4164 Arbor Lane
Use BLUE or BLACK Ink
For Office Use
I _
Permit
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City I I
of Eapn
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Permit Fee:
3830 Pilot Knob Road I I
Eagan MN 55122 I Date Received:
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Phone: (651) 675-5675 I
Fax: (651) 675-5694 I staff.
2013 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: Site Address L04 D4,0~ &A?!610 ! f v V
Tenant: Q/Vv~B~
Suite
Resident/Owner. Name:1 Phone: ra-0U - J
Address / City / Zip:
Name: MILBERT COMPANY INC dba CULLIGAN WATER License 063031-WC
C ontractor Address: 1801 50T" STREET EAST City: INVER GROVE HGTS
State: MN Zip: 55077 Phone: 651-451-2241.
Contact: BILL MILBERT Email
Type of Work _New replacement _Repair -Rebuild - Modify Space Work in R.O.W.
Description of work:
RESIDENTIAL
Water Heater
ater Softener
Lawn Irrigation RPZ PVB)
Permit Type Add Plumbin Fixtures
Septic System 9 Main Lower Level)
New Water Turnaround
_ Abandonment
RESIDENTIAL FEES:
$60.00 Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)
i $60.00 Lawn Irrigation (includes $5.00 minimum State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Tumaround* (includes $5.00 State Surcharge)
*Water Turnaround (add $200.00 if a 5/8" meter is required)
$105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge)
TOTAL FEES $
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.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, and work Is not to start without a permit; that the work will be in
accordance wjth the approXed plan in t e case of work which requires a review and approve f plans.
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Applicant's. Printed Name Applicant's Sig ature
FOR OFFICE USE + ati ~e'~ w~ ~s z~•'_
& . Reviewed By:
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05/2312014 11:25 Les Jones Roofing, Inc. OAX)9528817009 P.0021016
Use BLUE or BLACK Ink
For Office Use
75
1 Permit ! 1
City of Wan I ~7 J~ I
Permit Fee: ! / I
3830 Pilot Knob Road I r % I
Eagan MN 65122 1 Date Received: / I
Phone; (661) 576-5676
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Fax: (661) 6765694 1 Staff: I
2 ! ~a
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: SiteAddress: 4%(o0" 41f.2- "eq--4ttet- A12GOR C"ir Unit
Name: o T E Aemas Assoc JE Ana", hone: Io Sl - 4 o-S- T SSC'
Address / City/ Zip: 4 C C1o AsBO Q : 1- 4mg
i Applicant Is: Owner X Contractor
Description of work: Ks-M o vE p
Construction Cost: , 79 7. y Multi-Family Building: (Yee x / No
Company: sS &&AeS RwFe* /NG. -contact: Gillet sAzwa Zsod
Address: 'i f W. 80 7I/ .0- City: BGO`vtcs.t&z.,dZ
4r
r State: Zip; XfV20 Phone: q5-A - 76 7 - e78/9
License lead certificate WA1- If O 3 9 a = /
If the project Is exempt from lead certificatlon, 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, data and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor; Phone:
Sewer l~ Water Contractor.. Phone:
CALL BEFORE YOU DIG. Call Gopher State One Calf 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.aooherstateonecsll.oro
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 wilt 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.
Applicants Printed Name Applicante Signature
Page 1 of 3
EAGAN
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
(651) 675-5675 I TDD: (651) 454-8535 I FAX: (651) 675-5694
buildinginspectionsCo citvofeagan.com
r
For Office Use
Permit #:
Permit Fee:
Date Received:
Staff:
2020 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: 6°4,/ Site Address: ` A i® Z`
Tenant:
Suite #:
J
Resident/OwnerName:
C Phone: ‘ ✓gi-
Address / City / Zip: 32h4! S A t—D
Contractor
Name: 444 / .L.Lo x.- / 4f-efiv.4i!2-*- License #: Pe-4 14 f/ A t Z
�4.S r6 A) 5. .TP.
Address: City: Z—
Statet l,1\) Zip: -5-5—® Phone: b..rj—q..5j-38 l
Conte _�"" —� Email:
Type of Work
New 1-ReplacementRepair Rebuild Modify Space — Work in R.O.W.
— — — —
Description of work: J0-43 772—'7— °4—
Description
p
Tankless Water Heater
Lawn Irrigation ( RPZ / — PVB)
Standard Water Heater
Add Plumbing Fixtures ( Main / Lower Level)
Water Softener
Description:
Septic System
Connection to City Water from Well
New Abandonment
RESIDENTIAL FEES
$60.00 Water Heater,
$60.00 Lawn Irrigation
$60.00 New fixtures,
$60.00 Septic System
$100.00 New Residential
$115.00 New Septic
$60.00 Connecting to
*Sewer & Water
Water Softener, or Water Heater and Softener (includes State Surcharge)
(includes State Surcharge)
adding or removing piping (includes State Surcharge)
Abandonment
(fee collected with Building Permit)
System (includes County fee and State Surcharge)
City Water from Well* + $290 for Meter and $200 for Radio Read = $550
Permit also required for connection charges
TOTAL FEES $
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
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's
website at www.cltvofeaqan.com/subscribe.
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.
Applicant's Printed Name
x
Applicants Signature
Page 1 of 2
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA164392
Date Issued:09/28/2020
Permit Category:ePermit
Site Address: 4164 Arbor Lane
Lot:033 Block: 001 Addition: Wenzel 1st
PID:10-83570-01-330
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:One Window/Door
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 1,500.00
Fee Summary:BL - Base Fee $1500 $62.50 0801.4085
Surcharge - Based on Valuation $1500 $0.75 9001.2195
$63.25 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 -
Margaret K Soma
4164 Arbor Lane
Eagan MN 55122
(651) 528-3127
Pella Northland
15300 25th Ave N #100
Plymouth MN 55447
(763) 745-1400
Applicant/Permitee: Signature Issued By: Signature