4492 Clover Lane
For Office Usee~ / I
I-A
j Permit*: 2 1C~ 1
City of Ea
Ed~
Permit Fee: e
3830 Pilot Knob Road I 1
Eagan MN 55122 Date Received: P j
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 ;staff;
2009 2009 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: l AJ 'a -aC(
Tenant: Suite
RESIDENT I OWNER Name: G. '-P- CL's +%e > ks ' 10" hone: 6, - 22
Address / City / Zip:
Applicant is: Owner Contractor /
TYPE OF WORK Description of work: ae P Lot ~ 14 t L
i
Construction Cost. Q ob Multi-Family Building: (Yes / No )
CONTRACTOR Name:&;Job' cf ~I OYA Q 1j f,iQrO %j( H4-AKicense SO 41 j q 7
Address: 4N'h'7 Z-Clo 5T. uj•~ E ~ T rs'
City: I-aw Ih~ryt F~ State: />~1'~1,~ yZip:
Phone c-IT I - '4'
` 3 2 3 Contact Person:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateciory 1 Minnesota Rules 7672
Energy Code • Residential Ventilation Category 1 Worksheet New Energy Code Worksheet
Category Submitted Submitted
(4 submission type) • Energy Envelope Calculations Submitted
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 the are trade secrets.
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 plan .
x f _0Jh.! x
Applicant's Printed Name Applicant's Signature
Page 1 of 3
!D ; U' 'I U
MAY 2009
qqqoa CII)AL"C' DO NOT WRITE BELOW THIS INE
SUB TYPES
❑ Foundation ❑ 05-plex ❑ 16-plex ❑ Accessory Building ❑ Pool
❑ Single Family ❑ 06-plex ❑ Fireplace ❑ Porch (3-season) ❑ Ext. Alt. -Multi
❑ 01 of _ Plex ❑ 07-plex ❑ Garage ❑ Porch (4-season) ❑ Ext. Alt. - SF
❑ 02-Plex ❑ 08-plex Deck ❑ Porch (screen/gazebo/pergola) ❑ Multi Misc.
❑ 03-Plex ❑ 10-plex ❑ Lower Level ❑ Storm Damage
❑ 04-Plex ❑ 12-plex ❑ Miscellaneous
WORK TYPES
❑ New ❑ Interior Improvement ❑ Siding ❑ Demolish Building"
❑ Addition ❑ Move Building ❑ Reroof ❑ Demolish Interior
❑ Alteration ❑ Fire Repair ❑ Windows ❑ Demolish Foundation
je Replacement ❑ Egress Window ❑ Water Damage
Demolition (entire building) - give PCA handout to applicant
DESCRIPTION:
Valuation 3vGd'~ Occupancy MCES System
Plan Review Code Edition - 9 7 SAC Units (25%100% Zoning- City Water
Census Code ~f 3~( Stories Booster Pump
# of Units Square Feet 60 PRV
# of Buildings Length 16 Fire Sprinklers
Type of Const. _ Width /d
REQUIRED INSPECTIONS
Footings (new bldg) Sheetrock
Footings (deck) Final/C.O.
Footings (addition) _ Final/No C.O.
Foundation HVAC
Drain Tile Other:
Roof: -Ice & Water -Final Pool: -Footings Air/Gas Tests -Final
Framing Siding: -Stucco Lath -Stone Lath -Brick
Fireplace:_R.I. _AirTest `Final Windows
Insulation Retaining Wall
Reviewed By: Building Inspector
RESIDENTIAL ES:
Base Fee
Surcharge _
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
Total
Page 2of3
4qe)~0wc ~n
r e
LO
J+ co
if { ~~FF i
4
Now
rv.O It
t
V- A) z
4 U)
4O un
a pus f
r.
.44
Z~R :
LtJ
f ~
f
,r
Use BLUE or BLACK Ink
For Ofl<ce Use 1
I
City of Ea aD I Permit /Lr~
REC i
3830 Pilot Knob Road E~VED I Permit Fee: . 6 3 I
I
Eagan MN 55122 DEC C) 12011 I Date Received:
Phone: (651) 675-5675 I I
I
Fax: (651) 675-5694 I Staff:
2011 RESIDENTIAL BUILDING PERMIT APPLICATION`
Date: Site Address:
unit
Name: Phone:
RESIDENT /
OWNER Address / City / Zip: C! ~P .f` r, d e SSj~~
v
Applicant is: Owner Contractor
TYPE OF WORK Description of work: r, mk C. Construction Cost: Ile
g-p® Multi-Family Building: (Yes / No
\ _ t \ ~Si- ~TS'^t -7833
Company: Contact: ')oe-
CONTRACTOR Address: , (AttE, ~v(-k City: t"5')C-1. Q1AI
State: _ Zip: S) Phone: 6~5- / - 7! T? 34,10 3
License #:('l(g Lead Certificate
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 maybe 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.aoaherstateonecall 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 appro I of plans.
x_ <_)(7 e- ~(`X le~ x
Applicant's Printed Name A li ant's Signature
Page 1 of 3
LI`1 cl D- DO NOT WRITE BELOW THIS LINE
SUB TYPES
_ Foundation _ Fireplace _ Porch (3-Season) _ Storm Damage
_ Single Family _ Garage Porch (4-Season) - Exterior Alteration (Single Family)
_ Multi Deck _ Porch (Screen/Gazebo/Pergola) _ Exterior Alteration (Multi)
_ 01 of Plex Lower Level _ Pool Miscellaneous
Accessory Building -
WORK TYPES
_ New _ Interior Improvement _ Siding _ Demolish Building*
Addition _ Move Building _ Reroof _ Demolish Interior
_ Alteration _ Fire Repair _ Windows Demolish Foundation
T Replace _ Repair _ Egress Window _ Water Damage
Retaining Wall *Demolition of entire building - give PCA handout to applicant
DESCRIPTION
ValuationQ Occupancy J)~~4~ MCES System
Plan Review Code Edition SAC Units
(25%_ 100% Zoning City Water
Census Code Stories Booster Pump
# of Units Square Feet PRY
# of Buildings Length Fire Sprinklers
Type of Construction Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) Final I C.O. Required
Footings (Addition) Final / No C.O. Required
Foundation HVAC _ Gas Service Test Gas Line Air Test
Drain Tile Other:
Roof: -Ice & Water Final Pool: -Footings -Air/Gas Tests -Final
Framing Siding: Stucco Lath Stone Lath -Brick
Fireplace: -Rough In Air Test -Final Windows
Insulation Retaining Wall: _ Footings Backfill V Final
Sheathing Radon Control
Sheetrock Erosion Control
Reviewed By: , Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge r V
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3
These particular site plans were drawn from the previous permit. The decks will be rebuilt on the exact
same footprint*. The contractor noticed that the original decks were drawn incorrectly/not to scale and
did not want to further confuse the drawings.
*4492 Clover Lane will be extended 7'
s _
CITY OF NAGAN WATER SERVICE PERMIT
3795 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:
agree to comply with the City of Eagan Surcharge:
Ordinances. Misc. Charges: _
Total:
BY Date Paid: _
Date of Insp.:
CITY OF BAGAN SEWER SERVICE PERM.
37" Pilot Knob Road
Eagan, MN 55722 PERMIT NO.:
Zoning: DATE:
Owner: No. Of Units:
Address: -
Site Address:
Plumber: -
1 agree to comply with the City of Eagan
Ordinances Connection Charge:
.
Account Deposit
Permit Fee:
By Surcharge:
Dote of Ins Misc. Chorges:
p.:
Insp.: - Total:
Date Paid:
From:ALLSTAR CONSTRUCTION 19529427464 09/17/2013 08:52 #582 P.074/079
Use BLUE or BLACK Ink
I For Office Use I
j Permit City of Eap I Permit Fee: - 5 C,
3830 Pilot Knob Road I I
Eagan MN 55122 j Date Received: n (13
j
Phone: (651)675.5675 I I
Fax: (651) 675-5694 I Staff: I
I 1
Q 2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 1- - 1:3 Site Address: ~~}`1'1O ~y O 4 Z -Iy~ Z eti bane Unit
Name: W*J ►M 010 1 GQftll CWUV1N Phone:
Resident/ 'n Q I/►~p~
Owner Address / City / Zip: W~3 G11 vt V 1Wi pafgy I l~1JltJ1 , ~n~. MN 553'-H
Applicant is: Owner ^ Contractor
Type of Work Description of work: Tear off avid Ye'Vik
Construction Cost: $20 Z 1 tp Multi-Family Building: (Yes x ! No
Company: MAT 11YL=mi Wnaait ttt, I-Lt Contact: Jue ftlistow
Contractor Address: 5Iy5 I11twftal ,1 `tA -0103 City: Mo fti n
State: ► Zip: GY7YO ) Phone: 'I J - IIH -IL4I'7L
License L7~, ~3~'✓1Gj Lead Certificate Nr I T- ~VI 1p~t
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
~m~_ _ 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.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.
x clueitl~teAd x
Applicant's Pri ted Name Appl'c is Signature
kJ Page 1 of 3
From:ALLSTAR CONSTRUCTION 19529427464 10/21/2015 12:33 #269 P.019/020
Use BLE1E or BLACK Ink
� For Office Use ` �
� j Permit#: � �� �"`''" j
C1ty of���a� ECEIVED ; � �� �
R � Permit Fee: f �
3830 Pilot Knob Road c �
Eagan MN 55122 OC� 1 � Z��J � Oate Received: �
Phone:(654)675-5675 � �
Fax:(651)675-5694 I Staff: �
i ►
���-��_����������J
2015 R�������CE`4L ��1�LDi[�!G PE�IVf[�`a4P�L1CATtQI�
Date: Site Address: Unit#:
�,..�:...� ..,..r,.�,PT,�,.,r,.....,...��<-�,:._..,....�rrY.-....a.,.,K�...n,,.,,�m.,.,:�.�.,�...�:..�,.Y,�,.�.,..a.,....,�..a.,�.�..,.-���,...._..,.�,.�.�,_,.�.,�.,..,,..,,..,:..o..,..m.�.. ..._�..,._�...,,�_�
� � Name: L�n��✓�: 1��31t� -' �'�..t - ` �';
I"1c�� Phone: /1/�� I
[ Resident/
� Owner � Address�City/Zip: LI'�9���W�2- C��,,�� f ,�,��, �'i�-��,,.,
:
:
A licant is
pp : Owner � Contractor ` I
..,��,,..,�...�,�.aM.:..,e,..� .. _,,.�„K.:.:.,._.��.�_..:.n-_.w.��,...,..>...z.�..,,.....�,.�.,..w.�.�..�,...,.�..��._�_..,._..��,..,_R_.<.�.��.<.:4.�,w._...,:�<..,.�.._,,,.�,,.r...«..,>.�-._._.^.._ ,..�.,�,..,.a...�_.,,s..r.. I
` Descriptionofwork: ��•- '�f�� �,�/o'�� I�;.�E'�r� �Ll'.n(` •��R �
' Type of VUork
` Construction Cost: �Z�,�`�U'� Multi-Family Building:(Yes �No
�.N.t...,..,�,...,�. ..� �..,,,��.,�-�...-�,....n-:.�M._��..r.�._.m-_..T:�...,..�...�.,,�:..�_.,,..�..�..,.:.._...�.��...,�.,�_.._�.,..-.�.�
� Com an 115� �s�S� uc� ' � �• _<.�_.�.,�.�_,...�.�.,�._�s�:��.�w.��-.,a.,,�..,.�,,..
� J 'Tt!1�,r„�4„1 j
� P Y�� A/t- 1� .��f/�d�•'� Gi7Lq h�L� Contact: _` ,r*,
� � Address:S'��5 �n1�u15'l�'�,�L 5�' - Su�e��- IG� r �
� Contractor . - �'�Y� ��� 1���"� �
State:�Zip: �s��`3 Phone: ��``j✓2�7�5"�Email: i�'1't��ci 1�S'�z�P", b'�- �
�icense#: .�C lr9�'� ���G► Lead Certificate#: /�/�►• ��� � Z—
�„�,,._.�.�_._... ,.,-.�,_,.�,.,.,�..�.,.�. __-�-,�.....�.�,e�.,,�.�,,..,.,,.�...�n-�-.�,-.,��. � - -- .�<....�.,_,.�...�,.�,..,�,�.� ;
If the project is exempi from lead certification, please explain why: ,��`�, ;,,�p ���3 �
�
:
...�.m,.-H,,.�._.�.P,:.__..�.�.,_..�.,,�.....:.�._,,..,a...�..�-.�....,�.�—___—_,.,�.�....�,�,.� ,�:_r._,==.,.�...T._ ��,,.n,�.,�..,..,t.....�>.,..�..�r.�..h..,.,..,� ;
f
COIViPLETE THIS AREi4 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 8�Water Contractor Phone: �
�
�Fire Suppression Contractor: Phone•
.�..,..�..� , n:.�.,.r... _ r.:,....,r w. �..�a�,.�.� ,ry.,:,._...M..� .. ...�..�.,.� '
� NOTE:Plans and supporfing documenfs that you submit are considered to be public information.RPortions of
;
� the information may be c/assified as non-publlc if you provide speci�c reasons that wou/d permif the City to � ;
conc/ude that they are trade secrets.
�
�.�.,�.,...�.w�,,.�.,.-....��::.�,.,.�.:...n�.�.�..�.�„t.::m.,._,...,�.�_�._.r,�.�..�.�.�_�....�__-���,�_:..:,�_�..�..,��,,,.�.�.�,..:�,.�N.n.....___:.���...�..,...<�..�.r.,,.,..r_�..�_,��.�..xnM.�.,.�..,c».....��,��.._�
CALL BEFORE YOU DIG. Call Gophe�State One Call at(651)45A-0002 for protection against underground utility damage. Call 48 hours �
before you intend to dig to receive locaies oi underground utilities. www.aooherstateonecall.oro
I hereby acknowledge that this information is complete and ac�u�ate;that the work will be in confortnance wilh the ordinances and codes of the City of
Eagan; that I understand this is noi a permit, but only an application for a permit, and work is not to start withoui a permit; that the work wiil 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 180
days of permit issuance. rt _ .. �,�-�^�
;
x �'�. �//�.�,� X �� �
Applica�t's Printed Name �.�, Applic nt's Signature �
Page 9 oi 3
F"
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA160759
Date Issued:04/10/2020
Permit Category:ePermit
Site Address: 4492 Clover Lane
Lot:20 Block: 02 Addition: Eden
PID:10-22750-02-200
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 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 -
Joshua A Mikiska
4492 Clover Lane
Eagan MN 55122
(612) 718-8683
Majestic Custom Construction Inc
8800 Royal Ct NW
Anoka MN 55303
(612) 419-2173
Applicant/Permitee: Signature Issued By: Signature
GL M 4I 9
� 1
1 I
EAGAN
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
(651) 675-5675 1 FAX: (651) 675-5694
buildinginspections@cityofeagan.com
-----------
For Office Use I
t�tiO4b
I Building Permit #: I
I I
j S&W Permit #:
I
Permit Fee:
I I
I i
Date Received: I
I
I I
I Date Issued: I
I---------------------J
RESIDENTIAL BUILDING PERMIT APPLICATION
Date: �hqhQ23&te Address: -
Applicant is: ❑ Owner aContractor
nit #:
IName: ��L � 14 b vy,e- O L U--c_,v'S fa!5 (b aI a4 k b l/-N,
Homeowner Address:4q*) 14/13 qy q a ,41 B Clguev Lv-, city:,o`ct a
State:/ Vl V"-EiD: !D___� (.1- L Phone: Email:
Description of work: Pik QC. t -
Type of I 2 / f
Work Construction Cos t;J '7
of building: ❑ Single Family ❑ Townhome, of units Twin Home
Compan)T?Q�f71/l�%h c.LL o\A Contact:`r e f 1`C
Building Address:! L/39 ii .tl WeSi" + K— y City:e,
Contractor `� /
State)-Wip: 5.3�T Phone>�rZ�y5- Emailt_�/UIQ�C �e�/�
K2L6q� bzt�coxpir3/31 /�y2S
License #: EationDate: ,
Sewer & Company: Contact:
Water
Contractor Address: City:
Required for State: Zip: Phone: Email:
new construction
i License #: 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. /J
Applicant's Printed Name A licant's Signature