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
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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