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4368 Andromeda Way CITY OF EAGAN PERMIT TYPE: a 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 SITE ADDRESS: APPLICANT: r3ll1?0Mr (1A WAY i PERMIT SUBTYPE: TYPE OF WORK: INSPECTION :q f 9~ H LJ~ i Permit Holder Date Telephone # PLUMBING HVAC Inspection Date Insp. Comments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL DOMESTIC METER IRRIGATION METER FLUSH MAINS CONDUCTIVITY TEST HYDROSTATIC TEST BSMT R.I. BSMT FINAL DECK FTG DECK FINAL CITY OF EAGAN Remarks ` Y Addition WILDERNESS PARK 2ND ADDITION-Lot - 3 alk 3 Parcel 10 84251 030 03 Ownerm j: a Street 4368 Andromeda Way State Eagan, MN 55123 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK 1973 15.. 7. 171 20 Ac)j 1836 SEWER LATERAL WATERMAIN WATER LATERAL * WATER AREA 1979 631.00 63.10 1 315.50 A011836 1-20-83 * STORM SEW TRK 1979 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT Road I In i t i AF; no 19593 80 r~ WATER CONN. it BUILDING PER. n n SAC 1325 00 PARK • CASH RECEIPT • CITY OF EAGAN 3795 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 DATE 19 RECEIVED FROM AMOUNT $ I DOLLARS loo ❑ CASH ❑ CHECK FOR FUND CODE AMOUNT Thank You BY White-Payers Copy Yellow-Posting Copy Pink-File Copy Cities Digital Quality Control The following image represents the best available image from the original page. Every effort was made to capture the content from the original page. r CITY,. OF EAGAN WATER SERVICE PERMIT '3795 Pilot Knob Road PERMIT NO.: Eagon, MN 55122 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: By Date Paid: Dote of Insp.: Insp.: SEWER SERVICE PERMIT CITY~OF EAGAN 6745 Pilot Knob Road PERMIT NO.: .Eagan, MN 55122 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: Insp.: Date Paid: CITY OF EAGAN 8795 Pilot Knob Road Eagan, MN 55122 Na 59V PHONE: 454-8100 BUILDING PERMIT Receipt # To be used for Est. Value mate 19 Site Address Erect p Occupancy Lot Block Sec/Sub. Alter ❑ Zoning Parcel # Repair ❑ Fire Zone L~ Enlarge ❑ Type of Const. W Name C' Move p # Stories Z Address Demolish ❑ Front ft. o city Phone i' Grade ❑ Depth ft. Name Approvals Fees 0 uE Address Assessment Permit City Phone Water & Sew. Surcharge Police Plan check u~ WW Name Fire SAC U Name Address Eng. Water Conn. <W City Phone Planner Water Meter Council Road Unit I hereby acknowledge that I have read this application and state that Bldg. Off. the information is correct and agree to comply with all applicable APC Total State of Minnesota Statutes and City of Eagan Ordinances. Signature of Permittee A Building Permit is issued to: on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official Paadt # Osdt kned pemhf" Plumbing - S/_ ILL Mechanical p ~f 31 _ d W 712 I INSPECTIONS -~DATE INSP. Rough-In Finol Footings Dote I Insp. Date Insp. Foundation Plumbing 0--7r Frame/ins. Mechanical Wz) 10 Final c Remarks: I J CITY OF EAGAN 3795 Pilot Knob Road No Eagan, Minnesota 55122 INSPECTOR NOTIFICATION Pbene: 454-3100 REQUIRED BY LAW PERMIT FOR ALL INSPECTIONS Dote: Receipt No.: Single I Site Address z clTa~:.t ut Residential Lot Block Sub/Sec. Multi Res., Comm./Ind. Nome New/Alter./Repair. Address '-10th Cost of Installation C City i ` 5547 Phone: Permit Fee Name' Surcharge g Address 14745 _ c` car e e L7 OS@ 1CJtiriL r City Phone: Total ' This Permit is issued on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official CITY OF EAGAN 3795 Pilot Knob Road Bogen, Minnesota 55122 INSPECTOR NOTIFICATION No. Phone: 454-8100 REQUIRED BY LAW PERMIT FOR ALL INSPECTIONS Date: Receipt No.: Single I Site Address: Residential Lot Block Sub/Sec. Multi Res., Comm./Ind. Name - New/Alter./Repair. Address ; .0th fit. Cost of Installation %7 City Phone: Permit Fee Name Surcharge Address ' 7,! t City Phone: Total This Permit is issued on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official ROS 114,94W OF&O-4 Cf'wrw. ,sc..- a~?r, ~-c- _~u.~ a _ ~4 .~«'',S :a'"'°'.""" r ~T~ e: n.'!v':e~~ `y. ~ .~.osL as r Cnrrtifirate of Orrupaurg eta City of Cagan Drpartmrnt of Building -3n-gvrrtimt r This Certificate issued pursuant to the requirements of Section 306 of the Uniform Budding Code certifying that at the time of issuance this structure was in compliance with the various f Fj ordinances of the City regulating building construction or use. For the follounng• it SF DWG/GAR 5900 U. ..,~+;cmon Bid, N.tNo e, R1 i do- _'ia ? O. ,Type R3 Type Cooewep. Y Fim Zone 3 Zoning Drsmm l o rc.ate~nang S. Petersen Const. edd,e~ 4701 W. 110th St., Mpls.!\ awd gAdd ss 4368 Andromeda Wayr,.,,sLot 3, Block 3, Wilderness 'd 77 Park 2nd ~ October 21, 1981 g E ¢wtamgoiRwt Dw e Y1 s-aa za-~aa~~..z uovs . e CITY OF EAGAN 3795 Pilot Knob Road Eagan, MN 55122 N2 5 9 0 0 PHONE: 454-8100 BUILDING PERMIT APPLICATION Receipt # A a7 To be used for SF Dwl~/Gas. Est.volue 59,000.00 Date June 26. 19~a Site Address 4368 Andromeda Way g 3 3 Wilderness Pk.2n recr E] Occupancy _ 3 Lot Block Sec/Sub. Iter ❑ Zoning R1 Parcel # Repair ❑ Fire Zone 111 Enlarge ❑ Type of Const. V a Name S_ Pptereon Constr_ Move ❑ # Stories w z Address 4701 W. 110th St. Demolish ❑ Front 52 ft. City MPls., 5543Vhone 884-5144 Gmde ❑ Depth 28 ft. s Name Same Approvals Fees 0 ou Address Assessment 622418 Permit 1.53.00 Add ~ Ad Phone Water & Sew. Surcharge 20.50 city F Police Plan check 76.50 wW Name Fire SAC 525.00 Fw Address Eng. Water Conn, 105.00 '13 f'Z^ City Phone Planner Water Meter (VL OO Council Road Unit 185.00 1 hereby acknowledge that I have read is a cation and state th h Bldg. off. 6/25/80 the information is correct and agr to mply wi appli e State of Minnesota Sta an f Eag r' ARC Total 1 34.00 Signature of Permittee A Building Permit is issued to: S. Peterson on the express condition that all work shall be done in accordance i 11 applicabl St a of innesota Statutes and City of Eagan Ordinances. Building Official a Td ~g® GC2~~. fir vE' A r CITY OF EAGAN Include 2 sets of plans, 1-2 3 o C- ; lrA~- s Air T e. 1 site plan w/elevations & BUILDING PERMIT APPLICATION 1 set of energy calculations. To Be Used Fore: valuation _ Date S>~ Site Address ~dr~ ~nrrte~i ~L2Y Hn OFFICE USE ONLY Lot Block Sec./Sub.j;Koc-°°en11 5 Erect _ Occupancy Parcel Alter Zoning f?/ /,,_Repair Fire Zone 3 Owner: %~Tc S~ C'usy l~dPi~~~ Enlarge _ Type of Const. d Move # Stories Address:%/70 / u/ / Sf~ - Demlish _ Front S~2 ft. City/Zip Code: 1Y,01- s y5 y 7 Grade Depth a$ ft. Phone Sw 4/ !5-/ u APPROVALS FEES Contractor: Assessments Permit Water/Sewer Surcharge Address: Police Plan Check city/zip code: Fire SAC Water Conn. SOS Phone Planner Water Meter (moo Council Road Units Arch./Eng.: Bldg. Off. -T7fo Address: APC City/Zip Code: Phone TOTAL o-3 C This request void 1 8 months from X 3~ oO Date of this Request Au a o 3 S 4 2 9 4 9 I, as ® Licensed Electrical Contractor Owner, do hereby request inspection of the above electri- cal wiring installed at: ~r r Street Address or Route No. 4368 Andromeda City Fagan _ Section Township Range County Dakota Which is occupied by Svend Peterson Construction (Name or occupant) Is a roughin inspection required on this job? No ❑ Yes ® Ready Now ❑ Will Call Gd Power Supplier Dakota 41,ectric Assn. Address821 3rd St.. Farminetona NN 55024 Electrical Contractor Ken Sorenson Electric Contractor's License No.A3 (Company Name) Mailing Address 8100 12th Ave. So. Bloom~ing~L~ MN (Electrica nnt~cjor or owner Mak ng is lostallatlon) Authorized Signature Phone No. 854-4470 (Electrical Contractor or ownl;r Mak ng This Instanatidn) 21 u ~ BOARD COPY This impaction request will not accepted t 0 u State Board unless proper inspection fee is enclosed. Minnesota State Board of Electricity 19 University Ave., St. Paul, Minn. 55104-Phone 645-7703 REQUEST FOR ELECTRICAL INSPECTION a0~ A CHECK BELOW WORK COVERED BY THIS REQUEST S 4 Type of Building New Add. Rep. Check Appliances Wired For Check Equipment Wired For Home ® ❑ ❑ Ran Temporary Wtring ❑ Duplex ❑ ❑ ❑ Wat Lighting Fixtures ❑ Apt. Bldg. ❑ ❑ ❑ Dry Electric Heating ❑ Commercial Bldg. ❑ ❑ ❑ Fur cSilo Unloader ❑ Industrial Bldg. ❑ ❑ ❑ Air Bulk Milk Tank ❑ Farm F] C] 0 Other Fhlere 111 Here n e COMPUTE INSPECTION FEE BELOW i Service Entrance Size: # Fee Feeders&Subfeeders: # Fee Circuits: # Feq/ 0 to 100 Amps. 0 to 30 Amperes 13 26.00 0 to 30 Amperes 11 4-00 101 to 200 Amps. l 10, 31 to 100 Amperes 31 to 100 Amperes Above 200 Amps. Above 100 Amps. Above 100 Amps. Transformers Remote Control Cuc. Partial or other fee Signs Special Ins ection Minimum fee $5 Remarks Clete House Wiring TOTAL FE Q. 40.50 I, the Electrical Inspector, hereby certify that b~ pv~ inspection has been a } ~d (Rough-in) U Date- (Final) Date This request void 18 months from S. PETERSEN CONSTRUCTION, INC. 4701 WEST 110TH STREET 884-5144 BLOOMINGTON, MINNESOTA NAN I Da I I o ! ~ H ~ Al 1 se,~ 04 i + 1 ~ ' f i+ N 100l.. go .~7rJn~c~r~[=TN Gci~Y l e<'' :'av~ ' Y; >.i~:~~q,.~;s^~.k,.y6:-•A;xa~' ~ ' a: aY, :t~ . ir.:s ~f~ ` .S ~ , y ~<p' w fizs~,>:3;~*'s,¢>.. .fir1' ~ ; •>f~ : ~:~°):'L:. C' p~,'%%':'{~:~•§:".k. &PY;y'..>.i`.sjhg~q~ s ~ ` h&~~ L F }t>• 5:.~ i. .'~~Y.'.'~''^.::.'ww<"v4f4~iav.""ra~aR~t: ~:..::5ri•n~. +•.F.>...&..:< 6~+.~.' .tr .65 e.. :n~w>. : ~7 1994 PLUMBING PERMIT (COMMERCIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN MN 55122 (612) 6814675 PLEASE COMPLETE FOR ALL COMMERCIAUINDUSTRIAL BUILDINGS. ALSO FOR MULTI- FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. NEW CONSTRUCTION _ ADD ON REPAIR WORK DESCRIPTION: CONTRACT PRICE: $ FEE: 1% OF CONTRACT FEE. STATE SURCHARGE: $.50 FOR EACH $1,000 OF ~ FEE MINIMUM FEE: $ 25.00 CONTRACT PRICE X 1% $ STATE SURCHARGE $ TOTAL $ SITE ADDRESS: TENANT NAME: STE. # OWNER NAME: INSTALLER: ADDRESS: F CITY: STATE: ZIP CODE: PHONE FOR: CITY OF EAGAN APPLICANT F >:p: r ;11 lgg G'i ;is?e..;~:c~ i.•~1~a`.•~.e.~~q'0k~:,:~~.~.y ;3~u,~^ir...';~ <°-:i.~ 3.~~... . . '.u o: s,...;r., i.;:.8r1°„g!<°r kti'..az' ~;`."Y'..c..: .ire§~: 6:':A"T. .so-tw.~?` ;w~ ?M3.xn..;~'.ro, s3.:,, r'~ s:: <,.$;.< °A.i~s xMk~,~. .,c°• M~^r~kg:' ~~'aq:'.;.. 'y ..F.;xe: ~sa, ~~r~x~ _ 'a~.~s ~'s. 1994 PLUMBING PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN MN 55122 (612) 6814675 PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. NO, FIXTURES EACH TOTAL SHOWER 3.00 WA'T'ER CLOSET 3.00 BATH TUB 3.00 LAVATORY 3,00 KITCHEN SINK 3.00 LAUNDRY TRAY 3.00 HOT TUB/SPA 3.00 WATER HEATER 3.00 FLOOR DRAIN 3.00 GAS PIPING OUTLET • minimum - 3.00 ROUGH OPENINGS 1.50 WATER SOFTENER 5.00 PRIVATE DISP. • Dakcty. se. 20.00 U.G. SPRINKLER • home under-coast. 3.00 ALTERATIONS • to emsting 20.00 WATER TURN AROUND 20.00- STATE SURCHARGE .50 TOTAL: 7-10.5 SITE ADDRESS: SAUER PRITZ OWNER NAME: `?60 ANDROMEDA uAy 11 213 INSTALLER: H 04-2194 W ADDRESS: 1905 GARFIELD AVENUE SOUP ,v INNEAP@HS, AVNNE5eT*-55 CITY: 827.4033 SATE: ZIP CODE: PHONE ( ) SIGNATURE OF ERMITTEE ,3 -C- 9S ~s'iq 1 CITY OF EAGAN N0: Bne PAira iP/n7/98 TIME: 00606 ID:: 9007 4,ic, 3 4 „ i, ~.)001 4068 ANDRIDMI.'-DA r.50 t r Total Rprelpt Amnunb~ IT 2t'; rRr,ly y3 USER :FLT: NANCY :TyF~F n~F~yfN"~FSk~k%r~~X'~g'i'tX:>Kt~}rt'?Xif1K~3k)KSCre:hl'nY~?k%n:k%k~Y%R PERMIT CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road B U I L D I N G Eagan, Minnesota 55122-1897 Permit Number: 0 3 3 6 0 9 (612) 681-4675 Date Issued: 10/07/98 SITE ADDRESS: 4368 ANDROMEDA WAY LOT: 3 BLOCK: 3 WILDERNESS PARK 2ND P.I.N.: 10-84251-030-03 DESCRIPTION: REPLC LOOSE SHINGLES Building4`P,ermit Type SF (MISC.) $Uilding W6-,'t:, Type REPAIR ~ACensus Code 434 ALT. RESIDENTIAL ar T l~ ~ `1t i° e.5 V M1 __t !J ` REMARKS: FEE SUMMARY: VALUATION $1,000 Base Fee $34.75 Surcharge ---_$_.50 Total Fee $35.25 CONTRACTOR: OWNER: - Applicant 1 UNDEM BRET 4368 ANDROMEDA WAY EAGAN MN 55123 (651)686-9961 -1 hereby aekno-wledge that Y'have read this` application~,and state that the information is correct and agree to comply with all applicable State of Mn. 1 Statutes and City of-Eagan -Ordinarices. APPLICANTRERMITEE SIGNATURE SUED BY: SIGNATU E 1998 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF PAGAN 3830 PILOT KNOB RD - $5122 ] -35 - J [ 681.4675 New Construction Requirements Remodel/Repair Requirements I ' • 3 registered site surveys • 2 copies of plan • 2 copies of plans (include beam & window sizes; poured fnd. design; etc.) • 2 site surveys (exterior additions & decks) • t energy calculations • 1 energy calculations for heated additions • 3 copies of tree preservation plan if lot platted after 7/t/93 required: Yes _ No DATE: CONSTRUCTION COST; " tooo DESCRIPTION OF WORK: re~~ r rs~ P v o a,~ STREET ADDRESS: W A J s L4 CC7 n ~C r"LOT: BLOCK: SUED./P.I.D. Name: V (t? CL+4-u Phone 6 PROPERTY Last First OWNER Street Address:-1-4 1'e A--o,-0 r ecQc~ tau f City _ICw~ State: f J Zip: 5 S 1 Z Company: Phone CONTRACTOR Street Address: License # City State: Zip: ARCHITECT/ ENGINEER Company: Phone Name: Registration Street Address: City State: Zip: Sewer & water licensed plumber (new construction only): Penalty applies when address Chang and lot change is requested once permit is issued. I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicabl State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY Certificates of Survey Received Yes No Tree Preservation Plan Received Yes No Not Required OFFICE USE ONLY BUILDING PERMIT TYPE ❑ 01 Foundation ❑ 06 Duplex ❑ 11 Apt./Lodging ❑ 16 Basement Finish ❑ 02 SF Dwelling ❑ 07 4-plex ❑ 12 Multi Repair/Rem. ❑ 17 Swim Pool ❑ 03 SF Addition ❑ 08 8-plex ❑ 13 Garage/Accessory ❑ 20 Public Facility ❑ 04 SF Porch ❑ 09 12-plex ❑ 14 Fireplace ❑ 21 Miscellaneous ❑ 05 SF Misc. ❑ 10 _-plex ❑ 15 Deck WORK TYPE ❑ 31 New ❑ 33 Alterations ❑ 36 Move ❑ 32 Addition ❑ 34 Repair ❑ 37 Demolition GENERAL INFORMATION Const. (Actual) Basement sq. ft. MCIWS System (Allowable) 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 Census Bldg Census Unit APPROVALS Planning Building Engineering Variance Permit Fee 3 ( - -7 Valuation: $ Surcharge Plan Review License MC/WS SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment Pl. Park Ded. Trails Ded. Other Copies Total: % SAC SAC Units I Z `8 2 ct) RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 651-681-4675 New Construction Requirements Remodel/Repair Requirements . 3 registered site surveys showing sq. ft. of lot, sq ff. of house; and ag rooted areas . 2 copies of plan (20% maximum lot coverage allowed) . 1 set of Energy Calculations for heated additions • 2 copies of plan showing beam &window sizes; poured found design, etc,) . 1 site survey for exterior additions &decks . 1 set of Energy Calculations . Indicate if horse served by septic system for additions . 3 copies of Tree Preservation Plan if lot platted after 711193 • Rim Joist Detail options selection sheet (bldgs with 3 or lass units) DATE ~L1S(? - VALUATION Sy+-~l J SITE ADDRESS "1 J C n eiA Q MULTI-FAMILY BLDG _ Y _ N _ 2 TYPE OF WORK FIREPLACE(S) _ 0 -1 APPLICANT QB~QpQBJ®®~~ ~flOllllDV' STREET ADDRESS 49 SOa(ll OWaSSO Bl"' CITY . STATE ZIP TELEPHONE # ~~111e Canada, MN 55111 - FAX #t(.1~~ PROPERTY OWNER -TELEPHONE# COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNESOTA RULES 7670 CATEGORY I _ MINNESOTA RULES 7672 (J submission type) . Residential Ventilation Category 1 Worksheet Submitted New Energy Code Worksheet Submitted • Energy Envelope Calculations Submitted Plumbing Contractor: Phone # Plumbing system includes: _ Water Softener _ Lawn Sprinkler , Water Heater No. Of R.I. g~ 1 ~~p1 No. of Baths D vG Mechanical Contractor: Pho Mechanical system includes: Air Conditioning /Fee: $70.00 Heat Recovery System 01 Sewer/Water Contractor: Phone # I hereby acknowledge that I have read this application, state that the information is corre ; a r e to comply with all applicable State of Minnesota Statutes and City of Eagan Order S. Signature of Applicant OFFICE USE ONLY Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required Updated 4/02 OFFICE USE ONLY ❑ 01 Foundation ❑ 07 05-plex ❑ 13 16-plex ❑ 20 Pool ❑ 30 Accessory Bldg ❑ 02 SF Dwelling ❑ 08 06-plex ❑ 16 Fireplace ❑ 21 Porch (3-sea.) ❑ 31 Ext. Alt - Multi ❑ 03 01 of - plex ❑ 09 07-plex ❑ 17 Garage ❑ 22 PorchlAddn. (4-sea.) ❑ 33 Ext. Alt - SF ❑ 04 02-plex ❑ 10 08-plex ❑ 18 Deck ❑ 23 Porch (screened) ❑ 36 Multi ❑ 05 03-plex ❑ 11 10-plex ❑ 19 Lower Level ❑ 24 Storm Damage ❑ 06 04-plex ❑ 12 12-plex Plbg_Y or- N ❑ 25 Miscellaneous ❑ 31 New ❑ 35 Int Improvement ❑ 38 Demolish (Interior) ❑ 44 Siding ❑ 32 Addition ❑ 36 Move Bldg. ❑ 42 Demolish (Foundation) ❑ 45 Fire Repair ❑ 33 Alteration ❑ 37 Demolish (Bldg)* ❑ 43 Reroof ❑ 46 Windows/Doors ❑ 34 Replacement *Demolition (Entire Bldg only) - Give PCA handout to applicant Valuation Occupancy MC/ES System Census Code Zoning City Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS Footings (new bldg) _ Final/C.O. Footings (deck) _ Final/No CO. - Footings (addition) _ Plumbing _ Foundation _ HVAC Drain Tile Other Roof - Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final Framing _ Siding _ Stucco _ Stone - Fireplace - R.I. - Air Test - Final - Windows (new/replacement) - Insulation - Retaining Wall Approved By Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total 2004 RESIDENTIAL MECHANICAL PERMIT APPLICATION (o 0 City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for: single family dwellings & townhomes/condos when permits are required for each unit Date I I / I / (34 Site Address ~ p ail -y-c T1c-dQ LAX~! l Unit # Property Owner C~ 1 (Tl Telephone #((p_51) 8 (ri 4 q (0 l Contractor Wohlers Southside Htg. & Air, Inc. 6950 W. 14e St., 4106 Street Address _ Apple Valley, MN 55124 City (952) 431-7099 State y t~Telephone # ( ) Bond #:_P4-_' of) 4 r7 q r Expires: The Applicant is Owner Contractor Other Add-on or alteration to existing dwelling unit $ 30.00 furnace -Additional replacement _ air exchanger air conditioner -New ~acement other State Surcharge r$ .50 Total I~l NOV I d 200 ev- I hereby apply for a Residential Mechanical Permit and acknowledge that the informati is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; 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. LcLr'ru Sd~ B ch C~ Applicant' P ted Name ~ppli is Si r 2004 COMMERCIAL MECHANICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for: commercial industrial buildings multi-family buildings when separate permits are not required for each dwelling unit Date / / Site Street Address Unit # Tenant Name (if applicable) Previous Tenant Name Property Owner Telephone # ( ) Contractor Street Address City State Zip Telephone # ( ) Bond Expires: The Applicant is Owner Contractor Other Work Type New Construction - Underground Tank _ Install -Remove "see below Interior Improvement - Install Piping -Processed -Gas Nature of Work: "When installing/removing underground tank, call for inspection by Fire Marshal and Plumbing Inspector Permit Fees: $70.50 Underground tank installation/removal $50.50 Minimum (includes State Surcharge) or Contract Value $ x 1% = $ Permit Fee • If ep rmit fee is $1,000 or less, add $.50 $ State Surcharge If ep rmit fee is over $1,000, add $.50 for every $1,000 ep rmit fee $ Total Fee I hereby apply for a Commercial Mechanical 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 with the Mechanical Codes; 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 Applicant's Signature Approved By: Inspector Date: Use BLUE or BLACK Ink For Office Use Permit Z/3 j City of Ea R I Permit Fee: 3830 Pilot Knob Road I I Eagan MN 55122 Date Received: /0 Phone: (651) 675-5675 Fax: (651) 675-5694 1 Staff: 2009 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Gci Site Address: Tenant: Suite RESIDENT / OWNER Name: Phone: Address ! City / Zip: Applicant is: Owner Contractor TYPE OF WORK Description of work: Construction Cost: 2v cXD(D . Multi-Family Building: (Yes / No Nt~~ CONTRACTOR Name: License Address: Vcc~(;~~"-k -7i2- City: ~2sF~ w~ l t State: zip: d 2`"c- Phone: Contact Person: 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: 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.gopherstateonecall.org 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 pla'n` in the case of work which requires a review and approval of plans. x X_ ~~Szzamz_ - Applicant's Printed Name 1~~-- 'I7 carat's Signature U U I~1f Page 1 of 3 4J O C T 0 5 2009 j DO NOT WRITE BELOW T IS LINEl Jl SUB TYPES Foundation _ Fireplace P rch (3-Season) _ Storm Damage Single Family _ Garage rch (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 ew 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 ADO Occupancy MCES System Plan Review / -T Code Edition Aly? SAC Units - (25%_ 100% Y) Zoning D City Water Census Code L~3t/ Stories 1 Booster Pump - # of Units - Square Feet PRV # of Buildings Length /y Fire Sprinklers Type of Construction Width /G REQUIRED INSPECTIONS Footings (New Building) Sheetrock Footings (Deck) Final / C.O. Required Footings (Addition) Final / No C.O. Required Foundation HVAC fiP.V 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 P/c- o vi e-t - Reviewed By: , Building Inspector RESID - ENTIAL FS Base Fee g ow h Surcharge 1 ~P ~0 0 Plan Review ~f MCES SAC City SAC Utility Connection Charge S&W Permit& Surcharge Treatment Plant Copies Ar ¢ C',a TOTAL Page 2 of 3 ~r 100=00 _ 0 5 W~* NO 0 51 I I R . BY: DATE: E3!!',LDING l ?`lfIONS DIVISION f -S2, AO~~ ~'~►iv Ilo ww~~~ 15,~L5 ~ 1QQJ,00 PERMIT City of Eagan Permit Type:Building Permit Number:EA127574 Date Issued:10/07/2014 Permit Category:ePermit Site Address: 4368 Andromeda Way Lot:003 Block: 003 Addition: Wilderness Park 2nd PID:10-84251-03-030 Use: Description: Sub Type:Reroof Work Type:Replace Description: Census Code:434 - 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 by law in ALL single family homes . David Pederson Valuation: 4,000.00 Fee Summary:BL - Base Fee $4K $103.25 0801.4085 Surcharge - Based on Valuation $4K $2.00 9001.2195 $105.25 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 - Bret W Undem 4368 Andromeda Way Eagan MN 55123 Dun Rite Roofing 4086 Miller View Road Elko MN 55020 (952) 461-5155 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA137940 Date Issued:07/29/2016 Permit Category:ePermit Site Address: 4368 Andromeda Way Lot:003 Block: 003 Addition: Wilderness Park 2nd PID:10-84251-03-030 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. 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 (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 - Bret W Undem 4368 Andromeda Way Eagan MN 55123 (651) 295-2514 Champion Plumbing 3670 Dodd Rd., #100 Eagan MN 55123 (651) 365-1340 Applicant/Permitee: Signature Issued By: Signature