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4416 Clover Lane Use BLUE or BLACK Ink For Q1fte Use I I I Permit , City of Eatan A ' Permit Fee:/ / • ' 3830 Pilot Knob Road I Eagan MN 55122 M AY 1 1 2011 Date Received: Ct~~! Phone: (651) 675-5675 Fax: (651) 675-5694 j 1 Cof ~ staff _ _ _ L--- 2011 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit Name: S f D{ 17 Phone: RESIDENT / OWNER Address/ City/ Zip: LMi ( C WCr LA l e ~ Al o Applicant is: Owner Contractor TYPE OF WORK Description of work: 1 `r l / (V~~~C Construction Cost. Multi-Family Building: (Yes / No L Company: Contact: JC~t<' 2 CONTRACTOR Address: 19(,~95 b en e.V 1- 6 Ve- City: ~Ct K-!, a le State: Zip: is s 1 '-L'1 Phone: License* ? CXo 30 70r~- 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 Fagan 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 classed 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.ora 1 hereby acknowledge that this information is complete and accurate; that the work will be in conforma 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 (k is not t tart wi ut a permit; that the work will be in accordance with the approved plan in the case of worts which requires a review and appro l of plans. X ~l?~ ~C, ry X---- L, Applicant's Printed Name pl" ant's Signature U Page 1 of 3 Y DO NOTW R COVLO4 S LINE 'Am 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 f _ New _ 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 tQ Occupancy MCES System Plan Review Code Edition A OI SAC Units (25% 100%4 Zoning City Water Census Code Stories Booster Pump # of Units Square Feet PRV # of Buildings Length Fire Sprinklers Type of Construction Width REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings (Deck) Final / C.O. Required Footings (Addition) v Final / No C.O. Required Foundation -i~- 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 _ Final Sheathing Radon Control Sheetrock Erosion Control Reviewed By: , Building Inspector RESIDENTIAL FEES Base Fee DOC Surcharge Plan Review MCES SAC i City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL Page 2 of 3 Foot< 41 PAGE 36 6_p ~au:~ ~ ROBE cON""TIN13 ("IN ENGINEE3~tI~G PLANHEAS n,d LAHD SiURVEYa fts COMP11HY1 INC. +1000 EAST 146A ME7, BURNSVILLE, LIINH£!07a 5!:!37 PH AZZ-1000 C~ .~/ZC:7C? pL~ Z D7Z • /_07-5 36; 37, 3 AND 39/ BLOC,;( 2, FiCEA. A 0 Q I T; 0P-, DAKOTA? C04)417% M I A AJE 507__A DENOTES EX1!57_/k1C ELEV, 770A" f (935,x) DEQCTE FRcPC_ED ELEVAT/C" E G 4A. (IV C C v IJ R r 9 r NOR DATE r 1 I L- ~3►. EAST 5•z~ i 154:92 93s.~~ : '9Jg 76.92 -7"t- -78. oc -Ln i o I 1 LC7" ti L~~ I 1 a ~ ~~4 138.?3 ~ ~3833 ~93Q'•o~ ~ ; i ~2,{~`'`"' 935.0 G N i ~ f _ to 79.83- R ~UfLD' tV dl~p i 1 r, o Fe. CO. kl 38.5 ~ ~37_~7 RJ Ci ( a~S.o~138.33, ii< t3~.33 I Ut ~ ,.~I vv~~' I LOTS LOT 3^L 5I ~ Ai ~ ~ I , / 45 J ~ I !D t `f?"- ~~c o ~362,e -in a" 52.7 79.00 'n 13w2- / C~3~ J /0.74 _ 1~-0` ~EA<T 30. v DRAIAIA6c AND UTILMI EASEMENT I her :by certify that thin is a true and correct representation of a tract of and a: shewn'and described herecn.• As prepared by me on this _lr~ day of land' lY~~j _ ~ 19 ~L . Minn. leg. No. r~ FqR SAr.,L CITY OF EAGAN t- 36- -4-?? 3830 Pilof Knob Road, P.O. Bax 21-199, Eagan, MM 55121 PHONE: 454-8100 BUILDfNG PERMIT Receipt # 7o be used tor 1 OF 4 PLEX Est value $ 48r 00 0 Date ?--AY 15 11957 Site Address 4416 CLOVER LN Erect LJ" ?,K Occupancy R3 Lot3 7 Biock 2 Sec/sub. EDEPJ AUDY'3`I0.+ Remodel ? 2oning Parcel No. ` Repair ? Type of Const. V Addition ? No. Stories W Name `??D VALUE HQME$ Move ? Length 44 1460 9 3RD LAl Demo(ish ? Depth 24 3 Address Int. Impr. ? Sq. Ft ° Ciry ?1'AINFkone 780-5510 Install ? o Name SA`•i" = Address ~ City Phone - ?Q F W Name Address a W CiN Phnne Permit $ 274.00 Surcharge 24.00 ? Plan Review 137.00 SAG 575.00 , Water Conn. 599 • 00 Water Meter 63.50 Road Unit 2 g U. U O Tr.PI. 15b•UU I 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 Ciry of Eagan Ordinances. Signature of Permittee ?. A Building Permit is issued to: `;°JUD `JkiLile: HW'lLa all work shall be done in accordance with a44 applicable State of Minneso? & Sew. Date Copies Total $2r01.9•50 J on the express condition that ? tes and Ciry ot Eagan Ordinances. Building ? i f PsrmR No. PermN Holder Dafe Telephone 8 Plumbinp H.V.A.C. ElecVic Q ? - - Soflener Inspeclion Date Insp. Commente Fooringsl Footinga II • Foundatlon Fnming Rooflny Rough Plbp. , ??iQ?lll IIY ??? ? - /C •- ?G ?J l Rouyh Hty. Insul. Fireplace Final Htg. Final Plby. Bldp. Finat Cert.Oca Deck:Ft9. Deck Frmy. Well Pr. Dlsp. E l . . PERMIT # ' PLflMBING PERMIT RECEIPT # ? ? q(17 CITY OF EAGAN 383a PILOT KNOB ROAD, EAGAN, MN 55121 DATE: ?-9 :ONTRACT PRICE PHONE: 454-8100 ?ite AddresS.4 BLDG. TYPE WORK DESCRIPTION ot? Block c Sec/Sub Res. New ` Name ?? 4-? •? ?` Mult Add-on ;g Address Comm. Repair c Ciy? et.l .?(<<.• Phone ?'?/ 7Q Other FEES COMM/IND FEE - 1%OF CONTRACT FEE MINIMJM - RESIDENTIAL FEE - $10.00 MINIMUM - COMM/IND FEE - 20.00 STATE SvRCHAFtGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GOES BEYOND $1,000.04) rN.. FOR: CITY OF EAGAN FIxT'URES Closet - $3.00 'ubs - $3.00 ?ry - $3.00 or - $3.00 nSink-$3.00 /Bidet - $3.00 ry Tray - $3.00 Drains - $1.50 Heater - $1.50 ooi - $3.00 iping Outlets - $1.50 TOTAL s - $10.OU kte Disp. - $70.00 gh Openings - $1.50 FEE - STATE S/C: -' 'GRAND TO7AL• ` ? ? ?' PERMIT # /e ? '' . MECHANICAL PERM IT RECEIPT # f' S CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGA - N, MN 55121 DATE: CONTRACT PRICE ' PHONE 4548100 Site Address BLpG. TYPE WORK DESCRIPTION Lot ? Block r .P,- Sec/Sub R x N ? m Name S 'a es. M l ew - Add u t -on ? Address 1 C R omm. epair c City Phone Oth er Name FEES ? c Address RES. H VAC 0-100 M BTU -$24.00 p City Phone ADDITI ONAL 50 M BTU - 6.00 ADD-O N AIR COND. 0-24 BTU - 12.00 ADDITI ONAL 6 M BTU - 6.00 TYPE OF WORK ?0 GAS O UTLETS - 1.50 EA. Forced Air M BTU ? e1 FJ COMM/IND FEE - 1% OF CONTRACT FEE Boiler M BTU MINIMU M - RESIDENTIAL FEE - 10.00 Unit Heater M BTU MINIMU M - COMM/IND FEE - 20.00 Air Cond. M BTU t L STATE SURCHARGE PER PERMIT - .50 (ADD $. 50 S/C IF PERMIT PRICE GOES Vent CFM BEYON D $1,000.00) Gas Piping Oudgts # Other R FEE _; L ?'?` ? k.- L, . "_ ,: S/C: J ( SIGIVAT UR?F PERMITTEE TOTAL -% ? ' ?? FOR: C ITY OF EAGAN G BUILDING PERMIT To ba used tor 1 O:' 4 PLEX 0 SiteAddress 4416B CLOV$K LN Lot 36 Block 1 sec/sub. EDEN ADDZTION Z I Name GWD 3 Address 1460 o n r T T x7 U. = o Name 5?'? 0 ? Address ~ City Phone Name ? Address City Phone I hereby acknowledge that I have read this application and state thatthe information is correct and agree to compty with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Permittee A Building Permit is issued to: ? all work shall be done in accordance Building Official CITY OF EAGAN 3830 Pibt Knob Road, P.O. Eox 21-191 PHONE: 454-8100 Eagan, MN 55121 ;4 2 11 9s0 Receipt # / .? > J ? !ct 13 Occupancy x3 rodel ? Zoning Pn mir ? Type of Const.- vfk iition ? No.Stories ve ? Length 44 ,nolish ? Depth 24 Impr. ? Sq. Ft tall ? 8 Sew. Planner Council Bidg. Of Var. Permit S 274.00 Surcharge 24.00 j Plan Review 137.00 SaC 575.00 Water Conn. 500.00 ! Water Meter 63.50 ?Road Unit 290.00 ? .5/86 Tr. PI. 156.00 Parks Copies Total $2,019.50 on the express conditlon that of Eagan Ordinances. pKmN No. PKmit H~ Daft TNkphonw It PlumbMy N.V.A.C. `y ? )) VL Eaehic ) - (G - O ?; Y L - Soltene? Inspsctlon Da" Irap. Commenb Footlnys 1 FootMps 11 Foundatbn I Framinp Rooflny Rouyh Wby. Rouyh Hig. Insu1. • ?• ? yv` Fireplaee FMaI Hty. Final Plbp. zit ?j &dp. Fkial CMt Occ. Deck Ftp. Deck Frmy. Wdl Pr. Dlsp. PERMIT # PLUMBING PERMR RECEIPT # CITY OF EAGAN 3630 PILOT KNOB ROAD, EAGAN, MN 55121 DATE _ )NTRACT PRICE PHONE: 454-8100 Site Addr y`I" / ti C"l • Lot ? Block Sec/Sub m Name ao Addre c City ? BLDG. TYPE WORK DESCRIPTION Res. ? New Mult Add-on Coirmm. Repair ? Name c Addre?s 0 City ' FEES COMM/IND FEE - 196 OF CONTRACT FEE MINIMiJM - RESIDENTIAL FEE - $10.00 MINIMUM - COMM/IND FEE - 20.00 STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GOES BEYOND $1,000.00) FOR CITY OF EAGAN NQ. FIXTURES TOTAL Water Closet - $3.00 $ :1:Bath Tubs - $3.00 ?Lavatory - $3.00 Shower - $3.00 =Kitchen Sink - $3.00 Urinal/Bidet - $3.00 _LLaundry Tray - $3.00 ._L.Floor Drains - $1.50 ! Water Heater - $1.50 ' Whirlpool - $3.00 ?Gas Piping Outlets - $1.50 Softener - $5.00 Well - $10.00 Private Disp. - $10.00 Rough Openings - $1.50 FEE STATE S/C: 5 ? GRAND TOTAL• ? ? ? ` ? ? PERMIT # MECHANICAL PERMR RECEIPT # CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE: - Site Ad e ?Ll Z Lot Block m Name m Addrg c Ci4y r ? Name ? ? Address 0 City - TYPE OF WORK Forced Air Boiler Unit Heater Air Cond. Vent Gas Piping Oudets # Other ??1 -w Sec/Suh Phone BLOG.TYPE Res. ? Mult Other WORK DESCRIPTION New _?..? Add-on` Repair FEES RES. HVAC 0-100 M BTU -$24.00 ADDITIONAL 50 M BTU - 6.00 ADD-ON AIR COND. 0-24 BTU - 12.00 ADDITIONAL 6 M BTU - 6.00 GAS OUTLETS - 1.50 EA. COMM/IND FEE - 1% OF CONTRACT FEE MINIMUM - RESIDENTIAL FEE - 10.00 MINIMUM - COMM/IND FEE - 20.00 STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMiT PRICE GOES BEYOND $1,000.00) ? ? M BTU M BTU M BTU M BTU CFM FEE SIe• SIGNATURE OF)PERMITTEE TOTAL• ~1 ' FOR: CITY OF EAGAN . a __. - ;. L 310 j 37,3$k -3y CITY OF EAGAN 3830 Pllot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 N2 1195$ BUILDING PERMIT Receipt # - ' ? • Z pF 4 PLEX $48,000 86 j'`AY 15 To be used for Est. val oate ue 19 SiteAddress 4418 CLOVER LN Erect ? Occupancy `23 Lot "1'-?? Block 2 secisun. EDEN ADDiTION Remodel ? Zoning pD Parcel No Repair ? Type of Consl V?] . Addition ? No. Stories VUOl] VAI,(jE ?IDMRS Move ? Length 44 W Name I?bO 43RD Li1 Demolish ? Depth 14 o Address BL?1IPil3 78U-- Int. Impr. 5510 ? Sq. F± Ciry Phone Instail ? o sME Name = V < ~ Address City Phone Assessment Permit - Water & Sew. Surcharge ? Police s F Z Name Fire ? = Address Eng. < W City Phone Planner Council Iherebyacknowledgethatlhavereadthisapplicationandstatethatthe gldg.Off. 5/15/8 information is correct and agree to comply with all applicable State of Minnesota Statutes and City ot Eagan Ordinances. APC Var. Date Signature of Permittee A Building Permit is issued to: GC10D VALUE HUMii..?i on all work shall be done in accordance with all epplicable State ot Minnesota Statutes and City of Eegan Plan Review SAC Water Conn. Water Meter Road Unit- Tr. PI. .U0 I .00 .00 .UO :oo .SO :ou :oa 501 express condition that PsrmB No. PermM Holda Dd* Telsphone k Plumbiny ? `T N.Y.A.C. ¢- ( Eleeftic 5oftener Inspsctlon Date losp. Comments Footlnpsl !?? ? FooNnqs II Foundation Framing . ('- Roolfnp Rauqh Plby. Rouqh Hty. Insul. Firoplace FInM Ntq. ? Final Plby. &dy. Final CeA. Occ. DecN Ftq. Deck Frmy. w.n Pr. Disp. . PERMIT # J MECHANICAL PEAM{T RECEIPT # rO 3 s6 S CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE CONTRACT PRICE PHONE: 454-8100 Site Add BLDG. 7YPE WORK DESCRIPTION Lot? Block Sec/Sub ? ? N R ' ew es. ? ? Name ` ' - 1 7 `-` M l Add ? t -on u ? Addre?s R i G omm. r epa c City Phone?? Ot . ., her Name • FEfS - c Address RES. HVAC 0-100 M BTU -$24.00 p City Phone ADDITIONAL 50 M BTU - 6.00 . ADD-ON AIR COND. 0-24 BTU - 12.00 ADDITIONAL 6 M BTU - 6.00 TYPE OF WORK ? ? GAS OUTLETS - 1.50 EA. Forced Air M BTU COMM/IND FEE - 196 OF CONTRACT FEE Boiter M BTU MINIMUM - RESIDENTIAL FEE - 10.00 Unit Heater M BTU MINIMUM - COMM/IND FEE - 20.00 Air COnd. M BTU STATE SURCHARGE PER PERMIT - .50 (ADD $.50 SIC IF PERMIT PRfCE GOES Vent. t CFM BEYOND $1,000.00) , Gas Piping Outlats # Other I` FEE ( SIGNATURE OF-PERMITTEE S/C: TOTAL• •? ? , ?? FOR: CITY OF EAGAN PLUMBING PERMIT GTY 4F EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55121 Sec/Sub m Name ? Addre c City? ? Name 3 Addre p City4 FEES COMM/IND FEE - 1% OF CONTRACT FEE MINIMJM - RESIDENTIAL FEE - $10.00 MINIMUM - COMM/INO FEE - 20.00 STATE SURCHARGE PER PERMIT - .50 (ADD $50 S/C IF PERMIT PRICE GOES BEYOND $1,000.00) OF FOR: CITY OF EAGAN PERMIT # 2D ? RECEIPT # (10 J C/ `Z:z DATE (-'- SL2 BLDG. TYPE WORK DESCRIPTION Res. New - Mult Add-on Comm. Repair. NC,. FIXTURES TOTAL Water Closet - $3.00 -T- $ Bath Tubs - $3.00 TLavatory - $3.00 Shower - $3.00 =Kitchen Sink - $3.00 Urinal/Bidet - $3.00 -? Laundry Tray - $3.00 T Floor Drains - $1.50 =Water Heater - $1.50 Whirlpool - $3.00 z Gas Piping Outlets - $1.50 Softener - $5.00 Well - $10.00 Private Disp. - $10.00 =Rough Openings - $1.50 FEE ? ?' • ?-' G STATE S/C: J GRAND TOTAL: ? ? ?? ?? L31- : ?7,?,?r BUILDING PERMI ? CITY OF EAGAN , 3830 Piiot Knob Road, P.O. Box 21-199, Eagan, MN 55121 ?.? PHONE: 454-8100 T Aeceipt # 48,000 11959 86 Site Address 4418$ CI.OVEK LN Erect Q't Occupancy RJ lot 39 Block 2 SeclSub. F.DE;N AilDI7.'IQCJ Remodel ? Zoning YD Parcel No. Repair ? Type of Const L11} Addition ? No. Stories a Name GOOD VBSUE HU?lES Move ? Length 44 = 14 6 U 93 tZll Y.C1 Demolish ? Depth o Address Int Impr. ? Sq. Ft City BLAIIJEphone 7$0-5510 Install . ? = o Name SXME ? i Address City Phone ?Q F W Name ? n Address i W City Phone Assessment Water & Sew. Police Fire _ Eng. Planner Permit a 41%• vv Surcharge 24.00 Plan Review 137.00 SAC 575.00 Water Conn. SOU . UQ Water Meter 63 . 50 Council Road Unit 290.00 Iherebyacknowledgethatlhavereadthisapplicationandstatethatthe gldg.Off. $ 5 86 Tr.PI. 156.00 information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. APC PBrks Var. Date Copies Signature of Permittee Total $2, 019.50 A Building Permit is issued to: GOOD VALIIE HOt•SES on the express condition Mat ali work shall be done in accordance with all applicable State of t??innesota Statutes and City of F„gqan Ordinances. . Permft No. PsrtnH Hoide? Dele Talephone M Plumbiny H.V.A,,C. Co ?/ Eleetrie 4LI Softener Inspection Date Insp. Comments Footlngs l ?? 412 Footlnys 11 Foundation Fnming VU, Roofin9 Rouyh Plby. ? - G /U -?? -- G Rou9h Htq. Inwl. ?- Flreplace Ftnal Hty. Final Plbq. Bldg. Final Cert. Occ. Deck Flq. Deck Frmp. Wsll Pr. Disp. T ? M BTU M BTU M BTU ?L- M BTU CFM MECHANICAL PERMIT RECEI CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE: ? Name Addre c City' ' BLDG TYPE WORK DESCRIPTION SeclSub . R es. New Mult Add-on ,. ai _.,gmm. Repair Name T" ^ ? • ?` " 3 Address O CitY TYPE OF WORK Forced Alr Boiler Unit Heater Air Cond. Vent Gas Piping Outlets # Other PERMIT # FEES RES. HVAC 0-100 M BTU -$24.00 ADDITIONAL 50 M BTU - 6.00 ADD-ON AIR COND. 0-24 BTU - 12.00 ADDITIONAL 6 M BTU - 6.00 L GAS OUTLETS - 1.50 EA. COMM/IND FEE - 14/a OF CONTFiACT FEE MINIMUM - RESIDENTIAL FEE - 10.00 MINIMUM - COMM/IND FEE - 20.00 STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GOES BEYOND $1,000.00) _ FEE: ? • p ? S/C: S? ?GNAtyRE OF P ITTEE TOTAL• FOR: CITY OF EAGAN PLUMBING PERMIT CITY OF EAGiAH 3830 PILOT KNOB ROAD, EAGAN, MN 55121 PERMIT # ? ? c 69 RECEIPT # ?-? ?V :2 DATE G " ? - U L,? Site Address / -, I ; - "-c• '' . 's• -C BLDG. TYPE Lot Block Sec/Sub Res. ?-? Name ? ? : . > . _ - •.? + Mult Address ' ` i - Comm. c Ciry ??- =? : + { « Phoneo1` ~ Other Name ,- ? (D Addrqqs o Cit,,,/.a FEES COMM/IND FEE - 1% OF CONTRACT FEE MINIMiJM - RESIDENTIAL FEE - $1U.Q0 MINIMUM - COMM/IND FEE - 20.00 STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GOES BEYOND $1,000.00) FOR: CITY OF EAGAN WORK DESCRIPTION New Add-on Repair ? FIXTURES Water Closet - $3.00 Bath Tubs - $3.00 r-Lavatory - $3.00 Shower - $3.00 =Kitchen Sink - $3.00 Urinal/Bidet - $3.00 -?Laundry Tray - $3.00 ?Floor Drains - $1.50 Water Heater - $1.50 Whirlpool - $3.00 =Gas Piping Outlets - $1.50 TOTAL t mer - w.w - $10.00 ite Disp. - $10.00 Ih Openings - $1.50 FEE STATE S/C: GRAND TOTAL• " ??? CITY OF EAGAN Remarks Addition Fden Addition Lot 37 Rik 2 Parcel #10 22750 370 02 owner-- ? ' - I' street 4416 Clover Lane State Eagan MiV 55122 Improvement Date Amount Annual Years Payment Receipt Date STREETSURF, ?S(? $2 504.70 100.94 5 STREET RESTOR. ?- GRADING ]. 82 2?. Ia6.6o V SAN SEW TRUNK / 1974 62.93 4.20 1. ; * SEWER LATERAL ? 1 a2 1896.46 319.29 WATERMAIN * WA7ERLATERAL 1 $Q WATER AREA 1977 62.93 2 1$ * Services 1982 STORM SEW TRK 19$2 2 6. oo 51.20 5 * STORM SEW I.AT lggz 5 CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. AUILDING PER. SAC PARK CITY OF EAGAN Remarks Addition Eden Addition Lot 36 Rik 2 Parcel #10 22750 360 02 Owner street 4416B Clover Lane stete Eagan NIN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREETSURF. SZ 504.70 1d0.94 5 STREET RESTOR. i GRADING bqc) 232.99 46. 6o ? SAN SEW TRUNK * SEWER LATERAL 1 a2 18 6. 46 2 .2 WATERMAIN * WATER LATERAL 1982 WATER AREA 3 * serviccs 1982 STORM SEW TRK '^ G 1982 256.00 1.20 - 0 STORM SEW LAT 1982 S CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PEFi. SAC PARK CITY OF EAGAN Remarks Addi2ion F.den Addition Lot -iR Blk 2 Parcel #10 22740 3f30 02 owner street 4418 Clover Lane State Eagan NAI 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. L? p 19$2 504.70 100.94 5 STREET RESTOR. GRADING 1982 232.99 46.60 5 SAN SEW TRUNK P/ ?* SEWER LATERAL 19 2' 1896.46 3T9• 29 5 WATERMAIN WATER LATERAL 1982 5 WATER AREA • Services 1982 5 STORM SEW TRK 1982 25 .OO 51.20 5 • STORM SEW LAT 19 2 S CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILOING PER. SA C PARK CITY OF EAGAN Addition Fden Addition Lot 39 eik Owner Street 4418B Clover Lane #10 22750 390 02 Eagan M 55122 Improvement Date Amount Annual Years Payment Receipt Date STREETSURF. 0C, O ],9$2 504.7? 00.9 'rJ STREET RESTOR. GRADING (,pqQ 1982 2 . 46.6Q SAN SEW TRUNK / 1974 62.93 4.20 15 • SEWER LATERAL 1 82 18 6. 46 2T9.29 WATERMAIN f WATER LATERAL 1982 WATER AREA 1977 62.93 4.20 15 * Services 1982 STORM SEW TRK 1$2 Q 6. o0 1.20 * STORM SEW LAT 1982 5 CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. SAC PARK aCiTY OF EAGAN WATO SERVICE PERMIT 0 Pi;ot Knob Road , P. C. ftx 11199 ? PERMIT NQ.: r Eagsn, MN 55121 D^TE: ' -. gO^i^g• No. of Units: - I Px r: ?+lddrasr Site Mdress: r. La r: c r, l; .. , Plumber. i ? ; ' 1.;_?:•?1:? - Meter No.:•?'1 Z 15/ Sa .11 fo eo?0f M'Mh qyt; ; i . tll"Jf, i Or?isa.ar?. {u'•.' `o G?ly??y C??s: _ ? 5 6. O ll Dd 'I't, Totol: 50n,?P.Ler BY Dote Pold: Dote of Insp,; I nsp.: CITY OF EAGAN 3830 Pitot Knob Road P. O. Box 21199 Eagan, MN 55121 Zonirg: Owrmr: Address: Site Addron: Plumber. SEINER 5ERVECE PERMIT PERMIT NQ.; D/1TE: - No. of Unfts: ?OFM to we* wwb oM G!y of soMn A"AMMM. By DQh of Insp.: CcrxwreNon Charqe: AccOIA1T DppWr; Prmnit Fes: Surdhorpr Misc. Chorom TofaI; Da1r Pbid: CITY OF EAGAN WATER SERVICE PERMIT 3830 PNot Kr 7b Road ,,; 7 7 P. O. IIox 21199 PERMIT NO.: Eqgan, MN 55?21 D^TE: " o' ' Zoni `; _P ^v' No. of Untts: Owner: Addross: Site Addreas: 1? ?' ?- ?ver ^11e L_ L_ ;. en L_n Plumber. AAeter Wa.: d ?o. ' • P? + Siu: Rsader No.:Q?? Qi8 1 ~- Nrw !o cawoly wMh !V City ? ?. ? ? P Ordleano?s. o s. _ ..1 11 n .,. __. , • ?? . ?r.. _ . -c7, er CITY OF EAGAN SEWER SERVICE PERMIT 3830 Pifot Knhb Road P. O. Box 21199 PERMIT NO.: Eagan, MN 55121 DATE: Zoninp: - No. of Units: Ownsr: .• _ ? R?_ Address: $Ite Address: Plumber: -?„ :? ? ..?..?. ?.-... 5_16 _ .'?. ?o!" te esm* whb !M CMy ef E6900 Ol,?Mlli?ll, COrlfltCtiOfl Q1GIcQ: _ y' 7 r, n n r ! AooouM Deposit: - 15 .{Znn, T Permit Fee: - 1 C1 ll??r•? Surchorpe: By Dote of Irup.; Misc. Chorpes; Total; Dah Pafd: _ F EaGAN . WATER SERVICE PEWR nr Knob Road pERMIT N4.: ox 21199 pATE: MN 55121 No. o{ Vnits: I'em eo O0nvor wMr !m Cit)r Q??/11KtOM• ?1 _ ? . fVUSt. Taal: po" Roid: CITY OF EAGAN SEWER SERVICE PERMIT 3830 Pilot Knob Rcad '.2 pERMIT NO.: '7`'' ? P. O. Box 21199 7.1 ? '. .. Eagan, MN 55121 DATE: 4- ,. ?, ' . ZOI1ifIQ: NO. Of uRlft: - Owner: Address: Site Address: Plumbar. 1 Mm h ?Ph Wkb !M Clhr of !oww Or11M"aw. By Dote of Ifflp.: c.a+.wet+on Ciaroe: 4 7 5.. 0('1= Acoount D.pait: i ' Pom+it Fee: Surthargs: Misc. Gharom Totol: pcte Pold: :CITY OF EAGAN WATER SERVICE PERMIT 38' D P4t Knob Road _ P. 0. Box 21199 PERMIT NO.: Eslgan, MN 551? 1 DATE: ; ? ,Zoning: No. of Units: • ?oo a ue . an?es Ownar: ldd / ross: sih /?1?1'l3f: 44 . OVEr .F!. e.. ,:C;c.?. ? Pl1M11bQfC ,Meter No.: 370/ge7 p? Z!: ?? ?i?CJ t4 a llli Reoder No.: NL! (o S!P S e.,. Rc Y? ?1?P it F _ . rjup ' • i ym te eowpFp wN6 Nw Ciy e? • •- P _ 5 . , _ ,. ? Oni{MwaL OG u. Charpas: . . ?. Totcl: By Dat• Poid: Dafie of Insp.: Insp.: ?5- (L-flro CITY OF EAGAN SEWER SERvICE pERMIT 3830 Pilot Knob Road ' ' P. O. Box 21199 PERMIT NO.: . , Eagan, MN 55121 DATE: Zonirp: ?-? No. of Units: - P: 202? v=' ; 2 L _ ^.:-" pw,nar , ' Address: - ya ?,y SItO I?1?fQ58: ii 4 l0 `r1.OV't-'Y LAilc Plumbar: XiCkelBOn P1uIDb.LaF; 5-16-86 6?.S2^, I ym /o .eNy wMr IM G!f of ioMm Connoction ChoW: 47 .`L- OrdiMmam AoaourM Depotit: Permit Fes: Surdwrpr. 5 f13,. ' By Misc. O,orpss: Date of Insp.: Totol: ? Irnp.: Do» Pald: BY w - Do" of insp.. g! l???? REQUEST FOR ELECTRICAL INSPECTION ee-00001.04 1- 1 t? 4"`"?/' , Sse instruccions for complatirq tbis twm on bsek of yellow copy. - ? ( 2 4 409 ""X" 8elow Work Covered by Thrs Request ?? Add Rao, Tvoe ol Buildina Aooliunces YYired Equipment Wired M es ServiceEntrenceSi:e p Fee Feeders/Sobfeeders # Fee Circuits U to 200 Am s 0 to 30 Am s to 30 Am Above 200 Amps 31 to 100 Arnps 31 to 100 Amps Swimming Pool Above 100_Am s Above 100_Am s Transformers Irrigation Boorris Partial Other Fee SignS SpeciallnSpeCtion S ?-- emarks TOTAL?FEE ?OG I, the Elsct'rical Inspector, heraby certify tMl the above inspection hes 6een mede. This request void -7 18 nqnths trom I C 24409 Co y (0 D?- 7- Request Date Fire Na. h-in Inspection pired? RW ?Ready Now iII Notify Inspec- - es ?No Y or When qeady ? licensed Electrical Contrxctor I hsrsby repuest inspection of above ? Owner slsctrical work installed at: Str et Address, Box or Ro ute No. ? City W ection o. Township Name or No. ange o. County ? r 0 upent IPRI TI Phone No. r Supplier Address EI cal Contractor tCompany ) • Contracto.'s Licle No - V Mailin A ress (Cont ctor or 9wner Making Instailation) ?sS MAP& f? Auth ' ed SiBnature (Co ntractor/Owner Making Installation) Phone Number- ? MINNESOTA STATE ARO OF ELECTAICITY THIS INSPECTION NEQUEST WILL NOT Gripgs-Midwey Bldp. - Room N-191 BE ACCEPTED BY THE STATE BOARD 1627 University Ave., St. Paul. MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (612) 297-2111 ENCLOSED. THIS INSPECTION REOUEST WILI NOT BE ACCEPTEO 8Y THE 5T4TE BOARO UNLESS PROPEFl INSPECTION FEE IS ENCLOSED REQUEST F OR ELECTRICAL INSPECTION • - . EB-00001-O1 '?r? 13? 7/?? m/ O/ ? See msWCGOns br WmpleLry Mis fortn on back M Yellow coPY ' " k Covered by Thrs Requ W esf X P 12306 Or BB1OW d EquipmentWirad eoi8uilding e Ad8 Rep. " TYP AppliancesWire Temporary Service Home Range Electric Healing Duplex Water Heater Other (Specify) Apt Buddin9 Dryer Comm.llndustrial Furnace Farm Air Conddioner pther (speciry) Convacnor5 Flemarks' Compute lnspection Fee Below: Fee # arcueslFeeders Fee # ahef ?e g Service Enirance5ize 0 a tOD Amps Swimming Pool 0 to 200 Amps Amps 0 Ayove I Amps Transformers Slgns _ Above 20 Inspwor5 Use Only' 707AL So ?.......?...e Rnnms I, the Eleclrical Inspector, hereby certify that the above inspedion has been made. iCE USE ONLV requeat witl 18 moMhs irom Th ^. re0uest void 18 nwn[hs (rom 1 U C 2441o L.?(n -f n-/)(Q e Licensed Elec[ncal Contractor Owner raet Address. Boe or Nnuta No. un.in msuem?on lmretl> oReaGV No ,?]'Mw r es ?No C v I herebV request inspection ol above eleetrical work installed et: 0 l../ Phone MINNESOTA STATE BbARD OFELECTqICITY Grigpa-Midway Bleg. - Room N•181 1821 Univarsity Ave., 5[. Peul, MN 551 04 Phona (612) 297-2111 L? I Vill Notity Inspec- or When Ready I 5 ?Y lC/- ( 1 6O(n TMIS INSPECTION pEQUEST WILL NOT BE ACCEPTED BY THE STATE BOqpp UNLESS PROPER INSPECTION fEE IS ENCLOSED. t " - REQUEST FOR ELECTRICAL INSPECTION ee-ouoot.o4 ' See insimc4ana lor complebng this fwm on back of yellow copv. C 24410 "X" Below Work Covered by This Request Fdd NeD- TYOa f Builtling Applmntea WiraA Eqoiymenl Wired H ..e Range Temporary Service Duplex Water Heater Lightiny Fixtures Apt. Bwldmg Dryei Etectne Heatin Commercial Bldy. Fumace Silo Unloader Industnal BIAg Air Conditioner Bidk Milk Tank Farm Otnt,r Oeci y thor (Spcr.ify) 1 r,r peci v t er otnrr Y Fee ServwaEntrence$iie M1 Fae Pexders/5ubteeders b Fqe Cv uits I Qo 0 to 200 qm s 0 to 30 Am s I 0 tn 30 Am> Above 200 qnniny 31 io 100 qmps Q 31 to 100 Am s Swimming Pool Above 100-Am s Ahove 100_Am)s Trans(ormers Irngation Booms Partial. Other Fee Signs SpeciallnspecUOn Remsrks TOTAL FEE ? Rough-m I.ihe Electncal/ ? 7 ?T? V ?nspectoT, hereby certdy tpet the above Final i inspection has baen .?f da. flua repuesl voltl 10 monthe fram 7his repvast void ?7 18 nwnths from . / d- ? ?? (?7 Q 35002 3 c-'f Pequest pate n' Fve Licensed Elec[ncal Con[ractor Owner suectwn []fleaAy Now?ll Noti?y Insp¢c- ?No ??or When peady I hereby re0uest msOacOOn ot above r? ??_?(F REQUES7 FOR ELECTRICAL INSPECTION ee-00001-04 ? See instructions for completnrq this form on fack ol yeilow coOV. ?i:?, n n2 "X" Be,aW Work Covered bv This Renuest ? 7 / a 7 TYae of Buildin9 H Applmncea Wired ent W??er? o? Range Service Duplex Water Heater ixtures Apt Buildinc? Dryei ahn F Commeraal Bldg. Fumace i der m Industnal 61dg. Av CondiLOner ank Parm omrt oeu v ,iv? er Sueury Other o lrfs mpute pec[ron n Fee Below meE nlronceSKe f! Fee FBAders/5ubfaetlers tt FeA Cncurts z00qms 0 to30Ams Ot?30Am n Above 200 qmps 31 to 1 DO rnps 31 to 100 Am s mmin Pool Aboye 100-Amps Amps Above 100 siormers IrngaLon Hooms _ Pdrtia6'Other Fee gn s s SpeciallnspecLOn Remerks ? ? - SL?'l ? TOTAL FEE??? ) (/ J7 r?Y •- pough-rn i / D 1e? / I, the ElectNca t' Inspectoq hereby Final ? certdy that the above mspechan has baen made. Thle rBGUest vo1018 monft irom .•••? •^???? I lvrv neuuEST WILI NOT riggs• idway Bldg. - qoom N-191 BE ACCEPTED 9V 7HE STq7E BOqflD 1911 University qye., St. Paul, MN 56104 Phona 1872 UNLE55 PqOPEH INSPECTION FEE IS ) 297.2?7? ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION ee-oooot-na ? q?/ 1 Sae instrvct.ans ior complabng this brm on back ol vellow copy. `/ /?/ `4 2(?'?f. 1 3 ""X" 8elow Wak Covered by 7hrs Request C' 7«J AdA RBp TyoB Df BUIldiO9 APPIi?11Ce! W VEA EqmpmBnl Wir¢d Home Range Temporary Service Ouplez Water Heater Lightiny Fixtures Apt Bwlding Dryei Electric Heabn Commercial Bidy. Fumace Silo Unloader Intlusirial Bldg. Air Conditioner 8ulk Milk Tank Parm 01ny, peu y otnFr (Snecifyl L 9f SyOGlfy Qlhpf 01h(LI l.0/00!/TP /OROPLIIO/1 FPP KPfI1W M fee ServmeEn[renceSize q Fee Feeders?Subleetlers N Fee Gvwrts ? U to 200 qm ps 0 to 30 Am s 0 in 30 Am s A6ove 200 qmpy 31 to 100 Amps ,''? 31 to 100 A rep, Swimming Pool Above 100_Am s Ahove 100_Am)s Transtormers Irrigation Booms PerLal,'Dther Fee Signs Special Inspection - em3rks ( TOT E /! flough-in • D:te 1^the ' ch¢al r ,?? Isoecm., nereny certify thnt the above Fnal O"te? 'S?;? inspection has been mede. 'rhin reauest voitl 18 monihs irom This re(luest vaitl 17 _ 18 mon[hs Irom ? 24413 flenuest Oate U Ky?j Fire No. FouPh-in Inspect'on F qmred? ? Yes No 1 DReady Ni? I Nobty Inspec- tor When Ready LJ Licensed Electncal ConVactor I hereby requast inspection oi above ? Owner electncal work instelled ab Stree[ Atldress, 80. r Roure No. +? ( 8 ? Ciry ova J`-) ec ion o. Township Name or No. Range No. ° Cou nty e h ? , l '`_ k??.?C.? I ` O ?upant (PRINT) Phone No. 'a P i er Supplier ` ?+1.?_ Atldress Electncal Connactor ICompany Name) . S CoNrar.tor's License No, ??n EiJ).?,--r? Mailmg Address (COntrec or or Owner Makmg Insiadauon) Auffiir zed ig?^pature IContractor?Owner Making Installatw I S Phone Number / /? ? ? ??-?'J la? lG C.?'Q '5 . - MINNESOTA STATE BOARD OF ELEGTRICITV ` THIS INSPEGTION flEQUEST WILL NOT Griggs-Midway BIdB. - Room N-191 BE ACCEPTED eV THE STqTE BOARD 1821 University A,e., Sc Paul. MN 65100 l1NLES5 PROPER INSPECTION FEE IS Phorre 16121 297-2117 ENCLOSED. RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD - 55122 r 651-681-4675 ? I ?/,, Z5 NewConstruction Reauirements RemodeUReoair Reauirements • 3 registered sRe surveys showing sq. ft of lot, sq. ft. ot house; and ap roofed areas . 2 copies of plan (20% mazimum lot coverege allowed) • 1 set of Energy Calculatiom for heated addilions . 2 capies of plan showirg beam 6 window sizes; poured found design, etc J . 1 sBe suNey Ior exlerior addi6om & decks • t set a( Energy Calculatioiu • Indiwte N home servad 6y seplic system for add'M1ans • 3 capies ofTree Presenatbn Plan'rfiot platled after711/93 r,rn • Rm Joist DetaR Oplions seleclion shael (Gdgs wilh 3 or less units) ? ? v v,Cru DATE /?J -d I -I4I V ? 4??1? VALUATION JOB SITE ADDRESS yYl (,aA 9-YIll L e) eLo1cr2 [ Anuc IF MULTI-FAMILY BUILDING, HOW MANY UNITS? ?2_ PROPERTYOWNER ELIll NaVUC ownucK< A55oC TYPE OF WORK e fIREPLACE(S) _ 0_ 1_ 2 APPLICANT A1Oi Z1n., st-wZhS dRa6 Ca,.?<-0?UC-T7Zs A I PHONE??-1) &2 8- ?IPd' ADDRESS PAGER # CEII PHONE # FAX # - NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY ener9y Code Cate9ory _ MINNFSOTA RULES 7670 CATEGORY 1 (check one) - Residential Ventilation Category 1 Worksheet Su6mitted - Energy Envelope Calcuiations Su6mitted MINNESOTA RULES 7672 New Energy Code Worksheet Submitted Plumbing Contractor: _ Plumbing System Includes: Mechanieal Contractor: _ Mechanical System Includes: Sewer/W ater Contractor: _ Water Softener _ _ Water Heater _ _ No. of Baths _ Air Conditioning _ Heat Recovery System CODE SSII eD Phone # Phone # Fee: $90.00 Fee: $70.00 All above information must be submitted prior to processing of application. I hereby acknowledge that I have read this application, state that the with all applicable State of Minnesota Statutes and City of Eagan Or( Signature of ApplicaM Certificates of Survey Received - Tree Preservation Plan Phone C. Lawn Sprinkler No. of R.I. Baths ??n is cortect, and agree to comply / Not R uire - Updated 1101 ---------------- ? j Pertn@ #: ? Pennit Fee: ? ? ? Date fleceived: ? 1 f I Statt: I ?-----------------' 2008 RESlDENTiAL BUfLDiNG PERMIT APPLICATION ?te: Site Add,?s: C_ %?J ?r 1- AJ Tenanh _r,?n,a, RESIDENT / OWNER Name: &J?V Ik6J Phone: Rddress / City ! Zip: Applicant is: _ Ovmer _X_ Contracta TYPE OP WORK DescripNon of work: ? P l top 7-.?- - c Construction Cost:-F L5? Lp D Multl-Famiry 6uilding: (Yes / No CONTRACTOR Name: OC'Z ' dwt?Q -Fyn,fllbJPim s License#: 20 aadrass: ciTy: m ?z state: 011IJ ziP: 3'5 Ptwne: Gontact Parson: d,Cl?7 (?1aa? S COMPLETE THIS AREA ONIY IF CONSTRIIC TING A NEW BUILDIWG _ Minnesota Ruies 7670 Cateaorv 1 Minnesota Rules 7672 Energy Code . ResiaeMiei vermiau«+ Catea«y I worksf,ee2 • iJeuv Ensr9Y Cnde Workeheat Category Submitted S,hrr,tted (4 SubfnlSS1o11 iypB) • Ener9Y Enve" Catculatiwis SuPxnitled In the lest 12 momhs, has the City of Eagan isaued a permit for a almllar plan based on a rnaster plan? _Yes _No If yas, date and address of masier plan: Licenaed Plumber: Plane: Mechenlcal Contracror. pryone: Sewer & Water Contractw: Phone: ,TM(???AIlSBI?tl Y?"pGtl}1'?'6b7?iSfft86}?Wl?SU:fbM11BlB,iC0?7kl1??? t?tt`, 4F?; 01* ltur /1'ItAlr»afflorrht9y 6i0 ?dHtr,4Hl8d 8ffi f16111Wb?'?pc?t?i?e Lt?Bt.t?fld'at:?l??a ?? ?;_r:, I haraby adcnowledge that [tiis infamation is comple[e and accu2te; that ihe wwk wlil ba in contrnmance xiih tha ordinances and codes of the City d Eagan; ihat i undaratarM this is not a pertnit, but only an applicatiai fior a pertnit, arM work is not to s_-?a permir mat ma wo?x ?u ? in 0 accorciance with the approved plan in the case of which requires a review erid approval o ; x???? ? ` X_ ; ,,?- Applicant's PrlMed Name Applt ant's Signature Page 1 of 3 B°OK 4i P.? 6E 3(, /AOBE + ?pHSillT1N6 EH81NEfflS t?ro JawE r+o,MES ENGINEER1NG PLAHHf:15 ond LAHD fi1RVEY0115 IN COMt'RNY, INC, 1000 EAST 1463A STRE17, BUANSVIILE . YIHHE_OU ---=27 PH 4:2-3000 G'eTZ ZtZ CtZi!E LC>; 36, 37, 3e ANC 39) 6LOCX c`, EGE:? HDI:t7i0h DA, KOTf} CD'v,vT'/, A!1 IuN6507A pENC7E5 EX!<TlN6 E?6VAT/GA," ? (935,0) DEUOTE?a PRCF?- "ED ELEVATICA2 E -+- iAJD/CA7c`4-:: 01RE;771=A' CF SL'R,::-ACc'R FiA)16h'E-- 6ARACE FGZ'oR 6?z7/7' / NORTi-i scALE : i" _ 3-' t ` 1 ? 0 ? a c m ` ? L_ u? G f:, l ?c ?A5 Z? / {4'. 9Z ? , L 0 ? 15E. x ^f t?._, 9,a8J -+ ? PROPVSc'<7 -C 79.83 ?? ? gUlLO LOT 38-I- ? 93?Q? 9es.o: i c 0 4-UNIT ? EA57 I a Z fC d' 43g5? Q ? I ?,? 38s? 3 5iS.33? ?C`l32S.? 5 ? LO R??s.o ? Z?- '? -- - E41, 5 T o ? ?939.0? I LQT 37 ? ti ?o :°° _ I ? I I 4;' J j `3S K4_ ; ? V ? I ? yo. f _ A L_.? ORAlNA? AND UTILITV 6A56ME'NT I hersby certify that thia ia a t:,ie and corract raPrzeentation of a tzact o t land a: thovn"and dcscr?bed heracn.• Aa praparnd by me on this 9r? day of #0141 , 19,Ff- . ,?,,. Hfnn. l:E. Ho. /Ga?.? 4 ,. ? RESIDENTIAL , BUILDING PERMIT APPLICATION CITY OP EPIGAN (o ? 3830 PILOT KNOB RD, EACAN MN 55122 651-681-4675 ? ?? J• NewConsUUCtionReauirements RamodellReoairReouiremenfs L 0 . J registered site surveys snowing sq. fl of IcC sq A of house, and aN roofed areas • 2 copies of plan (20% marimum lot coverage allowed) • 1 set of Eneyy CakulaUOns for healed additwns , . 2 copies of plan showing beam 8 window s¢es, poured found design, etc I • 1 site survey kr eztenor addiGons 8 dttks . 1 set of Energy Calculations • Indicate if home served by SepGC system for additians . 3 wDies of Tree Preserva Wn Plan J lol Flatled after 711/93 . Rim Joist DefaA Options selec6on sheet (Cldgs with 3 or less units) OATE _4Z51Q?. SITE ADC TYPE OF LTI- ILY BLDG Y - N 'IRfPLACE(5) _ 0 _ 1 _ 2 APPLICANT v a STREETADDRESS# CITY?STAiE?&ZIP SS/zz TELEPHONE # 6 - CELL PHONE # FAX #? ? ? ? ? _,?? Gr? Y3?- yY68 Im?d,(.rt?tQ, o x PROPERTYOWNER L-I???41/?TELEPHONE# GT+ `/?z COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MIVNN:SO"C.1 RCI.I:S 7670 CxCEGORI' I \ (d suhmission lype) • Residenhal Venhlahon Category 1 Worksheet 5ubmitted • • Energy Envelope Calculations Submitted Plumbing Contractor: Pluinbing system includes: Mechanicol Contractor: Mccliltlica1 system includcs: Sewer/Water Contractor: .-1ir Conditioning Hc<it Rccovcry Systcm Phone # Phone # ocr 1 e 2002 'U Fcc: 570.00 I hereby acknowledge that,l hpve read this application, state thot ihe information is correct, and agree to comply with all applicable State of Iviinnesota Statutes ond City of Eagan Ordinances. - ? Signature of A anf r?- / ? OFFICE USE ONLY Water SoRener _ _ Water Hea[er _ No. of Baths Phone # I.aim Sprinkler ? No. of R.I. Baths VALUATION -?, Certificates of Survey Received - Tree Preservation Plan Received _ Not Required _ Updated 4/02 BccK 4r• p/46C 3'0 rnOpE • CDNSUL71N6 EN61NEffl5 ?D J4we Hv,++ES ENG1NEEfi1NG PLAHHEAS aad IAHD S11fiVEYOflS COMPAMYi INt. IC00 EA57 I46ES 57RE;7, flL'RNSYILL=, uINHE`_OTa :1237 P".i 432'Z000 e4e r.l dz crzze o? ?.S?t?'7?r? +r C`L3S?a ' DEAICTES EXIST??Jo E?'cV.?T/G:l,• ?qCl .?G.?CT'?P?2CTL: L?-`= =6, 371 ANC 39, ?_,,C-i E;.Er_ AOC17iC,'., C,=XOTi? C%?,t/`Y N;IAInIt°oT.?? j C9:5.? ) DEUC??_ !?R?F^_`cU E?E?.97leA.' ? r ;ti/pICA'=z'; NCiZT: ; G/RS,^'/G,ti 5VRsH )LL r. L_?? ? _i V? L_ ?l / " ? DRAINACz qN0 u"riU7Y eASEMENT I he:aby cartify 2hat this ia a t:ue and corr:ct rapr_aen:ation ot a traeL of land as ahexn'and deecr?bed her-cn.• Aa prspared by mn on thia day of , 19 2'I . Hinn. ltiE. Ho. l/ M1 A 1986 BQII.DING PERMIT 9PPLICATIOH - CITY OF EAGAN NOTS: ALL CONTRACTpRS MOST BS LICENSED iIITH THS CITY OF EAG9N CON1MUCIAL SINGLE F6FIILY DiiSLLIAGS INCLUDE 2 SETS OF ARCHITECTURAL INCLUDE 2 SETS OF PLANS & STRUCTURAL PLANS, 1 SET OF 3 CERTIFICATES OF SURVEY SPECIFICATIONS AND 1 SET OF 1 SET OF ENERGY CALCULATIONS ENERGY CALCULATIONS $2,000 LANDSCAPE BOND To Be Used For: 7 --Valuation: ??(? Date: ?- 9 fj' Site Address YY/? f?/.v??,.t! OFFICS USE ONLY Lot Z'Z_ Block 2,_ Pareel/Sub -4;4' Owner Gao?(J Address .tq/ 4a4/ City/Zip Code Phone Contra Addres cityiz Phone Arch./Engr. Address City/Zip Code Phone U Erect ? Oecupancy ? ? Remodel Zoning Repair _ Type of Const ? Addition @ of Stories Move Length / 74 Demolish _ Depth ? Int.2mpr. Sq Ft Install APPROVALS FEFS Assessments Permit ? Water/Sewer ? Sureharge ??. Police Plan Review /3 / Fire SAC ? Engr Water Conn Planner Water Meter ?D CouneiljL/? , Bldg OfF 6 Road Dnit Treatment P1 ??10_ / C? APC / Parks Variance _ Copies TOTAL NOTS: 9DDHESSES FOR CORPER LOTS - COATRACTOB/HOMEOiiNER MUST DS3IGNATE WHICH ADDRE55 IS DESIRID. NO CH9NGES WILI. BE ALLOW6D OHCE BiIILDIHG PERMTT IS ISSUED. FOR SALE TOWNH3830 Pilot Knob Ro di P.O. Bo 2GA90, Eagan, MN 55721 N°- 11957 PHONE: 454-8100 ?/' .1.6-3 BUILDING PERMIT - edlor 1 OF 4 PLEX Recei pt # value $48.000 oate mAY 15 ,1s86 - - 4416 CLOVER LN Erect Ef n? Occupancy Site Address 37 z EDEN ADDITION is b Remodel ? Zoning Vn Lat e lock u . Sec Repair ? Type of Const. Parcel No Addition ? No.Stories GOOD VALUE HOMES Move Demolish ? ? Length 24 Depth W Name 1460 93RD LN lmpr. Int ? Sq Ft. a Address BLAINEp hone 780-5510 . Instatl ? c?h, •"'_. ..I. F629 0 ? $U < ? SAME city Phone F W Name ? n Address a w CiTy Phone I hereby acknowledge that I have read this appl ication and state that the information is correct and agre to comply with all applica6le State oF Minnesota StaWtes and City ?n r?ances. ? Si9naWre of Permitte A Building Permit is issued to: GOOD VALUE HOMES all work shall be done in accordance with all a ' a State of Min Building Official Assessment water R Sew. Police Fire Eng. Planner Council Bldg. Ofl. 5 15/ 8 6 APC $ 274.00 Permit 24.00 Surcharge 137. 00 Plan Review 575.00 SAC 5 Q 0. 0 0 Water Conn. Water Meter 63.50 Road Unit z 9 0• 00 Tr. Pi. 156.00 Var. Date I Copie 2,019 . 50 Total on the express condition that ?SHyuies and Ciry of Eagan Ordinances. ?., J , 1986 B[TII,DING PERlIIT 9PPLIC9TIOA - CITY OF EAGAN NOTE: iLL CONTRACTORS M[JST BE LICSRSSD iTiTH THE CITY OF EAG96 COtflMLERCIAL SINGLS FAMIILY DiiS[.LINGS INCLUDE 2 SETS OF ARCHITECTURAL INCLUDE 2 SETS OF PLANS & STRUCTURAL PLANS, t SET OF 3 CERTIFICATES OF SURVEY SPECIFICATIONS AND 1 SET OF 1 SET OF ENERGY CALCULATIONS ENERGY CALCULATIONS $2,000'LANDSCAPE BOND To Be Used For: Valuation: `/)5ft-XD Date: Site Address OFFICB IISB ONLY Lot ? Block ? Erect ? Oecupancy 3 , Remodel Zoning Parcel/Sub Repair _ Type of Const Addition l! oF Stories ? Owner ??aQ Move Length n Demolish Depth Address /?/GD y?j ?ta? GInt.Impr. ? Sq Ft Install City/Zip Code ---------- ---°----------------- Phone APPFtOVALS FS&S Contractor Address City/Zip Code Phone Arch./Engr. _ Address City/Zip Code Phone # Assessments Permit ? Water/Sewer Sureharge Police Plan Review Fire SAC ? Engr Water Conn Planner ' Water Meter ? ,.S Council Road Unit 2NO Bldg Off,f 4' ;-rreatment P1 /5l'0 APC Parks Varianee Copies TOT9L NOTS: ADDRESSES FOR CORAER LOTS - CONTRACTOR/HOMHDfiNSR M03T DSSIGHATE iiHICH ADDRFSS IS DESIRED. NO CHANGES iiILL HE ALLOWBD ONCE BOILDING PERMIT IS ISSIIED. ?• ??- ?- CITY OF EAGAN N? 11960 ' 3830 Pilot Knob Road, P.O. Box 27-199, Eagan, MN 55121 ? PHONE: 454-8100 3 BUILDING PERMIT Receipts Tobeusedfor 1 OF 4 PLEX Est.Value $48.000 Oate MAY 15 19 86 Site Address 4416B CLOVER LN Erect E) occupancy R3 EDEN 36 Z ADDITION Remodel ? Zoning pD Sec/Sub. Lot Block Repav ? Type of Const. ?s?^ Parcel No. Addition ? No. Stories 44 GOOD VALUE HOMES Move ? Length 24 w Name Demolish ? Depth o 1460 93RD LN Address Int. Impr. ? Sq. Ft. Ciry BLAINE phone 7 0-5510 Install ? s ........aia Fees , o Name SAME z. ou a Address C ? Ciry Phons F W Name Address i w Ciry Phone I hereby acknowledge that I have read this application and state that the information is correct and agree com ly with all applicable State of Minnesota Statutes and Ci a rd.?'?yg-es. / Signature of Permitte?' A Bwlding Permd is issued to: GOOD VALUE HOMES all work shall be done m accordance with all app' StaD t Minnesc Budding OttiCial Assessment Water & Sew. Police Fire Eng. Pianner Council Bldg Off. 5/15/86 Var. $ 274.00 Permit 24.00 Surcharge , Plan Review 137.00 ! SAC 575.00 Water Conn. 500.00 Water Meter 63.50 RoadUnit 290.00 Tr. PI. 156.00 _ Copies Total $2,019.50 - on the express condition that ot Eagan Ordinances. 1986 H011 HOTE: ALL CONTI COPMERCIAI. MDST BB LZCB9SED NITH THB CITY OF EAGAA SIAIGLS F9MIILY DSiE[J.INGS INCLUDE 2 SETS OF ARCHITECTURAL & STAUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONSJ $2,000 LANDSCAPE BOND INCLUDE 2 SETS OF PLANS 3 CERTIFICATES OF SURVEY 1 SET OF ENERGY CALCULATIONS To Be Used For: Valuation: yr?Vl? Date: Site Address OFFICE IISE ONLY Lot 3-2?- Block 21 Parcel/Sub ?4`? Owner ?( _e?acVZ???!e ? Address City/Zip Code Phone 2?2- Contraetor _ Address_ City/Zip Code Phone Arch./Engr. _ Address City/Zip Code Phone # Erect LS Oceupaney - Remodel Zoning 7P Repair Type of Const Addition 0 of Stories Move Length !? Demolish ? Depth ? Int.Impr. Sq Ft Install APPROVAI.S FEFS Assessments Permit 27e- Water/Sewer Sureharge Police Plan Review /3-7 Fire SAC ? Engr Water Conn Planner Water Meter Council Road Unit Bldg Off 141?,IkZ Treatment P1 ? APC Parks Uarianee Copies TOT9L 80TE: ADD$ESSES FOR CORNER LpTS - CONTRACTOR/HOMHDWNER MOST DESIGNATE WHICH ADDRFSS IS DSSIRh'D. HO CHANGES WILL BB ALLOiiED ONCE BOILDING PERMIT IS ISSIIED. CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 N? 11958 ` PHONE: 454-8100 BUILUING PERMIT Receipt# 1 OF 4 PLEX $48,000 86 MAY 15 7obeusedfor EstValue Date 19 SiteAddress 4418 CLOVER LN Erect C? Occupancy R3 Lot 38 Block 2 Sec/Sub. EDEN ADDITION Remodel ? Zoning PD Repair ? Type of Const. Vn Parcel No Addition ? No. Stories GOOD VALUE HOMES Move ? Length 44 w Name ? 24 1460 93RD LN Demohsh oepth a Address Int. Impr. ? Sq. Ft ?ity BLAINE phone 780-5510 mstall ? a $AMF Approvals Fees . o Name ? ? Address ? City Phone Assessment Water & Sew. Police _ Fire - Eng.- Planner Council Bldg. Of t a w Name z ? a Address z a W Ciry Phone I hereby acknowledgethatl have read this application and statethatthe information is correct and agree to comply wrth all apphcable State of Minnesota Statutes and City of%a? Vlordina s. y? ? O Signature of Permmeg? A euilding Permit is issued to: GOOD VALUE HOMES all work shall be done in accordance wrth all applicable-41tate o&An0so Building Var. Permit $ 274.00 Surcharge 24.00 Plan Review 137.00 SAC 575.00 Water Conn. 500 . 00 Water Meter 63.50 Road Unit 290.00 TcPI. 156.00 Parks Copies Total 2, 019 . 5 0 - on the express condition that oi Eagan Ordinances ? - CITY OF EAGAN aOTE: ALL CONTRAC'lOBS MQST BS LICENSED WITH THS CITY OF EAGAP COMRRlEttCIAL SINGLS FAFIII.Y DiiSLLI9GS INCLUDE 2 SETS OF ARCHITECTURAL INCLUDE 2 SETS OF PLANS & STRUCTURAL PLANS, 1 SET OF 3 CERTIFICATES OF SURVEY SPECIFICATIONS AND 1 SET OF 1 SET OF ENERGY CALCULATIONS ENERGY CALCULATIONS $2,000 LANDSCAPE BOND To Be Used For: Valuation: /606 Date: Site 9ddress 41 ?-lg1 J3 4 f4 L.ir OFFICE OSS ONLY Lot 3 ?9 Block 2 Parcel/Sub Owner 9ddress /y(rQ 9,3?r?L?{l City/Zip Code ? ..v?ia ?, ???- y Phone 3f1/0 Contractor _ Address City/Zip Code Phone Arch./Engr. _ Address City/Zip Code Phone # Ereet ? Oceupaney -9-3 Remodel Zoning PD Repair Type of Const ZT - Addition U of Stories Move Length ? Demolish Depth _ Int.Impr. Sq Ft Install APPROVALS FESS Assessments Permit Water/Sewer Sureharge 2 Poliee Plan Review 137 Fire SAC S7(- Engr Water Conn ?? Planner Water Meter . Council Road Unit Bldg Offf /a/ /, Treatment Pl APC i Parks Variance Copies TOT9L NOTE: ADDRESSES FOR COBHER LOYS - CANTBACfOR/HOMHOiR1EE M[JST DSSIGNAYE WHICH ADDRESS IS DESIRED. NO CHAAGfiS WILL B& ALLONSD ONCE BOILDING PERMIT IS ISSIIED _ ? CITY OF EAGAN Nfl 11959 ' _ 3830 Pilol Knob Road, P.O. Box 27-199, Eagan, MN 55121 _ PHONE: 454-810 0 r BUILDING PERMIT Receipt k ? ? )- 3 io be used for 1 OF 4 PLEX est. value $ 4$,Q 00 oate MAY 15 .? s$ 6 SiteAddress 4418B CLOVER LN Erect C? Occupancy R3 EDEN ADDITION Lot 39 elock 2 Sec/Sub Remodel D Zoning pD . Repair ? Type of Const. {71L Parcel No. Addition ? No. Stories GOOD VALUE HOMES Move ? Length 44 w Name Demolish ? oepth o Address 1460 93RD LN Int Impc ? Sq. Ft City BLAINE phone 780-5510 Install ? Approvals Fees o Name SAMF. Z nt A Permit ? 2?4.00 ? p Adtlress ssessme 0 24 0 - Ciry Phone Water & Sew. . Surcharge 00 137 Police . Plan Review ? Fw Name Fire SAC 575.00 ?? Address Eng WaterConn. 500.00 w city Pnone . Planner Water Meter 63.50 Council Road Unit 290.00 Iherebyacknowledgethatlhavereadthisapplicationandstatethatthe Bid9.off.5/15/86 Tr.PI. I56.00 in(ormation is correct and agr to comply with all applicable State of ' " APC Parks n Or ances. Minnesota Statutes and Cit ;/ Signature of Permittee` ? ? z? Var. Date Copies TOtal $2,019.50 A Building Permit is issued to: GOOD VALUE HOMES o n the express condition that all work shall be done in accordance with all applicapt8'94ate of onesot a Siat es and jqiry ifiaoan Ordinances Building Official L V BL al SUBD. f-?- kLYN CITY USE ONLY RECEIPT #: ' 1513_ RECEIPT DATE: - 10 ? PERMIT # 1999 PLUMSIN6 P£RMIT (RESID£NTUL) crrY OF EAsax 3$30 Pll.OT KNOB RD EneAv. Mx 551 QQ (651) 681-a675 Please complete for: ? single family dwellings ? townhomes and condos when permits are required for each unit ? backflow preventer for underground sprinkler sy5tem FIXTURES EACH # TOTAL Bath tu6 $ 3.00 x = $ Floor drain 3.00 x = $ Gas i in outlet ' minimum • 1 3.00 x = $ Hot tub/s a 3.00 x = $ Kifchen sink 3.00 x = $ Laund tra 3.00 x = $ Lavato 3.00 x = $ Minimum fee alterations to existin dwellin 30.00 x = $ Private Dis osal S stem new/refurbished ' re uires MPC iic. 75.00 x = $ Private Dis osal S stem abandonment 30.00 x = $ RPZ new installation/re air 30.00 x = $ Rou h o enin 1.50 x = $ Shower 3.00 x = $ Under round s rinkler if dwellin is under construction 3.00 x = $ Under round s rinkler if existin dwellin 30.00 x = $ Water closet 3.00 x = $ Water heater 3.00 x = $ Water softener if dwellin under consauction 5.00 x = $ cc) Water softener if existin dweliin 30.00 x = $ Water turnaround 30.00 x ---- _ $ State Surchar e .50 --> ----> ---> $ 50 Total --> --> ----> ....> $ Reminder. Call for Inspections of alterations, i.e. water heaters, water softeners, etc. ------------------------------------ ---------------------------------------?-------------- I hereby admawfedge that I have reatl ?is application, state tliat tlie informatiw? is correct, and agree to comply with a0 applicahle City of Eagan ordinances. It is the applipnt's responsibility to notify the property owner Nat the City of Eagan assumes no liability for any damages caused by tha Ciry dunng its normal operaUOnal and mainlenance ac6viGes to W tacilities consWcted under this permit wiihin City property/right•of-way/easement. SITE ADDRESS: OWNER NAME: : INSTALLER NAME: STREET ADDRESS: ciTV: TELEPHONE #: SIGNATURE OF ? L gL CITY U3E ONLY 13 ??15 ? ? RECEIPT#: SUBD. ?A P/1?I RECEIPT DATE7 - O ? PERM IT # 2000 PLUMBING PERMIT (RESIDENTTAL) CITY OE EAGAN 3830 PILOT IINOH RD EAGAN, AIII 55122 . 651-681-4675 Please compiete for; ? single family dwellings ? townhomes and condos when permits are required for each unit ? backflow preventer for underground sprinkler system euvr"mec FscH # TOTAL - - Alterations to existing dwelling - minimum fee T $ 30.40 Describe: --- Bath tuh $ 3.00 x = $ Floor drain 3.00 x = $ Gas pipin outlet ' minimum - t 3.00 x = $ Hot tublspa 3.00 x = $ Kitchen sink 3.00 x = $ Laundry tray 3.00 x = $ Lavato 3.00 x = $ SeptiC 5 stem new/refurbished 'requires MPC Iic 75.00 X = $ Septic System abandonment 30.00 x = $ RpZ new installation/repaidrebuiid 30.00 x = $ Rough openin 1.50 x = $ Shower 3.00 x = $ Undergroundsprinkler if dwelling is under construction 3.00 x = $ Underground sprinkler if existing dwelling 30.00 x = $ Water closet 3.00 x Water heater 3D0 x ener If dwelling under eonatruction Water soft 5.00 x Water softener if existing dwelling 30.00 X : W Waterturnaround 3.0 x State Surcharge .50 .50 Total > 0.So ? Reminder: Call for inspections of alterations, i.e. water heaters, water softeners, etc. I hereby acknowiedge ihat I haveread this application, st2te that the informstion is correct, and agree-W compty with stV appllcable Cdy of Eegen ordinances. It is the applicanYs responsibility to notify the pmperty owner that tha Ciry of Eagan assumes no liabiliry for any damages caused by the Ciry dunng its normal operational anp maintenance astai4vst9 tlLe_fa g[fs_G4LStruded?er this pertnit within City propedy/righEOf-way/easement. SITE ADDRESS' gLUMSTEIN, STERLING 4416 CLOVER LANE #B ? TE?EPHONE OWNER NAME: EAGAN, MN 55122 I (AREA CODE) (651)452-0804 INSTALLER NA TELEPHONE #: rNORBLOM PLUMB (AREA CODE) STREET ADDRESS: .- - 033 . ?- - CITy; 2905 GA STATE: ZIP :INrvEAPoLsS, nnN 55403. SIGNATUR RMITTEE ??(Dl5 2006 RESIDENTIAL MECHANICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please cmnplete for. single family dwellings & townhomes/condos when permits are required for each unit 44 3()s10 Date_??_ / :2-10 I C) (0 Site Address (M (r, D(,e L ? Unit # J' Property Owner 5 ?'e Telephone # Contractor STANDARD HEATING & AIR CONDITIONING 4 StreetAddress MINNEAPOLIS, MN 55408 612 824 2656-- City Stafe Zip Telephoue # ( ) i , 1L ? Q S S E res: xp Bond #: n n C J The Applicant is _ Owner ? Contractor _ Other Add-on or alteration to existing dwelling unit $ 30.00 furnace _Additional ?Replacement _ New a'rr exchanger air conditioner 4 , heat pump other State Surcharge $ .50 Total I hereby apply for a Residential Mechanical Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Mechanic that I understand this is not a perm? but only an application for a permit, and work is not to start w' ou er it; that ork I be in acwrdance with the appr se of hich requires a review and approv of pl in the ca d SN plan ? Applicant's Printed Name Applic ' Si nature APPLICATION FOR PERMIT CITY OF EAGAN SEWER AND/OR WATER CONNECTION *iO C6: PAYMFM OF kM AT TII+1E pF APPLICAMON DOES NOr CONMTUM APPROVAL OF PIItNIIT. INSPncrioN oF sEPM Arro/ox MTm IN r.raTIpNS wn•r• NpT BE S(HED-. ULID UNPII, PEEiMIT HAS BF?7 APPROVID. P ease Print ^ ^ 1) PROPERTY ADDRESS : 11,4116 - (s " LEGAL DF.SCRTPTTCIN. •- . Lot Block Su6division or Tax Parcel ID ) IF EXISPING SIRCCii'RE, DATE OF ORIGINAL &!ILDING PERMIT ISSL'ANCE: ' PRFSENf ZANING/PROPOSID LSE: (!"bn Year) M CONAERCIAL/REPAIL/OFFICE F-7 INJPSTRIAL n INSTITL'TIONAL/GOVII2PAIE[JT ? R-1 SINGLE FAMILY Q R-2 DCPLEX (1WO Cfiits) ? R-3 MWNiOUSE (Three + Units ) Onits ) -r- ? R-4 APARTPfENT/COAIDOMINZtT1 ( Units ) 2) ••• i NALLE: ADDRESS: CZTY, STATE. 2IP: PHONE: 6f 3 3- S/ 7? 3) u c ?• NAME: ADDRFS$: ? CITY, STATE, 22P: PHONE: 4) ??• • IDI• - .- NAPE: ADDRESS: CI21', STATE, 2IP: ??.Qa?Lp '?fyl PHONE:?-!l0 U • ? ACt1V2 EScpired Not recorded Staff It11t1d1 5) ? ?r• ? i a: • ?• : ? • o? • a? ?CONNECTION TO CITY SE,tiJEEt r-•=? ?j CpNNECTION Zl7 CITY WATER Q pTfIER '. . 6) ?•'?'• [? PLEASE AOLD APPROVfD PERMIT F'OR PICK-UP BY ONE OF ABOVE ------ - ? PLFASE MAIL APPROVID PER6IIT RD 1, . 3, 4. ABOVE : (Circle one) ? 7) r r. u• • ?? ? f7?i"S,.t - - - ?.?? ?O/-?"s'!?' ? MASTER LICENSE# FOR CITY USE ONLY PERMIT # ISSC'ED 5 77 Pd w/Bldg. Permit FEES: $ $ lO .S v SEWER PERMIT (INCLUDE SL'RCHARGE) $ $ WATER PERMIT ( INCLDDE SL'RCHARGE ) $ ?J•S-Ti $ WATER METER/COPPERAORN/OL'TSIDE READER $ $ WATER TAP (INCLODE CORPORATION STOP) $ $ SEWER TAP $ $ 45-, C?ZJ ACCOUNT DEPOSIT - SEWER $ $ A"? Cr[; ACCOUNT DEPOSIT - WATER $ .h IiQ - G71 S WAC $ ?i 7S GZ' S SAC $ $ TRLNK WATER ASSESSMENT $ $ TRUNK SEWER ASSESSMENT $ $ LATERAL BENEFIT/TRUNK SEWER $ $ LATERAL BENEFIT/TRC'NK WATER $ ?? ?•C% D $ WATER TREATMENT PLANT SLRCHARGE $ $ OTHER: $ ?? Jc ?• S G $ 5-1, TOTAL RECEIPT s 7_3 RE E IPT C DOES UTILITY CO[VNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? F--j YES IF YES, THEIV A"PERMIT FOR WORK L42THIN PUBLIC Q NO ROADWAY" MUST BE ISSUED BY THE ENGINEERING DIVISION LIST AS CONDI ION . . A T SLBJECT TO THE FOLLOWING eONDITIONS: APPROVED BY: TITLE: DATE : CITY OF EAGAfV APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION ^KYPF': PAYMF:NT OF M AT Tgff; pF APPLICATION DOES NOr CONM? APPROVAL OF PERNIIT. INsPncrioN oF sUM Arm/oR kWM IIS'LAT.T.ATTONS WIIS+ NCYP BE SCHED- tII,ID UNPIL PERMIT HAS BEES7 APPROVID. x?,?=xxx,.xxxxxxw xxx-?xx---x,._x_ _..xfr P ease Print) ? 1) PROPERTY ADDRESS: - LEGAL DESCRIPTION: . Lot Block Subdivision or Tax Parcel ID ) IF E7QSTING STRCMIRE, DI{TE pg pgIGINAL BUILDING PEEiMIT ISSL'ANCE: ' ? (Mon earl PRFSENP ZONING/pROPOSID L'SE: cj COhP4ERCIAL/RE.'rAIL/OFFICE Q IbIDC'S2RIAL n INSTI7.i.'TIONAL/GOVERNAENT ( Uni.ts ) ( Units) 2) ? ADDRESS: CITY, $TATE, ZIP: ' PHONE:z/_3',4 ' ? /'7 / 3) u i:?• NAME: ADDRESS: CITY,.STATE, ZIP: PHONE: /a R-1 SINGLE FAMILY ? R-2 DL'PLEX (Ttao Units) ? R-3 4CJW[+?iOC?SE (Three + Units) p R-4 APARTNENf/COrIDOMINIOM MASTER LICIINSE# ?lumbers License: [] P,ctive Expired Not recorded Sta? tial 4) ??• • ? i?+• Nr,ME: rwnxEss: CITY, STATE, ZIP: PHONE: 7gO .5) ? r• ? ? r: ?• : o • a• • a? ? CONNF.CTION Tp CITY SEWEE2 ? CdNN]?7C..TION TO CITY WATER C3 OTHER ' 6} ? .-• r ? PLEASE HOLD APPROVID PER6'iIT FOR PICK-UP BY ONE OF AHOVE ---- - PLFASE MAIL APP OVID PERMIT TO 1& 3. 4. RHOVE (Cirale 7) r r• u• • /? // one) FOR CITY USE ONLY PERMIT # ISSL'ED Pd w/Bldg. Permit FEES: $ $ /(J- 5 Z•' SEWER PERMIT (INCLUDE SL'RCHARGE) $ $ WATER PERMIT (INCLODE SDRCHARGE) . $ G' ? ?D $ WATER METER/COPPERHORN/OCTSIDE READER $ $ WATER TAP (INCLODE CORPORATION STOP) $ $ SEWER TAP $ $ I•7 '? d ACCOUNT DEPOSIT - SEWER $ $ (1---z) ACCOONT DEPOSIT - WATER $ R?, C) c9 ? $ WAC $ 'CrT) $ SAC $ $ TRL'NK WATER ASSESSMENT $ $ TRUNR SEWER ASSESSMENT $ $ LATERAL BENEFIT/TRCNK SEWER $ $ LATERAL BENEFIT/TRUNK WATER $ '0--o $ WATER TREATMENT PLANT SURCHARGE $ $ OTHER: S_ SZ $ .? ?(r -(} TOTAL c/a7x RECEIPT RECEIPT DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? Q YES IF YES, THEN A"PERMIT FOR WORK WITHIN PUBLIC Q ROADWAY" MUST BE ISSL'ED BY THE ENGINEERING NO DIVISION. LIST AS A CONDITIO[V. SUBJECT TO THE FOLLOWING CbNDIT20NS: APPROVED BY: TITLE: ?/O !?O DATE: cpb- CITY OF EAGAN APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION ^T02'0: PAYKHw OF FkM AT 7Im pg APPLICATION DOFS NOT COIVSTI7VIE APPROVFIL OF PIItNSIT. INSPDLTION OF SStiM ADID/dR FiAZM nWmaT.ramrONS WII.L IJDT BE SCHED- ULFS) U[PPII. PIItNIIT HAS BEM APPROVID. +*?**?t*nx*? *,t*? ***+,e,e**,t**,t**?****x P ease Print) 1) PROPERTY ADDRESS: LEGAL DESCRIPTION: •- Lot Slock Subdivision or Tax Parcel ID ) IF EXISTING SIRL'C!L'RE. DATE OF ORIGINAL BC?ILPING PERMiT ISSL'PNCE: . -- ' PRESENf ZANING/PROPpSID USE: (Mon Year) Q coMMEtCrai,/RErAU./oFFzcE IbIDL'STR7AI, INSTI2S.'TIONAL/GpVgWE2pp n ? R-1 SI[Q;,LE FAMILY ? R-2 DL'PLEX (Tt.o Units) ?? R-3 TUWNHOL?SE (Three + Units) ( ? Units) T p R-4 ApARThgaVT/COrIDOMIbIIt'M ( Units) 2) 1? -- NAME: ADORESS: i5?! CITY. STATE. 2IP:-%,,,P??,,,??,??? 7 ? PHONE: 3) • u ?: ?• XAME. For City Use .. - Plumbers License: ADDRESS:_ 54r? Active CITY, STATE, 2IP: ? Expired ? Not recorded PHONE: PIASTER LICET75E# St nltial 4) t? r y • . , i?l?..,,'7CTa? NAM: ADDRESS: CITY, STATE, ZIP: PxorE: 7*0 ? S 1 o -5) ? v , i a: • ?• : a • s? - ?? ? CONI?CTION TO CZTY SEWII2 ? CpM,TION ? CITY WATER ? pT(?gli ' 6) ? ?• -??? PLEASE HOI.D APPROVED PERMIT FY1R PIqC-CtP BY ONE OF ABOVE VF PLEASE MAIL APPROVFD PERMIT 2?U 10 3, 4, AHbVE ? ?? ?n (Circle one) j 7) r n u• • ?../? ?r.sseaw /' ? ?' FOR CITY USE ONLY PERMIT # ISSLED ?7? ? 7doz Pd w/Bldg. Permit FEES: $ SEWER PERMIT (INCLDDE SURCHARGE) $ WATER PERMIT (INCLUDE SORCHARGE) . $ ? 3- S Z? $ WATER METER/COPPERHORN/OL'TSIDE READER $ S WATER TAP (INCLLDE CORPORATION STOP) $ $ SEWER TAP $ $ O 0 ACCOUNT DEPOSIT - SEWER $ $ /,s • ?d ACCOL'NT DEPOSIT - WATER S ??J 0- tl o $ WAC $ .]7S $ SAC $ $ TRUNK WATER ASSESSMENT $ $ TRUNK SEWER ASSESSMENT $ $ LATERAL BENEFIT/TRUNK SEWER $ $ LATERAL BENEFIT/TRCNK WATER $ / S7c 'O Z) $ WATER TREATMENT PLANT SLRCHARGE $ $ OTHER: $ ?•? ?'j ?' ? d $ ,? I O d TOTAL ?2 SZ 3 ?3573 RECEIPT RECEIPT DOES UTILITY CO NNECTION REQUIRE EXCAVATION IN POBLIC RIGHT OF WAY? F--j YES IF YES, THEN A"PERMIT FOR WORK WITHIN PDBLIC Q NO ROADWAY" MUST BE ISSUED SY THE ENGINEERIIVG DIVISION LIST AS A CONDITION . . SOBJECT TO THE FOLLOWING CbNDITIONS: APPROVED BY: TITLE: DATE: t?, // ??114 . CITY OF EAGAN APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION *KYPS: PAYMEW OF FF.B AT TIME pF APPLscAMoN ooFS NOr aarsriTUTE APPROVAL OE' PII2NIIT. naspnMoN oF sE,mz nrro/Ot MM TT1S'i'AT.7ATTQN$ 4nL NOr $E $(HED- ULID UNPIL PEEtMIT HAS BEa7 APPR0VFD. ----------------------- , P ease Print) •?1) PROPERTY ADDRESS: lij/`,?,? G4- &? ? LEGAL DESCRIPTION: _ Lot Block Subdivision or Tax Parcel ID ) IE' EXISTING STRCtZL'RE, DATE OF ORIGINAL BC'ILDING PERMIT ISSL'ANCE: ' ? (I•bn ear ) PRESEr7t ZONING/pROPOSID CSE: [:] CONMERCIAL/REI'AIL/OFFICE 0 IDIDCS'TRIAL n INSTI'A.'TIONAL/GOVII2rP'IENT 21 ? - : NAME: ADDRESS: ? R-1 SINGLE FAMILY R-2 DL'PLEX (7%%o L?nits) ? R-3 'IC)WNHOUSE (Three + Units) Lnits) ? R-4 APARTMEN'i'/CObID0A7INILfi1 ( Units ) ? CITY, STATE, ZIP: PHONE: -7 / 3) u .a• NAP'!E: P,DDRFSS : ? CITY, STATE, ZIP: PHONE: MASTII2 ISCENSE # 4) ?u • i?• NAME: ADDRFSS: a'IZ'. STATE, 2IP: PHONE: 7 eCT -- ? ? / G' Active EScpired NOt Z'E'.COTdECI statT Initlal 'S? '? Y• I 1 Y: • 01' :] • D? 70 .- ?'j coNrEcriorr iO crrsr sEMa ?-corNE,-rioN zv csTY wATEa Cl oTHEa . . 6) ?? • r ? PLEASE HOLD APPROVID PERMIT FOR PICK-0P BY ONE OF ABOVE PLEASE MAIL APPROVED PERMIT TO 1, 20 3, 4, AHOVE -y/,/ (Circle one) 7) /. r. n u• • ?.-/ Z rsr.-w. FOR CITY USE ONLY • PERMIT # ISSLED • ' /3 f `? 4?? I Pd w/Bldg. Permit FEES: $ SEWER PERMIT ( INCLQDE SC'RCHARGE) $ $ 5 71 WATER PERMIT ( INCLL'DE SL'RCHARGE) s !l'3• .S?ZJ $ WATER METER/COPPERHORN/OL'TSIDE READER $ $ WATER TAP (INCLL'DE CORPORATION STOP) $ $ SEWER TAP $ $ /,?CYd7 ACCOONT DEPOSIT - SEWER $ $ ACCOONT DEPOSIT - WATER $ n t7 $ wac $ $ sac , $ $ TRUNK WATER ASSESSMENT $ $ TRCNK SEWER ASSESSMENT $ $ LATERAL BENEFIT/TRUNK SEWER $ $ LATERAL BENEFIT/TRL'NK WATER $ $ WATER TREATMENT PLANT SURCHARGE $ $ OTHER: $ ?574 Q ? TOTAL RECEIPT RECEIPT ° DQBS UTILITY CONNEC TION REQUIRE EXCAVATION IN PL'BLIC RIGHT OF WAY? n YES IF YES, THEN A"PERMIT FOR WORK WITHIN PUBLIC Q NO ROADWAY" MUST BE ISSUED BY THE ENGINEERING DIVISION LIST S . A A CONDITION. SUBJECT TO THE FOLL OWING CONDITIONS: APPROVED BY: TITLE: DATE : r?_ PERMIT City of Eagan Permit Type: Mechanical 3830 Pilot Knob Rd Permit Number: EA075159 Eagan, MN 55122 . Date Issued: 09/15/2006 (651) 675-5675~~~ EPermit Category: ePermit www.ci.eagan.mn.us lflflUl tflflLLL Site Address: 4416 Clover Lane Lot: 037 Block: 002 Addition: Eden PID 10-22750-370-02 Use Description: Sub Type: e - Furnace Work Type: Replacement Description: Furnace Comments: Quesetions regarding electrical permit requirements should be directed to Ma rk Anderson, State Electrical Inspector, 952-445-2840Lisa Lyons 122 W 3rd S t Hastings, MN 55033 651-437-033811yons@haleycomfort.com Fee Summary: Surcharge-Fixed $0.50 9001.2195 ME - Permit Fee (Replacements) $30.00 0801.4088 Total: 530.50 Contractor: -Applicant - Owner: Haley Comfort Systems Stephen L Anderson 122 West 3rd St 4416 Clover Lane Hastings MN 55033 Eagan MN 55122 (651) 437-0338 I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Applicant/Permitee: Signature Issued By: Signature From:ALLSTAR CONSTRUCTION 19529427464 09117/2013 08:45 #582 P.056/079 Use BLUE or BLACK Ink For Office Use I I l j City of Ea j Permit* Permit Fee: - 3830 Pilot Knob Road Eagan MN 55122 Date Received C l Phone: (651) 675-5675 I I Fax: (651) 675-5694 I Staff: I I 1 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 9 (toy 2013 Site Address: HH 1U,y41U$ yL11X r 441k, Guyer will/ Unit M F Name: e0W ftA CAD' (70J%t ri C, Phone: Resident/ Owner Address / City / Zip: W 38 G 1\A "C11 PUNIC / & . W(Al Mki 6 e. MN 553yW Applicant is: Owner _ Contractor Type of Work Description of work: 2611 Off gnd M-YoU k YPe Construction Cost: Iq 1300 00 Multi-Family Building: (Yes / No t I Company:.. Y CMUdOn • l Contact: .11 V~ tbIftC4 t I Address: 949 IVI MNal S1 i *1102) City: Contractor maple ~'G 1 n State: MN Zip: (5c)%q Phone: "1"JL~ 1"12 1~~"1 License Pic U 315T-P Lead Certificate NRT- 20q V4 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 pennit the City to M rvY conclude that they are trade secrets.e 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.oot)herstateonecall.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. Al X_ x ..,..c~1~R✓ Applicants Piinte Name Appl cant's Signature . 1 Pagel of 3 From:ALLSTAR CONSTRUCTION 19529427464 02/10/2016 13:00 #301 P.011/022 4,111 CityofEaall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use Permit#: t037 Permit Fee: IR6Q= Date Received: Staff: 2016 RESIDENTIAL BUILDING PERMIT APPLICATION Date: P'//D 4 Site Address: *'&- Wf e41/14447i1- Resident/ Owner Name: 9VA F e, 6 L4 —1) 674 /-a,4 Address / City / Zip: 90i'- yo v G///ef 4 M e -Applicant is Owner i� Contractor Type of Work Description of work: "�''.5 (,q/jZ--4 "nv" ��in - Ge#/fal'rl'�fg ,%nafil i Construction Cost: 4t/4 000 — Multi -Family Building: (Yes / No ) Company: 4t( 4e, !„®sr Peaeirovs / iniii;111drUnce Contact: 'edI wt Ari ,,t -r7 Address: 6146 ! r W,S4-f IA 1 Si- -Su4 rl4- /'0 3 City: Aye- ?LA -1 el Contractor !! State: in/4 Zip: S6369 Phone:9 q .I6'r Email: ,474gt//S-)IeU'• ,4 .-. I. License #. t�l0.35 ® Lead Certificate #: //9-T doge, V - m� A t Unit #: !1 f I Phone: /✓% J If the project is exempt from lead certification, please explain why: 84; t: /983 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 Cali at (651)4544002 for protection against underground utility damage. Call 48 hours before you Intend to dig to receive locates of underground utilities. www.aopherstateonecall.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 Buildin amu, mpteted within 180 days of permit issuance. x Vi144 Afieint2.0x Applicant's Printed Name ( Appiicpnt's Signature Page 1 of 3 PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA139467 Date Issued:10/25/2016 Permit Category:ePermit Site Address: 4416 Clover Lane Lot:37 Block: 02 Addition: Eden PID:10-22750-02-370 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 - Stephen L Anderson 4416 Clover Lane Eagan MN 55122--244 Tony's Appliance 2090 County Road 42 West Burnsville MN 55337 (952) 435-2442 Applicant/Permitee: Signature Issued By: Signature 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651) 675-5675 1 FAX: (651) 675-5694 buildinginspections(cDcityofeagan.com -------------I For Office Use I L I Building Permit #: LIU I I I S&W Permit #: I I I Permit Fee: ;9, I I I I I Date Received: I I I I I I Date Issued: I t- - - - - - - - - - - - - - - - - - - - - RESIDENTIAL BUILDING PERMIT APPLICATION Date: _?/Site Address: Unit #: Applicant is: ❑ Owner Contractor Name:EG(LS!!nj �Ad OV,11y--X"5,_b4S'SC,e10-41 6In Homeowner Address:Q/ ; L4L& Llgle, Alt? Cbjc'.\,- to. -city: 1;;-cta v,,- State: Phone: Description of work: P2 is t�— Type of Q �/� Work Construction Cost ( —[ Type of building: ❑ Single Email: ❑ Townhome, of units Twin Home Compan 3QM �V'jSr�—V—CA C_ n\A Contact: `r ��✓ g Z/ � & Ujp ��Y � Building � Address: � t � City: � ��T� Contractor `J '/ State:A�Zip: S��T Phone>(otzJ`f S ' Emaili �l'Q� 3l/� S_ `0 License #: D Expiration Date: Sewer & Company: Contact: Water Contractor Address: City: Required for State: Zip: Phone: Email: new construction License #: Expiration Date: ` 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. Ll-� t�x c�� x Applicant's Printed Name A licant's Signature