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4464 Clover Lane - Use BLUE or BLACK Ink For Otte Use I City ofd clan Permit 1 Permit Fee: 1 3830 Pilot Knob Road I Eagan MN 55122 j Date Received: Phone: (651) 675-5675 I Fax: (651) 675-5694 1 staff: 1 1 L- -..------------J 2010 RESIDENTIAL BUILDING PERMIT APPLICATION Date: ? / .~17/y Site Address: 4,L1 &41 C'. 141 vt ~ G~ Tenant: PA AJ n1 .,u Suite M RESIDENT i OWNER Name: Phone: Address / City / Zip: Applicant is: Owner Contractor TYPE OF WORK Description of work: LA) I'rl A,~~P't_u Construction Cost t? 0 Multi-Family Building: (Yes No __j CONTRACTOR Name: c'6 64 el~n le- License _ C ~O 7C1`~ Address: _ I q rn crr City: M Cc I,- be 1.v State: hVW_ Zip: ] Dg Phone: 6 5l 75--2- ?4933 Contact: -~Cs raN"k; Email: ~aa k e~ba_, \30 - C.' COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the fast 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 suppor ft documents that you subn* are considered to be pubilu inlbrmatlon. Portions of the iniiormatfon nay be chimWed as non public if you provide specillc 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.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 lose of work which requires a review and approv of pans. XS,,;os ti X JCAA JA%-jL- 'k - - Appiicanrs Printed Name Ap 41cais Signature Page 1 of 2 I ~Cd U DO NOT WRITE j RITE BELOW THIS LINE I 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* A 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 OGO Occupancy MCES System Plan Review Code Edition SAC Units 0 0 (25 /o_ 100 /off Zoning City Water Census Code Stories - Booster Pump # of Units _ Square Feet PRV # of Buildings Length $ Fire Sprinklers Type of Construction- Width t;D REQUIRED INSPECTIONS Footi New Building) Sheetrock tines Final / C.O. Required ings (Addition) Final t No C.O. Required Foundation HVAC 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 Wail: _ Footings Backfill Final Meter Size: Radon Control Erosion Control Reviewed By: Building Inspector F 60' RESIDENTIAL FE Base Fee 73 Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL Page 2 of 3 ROSE qq6q PLANNEAS andaLANDx iiRVEYCRS ENGINEERING CONS COMPRNY, INC. 1000 EAST I461A STREET, SURNSYILLE, MINNESOTA 55337 PH 432-3000 Ce P01Y.Af Ccxzc --g# 6,XC.7-WjCeY GOOF 4cZl .l~e'.tcr~fel? LOTS 1,2,3, AkID .4, BLOCK 2, EDEN ADDITIOtiJ/ DAKOTA coUM-fY, MINNE5oTA X2!•1 DEMOTES Ex15TIM6 ELEVATION (2-1.5) DENOTES . PROPOSED' ELF-vAT/OA J OWNW--• fNDIGATES DIRECTION OF SUPFAOE DRAINAGE 94, FI1vISNED GARAGE FLUOR EL6vATlo,v '-A" Az REN1° ,VE ICI O RT H ATE I I ' 9'0 ~o~ SCALE : P= 3D' DRAINAGE A►.JD UTILITY EASEMENT ~d u 2~ 12 \ 30' FRC#JT aulL.Dhl1G ~9~6~ ° 3,p• 6~ SETBACK LINE 4 0 O Qio 41i ti` 141 1^~1 q~b la p o ti , z (k/ o ~0 a Z q) n/ tL~ O C, N ` / / R ti sa ao ys 73\ `q2, tie 'h~ of - 6V E AGAN s8'- RE I p w ~ ~ , , BY ' DATE: 9ULDIt,1G -`F-CTIONS DIVISION I hereby certify that this is a true and correct representation of a tract of land as shown'and described hereon.. As prepared by me on this lsday of NoveMBER , 19 8s . • HInn. Res. No.%lti (TOWNHOUSE) -• • CITY OF EAGAN N°_ 1 12 5 5 ? 3830 Pilot Knrob Road, P.O. Box 21•199, Eagan, MN 55121 PHONE: 454-8100 BUILDING PERMIT Receivt # Te M med Ier 1 OF 4 PLEX Ese. Val,e $60,000 pate NOVEMBER 7 I q 85 SlteAddress 4466B CLOVER LN Erect gl Occupancy R3 2 Lot 3 Block EDEN ADDITION Remodel ? Sec/Sub Zoninq PD Parcel No . Repair ? Type of Conat. V . Addltion ? No. Stories ? GOOD Neme VALUE HOMES INC Move ? Lenyth 44 Z 1460 Demolish ? 93RD LN NE Depth 24 ? Address BLAIN intlmpr. ? 7$0-5510 E Sq,pt. City phone Install ? SAME ADProrab Faes Name Addreas City Phone n Name ?? Address ?w City Phone I hereby ockrrowfedge that I have read this opDlicution ond store that the in(ormation is mrrecf nd agree fo comply with oll opplicoble Sfnta of Minnewta $tofut ond Ciry of Eaga ma es. Siprwturc of P i ee A Building Pe it ssued to: GOOD VALUE HOMES oll work sFwll done in accordnnce with all oppli Sfate of M( Buildinp Officiol Assessment _ Water & Sew. Police - Fira Enp. Planner _ Council _ Bldg. Off. 11 / ( / $ 5 APC Var. Date rermit $ 313.00 Surcharge 30.00 Plan Review 156.50 SAC 525.00 waterConn. 500.00 WaterMeter 63.00 RoadUnit 280_00 TcPI. 132.00 Parks I CoPies Totai $1,999.50 _ on the expreu cordifion Iho+ and Ciry of Eupan Ordinancea. ( TOWNHOUSE ) CITY OF EAGAN N_ 11256 • 3830 Pilot Knob Road, P.O. Box 21•199, Eagan, MN 55121 PHONE: 454-8100 BUILDING PERMIT Recelpt # T Te !e utad Ier 1 OF 4 PLEX Ft, Value $60,000 pOfe NOVEMBER 7 19 85 SiteAddress 4466 CLOVER LN Erect EX occupancy R Lot 4 Block 2 Sec/Sub EDEN ADDI I Remodel ? Zoninq PD Pazcel No . Repair ? Type ot Const. V . Add'Rion ? No.Stories Name GOOD VALUE HOMES INC Move ? li D h ? Langth 44 = 1460 93RD LN NE emo s Depth 24 ? Address lntlmPr ? ?.Ft, City BLAINE Phone 780-5510 Install ? SAME '`pvr"ab Fae+ F Name } ?? Address ? City Phone Gp u'?' Name ? 2? Address City Phone Assessmenf _ Water S $ew. Police _ Fire Eng. Planner _ Council _ I hereby acknowledge tFqf 1 Mve read this opplicotion nnd stote that Bldg. Off. IZ/EI/BS the in(ormation is correc d ogree to comply with oll applicoble APC State of Minnewto Stat te and City of Eagon Ordinnn s. Var. Date Si t f P Qztzr? Permit v -'?1• surcne,ge 30.00 PlanReview 156.50 snc 525.00 water Conn. 500.00 WaterMeter 63.00 RoadUnit 280•00 TcPI. 132.00 Perks Copies pno ure o erm? ? A euild'n Perm? s GOOD VALUE HOMES INC on tM ex? C? Q4q SO g prca cond(tbn ?ha? oll work sholl ne in acmrdance w?th all opp7it.ap State of nne o Starutes and Ciry ol Eapan Ordinancea. Buildinp Officiul (TOWNHOUSE) CITY OF EAGAN N° 11254 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE:454-8100 ??7 . / BUILDINC PERMIT ReceiPt ?! / )7' 1 Te M wed fe. 1 OF 4 PLEX Est. Volue $60,000 pOfe NOVEMBER 7 1y 85 SiMAddreaa 4464B CLOVER LN Erect K1 Occupancy R3 Lot 2 Block 2 Sec/Sue. EDEN ADDITION Remodel ? Zoniny PD Percel No Repeir ? Typa af Const. V . AddRion ? No. Stories N ame GOOD VALUE HOMES INC Move O Length 44 ? 1460 93RD LN NE Demolish ? Depth Zt] Address lntlm c ? BLAINE 7$0-5510 p gq,pt. City phone Install ? . g Name S?E AVVrovals Faes ? ?` Address ? city _ Phone Name _ Address City Phone Assessment - Water 8 Sew. Police _ Fire Enp. Plonner _ Council _ I hereby ackrwwledge thof I have read this aODlicafion and slafe fhat Bldg. Off. 11/6/85 the informotion is correct a ogree to wmply with oll applicoble AP? SMte oi Minnesolo Statute d Ciry of Eogan rdirwnces. Va Date Copies Permit .OO surcharee 30.00 PlanReview 156.50 SAC 525.00 Watar Conn. 500.00 WaterMater 6?00 RoedUnit 280_00 Tr.PI. 1?2-00 Parks r. I Sipnoture of Permi tf - Total $1,999.50 A Building Permi s is d to: GOOD VALUE HOME NC an tM ezprest condition that oll work sholl in otcordance with al,l o?cable Sfafe f,,Min to3o Storutes and Ciry of Eoyon Ordinoncea. Bulldinp Of/icial ( TOWNHGUSE ) CITY OF EAGAN N°_ 1 12 5 3 3630 Pilot Knob Rosd, P.O. Box 21•199, Eagen, MN 55121 . PHONE: 4548100 BUILDING PERMIT Receipr g 15E2W T. M wd hr 1 OF 4 PLEX FN v?i. $60, 000 n,,.e NOVEMBER 7 e 85 siteqdd.esa 4464 CLOVER LN Lot 1 e?ock Z ?c/s?b. EDEN ADDITION Parcel No. W. IN,rms GOOD VALUE HOMES INC ? Address 1460 93RD LN NE City BLAINE pha.e 780-5510 ig uS? r Name SAME Address Name _ Address City Phone Erect E Occupancy R3 Remodel ? Zoning PD liepair ? Type of Const. V Addition ? No. Stories Move ? Lengen 44 Demolish ? Depth 24 Int ImPC ? Sq. Ft. Instali ? Avorove6 Fees Assezsment _ Water 8 Sew. Police _ Fire Enp. Planrror - CAUncii 1 hereby ncknowledya ihct 1 ove read fhis apDlication ond stote thaf Bidg. Off. 11/6/8S fhe inlormotion is CorreCf ogree to comply with all applicoble AP? $tafo of Minnesoto $fntut and City of Eagon Ordinan Var. Date Sipnoture of Pemi e h Building Pertri Is ued to: GOOD VAL(lE I30MES I?N all work sholl one in accordance wifh a(l-applicoqfb State of MI neaoto tafutes Phone Permit $ 313.00 surcnarge 30.00 PlanHeview 156.50 SAC 525.00 Water Conn ?2.00-00 WaterMeter 63.00 RoadUnit 280.00 TcPI. 132.00 PaNCa Copies totat 1, 999. SO _ on the expren cordition Ihat ond City of Eaqan Ordirances. Buildirg Offlciol ? Lot Parcel No. CITY OF EAGAN 3830 Pilot Knob Rosd, P.O. Box 21-199, Eagsn, MN 55121 PH ON E : 454•8100 W Name ; Address b City Phone ? Name. -- OV U? Additss F- Citv . Dhnna . 1 hereby ocknowledye that I hove read this aF the inlormotion is correct ond ogree to corr State of Minnewto Stctutes ond City of Ea f. Sipnoturo of Permitfee A Building Permit Is iuued to: oll work sholl be done in accordante with oll Building Officiol and stote thot oll applicoble Srme of Repeir ? Addition ? Move ? Demolish ? Int Impr. ? r.'-1 11253 Occupancy Zoning Type of Const. No. Stories Length Depth Sq. Ft. ^ssessment Permlt ? Woter 8 Sew. Surcharge Police Plan Review Fin SAC Eng. waee. conrL Planner Water Meter " Council Road Unft Bldg. Off. Tc PI. APC i Pe?ks Var. Date Cppies Total on ths express conditlon thos sota Statutes ond Ciry oi Eoqon Ordinor?ces. QUILDING PERMIT Receipt #t Pamit No. Pamit Hdder DaU Telephone ik Plumbinp H.VA.C. 9 , f El?ctric ? ( ` /?f Softowr Irqpsetion Dsb Insp. Othor Footings I Footinps II Foundatlon Framiog ? ) Roofing Rouph Plbg. .? Rough Htp. Insul. Finpiacs Flnal Hty. $-/,Z_?L Final Plbg. Final GrVOcc. Water ??ibe Location: Wsll Sewer Pr. DIsP. ( TO'?L??;ryti;_ CITY OF EAGAN ' ; ; 254 3830 Pilot Knob Road, P.O. Box 27-199, Eagan, MN 55121 PHONE: 454-8100 BUILDING PERMIT Receipt # Ts 6o rwa fer -. ??-Lr?:?: F?? V?I. $?G,. i)'i'S n...e :d['!VI?I'11Bf:R io ;. - Site Address ?r • i; : i s t'. s; R LN Lot Block ? Sec/Sub. ADD I`I':l: ()N Parcel No, W Name :=000 VAI,UE HOMES lE+lC z Address 1. 4 1;fj 93 RD r N NE ' City Phone =o Name s? Address City Phone City Phone that I hove read rhis rrect and oyree to c and state that oll applicoble A : ? N Bu114ing Permit Is issued to: oll work shoil be done in cccordance with EreCt kJ Occupancy Remqdel ? 2oning Repair ? Type of Const. Addition ? No.Stories Move ? Length r. , Demolish ? Depth •,. Q Int Impr. ? Sq. Ft Assessment Permit -' • L) U I Water a Sew. Surcharge ? n. OC' + Palice Plan Review -1. 56. 5 0' Fire s,ac 5 25 - G0 Eny. ?I Water Conn. `` Q.0... 00 Plonner i Watar Meter 63.00 Councii Road Unit 24U_ a d Bldg. Off. $ 5 Tr. PI. = 3 2 _ 00 APC Parks Var. Date Copies Total 4 4. 5 0 on the express wridiNon Ihot esoto. Stotutes ond City o# Ecqon Ordir+orrces. Pwmit No. Parmit Holder Drta Telephons iR Plumbino C(..) )61 HMA.C. Ekct?is Soitonar Iropsction Date Insp. Other Footlngs I (,J 6 Footinys II Fou ndation Framing ze i B Rooting Rough Plbg. :- /,;. - Rough Htg. Insul. Flreplaee Final Htg. ?o-? ,?• Final Plbg. 42 Final C,lrtlOcc. '?; ` _ ' Weter Deseriba Lotstion: Well Sewer Pr. Disp. ( TawNHOtIsE ) sU1LDING 'ERMIT "', . 11255 Receipt # Site Address `? 4 f- .. ' ^ Lot ?- Black 2 Sec/5ub. Parcel No. . W Name v' ; Address ' • ? City Phone Erect Remodel Repair AddRion Move Demolish Int Impr. Install LJ ? ? ? ? ? ? ? Occupancy Zoning P Type of Const. No. Stories Length y Depth Sq. Ft. ? ? Name ? - Aporo vsls F•" i ? A?? Assessment Permit t ? City Phone Woter 6 Sew. Surcharge S G_ i! ?? ' Police Plan Review 156.50 F-W Name Fin SAC ?25.(?0 ? ?? Addresa Eny. Water Conn. ?Qi oc' t?Z.+ City Phone Plonner Water Meter t? 3•{: El ' Council Road Unit L?? 0. ?(3 { I hereby acknowledge thot I hovs rood this opplicution and state thot Bldg. Off. Tc PI. ? 2.3 (' fhe information is Correct and ogree to comply with all opplicable APC k Stote of Minnesoto Stotutes and City of Eogon Ordinonces. Par s . Var. Date C??? Sipnoturo of Pem+ittea . Total /1 Building Permit Is Issued to: on the exp?ess condition Ihat i oll work sholl be done in ocoordance with oll opplicable State of Min nesofa Stotu tes nnd City of Eopan prdinonces. Buffdinp Offidol CITY OF EAGAN 3830 Pifot Knob Road, P.O. Box 21-199, Eegan, MN 55121 PHON E: 454-8100 - Pamit No. Pwmit Holder Dsa TN?phoea # Plumbiny H.VA.C. 65b j 4-._/ Electric s (D I g `? v/? r?J ? ? Softsner Inspection Data Insp. • Othar Foo!'nys 1 1 ? 1 c? L.j6 Footinga 11 Foundatlon Fnminq Roofinp Rough Plbg. AdnZE Cw0 Rough Htg. Inwl 0 Flreplace Finai Htg. Flnel Plby. Final Csrt/Occ. -7. wetter Oese?ibe Loeation: WNI 8ewer Pr. bisp. I ? . . . . r . . ? BUILDtNG PERMIT SiUe Addrf Lot ` z, ? Name _ V? Address ?- Citv - Name CtTY OF EAGAN 3830 Pilat Knab Road, R.O. Box 21-199, Eagan, MN 55121 PH ON E : 454-8100 Phone I hcve reod this and ogree to t es and Ciry of ' Sipnature of Permittee A Building Pernit {s issued to: oll work shall be done in accordante with oll Buildfnp Official ond state that all applicoble A.•; , Occupancy Zorring r . Type of Const. No. Stories ? Length Depih Sq. Ft. F?es Assessment Permit 1.: • u i3 Water 3 Sew. Surcharge ''• t' fl i Police Plan Review Fire 5AC Enp. Water Conn. } v . Pionner Water Meter ; 4} Courui) Road Unit Bldg. Off. "?• Tc PL APC parks ? F'' 11256 Receipt # ? Copies Total on Ths exprtss candition Ihat ond Ci1y o# Eoflon Ordinonces. PerCel No. nepair u Addition ? , Move ? ? Name . . ? Demolish ? ? - . . ., Z r Address Int Impr. ? 4 Soitener ` Inspection Date I lnsp. n Other I Finsl Htg. Well Pr. MECHANICAL PERMIT RECEIPT # -7 L dI L CITIf aF EACAN ? `? / 8 ,7 3830 PILOT KN08 ROAD, EAGAN, MN 55122 DATE: ? I Site Address V-V - BLDG. TYPE WORK DESCRIPTION ? Lot ock Sec/Sub Res. ? New '? Mult Add-on -A%ld?"'A• ? Name 7- LVA6C Comm. Repair Address j c City X-2-2 ' ah? ? - FEES Name RES. HVAC 0-100 M BTU ? -$24.00 3 Address ADDITIONAL 50 M BTU - 6.00 p City Phone {RES. HVAC INCLUdES A/C ON NEW ? CONSTRUCTION) GAS OUTLETS (MINIMUM - 1 PER PERMII) - 1.50 EA. TYPE OF WORK COMM/IND FEE - 19'o OF CONTRACT FEE Forced Air M BTU APT BIDGS. - COMM. RATE APPLIES TOWNHOUSE & CONDOS - RES. RATE APPLIES Boiler M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON & Unit Heater M BTU REMODELS - 12.00 Air Cond. - M BTU MINIMUM COMMERCIAL FEE - 20.00 STATE SURCHARGE PER PERMIT - .50 Vent CFM (ADD $.50 S/C IF PERMIT PRICE GOES Gas Piping Outlets # BEYOND $1,000) Other FEE S/C: SfGNATURE dF PEfi ITTEE TOTAL• ? FOR: CITY OF EAGAN CITY OF EAGAN Remarks Addtion Eden Addition Lot 1 Blk 2 Parcel #10 22750 010 02 - owner screet 4464 Clover Lane State Eagan NM 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. ' Ll 19$2 504.70 100.94 5 STREET RESTOR. GRADIMG _ (nqO 1982 2.99 A6.60 --_l SAN SEW TRUNK ? QJ 93 4.20 15 i IF SEWER LATERAL - (OX 1982 896. 46 O.29 15 WATERMAIN • WATER LATERAL 1982 WATER AREA - ? 1977 4.20 15 *Services 1982 STORM SEW TRK - 3 1982 OO 1.20 ?- * STORM SEW LAT 19 2 CURB & GUTTER SIDEWALK STREET LIGHT Unit 280.00 57374 11/S 85 WATER CONN. 500.00 BUILDING PER. 53-11256 SAC • PARK CITY OF EAGAN Remarks Addition Lden Addition Lot 2 sik 2 Parcel #10 22750 020 02 p,,,,ner street 4464B Clover Lane State Eagan hIN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. ? ].9$2 504.70 100.94 Jr STREET RESTOR. GRADING (tqo 82 4 ?o SAN SEW TRUNK y/ 1974 62.93 4.20 15 -? f SEWER LATERAL 7 1896.46 479.29 5 WATERMAIN * WATER LATERAL 1982 WATERAREA 1977 62•93 4.20 ZS oZ/, D ? STORM SEW TRK 1982 26.4o 1.20 +1F STORM SEW LAT 1982 CURB & GUTTER SIDEWALK STREET LIGHT Road Unit $280.00 57374 11/8/85 WATER CONN. 500.00 BUILDING PER. 11253- SAC 0 PARK CITY OF EAGAN Remarks Addition Eden Addition Lot 4 sik 2 Parcel #10 22750 040 02 Owner I.': ' street 4466 Clover Lane State Eagan NW 55122 Improvement Date Amount Annual Years Payment Receipt Date STREETSURF. Q 1982 504.70 100.94 5 STREET RESTOR. GRADING C(p 232.99 46.6o SAN SEW TRUNK 1974 93 20 15 * SEWER LATERAL WATERMAI N i WATER LATERAL 1982 WATER AREA • Services 1982 STORM S EW TRK fl Q 6.00 1..20 * STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT ?2fJc"1C? LTIllt 280. WATER CONN. . BUILDING PER. -53-II25b SAC PARK . .,r cAGAN Remarks Adlition' 'F.den Addi ti on Lot ? Rik 2 Parcel_ #10 22750 030 02 Owner I", I ' Streec 4466B_'CloVer Lalle State Eagan MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. "o 19$2 504.70 100.94 5 STREET RESTOR. GRADING qt) 1982 232.99 46.6O ! :- /. SAN SEW TRUNK !l 7 3 * SEWER LATERAL , 82 1896.46 379.29 5 ' WATERMAIN * WATER LATERAL 1982 WATER AREA * STORM SEW TRK 1982 2 6. OO 1.20 i STORM SEW LAT 1982 CURB & GUTTER 51DEWALK STREET LIGHT Road Unit $280.00 57374 11 8 85 WATER CONN, 500.00 BUILDING PEFi, 56 sAC 525.00 PARK Roaipt MECHANICAI PERMIT CITY OF EAGAN Parmit No. ? FN ;. i flIl in numberod spscQS S/C ' Type or Prinr legfb/y Tot . 1. Date 2. Installation Cost . . 3. Job Address Lot Bi k. Tract 4. Owner 5. Contractor Phone 8. AddrKs 7. City State Zip 8. Building Type: Residential ? Commercial ? Institutional ? 9. Work Description: New 0 Add Cl Alter O Repair 11 10. Describe Fuel Type G 11. No, Equinment STU - M. Ea. Foroed Air No. Equipment CFM Ai H dli Mfg. ng: r an Boilers Mfg, Mech. Exhaust Unit Heater Mfg, Other Air Cond. Mfg, Gas, Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed : for Rough Pinal Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 Receipt PLUMBING PERMIT Permit Na. CITY OF EAGAN Fee ; r . FiN in numbered spaces S/C Type or Prini legibly Tot. ? 1. Date ' 2. Installation Cost 3. Job Address Lot Blk. Tract ' 4. Owner 5. Contractor " Phane , 6. Address 7. City State , Zip 8. Building Type: Residential ? Commercial ? Institutional ? 9. Work Description: New El Add ? Alter O Repair 0 10. Describe 11. No. - Fixtures Water Closet No. - Fixtures I I Cesspool/Drainfield Bath tubs Septic Tank I? Lavatory Softner Shower Well Kitchen Sink Urinal/Bidet Other Laundry Tray Floor Drains Drinking Ftn. Slop Sink Gas Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed: _ , for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 Receipt ? PLUMBING PERMIT CITY OF EAGAN FiII in numbered spaces Type or Print legib/y Permit No. Fee S/C Tot. 1. Date 't' ;" 2. Installation Cost 3. Job Address Lot Blk. Tract 4. Owner .. 5. Contractor ? ?Phone ? 6. Address " 7. City State Zip ` $_ Building Type: Residential 0 9. Work Description: New ? 10. Describe 11. Commercial O Institutional ? Add ? Alter ? Repair O No. Fixtures Water Closet No. Fixtures Cesspool/Drainfield Bath tubs Septic Tank Lavatory 5oftner 5hower Well Kitchen Sink Urinal/Bidet Other Laundry Tray Floor Drains Drinking Ftn. ? Slop Sink Gas Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed : for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 Receipt ? 4 PLUMBING PERMIT CITY OF EAGAN Fi!l in numbered spaces Type or Print legibly Permit No. Fee S/C Tot 1. Date 2. Installation Cost r 3. Job Address ?-. ,=./_ Lot Blk. _ Tract 4. Owner 5. Contractor Phone 6. Address ' 7. City State _ Zip, 8. Building Type: Residential ? Commercial ? Institutional O 9. Work Description: New ? Add ? Alter ? Repair O 10. Describe 11. No. Fixtures Water Closet No. Fixtures Cesspool/Drainfield Bath tubs Septic Tank Lavatory Softner Shower Well Kitchen Sink Urinal/Bidet Other laundry Tray Floor Drains Drinking Ftn. Slop Sink Gas Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed : I for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454$100 Receipt PLUMBING PERMiT Permit No. C17Y OF EAGAN . Fee • Fill rn numbered spaces S/C Type or Prin[ legibly Tat. • 1. Date 2. Installation Cost 3. Job Address - Lot Bik. Tract 4. Owner 5. Contractor Phone 6. Address 7. City State 8. Building Type: Residential ? Commercial ? Institutional O 9. Work Description: New 0 Add ? Alter ? Repair ? 10. Describe 11. No. Fixtures Water Closet No. Fixtures Cesspool/Qrainfield Bath tubs $eptic Tank Lavatory Softner Shower We I I Kitchen Sink Urinal/Bidet Other Laundry Tray Floor Drains Drinking Ftn. Slop Sink Gas Piping Outleis 12. I hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of Work. Signed : for Rough Final InspeCtions: Date Insp. _ Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-$100 SEDGWICK HEATING & AIR CONDITIONING CO. HF-ATING JoB No. 5 7 a3 ? 8910 WENTWORTH AVENUE SOUTH • MINNEAPOLIS, MN 55420 •(952) 881-9000 TEST RECORD ADDRESS y 66 +3 C t fl?` l(A OCCUPANT ? ? ? box6 ? SOLD BY I -t' N ? cirr '?jj0 OWNER ??J l ? ? ? " "` ? INSTALLED BY MAKE SERIALNO. ? THERMOSTAT VALVE ' UMIT e- i iuIT ecTruar_ / llJ ? FAN SETTING I vw`L- ' PILOT TYPE ? IGNITION MODEL ? C?'? r U ? PILOT TIMING PRESSURE PERCENT COZ O STACK TEMP. ?U PERCENT MODEL GrYotM r" v 0 INPUT ? VENT SIZE J TYPE OF LINER LINER SIZE FILTERS: SIZE WIRING S? k'f uZ" TEST TAG LIGHTING INST. -r DATE COMPANY TESTING NAME OF TESTER FORM 235 (REV. 17189) FORM DISTRIBVTION: WHITE CdP4`;1OWrILE YELJOW CdPY - CITY SEDGWICK HEATING & AIR CONDITIONING CO. HEATING JOB NO. <-)? 8910 WENTWORTH AVENUE SOUTH • MINNEAPOLIS, MN 55420 •(952) 881-9000 TEST RECORD ADDRESS LNv?? ?( /L- OCCUPANT ? h l ( h A 'µ,'L' SOLD BY N N)-st 1`-' CIn CA g a 0 OWNER ?S ?f I ` ? ? ? INSTALLED BY uo-o SERIAL NO. r ?l 7* THERMOSTAT VALVE ? UMIT - ? y e UMIT SETTING / v O FAN SETTING i PILOT TYPE IGNITION MODEL `J C C - ` ( PILOT TIMING ? PRESSURE PERCENT CO2 U INPUT CFH PERCENT OZ STACK TEMP. PERCENT CO FORM 235 iREV 11,891 MODEL 2 , INPUT VENT SIZE TYPE OF LINER v` LINER SIZE FILTERS: SIZE ` NUMBER WIRING ? -i ` -'- ? 1"JZ-.!` TEST TAG ?LIGHTING INST. DATE TESTED COMPANY TESTINO ?.. NAME OF TESTER FORM DiSTRIBUTION: WHITE C - 1 ? INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number. F; ?Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 I I f J I?', H ?j ?t i1 i J SITE ADDRESS:f APPLICANT: ? ? ,,,, . t + 10:11 st I AN1 ?a.? : 14 t I: fi k'N ( r, 1 'i3t.t. (iif PERMIT SUBTYPE: TYPE OF WORK: ri I I,.l t1i) I i hiil•, F L_ ? lmni Psrmit No. Permk Hotder Data Telephone ? ELECTRIC PIUMBtNG HVAC Inspecdon Dats Inap. Commems FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST HOUGH HEATINQ GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST FlNAL PLBG FlNAL HTG ORSAT TEST BlD(i FINAL BSMT R.I. BSMT FINAL DECK FTG .J DECK FINAL rI bs' 7 CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 SITE ADDRESS: APPLICANT: ' ' i1 1'?f 11 (A Nt - {, ifW PERMIT SUBTYPE: TYPE OF WORK: M A P h':: PtAtd RE V1tiJf f? HY HTi 1 Ai)AM^. F L ? ? Pertnit Holder Date Telephone N PLUMBING HVAC Inspection Date Insp. Comments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG aRSAT TEST BLDG FINAL DOMESTIC METER IRRIGATtON METER FLUSH MAINS CONDUCTIVITY TEST HYDROSTATIC TEST BSMT R.I. BSMT FINAL DECK FTG [ ?? «C7 DECK FINAL 9?iom.as o4?a?ag4E?[ 7• a ? d Z 4466B etovEZ 1'anz ?ayan, cJ1?dV 55122 n?,\c /u?y ?e..(?(,?._ C? _ Q Q.f/?•-?- ? , r A . ?.?..H?,?, , J?.r ,./,,,6?;(? E'? ??•?e ?. - f ° 6?? ??? ? r---_04w- AW M4 4t, Aaq ?qf ew-7 .? P&Ae?. ,r?t?lf? ?:e, " • . ?????p ? ? (/dy ur ?st P u1 U-`°`? °r /?e? a?P --?J a-t? Ca " V ozc CdY?( GaP.C?, ?r- ??Z? , ? ? gxr ?41Q x( 4 .?.`"e v ?. I ?? ?? ? ? &?";)f .9 C?.,.c`` a.?.?.y °Q,c,;,c ? ?? , ??•c4 v?... 2 a l?tcc.?.lao a ? ';,7 ,a?o c9 ?t'?? C o ? ? ? f ?? ? ?? ? CITY OF EAGAN WATER SERVICE PERl1AR 3830 Pilot Knob Road f="' P. Q. Box 21199 PERMIT NO.: _ Eapaee; MN 5512,1 DATE: R Zoninp: _ No. of Units: ^P ex ,oa a_ sc lc.acs Owrnr. Addnm Sit? /1dd?esr. 4466t . over Lait?? 'Vickelsa:t Plt•:,,•': " '?? Plwriber. 5:)0. OOpd MNftr No.: . & ? ? ?JO pd 51?.: ,/R 15. 10. 0 U pc? /O I R it ocdor No.: ( e?*^ 'i ? .Opd j 1 .ow' t°'°mpy' "W' el" Z„ R. ? ?..3 ? . ? S 1 Orri?onen. ?? ^v` ` MIsC. Gho ryn: er Total: By Dote Paid: Doh of Insp.: Ir?sp.: ER SERVICE PERMIT CITY OF EAGAN SEW 3830 Pilot Knob Road p??T NO.: P. O. Box 11199 Eagan, MN 55121 D'`TE: Zoning: No. of Unlts: - Gwnsr. Nddress: 'Site Addron: 44umber: I ym 10 OM11* 1ab the Cw1 of `os• ormNmCM. ey Dote of Insp.: GOflr10Cf10/1 Ch01ge: Account DepOsif: PaIR-Jt Fe!: Surd+arps: Misc. Chorpm Total: Dote Pold: - WATER SERVICE PERMIT PERMIT NO.: D/1TE: . .? -15 •- 8 `_ No. of Units: ` 51b /1dd?ess: Plun6er. • ' , , ? Metsr No.: Siu: b? d ? l5 ?l(l? ReOdOr NO.: t Fee: ' n ??tlnc? 1 p r M t o o e w 0 h v r Mb t? SurcF?o r p s: OrilMwa?. ? Misc. Charpes: . ' _ ' . OJn?,T• -- • Total: pcta Poid: 3$30 Pilot Knob Hoad : "'. PERMIT NO P. O. Box 21199 . Esgan, MN 55121 DATE: , _ Zoninp: No. of Units: ? OwrNr. /lddress: . ? .- Site Addross: Plumber. 1 eewMb wM !Iw Cft d yM¦ .?w. te Conrnction C]wrps: .?(j OfNMSOM 15 . Account apum: r . PeR11iY F!!: Surcharpe: By Misc. C]'rarOts: f I : t D Total: nsp. e o a Intp.: Dah Poid: ITY OF EAGAN WATER SERVICE PERMff 0 Pilo'r Knc•b Road ?. O. B0x 21199 PERMIT NO.: Esgan, MN 55121 DATE: anirg: . '13 No. of Units: `?-Fl eY r. Good Galuc iiame:, raw Mdrea? 4464R Clnver urnbar: '`'•fCkelsnn No.. De ?v p??.??? 1?? :?:-fpd dar No.: /Oh7 1'O .? 7 V-9"214;A A p ,ym M Mo/1y W" !w tQ?, crgs; Mtsc. Chorpes: ''t; LiC.Crw"?" Tatak 63 ??'•ad ?n??< Dcft Pald: of . I?tsp.: Pilot Knob Road Bux 2"!99 n, MN 55121 SEWER SEtVICE PERMR 1 prN te eeoPl1? Wuh IIN CMT of Be!a• Od1M.eM. By Dote of Imp.: Connettian C?wr'Os: AceDLmt pepodt: _ Pe"nit Fee: Surchorpe: Misc. Choroes: - Totol: Da" Paid: CITY OF EAGAN 3830 Pilot knob Rosd P. O. Box 21199 i Eagan, MN 55121 Zaninp: _ .73 Owrwr, l'aod Value Hom, llddrm: Site Addrom +464 Clover Lai plu,,,er '. ickelszn ?lum' AAeter No.: . ?? 7 Stze: 5m WATER SERVICE PERMIT PERMIT NO.: DATE: _ No. of Units: . 1 0 q?M h Oo?yyr 1uil? ty lG,oro.s: 132.00pd TP • ?Q? Total: 63 OQ :net -?r Dote Poid: a of I rup.: Insp.: 3-iy- 8G CITY OF EAGAN SEWER SERVICE PERMR ' 3830 Pilot Knob Road : P. O. Box 21199 PERMIT NO.: ; Eagan, MN 55 i 21 DATE: '-` S•'-` ?' ' Zoninp: No. of Units: Owrnr. /lddmss: Site /lddross: ' r,4 L:iov::r LIU1Q I,:,. :;? `F?'c:_n ?.Plumber. rI. i.: .. - • F.?!+,(???F.,1 ' I Mm to wly wMfi 1V Ghr 4 tp.¦ Connsctton Clwnps: 2 5-00"? ' QrdtMnam Accownt Depo:ih I " . M By ? Dote of I nsp.: Petmit Fw: Surchorps: Mix. CFwrym Total: Dote Poid: This requesl voitl C) ?^ J 18 mon[hs (rom d ? a 086189 L a A ;:)- :F,/-, Renuest Date. (? ' Fire No. Rouph-in Inspecbon fleqw d? ?Featly Now ?yrvill Notdy Inspi?r- / a-d L/' !? ? es ?No T tor When Readv ? Licensed Eler.tncal Contrnctor I hereby request ins0ecbon ol above ? Owner elacbical work mst Ilad ab Street AtlAress, Bua or Route No. Ca`/ ?y6 v ncLO?? o. Township Name or No. FanNe No. Cnumv Occupnnt PRINT? Phonc n. , J l/ Power 5 uher AAdress - Elr;ctn al ConUactor ICompany Namel Contrao:tor"s Licen se No. - - .3 wner M teilaboN arlinB .4dJress IConVar,tor o ? ? Q ?• Authorized Si a re ICoMractor/Owne, Making Installalionl Phone Nwnher &' G- G'o a MINNESOTA SirOE BOAflD OF ELECTRICITY Gri99s-Mitlway Bltlg. - floom N-191 1821 UmversrtV Ave., SL Peul, MN 55104 Phone 18121 297-2111 -IMIS INSPEGIIUN fiEQUE51 WILL NOT BE ACCEPTEO 9Y THE STATE BOAPD UNLE55 PROPER INSPECTION FEE IS ENCLOSED. ;EQUEST FOR ELECTRICAL INSPECTION Ee-00001 -04/ See msfractwns for comple<ing lhis form on back of Yellow copy. ? 9. ,? n Q{? ? Q Q "%" " Below Wak rnvP/Ed by This Request --1 ?c151? AAtl v Xeo , Typn ol Bwltling 'Apolot.es Wvetl Equupment Wved Home Ranye Temporary Service Duplex Water Heater Lightinq Fiztures Apt Bmlding Dryer Electnc Heabn Commercial Bld,y. Fumace Silo UnWader InduStnal Bldg. Av Condinoner Bulk Milk Tank Farm OtnPr , oea y, oino, isno<:,tvl ", ?SUru'- Otlhar Oihi;r N Fee rServicaEnt raneeSae p Pee Faadxrs/Subleetlers N Fee Cucuits r 0 to 200 qm)s 0 to 30 Am s 0-L0 0 to 30 Am s Above 20D Amps 31 to tU0 Amps $ 0 31 tu 100 A s Swintming Pool Above 100-AmUs Above 100_Amps Tiansrormers Irrigation Boorc's Partial.'Other fee Signs Specialinspection ?7 C 70? F?E` Remnrks /` 1 ? I , RouBh-in Date _ , I. e Electr? Insp , ereby ertify theI Ihe abova Final spection has been made. ThIS re0uest void 18 moMhs irom This reiruest vord ? 18 munths from Renuest Date `? Fre No. flouph-in Insuecbon Fequirod1 ?Reatly Nnw Will Noufv InsOec- ?ar Wh F d ? es ?NO ¢n c;u y ? Licensetl Electncal Contractor ? I hereby requast inspecfion ut above ? Owner electncal work installad at Sveet dress, Box or flou[e No. AA City ? / "1 ?6 ?? QiI?L.2J U=-G ecLOn o. Townsh?p Name o? Nn. Rnnge No. Cnunty Occupant P INT) / , vGc-ec?-?- Phone Nn Pow¢r $u pLer Address Elect cal ConVnctor ICompany Name Contmcmr''s License No( ? ?--?- 7 7 ? / 7 /' Mailinu Address ICOnVar.tur or Owner Mzkinp InstailaUOnl Authoraed namre ICm[ractor?Owner MakinB InswllaUOnl Phone Number a ? MINNESOTqGq'fq7E eOAND OF ELECTRIGITY Griggs-Midwxy Bldg. - Noom N•191 1821 University Ave., St. Paul, MN 55104 Phane (612) 297.2111 THIS INSPECTION REQUES7 WIIL NOT BE ACCEPTEO BV THE STATE 60AND UNLESS PPOPEF INSPECTION FEE IS ENCLOSED. REQUEST FOR ELECTHICAL INSPECTION ? E8-00001-04 See mstructions tor comoletin9 this lorm on beck ot vellow copv. "X'" Below Work Cavered by 7hls Request AAA 8BG Type Of BuiIeinp APqliances WvBtl EquipmBnt Wved Home Ranye Temporary Service Duplex N?ater Heater Liyhunq Fixtures Apt Bw Idmc? Dryer Electnc Heabng_ Commerci2l Bldg. Fumace Si!u UnloaAer Industnal BIAg. Air Condrtioner Bulk Milk Tdnl< Farm ot nTI Sura v ??ne?lSae?.,tvl M er ISUCr.ityi Oihcr n?h?" ...... M ,'...... .,.., Gee r.,.,.._....... _..._.. ServiceEnhencaSae H Fee fenders/5ubfaeders b Fne Circuits ? tp 200 qmps Above 200 A 0 to 3D Am ps 31 to 100 Amps ,?10 0 to 30 Am >s 31 to 100 Am s Swinuninq Pool P.bove 100_Amps Abave 100-Artips Tiansiormers Irriyation Fiuoms Partial Other Fee Signs Special In:;pection S ? TOT FF G Remarks - .. / - ? ? y, [A7M Roogh-m ? - D?t•? / ?( I. t Elect ? 1 ?v'Qp InsVec or. hernby certJy that the above Final e ?f ispacUOn has been TOis requea[ ww ,e mo.nro i..i.. This request void 5 ?8 nwnths tram [ ? - ? 0 86186 Fequest pate Fire No. RouPh-in InspPCtion )? `(?jt,? fle4u ?etl? DReaAY No Will NotHV InsPec- ?? Q l es ?No «Ir When Foady ? llcensed Electncal ConVactor I hereb ? ?w??,? Y requast mspection QI above elnu.iroi Sheet Address, eox or Rou[e No. C 9 ? ecuon o. iownship Name or No. qan y N C? OrcuGan[IP I T) ? Phone No. Poiyer Su ier AdAress N Eleztr al ConVactor (Company Name) Cnntracmr"s Lncense No M v o ? ailin9'lddress (Co n oc nr Owner Makmp Instailanon) ? Auihorved nature (Con[ractor OwperIV?Jkinellationl Phone Numbar -- o..o rcLeeinieiir wirvsrteilUNHEQLIESTWILLNOT Griggs-Midway BIdB. - Aoom N•191 BE qCCEPTED BV THE STqTE BOARD 1821 University Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS _ Phone (612) 297_2111 ENCLOSED. i' REQUEST FOR ELEC7RICAL INSPECTION ee-or?i-oa . sa ,- _ . ? ? D Aa Fep, _ ?X'" Selow WoM60cve.sd by lhis Request 'Type Of Bmltling Appliancea WireC Equipment Wped Home Range Ternpor2ry Service Duplex Water Heater Lightin Fizwres APi 8uilding Dryer Electnc Heatin Commercial Bldg. Fumace Sib Unioader Industrial didg, Air Condrtioner Bulk Milk 7ank Farm oinF. _neclFV o.ner isvecitv) IM1P? ?SI?fG??y O}hC'? O1h?,r # Fee Service Edtr,nc.Sjze Fee Feeders/SUbfeeders il Growts N 0 to 2 A6ove 0 to 30 Am s 31 to 100 Amps to 30 Am s to iQ0 Am Swimm Above 700__Amps Above 100Am s Tianst Irrigation eooms Partial'0 r Fee Signs Special InspecLon Aemarks TO FEE ? Houah-in p ? I. e EI cal Inspector, hereby Final ? •/?/-,'{?'? ! cartify that the above ms0ectton has been matle. rnus ?eq.PSt youa ? t ?G ? ,a ?,bntns rram 0 086187 y L__ ? a -a7- V1 r?? i Request Date Fire No, Rouah-in Inspecvon eq red? l NoLfv Insoec- EReady Now?Wil [or When Reatl ? ?as No y y ? Livensetl Electncal Coniractur ? I hereby raquest inspaction of abov¢ ? Owner alectncal work installed at' S[reet AAdress, Box or Ro e No. /j Ciiv ecLOn o. Township Name or No. anpe No. County ' 11L? Occupantl INTI Phonc No. Power Su? er ?? Address Eloctrir I Contractor (Company Name?? i ?Qi21?t?? Contractor's Liccnse No. ? Marlijn?p AdJress IConlr?cmr or Owner Mabng InstallaLOnl Author¢e ignature IConvacmr/Owner Making InstallaUOn) ? Phone Nurnber '6 G - ?6 ('D C) MINNES STATE BOARD OF ELECTflICITV Gnggs• idwav gJde- - floom N-191 1921 University Ave., St. Paul, MN 55104 Vhone (612) 297-2111 THIS INSPECTION ftEQUEST WILL NOT BE ACCEPTED BV THE STATE 80AFD UNLFSS PFOPEN INSPECTION FEE IS ENCLOSED. )REQUEST FOR ELECTRICAL INSPECTION See instructlons tor completin9 this lorm on back oi yeliow copy. 8? X"' Be/ow Work Covered by Thrs Request t EB-00001-04 AB Nep " Type af Buildin9 ApPIrBE Equipment Wved Home Range Temporary Service Duplex Water Heater LiyhLny Fixtures Apt. Bwldinq Dryer Elecmc Heatin Commercial Bidy. Fumace Silo Unloader Industrial Bldg. Air Condinoner Bulk Milk Tdni< Farm 0[her SPecify tnei i5nocity) thrvr ISpcufY O?hcr Other [,ampure inspa.cuuu ree aeiow # .Fwn ServiceEetranceSae R Gee FaeAers/Subfeeders b Fee I Cucurts 0 to 200 AmPS { U t0 3U Am 5 v ,?1 ' in a' tvr ?s Above 200 Amosi 31 to 100 Amps . QQ 31 to 100 Am s Pool ? ? TOTA E a Houeh-m t ??[e ? I, the Nect I ? Inspector, heraby erLty ffiat the qbove Pinal ?" ? '° 3 ?Jbb' inspeclion hes been made. Tnisrepuestvoiammainnsn?un _. --- • .-..111 ?Yr,??? R- ! _.__----_________ f j Permit #: ? &O 4 ? 2 6D ?CJ ? Psrmit Fee: ? Date Received: I I I S£aff: I ?________________? 20p8 RESIDEMITlAL BUILDiNG PERMIT APPLICATION nace: Sim aaa.ess: ? ?- TenanC Suita #: RESIDENT / OWNER Name: Zwn? ry7 QnA4 Y%C ibiJ Phone: Address i Ctty / Zip: Applicant is: _ Owner ? Corrtractor TYPE OF WORK Descripdon of work: con Cpnstruction Cost: /S, C?I'YCJ . p O Muttf-Family 8uilding: (Yes / Na CONTRACTOR Name: ??&,epeL9 46 eV -?on,?r?JE+n s Licensa? 'Z 0 4'/50 7 3 7 Address: City: r._?t? State: o?fo Zip: -? V Phone: - 6 - 2`t r' 3?1_Z 1 Contact Person: CONiPLETE TNIS AREA ONLY }F CONSTRUCTING A NEW BUIIDING _ Minnesota Rulss 7670 Cateaorv 1 Minnesota Rufes 7672 Energy COd@ . Residenlial Yantiiaiion Category t Waksheet . Naw Enfty Gade Workaheet Category stbnitted Submitted (4 SUbrt1183IOP1 typ8) ' Errergy Enveioge GakulaflonS SubmiUed M the last 12 moMhs, has the Gty of Eagan lsstced a permit tar a simllar plan based on a master pinn? -Ves `No If yes, date and address ot mastar plan: Ucensed Plumber: Phone: Aechanical Contractor. phorte: Sewer & Water ConVector: phorm; '.- flle Hl1V?R/?} ?}? uG ?soY ? ?,lin ?V ? .+ +j '? i°'?'lflfi4 P?WVY? ?F ?vM? P`..i3(/I1 ? ?'4# •: y .,t ? y ? S . I nereby adcnmvledge that ihis informatwn is complete arM accurate; that the wwk wfll be In Cpnformance with the prclinences arai codes of the CRy ot Eagan; that I urderstarM this is not a percnit, 6ut oniy an appiication {or a permit, arM w?artc 7g not to st withw a pennit; that dia walc wiil be in ?ar axo1dance with the approved plan in the case of qrork which requmes a ranew and approval 0f,?,m9 ? x ULf ? nt,ji4e15 Applicant's Printed Nartro AppllcflnYS Signature Page 1 of 3 ! ? December 12, 2003 Tom Gallagher - - - I ? 4466B Clover Isang Eagan, MN 55122 Deaz Tom: %oryt: /2 1. !,4 uvL I'? -/" <<J CtJ `?J ?K, h C crl 0dl /.G ?DJ??l ?t 0 / f expl??e7? y'au. ,03/ -z1oy 7?z Cr// a,-.. w,Ii I take this opportunity to respond to the concems expresseu ,u y.,... _...•... ..- --- being conducted in your neighborhood and the streetlight charges on your utility bill. A copy of your letter was forwarded to Mary Granley, Code Enforcement Technician, for the City. Mary will attempt to address your concerns conceming the business operating in your neighborhood. I understand from Mary that she has had previous contact with you. I recall a telephone conversation with you concerning the City's streetlights and the billing of charges to the residents. The charges are for neighborhood lights and community lights. I will explain the streetlight chazges and their jusrification. V 0? The community light charge pays for the operation of traffic signals and lights to illuminate major intersections within the City. These lights aze installed to promote safety and welfare of drivers and pedestrians as they move about the City. Their purpose is to prevent accidents and subsequent injury at those intersections whether you aze driving, a passenger or a pedestrian. I recognize that these lights do not shine directly on your property, but assert that you do receive benefit from those lights as you either drive, ride or walk about the City. The neighborhood lights are installed to provide illumination of your local neighborhood I streets. The justification for lighting is for the safety and welfare of the residents while on the roadway. The lights aze instalied to provide illumination to alert drivers to the existence of a pedestrian, a curve in the street, or obstacles such as parked vehicles and also as a deterrent to crnninal activity. The current Ciry policy is to install sireetlights at approximately 300-foot intervals. Some lights may be further apart and some may be closer depending on the configuration of the streets within the subdivision. This ? configuration includes the number of intersections and the design of the streets. That is whether the slseets are relatively straight or curved. The streetlights aze not installed to provide illumination of driveways although that may happen. Certainly the lights could be closer, which results in more lights being instailed, which requires more electrical usage, which results in a larger streetlight charge on your utility bill. An altemadve would be to petirion the City to install another streetlight to mark your driveway. The petirioners would need to waive their right to appeal the amount of the assessment for the cost of the additional streetlight. The cost of that installation estimated at $1,200 would then be assessed to the benefiting properties. I recognize the Bronko Nagurski name. He was a famous football player for the University of Minnesota and then later the Chicago Bears. I want to thank you for your service during WW-2. Please contact me if I can be of service. My direct dial number is 651-675-5024. Sincerely, Genld R Wobschall Cc: Parcel File I 0 e,^? sc,? ? • '/ , c? q 2? ? ?J c.?i{? ?oQ eAAI,f -Z"k a,7 wu,c/ ? U/!iG(O i , . e ?Pe ? A-?, ? 7t? -?-? ? ?. ?. .? ? ? ? ? -? ?-?- ? _ G'?Qn/1 .- ? L1.yY? dYt ? ? a 2 ? ANIRZ Mr. Thomas A. Gallagher 4466 Clover Ln Eagan, MN 55122-2440 w ? ? ?e? i ?? e4l? 6lac,l<, , ? ? ? iteee 4 " ( 1- t ? 7985 BUILDING PERMIT APpLICATION - CITY OF EAGAN ? POTE: ALL CONTRACTORS MUST BE LICENSED AITH THE CITY OF EAG9N C0141ERCIAL SINGLE FAlIILY D1fELLINGS INCLUDE 2 SETS OF ARCHITECTURAL INCLUDE 2 SETS OF PLANS & STRUCT'URAL PLANS, 1 SET OF 3 CERTIFICATES OF SURVEY SPECIFICATIONS AND 1 SET OF 1 SET OF ENERGY CALCULATIONS ENERGY CALCULATIONS 1OF ? $2,000 LANDSCApE BOND ;j„ r'/2JC (00,aoo To Be Used For: ' Valuation: Z??? Date: Site Address lv Lot ? Block ?- ? Parcel/Sub Owne K??? f?rs #j C. Address./f(pd' LUr- City/Zip Code 1q.J Phone - <'°Z j e) Contraetor - C;a??; Addres City/Z Phone Arch,/ Addres City/2 Phone !! - r ONLY Erect X Oceupancy Remodel ? Zoning Repair Type of Const ? Addition ? # of Stories Move Length Demolish ? Depth Int.Impr. Sq Ft Install APPROVALS FEES Assessments ? Permit Water/Sewer ? Surcharge Palice Plan Review Fire SAC Engr Water Conn Planner?"- Water Meter Council Road Unit Bldg Off Treatment P1 APC Parks Variance Copies TOTAL O 7985 BUILDING PERMIT APPLICATION - CITY OF EAGAN NOTE:_ ALL CONTRACTORS Mp3T BE LICENSED F/ITH THE CITY OF EAG9N COPQIERCI9L SINGLE FAHILY DWELLINGS INCLUDE 2 SETS OF ARCHITECTURAL INCLUDE 2 SETS OF PLANS & STRUCT'URAL PLANS, 1 SET OF 3 CERTIF'ICATES OF SURVEY SPECIFICATIONS AND 7 SET OF 1 SET OF ENERGY CALCULATIONS ENERGY CALCULATIONS' $2,000 LANDSCAPE BOND ? o F (oC??oN To Be Used For: llz ?-?J Valuation;? Site Address (fl&" Lj OFFICE Lot p- Block ?---- Erect x Parcel/Sub Owner Address City/Zip Code ??,- Phone 2LES?O C7 Contractor ??- Address City/Zip Code Phone Arch./Engr. Address City/Zip Code Phone # Remodel 1 Repair Addition ? Move T Demolish Int.Impr. ? Install , APPROVAL3 Date; Occupancy Zoning Type of Const ll of Stories Length Depth Sq Ft FEES Assessments Permit Water/Sewer Surcharge Police Plan Review Fire SAC Engr Water Conn Planner Water Meter Council Road lJnit Bldg Offi/ 6 Treatment Pl APC Parks Variance Copies TOT3L ? - l/?) s 7 ;Z ? 1985 BUILDING PERHIT APPLICATION - CITY OF EAGAN NOTE: ALL CONTRACTORS MUST BE LICENSED ilZTH THE CITY OF EAG9N COl4IERCIAL INCLUDE 2 SETS OF ARCHITECTURAL & STRUCT'URAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS- $2,000 LANDSCAPE BON? O To Be Used For: Valuation: S3te Address yy(0 6 a(jV%- Lot IL Block .? Parcel/Sub Owner?-r? AL G?t?-?P I '?"L?'_J%-- Address A) c. City/Zip Code ? ,.?..? TV3 - Phone -7d-p ?,,'S7 c7 Contra Addres City/Z Phone Arch./ Addres City/Z Phone SINGLE FAlIILY DHELLINGS INCLUDE 2 SETS OF PLANS 3 CERTIFICATES OF SURVEY 1 SET OF ENERGY CALCULATIONS GqfA0 ? ? Date: OFFICE USE ONLY Erect -?X- Remodel , Repair ? Addition Move ? Demolish Int.Impr. _ Install 1 APPROYALS Occupancy Zoning Type of Const I! of Stories Length Depth Sq Ft FEES Assessments Permit Water/Sewer Sureharge Police Plan Review Fire SAC Engr Water Conn Planner Water Meter Council ftoad Unit Bldg 0ffp1 Treatment P1 APC Parks Varianee Copies TOTAL ? 7985 BUILDING PERHIT APPLICATION - CITY OF EAGAN NOTE: ALL CONTRACTORS NUST BE LICENSED AITH THE CITY OF EAGAN COt41ERCIAL SINGLE FAMILY DMIELLINGS INCLUDE 2 SETS OF ARCHITECTURAL INCLUDE 2 SETS OF PLAMS & STRUCTURAL PLANS, 1 SET OF 3 CERTIFICATES OF SURVEY SPECIFICATIONS AND 1 SET OF 1 SET OF ENERGY CALCULATIONS ENERGY CALCULATIONS $2,000 LANDSCAPE BONO I oE f?o0o0 To Be Used For; X-? Valuation: Z:2? Date: ?- Site Address ?(ra6.? C/?„er 1.? OF'FICE USE ONLY Lot - -? Block Y Parcel/Sub 5Z?0- Owner ?•sz?, ? ?C??° ?^¢?' -?'v c=' address 1546 v 93" `?` L.J N E City/Zip Code??_ ILIJ Phone Contractor ol? ? .r. Addres City/Z Phone Arch./ Addres City/Z Phone Erect K Remodel T Repair , Addition Move ? Demolish Int.Impr. '- Znstall ? APPROVALS Occupancy Zoning Type of Const # of Stories Length Depth Sq Ft FEES Assessments p Permit Water/Sewer ? Surcharge Police Plan Review Fire SAC Engr Water Conn Planqer Water Meter Council Road Unit Bldg Off / S Treatment P1 APC Parks Variance Copies TOTAL CITY OF EAGAN 3830 PILOT KNOB RD - 55722 41995 BUILDING PERMIT APPLICATION (RESIDENTIAL) 681-4675 ? 3 registered sfte surveys ? 2 wpies of plan ? 2 copias of pWns (inGude beam 8 window sizes; poured fnd. design; etc.) ? 2 sNe surveys (exterior add'Rions 8 tledcs) ? 1 energy calculations ? 1 energy cakulations for heatad addidons ? 3 coples of lree preservation plan 'rf lot platted efter 711193 ' required: _ Yes _ No DATE: 16 ' za?7-,5?,S CONSTRUCTION COST: DESCRIPTION OF WORK: ?-2,:I I eV,,S 1,9 n a n iQti--Wj AN ??Lr STREET ADDRESS: L-L ,9 tJ Pc- LOT ? BLOCK SUBD./P.I.D. #: PROPERTY Name:(::?,o-+\ ?clSLA1'1 Phone OWNER IAST FIAS. Street Address, ?y?? Cl o v er C.c?m ? City: 5tate: N'Y\%&_ Zip: CONTRACTOR Company: Phone #: Street Address: License #: City: 5tate: Zip: ARCHITECT! Company: ENGINEER Name: Phone #: Registration #' Street Address, City: Sewer 8 water licensed plumber: change are requested once pertnit is issued. State: Penalty applies when address change and lot I hereby acknowledge that I have read this application and state that the information is correct and agree to wmply wfth all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY Certificates of Survey Received Tree Preservation Plan Received _ Yes _ No _ Yes _ No ???FEWED J U iV 12 1995 --------------- EDEN HOMEOWIdERS ASSOCIATION P.O. BOX 21476 EAGAN, MN 55121-0476 6/7/95 TO WHOM IT MAY CONCERN SUSAN J. GREEN (4466 CLOVER LANE EAGAN, MINN 55122) HAS THE EDEN HOMEOWNERS ASSOCIATION PERMISSION TO EXTEND HER EXISTING DECK. THSS DECK CAN BE EXPANDED IN ACCORDANCE WITH THE EAGAN HOMEOWNERS RULES AND REGULATIONS ADOPTED SEPTEMBER 12, 1981: "(2) DECK EXTENSIONS. THE EXTENSION OF DECK LENGTH TO THE END OF THE BUILDTNG IS ACCEPTABLE IF THERE IS NO STAIRWAY EXTENDING BEYOND THE END OF THE BUILDING. EXTENSIONS THAT EXPEND THE DECK WIDTH ON THE STREET SIDE OF THE BUILDINGS MUST RECEIVE COMMITTEE APPROVAL. EXTENSIONS THAT EXTEND DECKS ON THE REAR OF THE BUILDINGS TO A MAXIMUM OF (12) FEET ARE ACCEPTABLE. DECK EXTENSIONS MUST BE PAINTED THE SAME COLOR AS THE EXISTING DECK." PRIOR TO EXPANDING THIS DECK WE EXPECT SUSAN TO SECURE A Bi7ILDING PERMIT FROM THE CITY OF EAGAN AND TO ADHERE TO ALL CITY OF EAGAN BUILDING CODES DURING CONSTRUCTION. YOURS TRUL DOUGLAS HELGESEN PRESIDENT FERMIT CtTY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 1 SITE ADDRESS: P.7.N.: 10-22750-020-02 4464 CLOVER LANE LOTo 2 BLOCKa 2 EDEN PERMIT TYPE: Permit Number: Date Issued: UNIT B BUILDING 033135 09/83/9S DESCRIPTION: B4J'7,dkng-"Permit Type Building G3Crrk Type ,Census Code ' r" , E , ;E DECK ADDITION 434 AI.T. RESIDENTINI ?; ] REMIAW;REVZEwEo BY 9ILL ADAMS. FEE SUMMARY: Base Fee $50,60 Surcharge $.50 Total Fee $50.50 CONTRACTOR: , OWNER: - Appiicant - EDEN HOMEOWNERS ASSpC. P.O. BOX 22195 EAGAN MN 55122 (651)687-0597 L I here6y acknowledga that I have read this application and state that the infiormatibn is correbt and egree tQ cortrplywiChal3 applic`ab12 Stata of Iryn. Statutes and City of Eagan Ordinances. ? APPLICANT/PERMITEE SI NAT E JSUED BY: SIGNA URE - • ° . , 1998 BUILDING PERMIT APPLICATION (RFSIDENTIAL) ? CITY OF EAGAH ? 3830 PII.OT KN46O 7 RD - 55122 ?yy. ? ,7? New Construction Reauirements RemodeVReoair Reauirements ? 3 rcgistered site surveys ? Z wpies of plans (indude beam & window saes; poured fid. design; etc.) ? 1 eneryy calculations ? 3 coPies of tree Prexrvatwn plan iT lot platted after 711193 required: ?Yes No DATE: DESCRIPTION OF WORK: , ? 2 copies of plan ? 2 site surveys (erterior adddions 8 decks) ? 7 energy calculations Mr heated additions CONSTRUCTION COST;/ STREET ADDRESS: Io LOT: ?- BLOCK: '?L SUBD./P.I.D. #: PROPERTY OWNER Name: Phone #: Latt Fvst StreetAddress: City (t ? State: Zip: Company: Phone #: CONTRACTOR Street Add City _ ARCHITECT/ ENGINEER Company:, Name: Street Add City _ Sewer & water licensed plumber (new Construction only): and lot change is requested once permit is issued. License # State: Zip: Phone #: Registration #: _ Sute: Zip: Penalty applies when address chang 1 hereby acknowledge that I have read this application and state that the information is correct and agree to comply wfth all appliCabt State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY Certificates of Survey Received 2,?Yes ? No Tree Preservation Plan Received _ Yes _ No ^ Not ? ,. Troy Haskins Eden Homeowner's Association PO Box 22195 Eagan, MN 55122 City of Eagan Building Permits Department September 2, 1998 To Whom It May Concem: Marian Lee of 4464B Clover Lane has the approval of the Board of Directors of the Eden Homeowners Associarion to extend her deck per the plan submitted to us. All decks (including steps), not on the street side of the buildings, are allowed to be taken out twelve feet (12') from the building. Ali decks (including steps) are aliowed to be taken to the end of the building (front of unit), but no part is allowed w extend beyond the brick on the front of tha unit. If you have any questions or concerns, please feel free to contact me. Thank you for your help. Sincerely . ? Troy Haskins Maintenance Manager Home: 687-0597 VM: 458-7010 CITY OF EAGAN 3830 PZLOT KNOB ROAD EAGAN, MN 55122 PHONE: (612) 454-8100 BmGi: FOR CITY USE ONLY PERMIT # /e0,0-0 RECEIPT # O U 5 DATE : /a f PLEASE COMPLETE UPYER PORTION ONLY FOR SINGLE FAMILY h.... <4?"?.A. TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. ------------------------ -- WORK DESCRIPTION NEW CONST _ ADD ON A- REPAIR _ OWNER NAME: SITE ADDRESS: ??l' f or/Oq L? n LOT:1_ BLOCK a? SUBD. (_.Uaf'L4" INSTALLER: !? n l' ? fj ADDRESS: / Oo 1 /)'),'-1 t So CITY: ZIP: ??Q 1 DWELLINGS & '--- ------------------------- - COMPLETE THE FOLLOWING: N0. FIXTURES EA. TOTAL ADD-ON MINIMUM 15.00 _ SHOWER 3.00 WATER CLOSET 3.00 BATH TUB 3.00 LAVATORY 3.00 KITCHEN SINK 3.00 LAUNDRY TRAY 3.00 _ HOT TUB/SPA 3.00 _ WATER HEATER 3.00 _ FLOOR DRAIN 3.00 GAS PIPING OUT. _ (MINIM[TM - 1) 3.00 _ ROUGli OPENINGS 1.50 OTHER ? WATER SOFTENER ? _ PRIVATE DISP. 15.00 _ U.G. SPRINKLER 3.00 SUBTOTAL $ ST. SURCHARGE .50 5 50 TOTAL: , S C031MEkGIAiNLYITSTBTAI.? PLEASE COMPLETE THIS PORTION FOR ALL COMMERC IAL/INDUS TRIAL BUILDINGS AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. ------------- CONTRACT PRICE: OWNER NAME: _ SITE ADDRESS: LOT: BLOCK _ SUBD. INSTALLER: ADDRESS: CITY: ZIP: PHONE FOR: FEES 18 OF CONTRACT FEE. STATE SURCHARGE _ $.SO FOR EACH $1,000 OF PERMIT FEE. $25.00 MINIMUM FEE. CONTRACT PRICE x 18 STATE SURCHARGE TOTAL: (SIGNATURE) CITY OF EAGAN (Nbnth Year) PRESENT ZONING/PROPOSID L'SE: R-1 SINGLE FAMILY R-2 DCPLEX (Tt,a L'nits) R-3 TOAIDIIIOLSE (Three + L'nits) ( Units) R-4 APART:IENT/COAIDOMINICM ( Units) COAM4ERC7AL/RE.'TAIL/OFFICE INIDL'STRIai, I NSTITL'TIONAL,/GOVERNN'IHNNT NAME: R. &/ ?E-/s 6 . ':?, AnoizESS: (3 U X I Z FS CITY, STATE. ZIP: !?S07 ? PHONE: y3.i-s/71 3) • u: :w; For City L'se NAM: Plumbers icense ADDRESS: Active CITY, STATE, ZIP: CT Eired PHONE: MASTER LICII9SE # tbaV2I1i9 ecor( 5taf 'Initial 4) o • ., m• / ?l ?: c?'Go? f?a ?ur? l7or?r CV4 s. ADDRFSS: I'YE. CITY, STATE, ZIP: ,p ??q iN? fa1 JV SS?S?3Z/ PHONE: ?'?fd -S S10 5) io • d a?? • s• a?? ? CO.?TZON TO CITY SEWII2 ja CONNECTIO[V 'IC3 CITY WATER Q OTHII2 (Please Describe) 6) ? PLEASE HOLD APPROVID PERMIT FOR PICK-CP BY ONE OF ABOVE CI PLEASE MAIL APPROVID PERMiT TO 1,?,? 3, 4, ABOVE (Circle one) 7) ?6& 2&g& ? [ZZ_123/? IF EXISTING STRCCii'RE, DATE OF ORIGINAL BL?ILDING PERMIIT ISSL'ANCE: F O R C I T Y U 5 E O N L Y PE2MIT ° ISSUED FEES: $ 16, $ fU. 561 $ S S $ /j-_c• $ ' S(JC.vC, $ $ $ $ $ $ $ $ $ SEi:E.°. °ERMIT (I`ICLi;DE SU°C :?RGc) WATE2 PERP4IT (INCLuDE SliRCH?,RGL) WATER i1ETER/COPPERHORN/OUTSIDE READER WATER TAP (INCLUDE CORPORATION STOP) S::vER TyP -=C :c? ".''1, ?GS i: ' ?:_ ?__ ACCOliNT DEPOSIT - F7ATE?2 wAc SP.C TRliVK WATER ASSESS:!E:7T TRlii]K SES4ER ASSESSME:iT Li„E?.?L BE:IEFTT/TRU:IK SE:= LAicRAL BENEFIT/TRUiIK IJATE3 WATER TREATMENT PLANT SURCHARGE OTHER: TOTAL ArIO[J\T PAID/RECEIPT # DOES UTILITY CONNECTION REQUIRE EXCaVATION IN PUBLIC RIGHT OF WAy? YES IF YES, THEN n"PERMZT FOR TAORK WITHIy PUBLIC ROADWAY" MUST BE ISSUED BY THE Q NO ENGINEERING DZVISION. LIST AS A CONDI- TION. SUSJECT TO THE FOI.LOS9ING CONDITIONS: APPROVED BY: TI':LE: DAT°_ : `/ / ? "x/ s i ? • ? • ? • i ? ? • i?. • u ?. ?. . ?. ?ip ' 71' • • 7• • ? ? ? • • • M• • • ?I? ? 1 1 1 71 • ? I •D ? CITY OF EAGAN APPLICATION FOR PERhffT SEWEEZ P,NID/OR WATER CONNECTION (Please Pr1nt) 1) PROPII2TY ADDRFSS: n/ T,FY;A7, DFSCRIPTION: 7 '°G -?j _,? (LOt Block Subdivision or Tax Parcel I.D. Number) IF EXISTING S1RL'CTL?RE, DAT'E OF ORIGINAL BiJILDING PERNIIT ISSL'ANCE: (Nbnth Year) PRESENP ZONING/PROPOSID LSE: R-1 SINGLE FAMILY R-2 DCPLEX ('I4,v Cnits ) R-3 TOWNhiOL'SE (Three + L'nits ) ( Units ) R-4 APARTMEAPP/CODIDOMINIL'M ( Lnits) CONA"IEEtCIAL/RETAIL/OFFICE irroasTxzrL INS'I I'Iti TIONAL/GOVF.E2DPAENT 2) W.TJORRIUM NAME: ADDRESS: CITY, STATE, ZIP: PHONE: /C,C Bh O?Y ?a? /V'• ?G /?J??%?5+ ?J ?'/ S.? i D 7.? 3) • ?:?' For City L'se NP,ME: , Licenst ADDRFSS: Plumber 5?3 Eive CITY, STATE, ZIP: C? ired Not Recor, pxoNE: rAsTm Lzc:ECVSE ?e?es?gq?m9 . {v Staf Initial 4 ) • • i?• ruaME: Go a aDDREss: /e16 6 93 A "qwcz W. E. CITY, STATE. ZIP: ?1,A;L /AVF /77 X PHONE: 5) i? a • a• • a• a? ? COiQNECTION TO CITY SEWII2 ? CONNECTION 7O CITY FIIITER Q O'I'HER (Please Describe) 6) u • • ? PLEASE HOLD APPROVID PERMIT FOR PICK-CP BY ONE OF ABOVE I? PLEASE MAIL APPROVED PERMIT TO 1,? 3, 4, A?JVE (Circle one) 7) '?.i ' ,/`J? t9 ;G.? ? // //,j /d,-r F 0 R P=R`".IT °- ISSUED I T Y U S F°-^ S : $ $ $ ?d.u $ S $ / ? o L S `? c < $ $ $ $ S $ $ ?- ON:,Y ET1'L.. ?"D PE . RMT_T (I?ICL..'..^.L JLo...r._c.Aa ..CLJ WATEc2 PERflIT (IiJCL'uDE SuRC :ARGE) WATER METER/COPPERHORN/OL'TSID : READER WATER TAP (INCLUDE C03?CRATIODI STOP) SE:JER TAP nCCCi:-i'T AG.OUNT DFPpSZT - WAT°_3 WFiC SPC TRli`7K S4ATER ASSc,SS:i?':;m TRu:7K SEI4ER ASSLSS'•irNT L?„i?,AL BENEFIT/T3U`:K SE;=-R LA:ERAL BENEFIT/TRU::K SqATEn WATER TREATMENT PLANT SURCHARGE OTHER: TOTAL Ai`l0U`T PAID/REC°I?T # S 7c?jL- DOES UTILZTY CONNECTION REQUSP,E EXCaVATION IN PUBLIC RIGHT OF WAY? ? YES IF YES, THEN A"PERMIT FOR W0R?: WITHZN PUBLIC ROADWAY" MUST BE ISSUED BY TI?E C? NO ENGINEERING DIVISION. LIST AS A CONDI- TION. StiBJECT TO THE FOI.LOWING CONDZTZONS: APPROVED BY: TiTLE: DATE: - %?}? s ? ? ?•• ? ? i •• s i . . ?? . ?. .?. ??• r •a? •?? • ?? ?? ? ?? ? ? ? : CITY OF EAGAN APPLICATION FOR PII2MIT SEWEE2 APID/OR WATII2 CONNECTION (Please Print) 1) PROPII2TY ADDRFSS: LF7GAL DFSQ2IPTION: IF EXISTING STRC'CZVRE, DATE OF ORIGINAL BUILDING PERMIT ISSC?ANCE: (Month Year) PRESENT ZONING/PRQPOSID LSE: R-1 SINGLE FAMILY R-2 DIIPLEX ('I+ao L'nits) R-3 TOWNHOL'SE (Three + Cnits) R-4 APARTMENT/CODIDOMINICM COMMEF2CIAL/RE'PAIL/OFFICE IDIDL'STRIAI. INSTI7L'TIONAL/GOVERNNfENT ( Lnits) ( Lnits) 2) ? NArE: N.C'ZE ,Gc ADDREss: '6a x CITY, STATE, ZIP: 5f. .gN o//A 197 .V S':?07 ? PxoDE: 3) r?• For City Pse NAME: Plumbers License ADDRESS: ?A/yiE CITY, STATE, ZIP: d PF30NE: MASTEEi LICENSE #?alBS?L?h9 corc?tWaffni l 4 ) ? ? ?• /? N AME: I?Od?? 0 A/fLi!-? !'?OInES AoDxFSS: /5/6n g3 .4 sq ivc- A!eE'. crrst, sTATE, ZIP: a I AJX c< 'y 5S413 y PHONE : 7 rrO - S-!Srl Z) 5) io a • ?• a? ?? ,$ COiVNECTION TO CITY SEWECt ?I CONNECTIO[V TO CITY WATEE2 p OTfIII2 (Please Describe) 6) ? • ? PLEASE HOLD APPROVID PFd2MZT FOR PICK-CTP BY ONE OF ABOVE ? PLEASE MAIL APPROVED PERNIIT TO 1,(D 3, 4, ABOVE (Circle one) F 0 R C I T Y U S E O N L y P__°_MIT °- ISSUED FEES: $ /G_ t'c; $ ro.s ? $ ?-3 ? c• S . $ $ /S^?o S /?;- C O S $ C y S $ $ $ cG 9 SE.':LR !??RMTi (I.{?.CT..nLv Uor_"l?p.r`G^) J"r J....J WAT£cZ PERPII'P (INCL'JDE Su:CT.:eZaGi.) WATER METER/COPPERHORN/OCTSZD: RE.IDER WATER TAP (INCLUDE CORpORATiON STOP) S::dER TA? ACCOliNT DEPOSIT - 47AT°R wac SP.C TRCiNK WATER ASJC.SS:IE.:T TRli?]K SELdER ?,SSLS5:3E?iT L`nTER?L BEi•IEFIT/TRUVK SE:?3 LATcRAL BENEFIT/TRU,IK :7ATER WATER TREATMEnTT PLANT SURCHARGE OTHER: TOT?.L AMOL`::T PAID; REC°I?T : ?7v 71 DOES UTILZTY CONNECTION REQUZRE EXCAVATION IN PUBLIC RIGHT OF WAY? YES IF YES, THEN :y "PERMIT FOR `rlORK WITHZ'I PUBLIC ROADWAY" MUST BE ISSUED BY THE NO ENGINEERING DIVISIO[V. LIST AS A CONDI- TION. SCSJECT TO THE FOI.LOWING CONDITIONS: APPROVED BY; TITLEa DAT° : !! PI;F.ASE , NOTE- TfE: CIT)t" WILL PRC7VIDE: ONO, COPVOF? SEWER' ANDi+W?1TE;V PERMITS = ADMT[VISTRATIVE': COS'i'S: CITY OF EAGAN APPLICATION FOR PII2MIT SEWEE2 AI+ID/OR WATEE2 CONNECTION 1) PROPII2TY ADDRE55: T,FY;AT• DFSQ2IPTION: (Lot Block Subdivision or Tax Parcel I.D. Number IF EXISTING STRL'CTLRE, DATE OF ORIGINAL BUILiJING PERMIT ISSOANCE: (Month Year) PRESENT ZONING/PROPOSID USE: R-1 SINGLE FAMILY R-2 D('PLEX ('itao Lnits ) R-3 ZDWN[-IOL'SE (Three + Onits) ( Lnits) R-4 APARTMENT/COAIDOMIDII['M ( L'nits) CONA9ERCIAL/RETAIL/OFFICE IDIDUSTRIAL INSTITC'TIONAL/GOVERIZlEN'f 2) / NAME: ?lC.CE4a.v ADDRESS: 13 Q)e / Z & CITY, STATE, ZIP: SX-0 73 PxoNE: y33-6-1 7/ 3) • r?• NAME: ADDRESS: CITY, STATE, ZIP: PHONE: MASTII2 LICENSE Recor( ?----- 4) NP,ME : < f-?p D? 6),4 Zq c, A/O iri E ADnREss: I Il(,v 9'3 .4 ??tic? ? ? • CITY. STATE. ZIP: Al,g l.v& l?17 N 5'54?3? PxoNE: 790- SSi o 5) i? • ?• • a• ?. PrCONNECTION TO CITY SEWER 19 CONNECTION '1C) CITY WATER [] OTHII2 (Please Describe) 6) i? • ? i ? PLEASE HOLD APPROVID PIItMIIT FOR PICK-L'P BY ONE OF AEOVE A21- PI,EASE MAIL APPROVID PERMTT TO 1,0 3, 4, ABOVE (Circle one) ? 7) For City L'se P1LUnbers LicensE C=}lcive F 0 R C I T Y U S E O N L Y PERHIT u ISSUED FEES: $ ??. } C,• $ C$ S $ S $ $ c, +S $ $ $ $ S ??ot. GC? $ S S°::E.°, nEH)'!rT (I`ICL::DZ SURC : :3GE) WATER PET.214IT (SNCLuDE SuRCHARGc,) WATER PIETER/COPPERHORN/OUTSTDE READcR WATER TAP (INCLUDE CORPORATIOU STOP) S::iEB TaP ???cc::•r ___cs?: - ?_..?? AC^CliNT DF.POSIT - WATER wtiC SPC TR:i:viC SQATER ASSESS:+.E.`.T TRli:dK SEWER ASSESS:iE^i: Le`,:E?,nL BENEFIT/TRUNK SE: = LATE:;rIL BENEFIT/TRU:IK WATER WATER TREATMENT PLAIQT SURCHARGE OTHER: TOTAL AMOUtiT PAID/RECEIPT ; S7 ?j DOES UTILITY CONUECTION REQUIP.E EXCAVATION IN PUBLIC RIGi-IT OF WAY? YES IF YES, THEN n"PERMZT FOR WORK WITHIN PUBLIC ROADWAY" MUST BE ZSSUED BY THE ?_] NO ENGINEERING DIVZSION. LIST AS A CONDI- TION. SUEJECT TO THE FOILOS9ZNG CONDITIONS: APPROVED BY; TI:LE: ' DAT° : 2005 RESIDENTIAL MECHAWWA? PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for: single farnily dwelliogs & rownhomes/wndos when pertnits are required for each unit ?3D_5D Date ` / lb_ / 66 Site Address ro 4 ,Q lJ'v//1) S&m/ Unit # P t O hone #( Iv? /) Lo Tele roper wner y p Contractor Street Address 8910 Wentworth Ave. c;ty Minneepoils, state (952) 881-9000zip Telephone # ( ) Bond #: Expires: The Applicant is _ Owner L,/ Contractor _ Other Add-on or alteratioo to existing dwelling unit ?4o 1ct? ?a $ 30.00 ? fumace _Additional ? Replacement _ New air exchanger ? air conditioner heat pump other State Surcharge $ .50 g b.`2d Torat I hereby apply for a Residentiai 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 Ciry of Eagan and with the Mechanical Codes; 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. M5D Applicant's PrintedName JAN 12 2006 Applicant's Signature '7?71?l zoos RESIDENTIAL PLUMBING PeRnmTaPPUCarioN CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 Please complete for modifications to existing residential dwellings. Oate 5 ! ? / 0?0 , Sit St t Add L{Li b`'f ?' 0 vtf LQl e ree ress • Unit # I Property Owner r-) Telephone #( J I Contractor Telephone# ( FySk) 3?S-I341? Address(`) City C- SWte-M&L Zip CiSm? The Applicant is: _ Owner "6-Contractor _Other Septic System _ New _ Refurbished Submit 2 sets of plans and MPC license Includes County fee , $ 100.00 i Per as-built $ 10.00 Alterations to existing dwelling $ 50.00 _ Add plumbing fixtures. This fee includes installation of a water softe ner andlor water heater at the same time. If you are installing onlv a waier softener and/or water heater, do not complete this section; move to the next section and check the appliance(s) you are installing. _Septic System Abandonment _ Water Turnaround (add $130.00 if a 5/8" meter is required) Other: - I Water Softener L19Vater Heater $ 15.00 _ new ?replacement Lawn Irrigation _RPZ _PVB _new _repair _re6uild $ 30.00 State Surcharge - - - ? ?, $ 50 !UIJ U ' i Total I J' i $ I hereby apply for a Residential Plumbing_Permi4 andcacknowledge 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 the plumbing codes; that I understand this is not a permit, but only an application for a permit, work is no4 to start without a permit and work will be in accordanc with the approved plan in the event a plan is required to berevitWed and approved. I? ? L? n ' ApplicanYs Printe Name Applicanfs Signature N? , , . " )AOee ENGINEE(?ING C P?pNHEl?IS ondOlAND SiURVEYOflS , COMt?ANY, INC. `?1000 EAST 1461A STREET, BURNSVIILE, MINNE507A 35337 PH 432-3000 -r4 °e1On : LO75 1,2,3, aND 4, BI.oGK 2, EDEhI ADDITIOtJ) • DAKOIA Cov1.1TY, MIIJNESOTA i`Z1/712) DEWOTES EX15T1.)6 ELEVATION ( 92l•5' ) DEF.IO7E5 • PROPOSED ' ELEVLI7lOM "?- INDfC<ITES DiRECTION oF SuRFAcE DRAINA6E ,. .-92/•?.5,?= 1=lA115HED 641lq6f FLUOR ELEVqTION f.;?., . s, -70h _.-.., ` rr 1(D . . _. . _ .. . ..--.. ??n,\ .. ,Pl t iA I (: N O RT H SGALE : 1"= 30' ORAINAGE A?.ID o- ? U71LITY EASEMEN7 • P? 0 ? y 36' Fhbt/T Bwt.DhUG ` 3 96e 5°? SETBACK LINE ? D?' s • s J?? 0 ti ti \ 0 v l v OD ! r '` ;N'_ co>',? ra? ? o I C;l-' 0/ ?G ? ? ' ? ? ?c? go•?? Q ni ^ i< SZ oe p ?? o . P FN 1 4i b2, ` (; _ ? Ai / ?"? ?,?- .'t• .?,. (oa, ? / ? ? . / . M1h. .d, *V wc - ( -?S 4?x"'. '? ' ?•'?:3?? lil -? ' . 1 . I heriby certify that thii is a true and land uvho+m' and deacribed hsnon.. Aa 19 p?s- • . .. . ??;?^ ?.?"-:t ?/?) :, ???`.'?'?'?j;?y?,?•iq' /aosE . ENGINEEAING C P?pNHERS ondOlAHD SfURN / COMf?(?NY, INC. ?100EAST 1461h S7REET, BURHSVILLE. YINNESOTA 55337 PH 432•3000 (92/.s) ...?-- 92/.SO= ok? fV n' LOTS 1,2,3, AtiD 4, BLOLK 2, EDE1J AD01T1oW? • DAKO'fA CAVWTY, MIKINESOTq DE?JOTES EKISTIN6 ELEVATION bENOTES • PROPOSED ' ELEV,4T/ON itiDfLATES DIRECTION oF SuRFACE DRAINA6E P71A1IS14ED G4RR6E FLOOR ? 91EVAT/O/l! NOR7H SGALE : !"= 30' 96 Z6 :oc 9 ° 3; D Q. ? ?? • 0 G? ^g• 1?y \ lqti ?0? ? •a u 4 a O 1r,?'S SFQ ?? U% 4 L ? ?. a? io •/ ? ?O i? DRAiI.lAGE qMD ?O UTILITY EASEMENT y \ 30' FR[1t/T gUfLDlA1G SETBAGK LiNE • ? s ? \00 LJ o° • . %' ? N - Ife ? --\ ? (yZO.?I R \ ? ?pl n '^.? ? h \ \ b2• ? aa• (9zg s aQ? •z> ? . ?ti ?-9 ? ,?_ J °% ?y'/?13• ? ? <%? i N co 'yN 4-°I C , r SB(yZ/.O .. \ cn tv / ? ?. . , k9-.?+ ? ? .. _., ? i ? I hersby cnrtify that thia ie a true and eorrect representation of a traetot land as sho+m'and deseribed hereon.. Ae preparad by ma on thi¦ lsr day ot //?vEMBex , 19 8s . ' . ??????Nina. Esa. No. /GoP', =- CITY OF EAGAN 3830 Piiot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS: 4466 LOT: EDEN P.I.N.: 10-22750-040-02 PERMIT CLOVER LANE 4 BLOCK: 2 CR.CqIQ PERMITTYPE: Permit Number: BurLozNs 0 2 5 8 3 4 Date Issued: 0 6/ 16 / 9 5 DESCRIPTION: ? •. 86ildin9Permit Type DECK ;duilding Wb,r,k 7ype NEW ? i•'j .. ?<1_ REMARKS: FEE SUMMARY: Base Fee $30.00 Surcharge $.S@ Total Fee $30.50 CONTRACTOR: OWNER: - Applicant - GREEN SUSAN 4466 CLtlVER LN EAGAN MN 55122 (612)456-9450 S hereby acknowledge.that I have read this application and state that the infarmation is corre6t and agree ?to comply with allappliaable State of Mn. L Statutes and City ofi Eagan Ordinances. ? iLt -AN( A LICANT/ RMITEE SIGNATURE ISSUED Er. SI ATU E -_- IN5PECTION RECORD CITYOFEAGAN PERMITTYPE: eurLortie 3830 Pilot Knob Road Permit Number: 025834 Eagan, Minnesota 55122-1897 Date Issued: 06 / 16 / 9 5 (612) 681-4675 SITEADDRESS: P•I•N.: 1e-2 27 5 e-e4 e-e2 APPLICANT: LQT: q BLOCK: 2 4466 CLOVER LANE GREEN SUSAN EDEN (612) 456-9450 PERMIT SUBTYPE: TYPE OF WORK: DECK NEW INSPECTION ., . D. FOOTINGS FINAL F- L ? _, ? . aosE NGINEEAING C P?pHNEAS ond6LAND S3UflYEYOQS COMPANY, INC. 1000 EAS7 146M $TREET, BUHNSVILLE, MINNESOTA 55337 PH 432-3000 ?OCit Q4G1crJe?_ fgn: LOTS 1,2,3, An1D 4, BLOGK 2, EDfN AD91TIOtil) ? • DAKO7A CovN7Y) MINNESOTq itZ1•1 ? DEMOTES EXISTIN6 ELEVATION (92l•5) bENOTES • PROPOSED ' ELEViATION ? INDfLq7E5 DIRECTIUN oF SUfZFACE DRAINA66 _ v l`?, !:; F??;\1 = ?JAlISNED 4cV 4'E ov NORTHATE scnLE : r^= 30' GARASE FLUOR Et.EVA7/o,U h? \Q') DRAIWA6E qIJD UTILITY EASEMENT ?Q- o? ?v , 6v > !V ? \y ? 0,00 96 yq 3o i 0°. \ ? /t , \? ? h h?/ tiv5 ryR/ ? i i? 0 AN, ? yp ? \_ ?0 Zj . .` ? L I \ ... f ???`ryl??a 0X" 11? \ ?^ ? A < os?0 , ?., GC ` 9? oo G \ ? S8, ?l/ )3e Q? oi, s8, ?`V / o° . , 2Q ??. a; f ? T `n? / n ?O N I` N 30' FiftDvT gurtDlA16 SETBACK LINE roe \ ?P N1 ? ' -'\ \o, 4 ^ \/ R \ e All n c ' a?y ` e?zso ?? S, (9 g s') X ? ?9?. „ ? -; LJ M 20, 4% . . h { ?? ., ., .. I heriby certify that this ie a trve and corract repreeentation of a tract of land as thoxn'and deacribed heraon.. Ae preparad by ma on this lsr day ot ^/GVEMBE?e ? 19 BS . ? ' Hinn. Ee6. No. /GaPs? PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA109223 Date Issued:02/20/2013 Permit Category:ePermit Site Address: 4464 Clover Lane Lot:1 Block: 02 Addition: Eden PID:10-22750-02-010 Use: Description: Sub Type:Residential Work Type:Replace Description:Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Kris Oien 3670 Dodd Rd Eagan, mn 55123 651-365-1340 Fee Summary:PL - Permit Fee (WS &/or WH)$55.00 0801.4087 Surcharge-Fixed $5.00 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 - Kathryn S Bierman 4464 Clover Lane Eagan MN 55122 Champion Plumbing 3670 Dodd Rd., #100 Eagan MN 55123 (651) 365-1340 Applicant/Permitee: Signature Issued By: Signature From:ALLSTAR CONSTRUCTION 19529427464 09/17/2013 08:48 #582 P.065/079 Use BLUE or BLACK Ink I For Office Use( I npn j Permit of EaRd 1 Permit Fee: 3 .~5 I 3830 Pilot Knob Road Eagan MN 55122 Date Received: a 1 i3 Phone: (651) 675-5675 I I Fax: (651) 675-5694 1 Staff: 1 I I -fin 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: q N1 WI3 Site Address: 416 yyWa, 4LAW, L*4W9 u Laney Unit Name: _ft C'~ QSSC,~(1 C~YYIDAYI~1 Phone: Resident/ ~N i Owner Address / City / Zip: N3Y N V\ PUY a\j, EdW PIf, ifif, MN 1;5N - Applicant is: Owner K Contractor Type of Work Description of work: ~~aY off ahd re-roof Construction Cost: s n 1 Dlocl. Multi-Family Building: (Yes X / No t Company: 4JNAY \~nD1,V1t~~(1'1 ~~I~ LAX, Contact: J Address: FJI'1J IhdIal J11 #~~3 City: n Contractor r act r State: Zip: 15C23501 Phone: "I~~' "1'1 Z" 1y7y License ,t03~ 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 ff 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.aopherstateonecall.oro 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 1 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_ lug I~alst~ad x (~a _ Applicant's Printed Name A Ocant's Signature Page 1 of 3 From:ALLSTAR CONSTRUCTION 19529427464 02/10/2016 13:06 #301 P.019/022 C!ty of Earn 3630 Pilot Knob Road Eagan MN 55122 Phone: (651) 6755675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use Permit #: Permit Fee: Date Received: Staff: J 2016 RESIDENTIAL BUILDING PERMIT APPLICATION Date: °MO // Site Address: `/�Ci+' VV€itr £ 4'V6 t- �Yht- /l v ...,.........,.:...,:::,...,..,�._......_..:.,,.:......................:.. Unit fl Resident/ Owner Type of Work Contractor Name: ,r/ Atif,4 /7"i &Lt. — £.1ZEi/ NO4 Address / City/ Zip: Y9/05/ OftoCo t!/O✓ - Lie Applicant is: Owner ii Contractor Phone: Description of work: /SS -J2% W/7 bin,// /,(75.— cirri/Z-6414.1•44;11 04/Y, Construction Cost ./010G! Multi Family Building: (YesJ No ) Company: /Q il54 A2 davit ' u t reit J niiiivrruw,n Ce Contact: v) :en /4 A7-2 Address: S' 46 Indus -1-r; I Si- 3 I- -: /0� 3 city: Nil` o._ PLA- s State: /4 Zip: 5636'3 Phone:q) 4q. '7/57 Email: %f444..//S- r"• �.. . License #: (, o 3S io Lead Certificate #: iti/14 7 do nV - If the project is exempt from lead certification, please explain why: ;ur /993 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? Yes No If yes, date and address of master plan: Licensed Plumber: Phone: Phone: Sewer & Water Contractor: Phone: Fire Suppression Contractor. Phone: Mechanical Contractor: 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. CaII Gopher State One Cali at (951) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.og 1 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 wortc which requires a review and approval of plans, Exterior work authorized by a building permit issued In accordance with the Minnesota State Buildin. • mpleted within 150 days of permit issuance. x CJI r Mie-mao x Applicants Printed Name Applic nts Signature Page 1 of 3 PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA137500 Date Issued:07/08/2016 Permit Category:ePermit Site Address: 4464 Clover Lane Lot:1 Block: 02 Addition: Eden PID:10-22750-02-010 Use: Description: Sub Type:Residential Work Type:Replace Description:Water Softener 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 - Kathryn S Bierman 4464 Clover Lane Eagan MN 55122 Bettin, Inc 3208 1st Street South Waite Park MN 56387 (320) 251-2505 Applicant/Permitee: Signature Issued By: Signature 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651) 675-5675 1 FAX: (651) 675-5694 buildinginspections(@cityofeagan.com -------------- For Office Use I I n I I Building Permit #: I 0 I I S&W Permit #: I I I Permit Fee: I I I I I Date Received: I I I I Date Issued: I I t----------------------j RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit #: Applicant is: ❑ Owner Contractor Name: EGLs/� �4 o t/x-A-e— 0 y, U-__,,f ja5.s cz, a I OL4 Homeowner Address:law its gque u" /-I, City: �aaa Phone: Email: Description of work: P, e Q G bh- Type of Q Work Construction Cost:) Building Contractor Type of building: ❑ Single Family ❑ Townhome, of units Twin Home Compan)Thy �t h cl C_\lam Contact: Address: Li�� I' rJ & W QST 1-k\y City: j4;- -GLPV_,� State: Lip: 553�T Phone6tZ Emailia/V12 �[ �e� CSN`eo``�Q°��^ License #: t D -7r-K ) Expiration Date: Sewer & Company: Water Contractor Address: Required for State: _ new construction Zip: Phone: Contact: Email: License #: _Expiration Date: City: 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.aopherstateonecall.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. Applicant's Printed Name A licant's Signature