4117 Arbor Lane 0512312014 11:29 Les Jones Roofing, Inc. TAX)9528817009 P.0151016
Use BLUE or BLACK Ink
For Office use ^ _ I
non i a C&S
My of ME([ i Perm11#: ~ ~ ?C
I Permit Fee: s / I
3830 Pilot Knob Road I I
Eagan MN 65122 Date Received:
Phone: (661) 676.5676 I I
Fax: (651) 676-6694 I Staff: 1
I i
2014 RESIDENTIAL BUILDING PEWIT APPLICATION
Date: S' Site Address: 115, ll #+Q. L NC! 3 - 41085
L Unit
Name: o 1;,r AiIi. Assoc. (36"Ak*ir' K hone: 4 S'I- 40-S• 8 s-Irc-
ti Address / City / Zip: 'w 1, 5T
o R BO Q . f~+A NE -
Applicant Is: Owner X Contractor
Description of work: E'e 5-
A Construction Cost: '7 7 Multi-Family Building: (Yes---x- / No
Company: Xt;j 6-66Q; /NG Contact: <VAt s A?vog'LE2 J
Address: I'V/ W. 7N 10-/ZZTI~ City: AI6,-Z)A1 _
State: _ 1A/1 Zip-
Phone: 95*2 - 76 7 - 7
License l-? Lead Certificate A&41- `f 0 3 V R
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,13-11JILDING
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. Cell Gopher State one call at (851) 454-0002 for protection against underground utility damage, Cap 48 hours
before you Intend to dig to receive locates of underground ulllkles, a )necall.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
Eager; 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 plane.
Exterlor work authorized by a building permit Issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit Issuance.
Applicant's Printed Name Applicant's Signature
Page 101`3
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA136790
Date Issued:05/31/2016
Permit Category:ePermit
Site Address: 4117 Arbor Lane
Lot:008 Block: 002 Addition: Wenzel 1st
PID:10-83570-02-080
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.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
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 -
Forrest G Root
4117 Arbor Lane
Eagan MN 55122
(651) 686-6650
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA136790
Date Issued:05/31/2016
Permit Category:ePermit
Site Address: 4117 Arbor Lane
Lot:008 Block: 002 Addition: Wenzel 1st
PID:10-83570-02-080
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.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
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 -
Forrest G Root
4117 Arbor Lane
Eagan MN 55122
(651) 686-6650
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA153842
Date Issued:01/28/2019
Permit Category:ePermit
Site Address: 4117 Arbor Lane
Lot:008 Block: 002 Addition: Wenzel 1st
PID:10-83570-02-080
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
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 -
Laurie Living Trust Reding
4117 Arbor Lane
Eagan MN 55122
Tiger Heating & Air
12448 Plaza Dr
Eden Prairie MN 55344
(952) 942-5748
Applicant/Permitee: Signature Issued By: Signature