4485 Clover Lane - Unit BDate:
City of Evan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Staff:
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit #: , 6(O �►
Permit Fee:
Date Received:
2012 RESIDENTIAL BUILDING PERMIT APPLICATION
7 _I Z _ 26,/Z Site Address:
C lever-
I-044
�.
Unit #:
J
Name: ,g1:4C7711 an, 6_ / I c 'r$ Phone:
Address / City / Zip: 11/11 /!/p/ - 8
Applicant is: Owner Contractor
Description of work: Rb2/ I sTi Ck
Construction Costes��rr
, A 5- (5-7) Multi -Family Building: (Yes A /I No
Company: C -N 6,1 :Yoe Contact:
Address: /%S &eneVa 3WE' - iv City: 00kdak-
State: (` `I V Zip:/aF
Phone: (Q s-1 75.7 3Y 3
License #: t,6 3 01 OD,. Lead Certificate #:
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
/5?‘
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:
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.ora
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.�
Applicant's Printed Name
x
App
ants Signature
Page 1 of 3
011.6 C1w
SUB TYPES
Foundation
Single Family
Multi
01 of _ Plex
Accessory Building
WORK TYPES
New
44 Addition
Alteration
Replace
Retaining Wall
DESCRIPTION
Valuation
Plan Review
(25% 100% //l
Census Code
#of Units
# of Buildings
Type of Construction
(Jfi'- lg.
DO NOT WRITE BELOW THIS LINE
_ Fireplace
_ Garage
Deck
Lower Level
_ Porch (3 -Season) _
_ Porch (4 -Season) _
Porch (Screen/Gazebo/Pergola) _
Pool
Interior Improvement
_ Move Building
Fire Repair
Repair
aya
/a 3,V
1
743
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation
Drain Tile
Roof: _Ice & Water Final
Framing
Fireplace: _Rough In Air Test _Final
Insulation
Sheathing
Sheetrock
Reviewed By:
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
/47
) @ L5t
TOTAL
_ Siding
Reroof
Windows
Egress Window
Storm Damage
Exterior Alteration (Single Family)
Exterior Alteration (Multi)
Miscellaneous
_ Demolish Building*
_ Demolish Interior
Demolish Foundation
_ Water Damage
*Demolition of entire building — give PCA handout to applicant
2007
fes%
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Sprinklers
Meter Size:
Final / C.O. Required
,i0 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 a Backfill _ Final
Radon Control
Erosion Control
, Building Inspector
Page 2 of 3
CITY OF EAGAN WATER SERVICE PERMIT
3795 Pilot Knob Road PERMIT NO •
'Eagan, MN 55122 DATE:
Zoning: No. of Units•
Owner:
Address:
Site Address:
Plumber:
Meter No.: Connection Charge:
Size: Account Deposit•
Reader No.: Permit Fee:
1 agree to comply with the City of Eagan Surcharge:
Ordinances. Misc. Charges:
Total•
By Date Paid:
Dote of Insp.: Insp •
CITY (F EAGAN SEWER SERVICE PERMIT
3795 Pilot Knob Road PERMIT NO •
r•
Eagan, MN 55122 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.• Date Paid•
From:ALLSTAR CONSTRUCTION 19529427464 09/17/2013 08:27 #582 P.008/079
C!ty of Eaaft
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit #: I II(� I 05
Permit Fee: > O?�(1 • �1� O
Date Received: ` I 11 I' 7
Staff:
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Ci JE J 2uI3 Site Address: l'ILl<31LILIf3e,1+49 LiLik5R Clovo' Lar(/ Unit#:
[Namc,ncJo.n
Resident/
Company Phone:
iowner ' Address / City / Zip: �'W�2G(},{ t POitic"I a 11 ei MN ,3L -1'--i
Applicant is: Owner Contractor
Type of Work
Description of work: -ROW off and Ve-VOD
Construction Cost: J 21)I 20.00 Multi -Family Building: (Yes �/ No )
Contractor
Company:. MOM tiYIS•IniC11OI maymeiturt, L L Contact: 60e lialgtead
G �l-t,�m.�
Address:�51y5 Indl(stna( &t et�l #ID�J City:tMaple, Plain Plain
�
State: MN Zip: 55 f Phone: v1s2_ q -1 - 1 •1 9'7
0157,-q91-
License #: PjC113IGJIS Lead Certificate #: NWT - 2D01(0L1 -D
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
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: Phone:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
NOTE: Plans and
the information
-,,,.t...,.�.._._.,.. ..,�r_.�...,�,x�
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._
1
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. oopherstateonecall.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 1/completed within 180
days of permit issuance. .t
x due It alsil.ad
Applicant's Printed Name
1-9.0
Ap itant's Signature
Page 1 of 3
From:ALLSTAR CONSTRUCTION
19529427464 10/21/2015 12:29 #269 P.013/020
111)01. City of Eaall RECEIVED
OCT 2 1 2015
Date:
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use �p
Permit #:� ✓ ��
Permit Fee:
Date Received:
Staff:
2015 RESIDENTIAL BUILDING PERMIT APPLICATION
Resident!
Owner
Type of Work
JName: itdA✓A; i kaltr gbE4 �dA
J
Site Address: Unit #:
11/
Phone: //9
Contractor
Address / City / Zip: Wel.- ¥V 5 e/dr/rt
Applicant is: Owner X Contractor
Description of work: PE- 5,1,e 5.T ''.- j
Construction Cost: 24; LCC% ' Multi -Family Building: (Yes No
Y J
Company:I(I1'4Att- rGrr ?MA doliGnit{1r;e Contact: j,r+ A/% .rv-t
Address: 6-11/5 /ndi,251 i -i trL- 5 - - su;kf. /63
City:
)
State: ?lid Zip: 6-513�41 Phone: 452 4'2 Ema,,. /s1•4 ad /S4Z r. �s �
License #: 6 6.96356 Lead Certificate #: Ali • 2Ono
If the project is exempt from lead certification, please explain why: 844;L„ - ;4 fcs(83
via
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 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.00pherstateonecall.ora
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 coopleted within 180
days of permit issuance.
x
Applicant's Printed Name
Applicnt' s Signature
Page 1 of 3
-------------I
For Office Use i
Building Permit #: I
i I
EAGAN I
Permit Fee: 4 3 _
` I
I I
Date Received: I
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 I I
(651) 675-5675 �FAX: (651) 675-5694 1 I
I Date Issued: I
buildinginspections a.cityofeagan.com I----------------------j
RESIDENTIAL BUILDING PERMIT APPLICATION
Date: zh q Site Address:
Applicant is: ❑ Owner Contractor
Unit #:
Name: �G( �V� i--ib Vv`e- CDtt2.,rS
A95c,ei ot`-�i b li,/�
Homeowner
Address: z/L/P!5 yz�P,3 AJB
City: �o Ct a ',
`'' y
Stater l/�ip: 5122 Phone:
1�
Email:
Description of work: P, Q t' bh-
Type of
Construction Cost �, j
Work
Type of building: ❑ Single Family ❑ Townhome,
of units Twin Home
Compank3 l/� t'c .Lc_ �s
Contact: �JJ�`� �✓ M,
Building
Address p, 61, Wes* T 4/—\y
City:1de—yX
Contractor
�J '/
State: Zip: 553/T Phone6Iz�7
License #: � D Expiration
K- q� � 0 Expiration
Date:
Sewer &
Water
Contractor
Company:
Address:
Contact:
Required for State: Zip: Phone: Email:
new construction i
I 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
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