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4467 Clover Lane BCity of aau 5E,©TlY7 , 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 r Use BLUE or BLACK Ink Permit #: Permit Fee: Date Received: Staff: 2010 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: 4/1i C i o u,r Tenant: L5 Suite #: RESIDENT / OWNER Name: Phone: Address / City / Zip: Applicant is: Owner Contractor TYPE OF WORK Description of work:, o, L,.. `:j& dc. Construction Cost: C.70 Multi -Family Building: (Yes / No ) CONTRACTOR Name: er1,,511 y z)..sLicense #: ©C; 305 02 Address: IC/ 45-- (9-e-0Q,tie City: Ocelli, e.1 /--ti State: /14A) Zip: c's 1.2 V Phone: La S/ — ` 7 — 1 133 Contact: Seta-_ S44k Email: .. t Er-ic.,slg07r cC,,� C® cot. COMPLETE In the last 12 months, has Yes No If yes, THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING the City of Eagan issued a permit for a similar plan based on a master plan? 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 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.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 case of work which requires a review and apprq al of plans. x Applicant's Printed Name x Ap licaht's Signatu Page 1 of 2 � � 1 CoU& DO NOT WRITE BELOW THIS LINE SUB TYPES Foundation Fireplace _ Single Family Garage Multi ( Deck _ 01 of _ Plex _ Lower Level Accessory Building WORK TYPES New Addition Alteration Replace Retaining Wall DESCRIPTION Valuation Plan Review (25%_ 100% V) Census Code #of Units # of Buildings Type of Construction Porch (3 -Season) — Porch (4 -Season) — Porch (Screen/Gazebo/Pergola) Pool _ Interior Improvement _ Move Building Fire Repair Repair 1.6w 1'%1/ 7.6 —a REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) Foundation Drain Tile Roof: _Ice & Water Framing Fireplace: _Rough In Air Test Insulation Meter Size: Final Reviewed By:);-';2:/"%eEs RESIDENTIAL F Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies Storm Damage Exterior Alteration (Single Family) Exterior Alteration (Multi) Miscellaneous _ Siding Reroof Windows Demolish Building* Demolish Interior Demolish Foundation Egress Window Water Damage *Demolition of entire building – give PCA handout to applicant Occupancy JAG --!t Code Edition d07 Zoning Pp Stories Square Feet Length Width Final 8 f0 MCES System SAC Units City Water Booster Pump PRV Fire Sprinklers Sheetrock Final a C.O. Required Final I No C.O. Required HVAC 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 732r 1 TOTAL 411 e /64-!-/fe ilceoP S ROBE /5.0-(aCe9 0-tto-7 nougt tfl CONSULTING ENGINEERS NGINEERING PLANNERS and LAND SURVEYORS COMPANY INC. T .......1000 EAST 1461A STREET. BURNSVILLE. MINNESOTA 55337 CerZ caac__Qf y 446-7 c Z d crt r? 2 o rt : LOTS 5, ,7 AND 8, 8LocK i, EOEN ADDI T/a/l, DAKOTA cauMTY MINNEso-TA NORTH SCALE : /" = 30 C-11:517.2-) DENOTES EXIST/AJG E'LEVAT/ON (715-• °) DENOTES PROPOSED EL E VAT/oXJ /No/cATEs O/RECT/Q/J oT SuRPAcC ORAINA6E 9/5.0 = F/Ay/sit/EP G4K46lle,, rias \a''4V)) LNv 0i p► ELEVA7/ON REV IEY: DATE: %- -/l7 h7BUILDING INSPECTI NS DIVISION 30' PRoNT BulL own 5E`TPAcK LIIVE • / < %••••• 90 .40 $g. ,� I hereby certify that this is a true land as shown' and described hereon.. lxn# , 19 P5 . and correct As prepared I` l reps sentation of a tract of by me on this , 34) day of Him. Reg. No. / City 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: Mechanical EA091556 10/09/2009 ePermit Site Address: 4467 Clover Lane B Lot: 8 Block: 01 Addition: Eden PID:10-22750-080-01 Use: Description: Sub Type: e - Furnace Work Type: New Description: Furnace Comments: Quesetions regarding electrical permit 952-445-2840 Scott Lofgren 5708 Upper 147th St W #102 equirements should be directed to Mark Anderson, State Elec cal Inspector, Fee Summary: ME - Permit Fee (Replacements) Surcharge -Fixed $50.00 0801.4088 $0.50 9001.2195 Total: $50.50 Contractor: Lofgren Heating & Air 5708 Upper 147th St W Suite 102 Apple Valley MN 55124 (952) 431-5811 - Applicant - Owner: Pamela J Oslos 4467 Clover Lane Unit B Eagan MN 55122--243 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 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: By�2�- % �� Total: Date Paid: Date of I nsp Insp.. CITY OF EAGAN WATER SERVICE PERMIT 3830 Pilot Knob Road P. O. Box 21199 PERMIT NO • Eagan, MN 55121 DATE: h - /-y CITY OF EAGAN SEWER SERVICE PERMIT 3830 Pilaff Knob Road P. A. Box 21199 Eagan, MN 55121 PERMIT NO.: Zoning: DATE: Owner: No. of Units: Address: Site Address: Plumber: I ogre* to comply with the City of Eagan Connection Charge: Ordinances. Account Deposit: _ Permit Fee: By Surcharge: Date of Ins Misc. Charges: p.. Total: Insp.. Date Paid: From:ALLSTAR CONSTRUCTION 19529427464 09/17/2013 08:29 #582 P.017/079 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 I� Permit #. l Iti`�'9 303Permit Fee: c° Date Received Staff: 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 415 2013 Site Address: 4Likilfc 9'4 sB,94 1144 1(3 CloYtr Lane- Unit #: J Resident/ Owner . Name: ECIth VIVI Cl°. CIMSiiYl tompQlny Phone: ., 1.. Address / City/ Zip: IWLIVG I v) 1 W. Idle Yay EClean Name i MN L33LN I Applicant is: Owner Contractor Type of Work Contractor Description of work: Z'TGY off and Ye -roof Construction Cost S 11DiCIr) • DO Multi -Family Building: (Yes I / No ) rI` Company: t� to � UCtiOn Maiaf ent U,C,Contact dbe, italttead Address: 51LIS 111111011W S1YCet 0103 City: Move, plain n ryc� State: N/111 Zip: 55WOG) Phone: '157,— q`-IZ` 1HCJ� License #: 12C,P3191S Lead Certificate #: NAT'" 20q -D 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: Phone: Mechanical Contractor: Sewer 8 Water Contractor:-- Phone: Phone: NOTE: Plans and the information • supporting documents that you submit are considered to be public information. Portions of— 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.000herstateonecall.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. x due ttIsltad Applicant's Printed Name 0 's Signature Page 1 of 3 City of Eagan PERMIT City of Eaan Permit Type: Plumbing Permit Number: EA131072 Date Issued: 06/01/2015 Permit Category: ePermit Site Address: 4467 Clover Lane B Lot: 8 Block: 01 Addition: Eden PID: 10-22750-01-080 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) $55.00 Surcharge -Fixed $5.00 0801.4087 9001.2195 Total: $60.00 Contractor: Drain Pro Plumbing 8815 - 209th Street W Lakeville MN 55044 (952) 469-6999 - Applicant - Owner: Pamela J Oslos 4467 Clover Lane Unit B Eagan MN 55122--243 (612) 804-9456 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 02/10/2016 13:04 #301 P.017/022 4116City afkali 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675.5694 Use BLUE or BLACK Ink For Office Use 3�bLit Permit #: Permit Fee: Date Received: Staff; 2016 RESIDENTIAL BUILDING PERMIT APPLICATION Date: I/i0 / Co Site Address: iNGS- WO �i`/0Vele- Lr**•G Unit N: A ►3 Resident/ Owner , Address / City / Zip: 'HIPS- G✓8 L- Lie Name: Wil/4 'IA th NOR Type of Work Contractor Phone: /t'//, J Applicant is: Owner X/ Contractor Description of work: /Si -54 W/7 ti y/ 67A'/ j - t /Am'a/0 ;4 l'i y (J Construction Cost: IO1 d drJ — Multi-FamilyBuilding: ;.: .., .:... _ 9 (Yes No Company: A11544,t (.e rj41.0.Lt- n ! ff2q7,-ded1an cc° Contact: J. .;r1, A d Ern kr Address: Si 455 I n1bcS-1-r; A I 7- _5-1.4 rI-E /4 3 City: M}ple.- FLA- ;f1 State: /4 Zip: c63.59 Phone:g0-90•7'I5t% Email: /%14444-1/5114-r• 4 2--_ x License #:. OQO3Ss ® Lead Certificate #: /' i+7 - ,78 9eP V If the project is exempt from lead certification, please explain why:Blit `e4 /9,93 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: 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.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 approval of plans. Exterior work authorized by a building permit issued in accordance with the Minnesota State Buildin r +-amu jl . mpleted within 180 days of permit issuance.%/ /rd✓rr!v� x Jf r, n x Applicant's Printed Name Applic nt's Signature Page 1 of 3 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651) 675-5675 1 FAX: (651) 675-5694 buildinginspections(a-)cityofeagan.com r--------------------- I For Office Use I I (% / I I Building Permit #:� 0' lC I I I I I S&W Permit #: I 91. Permit Fee: 0 ' I I I I Date Received: I I I I I I Date Issued: I t- - - - - - - - - - - - - - - - - - - - - J RESIDENTIAL BUILDING PERMIT APPLICATION Date: 3h I el 12 Site Address: Applicant is: ❑ Owner aContractor Unit #: 1 Name: �GC t/� -} 0 o,/ e— CS I '23 C-2 C ► Ct_41 6 l/\� Homeowner Address: H&S Ai R yqV-- AIR City: kaQ0. ,'I10V�v Lv� Stater 1/R: 512-Z Phone: Email: Description of work: P,Q- C� Type of 1 Work Construction Cost, 2 19 of building: ❑ Single Family ❑ Townhome, of units J4,Twin Home Compan L Thy /-, Contact: Building Address:/LlPWQST T City:tr;cCPy-, le Contractor State ftkip:.55.3�T`� Phone6tZ-J'/5 EmaiICVtke�C Ae,,1j(- -6 ^ems` Ui O Z Cp License #: D =�l �r�C Expiration Date: Sewer & Company: Contact: Water Contractor Address: City: Required for State: Zip: Phone: Email: new construction License #: Expiration Date: [_I l 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 L are trade secrets. CALL BEFORE YOU DIG. Contact Gopher State One Call at (651) 454-0002 or www.gopherstateonecall.orq 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