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4166 Arbor Lane 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 I t 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 PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA165723 Date Issued:11/17/2020 Permit Category:ePermit Site Address: 4166 Arbor Lane Lot:034 Block: 001 Addition: Wenzel 1st PID:10-83570-01-340 Use: Description: Sub Type:Residential Work Type:Replace Description:Furnace & Air Conditioner Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 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 - Carol Ann Nelson 4166 Arbor Ln Eagan MN 55122 (651) 429-6163 Blue Ox Heating & Air Llc 5720 International Pkwy New Hope MN 55428 (612) 238-9709 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA165724 Date Issued:11/17/2020 Permit Category:ePermit Site Address: 4166 Arbor Lane Lot:034 Block: 001 Addition: Wenzel 1st PID:10-83570-01-340 Use: Description: Sub Type:Residential Work Type:Replace Description:Standard Water Heater & Water Softener Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087 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 - Carol Ann Nelson 4166 Arbor Ln Eagan MN 55122 (651) 429-6163 Noah Acquisitions Llc 5718 International Pkwy Brooklyn Park MN 55428 (612) 822-5292 Applicant/Permitee: Signature Issued By: Signature