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4437 Clover Lane BDate: City of Ea�all 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: ' Staff: 2012 RESIDENTIAL BUILDING PERMIT APPLICATION IZ_ °/ 2- Site Address: 11 u 37 oe-I#j -( Unit#: Name: /c j Ct Ci 2 - Address / City / Zip: 7711. cle.9ver- Applicant is: Owner Contractor Phone: J Description of work: RkI ! eX1 s -t- n Construction Cost3L r- 5 (51) Multi -Family Building: (Yes A / No ) Company: ckS Address: MPS Geneva wff ' IU Contact: Ot /Gl State: ('tI`r Zip: /a0 License #: K63 o 1 O' City: Ocuk.&cl . Phone: 671- 70- 7 - 3 Va1,3 Lead Certificate #: If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) .;I/N /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: 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.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 v t 4't Z4-4--- Applicant's Printed Name x Ap ants Signature Page 1 of 3 gg37 r inue- - b9 -146r 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% l/ ) Census Code # of Units # of Buildings Type of Construction DO NOT WRITE BELOW THIS LINE Fireplace _ Garage Deck Lower Level Interior Improvement _ Move Building Fire Repair Repair 134' -43 Porch (3 -Season) _ Porch (4 -Season) Porch (Screen/Gazebo/Pergola) Pool 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: _ Siding Reroof Windows Egress Window /'as57e 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 PD g'O /D MCES System SAC Units City Water Booster Pump PRV Fire Sprinklers Meter Size: Final / C.O. Required -- - -Final /-No C.O: Repaired — --_ 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 e Backfill _ Final Radon Control Erosion Control , Building Inspector RESIDENTIAL FEES Base Fee Surcharge Pian Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies 73 Li y otl TOTAL Page 2 of 3 ROBE ENGINEERING COMPANY INC. 1000 EAST 1461h STREET, BURNSVILLE, MINNESOTA 55337 PH 432-3000 CONSULTING ENGINEERS PLANNERS and LAND ENGINEERS, 37 Pie 4/7 37 Ce'rietlz ecgje itL "'y -e ' �Ds�7r ;Aged - S,t,,,�pe on: LOTS /3, l4, 15 ANO Ib, BLOCK 3, EDEN ADDITION, DAKOTA COUNTY, MINNEo7A WORTH SCALE : 1" = 30' BY: (..-.4106; DENO'T&5 Er/Sri/116 L EVA T1OAJ (935.x) DENOTES PRoP'7s D ELEv4TIoN --¢-- //VD/CATES D/RECT/cW OA' SVRF4CE DRAINAGE 933.0 = F/N/5HED Gf?RA6E FLOG/? ELEVATION EAGAN REVIEWED DATE: 7 "r DRK1aN q INSPECTIONS DIVISION /2.4fik N 99° 58' 02" E 113q'U� UTILITY EASEMENT /64:22 (M,'°" `930_2 /16.50 37.72 i V I 1 C92.a� ! 0 /N t�i' I n A\ f / 1 ��; L a7$,��0 k3 �A • ,�\ LOT 16 ., l ,ice �► / X33-.4, h 1 ' 1,9,,,9d2 (.13'1'19 ,101 4) 144 CLOVER LANE 930xZ61 I hereby certify that this is a true and correct representation of a tract of land as shorn' and described hereon.. As prepared by me on this 71N day of imbe44( , 19 te, , L� 3°' FROAIT 131..11 LD/ti16 S&'T$ACK L11VE . ,E Minn. Rag. No. /66ef CITY OF EAGAN WATER SERVICE PERMIT 3830 Pilot Knob Road PERMIT NO.: P. 0, Box 21199 Eagan, MN 55121 DATE: _----- _ No. of Units: Zoning: Owner: — Address: Site Address: Plumber: Connection Charge: Meter No.: Account Deposit: _ Size: Reader No.: Permit Fee: 1 agree to comply with the City of Eagan Surcharge: Ordinances. Misc. Charges: Total: _-- -- Dote Paid: By Date of Insp.: Insp.: 3830 Pilot Knob Road P. 0. Brox 21199 Eagan, MN 55121 Zoning: Owner: Address: Site Address: Plumber: SEWER SERVICE PERMIT PERMIT NO.: DATE: No. of Units: 1 agree to comply with the City of Eagan Ordinances. By Date of Insp.: Insp.: Connection Charge: Account Deposit: _ Permit Fee: Surcharge: Misc. Charges: Total: Date Paid: From:ALLSTAR CONSTRUCTION 19529427464 09/17/2013 08:35 #582 P.032/079 City of Eapil 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: Staff: 2013 RESIDENTIAL BUILDING PERMIT APPLICATION q Date: -115' 2013 Site Address: 4y35,4t- Bi L4 4 1, 443713 CIoVCX LI II&/ Unit #: Resident/ Owner Contractor Name: • vvhi ►1�,�oop cJo . (Aar) Compoiny Address / City / Zip: W`�3t1 Gltll VWPah/411610 Pt *it, MN 5G3( -IU -1 Applicant is: Owner Contractor Phone: Description of work: "Ray off cod Ire-Iixf Construction Cost: $ I,111% • 60 Multi -Family Building: (Yes / No ) Company: )tIls1O1 broffictiovl ,YNtymt tat Contact: Address:(�5t�'I5 ImtustrIa1 s-tre(ai- *103 !� City: t e1 Plan State: IY►N Zip: `JrJ�'J' `) Phone: "152- cIL12. License #: B5✓3Lead Certificate #: NITT— 20104-0 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: 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 y to conclude that the 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.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 1 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 UtitI .i,J Applicant's Prin ed Name City of Eagan PERMIT City of Eaan Permit Type: Plumbing Permit Number: EA120323 Date Issued: 01/31/2014 Permit Category: ePermit Site Address: 4437 Clover Lane B Lot: 13 Block: 03 Addition: Eden PID: 10-22750-03-130 Use: Description: Sub Type: Residential Work Type: Alteration Description: Fixtures 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. Fixtures:Toilet, Lav, Shower Theresa Bialon 11473 Kenyon Court Fee Summary: PL - Permit Fee (miscellaneous) $55.00 0801.4087 Surcharge -Fixed $5.00 9001.2195 Total: $60.00 Contractor: Spring Plumbing Lk 11473 Kenyon Ct Blaine MN 55449 (763) 614-7963 - Applicant - Owner: Rick W Pietz 4437 Clover Lane Unit B Eagan MN 55122--243 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 02/10/2016 12:54 #301 P.003/022 401111' City of £aall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675.5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use 6-5t 2 Permit Fee: Permit #: Date Received: Staff: 2016 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 4o7d4o44p Site Address: Resident/ Owner Type of Work Contractor 0/35- W37 £/i/4 L.An� Name: 39(//4 r ,P6/� -' �.1 874 No,4 /, Address /City / Zip: `�7 l3S rf77 �1d✓ %,77g Unit #: �,r8 Phone: /t///, plicant is: Owner Contractor Description of work: A* -.S/4 W/ 1n y/ 5.7eZr lr' "Pr, Construction Cost: 11:R6.) a Multi -Family Building: (Yes / No ) Company: A I I 4LE 61$40-c4441'01,1 , j /fir/ 1 rfl ee Contact: J I W% A al t' rn er n Address: St 4!S 1nafwS4-rrAE S77-S`fad-t /03 City: Jv1 p/e- RA -14 State: ms! Zip: 5'535' Phone:154,-90.7161 Email: ,16//S-/,. 4 License #: 136 GJ9'O3S 0 Lead Certificate #: AMI - 074;910V If the project is exempt from lead certification, please explain why: 5 k ;,4 X993 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. CaII 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 Buildin yu: mpleted within 180 days of permit issuance. 'i \ AilliMan Applicant's Printed Name Applic nt`s Signature Page 1 of 3 EAGAN 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651) 675-5675 I TDD: (651) 454-8535 1 FAX: (651) 675-5694 buildinginspectionsncityofeagan com 2018 RESIDENTIALIUILDING PERMIT APPLICATION For Office Use 01° Permit #: /114e b 7 Permit Fee: //t,3 Date Received: Staff: J Date: /(, / �/5 Site Address: (2/oveK Unit #: Resident/ ©Winer Name: 1 k W ^ / (ec �. Phone: i �/6 2. / & �v JL ( -_ % _ Address / City / Zip: ,�.nr� _ A �� 7" h t %j !i(/ (/1 ° .S j /22 ( Applicant is: ,/Owner Contractor r. Type of Worlc/ ° Description of work: 4VC c_a-,,, � l Construction Cost: ' Multi -Family Building: (Yes / No \---/) ntractor { r Company:' Contact: Address: City: State: Zip: Phone: Email: License #: Lead Certificate #: If the project is exempt from lead certification, please explain why: In the last 12 months, Yes No 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? If yes, date and address of master plan: Licensed Plumber: Mechanical Contractor: Sewer & Water Contractor: Fire Suppression Contractor: Phone: Phone: Phone: Phone: NOTE: Plant and su PPorti[tg docu+nei#s #/fatykiu submit ;:ooaidored c i i©on classified as you if non-publicprovide specific P seasons tha# would pe " fsr.% conclude that You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeaqan.com/subscribe. 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. 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.gopherstateonecall.orq I hereby acknowledge that this information is complete and accurate; that the be in conformance with t ances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, an. work is not o start ithout a mit; that the work will be in acco ance with the approved plan in the case of work which requires a rev' : w and approv. of piens X , a Applicant's Prihted Name oo�. •tee®EAGAN 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651) 675-5675 1 FAX: (651) 675-5694 buildinginspections(a2cityofeagan.com -------------- For Office Use I I Building Permit #: I I I I S&W Permit #: Permit Fee: I I I I I Date Received: I I I I I I Date Issued: I---------------------J RESIDENTIAL BUILDING PERMIT APPLICATION Date: 3h qhQ23Site Address: Unit #: Applicant is: ❑ Owner Contractor Name: �G(�t/� b vy`e— (t> - tr-�Q_v' S'S b C'_ I ct-4 i 6 lf, Homeowner Address: 14R A JR city: o` State: i Phone: Email: Description of work: 2 Q C3 Type of a q Work Construction Cost ` Type of building: ❑ Single Family ❑ Townhome, of units Twin Home Compan Q Building Address: �� it"� WQS'T� City:_FVGQ\-,C-l� Contractor / '/ State:&&6p: 5 Z Phone6t ZJIf 5- Email. vtke Z Cr�co S cp - 1_ License #: Expiration DateEL Sewer S Company: Contact: Water Contractor i Address: City: Required for State: Zip: Phone: Email: new construction License #: Ex iration Date: 1�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.00pherstateonecall.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