4159 Arbor LanePERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA110877
Date Issued:06/03/2013
Permit Category:ePermit
Site Address: 4159 Arbor Lane
Lot:009 Block: 001 Addition: Wenzel 1st
PID:10-83570-01-090
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Eric Bruckmueller
3992 Pennsylvania Avenue
Eagan, MN 55123
Fee Summary:PL - Permit Fee (WS &/or WH)$55.00 0801.4087
Surcharge-Fixed $5.00 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 -
Marilyn T Woodruff
4159 Arbor Lane
Eagan MN 55122
Bruckmueller Plumbing Inc
3992 Pennsylvania Ave
Eagan MN 55123
(651) 686-6696
Applicant/Permitee: Signature Issued By: Signature
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
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