4491 Clover Lane BCity of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 4491 Clover Lane B
Lot: 24 Block: 1 Addition: Eden
PID:10- 22750- 240 -01
Use:
Description:
Sub Type: e - Fumace
Work Type: New
Description: Furnace
Comments: Expired Perm
Fee Summary:
Contractor:
Home Energy Center
2415 Annapolis Lane #170
Plymouth MN 55441
(651) 766 -6763
PERMIT
City of Eaan
Closed w/o Required Inspections. Letter sent. 12/10/2008 pf
Quesetions regarding electrical permit requirements should be directed to Mark Anderson, State Elec
952- 445 -2840
ME - Permit Fee (Replacements)
Surcharge -Fixed
Total:
Applicant/Permitee: Signature
- Applicant -
Owner:
Irene Thorpe
4491 Clover Lane B
Eagan MN 55122
Permit Type:
Permit Number:
Date Issued:
Permit Category:
$50.00 0801.4088
$0.50 9001.2195
$50.50
Mechanical
EA083004
05/13/2008
ePermit
cal Inspector,
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
CITY OF EAGAN WATER SERVICE PERMIT
3795 Pilot Knob Road PERMIT NO.:
Eagan, MN 55122 DATE:
Zoning: No. of Units:
Owner:
Address:
Site Address:
Plumber:
Meter No.: Connection Charge:
Size: Account Deposit:
Reader No.• Permit Fee:
1 agree to comply with the City of Eagan Surcharge:
Ordinances Misc. Charges: _
Total:
By Paid:
Date of tiV.- tot Insp.:
CI1 OF EAGAN SEWER SERVICE PERMIT
3795 Pilot Knob Road
Eqgan, MN 55122 PERMIT NO.:
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:
By Surcharge:
Misc. Charges:
Date of Insp.:
Insp.: — Total:
Date Paid:
Fram:ALLSTAR CONSTRUCTION 19529427464 09/1712013 08:26 #582 P.005/079
Use BLUE or BLACK Ink
- - - - - - - - - - - - - - - - - -
l For Office Use rI~ l
Permit t,:
City of Eap
I Permit Fee: -2-)
3830 Pilot Knob Road 2
Eagan MN 55122 j Date Received: q ` (1 I V j
I I
Phone: (651) 675-5675
Fax: (651) 675-5694 1 Staff: _ I
I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: q 5 ZO _SlteAddress: 4y8q,Ln9Fijyyg1,gH4I13 Guyer Wa unit
--~.~~.~w
Name: C - aSS1~I t ftn kto _ Phone:
Cam n n
Resident/ Address / City / Zip: C ftirit MN SGJ
v4m 14%. IMP St NY'
Owner _
Applicant is: Owner Contractor
Type of Work Description of work: 1LGIY- UI I Omd Y1.-1 of
Construction Cost: 911 4 IQ-OD Multi-Family Building: (Yes / No__)
Company: 4IKiar C 6MM9r1#MMfftl Llf. Contact: a WSI
Contractor Address:51HS lyidm al Syef _41D3 city: 4491G PO I State; MN Zip: %!&-I Phone: 9521459
License W 03151 S Lead Certificate NWT- 200I6t-I "
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:
I
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 the information may be classified as non;public,.if you provide specific reasons that would.pennit the City to
conclude that they are trade secrets. =.a
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.qopherstateonecall.org
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance. ' Y
x x
Applicant's Printed Name Applicant's Signature
y Page 1 of 3
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA125560
Date Issued:07/28/2014
Permit Category:ePermit
Site Address: 4491 Clover Lane B
Lot:24 Block: 01 Addition: Eden
PID:10-22750-01-240
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Tony Boerner
2090 County Road 42 W
Burnsville, MN 55337
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 -
Irene Thorpe
4491 Clover Lane B
Eagan MN 55122
Tony's Appliance
2090 County Road 42 West
Burnsville MN 55337
(952) 435-2442
Applicant/Permitee: Signature Issued By: Signature
443 Lafayette Road N. � �j����,Q�� ��pp�r���yT p� (651)284-5005
St. Paul, Mingesota 55155 ���� � i�r�i I���� 1-800-342-5354
www.dli.mn. ov 1 i�� V
'� ;
10/31/2014
APPROVED FOR USE
Irene Thorpe
4491B Clover Ln
EAGAN,NIN 55122
^____----
RE: .�E���7`AIR CHAIR LIFT Elevator ID# ELV-1017960
S' e Irene Thorpe Unit 1
443�B Clav�r Li�
EAGAN, MN 55122
. __
De _.
Minnesota Statutes Chapter 326B provides that the Department of Labor and Industry, Construction
Codes &Licensing Unit, Elevator Safety Section, inspect and approve elevators and manlifts (endless
belt lifts) before they can be legally used in Minnesota. An Inspector from the Elevator Safety Section
recently inspected your facility and determined it meets requirements of the Minnesota Elevator Safety
Code.
NOTE: Compliance with Minnesota Rules and the ANSI/ASME A17.1, Safety Code for Elevators and
Escalators does not necessarily assure compliance with the Americans With Disabilities
Act of 1990.
Sincerely,
CONSTRUC'TTON (�'(�I�E� & T ICENSJNG
�Il���a.tt�"
Bra n erdahl
State Elevatar Tnspector
c: City of Eagan Building Official '
ARROW LIFT ACCESSIBILITY
E1FormCE2R
This information can be provided to you in alternative formats(Braille, large print or audio).
An Equal Opportunity Employer
443 Lafayette Road N. � ]�jNj���gTA �EP�.i�T�E��T" ��' (651) 284-5005
St. Pauf, Minnesota 55155 1-800-342-5354
www.dli.mn.goV L���F� �C I�,I�LJST"F�Y
� :
10/31/2014
APPROVED FOR USE
Irene Thorpe
4491B Clover Ln
EAGAN,MN 55122
____---
RE: RES STAIR CHAIR LIFT Elevator ID# ELV-1017961
S' e: Irene Thorpe Unit 2
4491 B Clover Ln
EAGAN, MN 55122
Dear Sir/Madam:
Minnesota Statutes Chapter 326B provides that the Department of Labor and Industry, Construction
Codes & Licensing Unit, Elevator Safety Section, inspect and approve elevators and manlifts (endless
belt lifts) before they can be legally used in Minnesota. An Inspector from the Elevator Safety Section
recently inspected your facility and determined it meets requirements of the Minnesota Elevator Safety
Code.
NOTE: Compliance with Minnesota Rules and the ANSI/ASME A17.1, Safety Code for Elevators and
Escalators does not necessarily assure compliance with the Americans With Disabilities
Act of 1990.
Sincerely, !
C�N�TT�ITCTION CODES & LICENSING
� �����
Brad Underdahl
State Elevator Inspector
c: City of Eagan Building Official
AIZROW LIFT ACCESSIBILITY
E1FormCE2R
This information can be provided to you in aitemative formats(Braille, large print or audio).
An Equal Opportunity Employer
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA127768
Date Issued:10/15/2014
Permit Category:ePermit
Site Address: 4491 Clover Lane B
Lot:24 Block: 01 Addition: Eden
PID:10-22750-01-240
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Tony Boerner
2090 County Road 42 W
Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088
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 -
Irene Thorpe
4491 Clover Lane B
Eagan MN 55122
Tony's Appliance
2090 County Road 42 West
Burnsville MN 55337
(952) 435-2442
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA132550
Date Issued:08/20/2015
Permit Category:ePermit
Site Address: 4491 Clover Lane B
Lot:24 Block: 01 Addition: Eden
PID:10-22750-01-240
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:One Window/Door
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 500.00
Fee Summary:BL - Base Fee $500 $40.00 0801.4085
Surcharge - Based on Valuation $500 $0.50 9001.2195
$40.50 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Irene Thorpe
4491 Clover Lane B
Eagan MN 55122
(615) 452-7753
Minnesota Rusco
5558 Smetana Dr
Minnetonka MN 55343
(952) 935-9669
Applicant/Permitee: Signature Issued By: Signature
From:ALLSTAR CONSTRUCTION 19529427464 10/21l2015 12:31 #269 P.017l020
Use Bl.UE or BLACK Ink
� For Office Use �
� {° j Permit#: `�� ��� I
�1�� Ol ���aIl �ECEIVED � W �
3830 Pilot Knob Road � Pertnit Fee: �
Eagan MN 55122 QCT 2 � 2015 � Date Received: �
Phone:(651)675-5675 � �
Fax:(651)675-5694 I Staff: �
I i
`��_�����������__J
2015 R�SE�Eli�'Tl�4L B�OL�(�G P�RIViIT'AF�PLIC�4TION
Date: Site Address: Unit�f:
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� Name: �,►,�l�✓!+: ) d�+31 t� � ���+.r r'�Qe� Phone: N�H �
� R�sident/ y���- ��� I �
Owner � Address/City/Zip: T/� € ��c'
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Applicant is: Owner � Contractor �
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� ���
� Description of work: �r ����C^v - �1,�''Y� ��,,-,
Type of Work �
�
Construction Cost: ��`;�-'�C.:— Multi-Family Building:(Yes �No )
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, � �'I lt Contact: �,.�,r+�, ����„�,�,.� �
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� Contrac#or s Address:Si�S �n��S�-�-+�� 5f - '�.,��. �G+� ci�y: (�11 o��jt� 1�1�,.! �
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State:�Zip: �53s� Phone: �2-`��2�7�5'S�Emai1: tlt•�i+�t�lj$'�c!". 6'� �
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License#: �� �t'gc:� ���c1 Lead Certi�cate#: /��iA7• �i��f(��- L � #
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If the project is exempt from lead certification, please explain why: p��o�� ;� �a��3 �
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� "' •
� CONIPLETE THIS AREP► OPILY IF CONSTRUCTiNG A NEW BUILDING �
�
' In the las!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: �
s Mechanical Contractor: Phone: � `
� Sewer 8 Water Cont�actor:
Phone: �
� �
� Fire Suppression Contractor: �_ M � Phone: �
��NOTE:Plans and supporting documents that you submit are considered to be public information. yPortlons ofv �
the information may be c/assified as non-public if you provide speci�c reasons that would permii the City to
� conclude that the�r aie trade secrets.
,
� '
�..��..,��.,..�.�,.�..,..M..�.��,-..�x,_.�.�...��.,�._...�.:,x-,..�.�.:�:..�....�...�,,.�_�...,:,..,,. �
CALL BEFORE YOU DIG. Call Gopher State One Cali at(651)454-0002 for protection against underground utllity damage. Call 48 hours.��
before you intend to dig to teceive locates of underground utilities, www.aoohersiateonecall.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 bui(ding permit issued in accordance with the Minnesota State Building Code must be com pleted within 180
days of permit issuanee. ^ _...,,.r�,,._.. .,,,..--;!
x �:;� ��.��,./ �� '��� -
�, x
Applicant's Printed Name Applic nt's Signature"
Page 1 of 3
c..
€
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA136295
Date Issued:05/05/2016
Permit Category:ePermit
Site Address: 4491 Clover Lane B
Lot:24 Block: 01 Addition: Eden
PID:10-22750-01-240
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:One Window/Door
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 500.00
Fee Summary:BL - Base Fee $500 $40.00 0801.4085
Surcharge - Based on Valuation $500 $0.50 9001.2195
$40.50 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 -
Irene Thorpe
4491 Clover Lane B
Eagan MN 55122
(651) 452-7753
Minnesota Rusco
5558 Smetana Dr
Minnetonka MN 55343
(952) 935-9669
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA136611
Date Issued:05/24/2016
Permit Category:ePermit
Site Address: 4491 Clover Lane B
Lot:24 Block: 01 Addition: Eden
PID:10-22750-01-240
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:One Window/Door
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 500.00
Fee Summary:BL - Base Fee $500 $40.00 0801.4085
Surcharge - Based on Valuation $500 $0.50 9001.2195
$40.50 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 -
Irene Thorpe
4491 Clover Lane B
Eagan MN 55122
(651) 452-7753
Minnesota Rusco
5558 Smetana Dr
Minnetonka MN 55343
(952) 935-9669
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA151738
Date Issued:09/10/2018
Permit Category:ePermit
Site Address: 4491 Clover Lane B
Lot:24 Block: 01 Addition: Eden
PID:10-22750-01-240
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 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 -
Irene Thorpe
4491 Clover Lane B
Eagan MN 55122
Minnesota Rusco
5010 Hwy 169 N
Brooklyn Park MN 55428
(952) 935-9669
Applicant/Permitee: Signature Issued By: Signature
-------------I
For Office Use I
I� Building Permit #: 3I
I
S&W Permit#:
EAGAN
`C
I Permit Fee: I)
I I
I
Date Received: 1
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
(651) 675-5675 1 FAX: (651) 675-5694
buildinginspections(@cityofeagan.com
I
I Date Issued:
1----------------
RESIDENTIAL BUILDING PERMIT APPLICATION
Date:„ /.yC % /ZIJ,�LQ Site Address:
Applicant is: ❑ Owner aContractor
Unit #:
Name: �G( �� b �/l/�� C�
j gs b C t CL-4 k 6 l/\
Homeowner
Address: *-1q I IN qy R!9 A
City: kaaa
Wip:5I2_2
State:/ vt Phone:
Email:
Description of work: P,f�-
Type of
Construction Cost
Work
Type of building: ❑ Single Family ❑ Townhome,
of units Twin Home
Compan -T7QM
Building
Address: ��f� Uj9S
City: In Pv K\ 11 ,
Contractor
r
'/
StateAwip:5 z Phone6t z�7
/?
aztEcp
y-
License #: O Expiration Date: ,3/ � % S
gcA5 �z
Sewer &
Water
Contractor
Company:
I
Address:
Required for State
new construction
Zip: Phone:
Contact:
Email:
License #: Expiration Date:
City:
*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.ora 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.
,(a,vM e.\c ��e.v �- x
Applicant's Printed Name A licant's Signature