4143 Arbor LaneCity of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 4143 Arbor Lane
Lot: 017 Block: 002 Addition: Wenzel 1st
PID:10- 83570- 170 -02
Use:
Description:
Sub Type: e - Furnace & Air Conditioner
Work Type: New
Description: Fumace & Air Conditioner
Fee Summary:
Contractor:
Genz Ryan Plumbing & Heating
2200 West Highway 13
Burnsville MN 55337
(952) 767 -1000
ME - Permit Fee (Replacements)
Surcharge -Fixed
Total:
Applicant/Permitee: Signature
PERMIT
City of Eaan
- Applicant -
$50.50
Owner:
Karl L Klasen Tste
4143 Arbor Lane
Eagan MN 55122
Permit Type:
Permit Number:
Date Issued:
Permit Category:
$50.00 0801.4088
$0.50 9001.2195
Issued By: Signature
Mechanical
EA091211
09/18/2009
ePermit
Comments: Quesetions regarding electrical permit requirements should be directed to Mark Anderson, State Electrical Inspector, (952)
445 -2840
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
05/23/2014 11:28 Les Jones Roofing, Inc. (FAX)9528817009 P.012/016
Use SLUE or BLACK Ink
For office use I
Yr f Evd ]~l n Permit
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1 Permit Fee: I
8630 Pilot Knob Road I 2 I
Eagan MN 65122 Date Received: ~cJ r l
Phone: (661) 6765676 l
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Fax: (661) 6765694 I staff: I
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: s 23. ! Site Address: _q137 ^ qQU- 91 "U-4Lu3 ~ L,~r~Unltax:
Name: O rE A1219GQS r, ~A hone: 4Sl-40
Address ! City/ ZIP: -.!±k 11(plQ o Q
r Applicant Is., Owner X Contractor
Description of work: EM0✓E_,Q~/Q
Construction Cost;
+37 7• Multi-Family Building: (Yes x / No
Company: AE NG Contact: QJ& s 1-(wAS7 .soAl
Address: t'_ 8Q 0-- City: .tai-i AI
state: lAd Zip: Phone: 9 - 7(0 7- 8/7
License il:
-A Ato
Lead Certificate M. 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. Call Gopher State One Call at (661) 484.0002 for protection against underground utility damage. Call 48 hours
before you Intend to dig to receive locates of underground utilities. WW gol?hetstateonscall.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 permll, and work Is not to start wllhout 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
Applicant's Printed Name Applicant's Signature
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