EA180824 - Building - Single Fam - Issued Date 01/23/2023�_ UV I.I 1
City of Eagan Permit Type: Building
3830 Pilot Knob Rd Permit Number: EA180824
Eagan, MN 55122 ®• EAGAN
(651) 675-5675
111111111111
www.cityofeagan.com E R 1 8 0 8 2 4
Site Address: 4175 Pond Wynde S
Lot: 5 Block: 2 Addition: Deerwood Ponds
PID: 10-19975-02-050
Use:
Date Issued: 1/23/2023
* 1 0— 1 9 9 7 5— 0 2— 0 5 0
Description:
Sub Type: Single Fain Construction Type: V -B
Work Type: Alteration
Description: Master Bathroom
Census Code: 434 - Residential Additions, Alterations Occupancy: IRC -1
Zoning: R-1
Square Feet: 0
Comments: Improvements to the home may require smoke detectors in all bedrooms.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota
State Building Code).
Fee Summary: BL - Base Fee $116.60 0801.4085
BL - Plan Review 65% $75.79 0720.4222
Valuation: 3,150.00 Surcharge - Based on Valuation $2.00 9001.2195
Total: $194.39
Contractor: - Applicant - Owner:
J3 Renovations and Design LLC William C & Shelley K Tstes Doneshefsky
21420 Larkin Rd 4175 Pond Wynde S
Hamel MN 55340 Eagan MN 55122
(612)812-4098
This permit shall be null and void if work does not start within 180 days of issuance, or if work is suspended for 180 days or more after
started.
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
ssued B : Signature
4 0 ® t
Applicant is: ❑
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9®®• e�00
EAG
rErp
Bill Doneshefdky o -VI'
Name:
Homeowner
3830 PILOT KNOB ROAD I EAGAN, MN 551
(651) 675-56751 FAX: (651) 675-5684
build inainspections0citvofeaaan. com
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For Office Use
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I Building Permit #:
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j S&W Permit #: 9
Permit Feer 1 L� ` , 1
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Date Received: I
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I Date Issued: l
I ---------------------J
RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 12-28-22 Site Address: 4175 Pond Wynde S. Unit #:
Applicant is: ❑
Owner � Contractor aot
rErp
Bill Doneshefdky o -VI'
Name:
Homeowner
4175 Pond Wynde S. City: Eagan
Address: ty:
State: MN Zip: 55122 Phone: 651-261-97 " Email: bllldaky@aOI.COm
777
Description of work: master bathroom
'type of
Cost: 30,000.00
work,"Construction
Type of building: Single Family ❑ Townhome, of units ❑Twin Home
Company: J3 Renovation 8r Design Contact: Jerry
Building
Address: 21420 Larkin Road City: Corcoran
Contractor
MN 55340 612-812-40jerry@j3renovationmn.com
ry��
State: Zip: Phone: Email.
77777
License #: BC583780 Ex iration Date: 3/31/24
Sewer -,t
Company: Contact:
Water
ionure'#fir ';
Address: City:
Required for
State: Zip: Phone: Email:
nsw constru bri
License #: Expiration 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
informatldn ,txtay be classltied ae natt�publi;.I#you °provide spciflceesans=that would pernrit the,pty to t~dnciude that the' ,
aretrade secrets.
CALL BEFORE YOU DIG. Contact Gopher State One Call at (651) 454-0002 or www.aooherstateonecall.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
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
accordance with the approved plan In the case of work which requires a review and approval of plans.
Jerry Ziemiecki'D9'0'ysigned byJerry Zlemiedd
derry Ziemiecki X t��:z°zz.'2.3°os:°'.25 os'°°'
Applicant's Printed Name Applicant's Signature
REQUIRED INSPECTIONS
Footings: New Addition Deck
Foundation: Before Backfill Poured Wall
i/ Framing: 1 Hour vGResidential Alteration
Braced Wall Framing/Blocking
Braced Wall Sheathing (prior to house wrap)
Interior Braced Wall Panel(s)
Firewalls
Insulation
Fireplace: _Rough In _Air Test _Final
HVAC: Rough In Final
Radon Control
Drain Tile
Meter Size:
Siding: _Stucco Lath _Stone Lath _Brick
Roof: _Ice & Water _Final
Erosion Control
Pool: _Footings —Air/Gas Tests _Final
Retaining Wall: _Footings _Backfill _Final
Fire Suppression: _Rough In _Final
Windows
Other:
a/ Final/No C.O. Required
Final/C.O. Required
Reviewed By: •/Ve/s®~- , Building Inspector
FEES
Calculated Valuation
Base Fee
Plan Review
State Surcharge
Met Council SAC
City SAC
Treatment Plant
Water Supply & Storage
SSW Permit & Surcharge
Meter
Radio Read
Other:
TOTAL $ 0.00
FOR uQ�F�GErUSE ONL�i
Site Address: 4175 Pond Wynde S.
Permit #: /(506,2g
SUB TYPES
„/Single Family
_ Fireplace
_ Lower Level
01 of _ Plex
_ Foundation
_ Porch
Deck
_ Garage
_ Pool
WORK TYPES
New
_ Repair
_ Siding
_ Retaining Wall
_ Addition
_ Fire Repair
_ Reroof
_ Move Building
Alteration
_ Water Damage
_ Windows
_ Demolish Building*
Replace
_ Egress Window
_ Solar
*Demolition of entire building - give PCA
handout to applicant
DESCRIPTION
Calculated Valuation
3� IS -c7
Occupancy TRC
MCES System
Pian Review
1725%100%
Code Edition _J-JVRC-gcjQo
SAC Units
Census Code
Zoning a-)
City Water
# of Units
Stories
Booster Pump
# of Buildings
Square Feet
PRV
Type of Construction
Vj!.j,
Fire Suppression Required
Separate Stormwater Management Permit Required
REQUIRED INSPECTIONS
Footings: New Addition Deck
Foundation: Before Backfill Poured Wall
i/ Framing: 1 Hour vGResidential Alteration
Braced Wall Framing/Blocking
Braced Wall Sheathing (prior to house wrap)
Interior Braced Wall Panel(s)
Firewalls
Insulation
Fireplace: _Rough In _Air Test _Final
HVAC: Rough In Final
Radon Control
Drain Tile
Meter Size:
Siding: _Stucco Lath _Stone Lath _Brick
Roof: _Ice & Water _Final
Erosion Control
Pool: _Footings —Air/Gas Tests _Final
Retaining Wall: _Footings _Backfill _Final
Fire Suppression: _Rough In _Final
Windows
Other:
a/ Final/No C.O. Required
Final/C.O. Required
Reviewed By: •/Ve/s®~- , Building Inspector
FEES
Calculated Valuation
Base Fee
Plan Review
State Surcharge
Met Council SAC
City SAC
Treatment Plant
Water Supply & Storage
SSW Permit & Surcharge
Meter
Radio Read
Other:
TOTAL $ 0.00