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4357 Medary Ave
Rec'd in Street MUNICIPAL MINNEGASCO PERMIT N0. Mpls.F1 SERVI[CE INSTALLATION ORDER N0. Sub. E-N0. Map No. Old? New? Bldg. Class Customer's Name Tel. Installation Address Legal Description: Lot No. Block No. Add Contr's Name ition Tel. Contr's Address Owner's Name? Tel. Owner's Address Date Ordered Max. Demand CF/Hr. Taken By Main AuTh. No. $ervice Location: Right [:] Left [] Front [] Add' I Info. Date Completed Foreman's Name To the (City Engineer (City Council (Village Council (Town Board The Minnesota Gas Company hereby requests permission to perform the work indicated above. MINNESOTA GAS COMPANY (Chiaf Dssign Enginaer) To the Minnesota Gas Company Permission is hereby granted the Minnesota Gas Company to perform the work indicated above. of Date gy (Aufhorizsd $ignature) FORM 52-2R 6/89 Rec'd in Street Mpls.r] Sub. Map No. Customer's Name Installation Address Legal Description: MINN EGASCO SERVICE INSTALLATION Lot No. Block No Tel. _ MUNICIPAL PERMIT N0. ORDER N0. E-N0. Id? New? Bldg. Class Addition ? Contr's Name Tel. Contr's Address Owner's Nome_ Tel. Owner's Address Date Ordered Max. Demand CF/Hr. Taken By Main Auth. No. Service Location: Right F? Left F-1 Front ? Add' I Info. Date Completed Foreman's Name To the (City Engineer (City Council (Village Council (Town Bqard The Minnesota Gas Company hereby requests permission to perform the work indicated above. MINNESOTA GAS COMPANY (Chief Design Engineer) ri To the Minnesota Gas Company Permission is hereby granted the Minnesota Gas Company to perform the work indicated above. of Date gy (Authorized Signature) FORM 52-9R 6/ 69 CITY OF EAGAN Remarks Addition RivPr H1,LI S 9*4t Lot ? Blk 3 Parcel .? 10 64400 080 03 Owner?/ Street 4357 Medary Ave. State Ea4an,MN 55122 ment Date A mount Annual Years Payment Receipt Date EET SUHF. I EET RESTOR. GRA DING SAN SEW TRUNK - x EWER LATERAL WATERMAIN , t WATER LATERAL 1476 3 WATER AFEA STORM SEW TRK Paid t}iTU urnsville STORM SEW LAT 1976 3 ' CURB & GUTTER SIDEWALK STREET LIGHT 1980 13.$6 5 WATER CONN, rt) BUILDING PER. ? SAC 7S PARK CITY OF EAGAN PERMIT TYPE: vAor iOrNG 3830 Pilot Knob Road Permit Number: o? 3'ih<It Eagan, Minnesota 55122-1897 Date Issued: lf+ti (612) 681-4675 ? SITE ADDRESS:' 14.7 ? tCITa 8 RltJCk'• ? rtttY AVE !'.%i i H i! i . + I li PERMIT SUBTYPE: APPLICANT: TYPE OF WORK: i•i ?.1 ;•.- I 1 1 ;iIlfl !•'f)PJ(,I f; REE'AYR l _O. F. Rf'RO(IF ' F I I ? I L J Pertnit Holder Date Telephone # PLUMBING HVAC Inspectlon Date Insp. Comments FOOTINGS FOUND FRAMING ROOFING t?/?` /! p I Y V `.1K v`H? ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PIBG FINAL HTG ORSAT TEST BLDG FINAL DOMESTIC METER IRRIGATION METER FWSH MAINS CONDUCTIVITV TEST HYOROSTATIC TEST BSMT R.I. " BSMT FINAL DECK FTG DECK FINAL CASH RECEIPT - CITY OF EAGAN 3795 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 DATE 19 rxscerveo FROM AMOUNT $ I & DOLLARS 1 oo ? CASH ? CHECK . FOR FUND I CODE I AMOUrvT - y? ?• BY P? ?.1 ?r J a ?3 NUMERICAL FILE CG" G i+ CITY OF EAGAN • 3795 Pilof Knob Road Eagon, MN 55122 N2 4418 ` PHONE: 454-8100 BUI4DING PERMIT ReceiPt # -- T.m be uaed for ' • Date , 19 Site Address Lot Block Sec/Sub. Parcel .# ? Name W t 7:i 3 Address 0 a Name " Zu v? Address Ered ?'- Occupancy Alter ? Zoning " j Repair ? Fire Zone _ Enlarge ? Type of Const Move ? .# Stories Demolish ? Front !t. Grade ? Depth ft. Appro vala Fees W W Name Fi ? re- x FD Address - Eng. _ a"' Ci Phone Planner _ Council _ I hereby acknowledge that I have read this application ond state that gldg. Off. the information is correct and ogree to comply with all opplicable Stote of Minnesota Statutes and City of Eagon Ordinances. APC - Signoture of Permittee A Building Permit is issued to: _ -_- all work shall be done in accordance with all appliwble State of Minn=sota Statu Building Official - Permit `• (AL Surcharge l? Plan check I SAC Water Conn. Woter Meter roral 1,052. 50 on the express condition that s and City of Eayan Ordinances. PamM # Dah Iw??d ?aNfN Plumbing 9e-O Mechanicol ? INSPECTIONS ? DATE INSP. Rouph-In Find Footings Date Insp. Dote Insp. Foundation r/ Plumbing • RO' Frome/ins. ? Mechoniwl Final Remarks: P7,Ut4$IDiG CITY OF EAGAN 3795 Pilot Knob Road Eagan, Minnesota 55122 Phone: 454-8100 PERMIT Date: =i-"t 23, 1977 Sife Address: ?-"' j°'edHYy Avetc:i.. Lot Block Sub/Sec RH 9th Name 5 3 Address O City PFrone: N e ?o?pson Plumbing Co. ? 3 Address '2201 Minnetonka Rlvd. e ? CitY `i":!.??o;•t?a i!:.34 ? Phone• • This Permit is issued on the express condition that all work shall be Minnewta Statutes and City of Eagan Ordinances. New/Alter./Repair w Cost of Installotion _ Permit Fee ` Surcharge .50 Receipt No.: 032a Single Residential I x Multi Res., Comm./Ind. Total ?'.^•`??` 1)i11rcn oTt statement C329 done in accordance with all applicable State of No. q00 Official ? CITY OF EAGAN 3795 Pilot Knob Road + Eagan, Minneaofa 55124 . Phone: 454-8100 SF.ATINC pERMIT Dote: "-ectt]St 19, 1977 Sice Address: Medary 'Avenue Lot Block I Sub/Sec. _- P31 at Name . • ; Address O City Phone: Nome 127 t:. G..'elter l:eatincr .^o. ? P Address A637 C hicago Ave. So. c 0 u ? ? - City -, , V Phone: This Permit is issued on ihe express condition that all work shall be Minnesota Statutes and City of Eagon Ordinances. „r - No. - ,.?. Receipt No.: Single Residential Multi Res., Comm./Ind. I New/AIte r. / Repai r Cost of Instollation Permit Fee C 5 Surcharge Tota l done in accordance with all applicable State of Building Official CITY OF EAGAN 3795 Pilot Knob Rood ? Eagan, Minnesofa 55122 - Phone: 451-8100 '-.',TER SOFTENER pERMIT Date: •-' , rual'V 27, 19 r_, Site Address: ' 1-7 ",-rl3t" Lot ? Block Sub/Sec. No. 185 Receipt No.: Single I Residential Multi Res., Comm./Ind. Name ?nald Whlteley . 3 Address _ O City Phone: Nor„e 1-bert Co. - ci 2 Address 11 Marie St. e 0 V City - Phone: This Permit is issued on the express condition that all work shall be Minnesota Statutes and City of Eagan Ordinonces. New/Alter./Repair. Cost of Instollation Permit Fee 5. n n c, n Surcharge ' Totul done in occordance with all applicable State of Building Ofticial CITY OF EAGAN SEWER SERVICE PERMIT 3795 Pilot Knob Road PERMIT NO.: Eaoan, MN 55122 DATE: Zoning: No. of Units: Owner: Addresr. Site Address: Plumber. - 1 agree to comply with fhe Cify of Eugon Connection Charge: Ordinances. Account Deposit: BY -- Date of Insp.: Insp.:-. :ITY OF EAGAN 1795 Piiot Knob Road iagon, MN 55722 'oning: hvner: kddress: _ ite Address: 'lumber: - Aeter No.: ize: :eader No.: ogroe ro eomply wit6 tha City of Eagan Permit Fee: Surcharge: Misc. Charges: Total: Date Paid: WATER SERVICE PERMIT PERMIT NO.: DATE: No. of Units: Connection Charge: Account Deposit: _ Permit Fee: Surcharge: Misa Charges: Total: Date Paid: This ztqaest void 18 months from ,.?e a >o.s..f,? ,61- o7aa9 Date of this Request P 11470 I, as'RLicensed Electrical ntractor Owner, do hereby request inspection of the above electri- cal winng installed at: Street AddreL?pr Ro te?No. 3?7 V?A"? C" Y Section ownship Range County Which is occupied by Is a roughin ins Power Supplier Electrical Conti Mailing Addresi on this job? No ? Yes & Ready Now ? Will Call)K Authorized Signat?e?_?t?ol/ - (Electrical Contractor or Owner M ST? F1 ? DBAR? COPY e Contractor's License N43&36 , ? ???I f?^ o aking In latlon) e No.,??969 ak ng I'his Insta lauon) ??- - (P 2004 RESIDENTIAL PLUMBING PERMIT APPLICATfON CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 4?1'1 1 Please complete for modifications to existing residential dwellings. ?--?? 1,5sb Date l1 I? l 7 ?S? m n 55/a a Unit # Site Street Address N- Property Owner ?" ) ????Y1?jQ.Y' Telephone # ((pSj) 890' Q-)CaL Contractor 3L• l.t"pi X V?.? . Pci C,L?L( X' Telephone # n1?j) <??lnr Address 7`),?, ('j'U K,U ?' t)(j 1 t4 IN City Hy C ?Fn StateIAIT: Zip The Applicant is: _ Owner l/ Contractor _Other AlteXations to existing dwelting _Add fixtures to rooms, excluding water softener and water heater _Septic System Abandonment _Water Turnaround (add $121.00 if a 5/8" meter is required) Other: $ 50.00 ? Water Softener Water Heater ? replacement _ additional $ 15.00 Lawn Irrigation System RPZ_ new _ repair _rebuild $ 30.00 State Surcharge $ .50 Total $ ? `J• 150 I hereby apply for a Residential Plumbing 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 plumbing codes; that I understand this is not a permit, but only an application for a permit, work is not to start without a permit and work will be in accordance with the approved plan in the event a plan is required to be reviewed and approved. ApplicanYs Printed Name A plicant's Signature ?, . „ ,! : - Minnesota State Board of-Electriaty ;fy O7?? -? ? - ?? nL? . 9J54 University Ave., St. Paul, Minn. 55104-Phone 645-77?3'e'?`a ?tL??' 9 • REQUEST FOR ELECTRICAL INSPECTION. CHECK BELOW WORK COVERED BY THIS REOUEST ?q, fr?° 11470 Type of Building New Add. Rep. . Check Applian ces Wired For Check uipment Wi[ed For Home JR, ? ? Range Tempoiacy Wiring ? Duplex ? ? ? Water Heater ? Lighting Fixtures lff Apt. Bldg. ? ? ? Dryer ? Electric Heating ? Commetcial Bldg. ? ? ? Fumace .? Silo Unloader ? Indusirial Bldg. ? ? ? Air Con 'tioner. ? Bulk Milk Tank ? Farm List List Othe: ? ? ? HeheIS? p Rehels? COMPUTE INSPECTION FEE BELOW Serviee Entrance Size: # Fee Feeders&Subfeedeis: # Fee Circuits: # Fee 0 to 100 Am s. 0 to 30 Am eres 0 to 30 Am eres 101 to 200 Amps. 31 to 100 A es 1: 31 to 100 Am res Above 200 Amps. Aba,N?4?Q Pr? " ps. . ?? Above 100 Amps. Transformers Re 'te ?ontro} Gr'?. ;? E: ' Paitial or other fee Signs Spect' Ins ion Minimum fee $5.00 Remazks TOTAL FEE ? I, the Electrical Inspector, hereby certi t the'?ingpection has been a (Rough-in) ' Date (a 4 • ? (Final) Date-A?'".?? '?. This request void 18 months from y CIT1f OF EAGAN 3795 PiIM Knob Road Eagan, MN 55122 PHONE: 454-8700 BUILDING PERMIT APPLICATION $399000. ReceiPt N? 4418 5775 To be uaed for Siag. Fem Dwlg. & Garg. DOYe July 20, 197 7 Site Address 4357 MEdaTV AV2 Erect ? X Occuponcy I Lot 8 Block 3 Sec/Sub. River Hills 9th Alter ? Zonin9- Rl Parcel # ? Nome Windsor Development Corp z Address 4660 W. 77th St. 3 ' Name _ 0 ?? Address ?:... Name _ Address 1 hereby ocknowledge that I have read this application and state that the information is correct and agree to comply with all applicoble $tote of Minnesota Stotutes and City of Eagan Ordinances. Repoir ? Fire Zone _ Enlarge ? Type of Const. V Move ? .# Stories Demolish ? Front 64 tt. Grade ? Depth 25 ft. Aoorovals Fees Assessment _ Water & Sew. Police Fire Eng. Planner _ Council _ Bidg. Off. - APC Permit 11-3.VV_ Surcharge 19.50 Plan check SAC 475.00 Water Conn. 205.00 Water Meter 60.00 Svw Trk 180.00 Toral 1,052.50 Signature of Permittee - I A Building Permit is i5sued ro: Windsor Dev., COip, on the express condition that oll work shall be done in occor¢ance with oll applicable State of Minnesota Statutes and City of Eagon Ordinances. Building Official RESIDENTIAL BUILDING Permit Application ? • ° City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Construction Reauirements RemodeVReoair Requirements 3 registered site surveys showin9 sq. ft. of lot, sq. ft. af house; antl ali roofed areas 2 copies of plan (20°k maximum lot coverage allowed) 1 set of Energy Calculations for heated addiGons 2 copies of plan showing beam & window sizes; poured tound design, etc. 1 site survey for additions & decks 1 set of Energy Calculations Addition - indicate if on-sfte septic system 3 copies of Tree Presenation Plan if lot plaried after 711193 Rim Joist Detail Options selection sheet (bldgs with 3 or less units -t`-1 I.o 6 C.__j2JJ-?? . I??) ,+ -o3 Office Use Onlv Cert of Survey Recd _ Y_ N Tree Pres Plan Recd Y_ N Tree Pres Reqd Y _N On-site Septic System _ Y_ N Date 10 / 7 103 Construction Cost Site Address 185-7 Me-dR->t c.j A-v t• UniUSte # ? n:jP-- ?lIt ?( 5 s r z z Description of Work ?E-pIACErn?,ni' p f o(c! . ? b' x (O Decf[ wA I1Eu> l? ?c (¢ d.G-Ck. . Multi-Family Bldg _ Y? N Fireplace(s) _ 01 _ 2 Property Owner GE,?? ?&2 Telephone #((oS1 )$Q o-zl 76 1 Contractor Address ?13 $ 7 M G-cIe,K k? A-c}6. , CSty 'F q-c1.R -1. State M r( Zip S S I Z Z Telephone #(9S 1) 8-70 "A? 76 1 COMPLETE THIS AREA ONLY IF CONSTRUCTING A Energy Code Category - Minnesota Rules 7670 Cateeorv 1 • Residential Ventilation Category 1 Worksheet (4 submission type) Submitted • Energy Envelope Calculations Su 'tted Have you previously constructed a building in Eagan with a fee applies. Licensed Plumber Mechanical Contractor Sewer/Water Contractor BUILDING Minnesota Rules 7672 . New Energy Code Worksheet Submitted Y Telephone # ( Telephone # ( TelepFione # ( N lf so. 25% plan review ? ?0 C''07 2003 Iil, I hereby apply for a Residential Building Permit and acknowledge that the informdfibn-as.calet and`accurate; 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; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. -goIA RI a Applicant's Printed Name Applicant's S?gnature OFFICE USE ONLY Sub Types ? 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. Ait - Multi ? 03 01 of _ piex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 08-plex ;15? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc. ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous Work Types ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ?"__ 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair r? .?. ?? 33 Alteration ? 37 Demolish (Bldg)* ? 43 Reroof ? 46 Windows/Doors ? 34 R2p18Cement *Demolition (Entire Bldg) - 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 Footings (new bldg) Footings (deck) _ Footings (addi6on) Foundation Drain Tile Roof Ice & Water Final _ Framing _ Fireplace _ R.I. _ Air Test Final Insulation REQUIRED INSPECTIONS FinallC.O. ? FinaUNo C.O. _ Plumbing HVAC Other _ Pool _ Ftgs _ Air/Gas Tests _ Final _ Siding Stucco Stone _ Windows (new/replacement) _ Retaining Wall Approved By f -) , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search ? Copies ?.T t7 Other Total .1 \ y? Cl ?• ?t r.? i?? i?-?? i??i i?? -,?,? ??????, ?-,,???, ._ \ /41 L tow t..0 I.0/ loooo ? , 1 . ? ,7 . i ??.4? r fi ?1:? H r xv J., ??y?4?195t? Fn ?; ? •..t 5 .. . . Y ?Si. y , " v? . •? '? a a? t} ?.,' 4? x ? ? 1'?_ j?.'. ? i ? , . .. , „ <<r` ??<c-? " .. j?'i'..;i ?x ..-.,?.. ...? ?. . .;°,? ; - :., , " r . .,:' .:?".?"ry :?j.•.?'?`"T? :"p Ih ,?n : xa. ? , v, ?., .,?,J# ? , ??.:!:.n? i .€.'.w?' a ?% ...a:;i ? • 'r :.n $,;r. L? r.? ..r. ,'t , k f5.., Tt. Y .,7' .F. ?J1.? ?L`:d.". ..n +'?ii 1 .,??. ?y 1 ?.?'. se, f 4v_r. ,.- {,r?k.?. .. M.16. .a kw.. 6"?..,,., t?.,fr . , vl-0:..: w.. 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'?? ?i =--- (T?+; ---' p? l,??zr .,• ., ?. .o ? k . < ? ? ?!? p. ,: ? - FERMIT CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 PERMIT TYPE: BuILDz NG Permit Number: 033691 Date Issued: 10/ 15 j g 8 SITE ADDRESS: 4357 MEDAftY AVE LUTe 8 BLOCKe 3 RIVER HILl.S 9TH P,T.N. c 10-64400-080-03 DESCRIPTION: REMARKS: FEE SUMMARY: (;UIV I FiAC: l (JFi: ERooF ST'ORM [lh1MAGE REPAIFt 434 ALT. RESIDENTTAL. ? y? ?? aP(?'lka?':; a€ r4L 2A $(h VVVIMCR: - HpplicanL - GEMPLER RONALD 4357 MEC1flftY AVE EAGflN hIN 55 (851)890-4761 Qk.3s? APPLICANT/PERMITEE SIGNATURE UED BY: SIGNATUR 1998 BUILDING PERMIT APPLICATION (RESIDENTIAL) r ' CITY OF EACiAN 3830 PILOT KNOB RD - 55122 ? Ug? l? I 681-4675 New Construdion Reauirements 4 3 registered site surveys ? 2 copies of plans (inGude beam $ window saes; poured fid. design; etc.) • 1 energy calculations • 3 copies of tree preservation plan if lot platted after 7!1193 required: _ Yes _ Na DATE: /0„A 5,l9 S DESCRIPTION OF WORK: STREET ADDRESS: RemodeVReoair Requirements ? 2 copies of plan ? 2 site surveys (exterior addi[ions & decks) 1 1 energy wlwlations for heated additions CONSTRUCTION COST; 6?500? qF r:t-La-faJU vtA--ii Rsot - SfOrm DLXm 7 ??l QNa-tz-y GGt2. , t LOT: ? BLOCK: ? SUBD./P.I.D. #: Q i&er PROPERTY OWNER CONTRACTOR ARCHITECT/ ENGINEER Name: G6-m-f/216-rz- ?o tiA? ? Phone #: I.az First Sueet Address: `t 3 S 7 i' R&C(A-a City ? A-vA 5tate: Zip: Z Z . Company: Phone #: Street Address: License # City State: Company: Phone #: _ Name: Registration Zip: Street Address: City State: Zip: Sewer & water licensed piumber (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: o-?c OFFICE USE ONLY Certificates of 5urvey Received _ Yes _ No Tree Preservation Plan Received Yes No Not OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex O 02 SF Dwelling ? 07 4-plex O 03 SF Addition O 08 8-plex ? 04 SF Porch ? 09 12-plex ? 05 SF Misc. ? 10 = plex WORK TYPE 0 31 New ? 33 Alterations ? 32 Addition ? 34 Repair GENERAL INFORMATION ? 11 Apt./Lodging ? ? 12 Multi Repair/Rem. ? ? 13 Garage/Accessory ? ? 14 Fireplace ? ? 15 Deck ? 36 Move ? 37 Demolition I 16 Basement Finish 17 Swim Pool 20 Public Facility 21 Miscellaneous Const. (Actual) Basement sq. ft. (Allowable) Main level sq. ft. UBC Occupancy sq. ft. Zoning sq. ft. # of Stories . sq. ft. Length sq. ft. Depth Footprint sq. ft. APPROVALS Planning Building Permit Fee Surcharge Plan Review License MCNVS SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment PI. Park Ded. Trails Ded. Other Copies Total: MC/WS System City Water Fire Sprinklered PRV Booster Pump Census Code. SAC Code Census Bldg Census Unit Engineering Variance Valuation: $ % SAC SAC Units G+ ? z CITY USE ONLY R L BL ?J RECEIPT#: 7 L SUBD. R1v-r ? I q 7J RECEIPT DATE: ? PERMIT# 1993 nUM$INfi flumrT Qf{ESIIIEENTIALI CPfY OF £AfiAN 3$30 P[LOT KN08 fiD EA&AN, MN 55122 (651) 681-4675 Please complete for: ? single family dwellings > townhomes and condos when permits are required for each unit i backflow preventer for underground sprinkler.system FixruRes EACH # TOTAL 5 Bath tuh Q 3.np x = ? Floor drain 3.00 x = $ Gas i in outlet " minimum -1 3.00 x = $ Hot tubls a 3.00 x = $ Kitchen sink 3.00 x = $ Laundr tra 3.00 x = $ Lavator 3.00 x = $ Minimum fee alterations to existin dwellin 30.00 x = $ 3, Private Dis osal 5 stem new/refurbished ' re uires MPC iic. 75.00 x = $ Private Dis osal S stem abandonment 30.00 x = $ RPZ new installation/re air 30.40 x = $ Rou h o enin 1.50 x = $ Shower 3.00 x = $ Under round s rinkler if dwellin is under construction 3.00 x = $ Under round s rinkler if existin dwellin 30.00 x = $ Water closet 3.00 x = $ Water heater 3.00 x = $ Water SOftener If dwelling under construction 5.00 x = $ Water softener if existin dwellin 30.00 x = $ Water turnaround 30.00 x ---- _ $ State Surchar e .50 --> ----> ----> $ 50 total --? --? ----> ----> $ 30.50 iceminder. i;afi for inspections ov aitierations, i.e. water heaters, water softeners, etc. -------------------------------------•------ ------- --------------------------- --------------- I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable City of Eagan ordinances. It is the applicanYs responsibiAty to notify the property owner thal the City of Eagan assumes no liability for any damages caused by the City tluring its normalbperational and maintenance acGvities to the facilities constructed under this permit within City property/right-of-way/easement. SITE ADDRESS: GEMPLER,RON . 4357 MEDARY AVENUE EAGAN, MN 55122 (651) 890-4761 _ TELEPHONE #: (AREA CODE) OWNER NAME: : ' INSTALLER NAME: STREET ADDRESS: CITY: TELEPHONE #: (AREA CODE) qum STATE: ZIP: SOUTH M IV 55408 l / SIG T OF PERMITTEE ? ? ? ..r?:.. i . .? ? . ,:1 ''??;,ii =ai?..t. ?.h.? 1? ? ' :.v.` :,? '+'?`?f. a.. .. ?:'eF1 .. :vr ?.? ? ' u . .ll.' ' ... . R ? . ?: I.GT ? Dates /7 ` 7 "7 _ BUILDIi?G PERtti1IT P,PPLICe3TYO*_7 BLOCK ? ?7DITIO?d?(f .'! .'•.:?.?T., & wP•.C7.IOP1 IN11L3ER Ik' ULdPLATTED Vl, tr'EL / h/ ? 1 ?j?/ ?d? T7 OCCUPANCY ? i jS1li 1'ri1S L"ii;'-1C x ?,a :_i)I' ?.EBS TELEPHONE 1T0. TELEPHONE 110. ?';utes Tncl.ude site plan, building plans, and energy calculations trith th?.r application Signed ..._ ._.__ _._ . OFFICE USE JALUi TIOi; ? ,.... '417 5? ? .. .t$'..C lJiPNEC'_IOLl I oS G//u,?z/?...... CAD __ ?_ . . . ,_ _ ?:? ?>•r.e??? _ _. . / ::7LT??Tr.IG PF?tt•IIT FEE r/r,7 ?IRCT3?1P,GT•. FEE ... L ? g o P:,mi C?SCIZ FE;: PaFtSZ DEDIC:^aTI0i:1 FEE OT; clt ---- ?r'..?4T4' '•';^. P"O`JZ1L.S; 73SSMMi'dT CLERK?BUILDIIdG PT. POLICE DEFT._ PARK DEPT £? SEi•dP,R D?,PT. FI1RE DEPT. . WINDSOR DEVELOPMENT CORPORATION July 19, 1977 Mr. Dale Peterson City of Eagan 3795 Pilot Knob Road Eagan, MN 55122 Dear Mr. Peterson: RE: Lot 8 Block 3 River Hills 9th Addition 4357 Medary Avenue Enclosed please find a check for building permit application and fees as allocated on the check stub in the amount of $1,052.50. This home will'-)be a Model 76-52 Elevation C and will contain the following: -Bath and 3/4 Bath -Patio Door off Dining Room with an 8 X 10 Deck -Fireplace - Family Room -Appliances -Finished Family Room -Short hip roof -Pass through in Kitchen Attached also find a copy of the proposed plot plan. Sincerely, WINDSOR DEVELOPMENT CORPORI-1TION Michael D. McCormick Vice President MDM/jb Enclosure SUITE 192, 4660 WEST 77TH STREET, EDINA, MINNESOTA 55435 0 PHONE (612) 831-0717 ? _ _ _ _ ' _ ' - ' _ _ _ - - _ _ _I ? rordfRc9 Us9? ? Permit #: U U I ? ? Pertnd Fee: ? I q Date Received: ? I ? ? Sfaff ? L----------------- I 2009 MECHANICAL PERMIT APPLICATION Date: - 1-1- 09 Site Address: Tenant: Suite #: RE5IDENTlOWNER Neme: 2(9 e-,,1 &em .nlC/(-, Phone: t.QS? - ?? V Address 1 City 1 Zip: 351 Mec1G kje.. (1 1'lljN) CONTRACTOR Name: Lfcense #: (SLtq C&v Address: ?00 Nj?j n 'N Zi St l ?3'51 a e p: City: Phone-qJ) -]4'j ' ILIUO Contacl Person: iei !'l TYPE OF WORK - New X% Replacement _ Additional _ Alteration _ Demolition Descripdon of work: n P Ruf'010(' _! AQ- NO7E: Both mof moanted and ground mounted mechanlcal equfpment is required to be screened by City Code. Pleasa confact the Mechanical lrtspector or one of the Planners for informatlon on ermitted screenin mefhods. RESlDENTIAL COMABE'RC/AL RERMIT TYPE ? Fumace _ New Conslrvction _ Interior fmprovement ? Air Condiliener _ Install Piping _ ProCessed Air Exchan9er _ Gas _ Exterior HVAC Unit Heat PumP Under / Above ground Tank ( _ Instelll_ Remove) ? •• When installinglremoving tank(s), call for inspection by Fire O[her Marshel and PWm6;ng Inspeclor RESIDENTIAL FEES: $50.50 Minimum Add-on or alteration [o an existing unit (includes $.50 Stale Surcharge) $90.50 FIf2 f@p81f (replace 6urnad out apphancas, dudwork, e[c.) (inciudes $.50 State Svrcharge) ? TOTAL FEE 50 s . COMMERC/AL FEES: $70.50 Underground tank installation/removal OR Contract Value $ x 1% E50.50 Minimum (includes State Surcharge) Permit Fee - If rmi ggg ig le9s than $7,000, surcharge ts $.50. - If Pertnit Fgg is > $1.000, surcharge increases by $.50 (or each =$ Siate SufCharge $1,000 Pertnit Fee (i.e. a$1,001-S2,OOD Permit Fee requlres a S1.0 surcharge). $ TOTALFEE I herehy acknowledge lhat Ihis informa(ion is complete and acwrale: that ihe work will 6e in canformance with the ardinances and codes of the City of Eayan: lhal I undersland Ihis is not a permil. bul only an applleaUan for a permt[, aM wortc is nol lo slart wllhoul a permll: Ihal Ihe xro wiA De fn acearAence with iBe approved plan in Ihe cese ofwork which requlres a review arW approva! of plane. FOR OFFICE USE Reviewed By; Data: Requlred Inspactlona: _Under Ground _ Rough In ___f1ir Test _Gas Service Test _In-floor Heat _Final Exterior HVAC r--------- --J------I I'Or~1Ce t~56City n Permit#: of Eagan 11 I Permit Fee: 3830 Pilot Knob Road Eagan MN 55122 Date Received: Phone: (651) 675-5675 I Fax: (651) 675-5694 1 Staff: 1 L -----------------I Gg 2009 MECHANICAL PERMIT APPLICATION Date: t t Site Address: M l l.l(.X(-(A ~t E(A- 0V , Q 1 55I Tenant: Suite -Ll~G~ RESIDENT/ OWNER Name: r;11 C-1 l?f'YYl ` Phone: Us ~ -2)90 2 1 eC)Ct 2l~ Address/ City /Zip: J~ I ~ r1V , (1 CONTRACTOR Name: 2..UCL+-- > License 1949 ~AO Address: + ~1~ c 1wL1 a155 ~ City: I h' A( YI-~J7 ~l ~1~ StateVA ~J Zip: Phone 5j Contact Person: Lbpiei~-' - n TYPE OF WORK New Replacement Additional Alteration Demolition Description of work: .P C~ f l (-CZACe l AQ- NOTE. Both roof mounted and ground mounted mechanical equipment is required to be screened by City Code. Please contact the Mechanical Inspector or one of the Planners for information on permitted screening methods. PERMIT TYPE RESIDENTIAL COMMERCIAL Furnace _ New Construction _ Interior improvement Air Conditioner _ Install Piping _ Processed _ Air Exchanger _ Gas Exterior HVAC Unit Heat Pump Under/ Above ground Tank L_ Install]_ Remove) When installingiremcving tank(s), call for inspection by Fire Other Marshal and Piumbing Inspector RESIDENTIAL FEES: $50.50 Minimum Add-on or alteration to an existing unit (includes $.50 State Surcharge) $90.50 Fire repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) $ 50 TOTAL FEE COMMERCIAL FEES: $70.50 Underground tank installation/removal OR Contract Value $ x1% $50.50 Minimum (includes State Surcharge) Permit Fee - If P rrni Fee is less than $1,000, surcharge is $.50. if Permit Egg Is > $1,000, surcharge increases by $.50 for each State Surcharge $1,000 Permit Fee (i.e. a $1,00142,000 Permit Fee requires a $1.00 surcharge). $ TOTAL FEE 1 hereby acknowledge that this Information is complete and accurate: that the work will be in conformance with the ordinances and codes of the City of Eagan: that I understand this is not a permit, but only an application for a permit, and work is not to start without a penult; that the wo will be in accordance with the approved plan in the case of work which requires a revlew and approval of plans. z x A I' ants Printed Name A ` li nt's Signaturel\j FOR OFFICE USE Reviewed By: Date: Required Inspections: -Under Ground - Rough In ____AirTest -Gas ServiceTest -In-floor Heat -Final Exterior HVAC Screening Inspection Use BLUE or BLACK Ink r For Office Use 1 l ; Permit lion City of EaRd 1 I Permit Fee: 3830 Pilot Knob Road Eagan MN 55122 ; Date Re eived: © ` 1 Phone: (651) 675-5675 of 1 I Fax: (651) 675-5694 C~ I Staff: I 2011 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Z 7 ZY Site Address: 14c~2 Unit Name: L-4 Phone: RESIDENT / G OWNER Address/ City /Zip: Applicant is: Owner Contractor X Description of work: v~S TYPE OF WORK Construction Cost: -7 - Multi-Family Building: (Yes / No Company: S cl 5 Contact: Jr G c~ C C CONTRACTOR Address: rj~~b 13 Ls--~ City: 1JU r--__v S y i State: i : )5-737 Phone: Zip: v l /UST ~a - o c a 3 S~~ s ~ License a Lead Certificate 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 & Water Contractor: Phone: NOTE. Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets. t 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.ora 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. xC~~J41~ x Applicant's Printed Name scan ' e Page 1 of 3 PERMIT City of Eagan Permit Type:Building Permit Number:EA112030 Date Issued:07/24/2013 Permit Category:ePermit Site Address: 4357 Medary Ave Lot:8 Block: 3 Addition: River Hills 9th PID:10-64400-03-080 Use: Description: Sub Type:Siding Work Type:Replace Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to ensure maximum ventilation to attic. Call for final inspection after installation. Carbon monoxide detectors are required by law in ALL single family homes . William Krech 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 - Pam Jex 4357 Medary Ave Eagan MN 55122 (952) 210-1659 Krech Exteriors Inc 5866 Blackshire Path Inver Grove Heights MN 55076 (651) 688-6368 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA112918 Date Issued:08/26/2013 Permit Category:ePermit Site Address: 4357 Medary Ave Lot:8 Block: 3 Addition: River Hills 9th PID:10-64400-03-080 Use: Description: Sub Type:Reroof Work Type:Replace Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar. Pictures are not acceptable in lieu of inspections. Carbon monoxide detectors are required by law in ALL single family homes . William Krech 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 - Pam Jex 4357 Medary Ave Eagan MN 55122 (952) 210-1659 Krech Exteriors Inc 5866 Blackshire Path Inver Grove Heights MN 55076 (651) 688-6368 Applicant/Permitee: Signature Issued By: Signature For Office Use Ø1: :::t:e : /97 REC!E'J z) Date Received: ♦ / 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 +� (651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 � Staff: buiidinginsoections{c citvofeagan.com t t..IU 4 2018 1- 2018 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: 1/357 Mevtar 4. a Unit#: Name: --tic Lin er� Phone: 6/497-768—/76G Resident/ Owner Address/City/Zip: 1 / r - e. SS/ZZ Applicant is: X Owner Contractor T of Work . Description of work: � C� K /Gerrrp Type Construction Cost: • ocw.oe Multi-Family Building: (Yes /No )() Company: Contact: Contractor Address: City: State: Zip: Phone: Email: License#: Lead Certificate#: If the project is exempt from lead certification, please explain why: 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 no blic if ' ovide=. elite reasons that would •-emit the Ci to conclude that the 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.citvofeacian.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. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.aopherstateonecall.orq I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a p- mit- hat the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. X cew i- hl r X / e Applicant's Printed Name / Applicant's Signature DO NOT WRITE BELOW THIS LINE z-/:-- f5 7 (Y) iPr1L) iYW6. = / / . / 7 SUB TYPES Foundation _ Fireplace _ Porch(3-Season) _ Exterior Alteration(Single Family) — Single Family Garage — Porch(4-Season) _ Exterior Alteration(Multi) — Multi Deck — Porch(Screen/Gazebo/Pergola) _ Miscellaneous 01 of_Plex Lower Level Pool Accessory Building WORK TYPES r' 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 V •� • Occupancy jZ c.–1 MCES System Plan Review Code Edition vin fa 2 0 lc' SAC Units (25% 100%'P ) Zoning 2 "1 City Water Census Code Stories Booster Pump #of Units Square Feet PRY #of Buildings Length Fire Suppression Required Type of Construction v-3 Width REQUIRED INSPECTIONS Footings(New Building) Meter Size: .0 Footings(Deck) Final/C.O. Required Footings(Addition) > Final/No C.O. Required Foundation Foundation Before Backfill HVAC_.Gas Service Test Gas Line Air Test Hood Roof:_Ice&Water _Final Pool: Footings _Air/Gas Tests Final Framing 30 Minutes 1 Hour Drain Tile Fireplace: Rough In Air Test _Final Siding:_Stucco Lath _Stone Lath Brick_EFIS Insulation Windows Sheathing Retaining Wall: Footings_Backfill—Final Sheetrock Radon Control Fire Walls Fire Suppression:_Rough In Final Braced Walls Erosion Control Shower Pan Other: Reviewed By: " VI; f- 17 / , Building Inspector RESIDENTIAL FEES j d �( 7.5 -- c 2 -7 o s�' . /4- Base Fee / �` J Surcharge 6)0 ic-fl a 59 , Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit&Surcharge Treatment Plant Copies TOTAL Page 2 of 3 • :. --1,-,,,....-7'7-4n' .•1 4'-....i.-.cr,..1,;7,.,-'t: .tt:4‘4,4•-',.tr.4i-r-, :. •t,';‘,-r'"*.--,. 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