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4163 Arbor LanePERMIT City of Eagan Permit Type:Mechanical Permit Number:EA120879 Date Issued:03/05/2014 Permit Category:ePermit Site Address: 4163 Arbor Lane Lot:019 Block: 001 Addition: Wenzel 1st PID:10-83570-01-190 Use: Description: Sub Type:Residential Work Type:Replace Description:Furnace Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Andrea Preusse 4145 Sibley Memorial Hwy Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088 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 - Wilbert J Walz 4163 Arbor Lane Eagan MN 55122 (651) 452-0538 Wenzel Heating & Air Conditioning 4145 Sibley Memorial Hwy Eagan MN 55122 (651) 894-9898 Applicant/Permitee: Signature Issued By: Signature 0512312014 11:26 Les Jones Roofing, Inc. (FAX)9528817009 P.0051016 Use BLUE or BLACK Ink For Office Ube 1 Permit 0: ZMS 1 City of Wan I7r. I Permit Fee: I 3830 Pilot Knob Road 1 I Eagan MN 66122 Date Received: Phone: (661) 676,6676 I 1 Fax: (661) 676-6694 1 Staff: I I I 2014 RESIDENTIAL BUILDING PERMIT APPLICATION Date: a3 ~ Site Address; 41W- 41G3L- 416S• 416.7 AR.J199- I.MN C Unit Name: l *E Ab2soRS ra SoL. ~fAr~fta' hone: S-S sE~ SI-ya = Address/ City /Zip: t S'(o AIZBo Q . (~q Applicant Is: Owner X Contractor Description of work: 6'K y per- pyc ` Construction Cost: 37 9 7. Multi-Family Building: (Yes X 1 No Company: AE,S ,To,U~3 Rt~O,~in!/r 1NG Contact ~x4 s Arjhax~ Al Address: / O 77/ j47Az57 City: State: --MA/_ zip: j"IV24) Phone: _ 95 a 76 7 - a?8/7 r License -ks(o~Lead Certificate M ,V,,47- 4'D 3 74 If the project 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: Sower & Water Contractor: Phone: CALL BEFORE YOU DIG. Cell Gopher state one Ceti at (691) 464.0002 for protection against underground utility damage. Cell 48 hours before you Intend to dig to receive locates of underground utilities. b0waltsonherslaleonecaif.om 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 permll, 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 Issuance. x_Glf,21s f #A-9$_0A1 x '4 ~ . Appllcanrs Printed Name Appilcanfs Signature Page 1 of 3