4423 Clvoer Lane Unit B,, , , � %'
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Name: Jr Jet) h e /4 cc wIL Gc4 Phone:
Address / City / Zip: L ig Z` � C Z694` er A
Applicant is: Owner 4 Contractor
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Description of work: Rebtt`t I d eXi s-f-i n
Construction Cosa A CS-D Multi - Family Building: (Yes / No
ONT AC ORS \
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Company: tEck 6.1 Joe Contact: ,) OL - 1 - a-1 1 /6.,1
Address: 1 % % &eneVaIVe - /V (X.� City: � `e-
State: 1 ' IQ Zip: S/c - Phone: 6 3 717 - 31d?3
a
Lice nse #: K6 3 0 i o •_.
Le ad Certificate #:
If the project is exempt
from lead certification, please explain why: (see Page 3 for additional information)
i 3 r7 -) /G-, i /4/ K
t-- -f ,
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:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
Phone:
� ►` . n ; + ts1t". ° , 1414 a re c { s s t tffr f e,
CO
Date:
City of Ea�all
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
x x
Applicant's Printed Name
For Office Us
- 7- j >>z
Permit #:
Permit Fee:
Date Received:
Staff:
~p 2012 RESIDENTIAL BUILDING PERMIT APPLICATION
7 2e' /Z Site Address: u 41 23 Of e v e r 4 Unit #:
Use BLUE or BLACK Ink
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.00nherstateonecall.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.
x / k ,
Ap ant's Signature
Page 1 of 3
SUB TYPES
Foundation
Single Family
Multi
01 of _ Plex
Accessory Building
WORK TYPES
New
v it Addition
Alteration
Replace
Retaining Wall
DESCRIPTION
Valuation
Plan Review
(25% 100% l/ )
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
Fireplace
Garage
Deck
Lower Level
Interior Improvement
_ Move Building
Fire Repair
Repair
341
i
REQUIRED INSPECTIONS
Footings (New Building)
j Footings (Deck)
Footings-(Addition) -
Foundation
Drain Tile
Roof: Ice & Water _Final
Framing
Fireplace: __Rough In _Air Test _Final
Insulation
Sheathing
Sheetrock
Reviewed By:
73
AG otl
TOTAL
DO NOT WRITE BELOW THIS LINE
_
Porch (3-Season)
Porch (4- Season)
Porch (Screen /Gazebo /Pergola)
Pool
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
_ Siding
Reroof
Windows
Egress Window
*Demolition of entire building — give PCA handout to applicant
gO
/D
A 7
Clo06 / � �r� ; (Am i-
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Sprinklers
Storm Damage
Exterior Alteration (Single Family)
Exterior Alteration (Multi)
Miscellaneous
Demolish Building*
Demolish Interior
Demolish Foundation
Water Damage
Meter Size:
Final / C.O. Required
Final - / C.O. _
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
Page 2 of 3
I
ROBE ENGINEERING PLANNERS and LAND iURVEYORS
COMPANY INC.
1000 EAST 146% STREET, BURNSVILLE, MINNESOTA 55337 PH 432
2iOn ; LOY5 21, 22,23 AND 24, BLOCK 3 EDEN!
DAKOTA COUNTY, MINt'J SOTA
NORTH
5 GALE. : I " = 3o'
lo kit . Li / /
C e, 1 ecs,1
7B -13
9.10.5
■ 36-! 1 '
30' FRONT BUILD/Ale
SEreA'K L1/J
Gto e)
CONSULTING ENGINEERS
DENOTES EX /5T 1/U6 ELEVATIOk1
DENOTES PROF't?SEU ELEVATION
INDICATES UIREcTION or SURFACE DRAIA/ACE
937.5 FIAT /SHED GARAGE FLOOR ELEVAT/ON
1 t I
: ,� 1 L L 1
S`u.rarey
BY:
ILA
1 J
N1
EAGAN
REV! ED
DATE:
rt
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EAST
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0T1L IZY
ADDIT1O!J,
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I hereby certify that this is a true and correct representation of a tract of
land as shown' and described. hereon.. As prepared by me on this — day of
47" ninn. Rea. No. "
CITY OF EAGAN WATER SERVICE PERMIT
3830 1?iltit Knob Road
P: O. Box 21199 PERMIT NO.:
Eagan, MN 55121 DATE:
Zoning: — No. of Units:
Owner:
Address:
Site Address:
Plumber:
Meter No.: Connection Chorge:
Size: Account Deposit:
Reader No.• Permit Fee:
1 agree to comply with the City of Eagan Surcharge:
Ordinances. Misc. Charges:
r - -. Totol:
By Date Paid:
Dote 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:
1 agree to comply with Hoe City of Eagan Connection Charge:
Ordinances. Account Deposit:
Permit Fee:
Surcharge:
By Misc. Charges:
Dote of Insp.: Total:
Insp.: Date Paid:
From:ALLSTAR CONSTRUCTION 19529427464 09/1712013 08:37 #582 P.038/079
Use BLUE or BLACK Ink
I For Office Use l n
' j Permit
Clt~ of Eap I Permit Fee: ° 50
3830 Pilot Knob Road I I
Eagan MN 55122 j Date Received. 1 j
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 1 staff: I
I I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 01f5 l 2013 Site Address: y4Z3 442>g T 11 , 4L41CVR CIvex LAW/ Unit
Name: dean VVr'1 CIO' C'JO yl cum Phone:
Resident/
Owner Address /City/ Zip: W-1 J UiN "M Pftmi, Eym rare , M N 5 y
Applicant is: Owner Contractor
Description of work: My and yt Ybof
Type of Work `l
Construction Cost: 411 M''ll
V U Multi-Family Building: (Yes / No
Company: _t1
ILVIA t JjOtsLI VVI l l l ►Y`u ! Contact:
.~-y Ct
Contractor Address: ~Iy~ I~ndU CAI St 1e # city: Wit Nih
State:
Zip: ~1 Phone:
License ~~,/r~ UI.~J~ S Icj Lead Certificate
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: 4
Sewer & Water 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
a a ~mvy~ conclude that thM 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.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.
x 6At S A x `L
°
Applicant's Printed ame Ap li ant's Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA140710
Date Issued:01/17/2017
Permit Category:ePermit
Site Address: 4423 Clover Lane B
Lot:24 Block: 03 Addition: Eden
PID:10-22750-03-240
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
$60.00 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 -
Jennifer K Mccullum
4113 E 104th Street
Bloomington MN 55420
Centraire Heating & Air Conditioning
7402 Washington Ave
Eden Prairie MN 55344
(952) 941-1044
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA149072
Date Issued:05/04/2018
Permit Category:ePermit
Site Address: 4423 Clover Lane B
Lot:24 Block: 03 Addition: Eden
PID:10-22750-03-240
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener).
Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087
Surcharge-Fixed $1.00 9001.2195
$60.00 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 -
Jennifer K Mccullum
4113 E 104th Street
Bloomington MN 55420
Centraire Heating & Air Conditioning
7402 Washington Ave
Eden Prairie MN 55344
(952) 941-1044
Applicant/Permitee: Signature Issued By: Signature
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
(651) 675-5675 1 FAX: (651) 675-5694
buildinginspections(@citvofeagan.com
-------------I
r For Office Use
I
I Building Permit #:
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I
SSW Permit #:
I I
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Permit Fee: 22q
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Date Received: I
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I Date Issued:
I---------------------J
RESIDENTIAL BUILDING PERMIT APPLICATION
Date: hqlSite Address: Unit #:
Applicant is: ❑ Owner Contractor
Name: �G([ b V\- fie_ C) S 4455 C7 C? i 0-4
; Address: qq2_3 Ah2 city: act a
Homeowner
ul� 5i! 2 ICU L�
State: i Phone(:: Email:
�'v� :
P,e Q
Description of work: t> e:,,
Type of
Construction Cost Li
Work
Type of building: ❑ Single Family ❑ Townhome, of units in Home
Compan _.ThLI�M
g IJljesk l� Building 'Address: � � �1 City: �
Contractor `J '/
State:/ Zip: 5�3 T Phone6tZ�'f 5 Email lmel f \e"
O'Z62(0 *� LCJD� ^-
License #: Expiration Date: J
Sewer & Company: Contact:
Water
Contractor Address: City:
Required for State: Zip: Phone: Email:
new construction
License #: Ex iration Date:
*1 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