4375 Andromeda WayCITY OF EAGAN WATER SERVICE PERMIT
3795 Pilo! Knob Roed PERMIT NO.:
Eogan, MN 55122 DATE:
Zsning: No. of Units:
Owner,
Address:
Sfte /lddress:
Meter No.:
Sixe:
Reoder No.:
I egroe to eomolr wiTh ths City of Eagon
Ordieanaes.
By
Dote of Insp.:
Connection ChGrge:
Account Deposit:
Permit Fee:
5urcharge:
Misc. Charpes:
Totol:
Date Paid:
CITY OF EAGAN SEVVER SERVICE PERMIT
3795 Pilot Knob Road PERMIT NO.:
.
Eogaa, MN 55122
DATE:
Zoniny: No, of Units:
Owner.
Address:
Site Nddress:
Plumber.
. ..? . . .1 r
' 1agm M oaeply wNh !he CiFr of Eagon Connectlon Charge: '
I OrdiaenoM.
i /lccount Deposlt:
Permlt Fee:
i
Surcharge:
BY Misc. Charpes:
Date of Insp.: Total:
I Insp.: Data Pald:
Receipt
PLUMBING PERMIT Permit No.
CITY OF EAGAN _,: _
Fee ....,_
Fill in numbered spaces S/C
Type or Print legibly ?. .
Tot.
1. Date - - 2. Installation Cost
3. Job Address Lot ' Blk. ---- Tract c,u;W.? VP6 ?
4. Owner
5. Contractor Phone '
6. Address ?
7. City State Zip
8. Building Type: Residential Cl Commercial Cl Institutional ?
9. Work Description: New ? Add ? Alter ? Repair ?
10. Describe
11.
No, Fixtures
Water Claset No. Fixtures
Cesspool/Drainfield
Bath tubs Septic Tank
Lavatory Softner
Shower Well
Kitchen Sink
Urinal/Bidet Other
Laundry Tray
Floor Drains
Drinking Ftn.
Slop Sink
Gas Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
Comply with all ordinances and codes governing this type of work.
Signed: for
Rough Final
Inspections: Date _ Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
Reoript MECHANICAL PERMIT
. CITY OF EAGAN
FiII in numbered apaces
Type or Princ /egib/y
1. Date 2. Installation Cost
3. Job Address Lot Blk.
4. Owner
5. Contractor _
6. Address
? Phone
s
Permit No.
Fee
S/C
Tot
Tract ?
? -1 ?-' _ (i { _ i t ?t
7. City State -• Zip
.
8. Building Type: Residential 0 Commercial ? Institutional O
9. Work Description: New 0 Add 0 Aiter ? Repair O
. 1
Describe - Fuel Type
No. Equinment 8TU - M. Ea.
Forced Air No. EQUipment CFM
Air Handling:
Mfg.
Boilers
Mfg. Mech. Exhaust
Unit Heater
Mfg, Other
Air Cond.
Mfg.
Gas, Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed: for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and apqroved.
Approved CITY OF EAGAN 454-8100
Cities Di i? tal Qualitv 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.
---?
• , CASH RECEIPT •
CITY OF EAGAN
3795 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE
RECEIVED
19
AMOUNT $ I
DOLLARS
100
? CASH ? CHECK
?.
FOR White-Payers Copy
Yellow-Posting Copy
Pink-File Copy
Thank You
L_? s Y
CITY OF EAGAN
)DITION Lot 17 Rik 2 Parcel 10 84251 170 02
street 4375 Andromeda Way state Ea.gar?, NIlV 55123
Improvement Date Amount Annual Years Payment Receipt Date
STREET 5UR F.
STREET RESTOR.
GRADING
SAN SEW TRUNK 1973 Is?.X, 7.71 20 2315 6-7-83
SEWER LATERAL
WATERMAIN
WATER LATERAL
* WATER AREA ? 1979 651.38 65.14 10 - 3
STORM SEW TRK 1979
STORM SEW lAT
CURB & GUTTEfi
SIDEWALK
STREET LIGHT
oa Unit 185.00 25229 6-17-81
WATER CONN. 335.00 25229 6-17-81
SUILDING PER,
sa,c 525.00 25229 6-17-81
PARK
crnr oF EAcAN
3795 Pilot Knob Rood Eogon, MN 55122
PHONE: 454-8100
BUILDING PERMIT
Receipt #
N2 6721
To be aed for Est. Value Dot e , 19
Site Address Erect ? Occupancy
Lot Block Sec/Sub. Alter ? Zoning
p
l Repafr ? Fire Zone
# .
arce
E
l f C
t
T
n
orge ? ype o
ons
.
Name ? Move ? .? Stories
W
Z Addreu Demolish ? Front ft.
6 Grode f°1 Death ft.
? Name
,o
?? Addre
? r:...
Nome _
Address
I hereby ccknowledge thot I have read this application and stote that
the informotion is corred and ogree to comply with all opplicoble
STate of Minnesota Statutes and City of Eagan Ordinances.
Assessment
Water & Sew.
Pol ice
Fire
Enfl•
Plunner
Council
Bldg. Off.
APC
Permit
Surcharge
Plan check
SAC
Water Conn.
Water Meter
Road Unit
Totol
Signature of Permittee I
A Building Permit is issued to: on the express condition thot
oll work shall be done in nccordonce with all opplicoble State of Minnesota Stotutes and City of Eogon Ordinances.
Building Officlal
Pwmk # DaN Isood twwiltM
Plumbing ? - ( - $' oZ- £s1 L -
Mechanital Z-.Z GF /t Z'
C'-
L -r 3L
INSPECTIONS DATE INSP.
Rouflh-In Final
Footings Date Insp. Date Insp.
Foundation Plumbing ,6-
Frome/ins. MecFwnical
Final /
Remarks: r, 7 - [ „ -? ? ,? :c ...?--.: ?. ( Q/?e? ., .a ?y-c<,-. ?-.. ? ?' y -4'.-?? ? "f
L .?
(g.rr#ifirttfr nf (Orrixpttnry
Citp of eagan
Erpttrfmrni o# t?uilbing Jnsprriimt
Tbit Ce+tifitate ittutd Pnrtuqnt to tbt requiremeatt of Sation 306 of the UniJortn BHilding
Codt artifyipg that at the time o f irstutrue tbir rtrurtura wa r in tom fliaur wrtb the variout
ordinanat af the Crty reguloting buiJdrng conn+xction o+ urr. For the follauing:
urCh..fi? SF DWG/GAR e?e6.eamm?po. 6721
(k-v? TYa R3 TYPCae.w?d. V Fm z NA z? rn,?t Rl
?M.fft9ft S. Petersen Const. ?d,.4701 W. 110th St., Mpls.
? Park 2nd
?'? ? May 17 , 1983
?? D.O.
Th,s request vo?d 3lf (? 1 ? `1 Tl } ?? ?\ ? ? `i ?
18 rnmths imm ? L f? IJ v< v
T 62536
Pequest Daie /iJ
? ? Fuo No. flouuh-m Insuer,tion
RQqyrYetl?
w II Notifv InSVec-
?RUadY Nu W?
.?_ ? ?
? ?
K?1'es Nu bor When ReaAy
)"ft icensaA Electncnl Contracior , .l
I hereby request mgpecfion ot above
? Owner electrmal work installad at'
Street AAA
ss
, eo
x or floure No
ie GtY
?
?
7
+
/V ,- '
4
(/1 T`
? 1-7
cuon o. Towns up Name or No. Ran' No. Cnuniy
,r s,.s c n o? ?
Oc?c^uOrntIPRINT / - ? e • '!
Power 'u0P lcr
G L AAdress
?trr
c?o
?
Electnca ConVaotor (Compuny Name) (' . Conttactoe's L icense No.
Mailinp AaWress ?COMractor, or Owner Maki g Instailati )
' '
-?
SSf??O
v
Authoraed Senature onu lor/ ner Mak. g Instal a ion ho Num ¢r
MI NNESOTA- STATE '-BOA?vHD Oi ` ELECTRICITY ? c TNIS INSPECTION REQUHST WILL NOT
- '
Gnqps-Midway Bldd. - Roo. N-181 - " . BE ACCEPTED BV THE STATE BOARD
1821 University Ave.; St Peul,'MN 56104 UNLE55 PROPEN INSPECTION FEE IS
...___ - 11 - ..... ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION x;. Es-ooooi-oa
See instruc4ons lor compleLn9 this form on back of yellow copV. ?`
?• 625 36 ' "
"X?" Below Work C,)vered by This Request q'v?
ew Add Aep. iVOe ur Bu. Winy ADPlmnces Wired Eqvipmen[ Wired
Home Ranye Temporary Service
Duplex Water Heater Lighhny Fixtures
Apt Bwlding Dryer Electnc Heatinc
Commercml BIAy. Fumar.e Silo tlnloader
InAustnal Bldg. Air Condrtioncr Bulk Milk Tanlc
Farnl Olher ..oecify pin,n ISUe,ify)
?hnrlSVecilY Other Othrr
Cornpute lnspeciion Fee Below
fl Fee ServicaEnVanceSize A F Fneders/5ublexders N Fee Cucwts
0 to 100 n s 0 to 30 qm s / i? ? to 30 Amps
1? 101 n 00 Aynps 31 ta 100 qmps 31 to 100 Am s
A6ove _Amps l Above 100__Amps Above 100_Amps
Transiormers Remote Control Cvc. Partiai•'Other e
Signs Inspection
briecral ?+ ?.
$-JJ
G? ?
TOTAI F
Remarks . . ` /f ?/. . /
/ ?
,?l?''1
? 1 l'.?L1'/ 19L-?- /1l?//1A..?'t./_.:.
Rouph-in ' 1
?
?
X
? Ua?e
?Y
I.the Elechicnl
&+
v
?
-,,,
.' ;.? ? ;
~ Y[ Insaector. heiebV
cerLf
thai the nb
fnldl 3 ?r'7 b `
r.
aJ? ? L
?9 y
ova
' SpetLOn 11A5 been
nade.
This reauest vn,A
18 mon[hs honr
This request void
18 months Gom
'T 62530
Gj-7, i3--?, f.t7tP? lo,ncD
a-7 3ov
Reques[ Uate '
F
re No. Rough-in Insuecuon
Rpqm
red? ?
?eTdy Now ?Will Noury InsOec-
? ?Yes Nu !Or When Rerdy
Licensgtl Electncal Contractor i hereby requxst mspecvon ol above
?Owner elecvrcal work installed at
'MINNESOTA SFATE BOAND OF ELECTNiCITY ]HI5 IlvsrECbIUN NEOUtei WiLL NOI
Griaes•MidweY Bld9• - Noom N-797 ' I ' BE ACCEPTED 9Y TME STATE BOAFD, 4821 University Ave., St Paul; MN 55104 , " . UNLESS PROPEH INS'ECTIOM FEE IS'
on....o f6121297.2111 ENCLOSEO.
REQUEST FOR ELECTRICAL INSPECTION „-? EB-ooom-oa
' See ins4uctions for completing this torm on hack of yallow cnpy.
?'b 25 30 "
X" Below Work Covered by This Reyuest 27 C)
Naw Add Rep. TYPo of BvilAm9 Ap0liances Wired Equinmenl Wrted
' Home Ranye TemFwraiy Service
Duplex Water Heater Lightinc Fixtmes
Apt Bmldmg Dryer Electric Heatin
Commercial Bldg. Furnace Silo UnloaAer
Industnal Bldy. Air Condiboner 6ulk Milk Tanl<
Fdfm Other pe.r.i v Other (SPecify)
tvu VociW Uthor Othrr
Compute Inspeciion Fee Below
b F o Ser ic nirence5iae p Fee Feeders/SUbfeeders d Fea Cvicerts
UIAOIOV Am ps 0 to 30 qm s 0 tu 30 Am ?
61dU 7 7 to 200 qmps 31 to 100 qmps 31 to 700 Am s
Above 200 qinFis Above 100_Amps
E
F
]? Abave lU0-Amps
Transronners RenioteControl Circ. - Partial/Other Fee
Signs Special Inspection
S
a
Re???k S ' E/a_?
e o 4 Prt/lL?, .o
Rouflh-in Date
ectricnl
Inspector, heraby
Fnal
D certily ffiat the above
.^? ry? insPection has Oxen
made.
This request voitl
18 nmnths fiam
cinr oF EaGaN
3795 Pilot Knob Raad Eagan, MN 55122
PNONE; 454-8100
BUILDING PERMIT APPLICATION
N? 6721
?
Receipt #
To 6a und for RF DHT/(+AR Est. Volue 80.000 Date StmP 17 , 1991
Srte Address 43 75 Andromeda Way _ Erea ?• p«upancy R3
Lot 17 Block 2 Sec/sub. Wilderness Pf. z qlter ? Zonin9 Rl
Parcel # 10 84251 170 02 Reuair ? Fire Zone NA
E
l of Const
T V
arge ?
n .
ype
w Name S. Peterson Const., Inc. Move ? # storie5
Z Address 47 01 W. 110th St. Demolish ? Front 78 ft.
?
Ci Phone 994-5144 Grode ? Depth 29 ft.
Avvrovals Faes
p
0 Name ?+ar
?? Address
r r:...
Name _
Address
I hereby acknowledge that I have read this application and state that
the information is correct ond agree to comply with all applicable
State of Minnewto Statutes and City of Eagon Ordinances.
Signature of Permittee
A Building Permit is issued to: _
oll work sholl be done in uccordonce
Assessment
Water & Sew.
Police -
Fire
Eng.
Planner
Council
81dg. Off.
APC
Permit lg5 50
Surchorge 40 00-
Plan check 99_5
SAC 595 f1
Water Conn. 335-00
Water Meter Ao,.()0
Rood Unit 1$5.??
Torol $1423.25
9IISt. s Inc. on the exDress conditlon thm
of Minnewta Statutes and Ciry of Eagon Ordinances.
Buildirg Official
?? i4 T ??i9L C' l/G.9 T/ O•? 'n `7`
' ? ' /?? L7F-Ei? e?q6 )
lk
\
G.r? CITY OF EP:GAN
Include 2 sets of plans,
• 1 site plan w/elevations &
ulations
f
l
1
FiUI ING PERN ffT APPLICATIOV .
energy ca
c
set o
'Ib Be Used For ???6valuation -?-r?? o ??
Site Address:y37.5 yWORoGlJr4Y OFFICE USE ODII.Y
Wt /7Block Z Sec./Sub. Pra',°KC{N.varS $rect oCCUpdT1Cy /?•.?
Parcel #: F70 d,- Alter
Repair Zoning
N/
Fire Zone /)! ? • -
-
Oemer: f `? -- ?
(2?? N?tr-"" ?
? ?
C?JN'? EUar4e _ TYFe of Const. ?/
?
•
" Move # Stories
Pddress: ?l7n ? u/ S-t--- ' Demlish Front 7'F ft.
Grade Dept1'i ? S ft.
City/Zip Code: ?IP?-s ys y3 7
Phone #: Zee - S/Y APPROUALS F?
Contractor: S?/?f L
Address:
City/Zip Code: _
Phone #=
Arch./Ehg..
Pddress:
City/Zip Code: _
Phone #:
Assessments
Water/52W2Z'
Police
Fire
Eng•
Planner
Council
Bldg. Off.
APC '
Perntit lBSSU
Surcharge y o, O o
Plan Check 99.75
SAC .s2Z-, a a
WatET COIIil. 33,5-. e 0
Water Meter 66, 00
Rpad Unit j8S, o 0
n=
11 \ v)?
. '
S. PETERSEN CON3TRUCTION, INC.
4701 WEST 110rx STREET 884-5144
BLOOMC.'GTON, MINNE30TA 561]7
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eaga
3195 PILOT KNOB ROAO. P.O. BOX 21799 ? BEA BLOnn9UiSi
EAGAN, MINNESOTA 55121 ^"?
PHONE: (612) 454$100 TFiOMAS EGAN
JAMES A. SMIiH
' JERRV THOMAS
THEODORE WACH[ER
DATE: Counci MemOers
?,il 19, 1983 THOMASHEDGES
Gtv Admrvelmlw
EUGENE VAN OVERBEKE
Gh CIeM
- SPECIAL ASSESShiENT SEARCH
DAKOPA CWNPY ABSTRACP Cp, RE:' WildeXness Paxk 2nd, Lot 17, Block 2 `
1250 Highsaay #55 4375 Andraneda Way S. Eagan, MN 55123
Hastinqs, MN 55033 Parcel # 10 84251 170 02
Enclosed herein is the search which you requested made on the abov e described property.
Kind of Improvement Runs Beginning Original'Amount Balance Due
Sewer 'ihuilc 20 yrs 1973 $151.21 $69.40
Water Area 10 yrs 1979 $651.38 $325.68
I further certify that according to the records of said office, th e following improve-
ments are contemplated or pending after having been approved, and are now in the process
of planning or completion. I
Kind of Improvemeni Approximate date ot Completion Approsimate cost
NONE
WAIVER:
Neither the City of Eagan nor its employees guarantees ttie accurac y of the above in-
formation which was requested by the person or persons indicated. Nor does the City
or its employees assume any liability for the correctness thercof. In consideration
for the supplying of the indicated information in ttie above form, and for all other
consideration of any nature whatsoever, any claim against the City or its employees
rising there from is hereby expressly,waived. Levied assessments to be paid to the
County Treasurer at Hastings, hL'V. 55033
Very truly ya rs,
/ / wnM ??/L.IiZ?? i
THE LONE OAK TTtEE. .. THE SYMBOL AND GROWTH IN OUR COMMUNITY
OF
3830 PILOT KNOB ROAD, P.O. BOX 27199
EAGAN, MINNESOTA 55721
PHONE (612) 454-8100
Special Assessment Search
Date: Januazy 21, 1987
Requested by:
0: DAKOTA COUNTY AIiSTHACT CO
1 1250 HWY 55t P O BOX 456
HASTINGS MN 55033
Re: Wilderness Park Znd
10-84251-170-02
BFA BLOM9UIS1
Mayor
iHOMAS EGAN
J.AMES A. SMITH
VIC ELL15DN
THEODORE WACtfTER
Couroll Members
MOMAS HEDGES
City Atlminrsholor
HIGENE VHN OVERBEKE
caHv aea
On the attached form is the City's response to your search request
on the identified property. The information includes the original
amount of the assessments and the payoff amounts of the assessments
on the parcel. In addition, pending assessments are included for
improvement projects that have been ordered to be installed by the
City Council as they may affect this parcel.
The City's policy is to levy assessments based upon the current
zoning or existing use of the parcel (whichever is higher) as
reflected in the above assessments. If, and when, the parcel is
re2oned or developed to a higher use, a condition of development
approval will require that this parcel assume any additional
assessment obligations that have not been previously paid for
existing gublic improvements. The City Engineering Division can
provide further clarification of this policy if you desire.
WAIVER/DISCLAIMER:
Neither the City of Eagan nor its employees guarantees the accuracy
or completeness of the information provided which was requested by
the person or persons indicated. Nor does the City or its employees
assume any liability for the correctness thereof. In consideration
of receiving and using information on the attached form and for a11
other consideration of any nature whatsoever, any claim against the
City os its employees rising therefrom is hereby expressly denied.
Pending assessments cannot be paid until levied. Levied assessments
can be paid to the CITY OF EAGAN.
Very truly yours,
SPECIAL ASSESSMENT
Attachment
THE LONE OAK TREE. .. THE SYMBOL Of STRENGTH AND GROWfH IN OUR COMMUNIN
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IllftIAL
? ?, j/ BUILDING PERMI7 APPLICATION ?? &J_-?L
55 q( U CITY OF EAGAN
? I 3830 PILOT KNOB RD, EAGAN MN 55122
651-687-4675
New Constructlon Beoulrements ?
. 3 replstered sMe surveys shaxing sq. fl. ol lot, sq. tl. of fause; aM gll roofed areas
(20% meximum Wt wverege allowed)
. 2 copies ol plan showing beam 8 wintlow sizes; poured faund dealgn, etc.}
. 1 aet M Energy Cak;ulatbns
. 3 copies ol Tree Preservation Plen tl ht platted aXer 711l93
. R9nJOi8tUet8ilOptbn38B1obnShCBf(bIUgsWiC13011055un115)
DATE LU-1_GZ
NamodeVfieoalr peaulrements
. 2 coplesof plan
• 1s8tWEnergyCakuletbnsforhe8tedadd'Aans
• i sAe survey lor exterror add'dions & decks
• IMicate If home served by septic system for adtlitbns
? QU ,?^, ?
U
VALUATION A-?N^??
IULTI-FAMILY BLDG _ Y ? N
FIREPLACE(S) _ 0 X 1 _ 2
APPLICANT
iLOlIPfAUP.S dTY¢?t,rfr/St/j.AP STATf,/?/?fQLZIP:M37
STREETADDRESS /f)
TELEPHONE #= 747 ?9?2 CELL PHONE # 0 FAX #?.C?
PROPERTY OWNER TfA0L1 SvMSUYI TELEPHONE #05I ' 4Sq!9 U 36
COMPLETE THIS SECTION FOR ••NEW° RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 MINNESOTA RULES 7672
(q submission type) • Residentiel Vendlation Category 1 WoAcsheet Submitted . New Energy Code Worksheet Submitted
• Energy Envelope Calculations Submitted
Plumbing Conhactor:
Plumbing system includes:
Mechanical Conhactor: _
Mechanical system includes:
Sewer/Water Contractor.
Phone #
Water Softener Lawn Sprinkier
_ Water Heater _ No. of R.I. Baths
No C C T C% 2002
. of Baths
I
Phone #
_ Air Conditioning ' ? Fee: $70.00
_ Heat Recovery System
Phone #
---------------------------------------------°°-------------------^----°------------------- -
I hereby acknowledge that I have read ihis application, state that the information is correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signqlure of Applicanf ?/??, ?t,. ??
..................................................
OFFLCE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4J02
OFFICE USE ONLY
? 01 Foundation
? 02 SF Dwelling
0 03 01 of _ plex
? 04 02-plex
O 05 03-plex
? 06 04-piex
O 07 OSplex 0 13 16-plex
O 08 06-plex O 18 Fireplace
O 09 07-plex ? 17 Garage
? 10 08-plex ? 18 Deck
0 11 10-plex ? 19 Lower Level
? 12 12-plex Plbg_Yor_N
? 20 Pool
? 21 Porch (3sea.)
? 22 PorchlAddn. (4sea.)
? 23 Porch (screened)
? 24 Storm Damage
? 25 Miscellaneous
.
? 30 Accessory Bldg
? 31 Ext. Alt - Multi
? 33 Ext. Alt - SF
? 36 Mufti
O 31 New ? 35 Int Improvement ? 38 Demolish (Interwr) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (FOUndation) ? 45 Fire Repair
O 33 Afteration ? 37 Demolish (Bldg)` O 43 Reroof ? 48 WindowslDOOrs
? 34 Replacement •Demolitfon (Entire Bldg only) - Give PCA handout to applicaM
Valuation Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Storfes Booster Pump
N6r. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footmgs (new bldg) _ FinallC.O.
_ Footings (deck) FinaUNo C.O.
_ Footings (addition) _ Plumbing
_ Foundation HVAC
_ Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ AirlGas Tesu _ Final
_ Framing _ Siding Stucco Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement)
_ Insulation _ Retaining Wall
Approved By
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
Buikiing Inspector
*dtV oF eagan
I'ATRICGI E. AWADA
Mayor
PAULBAKKEN
PEGGY CARLSON
CYNDEE FIELDS
MEG TILLEY
C;ouncil Members
THOMAS HEDGFS
Ciry Adminittraror
Municipal Cenrer.
3830 Pilot Knob Road
Eagan, MN 55122-1897
Phone: 651.681.4600
FzY: 651.681.4612
TDD: 651.454.8535
Maincenance Facility:
3501 Coachman Poinc
Eagan, MN 55122
Phone: 651.681 4300
Fax:651 681.4360
T?D: 651.454.8535
?.ciryofeagan.com
THE LONE OAK'IREE
The rym6ol ofsirengh
and grrnvth m our
wmmuniry
october s, 2002
MS DIANA SCHLIEFER
AMERICAN BUILDING CONTRACTORS
122471vICOLLET AVE S
BiJRNSVILLE MN 55337
RE: INCORRECT VALUATION
BUILDING PERiY1IT #55914
4375 ANDROMEDA WAY
Dear Diana:
A building permit application for permit #55914 was processed on October 3, 2002 with
a valuation of $18,000. Your recent letter states that the correct valuation should have
been $7,555.00. We are, therefore, adjusting the valuation on this permit and sending a
refund of $140.00 to ABC under separaCe cover to adjust the base fee paid. The State
Surcharge is non-refundable.
If you have any questions regarding this refund, please feel free to give me a call at 651-
681-4695.
rely, j/
? Xn?t ?.«??.??_
t?
Jan Severson
Office Supervisor
ec: Dale Schoeppner, Chief Building Offieial
CLAIM V OUCHER - REFUND REQUEST
CITY OF EAGAN
MAKE CHECK PAYABLE TO: AMERICAN BUILDING CONTRACTORS
12247 NICOLLET AVE S
BURNSVILLE MN 55337
LOCATION: 4375 ANDROMEDA WAY
RECEIPT #(DATE: 35334 10103/02
REASON FOR REFUND: INCORRECT VALUATION PERMIT #: 55914
VALUATION: $18,000 REDUCED TO $8,000
TYPE OF REFUND:
Plumbing Pemut 9001.4087 $
Mechanical Pernut 9001.4088 $
Building Pemut Fee 9001.4085 $ 140.00
Plan Review Fee 9001.4222 $
SAC (MC/WS) 9220.2275 $
SAC (Ciry) 9379.4681 $
SAC (Admin) 9001.4246 $
Water Connection 92203865 $
Sewer Pernut 9220.4532 $
WaterPemut 9220.4507 $
Account Deposit 92202252 $
Water Meter 9220.4509 $
WaterTreatment 9220.4685 $
Surcharge 90012195 $
Overpayment 90012250 $
Curb Box Deposit Refund 92202253 $
Construction Meter Dep Refund 9220.2254 $
Other $
TOTAL $ 140.00
I declare under the penalties of law that this account, claim, or demand is just and tha t no pazt of it has been paid.
f
cL?r_c.L- 10i8i02
SIGNATiJRE DATE
MN Contractors Lic. #20169383
12247 Nicollet Ave South
Bumsville, MN 55337
Phone:952-707-6959 Fax:952-808-8846
Attention;Jan Seberson,
This is a letter to inform you that ABC, Inc. applied for a
permit and on the job valuation we made a mistake and
entered the wrong amount, the correct amount would be for
$7,555.00 for work to be done on roof only.
Permit number: EA055914
Address: 4375 Andromeda Way
Sorry for the mistake, please refund back the difference of
the pertnit and if you could please mail back the correct
permit stating the correct valuation for the roof and permit
amouni. If you have ar.y questior.s please contact Diana
Schliefer @ 952-707-6959.
Thank you, Diana Schliefer
' ?u02 f?
r?;T Ci
I?
- - _,
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA118463
Date Issued:11/01/2013
Permit Category:ePermit
Site Address: 4375 Andromeda Way
Lot:017 Block: 002 Addition: Wilderness Park 2nd
PID:10-84251-02-170
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 .
Derek Lindsey
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 -
Terry E Sorensen
4375 Andromeda Way S
Eagan MN 55123
Action Roofing & Siding Llc
1315 Southview Boulevard
S St Paul MN 55075
(651) 457-2642
Applicant/Permitee: Signature Issued By: Signature