4466 Clover Lane B4,111111ty ofBalan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
LIUI. _ 1 '
Use BLUE or BLACK Ink
ForOttleettee
Permit #.
Permit Fee: ' 69
Date Received:
Staff:
2010 RESIDENTIAL BUILDING PERMIT APPLICATION Clg11
Date: 7 .*/ -A)/0 Site Address: A/4/6 cel 41 Ct (o u Lp
Tenant:
-I
Suite #:
RESIDENT I OWNER
Name: Phone:
Address I City 1 Zip:
Applicant is: Owner Contractor
TYPE OF WORK
{'� 8'Sc ie
Description of work: j gy p^ i ckC p 0 k 6 b_t� e k't- k �ti or ck.
Construction Cost, i,,9 0 C7 Multi -Family Building: (Yes I No )
CONTRACTOR
Name: 1>P._c cs. 6-7 e.. j c . License #: X Cc. 30 7O`f
Address: IGl.%S Ka--eoc) f" Lia City: M rttr. i%.c
State: l ' Ut1 Zip: S S' J 9' Phone: 6 51- 75-1 — -7 3T
Contact: S'te�.c kJ Email: c )ectc s1 e. - G'0,^-1
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 n Portions of
the information may be classified as non-public If you provide specific reasons that would permit the ter to
conclude that they we 'brie 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.pooherstateonecall.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 approv - , of pans.
x -•-3�2 _ SA-ccc 1'O
Applicant's Printed Name
s Signature
Page 1 of 2
1
n62l0 Nou.6 Ln
DO NOT WRITE BELOW THIS LINE
g5/
SUB TYPES
Foundation
Single Family
Multi
01 of Plex
Accessory Building
Fireplace
Garage
Deck
Lower Level
Porch (3 -Season)
Porch (4 -Season)
_ Porch (Screen/Gazebo/Pergola)
Pool
WORK TYPES
_ New _ Interior Improvement
Addition _ Move Building
Alteration Fire Repair
Replace Repair
Retaining Wall
DESCRIPTION
Valuation
Plan Review
(25%_ 100%
Census Code
# of Units
# of Buildings
Type of Construction
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation
Drain Tile
Roof: Ice & Water _Final
Framing
Fireplace: _Rough In Air Test Final
Insulation
Meter Size:
Reviewed By:
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
Ro
to
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Sprinklers
Sheetrock
Final / C.O. Required
Final / No C.O. Required
HVAC
Other:
Pool: _Footings
Siding: Stucco
Windows
Retaining Wall: _ Footings Backfill
Radon Control
Erosion Control
, Building Inspector
Air/Gas Tests Final
Lath _Stone Lath Brick
Final
RESIDENTIAL FE
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
73 '=
/dZCv °LP
Page 2 of 3
l6(7 C(o
ROBE ,
ENGINEERING `PLANNERS aAENGINEERS,URVEYORS
COMPANY INC.
1000 EAST 1461h STREET, BURNSVILLE, MINNESOTA 55337 PH 432-3000
Cert i 'i cc 1 u'ur-y-� �c
2,45fat _Ow cr4,ro2zon: LOTS I;2,3, AND 4, BLOCK 2, EDEN ADDITION)
• DAKOTP, coutTY, MINNESOTA
i2?�•1 ) DENOTES EXISTING
ELEVATION
( 921.5) DENOTES • PROPOSED ELEVATION
'�-- INDICATES DIRECTION of SURFACE. DRAINAGE
NIS1-IED 642AGE FLOOR CLEV 77O/I
�aky
NORTHfATE
SCALE : I"= 30'
!• 4
0
DRAINAGE ALIO
UTILITY EASEMENT •
30' FRONT 5UILDIMG
SETBACK LINE
N)
q0 4-
4.
REVFEWED
BY
>30
/ S8 qo
°i' 5-8„(9240
w
TIONS DIVISION
I hereby certify that this is a true and correct
land as shown' and described hereon.. As prepared
NOvemBER , 19 85 .
1064
paoK•
representation of a tract of
by me on this Isr day of
z.� nn. Reg. No. /r
CITY OF EAGAN
3830 Pilot Knob Road
P. O: Box 21199
Eagan, MN 55121
WATER SERVICE PERMIT
PERMIT NO •
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.
Dote Paid.
lnsp •
By
Date of I nsp.: /24-; 15"
CITY OF EAGAN SEWER SERVICE PERMIT
3830 Pilot (Knob Road
P. a 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 Connection Charge•
Ordinances. Account Deposit -
Permit Fee•
Surcharge•
By Misc. Charges•
Date of Insp • Total•
lnsp • Date Paid•
City of Eagan
PERMIT
City of Eaan
Permit Type: Plumbing
Permit Number: EA109468
Date Issued: 03/13/2013
Permit Category: ePermit
Site Address: 4466 Clover Lane B
Lot: 3 Block: 02 Addition: Eden
PID: 10-22750-02-030
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.
Deb Larson
8815 209th St
Lakeville, MN 55044
Fee Summary:
PL - Permit Fee (WS &/or WH) $55.00
Surcharge -Fixed $5.00
0801.4087
9001.2195
Total: $60.00
Contractor:
Drain Pro Plumbing
8815 - 209th Street W
Lakeville MN 55044
(952) 469-6999
- Applicant -
Owner:
Stephen Oslos
4466 Clover Ln Unit B
Eagan MN 55122
(612) 804-9456
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Applicant/Permitee: Signature
Issued By: Signature
From:ALLSTAR CONSTRUCTION 19529427464 09/17/2013 08:48 #582 P.065/079
City of EaRau
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit #: I it -1W)-
( I j �C
Permit Fee:
31 75
Date Received: a l flit 3
Staff:
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
J
Date: q IIo) WI3 Site Address: 44U4 4yV-i Bi L 41$p1.44Io1PB Cho Lane, Unit #:
Resident
Owner
Name: ei it 1 D CJo . (1QSSt,In Company Phone:
,`
Address / City / Zip: OL4 1c ( CI�Ndi Pa CAN
V E��1 IY 1t ( IAN ;CJ�4
t
X
Applicant is: Owner /� Contractor
Type of Work
Description of work: -Rail offgridre-roof
Construction Cost: $ hD100. bb Multi -Family Building. (Yes _.L1_ / No _)
Contractor
Company: , tVil bimAntalfyx Vtimoppent, UL Contact: Lg. kkalMd
, Address: 5I I mitdri at J 11 U.1 # tO3 City: Ma'l �j l n
Y� `�"
State: MN Zip: e352I Phone: "I�a2' "1a'c1 Z" iy'
^7y
License #: bcJP3I 19 Lead Certificate #: NPT— Gtl91.0
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:
NOTE Plans and
the information
Phone:
Phone:
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.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.
I'11/1lsthad
Applicant's Printed Name
x
cant's Signature
Page 1 of 3
City of Eagan
PERMIT
City of Eaan
Permit Type: Plumbing
Permit Number: EA109468
Date Issued: 03/13/2013
Permit Category: ePermit
Site Address: 4466 Clover Lane B
Lot: 3 Block: 02 Addition: Eden
PID: 10-22750-02-030
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.
Deb Larson
8815 209th St
Lakeville, MN 55044
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:
Stephen Oslos
4466 Clover Ln Unit B
Eagan MN 55122
(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 13:06 #301 P.019/022
City of Earn
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 6755675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit #:
Permit Fee:
Date Received:
Staff:
J
2016 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: °74 // Site Address: `��Ci 4' VV€i(r avow- t- �YhL Unit fl A vj
...,.........,.:...,:::,...,..,�._......_..:.,,.:......................:..
Resident/
Owner
Type of Work
Contractor
Name: ,r/ Atif,4 /7"i &Lt. - £.1ZEi� NO4
Address / City/ Zip: Y945/ Of to& e/O✓pZ- Lie
Applicant is:
Owner ii Contractor
Phone:
Description of work: /SS -J2% W/7 bin // /,(75.- I'ar# 1 4.144d11 Q4 )y
Construction Cost .'..,OGd Multi Family Building: (Yesi No )
Company: A il54 A2 lett 4;04 J ffitharuwn Ce Contact: Ji 'an A dern A1-2
Address: Sr 4S Indus -1-r; n I r- 5;4,=>*' E /0� 3 City: /No.- PL.
State: /71/4 Zip: 56369 Phone:Ta.+4 '7457 Email: i%7444//S- r". �.. .
License #: (, o 3S io Lead Certificate #: iti/14 7 do 9[e V - gsg
If the project is exempt from lead certification, please explain why: i ur. � 1993
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:
Phone:
Sewer & Water Contractor: Phone:
Fire Suppression Contractor. Phone:
Mechanical Contractor:
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 Cali at (951) 454 0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.og
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 . • mpieted within 150
days of permit issuance.
x CJI r M1Ernao 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(@cityofeagan.com
--------------
For Office Use I
I n I
I Building Permit #: I 0
I I
S&W Permit #: I
I I
Permit Fee:
I I
I I
I Date Received: I
I I
I Date Issued: I
I
t----------------------j
RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit #:
Applicant is: ❑ Owner Contractor
Name: EGLs/� �4 o t/x-A-e— 0 y, U-__,,f ja5.s cz, a I OL4
Homeowner Address:law its gque u" /-I, City: �aaa
Phone: Email:
Description of work: P, e Q G bh-
Type of Q
Work Construction Cost:)
Building
Contractor
Type of building: ❑ Single Family ❑ Townhome, of units Twin Home
Compan)Thy �t h cl C_\lam Contact:
Address: Li�� I' rJ & W QST 1-k\y City: j4;- -GLPV_,�
State: Lip: 553�T Phone6tZ Emailia/V12 �[ �e� CSN`eo``�Q°��^
License #: t D -7r-K ) Expiration Date:
Sewer & Company:
Water
Contractor Address:
Required for State: _
new construction
Zip: Phone:
Contact:
Email:
License #: _Expiration Date:
City:
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.aopherstateonecall.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.
Applicant's Printed Name A licant's Signature