4428 Clover Lane BCity of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675-5675
www.ci.eagan.mn.us
PERMIT
City of En
Permit Type:
Permit Number:
Date Issued:
Permit Category:
Building
EA089802
06/19/2009
ePermit
Site Address: 4428 Clover Lane B
Lot: 40 Block: 02 Addition: Eden
PID:10-22750-400-02
Use:
Description:
Sub Type: e-Windows/Doors
Work Type: Windows/Doors-New/Replacement
Description: House
Census Code: 434 -
Zoning:
Square Feet: 0
Construction Type:
Occupancy:
Comments:
Improvements to the home require smoke detectors in all bedrooms. If altering window openings, call for framing
inspection. Call for final inspection after installation.
Carbon monoxide detectors are required by law in ALL single family homes.
Fee Summary:
Valuation: 3,000.00
BL - Base Fee $3K
Surcharge - Based on Valuation $3K
$88.50 0801.4085
$1.50 9001.2195
Total:
$90.00
Contractor:
Renewal Andersen
1920 County Road C West
Roseville MN 55113
(651) 264-4777
- Applicant -
Owner:
Diane L Knudtson
4428 Clover Lane B
Eagan MN 55122
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
Applicant/Permitee: Signature
Issued By: Signature
411,11'lity of Eatau
3830 Pilot Knob Road rlq* n -311
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5894
Co
Use BLUE or BLACK Ink
2011 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address:
"41
Unit 1:
RESIDENT /
OWNER
Name: i Outs e_ jt •.e,41‘ (et' Phone:
Address / City / Zip: 114.7 0 3 clovt, 4-40,,xe_./ E.qam-. . fri 4/ - §-"gt7 2
Applicant is: Owner Contractor
TYPE OF WORK
Description of work: repA14t, lg. A.e ,..‘, be ok
//i.)i
4tc*5
Va
Construction Cost: 7Multi-Family Building: (Yes / No _J
CONTRACTOR
t A F.
Company: \-.)e.0 B\I %OK., Tim C. Contact: ... 4242. S. t1_,,,- ;
Address: I t(t) 5 & e " ek.),1 AAR- ILL City: Oa le,d.cir te.
State: AA 4) Zip: 5 S 1 VE) Phone: Co 5 1 - 797 "' 3 4123
License #: 20(0 30 70.49- Lead Certificate #:
If the project is exempt
from lead certification, please explain why: (see Page 3 for additional information)
In the last 12 months,
No If
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
has the City of Eagan issued a permit for a similar plan based on a master plan?
yes, date and address of master plan:
_Yes
Licensed Plumber
Mechanical Contractor
Sewer & Water Contractor
Phone:
Phone:
Phone:
NOTE: Plans and supporting documents that yousubmit are considered to be public information. Portions of
the information may be classified as nonpublic if you provide specific reasons that would permit the City to
conclude that they are trade secrets,
CALL BEFORE Y U 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. vvww.qopherstateonecall.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 9fptafls.
e- 54" ci
x
Applicant's Printed Name
nt's Signature
Page 1 of 3
a
DO NOT WRITE BELOW THIS LINE
7q15—
SUB TYPES
Foundation
Single Family
Multi
01 of Plex
Accessory Building
WORK TYPES
New
*--Addition
Alteration
— Replace
Retaining Wall
DESCRIPTION
Valuation
Plan Review
(25%_ 100%
Census Code
#of Units
# of Buildings
Type of Construction
_ Fireplace
Garage
Deck
Lower Level
_ Porch (3 -Season) _
_ Porch (4 -Season) —
_ Porch (Screen/Gazebo/Pergola) _
_ Interior Improvement
Move Building
Fire Repair
` Repair
Pool
_ Siding
Reroof
Windows
_ Egress Window
Storm Damage
Exterior Alteration (Single Family)
Exterior Alteration (Multi)
Miscellaneous
Demolish Building*
Demolish Interior
.— Demolish Foundation
Water Damage
*Demolition of entire building - give PCA handout to applicant
Occupancy _y - i MCES System
Code Edition_� �SAC Units
Zoning .� City Water
Stories — Booster Pump
Square Feet /0 q PRV
Length 0 Fire Sprinklers
Width / 3
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation
Drain Tile
Roof: _Ice & Water _Final
Framing
Fireplace: _Rough In Air Test _Final
Insulation
Sheathing
Sheetrock
Reviewed By: (,(
Meter Size:
Final / C.O. Required
Final / No C.O. Required
HVAC Gas Service Test Gas Line Air Test
Other:
Pool: Footings Air/Gas Tests _Final
Siding: Stucco Lath _Stone Lath _Brick
Windows
Retaining Wall: _ Footings _ Backfill _ Final
Radon Control
Erosion Control
, Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3
ROBE
ENGINEERING
COMPANY, INC.
1000 EAST 146Th STREET,
0
m
•
:—r
v
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5
CLeMetif,
CONSULTING ENGINEERS
PLANNERS and LAND SURVEYORS
BURNSVILLE. MINNESOTA 55337 Pit 432-3000
Ce,cer-144-liccitic_gy
jaggccl j,e.JOr 4eZ orz: LOTS 40,41,42 AND 43, BLOCK 2, EDEN ,ADDITIO11,
DAKOTA COUQTY, M I kJ NESOTA
`93274; DEMO TE5 EXIST/N6 ELEVATION
(933.0) DEK1OTE5 PROPOSED ELEVATION
--�--- INDICATES DIREC7l0/V OF SURFACE DRAINAGE
933.0 = FINISHED GARAriGE P'LOOFR ELEVATION
EAGAN
RE!. WED
NORTH
SCALE I" = 30'
_922X0/)
5 89°58'an"w'
722.0) 24.94
( 922.3)
BY:
'ONS DIV 5sON
DATE
°`..\(34-
\\e tip1
q �0�
)>°(/`3
(9_30,0
f.929 („
/54.92
EAST
�_- J 1
DRAINAGE AIJD
UTILITY EA5EMEI.IT
I . -7— -,
L_.-, ..l�.:
3O. FROM T BUILDING
SETBACK LINE
79'
1 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 /..5r day of
NOV61,156R' , 19 85.
"Ir
CITY OF EAGAN WATER SERVICE PERMIT
3830 Pilot Knob Road,
P. O. Sox 21199 PEkMIT 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.
I agree to comply with the City of Eagan Surcharge -
Ordinances. Misc. Charges.
Total -
By (� Date Paid.
Date of Inv . I nsp •
CITY OF EAGAN
3830 Pilot Knob Road
P. O. Box:,21199
Eagan, MN 55121
Zoning:
Owner:
Address:
Site Address:
Plumber: —
SEWER SERVICE PERMIT
PERMIT NO.:
DATE:
No. of Units:
1 agree to comply with Hie City of Eagan
Ordinances.
By
Date of Insp.:
Insp.:
Connection Charge:
Account Deposit:
Permit Fee:
Surcharge:
Misc. Charges:
Total:
Date Paid:
From:ALLSTAR CONSTRUCTION 19529427464 09/17/2013 08:46 #582 P.059/079
City of Eap
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit #: f'/'"I �Q O S
Permit Fee: J [ D r /�
Date Received: "i1l'0
Staff:
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: i I V 120I? Site Address: 4t-iik, 41-1/56b 4430 94317B CIDYCY Writ, Unit #:
Resident/
Owner
Name: EarlC jD • basceh Company
Phone:
Address / City / Zip: (DP) Chi Via ParICVY ( i f IUIIYI�t M N 553+1
Applicant is: OwnerT� Contractor
-
Description of work: fear offandYe-wxf
Construction Cost: 3 I1 t Dad . 00 Multi -Family Building: (Yes /r / No
Company:,41IStQir UntitiCt0I1 Marxticititnt LIZ Contact: 3K *IOW
Contractor Address: biLIC) IY►dtintriPI # IID3 city: Maw, Win
State: IAN Zip: %35°I I Phone: CICj ,ALI—1`15L1
License #: 1:6(,In3I ! Lead Certificate #: tV rt T— 2,1011p4-0
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City, to
conclude that they are trade secrets.
CALL BEFORE YOU DIG. CaII 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 permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
(Joe i c d
Applicant's Printed Name
A)ipficant's Signature
Page 1 of 3
City of Eagan
PERMIT
City of Eaan
Permit Type: Plumbing
Permit Number: EA132651
Date Issued: 08/27/2015
Permit Category: ePermit
Site Address: 4428 Clover Lane B
Lot: 40 Block: 02 Addition: Eden
PID: 10-22750-02-400
Use:
Description:
Sub Type: Residential
Work Type: Replace
Description: Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Fee Summary:
PL - Permit Fee (WS &/or WH) $59.00
Surcharge -Fixed $1.00
0801.4087
9001.2195
Total: $60.00
Contractor:
The Plumbing Guys
P.O. Box 2066
Burnsville MN 55337
(612) 746-5545
- Applicant -
Owner:
Diane L Knudtson
4428 Clover Lane B
Eagan MN 55122
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Applicant/Permitee: Signature
Issued By: Signature
From:ALLSTAR CONSTRUCTION 19529427464 10/21/2015 12:23 #269 P.005/020.
City of Eaaall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
RECEIVED
OCT 71 2015
Use BLUE or BLACK Ink
For Office Use *-S-3
Permit #:
Permit Fee: '-3L11t I%dj
Date Received:
Staff:
2015 RESIDENTIAL BUILDING PERMIT APPLICATION
Unit #:
Date: Site Address:
Resident/
Owner
Name: urlA✓A: i ik`3)a'r [-be-"J [-be-"JFlci
I Address / City / Zip: erne' -`/V ' 60101- L r C, eke' ,4
Phone:
Contractor ..
Applicant is: Owner X Contractor
a
Description of work: read' `,sc in/;71i Id y/ .S -741,/,'S .
Construction Cost: Zo; C'40Multi-Family Building: (Yes / No
Company: II�As� 6rr+S�uG�.ia-ti ti /ifh�►�kyi��AGG' Contact: �.', if! ,p,
4,3
Address: c /S /nJulS--r rt -L 103 City: 1V R{til: j'l f>•,.
State: > t Zip: S"S-31 Phone: 4524y2 '7`/5V Email: /r11Ccrgc�1
..........
License #: fi6 &go 350 Lead Certificate #: A/el►•• 2 e9 6 2_
I. If the project is exempt from lead certification, please explain why: 80 ;(....,.7 ;,,i 118 3
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?
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Yes No If yes, date and address of master plan:
r 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 t�Y are trade secrets
CALL BEFORE YOU DIG. CaII Gopher State One Cali at (851) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities, www.gopherstateonecall.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 approvai 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.
J1/4,11rn.1x
Applicant's Printed Name < Applicant's Signature
Page 1 of 3
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
(651) 675-5675 1 FAX: (651) 675-5694
buildinginspections(cD.cityofeagan.com
-------------I
For Office Use I
I Building Permit #:
I I
S&W Permit #:
I
I. I Permit Fee: I
1 I
I I
Date Received: I
I I
I I
I Date Issued:
t- - - - - - - - - - - - - - - - - - - - - J
RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Shqz6Q23Site Address:
Applicant is: ❑ Owner Contractor
Unit #:
I
Name: �G(� t/� b VV`� C� �_,�� 11�.�.1' S lasers e, C I Ot_4 l C> In
Homeowner 7
Address:
Me ( 1 f7"LAZ /AA City: �aQ OL \/1-,
Phone: Email:
Description of work: P, Q b t7Z
Type of
Work Construction Cost l
Building
Contractor
Type of building: ❑ Single Family ❑ Townhome, of units 19,Twin Home
Compan I7L,qj (� �t`t't.� C_ C� \lam Contact:
��
Address: � r t & W Q�T City: GCS' VG��11' l
StateAwip: 5�3_ Phone6tZ-'f 5 Email(Vtk .k[ �e,� CUk-- �
b 71*-/- / _ —
License #:� 7 4.3 ,i l � Expiration Date: J/ 3
Sewer $ Company: Contact:
Water
Contractor Address: City:
Required for State: Zip: Phone: Email:
new construction i
I License #: Expiration Date:
` 1 understand that Plumbing, Mechanical, and Fire Suppression work require separate applications.
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the
information may be classified as non-public if you provide specific reasons that would permit the City to conclude that they
are trade secrets.
CALL BEFORE YOU DIG. Contact Gopher State One Call at (651) 454-0002 or www.gopherstateonecall.org for protection against underground utility
damage. Contact Gopher State One Call 48 hours before you intend to dig to receive locates of underground utilities.
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
x
Applicant's Printed Name A licant's Signature