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4135 Arbor LaneCity of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675 -5675 www.ci.eagan.mn.us Site Address: 4135 Arbor Lane Lot: 9 Block: 2 Addition: Wenzel 1st PID:10- 83570- 090 -02 Use: Description: Sub Type: e - Furnace & Air Conditioner Work Type: New Description: Fumace & Air Conditioner Comments: Questions regarding electrical perm 952- 445 -2840. Fee Summary: Total: Contractor: Ductworks Heating & Air Conditioning LLC 5320 Triton Drive Golden Valley MN 55422 (763) 521 -0070 ME - Permit Fee (Replacements) Surcharge -Fixed Applicant/Permitee: Signature PERMIT City of Eaan - Applicant - Permit Type: Permit Number: Date Issued: Permit Category: equirements should be directed to Mark Anderson, State Electrical Inspector, Owner: Warren M Miller 4135 Arbor Lane Eagan MN 55122 $50.00 0801.4088 $0.50 9001.2195 $50.50 I hereby acknowledge that I have read this application and state that the informa of Minnesota Statutes and City of Eagan Ordinances. on is correct and agree to comply h all applicable State Issued By: Signature Mechanical EA082646 04/21/2008 ePermit 0512312014 11:27 Les Jones Roofing, Inc. TAX)9528817009 P.0111016 Use BLUE.or BLACK Ink For office use I City of Wan I Permit 1 1 Permit Fee: i ! 1,-75 3830 Pilot Knob Road I i Eagan MN 65122 1 Date Received: 5 J .0 /1 't 1 Phone: (661) 676-6676 Fax: (651) 675-6694 1 Staff. I 2014 RESIDENTIAL BUILDING PERMIT APPLICATION Date: S 23 Site Address: 417-4- 4131- 413 913o> A Agtoop 4,A-QC Unit Name;, /N*E Aims 5 Svc. ~ w%w• K phone: to SI --4 dS • 8 ss-c- Address /City /zip._ ` tfl, A R BC&l.t ' r' " Applicant la; Owner ` X-Contractor Description of work: X- E'at ✓6- r AWA t ti Construction Cost: q Multi-Family Building. (Yes x I No Company: -Es '&WAT Nix- Auc- Contact: Cam s Address ! City: ,tai-Trig/ State: - l Zip: XrV AD Phone: 95-2 - 76 7 - 0?11 t License Lead Certificate &A'r `f t) 3 V;? L- / If the project Is exempt from lead certlflcation, 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 Ragan Issued a permit for a similar plan based on a master plan? _-Yea __No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone; CALL BEFORE YOU DIG. Call Gopher State One Call at (661) 464.0002 for protection against underground utility damage. Call 48 hours before you Intend to dig to receive locates of underground uIllltles. mwno n 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 permll; 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 160 days of permit Issuance. x_ CLiets ~49AM- Al Applicant's Printed Name AX- /~Z' pplicant's Signature Page 1 of 3.