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4449 Clover LaneCllyofEaaali 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink ForOfkoitkili Permit #.�-- Permit Fee: / 2,? • Date Received: Staff: Atl6 i- '1) 2010 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 3 — / -.'O/0 Site Address: 144 4` Cy c t o o -eir L a .ve_ Tenant: M ckPot3C -tet- S Suite #: RESIDENT / OWNER Name: Phone: Address / City / Zip: Applicant is: Owner Contractor TYPE OF WORK i 15Y/0 1 Description of work: e'i)t p (- Vr�b_P.c.k. (-IQ k't-k /0,e -cif Construction Cost, f 0 0 t') Multi -Family Building: (Yes / No ) CONTRACTOR Name: pr kc 61 e• , X,t) a . License #: X) 6330 7O`( Address: 1 Q C� (y- cA.) e ctft. City: C3 etk.be.c14, State: !'VUO Zip: SISPhone: 657- ?S? - 783 Contact: -...014..- k.: Email: \gz=. c .l e e..(C..Sby.Oa e. - Cork .\c)..tc COMPLETE In the last 12 months, has _Yes If yes, THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING the City of Eagan issued a permit fora similar plan based on a master plan? date and address of master plan: __No Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE: Plans and supporting documents the you augur* are considered to be public information. Portions of the inhumation may be classified as nonpublic ifyou provide specific reasons that would pear* the City to conclude that they we trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. CaII 48 hours before you intend to dig to receive locates of underground utilities. www.00pherstateonecall.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 approvof pans. Applicants Printed Name x mfg -x,, Aps Signature Page 1 of 2 Ci Ln DO NOT WRITE BELOW THIS LINE SUB TYPES Foundation Single Family Multi 01 of_Plex Accessory Building WORK TYPES New _ interior Improvement Move Building Fire Repair Repair Fireplace _ Gavage 4 Deck Lower Level Addidon Alteration Replace Retaining Wali DESCRIPTION Valuation a(20 Plan Review (25%_ 100% K) Census Code # of Units # of Buildings Type of Construction V REQUIRED INSPECTIONS Footings (New Building) _ Footings (Deck) Footings (Addition) Foundation Drain Tile _ Roof: Ice & Water Final _ Framing _ Fireplace: Rough In Air Test insulation Meter Size: Reviewed By: Porch (3 -Season) Porch (4 -Season) Porch (ScreeniGazebolPergoia) Pool Occupancy Code Edition Zoning Stories Square Feet Length Width Final Siding Reroof Windows _ Egress Window _ Storm Damage Exterior Alteration (Single Family) _i Exterior Alteration (Multi) Miscellaneous _ Demolish Building* Demolish Interim Demolish Foundation Water Damage *Demolition of entire building — give PCA handout to applicant MCES System 1.-0 ) k)) SAC Units City Water Booster Pump PRV Fire Sprinklers Sheetrock Final / C.O. Required y Final t No C.O. Required HVAC Other: Pool: Footings Air/Gas Tests Final Siding: Stucco Lath Stone Lath Brick Windows Retaining Wail: 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 ` ` it /0` o : ' O x( Page 2 of 2 ROBE L. jc/L(i/`(o UC -IL l / ENGINEERING CONSULTING ENGINEERS PLANNERS and LAND SURVEYORS COMPANY INC. 1000 EAST 146IA STREET, BURNSVILLE , MINNESOTA 55337 PH 432-3000 CeF'Lej ccuze 'e' `Z•- irey 24$a1 4cr#roZicn: LOTS 5,6, 7 AND 8, BLOCK 3, EDEN ADDITION, • DAKOTA COUNTY, MINNESOTA NORTH SCALE : 111= 30' `$73.K 1 DENOTES EXISTING ELEVATION (920.0) .DENOTES PROP05ED ELEVAT/ON —1"-- INDICATES DIRECTION - OF SURF/ CE DRAINAGE. 920.00-r FIN 15J-1ED 6,ARA6E FLdoR ELEVAT/oit! DRA!FJA uE ARID UTILITY EASEMENT ,&I 8P° 58` 02" E (9/7.0) /33.27 (92a.5"..) ( 92v.4) (4/6.s1/ CT) 52,00 O N 30' FRONT BUI LDif46 SETBACK L/NE (92o O 9!9 5...7°.(3.42,4-18. 34 U 0S*) L= 33.80 R. 9 N 89° 59' X02'' E i d = /O° I/' / d•Oo 4 L✓ 33.E PIii � ,.1.7°.CLOVER LANE • x,, - I hereby certify that this is a true and correct representation of a tract of land as shove' and described hereon.. As prepared by ma on this //sr... day of Novcr*,ae-R 119 es- . Ns, PROPOSED 4— UNIT o 1 0 o L--- 0 5UI LG �92I.7i173 .044. IMG 67 923.o co (9J of o / IU 89° 5$'o "f ---66.53 -- - (9/9.5) ) M v 1,,922.z) a LOT 7 fI1 i Minn. Reg. No,/ -'s CITY OF EAGAN 3830 Pilot Knob Road P. O. Pox 21199 Eagan, MN 55121 Zoning: Owner: Address: Site Address: WATER SERVICE PERMIT PERMIT NO.: DATE: No. of Units: 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 , , tk r Date Paid: Date of Insp..��-- z' Insp.: CITY OF EAGAN SEWER 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: I agree to comply with the City of Eagan Ordinances. Connection Charge: Account Deposit: Permit Fee: 8 Surcharge: Y Misc. Charges: Dote of Insp.: Total: Insp.: Date Paid: From:ALLSTAR CONSTRUCTION 19529427464 09/17/2013 08:33 #582 P.026/079 City of Eaall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use Permit#: ` 4)94 Permit Fee: 15 Date Received: Staff: 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 1 1512013 Site Address: 444114414 1 b L L.1401444 g cAoLev lC ntI Unit #: J Resident/ Owner Name: Eden i1D19 Cjb : Gassen Company Phone: Address / City / Zip: t1p ��/D ` 1 ,```� W CAI Y 1 t PQtY {t � Pr iti l MN 5S 3y1 / Applicant is: Owner Contractor Type of Work Description of work: Irsiv Of o►nol rt i'bO I - Construction Cost: tI1J $1D• Do Multi -Family Building: (Yes / No ) Contractor Company: Ilsity tIW1S yiAC lDn ManotgPjtnt Contact: CV, kialstead Address: 5Ii-is IncluSi11c4l &1TC&t 4t 103 City: Mot Plain p QPp State: MN Zip: 6c) Phone: -t ✓2 �' -I c -12- I` GLI License #: tel, O •J1S Lead Certificate #: NYiT - 20 -0 If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) In the last 12 months, Yes 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: Licensed Plumber: Phone: Mechanical Contractor: Sewer & 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 cojnpleted within 180 days of permit issuance. (jot IJs lcl Applicant's Printed Name x Appli" a is Signature Page 1 of 3 From:ALLSTAR CONSTRUCTION 19529427464 02/10/2016 13:03 #301 P.015/022 Date: City of Eagan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use Permit #: / TSCa° Permit Fee: Date Received: Staff: 2016 RESIDENTIAL BUILDING PERMIT APPLICATION ,24e 4 , Site Address: 1/1/4/1' 9999 ��✓G� � Unit*: Name: OldVA- i i et — 466'1 M7,4 Resident/ Owner Type of Work Contractor Phone: Address / City / Zip: 9997- WV, C% dtZ 1v rL- £4- S w I Applicant is: Owner x Contractor Description of work: Construction Cost: 4$I010dd A'rk- W,r% t4»y/ 5:0'eri4'- Z/cebil-ed s44 42119= Multi -Family/ Building: (Yes/ No _) Company: ,QllstE44. 644e. 44;g44 f ��jil/tCeContact: V'WI 1114'n sk-r7 Address: C/ 04 6 1 n14S4-telt 1 S77. sr.Q rf-t /0 3 City: Mirk ; State: OW Zip: 56369 Phone:q0-90-7 6q Email: ./%/4 //s-/ Lieense #: &403S 0 Lead Certificate ft: A/IQ'% 070 9t/ 7 gsg If the project is exempt from lead certification, please explain why: ujur . ;. /983 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 8, 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 1 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 authorised by a building permit issued in accordance with the Minnesota State Buildin ompleted within 180 days of permit Issuance. x EhlctV Applicant's Printed Name Applic nt's Signature Page 1 of 3 EAGAN 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651) 675-5675 I TDD: (651) 454-8535 I FAX: (651) 675-5694 Email: buildinoinspections(a.citvofeaoan.com Commercial Plan Submittal: eolans a.citvofeaoan.com For Office Used Permit #: //Oa Permit Fee: C=> - 6 b Date Received: Staff: 2020 RESIDENTIAL MECHANICAL PERMIT APPLICATION Date: 07/29/2020 Site Address: 4449 Clover Lane J Tenant: Suite #: Name: Margaret Smith Phone: 952-826-9358 Address / City / Zip: 4449 Clover Lane, Eagan, MN 55122 Name: Ungerman Inc License #: MB765296 Address: 14000 21 st Ave N City: Plymouth State: MN Zip: 55447 Phone: 612-825-2800 Contact: Leif Tharaldson RESIDENTIAL Fumace Air Conditioner Air Exchanger Heat Pump ✓ other Gln,<s Q Vv rTr j�arc as n ej clue 10 -Lte. Jew,A1.e. Email: info@ungerman.net New ✓ Replacement Additional Alteration Demolition Description of work: Class B venting repairs as needed due to fire damage. (-6 RESIDENTIAL FEES $60.00 Minimum Add or alteration to an existing unit, includes State Surcharge $100.00 Residential New, includes State Surcharge = $ TOTAL FEE You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeagan.com/subscribe. 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 Hannah Thompson - Production Coord. - Ungerman Inc Applicant's Printed Name x As Signature FOR OFFICE'USE Required Inspections: Reviewed'By:, Underground , Rough In Air Test -;Gas Service Test In -floor Heat -'Finn EAGAN 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651) 675-5675 I TDD: (651) 454-8535 l FAX: (651) 675-5694 buildingi nspectionsacitvofeaaan. com r For Office Use -^-� Permit #: /1' 4` e/6 Permit Fee: - `' v Date Received: Staff: 2020 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: 07/29/2020 Site Address: 4449 Clover Lane Tenant: Suite #: Resident/Owner Name: Margaret Smith Phone: 952-826-9358 Address /city /zip: 4449 Clover Lane, Eagan, MN 55122 Contractor Name: Ungerman Inc License #: PC765280 Address: 14000 21 st Ave N City: Plymouth State: MN Zip: 5544 7 Phone: 612-825-2800 Contact: Leif Tharaldson Email: info@ungerman.net Type of Work New Replacement ✓ Repair Rebuild Modify Space — Work in R.O.W. — — _ _ Description of work: Replace exsisting 1 piece bathtub and vertical PVC piping through the roof. DesCri tlOn P Tankless Water Heater Lawn Irrigation ( RPZ / PVB) — Standard Water Heater V Add Plumbing Fixtures ( Main / Lower Level) Water Softener PVC Replace bathtub and vertical piping Description: Septic System Connection to City Water from Well New _ Abandonment RESIDENTIAL FEES $60.00 Water Heater, $60.00 Lawn Irrigation $60.00 New fixtures, $60.00 Septic System $100.00 New Residential $115.00 New Septic $60.00 Connecting to *Sewer & Water Water Softener, or Water Heater and Softener (includes State Surcharge) (includes State Surcharge) adding or removing piping (includes State Surcharge) Abandonment (fee collected with Building Permit) System (includes County fee and State Surcharge) City Water from Well* + $290 for Meter and $200 for Radio Read = $550 Permit also required for connection charges TOTAL FEES $ 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.00pherstateonecall.orq You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeagan.com/subscribe. hereby acknowledge that this information Is complete and accurate; that the work will be In conformance wlth 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 p1=ns. x Hannah Thompson - Production Coord. - Ungerman Inc. Applicant's Printed Name Ap Icant's Signature Page 1 of 2 PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA173907 Date Issued:12/13/2021 Permit Category:ePermit Site Address: 4449 Clover Lane Lot:6 Block: 03 Addition: Eden PID:10-22750-03-060 Use: Description: Sub Type:Residential Work Type:Replace Description:Standard Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087 Surcharge-Fixed $1.00 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 - Margaret C Smith 4449 Clover Ln Unit A Saint Paul MN 55122--243 Champion Plumbing 3670 Dodd Rd., #100 Eagan MN 55123 (651) 365-1340 Applicant/Permitee: Signature Issued By: Signature ®;1e I r i � E AGA N 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651) 675-5675 1 FAX: (651) 675-5694 buildinginspections(a)cityofeagan.com --------------I r For Office Use I I Building Permit #: �Y,��U� �✓ I I S&W Permit #: I I I Permit Fee: I I I 1 I Date Received: I I I I I I Date Issued: I---------------------J RESIDENTIAL BUILDING PERMIT APPLICATION Date: qhQ23Site Address: Applicant is: ❑ Owner Contractor Homeowner f Type of Work Building Contractor Sewer & Water Contractor Unit #: Name: �GC � t/� (7 V\/�,Z C� .� 11�¢.y� S / 45t s e' C' c 4 l 6 l/� Address: q t City: �aa OL v,-, Statel—Mip: 3512 2 Phone: Email: Description of work: P� QQ C. t - Construction Cost of building: ❑ Single Family ❑ Townhome, of units Twin Home Compan j?Q Mt'c.LC_ (�\lam Contact: �" `�' l/l Address/ r�1 W SSTy City: State: Lip: 553IVT Phone6t z-J7 5 EmaiI- AmeQ C '�� 9� fi o z �� 3% 3// `�' License #: � O Expiration Date: Company: Address: Required for State new construction Zip: Phone: Contact: Email: License #: Expiration Date: City: ylzl�I 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. av L\< — Applicant's Printed Name A licant's Signature