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4125 Arbor Lane 0512312014 11:29 Les Jones Roofing, Inc. (FAX)9528817009 P.016/016 Use BLUE or BLACK Ink For office use I I - I'D City o EaF Permit I I 3830 Pilot Knob Road Permit Fee: "571,75 I Eagan MN 66122 i Date Received: Phone: (651) 676-6676 I Fax: (661) 676-6694 i Staff: 2014 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Z3 Site Address: 40 l - 412S CAS ZQ ~ ifOt6~1/ AA Unit z 1 Name• D I µE Atzwga, taoG. ~6Ara~16" K • hone: ~'i ~ 4 S ^ 8 s~~ •a Address / City / Zip: `i A4R o R , y is Applicant is: Owner JX Contractor Description of work: _ l EN b yE ,A-rV /ship 4W _ v Construction Cost: 13 7 q r Multi-Family Building: (Yes x / No ' Company: AC5 7,o&SX gaW-I * / Iyim. Contact: Cesar s DE+~.so~/ " Address City: '&4e State: A/ zip: XrV 2D Phone: 9,5';l - 7 7 - a8/9 S i license ( Lead Certificate M If O 3 7 ~ - W47- 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: r CALL BEFORE YOU DIG. Cab Gopher State One Call at (661) 464-0002 for protection against underground u011ty damage. Call 48 hours before you Intend to dig to receive locates of underground u0tilles. 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 end approvel of puns. Exterior work authorized by a building permit Issued In accordance with the Minnesota Slate Building Code must be completed within 100 days of permit Issuance. x G ,ets 4wimsyAl x Applicant's ~ . _ Printed Name Appllcant's Signature Page 1 of 3 PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA148212 Date Issued:03/14/2018 Permit Category:ePermit Site Address: 4125 Arbor Lane Lot:004 Block: 002 Addition: Wenzel 1st PID:10-83570-02-040 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 - Theodore W Anderson 4125 Arbor Lane Eagan MN 55122 Minneapolis St. Paul Plumbing Heating Air 640 Grand Ave St. Paul MN 55105 (651) 228-9200 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA160532 Date Issued:03/16/2020 Permit Category:ePermit Site Address: 4125 Arbor Lane Lot:004 Block: 002 Addition: Wenzel 1st PID:10-83570-02-040 Use: Description: Sub Type:Residential Work Type:Replace Description:Water Softener 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. Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener). 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 - Theodore W Anderson 4125 Arbor Lane Eagan MN 55122 (651) 456-9781 Milbert Company (culligan) 1801 50th St E Inver Grove Heights MN 55077 (651) 451-2241 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA171052 Date Issued:07/28/2021 Permit Category:ePermit Site Address: 4125 Arbor Lane Lot:004 Block: 002 Addition: Wenzel 1st PID:10-83570-02-040 Use: Description: Sub Type:Residential Work Type:Replace Description:Standard Water Heater 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 - Theodore W Anderson 4125 Arbor Lane Eagan MN 55122--289 (651) 228-9200 Minneapolis St. Paul Plumbing Heating Air 640 Grand Ave St. Paul MN 55105 (651) 228-9200 Applicant/Permitee: Signature Issued By: Signature