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4401 Clover Lane - Unit BDate: City of Eaan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675 -5675 Fax: (651) 675-5694 Applicant is: Applicant's Printed Name 2012 RESIDENTIAL BUILDING PERMIT APPLICATION 16 / Z Site Address: Lill O/ Cl© j/ 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: State: f 'tIV Zip: la0 Contact: 0 t, City: Oal th l€- � Phone: CU Si — 7 7 "- 3 YL 3 License #: t��//��'(o 3 0 J CY Lead Certificate #: 1 i If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) 64-/ r /4 7f Description of work: Construction Cos Multi - Family Building: (Yes _ / No Name: !6 `e1i11 d lf / -' Address / City / Zip: 1 1 1- / C7 / cLoli Contractor x Appl' s Signature Staff: Phone: For Office Use / Date Received: — !i - I Z-- �7 Permit #: Permit Fee: YMONSONVY Use BLUE or BLACK Ink Unit #: L J CALL BEFORE YOU DIG. Call Gopher State One CaII 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.00pherstateonecall.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 days of permit issuance. Page 1 of 3 SUB TYPES Foundation Single Family Multi 01 of Plex Accessory Building WORK TYPES New Addition Alteration 4 ; Replace Retaining Wall DESCRIPTION Valuation Plan Review Fireplace — Garage Deck Lower Level (25% 100 %) Census Code �` #of Units # of Buildings Type of Construction RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S &W Permit & Surcharge Treatment Plant Copies Interior Improvement Move Building _ Fire Repair — Repair REQUIRED INSPECTIONS Footings (New Building) y Footings (Deck) !! Footings (Addition) Foundation Drain Tile Roof: Ice & Water _Final Framing Fireplace: _Rough In Air Test Final Insulation Sheathing Sheetrock Reviewed By: - TOTAL DO NOT WRITE BELOW THIS LINE Porch (3- Season) _ Porch (4- Season) Porch (Screen /Gazebo /Pergola) _ Pool _ Siding Reroof Windows _ Egress Window *Demolition of entire building – give PGA handout to applicant Occupancy 141 Code Edition s N ,17 Zoning Stories Square Feet Length Width rz 'MA Clover- Demolish Building* Demolish Interior Demolish Foundation _ Water Damage MCES System SAC Units City Water Booster Pump PRV Fire Sprinklers 105 Storm Damage Exterior Alteration (Single Family) Exterior Alteration (Multi) Miscellaneous Meter Size: Final / C.O. Required y 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 ()(7,0( 0 (9 0 vl Page 2 of 3 9 ID bJ tin ',II. 0 0 N c ITY OF EAGAN WATER SERVICE PERMIT 3P3O Pilo", Knob Road P. O. Box 21199 PERMIT NO.: Eagan, MN 55121 DATE: Zoning: No. of Units: Owner: - — Address: Site Address: Plumber: goo ill J il Meter No.: Connection Charg�e // Size: Account Deposit: Render No.• Permit Fee: 1 agree to comply with the City of Eagan Surcharge: Ordinances. Misc. Charges: Total: By Date Paid: Date of Insp.: lt114 " _ " r� Insp.: TY OF EAGAN SEWER SERVICE PERMIT 3P.3C 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 comply with the City of Eagan Connection Charge: Ordinances. Account Deposit: Permit Fee: Surcharge: By Misc. Charges: Date of Insp.• Total: Insp.- __ Date Paid: From:ALLSTAR CONSTRUCTION 19529427464 09/17/2013 08:41 #582 P.047/079 Use BLUE or BLACK Ink Abb. t For Office Use _ I 1 I Permit I I City of Eap 1 Permit Fee: i O I I I 3830 Pilot Knob Road I pt 1 I Eagan MN 55122 I Date Received: I t Phone; (651) 675-5675 Fax: (651) 675-5694 1 staff: I I I f, 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 2013 Site Address: I RQ9 11811, L44 LIL AB WAhlf L_OiU Unit ~'n {{~~ID r ` ~j Name: l~l~l~i l t ly~ 010' ~OISSP.L*1 C~YYI~i Phone: i Resident/ /city /zip: 3g C/I W1J~ ~Ykwow PGAW WAIYI f MN %3414 owner ' Address M Applicant is: Owner Contractor Type of Work Description of work: -Tim Dff Qr4 ye-VO Construction Cost: 1 Itnhm-oo Multi-Family Building: (Yes X /Nom Company: 1T~tft W tul.ll n { mTn& L Contact: (Jac 19 Contractor Address: 51y5 Mau&lcu Si rty--r 4 le City:.__hWG lain State: Myq _IIZ,iipp: Phone: gyy~L IySN License Lead Certificate NAT- 2-LAV4'-'0 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: i NOTE. Plans and supporting documents that you submit are considered to be public information. Portions of ~a 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.oooherstateonecall.oro 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. X_ ftad x ' f `dot Applicant's Printe Name Appli nt's Signature Page 1 of 3 From:ALLSTAR CONSTRUCTION 19529427464 02/10/2016 12:57 #301 P.007/022 *City ofEaQall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use Permit #: J© Permit Fee: Date Received: Staff: 2016 RESIDENTIAL BUILDING PERMIT APPLICATION Date:Q'ddllr Site Address: /O9 4/1 u✓ 4lvl /4 / 114e/' iG ..... _..._... t ,3 Unit *• Resident! / - G 4 Owner Address / City / Zip: de -o, � �� G4tltc /y�OJ 6441/1-r�iG Owner )( Contractor Type/ 1of Work Description of work: '-.5 1,0 r44 1/,Cn y/ 5:47/ss Name: 404VA /VA la - 4-6E/J f/OA Phone: /11/4 Applicant is: Construction Cost: lo?oj 4006 Multi -Family Building: (Yes "o ) Company: /41(514L d di'tYa 011 inity;11161211 t Contact: "i4 r A ri i,� Contractor Address:S/-S I r dw34-riA 1 s?< ��t,=f X03 City: Mfrp PLi rr dl State: 17114 Zip: 55359 Phone: '9V^7416'f Email: s%t%PJgGZ-!/S- ,r• License #: BIC 6/0.3S 0 Lead Certificate #: A/f/41-- a?® q , V " If the project is exempt from lead certification, please explain why: AL k -r r"4 /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) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall,orq 1 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 Buiidin ,`mt . mpleted within 180 days of permit issuance. x Ul lIi,na x Applicant's Printed Name Applic$nt's Signature Page 1 of 3 ®, 1 • f fEAGAN 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651) 675-5675 1 FAX: (651) 675-5694 buildinginspections(o)cityofeagan.com --------------I For Office Use I I Building Permit #: I I I j S&W Permit #: I I I Permit Fee: I I I I Date Received: I I I I I I Date Issued: t---------------------' RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: �h qZ?W3 Applicant is: ❑ Owner JELContractor t Homeowner Type of Work Building Contractor Sewer & Water Contractor Unit #: Name: EGCe�A �oVkAe_ (�D� -�j �t-r�5c�CX Or, k Cb l� Address: `/yoQl� City: i;;-a 0.y,, State:M%Wip:55122 Phone: Email: Description of work 9 ,—, QQ C, t - Construction Cost:J l �,q �21 Type of building: Compan T7Q� l/ :S&:y- �Contact: �J�`� �✓ Address:( f�i ��1 W ��T Btl=\AZ V ? City: ,Qe_V VG���' StateAwip: 5_37 T Phone6t z-.211Emailt_a/Ul2 �C �e �CSN`�'�"A �l -��oz�� r� License #: � i? .Expiration Date: .7F/ �% /L S Company: Address: ❑ Single Family ❑ Townhome, of units Twin Home Required for State: Zip: Phone: new construction Contact: Email: License #: Expiration Date: City: 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 L.9re 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. /1,1 V + x Applicant's Printed Name A licant's Signature