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4408B Clover LaneCITY OF EAGAN 3830 Pilot Knob Road P. O. Box 21199 Eagan, MN 55121 WATER SERVICE PERMIT PERMIT NO • 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 Hut City of Eagan Surcharge' Ordinances. Misc. Charges. Total• By �'' 1 Date Paid. Date of Insp.: __% �� insp • CITY OF LAGAN SEWER Pilot Knob Road SERVICE PERMIT P. Cl. Box 21199 PERMIT NO.: Eagan, MN 55121 DATE: Zoning: No. of Units: Owner: Address: Site Address: Plumber: I agree to comply with the Citi, of Eagan Connection Charge: Ordinances. Account Deposit: _ Permit Fee: Surcharge: By Misc. Charges: Dote of Insp.: Totol: Insp.: Date Paid: From:ALLSTAR CONSTRUCTION 19529427464 09/17/2013 08:43 #582 P.053/079 Date: City of Eagan 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 I `U ,5 S Permit Fee: )5 Date Received: e' It -1(13 Staff: 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Site Address: LIHN 9-10e611+110 LHIOP, Cts LCI hei Unit #: J Name: ECith ttTh t Clo: Gaccevi CDYYII any Phone: Resident/ n v 1n' Owner Address /City /Zip: li P CA 9 Y �ikV((�y, Arai riC N ISI (M Applicant is: Owner Contractor Description of work: Tec In l avidYe-vock Type of Work Construction Cost $19 l 4fa) • 00 Multi -Family Building: (Yes / No ) Company: Aillat Cbnsfiiuc ian Manap'nt1 LLC,Contact. On I-ta IS-tead j Address: vt-15 InduStf►aI sheet # 103 Cp1. Plaih Contractor State: MN Zip: G5CO3M Phone:-1"✓1—C4y2^ --MCA License #: 1:3Cto31e215 Lead Certificate #: N e T" 2J) by -D 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 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.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� � (i V l� 1V1.1 c Applicant's Printed Name x Lf t • Ap}iiijrant's Signature Page 1 of 3 From:ALLSTAR CONSTRUCTION 19529427464 02/10/2016 12:56 #301 P.005/022 41,11 City of Eaaall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax; (651) 675-5694 Use BLUE or BLACK Ink For Office Use 1 � �� �� Permit #: L� Permit Fee: L , Date Received: Staff: 2016 RESIDENTIAL BUILDING PERMIT APPLICATION Date: ../4 //Ce Site Address: rM9 1✓1/42 v142 -'.e-4-- 101-4r0e-- Unit #: /7i 'B Name: goyfildor,f4 /IA - 4:11C/4 /O,4 Phone: /11/4 Resident/ Owner z' Address / City / Zip: 7il/r/ ' 7(/40 dA/eic Type of Work Contractor Applicant is: Owner X1 Contractor Description of work: �P ®O �S W,T% t4n y/ �a Construction Cost: g, GM/ — Multi -Family Building: (Yes / No _) Company: 40- ditlette4d e?»1 diavdentnce Contact e w. A 11E111s vg Address: Cf q5 / r a&* 4-r.A Si--'�5 rI-t j`' /03 City: tkPL- ;ti State: ITh Zip: $5359 Phone:q5J "'99%"7�/�� Email: /;74444S -/-4.r. 42_ License #: & 6403S 3S D Lead Certificate #: A/AT- T- o?O 9to - o� If the project is exempt from lead certification, please explain why: ;LT. ;Ai /993 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.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 State Buiidin j mpleted within 160 days of permit issuance. x i rh I4)/ tnal' t Appi�nt's Signature Applicant's Printed Name Page 1 of 3 City of Eagan PERMIT 41' City of Eaan Permit Type: Mechanical Permit Number: EA151552 Date Issued: 08/30/2018 Permit Category: ePermit Site Address: 4408 Clover Lane B Lot: 32 Block: 02 Addition: Eden PID: 10-22750-02-320 Use: Description: Sub Type: Residential Work Type: Replace Description: Furnace Comments: Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Fee Summary: ME - Permit Fee (Replacements) $59.00 Surcharge -Fixed $1.00 0801.4088 9001.2195 Total: $60.00 Contractor: Haley Comfort Systems 4320 Hwy 52 N West Frontage Rd Rochester MN 55901 (507) 281-0138 - Applicant - Owner: Mary C Bolland 4408b Clover Ln 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 ®11® ® ® 1 I • I ® / �.�. ®®W® EAGAN 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651) 675-5675 1 FAX: (651) 675-5694 buildinginspections(cbcityofeagan.com -------------I For Office Use I Building Permit #: G I I I I S&W Permit #: I I I Permit Fee: i I I I Date Received: I I I I I I Date Issued: i---------------------J RESIDENTIAL BUILDING PERMIT APPLICATION Date: .3hSite Address: _ Applicant is: ❑ Owner Contractor Homeowner Type of Work nit #: Name: �GC 14b Vl�e_Cn, ._-, Address:41 49 iqle !YqfO 1918 CLUB I /_' n City: �l C(OL � Phone: Email: Description of work: P"2 C, Construction Cost 2 19, _11y Type of building: ❑ Single Family ❑ Townhome, of units NTwin Home Compan T7CM r� P Contact: (2 �t of M, Building Address3p) rr& es-� \A1 y City:�GLE�'� Contractor /J '/ /? State:A p: 553�T Phone6tI—J7 �' EmaiI0-Me.�[ �e V -'�/�9� o�t2(o 3/31/2s License #: ' D Expiration Date: Sewer & Water Contractor Company: Address: Contact: Required for State: Zip: Phone: Email: new construction License #: Expiration Date: City: ` 1 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. x Applicant's Printed Name A licant's Signature