Loading...
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 JY j I Cit o I ~fJ I 1 Permit Fee: I 8630 Pilot Knob Road I 2 I Eagan MN 65122 Date Received: ~cJ r l Phone: (661) 6765676 l i 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 Page 1 of 3