4419 Clover Lane BYip
40111 C!tyofEaau
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
's r: VE
MAYQg2011
Use BLUE or BLACK Ink
dr tie tise
Permit #: 1 q 7;
Permit Fee:
'O. cb
Date Received:
Staff:
2010 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: "} // Site Address: L/�/( E Clover L 6-610D
Tenant: Suite #:
RESIDENT / OWNER
Name: 5C 6-11- SC /`1 U. i f �. Phone: (06/ 63 lOd'7
Address / City / Zip: LI `� d -/�/� c /aver L a "...f2Applicant
is: Owner 1`� Contractor 4 s ijf en n do ws
w;
TYPE OF WORK
I
Description of work: -. 'I O. pa4 j o d DO ; � -e i's 41 r O�n,
Construction Cost: t `! % 0 1 Multi Family Building: (Yes / No )
CONTRACTOR
Name:1 Cm y `t License* (a-aLj 9
Address: ''9iq/ o L- rt r
c /1L/ Cirty: e ,
4
!
State: r l Zip: 1 Phone: 1 9,:, d Nos,
Contact: 100.- 2) Email:
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 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.
x a n cy m7 e 5 i i1
Applicant's Print d Name
x
Applicant's Sig re
Page of 2
41111` City
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
Permit #:
Permit Fee: •
Date Received:
(� % 2010 MECHANICAL PERMIT
�`
A�PPLIATION
Date: _ r 1 4 ! / 0 Site Address: 44161 — ! / - OD V 11-1
.
Tenant
Suite #:
RESIDENT / OWNER
�-�
Name. e --1/) Phone: 1012-`66:F6ed
Address /City / Zip: 441q '- / - clov'trip
/.Zi
CONTRACTOR
Name: 51,Lu r _ .
l
Address: iZ W • `� ` City:
1
State: / ►fl Zip: , Phone: �2 -4,---7-0-i./
Contact: _, ( !Y 1'� Email:
TYPE OF WORK
New N Replacement Additional Alteration Demolition
Description of work:
NOTE: and grorin mount ed mpeci>aii arl equiprir rlt Is required to Dae acrbsned by City
Owe. tine Mfikal lnspecterr for!i rhlsl an screening ttreth .
PERMlT TYPE
RESIDENTIAL
y ---Furnace
Air Conditioner
Air Exchanger
COMMERCIAL
-____ New Construction _,_ interior
Improvement
HVAC Unit
/ _ Remove)
for inspection by Fire
install Piping Processed
_ _ ...._...
— Gas Exterior
Heat Pump`
.„_
Under / Above ground Tank ( Install
_
— (cher
"When installing/removing tank(s), cal
Marshal and Plumbing Inspector
RESIDENTIAL FEES:
555.00 Minimum Add-on
or alteration to an existing unit (includes
burned out app noes, ductwork, etc.) (indudes
$5.00 State Surcharge)
$5.00 State Surcharge) $ L. • "" TOTAL FEE
595.00 Fire repair (replace
COMMERCIAL FEES:
575.00 Underground tank
$55.00 Minimum (includes
installation/removal OR
State Surcharge)
$10,010, surcharge is $ 5.00
surcharge increases by $.50 for each $1,000 Permit
.Fee requires a 5 5-50 surcharge)
Contract Value $, x 1%
$ Permit Fee
- if the Eggag,g is less than
Fee = $ Surcharge
• If the Permit ate is > $10,010,
0.e. a $10,01“11,010 PenNt
= $ TOTAL FEE
CALL BEFORE YOU PIG. CaU Gopher State One Cali at {661)454-0002 for protection against underground utility damage. Cali 48 hours
before you intend to dig to receive locates of underground utilities. www.00pherstateonecali.org
I hereby acknowledge that this information is complete and accrate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is nota permit, but only an application fora permit, and work is not to start without a . rmi • that the work will be in accordance
the approved plan in se of work which requires a review and approval of
7
Rough In Air Test _Gas
-,:.
Exterior HVAC Screening inspection
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.
1 agree to comply with the City of Eagan Surcharge.
Ordinances. Misc. Charges.
Total:
By A A - � Date Paid.
Dote of Insp.: Insp •
o
CITY OF EAGAN
3830 Pilot Knob Road
P. O.@ox" 21199
Eagan, MN 55121
Zoning:
SEWER SERVICE PERMIT
PERMIT NO.:
DATE:
Owner: No. of Units:
Address:
Site Address:
Plumber:
1 agree to comply with the City of Eagan Connection Charge:
Ordinances. Account Deposit:
Permit Fee:
8 Surcharge:
Y Misc. Charges:
Date of Insp.:
Total:
Insp.:
Date Paid:
From:ALLSTAR CONSTRUCTION 19529427464 09/17/2013 08:38 #582 P.041/079
C!tyofaall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use (�
Permit#: (l 1O3
Permit Fee: ✓' 5
Date Received: Gt kill tJ
Staff:
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 9I5!2D13 Site Address: L►`in iLiLil 16Cloyed( Lane/ Unit #:
J
Resident/
Owner
Name: tdein blq CIO . CIOKcth COrnDafy Phone:
Address / CRy / Zip: �t-i3 D G Y Y�J� PQrkwav, ec i Prairie, M ti I
3LH
Applicant is: Owner X Contractor I
1 Type of Work
1
Description of work: �Qli Off g re -not
n1t y
Construction Cost: 4 f ($�JO.Ot Multi -Family Building: (Yes X./ No
)
Contractor
e
Company: Oar to t l', i l ur f^ Mpro � Contact: (bt, ts-tectd
,
Address: SIMS ,t IGt AD11 I(Al 1 ee-T 41153 City: Maple, PM()
State: MN Zip: Jj CFA -Phone: "- CILI /-1L19-1
License #: 6k .D3)S13 Lead Certificate #: NWT— 2.O 1PLf -D
t'
If the project is exempt
from lead certification, please explain why: (see Page 3 for additional information)
rICOMPLETE
n the last 12 months,
If
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 _No
Licensed Plumber: Phone:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
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.4_
CALL BEFORE YOU DIG. Call Gopher State One CaU 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.aooherstateonecall.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 authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
IIS*
Applicant's Printed Name
Ap i ant's Sign ture
Page 1 of 3
41111
C!tyofEaali
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
r
Use BLUE or BLACK Ink
For Office Use 111(7.1A
rPermit #: / Z6/ / V
Permit Fee: 6 0 ` 0 L
Date Received:
Staff:
2015 RESIDENTIAL�PLUMBING PERMIT APPLICATION
Date: wit /4)pL Site Address: "r ckver Lao e '� '
Tenant:
Suite #:
^ -S'c('ILftt2. ‘/J----‘/J---Y
0'� Phone:
Name:G'
Address / City / Zip: 91/1f -4 eJ0/...er 4-1.4f) g ?? M 4 `S! 2
Name: W2-4dC, Lsi COA Cep S O) License #:
Address: OG``M •re r City: Pa (t1
* Ct91' f
State: f01 Zip: 5.616 E7 Phone:
7 9
Contact: r 2 Email:
. New X' Replacement Repair Rebuild Modify Space Work in R.O.W.
_ _ _
��j "� j[ may/ _
p e_T' r / [4tc� 61 Cl"'
Description of work: ��
RESIDENTIAL
Water Heater
Water Softener
Lawn Irrigation (_ RPZ / PVB)
Add Plumbing Fixtures (_ Main / Lower Level)
_
Septic System
_
Water Turnaround
_New
Abandonment
RESIDENTIAL FEES:
$60.00 Water Heater, Water Softener, or Water Heater and Softener
(includes State Surcharge)
Turnaround* (includes State Surcharge)
TOTAL FEES $
$60.00 Lawn Irrigation (includes State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment, Water
*Water Turnaround (add $280.00 if a 3/4" meter is required)
$115.00 Septic System New (includes County fee and State Surcharge)
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.gopherstateonecall.org
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.
Applicant'siPrinted Na
nspec ns:
ted Items Mete
r..
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
r
Use BLUE or BLACK Ink
For Office Use
Permit#: 7067q -S-(',
Permit Fee:
Date Received:
Staff:
2016 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit #:
e x
Name: ``�i- 1 -- S 4. -� pk<6 S6(o[�
' �G +A,' Phone:l.P�Z
Address / City / Zip: V IA- lq 6 C l ootit (.N6%H--A //YYl 56/Z_ -z --
Applicant is: Owner Contractor
Ty ®•Wor
Description of work: p1act_ jc, 5,17 PA -Art v e .4.>11. is gi n & cii p .,,,» -
Construction Cost: Multi -Family Building: No )
li�trattor�
Company: W )\N, 6 o rJ l orc'..ep 4S YY\ Contact: t. Sa
Address: dc'(1 7:::rA- '.1--- City: ..t r c,.1
State: t. Zip: 66) CY Phone: (pjj -9O5-016Smail: ,wo0-06nc,pp)d,C�•''1
License #:. kL.0?,rci.3 Lead Certificate #: J N --c" - a3"1 -1e, -- -7---
If
If the project is exempt from lead certification, please explain why:
In the last 12 months,
Yes No
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
ti
has the City of Eagan issued a permit for a similar plan based on a master plan?
If yes, date and address of master plan:
Licensed Plumber:
Mechanical Contractor:
Sewer & Water Contractor:
Fire Suppression Contractor:
Phone:
Phone:
Phone:
Phone:
NOT Flan lnd Supporting B • tints t ,® br»ft are consid* red public information - • o s
theinformation may e clan sed asw t epic rf ou provide specific • seat would ' C!t„�.
ude tll� ` ' ar£ traa�e S� ► :.~K y }
f
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 Building Code must be completed within 180
days of permit issuance.
0 oktP_a4
Ai6 11c nt's Printed Name
nt's Signature
Page 1 of 3
LlUleocutLn
SUB TYPES
Foundation
Single Family
Multi
01 ofYPlex
WORK TYPES
SDC NOT WRITE BELOW THIS LINE
Fireplace
Garage
Deck
Lower Level
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
101
7-3
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation
Roof: _Ice & Water
Framing 30 Minutes _
Fireplace: _Rough In
insulation
Sheathing
Sheetrock
Fire Walls
Braced Walls
Shower Pan
Reviewed By:
Final
1 Hour
Air Test
Porch
Porch
Porch
Pool
(3 -Season)
(4 -Season)
(Screen/Gazebo/Pergola)
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
Final
RESIDENTIAL FE
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
73 7-r-
it?e�
Siding
Reroof
Windows
Egress Window
Exterior Alteration (Single Family)
Exterior Alteration (Multi)
Miscellaneous
Accessory Building
Demolish Building*
Demolish Interior
Demolish Foundation
Water Damage
*Demolition of entire building - give PCA handout to applicant
std?c,-1
%d1y
MCES System
SAC Units
Pd City Water
Booster Pump
PRV
Fire Suppression Required
Meter Size:
Final / C.O. Required
Final / No C.O. Required
HVAC Gas Service Test Gas Line Air Test
Air/Gas Tests
Pool: _Footings Final
Drain Tile
Siding: Stucco Lath _Stone Lath _Brick
Windows
Retaining Wall: Footings _ Backfill _ Final
Radon Control
Fire Suppression: _Rough In _Final
Erosion Control
Other:
, Building Inspector
Page 2 of 3
RECEINTr-
WV 2 0 1-‘.111
3830 Pilot Knob Road 1 Eagan MN 55122
Phone: (651) 675-5675 1 buildinginspectionsPcitvofeattan.com
Use BLUE or BLACK Ink
For Office Use
Permit #:
Permit Fee:
1
Date Received: 111
Staff:
2017 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: 1 1-2" 7 Site Address: 4419 B Clover Lane
SchultzTenant:
Resident/Owner
Contractor
Type ofWork
Permit Type
Suite #:
Name: Phone:
Address / City /
Name: Northern Mechanical Contractors License #: PC645358
Address: 1975 Seneca Road Eagan
City:
State MN Zip. 55122 Phone: 651-789-2275
Contact: John Hanson
johnh@northemmc.com
New / Replacement Repair Rebuild Modify Space Work in R 0 w
Description of work: Replace bath tub with tub/shower.
RESIDENTIAL
Water Heater
Lawn Irrigation ( RPZ PVB)
Septic System
New
Abandonment
Water Softener
Add Plumbing Fixtures ( Main / Lower Level)
Water Turnaround
RESIDENTIAL FEES:
$60.00 Water Heater, Water Softener, or Water Heater and Softener (includes State Surcharge)
$60.00 Lawn Irrigation (includes State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes State Surcharge)
*Water Turnaround (add $280.00 if a 3/4" meter is required)
$115.00 Septic System New (includes County fee and State Surcharge)
TOTAL FEES $
CALL BEFORE YOU DIG. Call Gopher State One Cali at (651) 454-0002 for protection against underground utility darnage. Call 48 hours before you
intend to dig to receive locates of underground utilities. www.000herstateonecali 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.citvoteaean.comfsubscribe.
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 no sta 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 pla
x John Hanson
Applicant's Printed Name
x
Appli n $ Signature
FOR OFFICE USE Reviewed By: Date:
Required Inspections: Under Ground Rough -In Air Test Gas Test Final
Meter Related Items: Meter Size Radio Read Manometer Staff:
WINDOW
CONCEPTS 2
0f ltlinnesota, Inc
Eva Street St. Paul, MN
To: City of Eagan — Building Inspections
Regarding: 4419 Clover Ln
Permit Number: 136187
107 Office. 65
905-0105 Fax 651-905-1745
01/07/2019
I am writing to cancel the plumbing permit we pulled on this address. The job has been
completed by a different company.
After installation, the home owner hired a different company to fix some corrections needed.
The permits that the other companies pulled have been closed out. Jeff Wheeler told me that based on
the notes, the companies hired after us completed the work we started. Jeff advised me to write a letter
requesting our permit be cancelled.
There is also a building permit open under this address. Jeff confirmed that an inspections still
needs to be completed to close this out. So far, the home owner has refused to schedule an inspection,
but our efforts remain.
Please contact me directly with any questions or concerns.
Thanks,
Heather DeBoer
Administrative Assistant
651-604-8260
® 4 e f
®®®lie
E AG A N
�P
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
(651) 675-5675 1 FAX: (651) 675-5694
buildinginspections(c)cityofeagan.com
--------------
For Office Use
I Building Permit #:
I I
I I
S&W Permit #:
I I
I
I Permit Fee: I
I I
I
Date Received:
I I
I I
I Date Issued:
t----------------------
RESIDENTIAL BUILDING PERMIT APPLICATION
Date:,yhql
Site Address: Unit #:
Applicant is: ❑ Owner KContractor
Name: E?z sA �A b V1�2 O k ---I U-42-N17 S taS"S C�;l C I CX,4 k 6 l/-\�
Homeowner Address: l 1 City: �c Ct 0—
V�
State:% V�Lip: 50Z Phone: 16Vai
Description of work:t-
Type of
Work Construction Cost a t , -V
Type of building: ❑ Single Family ❑ Townhome, of units JRTwin Home
Compan 3QM l/J!SE&jt'c,lr✓ n\lam Contact:
Building Address � � (_. i1'�1 VJ T {�—City:G(�f;�Y\
Contractor 1/�
State:Lip: 553��Phone�o�z�7Email. a/ylQ.�[ �e � R5q(
�/ OZCa( �O
License #:EC T (� Expiration Date: .3C 2 ��
Sewer &
Water
Contractor
Required for
new construction
Company:
Address:
State: Zip:
i License #:
Phone:
Contact:
City:
Email:
Date:
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. Al
x
Applicant's Printed Name A licant's Signature