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4476 Clover Lane BCity of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675 -5675 www.ci.eagan.mn.us Site Address: 4476 Clover Lane B Lot: 7 Block: 2 Addition: Eden PID:10- 22750- 070 -02 Use: Description: Sub Type: e - Fumace & Air Conditioner Work Type: Replacement Description: Fumace & Air Conditioner Comments: Questions regarding electrical perm 952- 445 -2840. Fee Summary: Contractor: Haley Comfort Systems 122 West 3rd St Hastings MN 55033 (651) 437 -0338 Jeff Sammon ME - Permit Fee (Replacements) Surcharge -Fixed Total: Applicant/Permitee: Signature PERMIT City of Eaan - Applicant - Owner: Ann Eliz Ly 4476 Clover Lane B Eagan MN 55122 Permit Type: Permit Number: Date Issued: Permit Category: equirements should be directed to Mark Anderson, State Electrical Inspector, $50.00 0801.4088 $0.50 9001.2195 $50.50 Issued By: Signature Mechanical EA078398 06/20/2007 ePermit 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 ' CITY OF EAGAN r i`? c?. 1? ' 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 4548100 BUILDING PERMIT Re«ia # Te w wad fe. 7 51te Address ' Lot Block Sec/S Parcei No. ? Name ? Addre City _ Name 4 Addre Citv Name Erect U Occupancy Remodel ? Zoninq Repair ? Type of Const. Addition ? No. Stwies Move ? Length ' Demolish ? Depth . Int Impr. ? Sq. Ft. wpprwraw req /lssessment Pertnit Phone Woter S Sew. Surcharge -?' o? Police Plan Review 50 i Fin SAC ? -10 Enp. Water Conn. ? Phone Plonner Water Meter Council Road Unit ? 9 Q' edpe thot I have reod this opplication ond stafe that gldg. Off. Tr. PI. o C) is correcT ond ogree to tomply with oll opplicoble ,.,, c.......e. ....a r:... ,.s E h? Sipnoturo of Permittes A Bulldin9 Pe?nit is {ssued to: Buildinp Offidol monces. oll work shali be done in occordance a9on Ord APC Parks Var. pate Copies " - - rotal I? - on the exprcss conditlon thot oll epplicoble Stote of Minnesota Statutes ond Cify of Euqon Ordinances. . . - - --- -- 7 PormR No. Pormit Holdw Dace Tslephona # PlumWrq ?- ? H.VA.C. J Ebctrle j ??- Soherw Iropsetion Dete Insp. Othar Footlnys I Li Footings 11 Foundatlon &I?W Frsming ? Cvrj Rooling Rouyh Plby. Rough Htp. Inaul. Flnplece Finel Htg. -3G -lk rinei Pleg. -3y-?? ? JiM SSRS•? Finsl COVOCC. %,-'44 Lf/ Water Dfteribe Location: Well Sewsr Pr. Disp. CITY OF EAGAN Addicion E Pn Owner Lot 7 elk 2 Parcel #10 22750 070 02 street 44766Clover Lane State Eagan NIN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. 1982 504.7? 100.94 5 STREET RESTOR. GRADING QqD 9a 2 4 SAN SEW TRUNK # SEWER LATERAL 1896.46 179.29 5 WATERMAIN * WATER LATERAL 1982 WATER AREA I * SP.!'V C 8 1982 STORM 5EW TRK 1982 2 6. o0 1.20 i STORM SEW LAT 1982 CURB & GUTTER SIDEWALK STREET LIGHT WATER ONN. BUILDING PER. SAC • O PARK (TOWNHOUSE) CITY OF EAGAN N° 11218 ° '§$30 Pilot Knob Road, P.O. Box 21•199, Eagan, MN 55121 BUILDING PERMIT PHONE: 4548100 Receipt jk s ?)- 7 ?- Te ba and fer 1 OF 4 PLEX Est. Volue $60,000 pote NOVEMBER 7 1985 SiteAddrau 4476B CLOVER LN Lot 7 BIock 2 sec/Sub. EDEN ADDITIO Parcel No. EreCt 6J Occupancy nJ Remodel ? 2oning PD Repair ? Type of Conrt. V Additlon ? No.Stories Move ? Lengtn 44 Demolish ? Dep[h 24 Int Impr. ? Sq. Ft. Instell ? Approvals Faes W I Name GOOD VALUE HOMES INC ? Address 1460 93RD LN NE City BLAINE phone 780-5510 ,? Name SAME Address Assessment Permit $ 313.00 ? City Phone Wa1er $$ew. Surcharge 30.00 Polica PlenReview 156.50 Fw Neme Flre SAC 525.00 ?,-? Address Enp. WaterConn. 500•00 ?w City Phone Plonner WeterMeter 63.00 Countll Road Unit 280.00 1 here6y acknowledge tFwf I have reod fhis aODlicotion and state tFwf Bldg. Off. 11 4$rJ Tr. PI. 132.00 the inlormation is wrrect and agree to wmply wrth oll opplicable Stats of Minnewta Statute n d Ciry of Eogan Or inonces. AP? Parks 0 Vaa Date Copies Siqnafure of Pertnittes 1, 9 9. 50 h Building Dermi lss to: GOOD VALUE AOMES INC on tha ea? xprcss condieion Ihat oll work sholl in eccordonee with oll opDlicqble Stofe o newfu Statutes and City of Eoqon Ordirwnces. BuildirqOificial ?O. ! X?L c--i ? .: • 3830 Pili dU1LDfNG PERMIT To M rwd ier Site A ddreas Lot Block Sec/Sut Parcel No. W Name ; Address ' b Cky Phone z? Name ?? Addreu 1- City Phone tat W Name i? Addresa 1 her+eby atknowledga thot I hove read the inlormotion is correct ond ogree Stats of Minnesoto Statutes and Ciry Sipnofure of Permittes N Building Pe?mit is iuusd to: all work shall be done in occordonce w Bufldinq Officiol CITY OF EAGAN Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 Li7 U $60,000 Dote Erect ? j ; Remodel ? Repe{r ? AddRion ? Move ? Demolish ? Int Impr. ? Occupancy Zoning Type of Conat. No. Stories Length Depth Sq. Ft. /lssessment Pertnit - ?'i Q ; Woter & Sew. Surcharge )0 ? , Police Plan Review " 0 Firo SAC ' ri I Enp. J Water Conn. ' o Plonner Water Meter 4 Council Roed Unit plication ond state tfiot Bldg. Off. Tr. PL ply with all applicable on Ordinances. '4PC ParkB Var. Date Copies Total ` on t he exprcss conditlon thoi { appliwble Stote of Minnesoto Statutes ond City of Eapon Ordinonces. ? i" 11218 ReceiPt # Pwmk No. Pwmit Holder Dats Tslsphone Jk ???ing a g g H.VA.c. f I- 8 a o ENctric Sottarnr Impsction Date I Other Footlnps I 1G p 0 Footings II Foundatlon I Framinp C! Roofin9 !,?- t ROUQh Plby. '-? LG Rough Htg. Insul. Firoplace Final Htp. Flnal Plbg. Flnal c.rvocc. s; Water Dftcribs Location: Wall 8ewsr Pr. Dlsp. ?s------ ! - T- IN?PECTIOl? RECORD CITY OF EAGAN PERIUIIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (851) 681-4675 ! r; SITE ADDRESS: . , - ; i?VEit t ANI ! PERMIT SUBTYPE: f tit+ttti iW, 4'3`;N L?I /NHi9t) r'v -1 4' f " W 'f APPLICANT: r V31 r„C9 : TYPE OF WORK: lil':Z;170Ti'1 f.frN I ;?i?Vt: ; i 1M 1 ( f;s- P A ri, ftFF'i 14[;I li)IPJi, ? Permit Ho{der DBte Telephone # SEWER/ WATER PLUMBING HVAC Inspection Date Insp. Comments FOOTINGS FOUNO FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH FiEATIIVG GAS SVC TEST INSUL GYP 80ARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL DOMESTIC METEF IRRIGATION METER FLUSH MAf NS coNOUCTivirr TEST HYDROSTATIC TEST BSMT R.I. BSMT FINAL DECK FfG DECK FINAL Receipt PLUMBING PERMIT Permit No. " CITY OF EAGAN FN FiII in numbered spaces S/C •' ? Type or Prin[ legibly Tot. . 1. Date 2. Installation Cost 3. Job Address Lot Blk. Tract , 4. Owner 5. Contractor ' Phone 6. Address ' 7. City State 2ip 8. Building Type: Residential ? Commercial ? Institutional El 9. Work Description: New O Add ? Alter ? Repair O I 10. Describe 1 11. No. Fixtures Water Closet No. Fixtures Cesspool/Drainfield Bath tubs Septic Tank l.avatory Softner Shower Well Kitchen Sink Urinal/Bidet Other Laundry Tray Floor Drains Drinking Ftn. Slop Sink Gas Piping Outlets 12. 1 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 CITY OF EAGAN WATER SERVICE PERMtT 3830 Pilot Knob Rosd P, O: Box 21198 PERMIT NO.: _ Eagen, MN 551.1 ? DNTE: ? ?' . p Zanirg: _ ,U=, •olU2 No. of Untts: OwrNr: Mdnra: ,1µ, ; aver a,?. .., . ._ ,.iLen .tic: ,n. Slh Mdnss: , . Plunber. ? p;! 11Aet?r No.: 3 4 ction Charqe: , ?..,. Siu: ' ` R Oeposlt: ? : ; . , , i Itpder No.: a In '?'0 "itlt4eS ?s---?-;T-.-,?---- ?rJiw?woM. ? ? ! p•.: r1eter _ncni iiRrcD CITY OF EAGAN 3830 Pilot Knob Road P. A. Box 2ry 199 Eagan, MN 55121 ?fo Zoninp: ,,.....i ?r. ee oe.vh wMb ir. Ckr of lag.. DATE: No. of Units: CITY OF EAGAN WATER SERVICE PERMR SEWER SERVKE PERMIT pERMIT NO.: , 3830 Piloi Knab Rwd ` P. O. Box Z1199 ' PERMIT NO.: Eagan, MN 551? D/?TE: Zonirp;. No. of Untts: _ ?Mr: O 8 ue Addr+ess: , over ne . n. Sih Address: Nz e n ..; m., nlor P1 . u . ? fon CFw?ps: AAe/sr No. ? - • y . . i S ' • ` pr?IiCS-powt: ? = i RN ? `?fltjC. -~ x+ ? ? I , mmply 'W .? fle u t? ! °`a""'°"' EQUIR ED B`T",c?"?°`. I32.00pd TY R 63.oopa met g Doto Poid: Dote of Insp.: ? Insp.: ft - PI1 wbb !M CRY of aMn By Dote of Insp.: Insp.: 2m 30 Pilot Knob Rosd 0. Box 21199 yan, MN 55721 /ccouM Deposit: Pennit fw: Surdhorps: .- Misc. CF+orpes: Totol: _ DoM Poid: - Surcharps: By Misc. Choros: Oote of Insp.: Total: Irop.: Doft Po1d: Thre requesl void 18 imnths from o 096154 L? Rr.que+t DzW ?? Fre. No. PouP 1?? '??sper,tinn fie? retl? Vps E] NO ? Heatly Nuw Will No?ify Inspec- lor When ReadY LJ ucensea tlrctncal ConVactor I I hereby requxsl inspection ot above ? Owner electncal work mstalled at Street Addr sx, Bon or Roule o. . L CnY ?p 2 ec Name or No. Range No. County ?- Or,cupant IP I Phone No. Fnwer SuppLEr Addre55 Elec b iy I Contractor ICOmpeny Na Con[racmr's L icense No. / / , X' - 7 ? / O C Mailung AdJiess (Convar,tor or Owncr Makmg Instailabonl - pA) OF/allx_-' !+uthor¢ed 9A re IContracrodOwner Makmd IntitailaLOnl Phune Number MIryNESOTA ST{(y( 90ANO OF ELECTRICITY Griggs-Midwey Bldg. - Raom N-791 1821 University Ave., St. P.W. MN 56104 Phane (812) 297-2111 . THIS INSPECTION pEpUEST WILL NOT BE ACCEPTEO 9Y THE STATE BOAHD UNLESS PROPEH INSPECTION FEE IS ENCLOSEO REQUEST FOR ELECTRICAL INSPECTION % ee-oonoi-oa ' Sea mstmctiuns for complebng chis lorm on back of '? n= (? /1 p? A? p val low coov. U j j 1 1 I Y ?-X'* Se/ow Work Coveredbv Thi.c RP.,??r.<? iN 1, I t- j j Atl ilAmg Appliancea WveO Eqwpmenl I Wi dredl o H e Range Teinporary Service ), Water Heater Liqhtiny Fixtures K m? Dryer El ecin t: H ea m l Bldg. Fumace Sflo Unl o ad E:r ldq. Air Condrtioner Bulk Milk Tank mrr oe(.i rv ?iy pum, O?hcr 'Jq lUUt B lnS nacfinn Foa gF# Eiji e tt Fee Fxnders/Suhfaedera N Fee Grcwts 0 to 30 Am s 0 tn 30 Am>s ?y 31 to 700 Antps 31 to 100 pm Above 100_qm s Amps Above 100 Irrigavon Booms _ . Partial-'Other R¢poarks SUeaal Inspection rO TOTAL R • ? ? FEE/ 1 f"L ? ough-in DM,e ? I thy Elxcvicei? ? iIy/ , Inspecbr, hereby Fnal ce td h ? p ? - ?1eq' ? r y t at ihe abova oris0ecfmn has been mada. . City of Eap 3830 Pllot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax:(651)675-5694 ------------------ ? ?o?_om? u5a I j Pertntt5V`7?? ? Pertnit Fee: I ? Date Received: ? j I Statf: I i 2008 RESIDENTIAL BUILDING PERMIT APPLICATION Date: '`6 Z 1 5ite Address: ?/4 ?? 4 ql 7 6 C bjPf L lJ Tenent: 5uke 8: RESIDENT / OWNER Name: ? t43.. jbk*\f 01@?fS 0 .Cv??4hone: Address / City / Zip: Applicant is: _ Owner ? Contractor TYPE OF WORK Description of work: KE r?a T" Construction Cast:L?f700 ? Multi-Family Building: (Yes ?/ No ? CONTRACTOR Name: _? )_kboIS 40mP Tani/,2FJpin License#: 2046113'7 Address:11b4 C•y(/ 11r, 5+. Lo. City: i af I-N,?? State: MN Zip: aS02v 8D,4,1 ??b6Q?3 P ?W-34/23 erson: Contact Phone: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Cateaorv t Minnesota Rules 7672 Energy Code . Residential Vendlation Categwy 1 Worksheet • New Enargy Code Worksheet Category Submitted Submitted (4 sllbmission typ9) • Energy Envelope Calculations Submitted In the last 12 months, has the City of Eagan Issued a pertnlt for a similar plan based an a master plan? Yes _NO If yes, date and address of master plan: Licensed Plumber: Phone: Mechanlcal Condactor: Phorre: Sewer 6 Water Contractor: Phone: NOTE: Plans and supporting documents that you submR are consldered to be yub!!c informaNon. Portions of the lntormatloo may be classl/led as non-pu61(c N you provlde specltlc reasons thaf woWd permit the CRy to conclude that the are frade secrets. I hereby acknowledge Ihat this information is compiete and accurete; that the work vriil be in wnformance with the ordinances and codes of the Ciry o( Eagan; that I understand ihis is not a permit, but only an application for a permit, and work is not to start without a pertnR; that Ue work mll be in accordance with the approved plan in the case of work xfiich requires a review and approval of plans. z KOr??''1T x . ? Applicant's PriMed Name AppllcanPs Signature Page 1 of 3 2/84 CITY OF EAGAN APPLICATION FOR PERMIT SE:•lER AND/OR WATER CONNECTIODi (PLEASE PRiHi) 1) P??OP='?t?'?' ACDP.?.SS: g ? ? (IocBlock/Su:aivisicn or Tax ?arcel I.D. Nur.er) I i DaT':; 0° C2IGuAL ?.?.'1i ?SJI.l+.Cr: ..':::1.N:/!:.'?oPO-= LS: ? R-1 Si:GL'-. :?%+SLY ? R-2 DU?= ('?':'J II.?I.S7 . ? R-3 'IC7.t1?Hnr„*cg (mcro, + nIITS) ( W. ITS) ? ..-a AP:?2T-7r/c^_?.:.rrir,l ( cr,;zTS) ? CCi^IE.:C='i,/R._.?'".,IL?Ci?'IC:=.' ? ???•s?i Q L\?ST=_C`:ti../Cw"'v= ?n=T 2) A =Wi=_iP (PLEaSE PR1fiiJ -Zl,r C• rLcR=.ss: sT.= , zIP: ?c n w, r? ? ra Z???N ?d 73 Ph=: j) F7;`: (PLEAst Pflltii) FOR CSTY (1SE OYLY PLUH9F S-CIC:YSEc Active CIi?, ST?. ?-, ZI°; Q Esp' ed Pl-.C%Z= M??r. PLUYBER LICEVSE # ?/,4l?? /y/C? af Recard iL ' arC tnlLtdl g) cX'Z,?PS?/C(•.?:E2 r?cns? rnin?? Esz ACCRESS: Lo /3?f(E /vCS cri^r, sr;::::, zIP: ? f Rl NE J? Jv S"SF3 5% 5) IIdDIC:.Tr. ::'[-IICH PEF:•IIT IS SEP:G RFQLiESTLp: IZI CC..'.IEC:IC:1 ZO CITY SEYER ?[. CC:::,=IGN 'IC) CZTY hTATER ? al-L'.M (PL.ZA-CE D..SC.'RZBE) 6) • ? PI.: `SE f?OID APPP,OVID PER.mIT Farcle ?-L?i BY C:IE OF AFiCV? ? °T-EiSc :•T'r12L APP?20VE? PFF:•1IT 3, 4 ABOVE one) ' DATE• ! ll4lo OR?l c1?lY feJS ? Y? R??a?c:?.? a t P+t rs aFr a+.? _ s I?s i?a :a a?e ra ?tl?ff r-ss? fw f? t?s:?a F 0 R P-p"I"' °- ZSSU°D L E::::= C 2 T Y U S E O N L Y rrZS 7 $ /G S U $ /G-S(i S S $ +S $ $ 5 S ? / $ S S _?S7 1 v n??'.7T'^ J l: .....: :'.? LYATCR DER:1TT ?• ? \ (T?..C?;;L..:. SU..C::F,RGL/ hA'=SR i`1ETER/COPFE:?OrZ;;/CUTS=0? RE;,DER WA:ER TAP (ZNC:.UL`-^. CORPORnT?0N STOP) S=:IER Ta? AC.^_Ou?:T D=:POSIT - i•i;i^'?i WAC SAC TBC?iR WAT°R AS2ES...._... TRi:.i{ SE:]cR i?....?.,.. :..? ' ? LAiE:.=.L BLNLC:T/="';K C-'.:-? LA':?RAL BE\EFIT/'?':;v::K '=?-_? ?JATER TREAT?fENT PIaL`:T SCRCF?aRGE OTHER: TC i =.L A??cU?:T DalD;•R??z:- _ n LS2.t?'S DCES UTI:,Z:Y CD;7:IEC;ZON REQUZP.E EXCAVATION I,7 PUE:,IC RIGHT OF WAY? L Y: S IF YES. THE:: H"PER:IIT FOR :•70:.K SQIT??I:I PUBLIC ROAD:vAY" ,1UST BE ISSGEZ BY TEE O NO ET7GI:IEERZNG DIVISZON. LZST i,S A CONDI- TION. SCBjECT TO THE FOLLOWINIG CONDITIC^:5: APPROVED SY: TI':LE: ? . DAT°_: ? MeW M Wi+w40 VcW Ol?w?.? • ? '\ , ? ? 1985 BUILDING PERHIT APPLICATION - CITY OF EAGAN NOTE: ALL CONTR6C?ORS MUST BE LICENSED YITH THE CITY OF EAGAN C0141ERCZAL SINGLE FAMILY DiiEL[.INGS 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 I vF 4 ?oDpctJ To Be Used For: N '' Valuation: Afm= Site Address a?z(?6?? Lot _2 Block Parcel/Sub ;Lsa++V Owner >2!4 ?4'L,e Address lW?r, -r'-?'1?L,j F- City/Zip Code l2/A.iv x ?+t n> STr?3 54 Phone W-0 sr/o Contractor Addres City/Z Phone Arch,/ Addres City/Z Phone Date: ld ?D " -r OFFICE USE ONLY Erect Occupancy V•3 Remodel Zoning Repair _ Type of Const Addition U of Stories Move ? Length q Demolish Depth 714- Int.Impr. ? Sq Ft Install - - -------- - ---- - APPROVALS FEES Assessments Permit Water/Sewer Surcharge Police Plan Review Ffre SAC Engr Water Conn Planner Water Meter Council Road Unit Bldg Offd.4.gS? Treatment Pl APC Parks Variance Copies TOTAL C- T(q_ 10 30-?5 I 44q 6 Troy Haskins Eden Homeowner's Association PO Box 22195 Eagan, MN 55122 City of Eagan Building Permits Department March 21, 1999 To Whom It May Concern: Ann Ly of 4476B Clover Lane has the approval of the Board of Directors of the Eden Homeowners Association to extend her deck per the plan submitteci to us. All decks (including steps), not on the street side of the buildinga, are allowed to be built out a maximum of twelve feet (12') from the building. All decks (including steps) aze allowed to be taken to the end of the building (frant of unit), but no part ix allowed to extend beyond the brick on the front of the unit. If you have any questions ar concerns, please feel frce to contact me. Thank you for your help. Sincerely, ? Troy Haskins Maintenance Manager Home; 651-687-0597 VM: 651-458-7010 LOTS 5,6,7,Ati/D 81 BLUGK 21 EDEN AVDITIOV, , DAKOTA couNrY, MlNN65oTA /Il?vi. 1?rt 79 (,Qioio). pENOT65 EXISTlN6 66E?A7110N (Qta.o) DEA/OTE'S PROPaSED ELEVAT/oN /ND/CATES pIRECTIOti( oF SuRiACE DRA/NA6E NORTH sr-ALs : r" a30' `IT-'?•S = F/NlSHED GARf?66 FloaF ELEVAT/oN EY • DATE Ull I MPS DEPT. , 920 '-: a;jt ?l ZZX"12 c)r.c-w,w=n&3 .?o • v? s??,a•P?,vT i ? <_(J i- 'VF 7 Ter•bvi certify that thie im s true and corract t"epreeentation of a tract? ! ? ` 1999 BUILDING 3S3 ?-1 `lew Cons[ructian Requiremen4s PERMII` APPLICATION (RESIDENTIAL) CITY'bF EAGAN , 3830 PII.OT KNOB RD - 55122 (651) 681-4675 RemodeVReoair Reauirements ? 3 registered site surveys 0 2 copies of plans (inGude beam & window sizes; poured tnd. design; etc.) 0 1 energy calculations ? 3 copies ot tree preservation plan ff lot platted after 7N/93 required: _ Yes _ No DATE: 4-'9"'Iq DESCRIPTION OF WORK ? 2 Copies of plan ? 1 ske surveys (exterior additions & decks) ? 1 energy calculations for heated additions CONSTRUCTION COST. kt 4 oO STREETADDRESS: 406 Cl0?Pir laYIZ LOT: I BLOCK: SUBD./P.I.D. _??rh gLfCI i 7] dY1 T'h?c: ho P ?'c bla-7qa8 f Name: ? ?/ Phone #: PRC)PERT1' Laz First OWNER Sheet Address:?? b f'? ?I ?(er I QV--' City C?q a Yl State: (n A! Zip: ?- Company: Phone #: CONTRACTOR Street Address: License # Exp. Ciry State: Zip: ARCHITECT/ , ( 5; ENGINEER Company: ? Phone #: Name: Registration #: Street Address: City State: Zip: Sewer 8 water licensed plumber (new construction only): Penalty applies when address change and lot change is requested once permit is issued. I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: ? OF'FICE USE ONLY RECEIVED Certificates of Survey Received _ Yes _ No APR 19 1999 Tree Preservation Plan Received _ Yes _ Nol _ Not Required BY'? OFFICE USE ONLY 3UILDING PERMIT TYPE -1 01 Foundation ? 06 Duplex 7 02 SF Dwelling ? 07 4-plex -1 03 SF Addition ? 08 8-plex 1 04 SF Porch ? 09 12-plex 7 05 SF Misc. ? 10 = plex NORFf TYPE 0 31 New ? 33 Alterations ? 32 Addition ? 34 Repair ? 11 Apt./Lodging ? ? 12 Multi Repair/Rem. ? ? 13 Garage/Accessory ? ? 14 Fireplace 0 A 15 Deck ? 36 Move ? 37 Demolition GENERAL INFORfr9A7"ION Const. (Actual) 5•n? Basement sq. ft. (Allowable) Main level sq. ft. UBC Occupancy Sq. fq. Zoning f7•0 sq.ft. ? of Stories - sq. ft. 'Length - sq. ft. Nidth - Footprint sq. ft. 4PPhTOVALS °lanning Building ?? ? _ _l.(,/? - CT ? . ; ?. 16 Basement Finish 17 Swim Pool 20 Public Facility 21 Miscellaneous Census Code 43? SAC Code v 1 Census Units f Census Bldg D MC/ES System City Water Booster Pump PRV Fire Sprinklered Engineering Variance Permit Fee Surcharge Plan Review License MC/ES SAC City SAC iNater Conn. Water Meter Acct. Deposit S/W Permit 5/W Surcharge Treatment PI. Park Ded. Trails Ded. Other Copies Total: Valuation: $ L. % SAC SAC Units PE'RMIT CITY OF EAGAN 3830,Pilot-Knob Road Eagan, Minnesota 55122-1897 (651) 681-4675 SITE ADDRESS: P.I.N.: LQ-22750-070-02 DESCRIPTION: 44763 CLOVER LRfdE I.OT: 7 CtLOCK: F.CiEN PERMITTYPE: BujLDiNG Permit Number: 034390 Date Issued: 01 / 0 5 J 9 9 r?. REPLACL SIDINO BI+ildind'?ermit Type S'(ORM pAMAGE . Puildinq WO-rk Type ftEPAIR (t:ensus L'ode 43Q ALT. RES'LpENTIAL _y i / u ? -. . - . ... ._. i.._V".< ?A ._ `• ._, REMARKS: uNl'r BI. FEE SUMMARY: CONTRACTOR: - Hu? ? ? can 1' I I C OWNER: (:US70M CONCEPTS CONST 18987290 20142417 l_'Y HNPJ 1.654m KENkICK LOOP/STE B 4476B CLOVER LANE LFlKEV.[LLE MN 65044 EAGFlN MN 55122 (612) 898-7290 L hereby acknowledqe Ltiat .C have head this applic,ai.?on arid st,ite that the +nlurmation is correct rna aqrac to complv with all appticable StaT.e nh Mn St,atute?; and C1ty o7 F_at7an Ordineoaes. ? APPLICANT/PERMITEE SIGNATURE I ? ??/ z) - ? UED BY: SIGNA RE 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN 3830P1 51) 8104?-55122 9? ! I New Construction Reauirements ? 3 registered srte surveys ? 2 copies of plans (inGude 6eam & window sizes, poured fnd. design; etc.) ? t energy calculations ? 3 copies of hee preservation plan rf lol platted after 7!1193 required: _ Yes _ No DATE' i- ? Jql DESCRIPTION OF WORK: RemodellRepair Requirements ? 2 copies of plan ? 1 site surveys (exterior addi6ons 8 decks) ? 1 energy calculations for heated adddions CONSTRUCTION COST; ?? 7 S STREETADDRESS: "Iy-7Lo I7 OO\/2r ?-z,c v LOT: ? BLOCK: SUBD./PJ.D. #: Az--- vamc:_Lq !1 Vln A Pl?one #: PROPERTY Fu"st 0'vVNl12 Strcet r\ddress: City St?ate: Zip: Coliipauy:_ C4-"'1-/VP'1 Phoue - - ? -------- CO V'PRAC'1'OR Street Address:??If-O_Z?24[???? _or ? ---- License #Z?L/?' L%?--Erp' ----- City --- ??------------ S[ate: --ET• ?{?------- ???' ?------ ARCHITECT/ ENGINEER Comptuly:-------------- ------------------------ Phone k: -------- - --------- Regishntiou f#: SLreet Address:--------- --------------------- Cily ---------------------- ----- StaLc:,------- ------ Zip: Sewer & water licensed plumber (new construction only): _ change and lot change is requested once permit is issued. Penalty applies when address I hereby acknowledge that I have read this application, state that the information is correct, and agree to compiy with all appiicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY Certificates of Survey Received _ Yes Tree Preservation Plan Received _ Yes No I _ No _ Not Required? ? ??i ? ? " ,, ? O,? 33 PavE 38 AOBE COHSUlTIHO EHOINEEIIS p NGINEEt?ING PLpNNfAS and IAND 3UflVEY0115 COMPAN4, INC. N 14 1000 EAST 146111 STREET, BURNSVILIE, MlNHESOTA 85337 PH 4432'3000 ?CQ? I.D'CJC7'?p?20TC: LoTS 5,6,7AN0 8? BLUCK 21 EDE,V ADOIT/oN, ? DAKOrA CouNrY, MlNNESoTA ??to_a ) pENOTES EX15T/N6 E1EVAT10AJ ( 9La,o) pEA/OT65 PROP0560 ELEVAT/aN - /NDICATES O/RECTIOti( oF Su2FACE ORA/NA6E 9Z3•5 = FiNiSHED GARN6E FlaoR E"[.EVATioN NORTH SCALe: I"= 30' 3a - Qqi8 ? ? V t92o ?-? 51 O / /(X0 o / ? O ?( V i <? ?? ) r ?? , ' • / "- ? PRQ?S &sI .o0 3,S /? C9z3, r? ? ? ` ?vG13 3 W 0 o M ? o??r< ryh (9: b? / ti?s ?> / >/O ?ep 6`S3 i 30 • ? / Q GT ??ti i GC- '`. ,,?r ? . ?. , 9z51 ?/ p) s' (oyo C?4. 9 Z6 h ? m v tl? . I N ( ' ?J \ ? ` i ? c9 n? ; ? ra ? • o ?ti ? . \92 s? ? N •? ?/6. ? / i ? I harsby certify that thia ie a true and corract rnpresentation of a tract of land aa sho+m'and deecribed heraon.. Ae preparad by me on this 3eD day ot (?'zaBF.P , 19 g5 . ' . laa. Xo.?; From:ALLSTAR CONSTRUCTION 19529427464 09/17/2013 08:49 #582 P.068/079 Use BLUE or BLACK Ink For Office Use j Permit M 1 I l j City of Eap Permit Fee: 3830 Pilot Knob Road I I Eagan MN 55122 Date Received: a 1 L3 Phone: (651) 675-5675 I I Fax: (651) 675-5694 1 Staff: I I 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Dater Site Address: ~41' 4q_Hb,+'nV, Li q11190, UNeV WVlG Unit M Name E CIO' NO, CumDOnN Phone: Resident/ Owner. wner. ( Address / City/ Zip: ULM Utu V1 Sl ~I~~IXV r ~ irie, MN (~53fy - T Applicant is: Owner Contractor Type of Work Description of work: lay Off 1-fi f Construction Cost: IIlol loci, (N) Multi-Family Building: (Yes X / No-) ~ ontact: C lU~ ~i~~Qt~ ComPanY:c-t► ~ l~IUI~~t~+Yi On ll~l I Address: 1 iq ~ e (h Contractor 51 5 f~'-U~rS pI IQ~ UC city: Fw State: Zip: PJ35 1 Phone: License VC ,CJ15 Lead Certificate %'I7 2p9 wq --o If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) I COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE. Plans and supporting documents that you submit are considered to be public information. Portions of L Me information may be classified as non public if you, provide spa lp reasons that would permit the City to.. conclude that they are trade secrets. _ CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.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. n Applicant's Printed Name Ap i nPs Signature Page 1 of 3 From:ALLSTAR CONSTRUCTION 19529427464 02/10/2016 13:07 #301 P.021/022 City of £aan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 6754694 Use BLUE or BLACK Ink For Office Use 1300/3 Permit #: Permit Fee: Date Received: Staff: 2016 RESIDENTIAL BUILDING PERMITllAPPLICATION n Date:.?//d �/!o Site Address: VOW" Wi &JV87 - 4y Unit #: �l Name: Ae.A 4164 t ifi — e-li&/`f 1 0fl Resident/ Owner is Address / City / Zip: Phone: ////, J Type of Work Contractor Applicant is: Owner ai Contractor Description of work: /191-- /00 1nyiIs7P�°'t7nf/i8--(j�F.�4, ,vtCi+k�` cJ Construction Cost: /O,tOl/ ^ Multi -Family Building: (Yes /�/ No ) Company: All544itn giefi;71teelall cls Contact: J 1 nn A item'? Address:Sl445 I tcs-tr;A I $?- so r -I t. /03 city: MAO- O- fi t, -;et State: Zip: p 55359 Phone: '9 ' 6T Email: 4.7 74Gl.f/S- r..6 License #:.56 toCo 3S ® Lead Certificate #: itr. lk'% o2®91,9 V - d� If the project is exempt from Iead certification, please explain why: 1.3u , r� /9es 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: jSewer & 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 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.orq I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Exterior work authorized by a building pemnit issued in accordance with the Minnesota State Buildin .0 plated within 180 days of permit issuance. 10411 Applicant's Printed Name Applic nt's Signature Page 1 of 3 %t:0®, 1 I I I E AGA N I� 1 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651) 675-5675 1 FAX: (651) 675-5694 buildinginspectionsacityofeagan.com --------------I For Office Use ``�}, I 1 Building Permit #: 1 Le Z® 50 I I S&W Permit #: I Permit Fee: I I - t V I I I I Date Received: I I I I I I Date Issued: I---------------------' RESIDENTIAL BUILDING PERMIT APPLICATION Date: �6q/Site Address: Applicant is: ❑ Owner aContractor Unit #: Name: E- t/A �o0-Ae— d t,.l- S jags C-�, COt_4 Homeowner Address:&L j? AR Y147b 13 J 6 �,�(�I} Ae is Z city: �o Ct o- V� Phone: Email: Description of work: P, 2 Q C. J Type of Work Construction Cost 4(,q Building Contractor Sewer & Water Contractor Required for new construction Type of building: ❑ Single Family ❑ Townhome, of units Twin Home Compan�636 Address Ll 2,P, ( . i �� W QRV City: J�;66PY\ -Pv-GQ\-,r- l State: Lip: 5 / T Phone>�tZ�17 Emailia/UIQ�C CSN�eo"`�Q°�`�i License #: O Expiration Date: Company: Address: State: Zip: License #: Phone: Contact: _ City: Email: 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. Applicant's Printed Name A licant's Signature