4413 Clover Lane B
D 2 r -------------'Two D For Office Usi
City of Eap JUN 2009 i Permit
J
3830 Pilot Knob Road I Permit Fee:
Eagan MN 55122 Date Received: 5
Phone: (651) 675-5675 ~G
Fax: (6.51) 675-5694. I Staff:
2009 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: 6/09 Site Address:
Leann Kispert Tenant: 4413 Clover Lane Unit B Suite
RESIDENT/ OWNER Name: Eagan, MN 55122 6519050812 'one:
Address I City / Zip:
CONTRACTOR Name: NOR.BLOM PLUMBINGC.0. License O(P t 5
Address: (612) 827-4033
City: 2905 GARFIELD AVE. SO. State: Zip:
MINNEAPOLIS, MN 55408
Phone: Contact Person:
14
TYPE OF WORK _ New Replacement - Repair _ Rebuild _ Modify Space _Work in R.O.W.
Description of work: vvec7&r eaPERMIT TYPE RESIDENTIAL
I Water Heater Water Softener
Lawn Irrigation Add Plumbing Fixtures
RPZ I _ PVB) Main - Lower Level)
Septic System Water Turnaround
New
Abandonment
RESIDENTIAL FEES:
$50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge)
$30.50 Lawn Irrigation (includes $.50 State Surcharge)
$50.50 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $.50 State Surcharge)
*Water Turnaround (add $165.00 if a 5/8" meter is required)
$100.50 Septic System New ($10.00 per as built) (includes County fee and $.50 State Surcharge)
$90.50 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge)
TOTAL FEES $
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
X j L. iuorbt oyyi x .
Applicant's Printe Name A icant's Signal ure
FOR OFFICE USE Reviewed By: Date:
Required Inspections: Under Ground --Rough-In Air Test Gas Test -Final
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 4413 Clover Lane B
Lot: 29 Block: 3 Addition: Eden
PID:10- 22750- 290 -03
Use:
Description:
Sub Type: e - Fumace & Air Conditioner
Work Type: Replacement
Description: Fumace & Air Conditioner
Comments: Questions regarding electrical permit requirements should be directed to Mar k Anderson, State Electrical Inspector,
952- 445 -2840. Cindy Lilienthal 2 1210 Eaton Ave Farmington, mn 55024 651- 344 -4253 cilienthal@controlledai r.net
Fee Summary:
Contractor:
Controlled Air
21210 Eaton Ave
Farmington MN 55024
(651) 460 -6022 X253
Surcharge -Fixed
ME - Permit Fee (Replacements)
Total:
Applicant/Permitee: Signature
PERMIT
City of Eaan
- Applicant -
$0.50
$50.00
$50.50
Owner:
Leann M Kospert
4413 Clover Lane B
Eagan MN 55122
Permit Type:
Permit Number:
Date Issued:
Permit Category:
9001
0801
I hereby acknowledge that I have read this application and state that the informa
of Minnesota Statutes and City of Eagan Ordinances.
on is correct and agree to comply
h all applicable State
Issued By: Signature
Mechanical
EA076887
03/07/2007
ePermit
CITY OF EAGAN WATER SERVICE PERMIT
3830 Pilot Knob Road
P. O. Box - 21199 PERMIT NO.:
Eagan, MN 55121 DATE:
Zoning: No. of Units:
Owner: — —
Address:
Site Address:
Plumber:
Meter No.: Connection Charge:
Size: Account Deposit:
Reader No.: Permit Fee:
1 agree to comply with the City of Eagan Surcharge:
Ordinances. Misc. Charges:
�
Total:
By / � �� Dote Paid:
Date of Insp.: ( Insp.:
i/ r
CITY OF EAGAN SEWER SERVICE PERMIT
3830 Pilot Knob Road
P.,0. Box'21199 PERMIT NO.:
Eagan, MN 55121 DATE:
Zoning: No. of Units:
Owner:
Address:
Site Address:
Plumber:
1 agree to comply with the City of Eagan Connection Charge:
Ordinances. Account Deposit:
Permit Fee:
Surcharge:
By Misc. Charges:
Date of Insp.: _ Total::
Insp.- Date Paid:
From:ALLSTAR CONSTRUCTION 19529427464 09117/2013 08:40 #582 P.044/079
Use BLUE or BLACK Ink
For Office Use
'n 4
j Permit
City of Ea Ed~
~ Permit Fee: ~
3830 Pilot Knob Road 7
Eagan MN 55122 Date Received: ct1. 13
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff: _ I
I I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 4-5-1013 Site Address: 4411,4411%441:04 lab UDYCAr Loins Unit M
f Name: Edekt ftm r-10" Wmlr1 (iOYY1D01Yhl Phone:
Resident/ Owner Address / City / Zip: io fbb GhI Wect Pqrkvv N , Edw Pmi riC, MN 55344
Applicant is: Owner J Contractor
Description of work: TM Q* Ghd Ye' ME
Type of Work
Construction Cost 3 10i 150.00 Multi-Family Building: (Yes X /No Company: VS-Val COnSir"Un MfdYltlf MCJJ A IJ [_Contact: JOC *AISifad
k i
Contractor Address: 511-15 InCUStY 01 S tC-+ * 103 City: Ali pt Plai h
State: MtJ_ Zip: SSPhone: qS1 941_ 1454
License FIC1o31515 Lead Certificate NWT - ZDgID4-()
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
I
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 Classlfed as non-public if you provide specific reasons that would permit, the City to
N` conclude that they are trade secrets-
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.aooherstateonecall.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 Building Code must be completed within 180
days of permit issuance.
ISt~ad x c
x 4t Hy
Applicant's Printed Name A li ant's Signature
Page 1 of 3
From:ALLSTAR CONSTRUCTION 19529427464
City of aan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675.5675
Fax: (651) 675-5694
02/10/2016 12:59 #301 P.009/022
Use BLUE or BLACK Ink
For Office Use
Permit #:
Permit Fee: / 4 ea
Date Received:
Staff:
2016 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Of /d/e, Site Address: y%//- al/f.1e Unit #: 4,5
Resident/
Owner
Type of Work
Contractor
Name: 6/V,4 r f of - 4/3 &/ 1 -lo
Address / City / Zip: T �// *Vs 6;fg-
Applicant is: Owner Contractor
Construction Cost: f 01 000 Multi -Family Building: (Yes o )
Company:,4ii&44. d rifkrr.c 1 Ah:ftriellaneeContact: wi /1/t
` //0
Address: �f446 (ndW54 ri 4 1 Si-- .5-0;LC /03 City: %VTh jle-RA- Iil
State: %i itAI Zip: 5'636' Phone:q 4 ' 614 Email: ii74getllS r. -4 2- -.
License #: (DAOiSO Lead Certificate #: AM -r- e4®9(,f - e�
Phone: /✓//,
4.G1,01,
J
Description of work: 8-.5fa /eV/TA /417,,07/ 5; A
If the project is exempt from lead certification, please explain why:
gut 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 pian?
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 thatthey are trade secrets.
............
CALL BEFORE YOU DIG. Call Gopher State One Cali 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. aopherslateonecall.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 yl.. pleted within 180
days of permit issuance.
•
x of l` iT
Applicant's Printed Name
Applic>nVs Signature
Page 1 of 3
i / f
® o I I I
I I
EAGAN
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
(651) 675-5675 1 FAX: (651) 675-5694
buildinginspections(a)cityofeagan.com
-------------I
For Office Use
I
I Building Permit #: obo I
I I
I I
I S&W Permit #: I
I C�J I
I Permit Fee: � 1 I I
I A-0I
I I
Date Received: I
I I
I I
I Date Issued: I
i- - - - - - - - - - - - - - - - - - - - - J
RESIDENTIAL BUILDING PERMIT APPLICATION
Date: �h qZ?W3 Site Address: Unit #:
Applicant is: ❑ Owner IlContractor
Name: �G(�V� b v,�e Cc>ja5'Sc, C'_I Ct_4 k 6 U-\�
Homeowner Address: OW 3 Y413 Liq 11 /� (� ) � City: a
IIJ
Stat .[M WLi �� Phone: Email:
Description of work:t�-
Type of !
Work Construction Cost '7
Type of building: ❑ Single Family ❑ Townhome, of units Twin Home
Compan Th-�� CV1:S& -LA c_ \ Contact: (2-0,v'� �f
Building Addressl�A t�tVlieS`�r 1
Contractor �J /?
State: Zip: 5:53 Phone6t Z-/'/ 5 EmailCjAke�C V_ey
-2 - cP
License #: Expiration Date:
�- - - -
Sewer & Company: Contact:
Water
Contractor Address: City:
Required for State: Zip: Phone: Email:
new construction
License #: Ex iration 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.
E�\e_xc�y�+ x Z_ z, �,; �
Applicant's Printed Name A licant's Signature