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4407 Clover LaneCity of Eagan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 r Use BLUE or BLACK Ink 'kW—Ott-0'11—Se Permit #: Permit Fee:ft" 5 Date Re eived Staff: INFLOW INFILTRATION PERMIT APPLICATION Plumbing / Sewer & Water Date: -I- Site Address: 4 +07 C to\J . LA , A-6 \, H'jA. S ;2 Tenant: Suite #: !OWNER Name: 5 IAEJ G 7 -cPhone' t— O 3 HRESIDENT Address / City / Zip: 4 -1 -(yr C) 0\3)z L1L3s GIFT -C t t„)_ N), 55/22 CONTRACTOR Name: 5 i \.1261 1` ) l'-‘ rZ)) )1.- 6 IJR ii CSe V 1 dP•il— 0 &3,)57 10 Address: (O [ City: l V IbSt i) State: V.A. Zip: C J 1 6 Phone: 65( ' ( ^7 C —5300 contact: ‘ OZ' \. th Email: 5C'2Ot1'tt_p VImo( 1�I ), G7,l)tL COP- TYPE OF WORK PLUMBING (Within the building envelope) SEWER & WATER (Outside the building envelope) Sump PumpdRepeir 13 e..E %1-0"4 d1`' Repair Other: Other: DESCRIPTION Description of work: C, )V J Ti S C, '} j(l (SF I'?V"Ls" Sv.A isR 1v-- 0\J611,0 �" Ot - T3vi\c9i % v'1•1tp vp I FEES $55.00 I Each (includes $5.00 State Surcharge) TOTAL FEE $ * *Permit fees will NOT be reimbursed by the City of Eagan. If you plan to submit Ill repair costs for reimbursement, two quotes from qualified contractors must accompany this application. A list of contractors can be found by visiting www.cityofeagan.com/inflow, or City Hall at 3830 Pilot Knob Rd. 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.qopherstateonecall.orq • 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 rewires a revi9w and approval of plans. x1�� -3�t l i v\ Applicant's Printed Name x Applican ignature FOR OFFICE USE Required Inspections: Reviewed By: Under Ground Rough -In Final Date: Date: City otEatan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use /Ol'p Permit #: Permit Fee: 1/1 Date Received: Staff: 2012 RESIDENTIAL BUILDING PERMIT APPLICATION 7—/, —000g Site Address: Name: 1.JL(/t, Address / City / Zip: 4P- J) (` 6' Applicant is: Owner — Contractor Phone: Unit #: A J Description of work: Ile/ / l d- eX1 l I Al i Multi -Family Building: (Yes A / No Construction Costa. 3— Company: Company: NGk5 \04Jae Address: MPS- &eneVai ' - IV Contact:' C/ i State: ( ` t iv Zip:/ a0 License #:R63 a J d' Phone: City: 00.1 2.le s i - 7/7- 3Ya,3 Lead Certificate #: If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) 13(4--/ fL -r` .4r /4 7 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: CALL BEFORE YOU DIIG. 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.dooherstateonecall.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. c kC, 11t` Applicant's Printed Name x Appli s Signature Page 1 of 3 SUB TYPES Foundation Single Family Multi 01 of _ Plex Accessory Building qq7 (over fan DO NOT WRITE BELOW THIS LINE Fireplace Garage Deck Lower Level — Porch (3 -Season) Porch (4 -Season) _ Porch (Screen/Gazebo/Pergola) Pool WORK TYPES _ New _ Interior Improvement IleAddition Move Building _ Alteration _ Fire Repair Replace_ Repair _ Retaining Wall DESCRIPTION Valuation Plan Review (25% 100% ) Census Code #of Units # of Buildings Type of Construction 0 V REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) Foundation Drain Tile Roof: _Ice & Water _Final Framing Fireplace: __Rough In Air Test Insulation Sheathing Sheetrock Reviewed By: Occupancy Code Edition Zoning Stories Square Feet Length Width Final _ Siding Reroof Windows _ Egress Window 1 Storm Damage Exterior Alteration (Single Family) Exterior Alteration (Multi) Miscellaneous Demolish Building* _ Demolish Interior — Demolish Foundation Water Damage *Demolition of entire building — give PCA handout to applicant MCES System J/VA ).2-7l7 5 SAC Units City Water Booster Pump PRV Fire Sprinklers Meter Size: Final / C.O. Required \jl Final / No C.O. Required HVAC Gas Service Test Gas Line Air Test Other: Pool: _Footings Air/Gas Tests _Final Siding: _Stucco Lath _Stone Lath _Brick Windows Retaining Wall: Footings e Backfill Final Radon Control Erosion Control , Building Inspector RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL fi* 04 LW ( ce,9 0 -7 Page 2 of 3 r -)•-4IA! - Cis o c N „ .;e "�, Ott+ N_ W W w 1 104 00 CITY OF EAGAN WATER SERVICE PERMIT 3830 Pilot Knob Road PERMIT NO.: P. O. Box 21199 DATE: Eagan, MN 5121 Zoning: No. of Units: Owner: Address: Site Address: - Plumber: Meter No.• Connection Charge: Size: Account Deposit: Reader No.: Permit Fee: 1 agree to comply with the City of Eagan Surcharge: Ordinances. Misc. Charges: � —3'117 Total: By — " t 4 Date Paid: Date of Insp.: Insp.. CITY OF EAGAN SEWER SERVICE PERMIT 3830 Pilot Knob Road P. O. Box 21199 PERMIT NO.: Eagan, MN 55121 DATE: Zoning: ' No. of Units: Owner: Address: Site Address: Plumber: i agree to eonoolyfwhh the City of Eagan oririection Charge: Ordinances. \ Account Deposit: ermit Fee: Surch By , / _,7 4 Misc. Charges: Dote of Insp.: Total: Insp.: Dote Paid: From:ALLSTAR CONSTRUCTION 19529427464 10/21i2015 12:22 #269 P.003/020 Use BLl1E or BLACK Ink � ForOfficeUse---------i � j Permit#: �� Ity of�a�� ; . . �- � 3830 Pilot Knob Road RECEIVED � Permit Fee: � Eagan MN 55122 OCT Z � ZO� j Date Received: � Phone:(651)6�5-5675 � � Fax:(651)675-5694 I Staff: � 1 � �..��_�.�_��_��_��J 2015 RE�IDE�`f�AL �111LD[i�C P�RIVl�T APPLIC,4TI0l� Date: Site Address: Unit#: ��,..�,...,.,��me: .,.M.,....��✓A. 1 ��31�'� �.'�l..c..i i'7d+4.,.�,��...��.. ..Phone: ,Mnl�� Resident/ � Owner Address/City/Zip: �`I��"`�'5��7 �J�,/g� � �� -�,y�, � � Applicant is: Owner � Contractor t � ��.,,.�.�,.ma .�.. ._..., ..,�,,>-,.n...F...��.rt,�..-�..:�.......,�-,�...-�..r�....,m.._.�..�,.=.�...�..�,..r,�,...m..,...�.�..�....�..�._...�.,.......--�...�..�.,r�...-,.. ....�n,.._� , ; -# Description of work: ��•- '�i�e �,ti/�y-�� ,,,�',�� ,��n� Type .o.f Work. v . � , � Construction Cost: �,i� Muiti-Family Building:(Yes �No_) f .v.�..-�,.e.,� ..��..Y..�.,,�-�..�.� _ � Company:�ItS�� (..c,nS��uC�.�r► tr/�/t�htG�7laHG� Contact: �..�,sn_ �l�f.�.-►J�..�:,....�...,.A,.�.=„'_� � � Contractor add�eSS:S�i�JS 1n��S�f�.�+�c��,f - S►�;kE ��3 c�ty: t`V1A�+It i��,.! � State:�Zip:��`'� Phone: �52-'�/2=?�/5'S�Email: t�t��td.1/��/". �'Z. � •. / �icense#: .�� !c"9c.`� �� Lead Certi�cate#: A/�=' ��I(d� L.. �..�-�,�.,,.�� ---�-- __ _ _ - - - - -�.�,....�.,.a,.e.�. ; If the project is exempt from lead certification, please explain why: ��L,� �„� �c��3 � � , �" � �T COMPLETE THIS AREA ONLY iF CONSTRUCTING �,NEW BUILDING ��T�~�� In the last 12 months,has the City of Eagan issued a permit for a similar plan based on a master pian? Yes No If yes,date and address of master plan: I Licenced Piumber: oM,,,,,,. & � _ � � Mechanical Contractor: Phone: � � Sewer 8 Water Contractor. Phone: � � Fire Suppression Contractor: Phone: � NOTE:Plans and supporting documents that you submit are considered to be public information. Portions of ; : t e iniormation may be classified as non-public if you provide specifc reasons that would permit!he City to �„_� conciude thaf they are trade secrets �Po�� CALL BEFORE YOU DIG, Catl Gopher State One Call at(651)454-0002 for protection against underground utilky damage. Call 48 hours Y before you intend to dig to receive locates of underground utilities. www.00pherstateonecali.ora I hereby acknowledge that this iniormation 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 oniy an application for a permii, and work is not to start without a permit; that the work will be in accordance with the appraved pian in the case of work which requires a review and approval of plans. Exterior work authorized by a buiiding permit issued in accordanee with the Nfinnesota State Building Code must be co pleted within 180 days oi permit issuance. ___ ,.�-� X _-►'.�. �//E.��1 x �.y-T --.- �. Rpplicant's Printed Name �,.,,,�Applic nYs Signa'ture Page 1 of 3 i: PERMIT City of Eagan Permit Type:Building Permit Number:EA141800 Date Issued:03/31/2017 Permit Category:ePermit Site Address: 4407 Clover Lane Lot:34 Block: 03 Addition: Eden PID:10-22750-03-340 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:One Window/Door 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 within 10 feet of all sleeping room openings in residential homes (Minnesota State Valuation: 500.00 Fee Summary:BL - Base Fee $500 $40.00 0801.4085 Surcharge - Based on Valuation $500 $0.50 9001.2195 $40.50 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 - Ilya Freyter 3554 Rolling Hills Dr Eagan MN 55121 (612) 408-4257 Crew2 Inc 2650 Minnehaha Ave Suite 100 Minneapolis MN 55406 (612) 276-1680 Applicant/Permitee: Signature Issued By: Signature -------------I r For Office Use I ► Building Permit #: � , , / I 1 0•, j S&W Permit#: `.. •..® EAGAN I� I ,� I Permit Fee: I I I ^1 I Date Received: I 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 I I 1 (651) 675-5675 �FAX: (651) 675-5694 I I Date Issued: I buildinginspections cityofeagan.com I---------------------� RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Applicant is: ❑ Owner Contractor Unit #: h �5 e' C' pL4 1 6 l� Homeowner i Address: qllb C% City: �aQ Q_ State: i Phone::''' Email: Description of work: P e—b�- Type of Q Construction Cost, a Work Type of building: ❑ Single Family ❑ Townhome, of units Twin Home Compan T7QM Building Address: �t"� WQST' K--y City: GGC('V6�� Contractor , //� '/ State:AWIp: � Phone61L2'f _/_/ � � 9� fi 0 Z G2xCo 7131 5 � License #: o O Expiration Date: Sewer & Company: Contact: Water Contractor Address: City: Required for State: Zip: Phone: Email: new construction ! License #: Expiration Date: *I 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. Applicant's Printed Name A licant's Signature