4257 Malmo Lane N, CITY OF EAGAN
' 3795 Pilot Knob Road
Eagan, Minnesota $5122
Phone: 454-8100
pLtvoam PERMIT
Dote: AaY 1, 1979 Receipt No.:
Single
Site Address: 42 57 ND• l1a1= I,oM Residential
No. 1339
n
Lot 'Block 2 Sub/Sec. _WR 6th I Multi
Name ??lem Hoew8 1nc• air now
New/Alter
/Re
.
p
`
Address 525 So. Snellii2=J Ave.
Cost of Instollation
?
?It. Panl 55116 20.Ot?
City Phone: Permit Fee
Ralph' s Pltmtbir-q • 50
Name Surchorge
.
? Addreu 9900 XesvfCk Nrr.
0
v -_:; slwce! 55082 City _ Phone: Total
This Permit is issued on the express condition that all work shall be done in accordante with oll applicoble State of
Minnesota Statutes ond City of Eagan Ordinances.
Building Official
. . • CITY OF EAGAN
' 3796 Pilot Knob Rood
Eogan, Minneaota 55122
Phoee: 454-8100
? MA`?'IN'J PERMIT
Date: -- 14, 1978
Site Address: 4257 bIo=. M31111o In.
Lot } Block 2 Sub/5ec. _ WP 6th
Name Tilson Home$ IrC.
.
°e Address 624 SO. Snelllilu Avr?,.
3
O
ty "?. Paul 55116 Phone:
Nome A. BiDd!!t S SATt : nt:.
2 Address 120 E. Btitle= AYt- e
e
0
V --It. Faell r = ? ;
City ?' - Phone:
This Permit is issued on the express condition that oll work shall be
Minnesota SYotuies ond City of Eegan Ordinonces.
C?USTIO?II AIR IMMI1tLD
No. 1364
12697
Receipt No.:
Single
Residentiol X
AAulti Res., Comm./Ind. I
New/Alter,/Repair new
Cost of Installation
Permit Fee 20.00
Surcharge .50
Total ?'''• ??
done in aCCOrdante with oll applitable State of
Building Officiol
INSPECTIaN RECORD
? CITY OF EAGAN PERMIT TYPE: :?+ ?! ?? ?,?,?
I 3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 661-4675
SITE ADDRESS: APPLICANT:
•I? . ;1?. i .iVj- ?{ ?. , ?`i ?lili f..?i
'??il'i(?.f?l.., itil?'1 I:?lf? ? ,-•?.1 ti'•}<.`.i?,cs? .
PERMIT SUBTYPE:
TYPE OF WORK:
R VP A rR
(R ii nE tNO?
[) C '!c (.: p J #' 1 .1 (.i {l
II -E fNl;
?
?
Permit No. Permit Hotder Date Telephone #
ELECTRiC
PLUMBING
HVAC
Inapection Date Insp. Gommenta
FOOTINGS
FOUND
FRAMING
ROOFING /
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP80ARD
FIREPLACE
FIF?EPLAGE
AIR TEST
FINAL PLBG
FINAL. HTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECK FfG
DECK FiNAL
r
CITY OF EAGAN Remarks
Addttion Loc 4 BIk 2 Parcel 10 84355 040 02
Owner0){ street 4257 North Malmo Lane State Eagan, Minnesota 55123
`12 r
Improvement Amount Annual Years Payment Receipt Date
STREET SUR F.
STREET RESTOR. il
GRADING
SAN SEW TRUNK 1973 161.21 8.04 20 96.73 A009278 7/28/80
SEWER LATERAL
WATERMAIN
WATER LATERAL
WATER AREA 1977 162.14 V8:-96 15 118.94 A009278 7 28 80
STORM SEW TRK 3 19719 277-61 8 ? 1 222.11 A009278 7/28/80
STORM SEW LAT
CURB & GUTTER ?
510EWALK
STREET LIGHT
WATER CONN. 250.00 I2485 1-22-75
BUILDING PER.
SAC
11-92-79
PARK . 7.G, ?tZ ,
I
?r R
? . CITY OF EAGAN
9795 Pilet Knob Read Eegae, MN 95122 N! 5064
PHONE: 454-8100
BUILDING PERMIT ReceiPt #
-, ?
Ta he u"d fsr Est. Volue Date . 19 '
Site Address Erect ? dccuponcy
T?LZ]? ?T-; •,i
Lot Block Sec/Sub. Alter ? Zoning
. Repoir ? Fire Zone
Parcel # T
Enlarpe 0 Type of Const.
?
oe Name ?
' ' Move ? # Stories
Z
Addres ,
,,-, ? -? , ? ?.-,.?
s •
Demolish
?
Front • -?
ft.
? _ Grade ? Depth
wp Name -?.i.?cai s ?t?? •:
ZF- 17*117 !'r, ='-: -7 ',-"
OU Address _
r r?:... ' o?.,.....
I hereby acknowledge that I have read this application ond state thut
the infortnation is correct and ogree to comply with all applicable
State of Minnesota Stotutes and Ciry of Eaflan Ordinonces.
Slgnature of Permittee
A Building Permit is issued to:
oll work shall be done in occordance with all opplicable 5tote of Mir
Building Officfol
Feet
Assessment
Weter & Sew.
Police
Fire
Eng.
Plonner
Countil
Bldg. Off.
APC
r . • i
Permit Surcharge
Plun chetk
SAC
,
Water Conn.
Woter Meter '
Torul '
on the express condition that
Statutes and City of Eagan Ordinanc=s.
rwmK # oeft ho..e r..wA"«
v3 g- i a - 14 - 7 S'
-J-ctly
? ,
.S
INSPECTIONS DATE INSP. RouAh-In Finol
Footings Dote Irop. Dats Irnp.
Foundotion Plumbing -
F rame /ins. Mechonical
FinCl
Remorks: ,...- ?? ?? /?.,,.? ??
?
6 --Z74-g0
BUILDING PERMIT
N° ._ 12235
Receipt # tf - , ;
To be used tor DECK Est Value $1? 500 p8te JULY 7 ,19 86
SiteAddress 4257 NO MP?LMO LN Erect ? Occupancy
WILDFRNESS RU
Lot4 Biock 2
sec/sub iv Remodel ? 2oning
Parcel No. -- -
.
6TEI ADDITION Repafr ? Type of Const
Addition ? No. Stories
W Name LAVERNE SIMONSON Move ? Length 20
16
3 Address SAME Demolish ?
?
l
t l Depth
Ft
S
° City 456-0120
Phone n
mpr.
Instali KK q.
o Name SAM
=
? ¢ Address
~ City Phone
m
W
Name
?
? ?-y Address
i z W City Phone
I hereby acknowledge that I have read this application and state thatthe
intormation is correct and agree to comply with all applicable State of
Minnesota Statutes and Ciry of?agan rdinances.
Signature of Permittee.??''• u --
Water & Sew.
Police
Fire
Eng.
Planner
Council
BIdg.Off-I
Var.
Permit Y"" • ""
Surcharge '
Ptan Review
SAC
Water Conn.
Water Meter
Road Unit
Tr. PI.
Parks
Copies-
Total $27•00
A euilding Permit is issued to: LAVFRNE S IM0111SON on the express condition that
all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances.
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
Building Official
I I I Pwm81b. I P~ Ho1dK I Date I TNophom • I
iagh Pt6p.
iph Htg.
ul.
pplaee
N Hty.
N Plby.
p. Final
t Oct.
;k Fty.
;k Frmy.
B
Dhp.
?
ciTI oF EAcaN SEWER SERViCE PERMIT
3795 Pilot Knob Roed PERMIT NO.:
Eagon, MN 55122 DATE:
Zoning: No. of Units: '
Owner: _
Address: _
Site Address: _ ?. L_1A__R?
to eomply wrth the City of Eagan
. '
Connection Chorge: Account Deposit:
Permit Fee:
Surcharge:
Misc. Charges:
Total:
Dcte Paid:
of I nsp.:
CITY OF EAGAN
3795 Pilot Knob Road
Eagan, MN 55122
Zoning: .
Owner:
e,u.b
WATER SERVICE PERMIT
PERMIT NO.:
DATE: - 14
? No. of Units:
Site Address:
Plumber.
Meter No.: ?
c,.e
Reoder No.:
1 agree fo oomplr wifh fhe City of Eagan
Ordinances.
By
Connection Charge:
Account Deposit: _
Permit Fee:
Surchorge:
Misc. Chorges:
Totoi:
Dote Paid:
? CASH RECEIPT ?
.
CITY 4F '-EAGAN
3795 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE 19
RECEIVED
RRpM ?
AMOUNT $ I
DOLLARS
100
E] CASH Q CHECK
FUNG CODB AMOUMT
i
Th nk You
j B,Y
v
White-Payers CoPy
Yellow-Posting Copy
Pink-File Copy
Renewal By Andersen
350-73rd Ave. NE ,
Fridley, MN 55432 10
763-502-4777 ? ?
#tMN20130983
-EPLACE(S) _0 _1 _2 _3
PHONE# ?Sa•34S•(ON+
CELL PHONE #
New Construction ReouiremeMS - RemodellReoair Reauirements
• 3 registered site surveys showing sq. fl. of lot, sq. ft of house; and all raofed areas • 2 wpies of plan
(20% mazimum lot wverage allowed) • 7 sei of Energy Calculations for heated additions
• 2 wpies of plan shmring beam & window sizes; poured found desgn, etc.) . i site survey for extenoredditions & decks
• i set of Energy Calculations
• 3 copies of Tree Preserva6on Plan if lot platted aRer 7f1193
• Rim Joist Detail Options selection sheet (bldgs wifh 3 oi less units)
DATE «- 'Y1ll4, • 0M QVALUATION (EXCLUDING LAND) I!9 7 _`? I .?IS
JOB SITE ADDRESS 4?IS3! h).
IF MULTI-PAMILY BUILDING, HOW MANY UNITS?
PROPERTY OWNERjjYiu}„$ 't?c?t?io
TYPE OF WORK ???-
? ?
APPLICANT
ADDRESS
PAGER #
331. z5
ZIP CODE
FAX #
NEN' RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY
Energy Code Category
(check one)
RESIDENTIAL
G PERMIT APPLICATION
CITY OF EAGAN
0 PILOT KNOB RD - 55122
651-881-4675
MINNESOTA RULES 7670 CATEGORY 1
- Residential Ventilation Category 1 Worksheet Su6mitted
- Energy Envelope Calculations Su6mitted
MINNESOTA RULES 7672
Plumbing Contractor: _
Plumbing System Inctudes:
Mechanical Contractor:
Mechanical System Includes:
Sewer/Water Contractor:
_ Air Conditioning
^ Heat Recovery System
Fee: $90.00
Phone #
Fee: $70.00
Phone #
All above information must be submitted prior to processing of application.
I hereby acknowledge that I have read fhis opplication, state that the information is correct, antJ agree to comply
all applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant
Certificates of Survey Received
New Energy Code Worksheet Suhmitted
Phone
Water Softener _ Lawn Sprinkler
Water Heater _ No. of R.I. Baths
No. of Baths
Tree Preservation Plan Received
Updated 1/01
cirr oF E+cnN
9795 Pilof Koe6 Rmd Eagan, MN 55122
PHONE: 4548700
BUILDING PERMIT APPLICATION
Receipt #
To be umd for SF 17a1g & Garage Est. Volue 52,000. Dote 11-22, 19 7$
Site Address 4257 NO. Mdl3C1O LalZe Ered Occupancy I
Lot 4 Black 2 See/Sub. W11d2YT105S RIIll 6Yh qlter ? Zoning Rl
porcel # 10 84355 040 02 Repoir p Fire Zone 3
Enlarge ? Type ot Const. V _
z Name SPeC HaW- Move ? # Srories _
Z
I Address 4257 NO. M3SI'(b i`'lTle Demolish ? Front 52 fr.
? ,.._. Eagan eL..__ Grade ? Depth 34
? Nnme T11SPS1 Hci?S
627 So. Snelling
?? nddress
1, 1,,..st. Paul 55123 ,,,,,.,e 698-5501
Name _
Address
I hereby ecknowledge that I have read this application and state that
the infortnation is correct and agree ro comply with all applicable
State of Minnewta Statutes ond City of Eaflan Ordirwnces.
Signature of Permittee
A Buliding Permit is issued to: TZS
all work sholl be done in accordan th all
Building Officlal
Assessment _
water & Sew.
Polite _
Fire
Eng.
Plonner _
Council _
Bldq. Off. _
APC
N? 5964
Feee
Permit ? •?v
SurcFwrge 26.00
Plan check
SAC 500.00
Water Conn. 250.00
Water Meter 60.00
Torai 979.50
on the express condition that
Statutes ond City of Eagon Ordinances.
CITY OF EAGAN - ?j
- 3830 Pilot Knob Road, P.O. Bax 21-199, Eagan, MN 55721 N2 12235
BUILDING PERMIT PHONE: 454-8100 Receipt q `?-
4 4-4 I 1 (e
To be used ror DECK Est vawe $ 1, 5 0 0 Date JULY 7 ,19 -8-E
3iteAddress 4257 NO MALMO LN
L'ot4_ Block 2 Sec/Sub. WTT.DERNESS RON
Parcel NO. fiTH ADDITION
w Name LAVERNE SIMONSON
3 Address SAME
°
City Phone 456-0120
= o Name SAMR
? p Address
? City Phone
w W Name
?
? z
Address
< W City Phone
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 an of?agan tlinances.
Signature of Permittev a ? -
Erect ? Occupancy
Remodel ? Zoning
Repeir ? Type of Const.
Addition ? No. Stories
Move ? Length 20
Demolish ? Depth 16
Int. Impr. ? Sq. Ft
Inshall x{
Aeorevals Fees
Assessment
water & Sew.
Police
Fire
Eng.
Planner
Council
Bldg. Off. 7 /7 /86
APC
Var. Date
A Building Permit is issued to: LHVr:xrvr: a1P'iULV:
all work shall be done in accordance with all applicable State of
Building Officlal
Permit $25.00
Surcharge 1.00
Plan Review
SAC
Water Conn.
Water Meter
Road Unit
I Tr.
Parks
Copies- 1.00
Total $27 . 00
on the express condition that
Statutes and City o( Eagan Ordinances.
? -. Minnesota State Board of Electricity
1954 University Ave., St. Paul, Minn. 55104-Phone 645-7703
' REQUEST FOR ELECTRICAL IN$PECTiON
WECK BELOW WORK COVERED BY THIS REOUEST
1.3.!5-6 '-,4
'R 55806
Type of BuOding New Add. Rep. Check Appliances Wired Foi Check Equipment Wirod Fot
Home XR ? ? Rangc mIC . Tempocaxy Winng ?
Duplex ? ? ? Watet Heater ? Lighting Fixtures
Ap[. Bldg. ? ? ? Dryer ? Electric Heating ?
Commercial Bldg. ? ? ? Fumace Sdo UNoade[ ?
Industrial Bldg. ? ? ? Av Conditioner Q Bulk Mdk Tank ?
Fazm ? 11 ? List , List )
Othet ? ? ? p
Herels? 19p. 15 •XX r Rthers}
exe 1
COMPUTEINSPECTION FEE BELOW
Service Entrance Size: ik Fce Feeders&.5ubfeeders: # Fee Cucuits: # Fce
0 to 100 Am s.
201 to 200 Amps.j
Above 200 Amps.
QjJ' 0 ? A es
31 ' es
A e 10 0 to 30 Am exes
3] to 100 Am eres
Above 100 Amps.
Transformers R o[e Kol Pa[tial or othex fee
Signs Spec?al Inspection Minimum fee $5.0
Remarks
TOTALFE .o '
I, the Electrical Inspector, hereby ce' that bove inspection has been made.
(Rough-in) Date J
(Final) ? Date
This request void 18 months from ' ?
rp 4V.7U--'13579b 3?S G 7'
This requpst void ] 8 months from ?
? R 55806
Date of this Request2-28-1979
I, asAM Licensed Electrical Contractor ? Owner, do hereby request inspection of the above electri-
cal wiring installed at L 48 Z c-:, 12- 6
Street Address or Route No. 4257 North b4almo CityEagaii
Section Township
Range County Dakota
Which is occupied by Tilaen Homes
(Name of Octupant)
Is a roughin inspection required on this job? No ? Yes Mc Ready Now O Will Call EK
Power Supplier nokn+a C+v_ Address
Electrical Contractor 0. B. Thompson Flectric Co. Contractor's License NoA36835
12201 Mt1ca°B?vd.?;' Mtxa 55343
Mailing Address
AUthorized Signature Phone No. 933-2521
(Elxtrical Contra feTOr Ownef M aking TMS InstallaSlon)
?? /?1r,1?? 2 ?? ???? ?O(??/J
r?? u This inspection request will not 6e accepted 6y ffie
State Board unless proper inspectian fee is endosed.
VRM . IT# 5tOA(P RECEIPTDATE:
8002 BU1DENTLkL PLUM$INfi PERMIT APP11CATlON
CITY OF EA6AN
S$SO fII.OT KAOB $D
gwsM, MN 58122
651-881-4675
Please compiete for: single family dwellings, townhomes and condos when permits are required for each unit,
SITEADDRESS: backflow preventer for irrigation system
OWNERNAME::
TELEPHONE#: i 7
??-
(AREA CODE)
INSTALLERNAME: TELEPHONE#:
? (AREA CODE)
STREET ADDRESS:
CITY: STATE: ZIP: U
_ SEPTIC SYSTEM, new/refurbished (requires two sets of plans and MPC license) $ 100.00
includes $40.00 County fee
Note: Additional consultant fees may apply
• MODIFICATION/ALTERATION TO EXISTING DWELLING UNIT, INCLUDING:
_ Adding fixtures to lower levels or room additions, excluding water softeners and water heaters. $ 50.00
_ Abandonment of septic system.
_ Water tumaround - existing dwelling unit (+ 5/8" meter if needed -$118)
Other:
_ RPZ: new installation/repair/rebuild $ 30.00
_ lawn irrigation system
Replacement/additional: ?/ water softener _ water heater $ 15.00
State Surcharge $ .50
Total $ I _,> • S a
I herebyacknowledge that I have read this application, state that the information is correct, and agree to complywith all applicable Cityof Eagan ordinances. It
is the applicanPs responsibility to notity the property owner that the CITy of Eagan assumes no liability for any damages caused dy lhe City during its normal
operatlonal and maintenance ac6vitles to the facilitles consWCted under this permit within City praperty/nght•of-wayleasement.
?,A?.,1..
r,l ??.. ?
SIGNATURE OF PERMITTEE ? 1102
`k?'?'S??kSk:":.K%!:?kW.??(M'.9lY?'X.:''FT'??FM1YYCi nY."?:i$>k+XN?k'n{Y,SW, 'N?}?..?r:.?k?kYt
i,'.CT'`{ 1'll' SAGfil7
CA.`.:il-!:CE'R; MG ''1='!?MTTJN_. NG: 60
D;l?I:'e i.`J/21.I97 'i'7:M'_e 00902
TWa
Nf; ir';; T:RAiil.1=V 1 Gf1kiNE5
3c^_7 {] 9001 425? t'AI_.h'^ L.N 74.75
205 9001 4257 rfr.I...MG I_N ,..50
, -?
Toi n7. !tie.r.e:i.p9; ktntim` s 76.25
^4(782?.??
'.15G:R ?.".?o l4RF'tl.YNrd
Y,<Si ?d??'FWYF.*>K%k%6XC?:r7kRc&'9'n:.'t>!: :';n9FM 'M+YS°i.H.,^<m *X'.:KP:?>"YF?k
A
? CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMIT TYPE:
Permit Number:
Date Issued:
BUILDING
030993
10/21/97
SITE ADDRESS:
4257 MALMD LANE N
LQT: 4 BLOCK: 2
WILDERNE55 RUN 6TH
P.X.N.: 10-84355-040-02
DESCRIPTION:
(ROOFING)
rmit Type SF (MISC.)
Kh Type REPAIR
434 AL7. RESIOENTIAL
?, -
_-
PERMIT
°?-:??g .. t
' '
REMARKS:
FEE SUMMARY:
VALUATION
Bese Fee $74.75
Surcharge $1.50
Total Fee $76.25
$3.006
CONTRACTOR: OWNER: - Appiicant -
? 6ARNE5 BRADLEY
4257 MALMO LANE N
EAGAN MN 55123
? (612)858-0434
? hae???ty? ack'rss?wl?cl`g,? ???
'6,Ltk„c?? ?5 ?rR14 R?,d C m ?--
AP C T/PERMITEE SIGNATURE ISSUED 8V. SIG IJR
97 BUILDIMG PERMIT APPLICATION (RESIDENTIAL) ?K(.25
3 09q5 CITY OF EAGAN
3830 PILOT KNOB RD - 55122
681-4675
New Construction Reauirements
3 registered sde surveys
2 copies of plans (indude beam F, window sizes; poured fnd, design, etc.)
1 energy calculations
3 copies of tree presarvatlon plan rf lot platted atter 7/1l93
required: _ Yes _ No
DATE: Ci-"rUp)Ee- Z1, Ikq-l
RemodeUReoaif Reauirements
? 2 copies of plan
? 2 sRe surveys (exteriar aOditions 8 decks)
• 1 enargy Wlculations for heated additions
CONSTRUCTION COST: f Z-'70v
DESCRIPTION OF WORK: _RP_- 4lne.cnc?(? I/wti1yC ewV?
STREETADDRESS: q??j tIU2TN M,4L440 LfkN? eq6q4
LOT ? BLOCK ? SUBD./P.I.D. ?14.
rtnn ?i z (brb43 -3(!30
PROPERTY
OWNER
CONTRACTOR
ARCHITECT!
ENGINEER
Name: CrARnIFS 6 fZ.A+rX?E k/
WV-- (ofL
Phone
usr nxs
StreetAddress: q1?1 A/, /'t4L'ti't? L41VE
ciry:
E-AiArJ
State: L IV Zip: `? ?'j Z-z,
Company: N IA Phone #:
Street Address:
City: State:
Company: NIA
Name:
License #:
Zip:
Phone
Registration #:_
Street Address:
City:
Sewer & water licer•ned plumber (new construction only):
and lot change are ?equested once permit is issued.
Penalty applies when address change
i hereby acknowledge that I have read this applicaGon and state that the infortnation is correct and agree to comply with ail applicable
State of Minnesota Statute5 and City of Eagan Ordinances.
Signature of Applicant: 14?L X
OFFICE USE ONLY
Certificates of Survey Received
Tree Preservation Plan Received
_ Yes _ No
J Yes _ No _ Not Required
State: Zip:
a5-?a-oy3Y
c ? ? _??
1986 BOILDING PERNIIT APPLICATION - CITY OF EAG9H
NOTS: ALL CABTRACTORS MOST BE LICENSSD iiITH THE CITY OF EAGAN
SIBGLE FAlIILY DWELLINGS
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS
MOLTIPLS DHEI,LINGS -&ESIDfiNTIAL RENTAL peTITS FO& SALS UlIITS
INCLUDE 2 SET5 OF PLANSo CERTIFICATE OF SORVEY - CHECK iiITH BL1)G. DSPT.,
1 SET OF ENERGY CALCULATIONS
COMMERCIAG
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS,
$2,000 LANDSCAPE BOND
To Be Used Fo C4.-
Site Valuation. Date: '?If3f?ig
Address
Lot ? Bloek
Parcel/Sub W 2??2,? /?*-?,•? ? ?
Owner l,n UCc AJ C. S?Yv?OA)5o4J
Address L.N e
City/Zip Code P-!!;uL,j 55??-3
Phone 41?
Contractor
Address
City/Zip Code
Phone
Arch./Engr.
Address
City/Zip Code
Phone S
Ereet Oceupaney 45--
Remodel Zaning
Repair _ Type of Const _0?7
Addition # of Stories
_
Move Length
-
Demolish ?
Depth
Int.Impr. Sq Ft
?
Install
APPROVAL3 FEES
Assessments Permit 25
Water/Sewer Sureharge
Police Plan Review
Fire SAC
Engr Water Conn
Planner Water Meter
Council ? Road IInit
Bldg OfP
;?? Treatment P1
i
APC Parks
Variance Copies ?
TOT9L
60TE: ADDHESSES FOR CORNER LOTS - CONTRACTOR/HOMEOHNER HDST DESIGNATE WHICH ADDRESS
IS DESIRED. NO CHANGES SiILL BE ALLOiiED ONCE SOILDING PERMIT 13 ISSIIED.
$51
?.?i 'DEEP VR?'hh C Fe?vs e, ?"?5
bea 41cwN (MkN, ?d??1?P??17 06" ?s
Mo-a -?.a -?"
? ?? DeCY. 14A4?aaLrr
?
,.
-f -
?
4
i I'
15'
78`
aY'
b?
?y,
pA2E
T
BUILAING PERMIT APPLICATION
include 2 aeta of p7Ans, 1 sfte plan w/elevations and 1 set of enesgy c8lculations.
To be used Eor
Site AddresE: ?',-i pr Y17??'?z-C? ra?,?
4
Lot
damer ?
Address
Afldress
Arch./Eng.
Address
Telephone
Telephone (!J C/ e- ?5 e5 C?1 /
Telephone
OFFICE USE
? .
valuation oa _
??, ?Jo
Block See. SuD. Parcel Number j,?q 1*1 0;-
Erect ?
Alter
fiepair
Enlttzqe
Mcrve
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flII18 7,2001
City of Eagan
3836 Pilot gnob Road
Eagan, MN 55122
To Whom It May Concern:
Elder Jones is authorized to puIl building permits for Renewal by Andezsen_ Please allow
Elder Jones to provide this service for us in Eagan. This authorizatinn is valid for any
date beyond 6f6101; untiI a Renewal by Andersan manager expressly revokes it in writing
to the City_
I reqnESt this attthorization be accepted expeditiously, as to not delay in the procassing of
our building pcrmits any {uythcr. Plcasc call mc if t3icrc arc auy questions. I can Ue
contacted at 763-502-4706.
Yaur immcdiate attention to this matter is appreciaced.
Sincerely,
onstalln Manager
Renewal by E#ndeisen Carporation
C'e: Kara_F.1rie.r.Tnnec
HADA M. EL MAl
NO??Y PUOGC
Minnespts
OGMYCOmmawanEeo'spJan
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Received Time Jun. 7. 1:07PM
, ?0 8' S a
2005 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
IV ?-o . 06
CiW 9/2 g . ArJ
New Construction Reauirements RemodebReoair Reouiremenis Office Use OnN
3 registered site surveys shmving sq. R. of lot, sq. tl of housa; and ?II mofed areas 2 copies of plan Cert at Survey Real _Y _ N
(20%maximum lot coverage atlowad) i set of Energy Galculations forheated additions Trse Pres Plan Recd _Y _ N,
2 copies a( plan showing beam & window sizes; pou2d found design, etc i site survey for additions & decks Tree Pres Required _ Y _ N
isetofEnergyCalculatbns Addifwn-fndlceteifon-sdesepGbsystem OnsiteSepGcSystem _Y. _N
3 copies of Tree Preservation Plan'rf lot platted atler 1/1193
Rim Joist Detail Options seledion sheet (buddings with 3 orless unfts)
Date Canstructian Cost
SiteAddress 'MO C4k-kk1¢- J\-b?f-"L+ UniUSte #
Description of Work ad CI&J-? 04Yk-
Multi-Family Bldg _ Y_ N Fireplace(s) _ 0 _ 1 _ 2
PropertyOwner GVOr.Z' ce,wQ ?bAU,'e Telephone#(laS1 ) (9'20-3160
Contractor C??`?N C?a?e ?ic"?c2a.?5 # a?K33a? a
Address 1;"70,a VV?Oc.? t`"r7 4" S? -
State 1"t N Zip ISn/ J?wf City AAv
Telephone #(??}) 23 7"331S--
COMPLETE THIS AREA ONLY IF
Energy Code Category - Minnesota Rules 7670 Cateeorv 1
• Residentiai Ventilation Category 1 Worksheet
(Jsubmissiontype) Submitted
. Energy Envetope Calculalions Submitted
A NEW BUILDING
Minnesota Rules 7672
. New Energy Code Worksheet
Submitted
In the 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
Mechanical Contractor
Sewer/Water Contractor
Telephone #(
Telephone #(
Telephone # (
I hereby apply for a Residential 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
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 and
approval of plans. _ 2 ?? ?
c",9 o1gt„
ApplicanYs Printed Name
Applicant's Signature
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. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 Ent. Alt - SF
? 04 02-plex ? 10 08-plex A( 16 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
CI 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
C] 31 New ? 35 Int Improvement ? 38 Demolish Interior Q 44 Siding
A 32 AddRion ? 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
Valuation ? Occupancy R? ? MCES System ?-
Plan Review/// 100% or _ 25%
Census Code L/ ?y Zonin l
g ' City Water ?
SAC Units - Staries - Booster Pump r"
# of Units Sq. Ft. 3Ao PRV
# of Bldgs Length /? Fire Sprinklered
Type of Const - Width 120
REQUIRED INSPECTIONS
Footings (new bldg) FinaVC.O.
? Footings (deck) ? FinaUNo C.O.
_ Footings (addition) _ Plumbing
_ Foundation HVAC
_ Drain Tile Other
? Roof _ Ice & Water
Framing _ F inal - Pool = Ftgs =Air/Gas Tests Final
Siding Stucco Stone Brick
_ Firepiace _ R.I. _ Air Test _ Final _ Windows
_ Insulation _ Retaining Wall
Approved By. A ') e4 w' , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
?! $S?
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PERMIT
City of Eagan Permit Type:Building
Permit Number:EA130582
Date Issued:05/01/2015
Permit Category:ePermit
Site Address: 4257 Malmo Lane N
Lot:004 Block: 002 Addition: Wilderness Run 6th
PID:10-84355-02-040
Use:
Description:
Sub Type:Reroof & Siding
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and house wrap and leave on site.
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.
Valuation: 8,000.00
Fee Summary:BL - Base Fee $8K $162.25 0801.4085
Surcharge - Based on Valuation $8K $4.00 9001.2195
$166.25 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 -
Bradley J Garnes
4257 Malmo Lane N
Eagan MN 55123
(651) 688-3180
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:Mechanical
Permit Number:EA138254
Date Issued:08/17/2016
Permit Category:ePermit
Site Address: 4257 Malmo Lane N
Lot:004 Block: 002 Addition: Wilderness Run 6th
PID:10-84355-02-040
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
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 -
Bradley J Garnes
4257 Malmo Lane N
Eagan MN 55123
Haley Comfort Systems
122 3rd St W
Hastings MN 55033
(651) 437-0338
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA143299
Date Issued:06/12/2017
Permit Category:ePermit
Site Address: 4257 Malmo Lane N
Lot:004 Block: 002 Addition: Wilderness Run 6th
PID:10-84355-02-040
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Softener
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 -
Bradley J Garnes
4257 Malmo Lane N
Eagan MN 55123
Bruckmueller Plumbing Inc
3992 Pennsylvania Ave
Eagan MN 55123
(651) 686-6696
Applicant/Permitee: Signature Issued By: Signature