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4419 Clover Lane
CityofEaaall Date: Site Address: Use BLUE or BLACK Ink For Office Use Permit #: 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675 -5675 staff: Fax: (651) 675 -5694 Permit Fee: Date Received: 2012 RESIDENTIAL BUILDING PERMIT APPLICATION Unit #: Name: Address / City / Zip: I I 4// C f d` Applicant is: Owner >v Contractor Description of work: Relati 1 eXi S I c le k Construction Coster S d-D Multi - Family Building: (Yes _ / No Company: ' Ck 5o j 6 l Contact: �©. 41Gi Address: /91PS V enet Wf - iV City: O( I:. de- State: (' `1 v Zip: S Phone: 6 S ° 777 3 Yal 3 License #: I /tn 3 0 Al d 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: Phone: Sewer & Water Contractor: Phone: Mechanical Contractor: 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.gopherstateonecall.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 Minneso State Building Code must be completed within 180 days gf ermit issuance. Applicant's Printed Name Ap . nts Signature /` J Page 1 of 3 DO NOT WRITE BELOW THIS LINE SUB TYPES Foundation Single Family Multi 01 of Plex Accessory Building WORK TYPES New *' Addition Alteration Replace Retaining Wall DESCRIPTION Valuation Plan Review (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 Copes Fireplace Garage .# Deck Lower Level Interior Improvement Move Building Fire Repair Repair REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) Foundation Drain Tile Roof: Ice & Water Final Framing Fireplace: Rough In Air Test Insulation Sheathing Sheetrock Reviewed By: TOTAL Occupancy Code Edition Zoning Stories Square Feet Length Width Final J A Porch (3- Season) Porch (4- Season) Porch (Screen /Gazebo /Pergola) Pool Siding Re roof Windows _TA? -1. zcw7 PP wig Egress Window Water Damage *Demolition of entire building — give PCA handout to applicant MCES System SAC Units City Water Booster Pump PRV Fire Sprinklers Cl c✓we/ Ltt- e Storm Damage Exterior Alteration (Single Family) Exterior Alteration (Multi) Miscellaneous Demolish Building* Demolish Interior Demolish Foundation Meter Size: Final / C.O. Required Ai. 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 f 3 i j ao , BE ENGINEERING COMPftNY INC. 1000 EAST 146th STREET, 5URNSVILLE MINNESOTA c tz1� NORTH SCALE : I r 30' ?lase" 1,to(e4 s -t dicie.6; 1 t 'i L _ 93S.pj / 115.N CONSUi.T1110 EtiOuWEERS PLAIIIIERS and LAND SURVEYO nS I ' r L . 0T .S 16° 00 °3$4?) 30' FRONT BuiL 1W6 �l VS' SETBACK LINE '- fiilk 3�7 P 57 ° _',' t/i7 LA 5337 P11 432 -3000 I t�.+ 2 LOTS 25, 26,27 AND 28, BLOCK 3 EDEK1 ADDITION, DAKOTA COUNTY, MINNr5O TA �`ir35�o a DENOTES ExISTIN ELEVA1 ION (935, o) DENOTES PROPOSED ELEVATION �,. UJDICATES D,RECTJON OF SURFACE DRAINAGE IN3.0 = F+105HED GARAGE FLOOR ELEVATION t / A R E W E BY: EAG Ai REV! , 4 ED E: 7 / -/7. f.IONS DIVISION r 3 .5_ (13G 0) PROPOSED • _ v�111�T S in At ■ G� Zt t A l ; 2.00 EAST k i10A <_ 1 1q1.0) � P I LDT 28 M _ J 5 62. 00 th C933. 2 ry I 1_,_k-) 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 an this 7) day of m I 19 a PRA+NA4E AMP UTILITY EASEMENT CITY OF EAGAN WATER SERVICE PERMIT 3830 Pilot Knob Road PERMIT NO.: P. O. Box 21199 Eagan, MN 55121 DATE: Zoning: -- No. of Units: Owner: Address: Site Address: Plumber: Meter No.• Connection Charge: Size: Account Deposit: Reader No.• Permit Fee: ogre. to comply with the City of Eagan Surcharge: Ordinances. 0 Y Misc. Charges: By Total: / Date Paid: Date of Insp.: c•- Insp.. E p' 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 the City of Eagan Connection Charge: Ordinances. Account Deposit: Permit Fee: Surcharge: By Misc. Charges: Date of Insp.: Total: Insp.: Dote Paid: From:ALLSTAR CONSTRUCTION 19529427464 09/17/2013 08:38 #582 P.041/079 Use BLUE or BLACK Ink I For Office Use I j Permit City of Bap I Permit Fee: ' ~ . -1 -5 3830 Pilot Knob Road o n J 12 Eagan MN 55122 1 Date Received tJ Phone: (651) 675-5675 I Fax: (651) 675-5694 I Staff: I I 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 9151201-3 Site Address: L44n ,L4qh t5, L4q&4gj96 Clover L CIM, Unit : Name:_ l~ C'~ C~oliseh C0h'1Dq~ Phone: Resident/ p l' Owner Address / CRY / Zip: ~py3 b UtV 41A PQYk ay , Ulm prWric,~T 3~ L4q C I Applicant is: Owner X Contractor Type of Work Description of work: 201Y off d 1 P-Irp I Construction Cost. 4 0 t O -lDO Multi-Family Building (Yes No l~ Company: 1ft COMUGtlM MaVI~01C YIf 1. Contact: C l~le,~tll~stC~(~ ,r Address: SIyS 1h &ATia1 S'1'ref,4 153 City: Woe, Plain Contractor State: Jam- Zip: C_55 Z l Phone: Cnl- q, 4,L- ly e License # S cw1rals Lead Certificate N- 2(~ilP+0 1~7 r1fthe 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: G 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 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 46 hours before you intend to dig to receive locates of underground utilities. www.aooherstateonecall.org 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 Building Code must be completed within 160 days of permit issuance. ~.pn ~ `y X_ u 1. ~clt IAIA x Applicant's Printed Name Ap i ant's Sign ture Pagel of 3 PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA142634 Date Issued:05/11/2017 Permit Category:ePermit Site Address: 4419 Clover Lane Lot:26 Block: 03 Addition: Eden PID:10-22750-03-260 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. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). 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 - Barbara A Larson 4419 Clover Lane Eagan MN 55122 (651) 319-1543 Benjamin Franklin Plumbing 5718 International Parkway New Hope MN 55428 (612) 238-9709 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA165491 Date Issued:11/04/2020 Permit Category:ePermit Site Address: 4419 Clover Lane Lot:26 Block: 03 Addition: Eden PID:10-22750-03-260 Use: Description: Sub Type:Residential Work Type:Replace Description:Water Softener Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Please call Building Inspections at (651) 675-5675 to schedule a final inspection. 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 - Barbara A Larson 4419 Clover Lane Eagan MN 55122 (651) 319-1543 Bruckmueller Plumbing Inc 3992 Pennsylvania Ave Eagan MN 55123 (651) 686-6696 Applicant/Permitee: Signature Issued By: Signature ® 4 e f ®®®lie E AG A N �P 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651) 675-5675 1 FAX: (651) 675-5694 buildinginspections(c)cityofeagan.com -------------- For Office Use I Building Permit #: I I I I S&W Permit #: I I I I Permit Fee: I I I I Date Received: I I I I I Date Issued: t---------------------- RESIDENTIAL BUILDING PERMIT APPLICATION Date:,yhql Site Address: Unit #: Applicant is: ❑ Owner KContractor Name: E?z sA �A b V1�2 O k ---I U-42-N17 S taS"S C�;l C I CX,4 k 6 l/-\� Homeowner Address: l 1 City: �c Ct 0— V� State:% V�Lip: 50Z Phone: 16Vai Description of work:t- Type of Work Construction Cost a t , -V Type of building: ❑ Single Family ❑ Townhome, of units JRTwin Home Compan 3QM l/J!SE&jt'c,lr✓ n\lam Contact: Building Address � � (_. i1'�1 VJ T {�—City:G(�f;�Y\ Contractor 1/� State:Lip: 553��Phone�o�z�7Email. a/ylQ.�[ �e � R5q( �/ OZCa( �O License #:EC T (� Expiration Date: .3C 2 �� Sewer & Water Contractor Required for new construction Company: Address: State: Zip: i License #: Phone: Contact: City: Email: Date: 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 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. Al x Applicant's Printed Name A licant's Signature