�@itagr,
CITY, STATE ZIP
PHONE. 571
PLUMBER:
ADDRESS: 6)0,
CITE', STATE J � r zw
PHONE: 2— ".
OWNER:
ADDRE a�
05/06/2014 09:40 Les Jones Roofing, Inc.
416* City of Eapli
3830 Pilot Knob Road
Eagan MN 55122
Phone: (661) 676-6675
Fax: (661) 676-6694
2S V3
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
(FAX)9528817009 P.0061011
Use BLUE or BLACK Ink
For Office Use
Permit #:
Permit Fee:
Date Received:
Staff:
Date; z//c'//y
Site Address: 410 j `1/r/, W1 YU 9 BE»v6J _ O.., 20 ,4 p Unit #:
t ` %. ' a1
` rl 1' $ , ° ti :4
`.. A...0",
�t.. `+'Y'' ' , 'l1 'k7
Name: r90 PeoPd r/ G /'.e l 4... Phone: 65w' -- FS-?/- ?7,-/I
t
Address / City / Zip: RID- Bost 21,2 5 04/1,672C_Ovz 26 /lam/ 6Y`' 94
Applicant is: Owner X Contractor
' )
.. y°�
,; a.
Description of workiGffJliE /�..1/ F
64,
Construction Cost $ W, 1, 4/.J Multi -Family Building: (Yee x / No )
fir, °`�'
.' 4 Ir. B 3,
u `°:1
, 6'
� 4'n '
� J ""
t :
Company: A1-5 ,7 t/63 ,Ri F,V6- /Air -Contact: Chiles s ii-vDE72so,J
Address: 1 Clt Go a�r��
7 � W, gelThi "r ��%� y: f_ _i__
State: Mi) zip: f e2O Phone: 9'SA Ira 7 — c?819
License #: 65-6P Lead Certificate #: ,f),4T LI0 3 ? — /
If the protect 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:
...
c. �-+c yvl Cirf'.. ' .n 1, h �. � 1 �.7.•� . *cC'h � - her f, r '.y : `r 1 7i.m'T 'T "F q°!' ,' 'y h '
e� i i y��� 1 !7, c o�oiv l o . o s ��r� '''i_ i l ^ r ale si r, -- 3 � ro ; zo�/ o a o 1.']'; of - T.,;) -r1 e d�,.TZ.4- -,
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I BZ= °�QI i "�4 �1 ,ol e ` o p : Y o l' o o el a 1 ���a�':r j a,; • . y T i cY of 1,6 111
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/Ps 9 . 10 I , 1!c,,,r 1- rtT:, l- < ,M. ,t� . 1.ea : f 1* , ?c am
CALL BEFORE YOU DIG. Call Gopher State One Catl at (661) 464-0002 for protecUon against underground utility damage. Call 48 hours
before you Intend to dig to receive locates of underground utilities. www.00raherstaleonecall.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 1 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 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 leeuance.
x Cimis 441D6720N'
Applicant's Printed Name
Applicant's Signature
Page 1 of 3
05/21/2014 10:18 Les Jones Roofing, Inc. TA)!)9528817009 P.007/011
44,111'`City otPaaau
Date:
3830 Pilot Knob Road
Eagan MN 55122
Phone; (661) 676-5675
Fax: (651) 675-5694
Use BLUE or BLACK kik
For Office Use
Permit ft:
Permit Fee:
Date Received:
Staff:
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Site Address:41/1l
fl 7Jv Wh < Eq+�6d 120.E Unit#:
Nems: y0 i° CPe2TY -4-t? E WC -
Address / City / Zip:
C -
Address/City/Zip: 'Rd. Bok 2125
Applicant is: Owner X Contractor
Phone: $,s -ll. ?. 'q
grs-/kit/ 6T'24
Description of work: Sem our- Awe Al)
Construction Cost 23i.-153,
gritIng 12441446e7) S30/Alb''
Multi -Family Building: (Yes / No )
Company:.ES 172,4/63'RGIOFsAUT; /AJG Contact Ciwats 4s iso
Address: 9 1 W 8d 7 Srizr
City: 14A h
State: MA/ Zip: .1.5-4120 Phone: 95A - 0?8/7
License #: 4.5701) Lead Certificate #: _&41 yes g 7? - /
If the project is exempt from lead certification, please explain why: (see Page 3 fof 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 Ryes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor Phone:
Sewer & Water Contractor: Phone:
41.4004:-.. la -WA; 440#604041Mildit
BellO,.�i/Stela,�vlESO Siff fa tiO►(l�
' rill y rti.. � ��t�if/ O@ i
0.0471-PWORIO"hair10;'?
CALL BEFORE YOU DIG. Cali Gopher State Ono Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours
before you Intend to dig to receive locates of underground uUlitles• www.aooherstateonecall.orq
1 hereby acknowledge that this Information Is complete and accurate; that the work will be In conformance with the ordinances and codas 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 will be In
accordance with the approved plan In the case of work which requires a review end approval of plans.
Exterior work authorized by a building permit issued In accordance with the Minnesota State Building Code must bo completed within 180
days of permit Issuance.
x diets ANDERsd,A/
Applicant's Printed Name
Applicant's Signature
Page 1 of 3
41110111" City of ft
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
i
For Office Use
Permit#: p2 5
Permit Fee: (OO ^ 00
Date Received: 1\ J 11 1
Staff:
2014 MECHANICAL PERMIT APPLICATION
❑ Please+submit two (2) sets of plans with all commercial applications.
Date: 1 1) J 1) /q Site Address: Li / �eeeeatlae 7
s !i
Tenant:
Suite #:
J
Resident/Own'
Name: L(, -t (Y\ il-•caflC Q> Phone: c52.0- / - S-730
Address / City / Zip:
Name:
Address:
AIR MECHANICAL INC
16411 Aberdeen Street NE
4
State: Zip: Ham Lake, MN 553 04e:
Contact: ( z
l
New Replacement
Description of work:
License #: rn ei, c5)22 -
City:
Email: V efa 0- L dart/
TE:'Re mounted and round mo n
ode. Please costa t the Mechaniici.
RESIDENTIAL
Furnace
Air Conditioner
Air Exchanger
Heat Pump
Other
Additional
Alteration
Mac
ie icat uipment
pector forinformationl on p
PVC.
Demolition
eerie
ng
COMMERCIAL
_ New Construction _ Interior Improvement
Install Piping _ Processed
Gas Exterior HVAC Unit
Under/Above ground Tank ( Install / _ Remove)
RESIDENTIAL FEES
$60.00 Minimum Add or alteration to an existing unit (includes $5.00 State Surcharge)O
,��,//'�
$100.00 Residential New (includes $5.00 State Surcharge) = $ lel/ , TOTAL FEE
COMMERCIAL FEES
$55.00 Permit Fee Minimum
$70.00 Underground tank installation/removal
*If contract value is LESS than $10,010, Surcharge = $5.00
**If contract value is GREATER than $10,010, Surcharge = Contract Value x $0.0005
***If the project valuation is over $1 million, please call for Surcharge
Contract Value $ x .01
_ $ Permit Fee
= $ Surcharge*
TOTAL FEE
=$
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 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.
x&ea,t, Arw2e1
Applicant's Printed Name
x
fr' / 4040
Ap • cant's Signature