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4404B Clover Lane CITY OF EAGAN WATER SERVICE PERMIT 3830 Pilot Knob Road P. O. Box 21199 PERMIT NO.• Eagan, MN 55121 DATE: 1 Zoning: No. of Units: 4 Owner: Address: Site Address: Plumber: Meter No.: Connection Charge: Size: Account Deposit: Reader No.: Permit Fee: 1 agree to comply with His City of Eagan Surcharge: Ordinances. Misc. Charges: Totol: By - Date Paid: Dote of Insp.: — o f /p Insp.: Y 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: Date: City of Eago 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 r Use BLUE or BLACK Ink For Office Use 2j , Permit #: ` 1 ✓�! Permit Fee: I P . �l°t Date Received: (0- "1-t3 Staff: 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Site Address: Unit #: Resident/ Owner ` Name: /1,-_t_ ✓t I,AI1 C°°Yv7 e v JPhone: /2.— 5'19 -33.2,1) �./ Address / City / Zip: 11L1d lI.?C. l t3 J€ 4,' . 4.0 6 -ii_ 6 6-572..Z. Applicant is: Owner / Contractor Type of Work Description of work: ttg,t,4.) A — Construction Cost: 41 e 0 t7 Multi -Family Building: (Yes / No ) Contractor Company: '_-e, 11 n- e^ /k 0d 611 rl`2 Contact: 12-6k L , /6 „D3' Address:Z / Z_2 L .eiL. -j V, . , L.,/ Z -A/ City: ALOV State: ,elf✓ Zip: $5 3 C' Phone: ,C/ Z — -5 -Z.7 " 7 5-e7 License #: lc -7 o 3 14-63 7 Lead Certificate #: If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) In the last 12 months, 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: _Yes _No Licensed Plumber: Mechanical Contractor: Sewer & Water Contractor: Phone: Phone: 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 Cityto 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.qopherstateonecall.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. X / '7 vt. Pry Applicant's Printed Name Applicant's Signature Page 1 of 3 WW°V 8 cLovtr Vie. DO NOT WRITE BELOW THIS LINE ///d3‘0, SUB TYPES Foundation Single Family Multi 01 of _ Plex WORK TYPES Fireplace Garage deck Lower Level ✓ 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 REQUIRED INSPECTIONS Footings (New Building) ✓-Footings (Deck) Porch (3 -Season) Porch (4 -Season) Porch (Screen/Gazebo/Pergola) Pool Occupancy Code Edition Zoning Stories Square Feet Length Width 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 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 ,O.067 MSBG- PA 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 Other: Pool: _Footings _Air/Gas Tests Siding: _Stucco Lath _Stone Lath Windows Retaining Wall: _ Footings _ Backfill _ Final Radon Control Erosion Control , Building Inspector Final Brick RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies ?3.75- 0 GI 5 TOTAL p /oU G? ditsed 4 k. *Levi?g_0d °2 - Page 2 of 3 2- Page2of3 ROBE ENGINEERING COMPANY, INC. L....--.1000 EAST 146111 STREET, BURHVILLE, MINNESOTA 5E337 PH 4n -B000 .3"Z Zdjki C �a ,4_ eii c7t: L013 26, 29,3c AAID 31, esi.ocv z, aDEeu` ADOI r,ck DAK07A COL/ TY, tVilNNE-50TA _ EAGAN 0.473.a) DEIUDTE5 EX/f,7 N6 ELE VAT/°(EV1 EW ED 044 a) DENOTE PROPOSED ELEEVAT1O1\1r//, ..�----^' 1NOlCATES DIRECTION OFYSURFACE DRAIAJA&E /J 1,1.33= FlNf4NE% GARAei- � EL&'vAT/CN 7-/ 5-i `2. BUILDING INSPECTIONS DIVISION COHStUtTII1G ENOINEIRS PLANN6AS and LAND SuavEVOl1S coK 4: P46t 57 CSD Vise..Le 14.r.a5 C1Cve' (JAi1 N 3FTH SCALE : f �' 30' • c&. / Pao, e VA RAI s,L7 dilM ' -f 3o,0 r ice__ L_l ) /r '1 r DRAIAbE AND Uri L ;TY ERSEME'..rr /64 47 A/83�, a� I I ' l `7 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 on this , TI71 day of m , 19 SL From:ALLSTAR CONSTRUCTION 19529427464 09117/2013 08:42 #582 P.050/079 Use BLUE or BLACK Ink For Office Use I j Permit j City of Eagan I 33 Permit Fee: I 3830 Pilot Knob Road Eagan MN 55122 Date Received: _Ot Phone: (651) 675-5675 I I Fax: (651) 675-5694 1 Staff., I I I 2013 RESIDE\I f'Tf(IAL' BUILDING PERMIT APPLICATION Date: I I ZU~3 Site Address: 4LAIL7LH 1409, 44CH E ChO ~,Cllrhi Unit to Cf~ ~m~ Name: Phone: Resident E Owner Address / City / Zip: ~n WU?) Uhl St PULNOi\V' f& 646 MN %NY ~ Applicant is _ Owner K Contractor Type of Work Description of work: TO off and Ye-troc~ Construction Cost: Multi-Family Building: (Yes / No I 4 Company:Abgi t Uh l I LLL Contact ~)Ut I Address:514Gj Ir1d"IUI S11 d *10 City: MQLDV_ P t Contractor State: MN Zip: %Fo 1 Phone: "t b1_g41_ _IHSLA License* _-r,~l,~2JICJIS Lead Certificate NIT' W~tv-1-O 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: I Sewer & Water Contractor: _ Phone: NOTE. Plans and supporting documents that you submit are considered to be public-in-formation. ~Pariions 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.cioi)herstateonecall.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. X_ (It H~ Iwad x 1 .i"Z Applicant's Print d Name Applicant's Signature f Page 1 of 3 From:ALLSTAR CONSTRUCTION 19529427464 10/21/2015 12:20 #269 P.001 /020 Use BLUE or BLACK Ink � For O�ce Use � � L�A j Permit#: �� /�� j Clty of �� REc��v�� Permit Fee: i 3830 Pilot Knob Road �� Z � �� Eagan MN 55122 � Date Received: � Phone:(651)675-5675 I I Fax:(651�675-5694 I Staff: I � �---------------�� `� 2015 RESIDENTIAL BUILDING PERMIT APPLICATION � �� ,�1 Date: Site Address: Unit#: ; : � Name: i�iJA✓�►. 1 �31 t�' " �J�..i �d� Phone: /1//� :�;�tesi,dent/;:�:'`:;: / \ ,.:,..>�.:::.:::::::. �Z- y' L�� 1 c- ,;;;;°..;•-��:e:;;:;:;::;::;';;,� Address/City/Zip:`�t/ "7� l ��+v�� /�4,�.�� F��M ;;::;;,.:�.._1?.,..1'. ,� a�:i;`:;; A i I cant is: n r Ow e Co tr r PP � n acto .:`:�.":;`:';?:::;;':;.;;t;;;g.;:'> , , Desc' � � n in fwr • t o 0 o k. � �C .�C in/ n .,i� t� , P r��/ if ::�:'::�_..:�;;,.Q: `.:r�.;.; / s-'� � e, ..�:�%a ,YJ?.: - # � ,✓ ;��;>>:��'`':�:: 2.� , c��`_ ,:: Construcii G� :..:.:.:.....:.:::>.::.-:.:.:..:.,::.,, on Cost: - ' F 'I B Multi ami ild' � u i Yes /No Y �9�� ) �,...�...�,.,. y . + /I . ,�.::.;<:;;<::.:;;.';<;::,�:::>::�:::::.:;�:,::::;::,:;,>,:: Company:�I�St�ql� 4%nj��2uG�.�� y/hlt�n��/Caft�;G Contact: �a rn A��rr+et-..� 9. ;,,:,; , , c ;;�;:;:;:'<::;��;'':<<`::';,,'.',�;`,°;;.;;c,;>':.'':;':' J _ ,� ,q ,q � �.;�>;;";>' Address:�� n/��5��-��t-t, - S�s.�� /C.� � � ..::...:: .::::.:;,":i�'i�;:; �i/ ' S?- , City: 1'Y i 1�� A..• �`:;�?DT1ti`��t.p�:;;:;�';' . , / ' ; � '; ` . State:,�Zip: ��`3 Phone: ��-`j/2']5/��Email:___i��c+�c:c t�S'frt I". b'Z _ cp � � �::.e=::::::._<:;;_:::�s::<:::;;_::;; License#: �C (t'�� S' �c. Lead Certificate#: hIt►T� ac%f(p� L If the project is exempt from lead certification, please explain why: ��;L, �„� �c�8� 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: ..:::.-.. ,....; :: . _..:.,:,:;,;::.::- ........:.... :::::::,.::...:.,:::;::..:;::.:.::.,:..:.,;:,..,::.,:;::....:.::._.::;::::.:,:::: :::.-::.;....:,,:.<::.::.::>;>.;.:::::.::::;::..,:;::.:::::_..::,:::::,,:..:<-:::::;::..;,:...::.•::.:: .:::.,:,>::;:,...,..:.::.,:,:::: :.::;.:.::.,,:.::;.,.:<::.:: ;:.. �ID�E Plans�nd suppQr{t�Rg alocuments that y�u subrr►it�re consldece,d:•#o„�ie.publlc r��or�►�t�ar�..�For��o,ns of � the�,niormation maybe ciassifietl as non pkblic rf you�rov�ple s,pecifi��ie��Qn,s�ha#y�►ou�d p"ern�at th��ity',,#o � .:�or►clu.�le that.:fhe ;�re.trade;:secrets.: �� CALL BEFORE YOU DIG. Call Gopher State One Call at(659)454-0002 for protaction against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.aoaherstateonecall.org I hereby acknowledge that this informaqon is complete and accurate;that the work will be in conformance with the ordinances and codes ofi the City of Eagan; that I understand this is �ot a permit, but oniy an apptication 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 co. pleted within 780 `' days of permit issuance. ,_ -. ,..✓� 7: x ��•�+ �/�fm�hJ X �� ApplicanPs Printed Name Applic nt's Signature ` � Page 1 of 3 S � t � -------------I r For Office Use 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651) 675-5675 1 FAX: (651) 675-5694 buildinginspectionspcityofeagan.com 1 �ZlL��b✓ I Building Permit #: 1 i I 1 S&W Permit #: I Permit Fee: I I I v I I I Date Received: I I I I 1 I Date Issued: I I I— — — — — — — — — — — — — — — — — — — — — j RESIDENTIAL BUILDING PERMIT APPLICATION Date: �h Site Address: _ Applicant is: ❑ Owner aContractor Homeowner Name: G(�t/� b V\/�� C'� V. �� U�y'/�� _/fi- CAS e, C' ct-4 6 In Address:' !A A10 16/04/ �,� r%?�buzy LEI City: �aQOL \P, Phone: Description of work: P, 2 Q Cs t�— Type of Q Work Construction Cost l `/ Type of building: ❑ Single Family ❑ Townhome, of units Twin Home Compan 3CM �t/t t't,LC_ C�\/� Contact: �u �✓ Building Address :�� 1'� WEST T 1�— y City:z66py- Contractor fJ / ,/ /? aJ�C ^ >✓L , State:��Zip: .SU�T Phone:cotZ�7� Email.{a/Vle.�f �eyr License #: D 0 Z Expiration Date: Sewer & Water Contractor Company: Address: Contact: Required for State: Zip: Phone: Email: new construction i License #: Expiration Date: City: S: I l understand that Plumbing, Mechanical, and Fire Suppression work require separate applications. R 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. ,�0.y eA x Applicant's Printed Name A licant's Signature