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4308B Clemson Cir CITY OF EAGAN WATER SERVICE PERMIT 3830 not Knob Road P.O. Box 21199 PERMIT NO.: Eagan, MN 55121 DATE: Zoning: No. of Units: Owner: Address: Site Addess: Plumber: Meter No.: Connection Charge: Size: Account Deposit: Reader No.: Permit Fee: I agree to comply with the City of Eagan Surcharge: Ordinances. //j Misc. Charges: Total: By Date Paid: Date of Insp.: j c • Insp.: CITY OF EAGAN SEWER SERVICE PERMIT 3830 Pilot Kr.ob Road PERMIT NO.: P.O. Box 21199 Eagan, MN 55121 DATE: Zoning: No. of Units: Owner: Address: Site Address: Plumber: I 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: Use BLUE or BLACK Ink rr I - For Office Use---___-- Permit City of Ea aii c u~ ' Permit Fee: 3830 Pilot Knob Road Eagan' MN 55122 Date Received: O j Phone: (651) 675-5675 1 1 Pax: 651) 675-5694 1 Staff: I 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: S(l~ 017 C7 4f ~t) If W 13 C (eAWN tf'l Unit Name: Wt n1~ L(----- d- dA Phone: i Resident/ Owner Address / City / Zip: Ql t~~ UL i Applicant is: Owner Contractor Type of Work Description of work: ~J AS C t ep 7 C -IdIlke Construction Cost;__ __..._.__~___Multi_arra.ily_~uild#ng ('fes~f-No- Com ari : 1 L8 Re, a4^ . h (#r !E p y ` Contact: I q3q). A/ K, t 1. + f `k City: I/Mni'"(Lo Contractor Address: (4 7 - 75 State: Zip: Phone: NA L-ieense-#~ Bgm_q - et as-Cert ic`f' aTe --77.21- 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 0- I the information may be classified as non-public if you provide specific reasons that would permit the City to 1.~ ' _ 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.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 St to Building Code must be completed within 180 days of permit issuance. X_ x Applicant's'Printed Name Appli s Signature Page 1 of 3 PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA138809 Date Issued:09/21/2016 Permit Category:ePermit Site Address: 4308 Clemson Cir B Lot:31 Block: 02 Addition: The Trails Of Thomas Lake PID:10-75865-02-310 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 - Peter Brogle 4308 Clemson Cir Unit B Eagan MN 55122 (952) 838-5257 Appliance Connections Inc 12850 Chestnut Blvd Shakopee MN 55379 (952) 445-4803 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA139027 Date Issued:10/05/2016 Permit Category:ePermit Site Address: 4308 Clemson Cir B Lot:31 Block: 02 Addition: The Trails Of Thomas Lake PID:10-75865-02-310 Use: Description: Sub Type:Fireplace Work Type:Gas Insert Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home may require smoke detectors in all bedrooms. Chimney / flue must be inspected prior to concealing. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Valuation: 3,000.00 Fee Summary:BL - Base Fee $3K $88.50 0801.4085 Surcharge - Based on Valuation $3K $1.50 9001.2195 $90.00 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 - Peter Brogle 4308 Clemson Cir Unit B Eagan MN 55122 Fireside Hearth & Home 2700 Fairview Ave N Roseville MN 55113 (952) 985-6675 Applicant/Permitee: Signature Issued By: Signature • Use BLUE or BLACK Ink For Office Use I Permit:e: {C1ty 0f EaQa1 � �, Permit ���� 3830 Pilot Knob Road �tn' 1 ';; } ! Eagan MN 55122 Date Received: t,' Phone: (651)675-5675 Fax: (651)675-5694 Staff: �ctj 2016 RESIDENTIAL BUILDING PERMIT APPLICATION ll,D-73- lw Date: 11/04/2016 Site Address: 4308 Clemson Cr. Unit#: B i Name: Dana Palbicki Phone: 952-838-5257 Resident/ 4308 Clemson Circle, Unit B - Eagan , MN 55122 Owner Address/City/Zip: g Applicant is: Owner X Contractor Description of work: Kitchen Remodel-Remove non-load bearing wall, replace cabinet,countertop,floor Type of Work No work is being Ve on any shared walks Construction Cost: 5,500 Multi-Family Building: (Yes A /No ) I Hale Built Homes Chris or Brad (or office) i ( ' , Address: 12550 W. Frontage Road, SUITE #210 City: Burnsville ContractorHalebuilthomes@gmail.com Brad:612-715-2645 State: MN Zip: 55337 Phone: Alicia:612-695-2849 Email: Brad@minnesotakitchens.net License#: BC696902 Lead Certificate#: NAT-F167467-1 If the project is exempt from lead certification, please explain why: VI . . 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 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 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 S Building Code ust be completed within 180 days of permit issuance. xChristopher Hale x Applicant's Printed Name Ap ant's Signatur Page 1 of 3 DO NOT WRITE BELOW THIS LINE (410 SUB TYPES Li31c C esC-1 c Foundation Fireplace Porch (3-Season) Exterior Alteration (Single Family) Single Family Garage Porch (4-Season) _ Exterior Alteration (Multi) Multi Deck Porch (Screen/Gazebo/Pergola) Miscellaneous ?IG 01 of K Plex Lower Level Pool Accessory Building WORK TYPES New n Interior Improvement Siding Demolish Building* Addition Move Building Reroof Demolish Interior Alteration Fire Repair Windows Demolish Foundation Replace Repair _ Egress Window Water Damage Retaining Wall *Demolition of entire building—give PCA handout to applicant DESCRIPTION Valuation iZ' 2 ° O. Occupancy z C—3 MCES System Plan Review Code Edition pnrl ZE 13 SAC Units (25%_ 100%?"' ) Zoning City Water Census Code Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Suppression Required Type of Construction 03 Width REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings (Deck) Final/C.O. Required Footings (Addition) Xp Final/ No C.O. Required Foundation Foundation Before Backfill pp HVAC _Gas Service Test Gas Line Air Test Roof: _Ice &Water Final Pool: _Footings _Air/Gas Tests _Final ZO Framing 30 Minutes 1 Hour Drain Tile Fireplace: _Rough In _Air Test Final Siding: _Stucco Lath _Stone Lath _Brick_EFIS X) Insulation Windows Sheathing Retaining Wall: _Footings_ Backfill_ Final Sheetrock Radon Control Fire Walls Fire Suppression: Rough In_Final Braced Walls Erosion Control Shower Pan Other: Reviewed By: %vvri /Yf: , Building Inspector RESIDENTIAL FEES /3 ere• 0 Base Fee SurchargeZ a Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit& Surcharge Treatment Plant Copies TOTAL Page 2 of 3 PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA140844 Date Issued:01/26/2017 Permit Category:ePermit Site Address: 4308 Clemson Cir B Lot:31 Block: 02 Addition: The Trails Of Thomas Lake PID:10-75865-02-310 Use: Description: Sub Type:Residential Work Type:Replace Description:Furnace & Air Conditioner 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 - Dana Palbicki 4308 Clemson Cir B Eagan MN 55122 St Paul Plumbing & Heating 640 Grand Ave St. Paul MN 55105 (651) 228-9200 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA141793 Date Issued:03/30/2017 Permit Category:ePermit Site Address: 4308 Clemson Cir B Lot:31 Block: 02 Addition: The Trails Of Thomas Lake PID:10-75865-02-310 Use: Description: Sub Type:Residential Work Type:Alteration Description:Basement 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. 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 (miscellaneous)$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 - Dana Palbicki 4308 Clemson Cir B Eagan MN 55122 (952) 838-5257 St Paul Plumbing & Heating 640 Grand Ave St. Paul MN 55105 (651) 228-9200 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA142278 Date Issued:04/24/2017 Permit Category:ePermit Site Address: 4308 Clemson Cir B Lot:31 Block: 02 Addition: The Trails Of Thomas Lake PID:10-75865-02-310 Use: Description: Sub Type:Residential Work Type:Replace Description:Water Softener 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 - Dana Palbicki 4308 Clemson Cir B Eagan MN 55122 (952) 838-5257 Croix Crystal 3440 Yoerg Dr Hudson WI 54016 (715) 386-8667 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA166001 Date Issued:12/07/2020 Permit Category:ePermit Site Address: 4308 Clemson Cir B Lot:31 Block: 02 Addition: The Trails Of Thomas Lake PID:10-75865-02-310 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Valuation: 5,000.00 Fee Summary:BL - Base Fee $5K $118.00 0801.4085 Surcharge - Based on Valuation $5K $2.50 9001.2195 $120.50 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 - Dana Palbicki 4308 Clemson Cir Unit B Eagan MN 55122 Renewal Andersen 1920 County Road C West Roseville MN 55113 (651) 264-4777 Applicant/Permitee: Signature Issued By: Signature