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