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4474 Clover Lane BCity of Eagan Eagan, PERMIT City of Eaan Permit Type: Building Permit Number: EA102069 Date Issued: 11/12/2011 Permit Category: ePermit Site Address: 4474 Clover Lane B Lot: 6 Block: 02 Addition: Eden PID: 10-22750-02-060 Use: Description: Sub Type: e-Windows/Doors Work Type: Windows/Doors-New/Replacement Description: House 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, 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: 3,000.00 BL - Base Fee $3K $88.50 Surcharge - Based on Valuation $3K $1.50 0801.4085 9001.2195 Total: $90.00 Contractor: Champion Window Company of Mpls 5100 HWY 169 N, #B New Hope MN 55428 (763) 574-2054 - Applicant - Owner: Dale F Kaufman 4474 Clover Lane 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 41' C!tyofEaa Permit Type: Plumbing Permit Number: EA105538 Date Issued: 07/18/2012 IIPermit Category: ePermit Site Address: 4474 Clover Lane B Lot: 6 Block: 02 Addition: Eden PID: 10-22750-02-060 Use: Description: Sub Type: e - Water Heater Work Type: New Description: Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments: Kris Dien 3670 Dodd Rd Eagan, mn 55123 651-365-1340 Fee Summary: PL - Permit Fee (WS &/or WH) $55.00 Surcharge -Fixed $5.00 0801.4087 9001.2195 Total: $60.00 Contractor: Champion Plumbing 3670 Dodd Rd., #100 Eagan MN 55123 (651) 365-1340 - Applicant - Owner: Dale F Kaufman 4474 Clover Lane 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 4i 411' City of Eaall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use Permit #: Permit Fee: Date Received: 7 - ZL / 2– Staff: 7 2012 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit #: B RESIDENT / OWNER Name: Phone: %/L j 7 y 1c l i,, --'y (—i ley --6---- Address / City / Zip: Applicant is: Owner Contractor TYPE OF WORK Description of work: i� ' l t i/, -O//( / le c �,, /g -e444 -.-- Construction Cost: 1 Multi -Family Building: (Yes ?4 / No ) CONTRACTOR Company: Pees h y .70 •e-..- Contact: alrt ' Address: / a-e�`et'`-,,--- �---- City: k 2'C - State: %/%V Zip: ES , 1 „ Phone: Ci z - z L'' a'? a_ License #: Lead Certificate #: If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) , L...1 --„AL,- -7e ass' In the last 12 months, _Yes 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: Licensed Plumber: Mechanical Contractor: Sewer & Water Contractor: Phone: Phone: Phone: NOTE: Plans and supporting documents that you submit are considered tobe 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 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 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. j0G-1 14(412- 4--- Applicant's Printed Name App,; ant's Signature Page 1 of 3 DO NOT WRITE BELOW THIS LINE SUB TYPES Foundation Single Family Multi 01 of _ Plex Accessory Building Fireplace Garage Deck Lower Level w2c/8 ctcofQ Porch (3 -Season) Storm Damage Porch (4 -Season) Exterior Alteration (Single Family) WORK TYPES New Interior Improvement Addition Move Building Alteration Fire Repair Replace \?(‘, Repair Retaining Wall (( DESCRIPTION Valuation Plan Review (25%_ 100%) Census Code # of Units # of Buildings Type of Construction REQUIRED INSPECTIONS Footings (New Building) Porch (Screen/Gazebo/Pergola) Exterior Alteration (Multi) Pool Miscellaneous Occupancy Code Edition Zoning Stories Square Feet Length Width Footings (Deck) Footings (Addition) Foundation Drain Tile Roof: Ice & Water Final Framing Fireplace: Rough In _Air Test Final Insulation Sheathing Sheetrock Reviewed By: M! F-€. L - Siding Reroof Windows Egress Window Demolish Building* Demolish Interior Demolish Foundation Water Damage *Demolition of entire building — give PCA handout to applicant MCES System SAC Units City Water Booster Pump PRV Fire Sprinklers Meter Size: Final / C.O. Required 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 _ 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 Page 2 of 3 CITY OF EAGAN it WATER 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: Meter No.: Connection Charge. Size: Account Deposit. Reader No.: Permit Fee• 1 ogre. to comply with the City of Eagan Surcharge - Ordinances. By Date of Insp.: // ,f/ re- Misc. Charges. Total. Dote Paid. Insp • CITY OF EAGAN 3830 Pilot Knob Road P. O. Box 21199 Ragan, MN 55121 SEWER SERVICE PERMIT PERMIT NO • DATE: Zoning: No. of Units. Owner: Address: Site Address. Plumber 1 ogres 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- City of Eagan PERMIT City of Eaan Permit Type: Building Permit Number: EA110823 Date Issued: 05/30/2013 Permit Category: ePermit Site Address: 4474 Clover Lane B Lot: 6 Block: 02 Addition: Eden PID: 10-22750-02-060 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, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required by law in ALL single family homes. Fee Summary: 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: Dale Kaufman 9251 185th St E Prior Lake MN 55372 (651) 687-0734 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: Mechanical Permit Number: EA111436 Date Issued: 06/24/2013 Permit Category: ePermit Site Address: 4474 Clover Lane B Lot: 6 Block: 02 Addition: Eden PID: 10-22750-02-060 Use: Description: Sub Type: Residential Work Type: Replace Description: Air Conditioner Comments: Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Diane Moyer Home Energy Center Fee Summary: ME - Permit Fee (Replacements) $55.00 Surcharge -Fixed $5.00 0801.4088 9001.2195 Total: $60.00 Contractor: Home Energy Center 2415 Annapolis Lane N #170 Plymouth MN 55441 (651) 766-6763 - Applicant - Owner: Dale Kaufman 9251 185th St E Prior Lake MN 55372 (651) 687-0734 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 From:ALLSTAR CONSTRUCTION 19529427464 09/17/2013 08:49 #582 P.068/079 C!ty of aan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use �j Permit #: 1 [� l 463 Permit Fee: 303. S Date Received; all -1113 Staff: Cf[ 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 1I DI2O13 Site Address: 411-1 i9' B, 1 ,1411U{J CItev Lot, Unit #: J Owner -ne. Owr Name: E(j l OR CIO! Nato CVt t Ipqly Phone:Res le-Kst/ I Address / City / Zip: G 11e51 Parkway, Urn Waffle, MN "J�T1 Applicant is: Owner Contractor Type of Work Description of work: lay Off owl O ktrilif Construction Cost: 3 Ito, 1D9, DO Multi -Family Building: (Yes X / No ) Contractor I Company:. lS Ir COt'&fl Vtl/1 ►On 101 0 1 t%ontact: Lilt tialtiCCICI ► p Address: J S industrial O1 -4IO3 City: M&I If Plain State: MN Zip: 53V:i Phone: C61 CtiZ' 1'tC)y License #be-kiAelS Lead Certificate #: %fI7 2.0%,-1-0 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: Phone: Mechanical Contractor: Sewer & Water Contractor: NOTE Plans and the information Phone: Phone: supporting documents that you submit are considered to be public information. Portions of 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 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 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. r/1 x 1 • —et - x UQe tiVttead Applicant's Printed Name Apjilrgant's Signature Page 1 of 3 From:ALLSTAR CONSTRUCTION 19529427464 02/10/2016 13:07 #301 P.021/022 City of £aan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 6754694 Use BLUE or BLACK Ink For Office Use 1300/3 Permit #: Permit Fee: Date Received: Staff: 2016 RESIDENTIAL BUILDING PERMITllAPPLICATION n Date:.?//d �/!o Site Address: VOW" Wi &JV87 - 4y Unit #: �l Name: Ae.A 4164 t ifi — e-li&/`f 1 0fl Resident/ Owner is Address / City / Zip: Phone: ////, J Type of Work Contractor Applicant is: Owner ai Contractor Description of work: /191-- /00 1nyiIs7P�°'t7nf/i8--(j�F.�4, ,vtCi+k�` cJ Construction Cost: /O,tOl/ ^ Multi -Family Building: (Yes /�/ No ) Company: All544itn giefi;71teelall cls Contact: J 1 nn A item'? Address:Sl445 I tcs-tr;A I $?- so r -I t. /03 city: MAO- O- fi t, -;et State: Zip: p 55359 Phone: '9 ' 6T Email: 4.7 74Gl.f/S- r..6 License #:.56 toCo 3S ® Lead Certificate #: itr. lk'% o2®91,9 V - d� If the project is exempt from Iead certification, please explain why: 1.3u , r� /9es 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: jSewer & 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 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.aopherstateonecall.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 pemnit issued in accordance with the Minnesota State Buildin .0 plated within 180 days of permit issuance. 10411 Applicant's Printed Name Applic nt's Signature Page 1 of 3