4497 Clover Lane CITY OF EAGAN WATER SERVICE PERMIT
3,95 Pilot Knob Road PERMIT NO.:
Eagan, MN 55122 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 the City of Eagan Surcharge:
Ordinances. Misc. Charges:
Lam` Total:
By Date Paid:
Date of Insp.: 7`D " / D =__ I nsp.:
CITY OF EAGAN SEWER SERVICE PERMIT
3795 Pilot Knob Road PERMIT NO.:
Eagan, MN 55122 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:
r 11
City of Eapll
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 < 1 ( ��ryry
Permit Fee: z! a +- lig
Date Received:
Staff:
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit #:
Resident/
Owner
Name: / A N t/el G2..1 L/06, 5
Phone:
Address / City / Zip: Ci l f`7 G 1 J4? � ,;w.r!/ c �a c‘,ylr, j S / 2:z.
Applicant is: Owner !/ Contractor
Type of Work
Description of work: hi1.4,4) 13 -12—C -
Construction Cos
02000 0t
Multi -Family Building: (Yes / No )
Contractor
Company: h., f? )C 5 4,e,,/top,J P., Il 5
Contact: /2....e.;)< i ,A%edyt
Address: 4/ Z - i5. G em--f-e,"-
...a1,,- f-/ L/, Pte% 1.,/" City: JtApWA,4
State: MA/ Zip: 5-5 3 -(6-( Phone: ,,:67 v' -5 7 f 75-677
License #:
Lead Certificate #:
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
Q\) Ms -I
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:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
Phone:
NOTE: Plans and supporting documents that you submit are considered to be public informationPortions 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 Building Code must be completed within 180
days of permit issuance.
y�,
X I r /fJr/t i J
Applicant's Printed Name
x,, _‘ f,
Applicants gnature
Page 1 of 3
SUB TYPES
Foundation
Single Family
Multi
01 of _ Plex
WORK TYPES
New
Addition
Alteration
Replace
Retaining Wall
DESCRIPTION
Valuation
Plan Review
(25%_ 100%)
Census Code
# of Units
# of Buildings
Type of Construction
07 4 clover L4 rL
DO NOT WRITE BELOW THIS LINE
Fireplace
Garage
✓ Deck
Lower Level
Interior Improvement
Move Building
Fire Repair
Repair
1.11006 =o
ye -C
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 nA
Reviewed By: Ake_ L
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
;Od7 /n.SBG.
•PD
IF
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 _
Siding: _Stucco Lath _Stone Lath -
Windows
Retaining Wall: _ Footings _ Backfill
Radon Control
Erosion Control
, Building Inspector
Final
Brick
Final
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
/.aa
4h79i
TOTAL l/aaj. Gq
,,E- >sly, F%
1144411144-4"- tee h $ec OW
Page 2 of 3
/14335
1
3
0
From:ALLSTAR CONSTRUCTION 19529427464 09/17/2013 08:25 #582 P.002/079
Use BLUE or BLACK Ink
For Office Use
j Permit M , t
City of Eap I Permit Fee: 79 11°9/
3830 Pilot Knob Road
Eagan I I
Eagan MN 55122 ~ Date Received: ~ j
I I
Phone: (651) 675-5675
Fax: (651) 675-5694 i Staff: 06 1
- - - - - -
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: q-5- 2013 Site Address: S Lm 5 y 1 unit
Name: CdtVl ftr7 C'0 • ~Vi( = Wm h~ Phone:
Resident/
Owner Address/City/zip: V439flitu We&t payk-W U , Edetl%Mitie , MN %-Nq
Applicant is: Owner -)LContractor
i Type Description of work--Tear off and re- roi~
of Work
Construction Cost: S OIS. OD Multi-Family Building: (Yes JC /No Company: A119INY [QnCJMCtDn W .rilLContact: JQC tact tfmd
Contractor Address: 5145 Indl TiAl S1 etf # 103T City: MCIDiL Nam
State: MN zip: 653,59 Phone: 952-941-74S79
a License BC10315'15 Lead Certificate NRT- 20910"4_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 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.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. !
xJoe N-Qilsfegd x fly- ~
Applicant's Printed Name Applicant's Signature
Page 1 of 3
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PERMIT
City of Eagan Permit Type:Building
Permit Number:EA140373
Date Issued:12/13/2016
Permit Category:ePermit
Site Address: 4497 Clover Lane A
Lot:27 Block: 01 Addition: Eden
PID:10-22750-01-270
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 -
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: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 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 -
Samuel Ruelas
1835 Walnut Lane
Eagan MN 55122
(612) 730-6684
Signature Select Contracting
332 Minnesota Street - W3171
St Paul MN 55101
(651) 248-4994
Applicant/Permitee: Signature Issued By: Signature
-------------i
i For Office Use
I Building Permit #:
i� i 0 I I
�0 �i I S&W Permit #:
EAGAN I Permit Fee:
Date Received: I
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 1
(651) 675-5675 1 FAX: (651) 675-5694 I
I Date Issued: I
buildinginspections(a)cityofeagan.com 1---------------------,
RESIDENTIAL BUILDING PERMIT APPLICATION
Date: W 7 /o4g2L2
Site Address: Unit #:
Applicant is: ❑ Owner aContractor
I 71Name:)_�
e d k_ A!9C S e, C" a-41 Cy
Homeowner
Address: �� pC e q `�1� q 5 City: �aQ O_`�
State:% Wip: 1>, Phone: Aoki-e' Email:
Q
Description of work: ►" 2 t:
Type of
Construction Cost
Work
Type of building: ❑ Single Family ❑ Townhome, of units Twin Home
-Ths ��L/L (fO,—�-ef
Compan r�A_�_,�-`p�/� Contact:
Building
Address: z-/3�� ( . i � j V-\A/ City:F-6ZF A
Contractor
State:% &4: �U `7/�/Phone6tZ-J,/
/ / b 62(0 2 ��
�!Q(�
License #: �� J Expiration Date:
Sewer &
Company: Contact:
Water
Contractor
Address: City:
Required for
State: Zip: Phone: Email:
new construction
rLicense #: - Expiration Date:-
! 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.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. Z�
Applicant's Printed Name A licant's Signature