4157 Arbor LaneRESIDENT /OWNER
NI arn . I di is C.YI
Address / City / Zip: LI 15 __T
Phone: US\ Lw -5 -/
�L L 5509,
CONTRACTOR
r —
Name ` ��' / tz_t_� License #: 0 "P I
Address 313 n (+ � e City:
State: ‘1 'v Zip: 55I Ol 02
Phone: Ct_a: t LL5- 1'1.3
__
Contact: Ste 1 Email:
TYPE OF WORK
- -- New Replacement ___ Repair ___ Rebuild ___ Modify Space ___ Work in R.O.W.
Description of work:
PERMIT TYPE
RESIDENTIAL
_ I Water Heater
Lawn Irri
____ Irrigation
g (_ RPZ / _ PVB)
____ Septic System
New
_ Abandonment
____ Water Softener
Add Plumbing Fixtures L__ Main / Lower Level)
___
____ Water Turnaround
RESIDENTIAL FEES:
$60.00 Minimum Water
Heater, Water Softener, or Water Heater
(includes $5.00 State Surcharge)
Fixtures, Septic System Abandonment, Water
and Softener (includes $5.00 State Surcharge)
$60.00 Lawn Irrigation
$60.00 Add Plumbing
*Water Turnaround
$105.00 Septic System
Turnaround* (includes $5.00 State Surcharge)
and $5.00 State Surcharge)
TOTAL FEES $
(add $189.00 if a 5/8" meter is required)
New ($10.00 per as built) (includes County fee
4 City of EaQafi
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
Date:
Tenant:
JUN 2
2
For Office Use
Permit #: JC.)
Permit Fee:
Date Received:
Staff:
2012 RESIDENTIAL � TIA PLUMBING PERMIT APPLICATION
(
(Jo - 0--/2 Site Address: '1 I5 ! I 4 r &r Ln
cant's Signature
Use BLUE or BLACK Ink
•
/2-
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.gopherstateonecall.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 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 T�1Lr r 1i e __ y �
Applicant's Printed N
Reviewed By: Date:
Under Ground Rough -In Air Test
FOR OFFICE USE
Required - Inspections:
Final
0512312014 11:28 Les Jones Roofing, Inc. OAX)9528817009 P.0141016
Use BLUE or BLACK Ink
For Office Use - - I
j Permit 8: 7 I
City of Ealu I r ~5 1
I Permit Fee: . 1
3830 Allot Knob Road I I
Eagan MN 66122 j Date Recelved:
Phone: (661) 676-5675 I I
Fax: (661) 676-5694 1 Stat I
1 I
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Data: 23 Site Address: I - 411-unit Name: TE Amal oRS_ 46x06. ~.~e-Pr~nfe l~► hone: Ao5`I-9P-S ss~
Address / City / Zip: l St A&I
Applicant Is: Owner X Contractor
Description of work: 6'rt b ✓A-
Construction Cost: 3 / 7 17 Multi-Family Building: (Yes x / No
Company: -E5 ,ToNm3 goo&_ * WC. Contact: ~'s12t s A yi
Address: %I O City:
' State: _ 14AI Zip: ,a24) Phone: 9sa - 76 7 - a8/7
License* Lead Certlflcate AIAI"' Y03 9.7 =1
If the project is exempt from lead certlflcatlon, 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:
CALL. BEFORE YOU DIG. Call Gopher State One Call at (661) 464-0002 for protection against underground utIfty damage. Call 48 hours
before you Intend to dig to receive locates of underground ulllltlea.
I hereby acknowledge that this information is complete and accurate; that the vmrk vdll 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.
Exterior work authorized by a building permit Issued In accordance with the Minnesota State Building Coda must be completed within 180
days of permit issuance.
G .2fs ~40095VAI
Applicant's Printed Name Applicant's Signature
Page 1 of 3
Use BLUE or BLACK ink
r-----------------�
I For Office Use �
�1�' � Permit#: ��Ov� i
�� �� �� ��� , � ��w�'�s` ce�'�°,�"'`' � 1
� � ; r � -� � ..< � �rya„�...�'�`.�� � /`,� �
� '4' f � 1 Perm�Fee: (A�J �
� � 3sso Pi�ot Knob Roaa r .; OCT 2 3 2014 �; ;� � oafe R����r: /l�-•�•3-��- ;
Eagan MN 55122 � � .�� � �
Phone: (651)675-5675 � � �a�. /�/� i
Fax: (651)675-5694 .--.� --_----___.___.
�-----------------i
2014 RESIDENtIAL PLUMBING PERMIT APPLICATION
Date: � 'j � L'� Site Address: � � `-'� �
Tenant: 1 + 1 �.� Suite#:
. ,.�,�
�
�� ` Name: � l � Phone: �O�i�'���3�`��/ �
��'�i€#�C1��l�#' �
Address/City J Zip: � �1 � k
� ;�. ��.��_� . �..�,� ��...��.�
y-�. < /; ' ' f �
� Name: �1 U U License#: ���7 � w� �
� ,� , �
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° ` Address: ��V '� . City: �
� ������
` g ` State: l:✓L.J I Zip: 1 10 Phone: ��t� 1, 1 (J�"�'_1 �
�
�
f �i,� ' ,�
Contact: Email: l_.,�{ V' � ;
� _�,� a _ �m�
� �
_ ` ` New �Replacement _Repair _Rebuild _Modify Space _Work in R.O.W. a
� '�`�p�Af��� ; —
�
> Description of work: �
�. : �.` � _ ,��,.�
': RESIDENTIAL
� Water Heater � � �
� — Water Softener �
t�awn trrigatiort(_RPZ/ PVBj �
��!"�'t�I���'� :
� Add Plumbing Fixtures�Main/_Lower Level) ¢
� Septic System � i,
� New Water Turnaround �
� _ �
�
� _Abandonment �
d� �< : ; � .� ,.����
� RESIDENTIAL FEES: y
� $60.00 Water Heater,Water Softener, or Water Heater and Softener(includes$5.0o State Surcharge) �
� $6Q.00 Lawn Ir'r'igation(includes$5.00 minimum State Surcharge) �
k
� $60.00 Add Plumbing Fixtures,Septic Svstem Abandonment,Water Turnaround*(includes$5.00 State Surcharge) ;
� '"Water Turnaround(add$200.00 if a 5/8"meter is required) �
� $115.00 SeptiC SYStem New($10.OD per as built)(includes County fee and$5.00 State Surcharge) �,\ �
�,.,�.,�..,.� _ � _ TOTAL FEES $ � ° I.JU.��.�
CALL BEFORE YI�U DIG. Call Gopher State One Gall at(651)454-0002 for protection against un�erground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities. wuvw.qopherstateanecall.ora
I hereby acknowledge that this iriformation is complete and accurate;that the work will be in conformar�e 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
accorda with the approved plan in the case of work which requires a review an ppr I of plans.
x �� C�t' lu�LJ�
Applicant's Printed Name Appli ant's Signature
���;�?���k�:� '; : : : ���r�d$�' ; ���`
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�e�u�r��p+�±tsns l�����zc�r�� �„�o�g#��� � �,�,t�"�"��t �„��`� : ��a[ '
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PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA143875
Date Issued:06/30/2017
Permit Category:ePermit
Site Address: 4157 Arbor Lane
Lot:012 Block: 001 Addition: Wenzel 1st
PID:10-83570-01-120
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
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 -
Mildred H Lofgren
4157 Arbor Lane
Eagan MN 55122
(651) 456-5329
K & S Heating, A/c & Plumbing Llc
4205 West Hwy 14
Rochester MN 55901
(507) 282-4328
Applicant/Permitee: Signature Issued By: Signature