4154 Arbor Lane 0512312014 11:26 Les Jones Roofing, Inc. (TAX)9528817009 P.0061016
Use BLUE or BLACK ink
For Office Use I
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City of EaRan ; PerI
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I Perrnlt Fee: -5 l + ~
31330 Pilot Knob Road
Eagan MN 55122 1 oats Received: I
Phone: (661) 676-6676
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Fax: (661) 6765684 I stag:
1 I
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date; et 3 Site Address: t'1152 - it ~ gLrs A LA vo- Unit
Name: o l AR-was. 6 SaG. JE AwNE lei hone: 6 SI - 4 o s - 8 s~t~
Address (City /71p: 4l t V(, j4
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Applicant Is: Owner X Contractor
Description of work: r-'t o vE
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Construction Cost: 3 9 7. Multi-Family Building: (Yes X / No
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Company- Ae
NG Contact: 4We4 s A-tiO SOA
Addreae; U/. 8d X2 7 " City: Aaalg'e&b ~
State: _ (lam Zip: Phone: _ 9'SR - 7b 7 - IIIII
License 4 ago Lead Certificate M VAT- `f o 3 7.7 _
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:
Sewer & Water Contractor: Phone:
CALL BEFORE YOU DIG. Cali Gopher Stale One Call at (681) 464-0002 for protection against underground utility damage. Gall 48 hours
before you Intend to dig to receive locates of underground utilities. MMUmpherstateonecall.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 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 Code must be completed within 180
days of permit Issuance.
x_ cimis 4 00-0AI
Applicant's Printed Name
Applicant s Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA125671
Date Issued:07/30/2014
Permit Category:ePermit
Site Address: 4154 Arbor Lane
Lot:024 Block: 001 Addition: Wenzel 1st
PID:10-83570-01-240
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:One Window/Door
Census Code:434 -
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 by law in ALL single family homes .
Valuation: 500.00
Fee Summary:BL - Base Fee $500 $40.00 0801.4085
Surcharge - Based on Valuation $500 $0.50 9001.2195
$40.50 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 -
Doreen L Mckenney
4154 Arbor Lane
Eagan MN 55122
(952) 941-0426
Pella Northland
15300 25th Ave N #100
Plymouth MN 55447
(763) 355-1300
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA126180
Date Issued:08/15/2014
Permit Category:ePermit
Site Address: 4154 Arbor Lane
Lot:024 Block: 001 Addition: Wenzel 1st
PID:10-83570-01-240
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.
Jennie Wood
1424 3rd St N
Minneapolis, MN 55411
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 -
Doreen L Mckenney
4154 Arbor Lane
Eagan MN 55122
(952) 941-0426
Benjamin Franklin Plumbing
1424 N 3rd St.
Minneapolis MN 55411
(612) 604-4285 X61
Applicant/Permitee: Signature Issued By: Signature
Use B�UE or BLACK Ink
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3830 Pilot Knob Road � I 9 � 7� �
Eagan MN 55122 I Date Received: �
Phone: (651)675-5675 ��� –._-------.--__-------__� � staff: /�l j
Fax: (651) 675-5694 i________________�
2014 RESIDENTIAL PLU ING PERMIT APPLICATION
Date: ` ,,� Site Address: J 1..�.J�
Tenant: 1 ��' Suite#:
'R��iCf@(1�/(�Wlfif.'1' Name:� Phone: IJ �—�`l �V4 ��['j
Address/City/Zip:
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Name:' � r ' l _ � � ' ' #: � ���� l�..JV .
COi1#I',�Gt(ir� Address: \��, ���� 1 ���_City: �M t UI�
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Contact: EmaiL
`- ��/���f��rk �_ —New _Replacement _Repair _Rebuild _Modify Space _Work in R.O.W.
Description of work:
i RESIDENTIAL
Water Heater
�Water Softener
Lawn Irrigation(_RPZ/_PVB)
Perr��T�jae
Septic System Add Plumbing Fixtures(_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)
$60.00 Lawn Irrigation(includes$5.00 minimum State Surcharge)
$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 Svstem 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.gopherstateonecal�.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, l�ut only an application for a permit, and work is not to'start ithout a permit; that the work will be in
accord n e with the approved an in the case of work which requires a review and appro f plans.
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