4335 Andromeda WayCITY OF EAGAN PERMIT TYPE: '."" i ?' i ar}
3830 Pilot Knob Road Permit Number; 1.830
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
? ? };?,?:. i ; .,..
I SITE ADDRESS: APPLICANT:
itir111h'0Mk IlA IJAY k I? i#A!<ii
( I I, ? ! i f ; ' i a ? . . i ;'•f . I- . • N f 1 , , i , . ? , . ,, i 1 1 .
PERMIT SUBTYPE: TYPE QF WORK:
,-,?.? ? ?, r?? ; , - ii i .? , ? ? ; , .•ti i ????
f'nAMI tai, I I I rt4 ;1.11 ntlc?N
,????????? ? i•? ? ? ., . ? ra;, ?
I
? ?
Permit No. Pertnit Holder Dete TelephWN #
ELECTRIC ff yr r.?' ,l N
PLUMBING
HVAC
Inapectlon Date Inep. Commerris
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
9
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL I
GYPBOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG /
FINAL HTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL ZJ 7/?
.?v
DECK FfG
DECK FINAL
BUILDING PERMIT
To be used for K
Est. Value $1 ? ?()0
Site Address ` , , " " , : ;'. ,
Lot Block Sec/Sub.
Parcel No.
Name ....?...,....
Address
City Phone
a Name
ot Address • `-?
? City Phone <.? Address
C ity
I hereby acknowledge that 1 have read this application and state
that the information iscorrect and agree tocomply with all applicable
State of Minnesota Statutes and City of Eagan Ordinancea
Signature of Permittee
Recefpt #
Date ,19
On Site Sewage
MWCC System
On Site Well
City Water
APPROVALS
Assessments
Water/Sewer
Police
Fire
Engr.
Pianner
Council
Bldg. Off.
APC
Variance
OFFICE USE ONLY
Occupancy
Zoning
Type of Conat
(ActuaQ
(Allowable)
* of Stories
Length
Depth
S.F. Total
Footprint S.F.
FEES
Permit
Plan Review
SAC, City
SAC, MWCC
Water Conn.
Water Meier
Road Unit
Treatment P1
Parks
Copies
TOTAL
A Building Permit is issued to: ' on ihe express condition that
all work shall be done in accordance with all applicable State of Minnesota Statutes and Ciry of Eagan Ordinances.
Building Official
CITY OF EAGAN . 3830 Pllot Knob Road, P.O. Box 21-189, Eagan, MN 55121
PHON E: 454-8100
Permit No. Ptrmit Holder Date Telaphone 7t
Plumbing
H_V.AC.
E lectric
Softener
Inspaction Date Insp. Comments
Footings I
Footings II -
Foundation
Framing
Roofing
Rough Plbg.
Rough Htg.
Isul.
Fireplace
Final Htg.
Final Pibg.
Bidg. Final
Cert. Occ.
Temp. LP
Deck Ftg.
Deck Frmg.
Well
Pr. Disp.
CIaY UF?FAGAN
`3830 Pilot Knob Road WATER SERVICE PERMlT
, P. O. Box 21199 PERMIT NO.:
Eaga'n, MN 55121 DATE:
, Zoning: No. of Units: '
Owner: `?? e[ld
Addr+ess:
site Address: '?.#t3t f
?t?
,
104y
Pl o
L r -
1 r t
C
t1
1T1bCf. FCJE .
AA@ftr No.: 4 on Ciwrge: '+ i;1. ()Q j?d
lSize: `1?Q? Deposir: 15 . 00 F;
ead r No.: Permit Fee: 1 G. 00 pt'.
1 elree MrN6 ef Eeya Surcho.ge: . 50pd
Ora Miae. CFwrges: _ 63 , ' V) p c : e i ; .
Totol:
BY ?
Date Paid:
Date of Insp.-: ' , Insp.:
CIIY OF EAGAN SEVI/ER SERVICE PERMIT
3830 Pilot Knob Road
P. O, Box 21799 PERMIT NO.:
Eagan, MN t5T DATE:
Zoning: No. of Units:
4wner: Svend Peters?::i
l,ddress:
?,.? 3rK
SitB Addre55: 4315 An ZO'.tlEliZtl [,12 1'
i?
Plumber: ?'eriz RyBn
<:- . .:
I egroe to eomplp wilh !6e Ciy oF Eogon
Ordiuenees.
By
Date of Ir?sp.:
Connection Chorpe: 42.5.00 ?,ci
Account Deposit: 15. 00 Dd
Permit Fee: - , . 00 pd
Surchorpe: • 5 P`'
Misc. Chorges:
Total:
Oote Paid: -
.
BUILDtNG PERMIT
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Esgan. MN 55121
PHONE: 454-8100
#
$ 109 t 0(]fi Recetat
6, G.?Is....?. ? ti._
Site Addres: 4335 ANUROMEDA WAY
Lot 12_ Block 7 SeclSub. w ILUFRNESS PARK II
Parcel No. 1 Q- S 4251- L 2(q92
a; Name SVEND PETLRSEK
? Address 4701 W 11 Q th S t_
City ?p 1 5 Phone 884- Si 44
?o Name
? Addresa
V
H Citv _ Phone
Address
City , Phone
1 hereby acknowledge that I have reod this applicotion ond stote that
the intormation is torrect and ogree to comply with oll opplicable
State of Minnesoto Stntures and City of Eogon Ordinonces.
Sipnature of Permiftee
A Building Permlt is iuued to: SVEND P' CUNSTk
oll work sF?oll be done in occordmxe with o 1' opplimble 5?. f
Buildinp OffiNol ?`?l-?
N° M3
?2 ??'-/ -)
June 1 ,- 84
Erect ? ?: accupancy R- 3
/11ter Q Zoniny R- I
Repoir ? Fire Zona NA
Enlarpe ? Type of Const. Y
Move ? # 5tories
Demolish ? Length 54
Grode ? Depth 3LSq. Ft.
Appr ovals Fees
Assessment
Water & Sew.
Poliu
Fire
Eng.
Plonner
Council
Bldg. Off.
APC
Permit 4
Surthor9e -
Plon check _
SAC 52
Water Conn.
Woter Meter
Road Unit-
Toral 2055. 7 5
i1" Cu Ih,' on tha expreas condltion that
Stotutes ond City of EaQan Ordinances.
75
Psrmit No. Permit Holder Mise. Permit No. Hotder
Plumbiny Li 3 9 ? C_ Z,7,..,?
H.V.A.C.
WeII
Water
Dicp.
S?WOr
Electric
Iropsction Date Insp. Other
Footings rp?1 - . ?r?2 ?.?C ?• ..,- • ,-?'
Foundation
Frsminq ::Ou W ?
1
F
Rouph Plbg. uf ?.
Rouph HVA
Inwlation
94
Final Plbq.
Final HVAC
. ?
Final
Waar Duc?iba Location:
YYsll _
Sewer ?
Pr. DNp. +
CITY OF EAGAN Remarks
Addition Lot IZ Blk 2 Parcel l n R42S1 ] 7(] 09
Owner Street 4335 Arit1x'OIileCIa Way StateEag.SIL*_ A'IlV 55173
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
5AN 5EW TRUNK 61.69 A014472 8-23-84
SEWER LATERAL
WATERMAIN
WATER LATERAL
WATER AREA 4041- 1979 635.84 63.58 1 254.36 A014472 8-23-84
STORM SEW TRK 1979
STORM SEW LAT
CURB & GUTTER
SIpEWALK
STREET LIGHT
Road Unit 260.00 #43748 -1-8
WATER CONN. 470.00 ii ri
BUILDING PER. if
SAC
995-00
PARK
0 073 285- 9/ria Ag I,)OaOMM6MJ?,.,? ,421)
flaquast Date Fra Ifto ough-In Inspection Reqmretl Irwpeotion O[her Then Rough-In
(U ? (VOU a t
?l mspaotor whan reatly)
? ? Ready Now ? Wtll No01y Insper,tor
/ v
N. D2fE RBAtlY
IXlicensed contractor ? owner hereby request inspection of above electrical work at
Job Atldrass (Sireat Box or Rou[e No ) City ?
.3 3.5 ?tc.?
Section No Township Name or No Range No County
Occupant(PRINT)
D Phone No
r
PomprSuppher Atltlress
Eleclncal ConVacror (Company Name) ConVadors License No
C% ? s-
Maihng Addmss (Conhector or Ow r bng Ins?sllahon) ?
?
/4YaP--7LG?+/ "?
•
Authorrze ignature (COniractodOwner Making InsiTllation) Phone Number
7?3- a 79S
5t PaSMN85 ?NIpTY NIIII IuI III I? I?? UNLESS OPEP INSPECTION FEE
Ph o pT
na 6121 i862D800 ENCLOSEO
I W II II II A N?^??? "
REQUEST FOR ELECTRICAL INSPECTION
jll?p See instmcnwns for cbmpleling this form on bnck oi yellow copy
0 073 285 "X" Be/ow Work Covered by This Request
{EnB-0N,0007/-0?9
New Add Rep. Type of Budding , Appliewces Wired Equipment Wved
Home Fange Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer Load Management
Comm./Industrial Fumace Other (Specdy)
Farm Air Condrtioner
Other (specify) Contractor's RemaBS .
'tc?l.GL%
Campute Inspeclion Fee Below:
# Other Fee Jt Service Entrance Size Fee # Circuits/Feeders Fee
Swimmin Pool 0 to 200 Amps 0 to 100 Amps
Transformers A6ove200 Am A 700-Amps
Slgns lnspecmr's Use only. TOTAL _Jllrt
Irrigation Booms ? • ?? ?
S ecial Inspection
Alarm/Communication THIS INSTALLATION MAY ORDERE DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN TH r
I, the Elecirical Inspector, hereby
if
h ROUyn-in V r ate
cert
y t
at the ahove inspecnon has
been made.
F??a? • ?! 7 y
OFFICE USE ONLV
This requesl voitl 18 monihs from
CITY OF EAGAN N a 13 6 9 5
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
' PHONE: 454-8100 ?////v
^ (}
BUILDINGPERMIT Receipt# /`?`" p/
To be used for DECP- Est. Value $Z , 600 Date ,1 g-467-
Site Address
Lot 12 E
Parcel No.
a Name RARRY ANDRliSS
# Address SAME
° City phone
4335 ANDROMEDA WAY
c 2 Sec/Sub. WILDERNESS PK
s Name RAIMD M. MIKKOLA
0
?? Address P.O. BOX 8156
P City MPLC Phone 825-0868
a
w
z
u
z
w
Name_
Address
City _
I hereby acknowledge that I have read this application and state
that the information Is cortect and agree to comply with all applicable
State of Minnesota Statutescqp?d./C? ty of Eagan Ord?in,a?nc}es.
Signature of Permittee ?. d/I?.bf?a?c
A Building Permit is issued to: RAIMO M. MIKKDLA
all work shall be done in accordance with all applica e te of
Building Official ?
OFFICE USE ONLY
On Sile Sewage _ Occupancy
MWCC System _ Zoning
On Site Well _ Type of Const
Ciry Waler _ (AC1uaQ
(Allowahle)
# of Stories
Length
Depih
S.F. Total
Footprint S.F.
APPROVALS FEES
Asseasments Permit $44.50
Water/Sewer _ Surcherge -1T
Polica _ Plan Raview
Pire _ SAQCity
Engr. _ SAC, MWCC
Planner _ WaterConn.
Council _ WaterMeter
BIdg.Off. _ Road Unit
APC _ Treatment P1
Variance _ Parks
Copies
ToraL 46.00
r
on the express conditlon that
and City of Eagan Ord(nances.
CITY OF EAGAN
7??
? 9?f
?
3
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 551 21 lr
i
.. PHONE: 454-8100
BUILDING PERMIT Receipt # ?
$109,000
ud 4erSING FAM DWLG
Te ba ?a
d G
?.'Value Date
June 1 84
19_
SiteAddress 4335 ANDRO MEDA WAY Erect ?X p??upancy R-3
Lot 1 9_ Block 2 Sec/Sub. WT7.DF.RN .SS PARK II Alter ? Zoning R-1
Parcel No. 1 G-R4251 -7 241i4 i2 Repnir ? Fire Zone NA
Enlarge ? Type of Const. V
rc Name SVFNn PFTF RSFN Move ? # Staries
Z Address 4701 W 11
? 0th St,
Demolish ?
LengTh 54
City mP7 s Phone R$4-9144 Gmde ? Depth 36 Sq. Ft.-
? Approrala Fees
o Nama SAM
u Address AssesSmenf Permit 455.50
?
l- City Phone Warer & Sew. Surchorge 54.50
7
7S
Police Plan check?
i
Fw Neme Fire $AC 525.00
?? Address Eng. Woter Conn. ?s00
<W City Phone plpnner WaterMeter63..00
I hereby ocknowledge ihut I have reod Ihis aODlication ond state that
the inlormotion is correct and ogree to comply with oll opplicable
State of Minnesota Stotutes and City of Eagon Ordirwnces.
Signature of Permittee
A Building Permif Is iuued fo: SVENI
oll work shall ba done in accordance wilh
Buildirg Of/iciol
Council _
Bldg. Off. -
APC -
Rood Unit 260 _ OQ
Terai 9055 7 s
q W LLVI. on the express conditlon thni
$fatutes and City of Eagan Ordinante5.
CITY OF EAGAN Include of pK14,3
1 Gertificate of Survey,&
BUILDIIIG PERMIT APPLICATION 5?? o?ener9Y,-calculations.
? ?-- ---
?
Valuation
?b Be used For
Site Address :133 5 i^E >v* '?4 y
((Ji L DrF'NCSs
Lot /2 Block :,: Sec./Sub. A"9Erect
Parcel #: Alter
? L!C./1 _ Fdepair
Assessments
[4ater/Sewer
Police _
Fire
Address: --?Y7p/ u/ pEmlish Front Gj¢ ft.
City/Zip Code: l-/i?l ? /yj/v.' ?5k; y 37 Grade Depth 3Co ft.
P]1UI12 #: v - :> / e/ L/
APPROVALS FEES
Contractor:
P,C1C1Y'0ss: l"---
?G
City/Zip Code:
Phone #:
Arch. /g'ig • :
Address:
City/Zip Code: _
Phone #:
OFFICE USE ONLY
n Occupancy
_ Zoning (Z- ?
Fire zone til h
'Iype of Const. ?
# Stories
E4 -
Planner
Council
Bldg. Off.
APC
Surcharge _
Plan Check
SAC
Water Conn.
Water Meter
Road Unit
5
TO''AL a?U 5 S' 7 /
O>
`
l?.
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.?
?
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R 1?
?
n
?
?
2o x 2(, = 52o x s4 = 280?
13x 3o ° '2A? o x '5 4= 210(, 0
I5.-? ZZ = 33o x 54- = 1?820
22 22 = 6 4-x (1 = 53Z4
-s3 ,c 2-7 _
1
o°If x 4
I C?B, ?15
109, oc?,
0, .x
4 ?) 'i ° 5 0 i
54•SG<-
z _ 7 7 5' y
525=CC'
470?pCt
5 ? ^ 0 0 +
2c0?JL,+
2n5:-75+
Certificate for;
_ , • ?vend Peterson
DELMAR H. SCHWANZ
L.ANOSVAVEVOAS? loC,
qpisbrM Untlar Laws ol The State of MmnesoU
4978 - tA6TH STiiEET W. - BOX M HO6EMOUNT, MINNESOTA 56068
?4a /?6. 2?
3 I
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PHONE 672 423-1769
SURVEYOR'S CERTIFICATE ?
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4,°
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SCALE: 1 inch a 30 feet
Elevations shown are exieting
? Denotee set wood hub
Proposed garage floor
elevation
I hereby certify that thia le a true and correct representation uY
Lot 12, Block 2, WILDIItNESS PARK,SECOND ADDITIbN, according to the
recorded plat thereof, Dakota County, Minnesota.
Also Bhowing the location of a proposed house as staked thereon,
Dated: May 24, 1984
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MINNESOTA REGISTRA ION N0.8825 ?(
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7987 BOILDING PERMIT APPLICATION - CITY OF fiAGAN
SINGLE FAMILY DWELLINGS
I9CLQDE 2 SETS OF PLANS, 3 CERTIFICATfiS OF SDRVEY, 1 SET OF ENERGY CALCQLATIOAS
NOTE: ADDRESSES FOR CORNBR LOTS - CONYRACTOR/HOMEOiiDiSR MOST DESIGAAiE WHICH ADDRESS
IS DESIRED. NO CH6NGSS WILL BE ALLOWED ONCS BIIILDING PfiRMIT IS ISSIIED.
MULTIPLE DGTELLINGS - RFSIDENTI9L RENTAL OAITS FOR SALE Um1IY5
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SQRVEY - CIiECK WITH BLDG. DEPT.,
1 SET OF ENERGY CALCULATIONS
COMIl76RCI6L
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 7 SET OF
ENEHGY CALCULATIONS,
$2,000 LANDSCAPE BOND
To Be Used For: O'Pck Gnsfruclio.+ Valuation :t Z!'nao Date:
Site Address ?335 Andromec?a- 0"1
Lot )4)-- Block
Parcel/Sub
Owner ?j?dpvey 4.U02UJ'J
?
Address 4335 A'2jro mech
5 -27'86
On Site Sewage_
MWCC System _
On Site Well _
City Water _
City/Zip Code faadn
?
Phone
Contractor N. /A`.Ekola
Address ft. ?3ox 8156
City/Zip Code /j')a?t /nn ?5908
,
Phone 825--0868
Arch./Engr.
Address
City/Zip Code
APPROVALS
Assessments
Water/Sewer
Police
Fire
Engr
Planner
Council
Bldg Off _
APC
Variance
Oceupancy
Zoning
Type of Const
(Actual)
(Allowable)
# of Stories
Length
Depth
S.F. Total
Fooptpp?r?int S.F.
1 G?1N
Permit
Surcharge
Plan Review
SAC, City
SAC, MWCC
Water Conn
Water Meter
Road Unit
Treatment P1
Parks
Copies
TOT9L
so
? , z4
Phone #
CITY OF EAGAN ?
10 b J`-' 3830 PILOT KNOB RD - 55122 ? S' s a
1995 BUILDING PERMIT APPLICATION (RESIDENTIAL)
681-4675 1
? 3 registered ake surveys ? 2 copiea o/ plan
? 2 eopiea of plans (indude beam & window saes; poured ind. design; eto.) ? 2 site surveys (exterior atlddions & decks)
? 1 energy Cakulalions ? 1 energy calwWUons for heated additions
? 3 copies of tree pmservation plan H bt pletted aRer 771/93 isquired: _ Yes _ No
DATE: I IIfu k CONSTRUCTION COST: ?rX,0
D?CRIPTION OF WORK: 20^n.'j
?
STREETADDRESS: `r 2-95 f?W'il)`knMe-O R w6
LOT ?O BLOCK ? SUBD./P.I.D.#:
2
PROPERTY
owNeR
CONTRACTOR
Name: /1- r n i/" 9 V c.` ? ,,Iel..d e-.
u.. -t FMU -
StreetAddress• 433?' .unHo w, db4 X,1
City: CA-G p-TI State: M,oL
Company:
Street Address:
City:
ARCHITECT! Company:
ENGINEER
Name:
Street Address:
City:
Sewer 8 water licensed plumber:
change are requested once pertnit is issued.
Penalty appfies when address change and lot
I hereby acknowledge that i have read this application and state that the infortnation is corred and agree to comply with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY
Certificates of Sunrey Received _ Yes _ No
Tree Preservation Pian Received _ Yes _ No
State:
Zip:
Phone -
`?y-i 1 p u G
?
Zip: 5 K 1?oz
Phone #:
License #*
State: Zip•
Phone #•
Registration #•
OFFICE USE ONLY
BUILDING PERMIT TYPE
a 01 Foundation o 06 Duplex o 11 Apt./Lodging &::::? 16 Basement Finish
0 02 SF Dwelling a 07 4-plex ? 12 Multi Repair/Rem. ? 17 Swim Pool
0 03 SF Addition o 08 8-plex o 13 Garage/Accessory o 20 Public Facility
0 04 SF Porch o 09 12-plex ? 14 Fireplace o 21 Miscellaneous
0 05 SF Misc. a 10 = plex o 15 Deck
WORK TYPE
?33 Alterations o 36 Move
32 Addition o 34 Repair o 37 Demolition
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. MC/WS System
(Ailowable) Main level sq, ft. City Water
UBC Occupancy sq. ft. Fire Sprinklered
Zoning sq. ft. PRV
# of Stories sq. ft. Booster Pump
Length sq. ft. Census Code. ?
Depth Footprint sq. ft. SAC Code ?L
Census Bldg _L
Census Unit
?
APPROVALS _
Pianning Building
Perrnit Fee
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter ?
Acct. Deposit
SIW Pertnit
S/W Surcharge
Treatrnent PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
Total:
_ Engineering Variance
.?-
Valuation: $
% SAC
SAC Units
CITY USE ONLY
L BL ? RECEIPT #: 5D ?
SUBD. /?,1?XD?tinon? l.Yu?- a ? DATE:
1995 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please compiete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
FIXTURES -- EACH NO. TOTAL
Shower 3.00 x = 3.a?
Water Closet 3.00 x
Bath Tub { 3.00 x
Lavatory 3.00 x 3.0 0
Kitchen Sink pt5 3.00 x
Laundry Tray ? 3.00 x ?= 3 ?a
Hot Tub/Spa 3.00 x
Water Heater 3.00 x =
Floor Drain 3.00 x
Gas Piping C7utlet * minimam - 1 3.00 X =
Rough Openings 1.50 x =
Water Softener 5.00 x =
Private Disposal " Dakota Cty. license 20.00 =
U.G. Sprinkler * home under const. 3.00 _ _?o
Alterations ' to existing 20.00 = ???
Water Tum Around 20.00
STATE SURCHARGE .50
s°
TOTAL c?p'-/) ?
SITE ADDRESS: `:z-SSS 4 K-
OWNER
INSTALLER
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STREET ADDRESS: ?.>-u?
CITY: <Q?l 6'L STA
PH0NE#:((v0.) 7777
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ZIP:
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OFFICE USE ONLY
L _ BL _ RECEIPT
SUBD.
1995 PLUMBING PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 687-4675
Please complete for: . all commercial/industrial buildings.
& multi-family buildings when separate pertnits are DDI required fOr each dwelling
unit.
DATE:
CONTRACT PRICE:
WORK TYPE: _ NEW CONS7RUCTION _ ADD ON REPAIR
DESCRIPTION OF WORK:
IS WATER METER REQUIRED? _ YES _ NO. IF SO, PLEASE PROVIDE THE FOLLOWING:
WATER FLOW: GPM. ARE FLUSHOMETERS TO BE INSTALLED? _ YES _ NO.
FAILURE TO PROVIDE THIS INFORMATION WILL RESULT IN A DELAY OF METER ISSUANCE.
WILL YOU BE INSTALLING A METER FOR A FUTURE U.G. SPRINKLER SYSTEM? YES NO.
IF 50, YOU MU5T APPLY FOR A SEPARATE U.G. SPRINKLER PERMIT.
FEE: $25.00 minimum fee or 1°h of contract price, whichever is greater. State surcharge of $.50 per
$1,000 of ppgaft fee due on all permits.
CONTRACT PRICE x 1%
STATE SURCHARGE
TOTAL
SITE ADDRESS:
TENANT NAME:
OWNER NAME:
INSTALLER:
DATE:
STE. #
ADDRESS:
an:
PHONE #: SIGNATURE:
STATE: ZIP:
APPLICANT
OFFICE USE ONLY
I METER SIZE: 11 DATE: INSPECTOR:
I PERMIT Mo.sos 8'5
? CITY OF EAGAN PERMIT TYPE:
? 3830 Pilot Knob Road B U I L D I N G
Eagan, Minnesota 55122-1897 Permit Number: 0 2 6 6 3 0
(612) 681-4675 Date Issued: 12 /06 /95
SITE ADDRESS:
4335 ANOROMEDA WAY
LOT: 12 BLOCK: 2
WILDERNESS PARK 2Np
P.T.N.: 10-84251-120-02
DESCRIPTION:
Buildirrg. Permit Type BASEMENT FINISH
fBuilding LJgrk Type ALTERATION
" Census Code ?' 0434 ALT. RESIDENTIAL
q`
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: .- I' ._.. .? •? __
REMARKS:
SEPARATE ELECTRICAL & PLUMBING PERMI75 REQUIRED
FEE SUMMARY:
Base Fee $35.00
Surcharge $.50
Total Fee $35.50
CONTRACTOR:
OWNER: - Applicant -
PUYVELDE RICHARD
4335 ANOROMEDA WAY
EAGAN MN
(612)452-0412
I hereby acknowledge that I haye read tha,s,applicati.on an,d state that the
infiormation is correct and agree to comply with all applicable State of Mn.
Statutes and City o'F Eagan prdinances. ••. ? _ . _
P AN /PEFMITEE SIGNATURE ISSUED Y: SIGN E
INSPECTION RECORD
CITY OF EAGAN PERMiT TYPE
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
BUILDING
026830
12/06f95
SITEADDRESS: P.I• N. : 10-84251-120-e2 APPLICANT:
LOT: 12 BLOCK: 2
0.335 ANDROMEDA WAY PUYVELDE
WILDERNE55 PARK 2ND (612) 452-0412
PERMIT SUBTYPE: TYPE OF WORK:
BASEMENT FINISH
RICMARD
ALTERATIQN
INSPECTION
FRflMSN6 ., .
INSULATION ,.
ROUGH IN PLBG FINAL
REMARKS: SEPARA7E ELEC7RICAL & PLUMBING PERMIT5 REQUIRED
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PERMIT # RECEIPT DATE:
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Please complete for:
SITE ADDRESS:
iiUIDENTLkL PLUM$INfi i'ERMiT APPLiCATION
crrY of EasAv
3830 PaoT Krros Rn
BA6RN, buY 55122
851-681-4675
% single family dwellings
? townhomes and condos when permits are required for each unit
? backflow preventer for irrigation system
OWNER NAME: : kc!( Vrt???v l1e?c?P TELEPHONE #: (p5\
-t (AREA CODE)
WSTALLER NAME: mgG, IGRE & SONG TELEPHONE #: qr-)a -
STREET ADDRESS: G3?- 9b?to
6a512th Avenue SeUth (AREA CODE)
010, q?
l
CITY:
Place a check mark next to the ermit work t e
STATE:
ZIP:
New residential dwelling unit under construction and not owner/occupied $ 90.00
Add-on, modification or alteration to existina dwelling unit, including: $ 50.00
• abandonment of septic system
• new installationlrepair/rebuild of RPZ
• lawn irrigation system
• water turnaround
Nature of work?????
Septic System, new/refurbished - $ 225.00
• includes County & Consulting Inspector fees
• requires MPC license
State Surcharge $ .50
Total I $ PV\ fo.
Reminder. Be sure to schedule inspections of alterations, i.e. water heaters, water softeners, etc
I hereby acknowledge that I have read this application, state that che intormation is correct, and agree to tomplywith all applicable City ances. It
is the applicanPs responsihility to noti(y the property owner that the City of Eagan Assumes no IiAhi14 : any damages caused by th ity dunn its normal
ope26onal and maintenance activities lo the facilities constructetl under this per?? ?t within ily propertylri -of-way/easement.
ITTEE
Updated 1l01
2007 RESIDENTIAL SUILDING rExMIT arrLicaTtort
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New ConsWclion Reowrements
3 registered sile surveys showing sq. ft of lot, sq, ft, of house; and all roofed areas
(20% maximum lot coverege allowed)
1 Soils Report A proposed building is to 6e placed on disNrbed soil
2 copies of plan showing beam & window sizes; poured found design, etc.
1 setof Energy Calr.ulations
3 copies of Tree Preservatbn Plan if lol platted aRer 7l1193
Rim Joist Detail OpGons selechon sheet (buildings wAh 3 or less umts)
\,?4. ?K3
RemodeUReoair Reouirements Office Use OnN
2 cropies of plan showing foo6ngs, beams, joists CeA of Survey Reoi _ Y _ N
1 set of Energy Calculalions for heated additans Soils RepoR _Y _ N
t s'rte survey for addilions 8 decks Tree Pres Plan Recd- --;_ _Y - _ N,
AtldRion - irMkate ff onsde septic system Tree Pres Requlred Y _ N
On-sileSeptlcSystem- _Y =N
Minnegasco mechanical ven6'la4on Fortn a? ??-/?
i7
sar _t and the reason.
rIQ11J QIG VV??J?MG?YM
Date -
Construction Cost OCi"u
Site Address ?J 'rJ UniUSte #
A,
tion of Work ? S?.%e vR N
Descri +D rz G Y
_
p
Multi-Family Bldg _ Y__)< N Fireplace(s) _ 0 ?C 1 _ 2
Property Owner R(?-??AfiLg L'#rv 9 U? r i,?np Telephone #((05 T) L/ 57=?
Contractor A ?p py:z: "r'Nn?
Address 9 ZCi CU'v^
State ??
Zip ?. City JF4L An?
Telephone #(?95? )qTZ - ?? f 2
0,112P (c lL -7-1 szp -l 66 So
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Code Category
• Residantial Ventilation Category 1 Worksheet • New Energy Code Worksheet
(Jsubmissiontype) Submitted Submitted
. Energy Envelope Calculations Submitted
In ihe last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_ Y _ N If yes, date and address of master plan:
Licensed Plumber
Mechanicnl Contractor
Sewer/Water Contractor
Telephone #(
Telephone # (
Telephone # (
I hereby apply for a Residentia] Building Permit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
' out a
Statutes; I understand this is not a permit, but only an application for a permit, and work ' jLmLUsta
permit; that the work will be in accordance with the approved plan in the case of war D?c?"uReTa? ' and
approval oFplans. AUUGG $ 12007
Applicant's Printed Name ? Applicant' Signa e By
DO NOT WRITE BELOW THIS LINE
Sub Tvaes
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace X 21 Porch (3-sea.) ? 31 Ext. Alt - Mutti
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 OS-plex g 18 Deck ? 23 Porch (screen/gazebolpergola) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex ? 25 Miscellaneous
Work Tvaes
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
x 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building* ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement •Demolition (Entire Bidg) - Give PCA handout to applicant
DBSCriptlon: WaterDamage_ Yes /,
IKG-)
Valuation qGU Occupancy __A_?_ MCES System -
Plan Review P"'100% or 25% Code Edition 2 q?6
Census Code Lf??/ Zoning Pd_ City Water ?
SAC Units - Stories / Booster Pump
# of Units - Sq. Ft. 02? PRV -
# of Bldgs - Length Fire Sprinklered
Type of Const v? Width
REQUIRED INSPECTIONS
_ Footings (new Uldg) _ Sheetrock
Footings (deck) FinaUC.O.
?Y Footings (addirion) ? FinaUNo C.O.
Foundarion HVAC
Drain Tile Other
Roof JL Ice & Water ? Final Pool Ftgs Air/Gas Tests Final
? Framing _ Siding _ Stucco Lath _ Stone Laffi _Brick
_ Fireplace _ RI. _ Au Test _ Final _ Windows
_ Insulation f _ Retain'vtg Wall
Approved By:
Building Inspector
Base Fee v
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W I?ermit &.Surcharge
1' _
Trealtment PI'ant
ir '
License SearQh . '
+? • , :;1j:'
Coples
r
OthEr
Total
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TiT- /ao
3 ,bdw< Q 05-,2,
ane #_
lo`y610
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d
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-'blPicate for:
.Z -,nd Peterson
?2 -
? DELMAR H. SCHWANZ
. LANOSUNVEYORS? IFQIC,
? RpiBwM UnGer Liws Df The Sfat* Of MmnnOp
7876- 148TH STREET W. - BOX M ROSEMOUNT. MINNESOTA 66066
SURVEYOR'S CERTIFICATE
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SCALE: 1 inch m 30 Peet
Elevations shoxn are ezisting
O Denotes set woofl hub
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PHONE 672 4231768
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Propose@ garage floor
elevation
I hereby certify tha.t this is a true and correet representation ui'
Iat 12, Block 2, W2LDERNES$ PARK 3ECOND ADDITI6N, accarding to the
recorded plat thereof, llakota Couiity, l+li-nr?esata.
Also showing the Iocation oP a proposed twuse as staked thereon.
Dated: May 24, 1984 EAQAN
G?EM(????
Bv: 7??L
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!'.';i,^JG iIJSPECT' ''!'dS DIVISIOft!
i ?
MINNESOTA REGISTNATION N
%
App - 131.111LUIN(i Kesiaential.pd* nttp://www.ci.eagan.mn.uslImages/uommunityuevelopmenvttuill
' Use BLUE or BLACK Ink
I For office Use __-T_-_- I
I Permit* City of Ear I 93
Permit Fee:
3830 Pilot Knob Road I I
Eagan MN 55122 x Date Received: j
Phone: )651) 675-5675 I I
Fax: )651) 675-5694 1 Staff: I
1 I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: 4935 A W a Unit
Name: Q: r awn Gt-t LAN )7~? Oia Phone: 51 -116 1 ~
Resident/
Q er 1 Address/ City /Zip: 3 S_
z
) Applicant is: Owner Contractor
Type of Work Description of work: eL'J ~'tdk'e ^L
Construction Cost: j 2' i oO o Multi-Family Building: {Yes / No
I i
e ~
Company: rz-- 41 V S V_. Contact: _ i
14
4
Contractor Address: 2s L v r+4 - -Y-pa L CRY: _L At.- AM
I
State: 1* j_ Zip: 5S-1 Z 'I _ Phone: 61 z - -ZA
License V. C'2 ONS Li 5 7 (,~J Lead Certificate !2a ~1--!
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
Vic) 0 '
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a sirrdlar plan based on a master plan?
_Yes -No If yes, 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
i
conclude
de ha. that they are re trade
_ ._,~..ade _ secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 464-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www. o herstateonecail.or
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.
x 53 e; C A-T ,h e 0 0,14 A
Applicant's Printed Name 13 Appl s SignattifV-
Page 1 of 3
1 of 3 4/7/2013 1:26 F
uv ivv 1 YYMI I t bLLUW THIS LINE
SUB TYPES t t335 Amkrnlt 'day ) o q q4 b
Foundation - Fireplace _ Porch (3-Season) _ Storm Damage
Single Family _ Garage _ Porch (4-Season) _ Exterior Alteration (Single Family)
Multi _ Deck _ Porch (Screen/Gazebo/Pergola) _ Exterior Alteration (Multi)
01 of - Plex _ Lower Level _ Pool Miscellaneous
_ Accessory Building
WORK TYPES
New _ Interior Improvement - Siding _ Demolish Building*
_ Addition _ Move Building _ Reroof _ Demolish Interior
Alteration _ Fire Repair - Windows _ Demolish Foundation
Replace - Repair _ Egress Window _ Water Damage
Retaining Wall *Demolition of entire building - give PCA handout to applicant
DESCRIPTION
Valuation l~ Occupancy( MCES System
Plan Review Code Edition k- - SAC Units
(25%_ 100% Zoning City Water
Census Code Stories Booster Pump
# of Units Square Feet PRV
# of Buildings Length Fire Sprinklers
Type of Construction Width
REQUIRED INSPECTIONS
Footings (New Building) Sheetrock
Footings (Deck) Final / C.O. Required
Footings (Addition) Final / No C.O. Required
Foundation HVAC
Drain Tile Other:
Roof: -Ice & Water -Final Pool: -Footings Air/Gas Tests -Final
Framing Siding: -Stucco Lath -Stone Lath -Brick
Fireplace: -Rough In Air Test -Final Windows
Insulation Retaining Wall: _ Footings _ Backfill _ Final
Meter Size: Radon Control
Erosion Control
Reviewed By: Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge ; rR
Plan Review f
MCES SAC
City SAC
Utility Connection Charge
Y
SSW Permit & Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 2
Use BLUE or BLACK Ink
I For Office Use
I
j Permit*
City of Eap I
Permit Fee:
3830 Pilot Knob Road I I
Eagan MN 55122 I Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff: I
I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: cs Site Address: 4J 12L 1A )V~A, Unit M
Name: R % C-M 9,, ` 1 Phone:
Resident/
Owner Address / City / Zip: ICf~-W
Applicant is: Owner ontractor
Type of Work Description of work: _ , cs
Construction Cost: _ Multi-Family Building: (Yes / No
\ Contact: r _Z6 ,I I z - 'z.I
Company: 1~ '0 TI-M 0&4 6n..,a~
Address: _ 92.0- City: -Ae~'t't-IJ
Contractor
State: Zip:v ~Z Phone; try ` Z- Z i O' ~n (o U
License ' Lead Certificate A))4" ~i
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY'IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permitfor a similar plan based on a1 master plan?
_Yes ,No If yes, 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 the 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.oro
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.
X t? C-i."s- t JJ~A cry ii/~ x
Applicant's Pr ted Name- Applicants ignatu w
Use BLUE or BLACK Ink
I For Office UtsieQr(-~+_
` j Permit*
1 l o vl W j
City of Eajan 1 Permit Fee: O~as I
3830 Pilot Knob Road 1 I
Eagan MN 55122 j Date Received: j
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff: I
I I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 70 1:3 Site Address: An Unit M
Name: 6 1 • n rArn~,r wy t& Phone:,6 ` 1-td ~ -72-41
Resident/
Owner Address / City / Zip: v i '..A,
Applicant is: Owner Contractor
Type of Work Description of work: 0zw_ VAS
Construction Cost: *W-0 Mufti-Family Building: (Yes / No~Li
Company: 4Aint,& m±y go,~ Contact: (5t_i "
Contractor Address: 9-1-C C'A (4a- r City: •7 aza 2
State:M~J J zip: 1~? Phone: I ` 1D °-16 6 X
License ~ 5 ~J tj -7 P Lead Certificate -6 t qCr-l " / )Vitt If the project is exempt from lead certification, please explain why: (see Page 3 for additional
information)
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 S 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 tirade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (661) 464-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.gopherstateonecali.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 approval of plans-
Exterior work authorized by a building permit issued in accordance with the Wrinesota State Building Code must be completed within 160
days of permit issuance.
X C Lk--N AL myAr-, X ut, fe~
Applicant's Printed Name Applicant! Slihature %V
Page 1 of 3
,
For Office Use
4 Permit#:
%„:*... ./.# E AG A N
Permit Fee:
Date Received: :/
IF
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
(651)675-5675 I TDD:(651)454-8535 I FAX: (651)675-5694 Staff:
buildinginspections(@cityofeagan.com L. 1 .+
2018 SEWER AND WATER REPAIR I DISCONNECT PERMIT
Date: 5- 3,1 Fee: $65.00
Y
City Sewer City Water
r n iRe'pair Disconnect
Description Of Work: R ply h t� CA, t-.L'I i 1: �J +Lunhau
, , „u
Street Address for Proposed Work L4ff) AA rOjfl(c L W to
f
Name: Van Pay yak_ Phone: .).0.
Owner Information ' Address/City/Zip: c/ '.L_
i____ 1 Applicant is: Owner ✓ Contractor
Licensed Pipelayer V Master Plumber Property Owner
Name: fl\ ± D ✓ X W , l Phone: iii ).�a 34 8y
Olg
Address/City/Zip: ctt flL a i\\ c ' i[ ban,/
Pipelayer Training Certification Card#: 01. 5 or Master Plumber License#:
I acknowledge that the information is complete and accurate and that the work will be in conformance with the ordinances and codes
of the City of Eagan and the State of MN Statutes. I understand this is not a permit, but only an application for a permit, and work is
not to start without a permit.
It.)LVe_. a all t C _
Applicant(Print Name) Applicant's Signature
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.
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.gopherstateonecalLorq
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA161687
Date Issued:06/09/2020
Permit Category:ePermit
Site Address: 4335 Andromeda Way
Lot:012 Block: 002 Addition: Wilderness Park 2nd
PID:10-84251-02-120
Use:
Description:
Sub Type:Fireplace
Work Type:Gas Fireplace (new)
Description:
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home may require smoke detectors in all bedrooms. Chimney / flue must be inspected prior to
concealing.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 3,000.00
Fee Summary:BL - Base Fee $3K $88.50 0801.4085
Surcharge - Based on Valuation $3K $1.50 9001.2195
$90.00 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 -
Samuel < Kidder
4335 Andromeda Way
Eagan MN 55121
Fireside Hearth & Home
2700 Fairview Ave N
Roseville MN 55113
(651) 633-2561
Applicant/Permitee: Signature Issued By: Signature
•
A
ECEIVE
E AlG Jim"
ID
BY•
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
(651) 675-5675 I TDD: (651) 454-8535 I FAX: (651) 675-5694
buiIdinoinspectionsc citvofeauan.com
Date:
r
\°"`
For Office Use I 43
Permit j6�i�� (.
#: / 2
Permit Fee: 3- l v 9
Date Received:
Staff:
2020 RESIDENTIAL BUILDING PERMIT APPLICATION
Type of Work
J
Site Address: Unit #:
Name: r/1 yvi /k'1 oldr€ Y Phone: a%S Z w p _ Ns /
Address / City / Zip: 21335 A n c rO Yy,v+ ri et_ 14 ,/
Applicant is: Owner i-Contractor
Description of work: * $ 4 �• f yrd
Construction Cost: /g0c2r1
Multi -Family Building: (Yes / No )
Company: r.S h pr..4 p /1 14 r -L Contact: a in t g't I S i'.o' f
Address: 31caL, ? Ca--/ S 4744 O ct P. City: I/41 L d eow /- 'R------
State:A/ zip: Ss/1 U Phone: 6/2-0 73 IpS Email: do,,taPrisIPrOShio<t.✓rrrim.Ji!„i
License #: gr =17 !, 2 S 1' Lead Certificate #: /1)14-r - - 8 <( 2.0 —2_
If the project is exempt from lead certification, please explain why:
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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 & 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.
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.
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.
CALL BEFORE YOU DIG. Cali 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.gooherstateonecall.or.
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 r pr-e
Applicants Printed Name Applicant's Signature
e n
Addition
Alteration
_ Replace
Retaining Wall
DESCRIPTION
Valuation
Plan Review
(25%_ 100% )
Census Code
# of Units
# of Buildings
Type of Construction
DO NOT WRITE BELOW THIS LINE
„SUB IYPES
Foundation
Single Family
Multi
01 of _ Piex
WORK TYPES
New _ Interior Improvement
Move Building
Fire Repair
Fireplace
_ Garage
Deck
Lower Level
A yLio /6.2/6
_ Porch (3-Season) _
Porch (4-Season)
Porch (Screen/Gazebo/Pergola) _
Repair
q 340
T7
Pool
Occupancy
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
Code Edition MPG Z 02
Zoning
Stories
Square Feet
Length
Width
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation Foundation Before Backfill
Roof: _Ice & Water _Final
k Framing 30 Minutes 1 Hour
Fireplace: _Rough In Air Test
k Insulation
Sheathing
Sheetrock
Fire Walls
Braced Walls
Shower Pan
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Suppression Required
Meter Size:
Final / C.O. Required
Final / No C.O. Required
is HVAC _ Service Test Gas Line Air Test _ Hood
_ Pool: _Footings Air/Gas Tests _Final
Drain Tile
Final Siding: _Stucco Lath _Stone Lath _Brick _ EFIS
Windows
Retaining Wall: _ Footings _ Backfill _ Final
Radon Control
Fire Suppression: _Rough In _Final
Erosion Control
Other:
Reviewed By: , Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
SSW Permit & Surcharge
Treatment Plant
Radio Meter Read
Copies
TOTAL
Page 2 of 3
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA162519
Date Issued:07/16/2020
Permit Category:ePermit
Site Address: 4335 Andromeda Way
Lot:012 Block: 002 Addition: Wilderness Park 2nd
PID:10-84251-02-120
Use:
Description:
Sub Type:Residential
Work Type:Alteration
Description:Basement Fixtures
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.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Fee Summary:PL - Permit Fee (miscellaneous)$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 -
Samuel < Kidder
4335 Andromeda Way
Eagan MN 55121
Lake Area Plumbing Inc
8999 305th Ave NE
North Branch MN 55056
(612) 735-2317
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA165785
Date Issued:11/19/2020
Permit Category:ePermit
Site Address: 4335 Andromeda Way
Lot:012 Block: 002 Addition: Wilderness Park 2nd
PID:10-84251-02-120
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 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 -
Samuel M & Sylvia F Kidder
4335 Andromeda Way
Eagan MN 55123
Clear Cut Xteriors Llc
1979 Geneva Ave N
Oakdale MN 55128
(651) 395-1370
Applicant/Permitee: Signature Issued By: Signature