1540 Clemson Dr05/31/2011 WED 11:.47 FAX
4411`bCity ofBaQen
Date:
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675.5675
Fax: (651) 675-5694
b
IjJQQz/oo4
Use BLUE or BLACK Ink
For Office Use
Permittt: /Of Ll5
Permit Fee: NO'
J
2011 RESIDENTIAL BUILDING PERMIT APPLICATION
1 1 Site Address: _ Fenn 4,:5Qe.. Unit 6:
=d�li1'1/
Name: � .����� 1MMeA9 Phone: a&_ t- 4:caLe.
Address / City / Zip: d
ism t o�
Applicant is: Owner ✓ Contractor
Description of work:akkixt7nC1YYl — P_
Construction Cost: Lo,5 Lt ^ Multi -Family Building: (Yes / No t./.). )
Company: Contact: �� �Sda ��� L� ^ 1
Addres (•� O i((LA M A h A Ai/ City: ` .1 t u P L '
ii�_ �1l�Co�J
State: Zip; 5 cf)f _ Phone: ���'t9't (Sr.� 1 Co 16
License #:
00 5 kg nun
Lead Certificate #:
A/AT 0,340-/
If the project is exempt from lead certification, please explain why: (see Page 3 for additional Information)
COMPLETE THIS AREA mix IF CONSTRUCTING A &kw BUILDING
In the last 12 months, hos 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;
•
gfra., r.r.i. r> >
CALL BEFORE YOU DIG. CaII Gopher Siete Ono Cad at (051) 454-0002 for protection against underground utility damage. Cab 48 hours
before you Intend to dig to receive locates of underground utilities. www.000herslateoaeoall.om
1 hereby acknowledge that thle information 10 complete end accurate; that the work will ba In conformance with the ordinances and codes of the City of
Eagan; that I understand this Isnot a permit, but only an application for a permit. and work to not to start without a permit; that the work will be In
accordance with the approved plan In the oase of work which requires a review end approval of plans.
Exterior work authorized by a building permlt Wooed In accordance with the Minnesota Slaps BulldIng Code must be completed within 1BO
days of ermlttIIsssuance. gyp@
X J Me//d,
Appll nt's Printed Name
fro
Applltanes S urs
Page 1of3
09/31/2011 WED 11:49 FAX 1003/004
75q0C(cmoli �-
DO NOT WRITE BELOW THIS LINE
/ O(/6
SUB TYPES
_ Foundation _ Fireplace — Porch (3•Seaaon) _ Storm Damage
XC Single Family` Garage Porch (4•Season) _ Exterior Alteration (Single Family)
— Multi _ Deck _ Porch (Screen/Gazebo/Pergola) Exterior Alteration (Multi)
01 of _ Plex _ Lower Level _ Pool _ Miscellaneous
Accessory Building
WORK TYPES
New _ Interior Improvement — Siding _ Demolish Building*
_ Addition Move Building _ Reroof Demolish Interior
X( Alteration— Fire Repair _ Windows Y Demolish Foundation
Replace — Repair
_ Retaining Wall
pESCRIPTIOI'( 3000
Valuation 44f0, Occupancy TQc - 3 MCES System —
Plan Review Code Edition SAC Units
(25% 100% Zoning',V City Water
Census Code /114 Stories Booster Pump
# of Units — Square Feet — PRV
d of Buildings — Length Fire Sprinklers —
I Type of Construction DA Width
1
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) Final / C.O. Required
Footings (Addition) • Final / No C.O. Required
Foundation HVAC Gas Service Test Gas Line Air Test
Drain Tile Other:
_ Egress Window _ Water Damage
'Demolition of entire building- give PCA handout to applicant
Roof: _Ice & Water Final Pool: Footings ,Air/Gas Tests _Final
j Framing Siding: Stucco Lath Stone Lath Brick
Fireplace: _Rough In Alr Test _Final Windows
-Insulation Retaining Wall: _ Footings _ Backfill _ Final
$heathen Radon Control
Sheetrock Erosion Control
0 . Building Inspector
RESIDENTIAL FEES v
Base Fee 6,j'
S—'
Plan Review 5253
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies /5"N A
TOTAL
/06 41i Ao
A./1/
Page 2 of 3
City of Eagan
Eagan,
PERMIT
City of Eaan
Permit Type: Plumbing
Permit Number: EA101378
Date Issued: 10/05/2011
Permit Category: ePermit
Site Address: 1540 Clemson Dr
Lot: 4 Block: 01 Addition: Thomas Lake Heights 2nd
PID: 10-75951-01-040
Use:
Description:
Sub Type: e - Fixtures
Work Type: New
Description: Main Floor
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:
Alex Barna
PO Box 188
Cedar, MN 55011
763 444 0292
Fee Summary:
PL - Permit Fee (miscellaneous) $50.00
Surcharge -Fixed $5.00
0801.4087
9001.2195
Total: $55.00
Contractor:
Sowada and Barna Plumbing
PO Box 188
Cedar MN 55011
(763) 444-0292
- Applicant -
Owner:
Christie J Thames
1540 Clemson Dr
Eagan MN 55122
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.
Applicant/Permitee: Signature
Issued By: Signature
CI
Y
3830 Hot WATER SERVICE PERMIT
3830 Pilot Knob Road
P.O. Box 21199 PERMIT NO.: ? e
Eagan, MN 55121 1
Zoning:
DATE: t sz p
No. of Units:
Owner:
To
Address:
Site Addess: 'Lt'1 a --- T►ri w T Le R1 T}inm t t T
Plumber:
Meter No.: Connection Charge:
Account Deposit:
Reader No..
Permit Fee:
I agree to comply with the City of Eagan Surcharge:
Ordinances. Misc. Charges:
By L,Cc,{ 7 id 6 Total:
Date of Insp.: /D ./ �!� �� Date Paid:
Insp.:
Size:
CITY OF EAGAN
3830 Picot Knob Road
P. O. Box 21199
Eagan, MN 55121
Zoning:
Owner:
Address:
Site Address:
Plumber:
SEWER SERVICE PERMIT
PERMIT NO.:
DATE:
No. of Units:
1 agree to comply with the City of Eagan
Ordinances.
By
Date of Insp.:
Insp.:
Connection Charge:
Account Deposit: _
Permit Fee:
Surcharge:
Misc. Charges:
Total:
Dote Paid:
13-q,)
5A-1/4
45
S..
Date:
Ciliy of Eaaall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use I
Permit #: t t� 110
d 1
Permit Fee: Y U 1• 1 5 -
Date Received:
Staff: Sib
t3
2013 RESIDENTIAL BUILDING PE(RM)IT APPLICATION
- 11- 13 Site Address:.L��_,,_ /5 3A1e3)) $ itO).60
Name: /00.26,/ '7-11r ItS 77, t.) hf '1_L� _ Phone:. -Z• 72/- 3-3-0411
J
Address / City / Zip:
Applicant is: Owner Contractor
Description of work: Re rec # m n j
Construction Cost: _L (`I 5
Multi -Family Building: (Yes _ / No
Company: f} ( C()/?$?tit %/f' Contact: Live.)
Address: _an. 3 e2. M city: M lnr)ea. poh`s
State: MAJ Zip: 5-5-4i0 ` Phone: _ol ' / Z. - 55 5
License #: t^ - 1 92.0 2- Lead Certificate #: N 2 412.'7 " %
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:
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Cali 48 hours
before you intend to dig to receive locates of underground utilities. www.00pherstateonecali.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 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 ofjpermit issuance.
E
x t204. ' -M ., t e/?
Applicant's Printed Name
x
Applica s Signature
Page 1 of 3
1,11/
City of Eaali
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
JAN 0 2 2014
Use BLUE or BLACK Ink
1
For Office Use
Permit #:
Permit Fee:
Date Received:
Staff:
2013 MECHANICAL PERMIT APPLICATION
D Please submit two (2) sets of plans with all commercial applications.
Date: i z/ 1 i ' Site Address: 1.41 Ce ' r S V -
Tenant: Suite #:
J
Name: V-eut h Te t\S-P-Phone: CO SI 4 5 (' O42-
Address/City/Zip: 164 Q f Ve-,r Dr ga9Ck.r\, (22
Name: Flare., tAtslinyl �r - P % C ( C'ci,1 License #:
Address:9 -;03 pl 1 PN`e--- pc) - City: (" lvldeh tJOIA�Qs--(
State:M /kJ Zip: `' ' 2 Phone:1 Lo3 - v '2 -(I 1 �D
Contact: Email: i62CeANe.L1t-k- - CO `'Y>
New- Replacement Additional Alteration Demolition
Description of work:tiat'F.hne i -N t I`CY\C e l`n ((tS
NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened byLLCi
Code. Please contact the Mechanical Inspector for information on permitted screening methods.
RESIDENTIAL
Furnace
Air Conditioner
Air Exchanger
Heat Pump
Other
COMMERCIAL
New Construction Interior Improvement
Install Piping
Gas
Processed
Exterior HVAC Unit
Under/Above ground Tank ( Install / _ Remove)
RESIDENTIAL FEES
$160.00 Minimum Add or alteration to an existing unit (includes $5.00 State Surcharge)
$100.00 Residential New (includes $5.00 State Surcharge) $ (26
TOTAL FEE
COMMERCIAL FEES
$55.00 Permit Fee Minimum
$70.00 Underground tank installation/removal
*If contract value is LESS than $10,010, Surcharge = $5.00
**If contract value is GREATER than $10,010, Surcharge = Contract Value x $0.0005
***If the project valuation is over $1 million, please call for Surcharge
Contract Value $ x .01
= $ Permit Fee
$ Surcharge*
= $ TOTAL FEE
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.
City of Eagan
PERMIT
City of Eaan
Permit Type: Building
Permit Number: EA121411
Date Issued: 03/31/2014
Permit Category: ePermit
Site Address: 1540 Clemson Dr B
Lot: 3 Block: 01 Addition: Thomas Lake Heights 2nd
PID: 10-75951-01-030
Use:
Description:
Sub Type: Windows/Doors
Work Type: Replace
Description: Two or More Windows/Doors
Census Code: 434 -
Zoning:
Square Feet: 0
Construction Type:
Occupancy:
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.
Fee Summary:
Valuation: 4,000.00
BL - Base Fee $4K
$103.25
Surcharge - Based on Valuation $4K $2.00
0801.4085
9001.2195
Total: $105.25
Contractor:
Champion Window Company of Mpls
5100 HWY 169 N, #B
New Hope MN 55428
(763) 574-2054
- Applicant -
Owner:
Donna Mae Mccloud
1540 Clemson Dr B
Eagan MN 55122
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.
Applicant/Permitee: Signature
Issued By: Signature
City of Eagan
PERMIT
City of Eaan
Permit Type: Building
Permit Number: EA127912
Date Issued: 10/20/2014
Permit Category: ePermit
Site Address: 1540 Clemson Dr
Lot: 4 Block: 01 Addition: Thomas Lake Heights 2nd
PID: 10-75951-01-040
Use:
Description:
Sub Type: Fireplace Construction Type:
Work Type: Gas Fireplace (new)
Description:
Census Code: 434 - Occupancy:
Zoning:
Square Feet: 0
Comments:
Improvements to the home may require smoke detectors in all bedrooms. Chimney / flue must be inspected prior to
concealing.
Carbon monoxide detectors are required by law in ALL single family homes.
Fee Summary:
Valuation: 3,000.00
BL - Base Fee $3K
$88.50
Surcharge - Based on Valuation $3K $1.50
0801.4085
9001.2195
Total: $90.00
Contractor:
Hearth and Home Technologies
2700 N. Fairview Ave
Roseville MN 55113
(651) 638-3309
- Applicant -
Owner:
Kevin J Jensen
1540 Clemson Dr
Unit A
Eagan MN 55122
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.
Applicant/Permitee: Signature
Issued By: Signature
E For Office Use
�G 6,
%.1":
" : a",,0
�� 0 Permit* / I
...... .......
Permit Fee: /417- .5,.&
I"1EC
EIV ' Date Received: ye
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 i
(651)675-5675 I TDD:(651)454-8535 I FAX: (651)675-5694 JUAN 10 2613 Staff: 4
buildinginspectionsacitvofeaaan.com
2019 RESIDENTIAL BUILDING
BUILDING PE APPLICATION
Date: 1 / 7/1 "/ Site Address: !7 yU ���' 4.�y�/ )0~ Unit#:
Name: ,4 - /L( .-u+ /erwaytf firma aiSb �i,ticy f Phone:
Resident/@nt/
Address/City/Zip:
d Applicant is: Owner Contractor
Type: 3 Description of work: IC�[,�¢E�1' v,r .il /1� (s;,,� ,'�-', ray 4`%"r�t IL
a6 r f / X&Citta
Construction Cost:5.0®• Multi-Family Building: (Yes I No )
`a
//11 re aa� 'v't� r r ve,
. Company: Dk7 effr/L 77eKLTT4's 99V6 Arnie. ontact: /O ti e r., 4471,/
�-n
Contra-afar'
Address: 14//.2 &/finezfr !me- City: I%t'LiE .LeViI
� r
,- State:00V Zip: sem-/,3L f Phone:4,47-624/4-Y �A,/,nail:/ �x frp v5rArez•Ticro/.riuc ? • c
e....:-
.-, License#:.t 22. 9 f 24- Lead Certificate#:
If the project is exempt from lead certification, please explain why:
(�
�L aA1 ® idigo a
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:
� SwP7' orr
class eafas i''''''''''"`-7.-
.� r l 4 ' .. .
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's
website at www.citvofeasian.comisubscribe.
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.
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.aooherstateonecall.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 pe '; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval cans.
xPLLI/ r x mi
Applicant's Printed Naarrib �
Applicant's Signature
DO NOT WRITE BELOW THIS LINE /5Z7 C! m-c 'i 2 /.S- D " 1
SUB Tlr''ES
Foundation _ Fireplace — Porch(3-Season) _ Exterior Alteration(Single Family)
_ Single Family _ Garage _ Porch(4-Season) _ Exterior Alteration(Multi)
_ Multi C Deck _ Porch(Screen/Gazebo/Pergola) _ Miscellaneous
le111 of A Plex _ Lower Level _ Pool _ Accessory Building
WORK TYPES
— New — Interior Improvement. — Siding _ Demolish Building*
_ Addition — Move Building — Reroof _ Demolish Interior
_ Alteration _ Fire Repair _ Windows Demolish Foundation
_
Replace _ Repair _ Egress Window _ Water Damage
Retaining Wall *Demolition of entire building—give PCA handout to applicant
DESCRIPTION
Valuation je 3/ e D 0•^ Occupancy – MCES 0ystem
/r
Plan Review Code Edition ^2 0>C SAC nits
(25%_100%p) _ Zoning PD City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Suppression Required
Type of Construction VS Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) Final/C.O. Required
Footings(Addition) l0 Final/No C.O. Required
Foundation Foundation Before Backfill HVAC_Service Test Gas Line Air Test_Hood
Roof:_Ice&Water _Final Pool:_Footings _Air/Gas Tests _Final
Framing 30 Minutes 1 Hour Drain Tile
Fireplace:_Rough In Air Test _Final Siding:_Stucco Lath _Stone Lath _Brick_EFIS
Insulation Windows
Sheathing Retaining Wall: _Footings_Backfill_Final
Sheetrock Radon Control
Fire Walls Fire Suppression: Rough In_Final
Braced Walls Erosion Control
Shower Pan �(�/% Other:
Reviewed By: Mb ' 'r '1c-` Le A- , Building Inspector
RESIDENTIAL FEES
Base Fee !r✓
X; S %nq /Go+d I i rl
Surcharge
Plan Review /D 'C 2v 2 00 Sf
S ' /
MCES SAC ®,.,p /`rj.D J 1I - 14T
City SAC
Utility Connection Charge
S&W Permit&Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3