4125 Arbor Lane 0512312014 11:29 Les Jones Roofing, Inc. (FAX)9528817009 P.016/016
Use BLUE or BLACK Ink
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City o EaF Permit
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3830 Pilot Knob Road Permit Fee: "571,75
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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/
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1 Name• D I µE Atzwga, taoG. ~6Ara~16" K • hone: ~'i ~ 4 S ^ 8 s~~
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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