4418 B Clover LaneRESIDENT i
OWNER
Name: (' E 1).0 Phone: 7 Z / 3C,, Y._>
Address / City I Zip: / J C J C fOV?' Z_Qo � .+ 1
Applicant is: Owner X- Contractor
TYPE OF WORK
Description of work: fMk/Cc/ / 1 (d' 4t✓ C
�
Construction Cost: 2 $� Multi- Family Building: (Yes / No
CONTRACTOR
Company: Pty )6 67 _mac ) C Contact: Joe 5 A .
Address: / 96 ,5 e' °l 4 t i City: C
State: / 114 Zip: Cc/2b Phone: 6 .5 - 7? 7 - VZ5
License #: 2o 7C)-- Lead Certificate #:
If the project is exempt
from lead certification, please explain why: (see Page 3 for additional information)
In the last 12 months,
No If
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
has the City of Eagan issued a permit for a similar plan based on a master plan?
yes, date and address of master plan:
_Yes
Licensed Plumber.
Mechanical Contractor.
Sewer & Water Contractor:
Phone:
Phone:
Phone:
NOTE: Plans and supporting d ocu m ents that you submit are consid ared to be p i nformation. Portions of
th informat may be class ified a S rfo -pu blic if you prate Specific reasons #ltaf W ould p mtit the Cit to
conclude that they are trade secrets.
City of EaQRII
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
I hereby acknowledge that this information is complete and accurate; that the work will be i
Eagan; that I understand this is not a permit, but only an application for a permit, and
accordance with the approved plan in the case of work which requires a review and approve
_e ms
Applicant's Printed Name
2011
c)')
icant's ignature
Permit #: 9'0\20
(
Permit Fee: I / 0 ) - (05
2011 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address:
onecal
Use BLUE or BLACK Ink
Unit #:
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454 -0002 for protection against underground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities. www. • o • hersta
in mance
won is not to s
of +tans.
nances and codes of the City of
permit; that the work will be in
Page 1 of 3
SUB TYPES
Foundation
Single Family
Multi
01 of Plex
Accessory Building
WORK TYPES
New
Addition
Alteration
Replace
Retaining Wall
DESCRIPTION
Valuation
Plan Review
(25 %_ 100 %
Census Code
# of Units
# of Buildings
Type of Construction
Fireplace
_ Garage
Deck
f Lower Level
_ Interior Improvement
_ Move Building
Fire Repair
— Repair
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation
Drain Tile
Roof: Ice & Water _Final
Framing
Fireplace: _Rough In Air Test _Final
Insulation
Sheathing
Sheetrock
Reviewed By:
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S &W Permit & Surcharge
Treatment Plant
Copies
TOTAL
% 'il 6 C( t 9 9D 20
DO NOT WRITE BELOW IS LINE
Porch (3- Season) _
Porch (4- Season)
Porch (Screen /Gazebo/Pergola)
Pool
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
Storm Damage
Exterior Alteration (Single Family)
Exterior Alteration (Multi)
Miscellaneous
_ Siding — Demolish Building*
_ Reroof _ Demolish interior
Windows Demolish Foundation
Egress Window _ Water Damage
`Demolition of entire building — give PGA handout to applicant
- 1 4 4 , MCES System
,,. 0 SAC Units
City Water
Booster Pump
PRV
Fire Sprinklers
0'
Meter Size:
Final / C.O. Required
Ni Final / No C.O. Required
! HVAC _ Gas Service Test
Other:
Pool: _Footings
Siding: __Stucco
Windows
Retaining Wall:
Radon Control
Erosion Control
, Building Inspector
Air/Gas Tests Final
Lath Stone Lath Brick
_ Footings _ Backfill — Final
Gas Line Air Test
Page 2 of 3
O NORTH
f p SC/ALE : i" _
(12/.7)
�31
ROBE
ENGINEERING
COMPANY, INC.
�� 1000 EAST I461!1 STREET, BURNSVILLE, MINNESOTA 55337 PH 422
c etZ e ey
Zgcl . e! : ? Cr4p22o72: LOTS 36, 37, 3E AND 39,, BLOC.( 2 ECE.k, ADDJTr"c,'�
DAKOTA CO/JA/Ti' MI A IN 5OTA
Cle .a , DENOTES EX! S7 ELEVA7/ai;/
(935, ) DEMOTE; FROFCSED ELEVATGAI
/54,
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EAST
CONSULTING EHGIHEERS
PLAHHEAS and LARD SURVEYORS
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BooK 4/ PA c 6 36
76.92 - g�.c� 78. oo - 4 - 1
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DRA /NAEe: AND
UTIL /TY EASEMENT
I her :by certify that this is a true and ccrrect representation of a tract of
land as shown' and described herecn.• As prepared by me on this 9 day of
41011 , 19 a.
60.0D JAL.,* t -Fa-vir,
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Minn. 1t eg. No. /Gages"
CITY OF EAGAN WATER SERVICE PERMIT
3830 Pilot Knob Road
P. O. 8oz 21199 PERMIT NO.•
Eagan, MN 55121 DATE:
Zoning: No. of Units:
Owner: — —
Address:
Site Address:
Plumber: —
Meter No.: Connection Charge:
Size: Account Deposit:
Reader No.: Permit Fee:
1 ogres to comply with the City of Eagan Surcharge:
Ordinonas.4 Misc. Charges:
Total:
By Date Paid:
Date of Insp.: / C y . Insp.:
CITY OF EAGAN SEWER SERVICE PERMIT
3830 Pilot Knob Road PERMIT NO.:
P. O. Bdx 21199
Eagan, MN 55121 DATE:
Z oning: No. of Units:
Owner:
Address:
Site Address:
Plumber:
I agree to comply with the City of Eagan Connection Charge:
Ordinances. Account Deposit:
Permit Fee:
Surcharge:
By Misc. Charges:
Dote of Insp.: Total:
Insp.• Date Paid:
From:ALLSTAR CONSTRUCTION 19529427464 09117/2013 08:45 #582 P.056/079
Use BLUE or BLACK Ink
For Office Use
I I
l j
City of Ea j Permit*
Permit Fee: -
3830 Pilot Knob Road
Eagan MN 55122 Date Received C l
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff: I
I 1
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 9 (toy 2013 Site Address: HH 1U,y41U$ yL11X r 441k, Guyer will/ Unit M
F Name: e0W ftA CAD' (70J%t ri C, Phone:
Resident/
Owner Address / City / Zip: W 38 G 1\A "C11 PUNIC / & . W(Al Mki 6 e. MN 553yW
Applicant is: Owner _ Contractor
Type of Work Description of work: 2611 Off gnd M-YoU k
YPe Construction Cost: Iq 1300 00 Multi-Family Building: (Yes / No
t
I Company:.. Y CMUdOn • l Contact: .11 V~ tbIftC4 t
I Address: 949 IVI MNal S1 i *1102) City:
Contractor maple ~'G 1 n
State: MN Zip: (5c)%q Phone: "1"JL~ 1"12 1~~"1
License Pic U 315T-P Lead Certificate NRT-
20q V4 D
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:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would pennit the City to
M rvY conclude that they are trade secrets.e
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.oot)herstateonecall.org
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 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.
Al X_ x ..,..c~1~R✓
Applicants Piinte Name Appl cant's Signature
. 1 Pagel of 3
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA128165
Date Issued:10/28/2014
Permit Category:ePermit
Site Address: 4418 Clover Lane B
Lot:39 Block: 02 Addition: Eden
PID:10-22750-02-390
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Wade Sedgwick
7588 Washington Ave S
Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088
Surcharge-Fixed $5.00 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 -
Marion Tste Rustvold
4418 Clover Lane B
Eagan MN 55122
Pronto Heating & Air Conditioning
7588 Washington Avenue South
Eden Prairie MN 55344
(952) 835-7777
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA127566
Date Issued:10/07/2014
Permit Category:ePermit
Site Address: 4418 Clover Lane B
Lot:39 Block: 02 Addition: Eden
PID:10-22750-02-390
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required by law in ALL single family homes .
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 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 -
Marion Tste Rustvold
4418 Clover Lane B
Eagan MN 55122
Window Concepts Mn
291 Eva St
St Paul MN 55107
(651) 905-0105
Applicant/Permitee: Signature Issued By: Signature
From:ALLSTAR CONSTRUCTION 19529427464 02/10/2016 13:00 #301 P.011/022
4,111 CityofEaall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit#: t037
Permit Fee: IR6Q=
Date Received:
Staff:
2016 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: P'//D 4 Site Address: *'&- Wf e41/14447i1-
Resident/
Owner
Name: 9VA F e, 6 L4 —1) 674 /-a,4
Address / City / Zip: 90i'- yo v G///ef 4 M e
-Applicant is Owner i� Contractor
Type of Work Description of work: "�''.5 (,q/jZ--4 "nv" ��in - Ge#/fal'rl'�fg ,%nafil
i
Construction Cost: 4t/4 000 — Multi -Family Building: (Yes / No )
Company: 4t( 4e, !„®sr Peaeirovs / iniii;111drUnce Contact: 'edI wt Ari ,,t -r7
Address: 6146 ! r W,S4-f IA 1 Si- -Su4 rl4- /'0 3 City: Aye- ?LA -1 el
Contractor
!!
State: in/4 Zip: S6369 Phone:9 q .I6'r Email: ,474gt//S-)IeU'• ,4 .-.
I. License #. t�l0.35 ® Lead Certificate #: //9-T doge, V - m�
A t
Unit #: !1 f I
Phone: /✓%
J
If the project is exempt from lead certification, please explain why: 84; t: /983
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:
Fire Suppression Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that they are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Cali at (651)4544002 for protection against underground utility damage. Call 48 hours
before you Intend to dig to receive locates of underground utilities. www.aopherstateonecall.ora
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 and approval of plans,
Exterior work authorized by a building permit issued In accordance with the Minnesota State Buildin amu, mpteted within 180
days
of permit issuance.
x Vi144 Afieint2.0x
Applicant's Printed Name ( Appiicpnt's Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA165380
Date Issued:10/29/2020
Permit Category:ePermit
Site Address: 4418 Clover Lane B
Lot:39 Block: 02 Addition: Eden
PID:10-22750-02-390
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Softener
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 -
Mark A Goff
4418 Clover Lane Unit B
Eagan MN 55122
Haferman Water Conditioning
12142 12th Ave.
Burnsville MN 55337
(952) 894-4040
Applicant/Permitee: Signature Issued By: Signature
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
(651) 675-5675 1 FAX: (651) 675-5694
buildinginspections(cDcityofeagan.com
-------------I
For Office Use
I L
I Building Permit #: LIU I
I I
S&W Permit #:
I
I
I Permit Fee: ;9, I
I I
I I
Date Received: I
I I
I I
I Date Issued: I
t- - - - - - - - - - - - - - - - - - - - -
RESIDENTIAL BUILDING PERMIT APPLICATION
Date: _?/Site Address: Unit #:
Applicant is: ❑ Owner Contractor
Name:EG(LS!!nj �Ad OV,11y--X"5,_b4S'SC,e10-41 6In
Homeowner Address:Q/ ; L4L& Llgle, Alt? Cbjc'.\,- to. -city: 1;;-cta v,,-
State:
Phone:
Description of work: P2 is t�—
Type of Q �/�
Work Construction Cost ( —[
Type of building: ❑ Single
Email:
❑ Townhome, of units Twin Home
Compan 3QM �V'jSr�—V—CA C_ n\A Contact: `r ��✓
g Z/ � & Ujp ��Y � Building � Address: � t � City: � ����T�
Contractor `J '/
State:A�Zip: S��T Phone>(otzJ`f S ' Emaili
�l'Q� 3l/� S_ `0
License #: D Expiration Date:
Sewer & Company: Contact:
Water
Contractor Address: City:
Required for State: Zip: Phone: Email:
new construction
License #: Expiration Date:
` 1 understand that Plumbing, Mechanical, and Fire Suppression work require separate applications.
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the
information may be classified as non-public if you provide specific reasons that would permit the City to conclude that they
are trade secrets.
CALL BEFORE YOU DIG. Contact Gopher State One Call at (651) 454-0002 or www.gopherstateonecall.org for protection against underground utility
damage. Contact Gopher State One Call 48 hours before you intend to dig to receive locates of underground utilities.
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 and approval of plans.
Ll-� t�x c����� x
Applicant's Printed Name A licant's Signature