4437 Clover LaneDate:
City of Eakan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
1011
Use BLUE or BLACK Ink
For Office Use
Permit #: ---1 D 5--‘/�
Permit Fee:
�a3.1
7417(fi9Z
Date Received:
Staff:
2012 RESIDENTIAL BUILDING PERMIT APPLICATION
7-/2 -2012_ Site Address: L/ 1/ ?7 GOk eY 1-644-e....—Unit #:
Address / City / Zip: 111137
Phone:
J
Applicant is: Owner Contractor
Description of work:
l?d c i J d exis-i-in cAeG
Construction Cost s -(5--D Multi -Family Building: (Yes / No
Company: Oec `! 6,1, ape Contact:
Address: N2 -S &eneVaT4Vf lV City: 0 .,(. d2-' -
State: ( p' 1 i v Zip: SSVae Phone: (o�� 717 -
License #: N,6 x. Lead Certificate #:
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
/nl / ?
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.gopherstateonecail.orq
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of thejCity 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
Ap cant's Signature
Page 1 of 3
` 37 CIDU [� I Vi ONO i WRITE BELOW THIS LINE
SUB TYPES
Foundation
Single Family
Multi
01 of _ Plex
Accessory Building
WORK TYPES
New
vit Addition
Alteration
Replace
_ Retaining Wall
DESCRIPTION
Valuation
Plan Review
(25% 100% 14 -
Census
)Census Code
#of Units
# of Buildings
Type of Construction
Fireplace
Garage
Deck
Lower Level
/D 56 7%
Porch (3 -Season) — Storm Damage
_ Porch (4 -Season) _ Exterior Alteration (Single Family)
Porch (Screen/Gazebo/Pergola) _ Exterior Alteration (Multi)
Pool Miscellaneous
Interior Improvement
_ Move Building
Fire Repair
Repair
'/341
i
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 23
Surcharge
Plan Review L/ % % `/
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies -e .4 5-1
TOTAL
Siding
Reroof
Windows
Egress Window
Demolish Building*
_ Demolish Interior
Demolish Foundation
Water Damage
*Demolition of entire building — give PCA handout to applicant
g-
PD
gO
/D
Meter Size:
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Sprinklers
Final / C.O. Required
-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 e Backfill Final
Radon Control
Erosion Control
, Building Inspector
Page 2 of 3
-1;ROBE
IGINEERING
COMPANY, INC.
1000 EAST I461A STREET,
CONSULTING ENGINE#AS
PLANNERS and LAND MUAVEY4RS
x 37 1166e5-1
214137
Ciove
BURNSVILLE. MINNESOTA 35337 PH 4323000
ugaz 3cr4p xort: LOTS 13, 14,15 AND Ib, BLOCK 3, EDE1V ADDITION,
DAKoTA C4u/VTY, MINNESo7A
tQ D RTH
Cs& o ; DENOTOS Ex/sr/A16 ELEVATIO4J
(135.0) OENOTEs P oPosOD ELEVrATla/V
�--- /ND/ cATE5 D/A E C T/DA/ CF SURFACE' DRA IN AGG E
933.0 = F/N15HCD GliRA6E FLOOR' ELEVAT/CW
EAGAN
REV FWED
ffiV
SCALE 1" = 30' BY:
DATE:
BUILDING IN: P =L TIONS DIVISION
DRAINAGE AI4P
UTILITY EASEMENT
`930_ 2)
(Q3e,a)
t N.V
er-
/
N 89° 58' 02" E
/5.41 EZ
//6.50
LOT !3
37.72
5�
LOT /6
h
....--------•
't•‘\ psi
tl9, .f)
Ix
r/ ` vf()
V.11`
L 4
2y1
kJi I
L. -
CLOVER
LANE
;910
2f.1
I her*by certify that this is a tr
land as shown' and described hereon..
!1'/Ae4/1 , 19 g .
3s
1-
0
Z
f-.
sentation of a tract of
As prepared by ma on this ?771 day of
,..,E Minn. Reg. No. /___
1'
City of Eagan
PERMIT
41'
C!tyofEaa
Permit Type:
Permit Number:
Date Issued:
II Permit Category:
Mechanical
EA106025
08/07/2012
ePermit
Site Address: 4437 Clover Lane
Lot: 14 Block: 03 Addition: Eden
PID: 10-22750-03-140
Use:
Description:
Sub Type:
Work Type:
Description:
e - Furnace & Air Conditioner
New
Furnace & Air Conditioner
Comments: Questions regarding electrical permit requirements should be directed to Mark Anderson, State Electrical Inspector, (952)
445-2840
Fee Summary:
ME - Permit Fee (Replacements)
Surcharge -Fixed
$55.00
$5.00
0801.4088
9001.2195
Total:
$60.00
Contractor:
Standard Heating & Air Conditioning
130 Plymouth Ave. N
Minneapolis MN 55411
(612) 824-2656
- Applicant -
Owner:
Susan Olson
4437 Clover Lane
Eagan MN 55122
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
CITY OF EAGAN WATER SERVICE PERMIT
3830 Pilot ,£nob Road PERMIT NO.:
P. O. Boz 21199 DATE:
Eagan, MN 55121
No. of Units:
Zoning:
Owner:
Address:
Site Address:
Plumber:
Connection Charge: —_--
Meter No.:
Account Deposit:
Size:
Permit Fee:
Reader No.:
1 agree to comply
with the City of Logan Surcharge:
Misc. Charges: -------
Ordinances. Total:
By,i Date Paid:
Date of Insp.: .� - /y
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:
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 08:35 #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
41,111
City of Eau
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
RE�E�v14
E�
Use BLUE or BLACK Ink
For Office Use
Permit #: • a 0 a a3
Permit Fee: 1 « 01 • vl
Date Received: / I /'
Staff:
2014 RESIDENTIAL BUILDING PERMITp APPLICATION
Date: \ II 'l Site Address: 41i'J 1 010\1VLo IV
Name: S Ul s c '\ v i s o r
Address / City / Zip: 4 O
Unit #:
i J
Phone: u 817_-4513
10v-er I One), ,129001 MN 6122_
Applicant is: Owner '' Contractor
Description of work: M o tt r V Oft roonq airy -1041
Construction Cost: 2.2 0 U 0
Multi -Family Building: (Yes / No )
112_8 'VI I
Company: OIC VI VIC GOVT S-I'rUIO h I IIsi C • Contact: N°' --1`i Q
Address: \62tiL C�Q�Y�j� CI • City: F JQi VO 1ILf
State: MN I V Zip: 5"12_1--1-- Phone: U51 - 21 -6 I I tji
License #: B tE' 0 6 LI
Lead Certificate #:N-11-1- (p9 3 9 1 I
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
j,36/G7 !�✓
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.aooherstateonecall.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.
P �Y\ SeN IU
Applicants Printed Name
Page 1 of 3
3►.
4(-1-3-1 G (av v- lrcu'Le
DO NOT WRITE BELOW THIS LINE
1 oa33
SUB TYPES
undation
Single Family
Multi
01 of %' Plex
Fireplace
Garage
Deck
Lower Level
_ Porch (3 -Season)
Porch (4 -Season)
WORK TYPES
_ New _ Interior Improvement
_ Addition — Move Building
Alteration_ Fire Repair
Replace _ Repair
Retaining Wall
DESCRIPTION
Valuation
Plan Review
(25%_ 100% ✓ )
Census Code
#of Units
# of Buildings
Type of Construction
A
34
Porch (Screen/Gazebo/Pergola)
Pool
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation
Roof: _Ice & Water _Final
Framing
Fireplace: _Rough In _Air Test _Final
Insulation
Sheathing
Sheetrock
Fire Walls
Braced Walls
Siding
Reroof
Windows
Egress Window
Exterior Alteration (Single Family)
Exterior Alteration (Multi)
Miscellaneous
Accessory Building
Demolish Building*
Demolish Interior
Demolish Foundation
Water Damage
*Demolition of entire building - give PCA handout to applicant
1
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Sprinklers
Meter Size:
Final / C.O. Required
Final / No C.O. Required
HVAC _ Gas Service Test Gas Line Air Test
Pool: _Footings Air/Gas Tests _Final
Drain Tile
Siding: _Stucco Lath _Stone Lath _Brick
Windows
Retaining Wall: _ Footings _ Backfill _ Final
Radon Control
Erosion Control
Other:
Reviewed By: , Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
?3 r
80 W eta fYia /640
Page 2 of 3
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
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