4167 Arbor Lane
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0512312014 11:26 Les Jones Roofing, Inc. (FAX)9528817009 P.0051016
Use BLUE or BLACK Ink
For Office Ube 1
Permit 0: ZMS
1
City of Wan
I7r.
I Permit Fee: I
3830 Pilot Knob Road 1 I
Eagan MN 66122 Date Received:
Phone: (661) 676,6676 I 1
Fax: (661) 676-6694 1 Staff: I
I I
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: a3 ~ Site Address; 41W- 41G3L- 416S• 416.7 AR.J199- I.MN C Unit
Name: l *E Ab2soRS ra SoL. ~fAr~fta' hone: S-S sE~
SI-ya =
Address/ City /Zip: t S'(o AIZBo Q . (~q
Applicant Is: Owner X Contractor
Description of work: 6'K y per- pyc
` Construction Cost: 37 9 7. Multi-Family Building: (Yes X 1 No
Company: AE,S ,To,U~3 Rt~O,~in!/r 1NG Contact ~x4 s Arjhax~ Al
Address: / O 77/ j47Az57 City:
State: --MA/_ zip: j"IV24) Phone: _ 95 a 76 7 - a?8/7
r License -ks(o~Lead Certificate M ,V,,47- 4'D 3 74
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:
Sower & Water Contractor: Phone:
CALL BEFORE YOU DIG. Cell Gopher state one Ceti at (691) 464.0002 for protection against underground utility damage. Cell 48 hours
before you Intend to dig to receive locates of underground utilities. b0waltsonherslaleonecaif.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 1 understand this Is not a permit, but only an application for a permll, 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 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_Glf,21s f #A-9$_0A1 x '4 ~ .
Appllcanrs Printed Name Appilcanfs Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA158762
Date Issued:10/30/2019
Permit Category:ePermit
Site Address: 4167 Arbor Lane
Lot:017 Block: 001 Addition: Wenzel 1st
PID:10-83570-01-170
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 -
James S Hoskins
4167 Arbor Lane
Eagan MN 55122
(612) 743-0642
Standard Heating & Air Conditioning
130 Plymouth Ave. N
Minneapolis MN 55411
(612) 824-2656
Applicant/Permitee: Signature Issued By: Signature