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4322 Medary AveCITY OF EAGAN ,3830 Pilot Knob Road, P.O. Box 21-199, Eagsn, MN .+ PHONE: 454-8100 BUILDING PERMIT Ts M wd fer PORCH Receipt * 'i .' ., G Site Addrets , t'i': „..r l ii V i: ` Erect ? ?, Black A Lot ;? V t:st r, i l.LS' ?lSub 5' Remodel ? . Repair ? Parcal No. Enlarge ? Move ? Name ? Demolish ! Addresa Grede ? e?"' ' ; "5 2 _) -J 1-..11 I-I A 1 9 Name _ to Addrees u ? City _ t? !uW Name _ ?? Addreu ? W City _ Assessment _ Pnone wcrer a sew. Poliu Fin Erq. Phone Plonner - Council _ I hercby ocknowladqe that I hove road this appliwtion and atote that BIdB• Off• -2)) the inlormotion is correct and agree to comply wlth oll opplicable APC Stob of Minnesota Statutes ond City of Eagon Ordironus. Var. Date _ Sipnaturo of Permittae A Buildiny Pertnit is isswd w: oll work ahall be dorr in accordance with oll oooliooble State of Minnesoro Srotutes 5.At+lA U" ?e ot Gonst. Sioriea _ gth )th Ft. Permit ?` .• _j'.. $urcFwrge 1 ^ ?' ' Plan Review $/1C Woter Conn. Woter Meter Rood Unit Perks Total 7 - on tM express cadition thot and City of Eapan Ordinoncoa Buildirq OfHcial 1 Permit No. Pwmk Holder DaN Tels hone * Plunibing H.VA.C. ENeMc Softensr Impsetion Date Insp. Othn Footinqt Foundation Framinq Roofing Rouqh Plbq. Rouyh HVAC Inwletion Final Plby. Final HVAC Final CMt/OCe. Water Dfturibe Lowtion: YVell Sovver Pr. Disp. CITY OF EA6AN Femarks Addition R1VP.i' HillS 9th Lot 6 Rlk-2 Owner -'- "' U1 L' Po ri , Street 4322 Medary Ave. Improvement Date Amount Annual Years Payment Receipt Date STREETSURF. - STREET RESTOR. GRADING SAN SEW TRUNK 1973 148.72 ,. 9.91 1 Paid SEWER LATERAL _ 1976 4.,l WATERMAIN ,EWATER LATERAL 1976 3 WATER AREA STORM SEW TRK a• *STORM SEW LAT 1976 CURB & GUTTER SIDEWALK STREET LIGHT i ^ 1980 WATER CONN. BUILDING PER, 8 6 SAC 450.00 2341 Q- -7 PARK e,a.a;+;,,,,nl Qe,.re,. +.. i Rn nn 2111 2-21t-7 7 CITY OF EAGAN . 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS:` ; :R Faf: (41.6 0 ? u I ? ?, Izi in F TS> ?Ji1R1' A1/p 1 I II I }:5,. 1".(.1. rA FiEittiiti fSnur.i' FlMl, fiAI:Al:i PERMIT TYPE: Permit Number: Date Issued: APPLICANT: ,i; i' ?,MI 1N(3 rn k:ts 1 t 111 Nc3 N:i sr;(9r; iwloll(ifi PERMIT SUBTYPE: TYPE OF WORK: . , ;.; f>Azta ps . :t?, f,PI fE, !G YzEliAt) F Permit Holder Date Talephone # PLUMBING HVAC Inspection Date Insp. Comments FOOTINGS FOUND FRAMING ROOFING ? J A) ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST FlNAL PLBG FINAL HTG ORSAT TEST BLDG FINAL DOMESTIC METER IRRIGATION METER FLUSH MAINS CONDUCTIVIN TEST HYDROSTATIC TEST BSMT R.I. BSMT FINAL DECK FTG DECK FINAL CITY OF EAGAN ?3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 v?SCTE ADDRESS: PERMIT SUBTYPE: I I , ,,1 PERMIT TY Permit Number: Date Issued: }t?1! 1 1?7 Nli t9:;.'t.i.13 bi7 i.-^4/yit ?., .,. ,. ., APPLICANT: TYPE OF WORK: ;' i, , ii+,: I ; r MrA R t'r., F1.F1M kFVJf't•ai'li HV iCif vM t Hir-r1 iiiir t; (.i,Rniii nI. rrFnraorv stftFii+o!:r: 6AHAni I Permit Holder Date Telephone k PLUMBING HVAC Inapection Date Insp. Comments FOOTINGS FOUND FRAMING 23uD ROOFING ROUGH PWMBING PLBG AIR TEST ROUGH HEATtNG GAS SVC TEST INSUL GYPBOARD ? FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG -- ORSAT TEST BLDG FINAL DOMESTIC METER IRfiIGATION METEF FLUSH MAINS CONDUCTIVITY TEST HVDROSTATIC TEST BSMT R.I. BSMT FINAL DECK FTG DECK FINAL CITY of EAGAN -r BUILDING PERMIT . . . ... Y Owner 2Z)L/,ZA? . .....rLI.:Q?J-. ... %... Addrass (Preseni) i?GrC).L..iJ...:.--•?.?..z.?.. Suilder ............... ........_.............••-•---....---................. Address ...................................................................••-•-•--.........._........ DESCRIPTION r is N2 3836 3795 PiloY Knob Road Eagan, Minnesota 55122 454-6100 a a :. . .? a.?. . .- . .? . . .' . .`:? : . ` . ?Ae4 ............. Ssoriee To Be Used Foz Fxont I Depth Height Est. Cos! Permit Fee Remarks .D??? a,??,n I ? lQ t z, I b'Yoa a, lq??? . f 17 LOCATION / l '' Slraet, Road or olher Deseripiion oi Location ? Lo! Bloek Addition or Trac! This permit does not aulhd'rize the use of streels, roads, alleys or sidewalks nor does it give the owner or his egan! the right fo create anp situaiion which is a nuisance or which presen2s a hazard !o the heallh, safely, convenlence aad general welfare !o anyone in the community. THIS PEAMIT MLTST BE KEPT ON THE PREMISE WHILE THE WORK IS IN PROGRESS. , This is !o ceriifp, lhai.?v.??i44ae-tw ....................................has permission !o erect a.15'_.F.... ..f.t. . ...F??...?Jk?,..upon the above described premise subjeci !o the pxavisions of all applicable Ordinances for the Cifp of Eagan . ................ ......l..?r...... ;1...... ................•°--...__.....-°°--.._...._..... Per _..??...??.??l..yf.... Mayor Suilding Inspect. os... •- czlY.or, Fae_:,rt 3795 "'llO t Ir"C;b i{Oa.d EaSr,.:1, M7_i:_]:?;;0?'i,a j5122 YLSJ"'1.Lm" . . :V J ? e 805 T:ne Ci t,y of Lagan hereby grr_n lls to Ray N. Welter Heating Co.? ri 4637 Chicago Ave. So.^ a fiEATING Pe?:?,it for: 0-,aner Windsor Dev. coip. at _4322 Medary Avenue pursuant to application da11-ed 3/11/76 Fee Paide _$20.08 dated i,his 16th day oi March , 19 76 .50 s/c Fuilding In,spe^ MechsnicaJ_ Yer•mi+s: Bia T:, ta1: GITY Oli' ri?G_?N li.lot Knob F-.oad E:??a.?, Yin?ie,>ota 55122 PEFRIT NO m : 659_ The C;_ty oi E„ga,n hereby grants to `?;mpson Plumbinq Co. of Minnetonka a PI,UMING pErmit for: (Cwner)_ Windsoz Drev. dorp. a? ? 4322 Medary Ave.? p,arsuant co appiication da-?ed 2f25/76 ir'"e?."? - - Fee ? $20.00 clE; ted this ?9 day o° _Feb. 1 s c ee Statement Fuildiri.-- Me--har.ical Permits: Bid Total: 4,?t 4? F5 14< .? c17f oF EAUpra 3795 Pi.lot Knob F•.oad Eagan, P?innesota 55122 PERMIT NO.: 6 7 The City of Eagan hereby grants to T i nAaaw Wator SoF+o.,er r.,_ of 4715 n r A390- c x'aq n SS12-2_ a wa --r cof --nerl'ermit for: (Owner) °alph, PPrYy at 4322 Mijary AvenLe , pursuant to application dated 42.176 Fee Paids g5_oo dated this a day of ?aept ,,1976 . .50 s/c Euilding Insp°etor Mechanical Permits: Bid Totals CITY OF EAGAN jv° 1019 7 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 BUILDING PERMIT tteceipt Te W uwd ie? SCREEN PORCH Est. Volue $1, 800 Date MAV R , ?qBy Site Addresf 4 3 2 2 MEDARY AVE Erect ? occupancy Lot 6 elock 2 RIVER HILLS Sec/Sub 9THRemodel ? Zoning . Repair ? Type of Const. Percel No . Enlarge ? No. Stories DAVID C_ JACKELEN Move ? Length el Name Demolish Depth Z ? Address SAME Grade ? Sq. Ft. City EAGAN phone 890-5256 Install O SAME 920-9720 (W) Aowm'als Ftas i0 u? r Name Address City Phone F, ? ?,?+, I Name ? Addresa _ ? W City Phone Assessment Water & Sew. Police Fira P anner CounNl Bldg. Off. 5 8 8 5 APC Var. Date Permit a L 7. J V Surcharge 1 _ 00 Plan Review SAC Water Conn. Woter Meter Road Unit Parks Totel $ 3 0. 5 0 I hereby acknowledgs thot I hove read this applicotion and state that ihe intormntion is rnrrect and ogree to comply with all applicuble Stota of Minnesoto Statutes ond Ci of E pon Ordinonces. Sipnaturo o( Permittca A Buildinq Permit Is +ssued to: ? VID C. JACKELEN oll work ahcll be done in occordance with oll appliqE4le Sfote o Minna an ths express conditlon that and City of Eopan OrdinonceL Buildinp Official -VILL4(iE OF EAGAN WATER SERVICE PERMIT 3795 Pilot Knob Rood PERMIT NO.: 1930 Eagon,MN 55122 llATE: 2I25I76 Zoning: RI ? No. of Units: 1 Owner: Windso=' DEV. Ool'p. Address: Site Address: 4322 MedaY'y? Ave L6 B2 RH 9 Plumber. ThomPoon P11]fibinq CO. me[er.l?o.oS Connection Charge"J°'"" Lju Si? Account Deposit: Reader No.: '7' pe?it Fee: 10. 00 bi13e5- ? 94rq8 to compir wirh the Villoge of Eagan Surcharge: -?WblEd-168s ???d'?'?es• Misc. Chazges ?0.? AlEfer ?- /l?{' Tata,: By Date Paid: Date of Insp.: Insp.: vILu?vs oF eaoaN SEWER SERVICE PERMIT 3795 Pilot Knob Road PERMIT NO.: 2687 Eagae, MN 55122 DATE: 2/25/76 Zoning: Ri No. of Units: 1 Owner: W1ndSOr DeV COrP Address: site Address: 4322 Medary Ave L6 B2 RA 9 Plumber: ThOmpSOn PltnnbiTlQ 00 1 ogrea ro comply with tM ViOnge ef Eagon Connection Chazge450.00 pd Ordinoncaa. Account Deposit: P 't F • 10.00 billed #685 By ernu ee. _ Surcharge: - Misa Charges: Total: Date of Insp. Insp.: - Date Paid: - .50 billed #685 DEVELOPMENT CORPORATfON February 23, 1976 Mr. Da1e Peterson City of Eagan 3795 Pilot Knob Road Eagan, MN 55122 Dear Mr. Peterson: Enclosed please find a check in the amount of $1,027.50 for building permit fees, surcharge, SAC, water connection and meter on: Lot 6 Block 2 River Hills 9th 4322 Medary Avenue Eagan, MN This home wi11 be a Mode1 76-50 Elevation A. It wi11 include appliances, fireplace down, finished family room down, foyer window over door and 8 x 10 sundeck with patio doors. A proposed plot plan is enclosed. Thank you for your cooperation. Sincerely, WINDSOR DEVELOPMENT CORPORATION ?oavu? i? ljal-? Warren R. Anderson Vice President wRA/ks Enclosure SU17E 192, 4660 WEST 77TH STREET, EDINA, MINNESOTA 55435 • PHOIVE (612) 831-0717 ?k?S7k?W?X?K ?K?k ?K?,'??Y?X<?X?kYF?C?k?<????Kk?:??>;t?%?sX ?k:?..?f?!#?7kX??? C:I:TV OF I:iiCs(lN CA"iHIF_fis 6 TE::RNiIAAL.. NON 808 DEl'7'E::; 10/07/38 YIA4?=N i i2°;c:51 ID. hANir.' BC1X'i fS: '.:iUNa RC}C?h:L'iUG t:;Q C1f' MI=9_EiC? 3?:I.O 301:11, 4322 Nil-:I:tARY F1V[ ry`3e"r'S 055 9001 4322 MF1!AI=iY AVG' 2.50 300 9001 432E3 Mi_:TiAfiY AVE i2fi o75 205 9001 4328 Pfr'X)(-ikY AU!= :3.50 I TClt:l.C C'i_•ralprF, AmUun'F : '<'_3Q.•`.:r0 Cnf:)9809 IJSEl; 'f.%!e NANCY ?k:'FYF?X'ki YF??`ri????kYd%k??Y,t?Y,<?M+?'?>K??.?7kl??i }#YF???X'Mk'h?)K#?? FERMIT CITY (yF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 PERMIT TYPE: Permit Number: Date Issued: E3UTLOING 033606 10/07/98 SITE ADDRESS: 4322 MEOflRY AVE LO7. 6 BLOCKa 2 RIVER HILLS 97H P.I.N.c 10-64400-060-02 DESCRIPTION: sF fm=sca REPAIR 434 AL7. RE5IDENTTAL 53 cNP+,q`?44'Ik}? t*e?a+£aM.?X{?A`?$L .?o-. a.i:i?«?... REMARKS: T.O. & REROOF HOUSE AND GARAGE. FEE SUMMARY: VALUATIDN Base Fee Siarcharge 7atal Fee $99.75 2 . 50 $102.25 $5,000 I.V,V11-fAt, IVhf: -- Applicant - ST. LZC, VVVIVtFS: 608 & SQNS Ft00FING CO 19201251 20012891 .7ACKELEN 4553 XERXES AVE S 4322 MIMNEAPCJLIS MN 55410 EAGAN (612) 920-1251 (651) - -ERonF DAVID MEDARY AVE MN /?- APPLICANT/PERMITEE SIGNATURE ISSUED BY: SIGNA URE ` - ' 1998 BUILDING PERMIT APFLICATION (RESIDENTIAL) CITY OF EAGAN -- ? 3830 PILOT KNOB RD - 55122 681-4675 ? New Construction Reauirements RemodeVReoair RequiremeMs ? 3 regiatered sde surveys ° 4 2 copies of plans (inGude beam & window sizes; poured fid. design; etc.) 0 1 energy calculatfons ? 3 copies of tree preservation plan 'rf lot platted after 717/93 required: _ Yes _ No DATE: DESCRIPTION OF WORK 13TIqG? a STREET ADDRESS: Name: rGG??1'E'.? ?.JQIV 'j Phone #: Last First LOT: (v BLOCK: ?-- SUBD.lP.I.D1#: 0 1 l/?2_ +( ? t ''s, 9,?L- PROPERTY OWNER Street ? 2 copies of plan ? 2 site surveys (ezterior additions 8 decks) ? 1 energy catwlations for heated addftions CONSTRUCTION COST; `i?? RV_'e...r ?? City State: Zip: Company: )Z? Phone #: q Iao CoNTRACTOR ?553 ?+,c?l Street Address: OV? , 5 License # ? Z1 ?atS ) City State: 1` 1??/ Zip: ARCHITECT/ ENGINEER Company: Name: Phone #: Registration #: Street Addtess: City State: Sewer 8 water licensed plumber (new construction only): and lot change is requested once permit is issued. Zip: Penalty applies when address chang I hereby acknowiedge that I have read this applicabon and state that the infortnation 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 Pr.eservation Plan Received Yes No OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation 0 06 Duplex O 02 SF Dwelling ? 07 4-plex 0 03 SF Addition ? 08 8-plex ? 04 SF Porch ? 09 12-plex ? 05 SF Misc. ? 10 = plex WORK TYPE 0 31 New ? 33 Alterations ? 32 Addition T] 34 Repair GENERAL INFORMATtON Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Depth APPROVALS Planning ? 11 Apt.lLodging ? ? 12 Multi Repair/Rem. ? ? 13 Garage/Accessory ? ? 14 Fireplace O 13 15 Deck ? 36 Move ? 37 Demolition Basement sq. ft. Main level sq. ft. sq. ft. sq. ft. sq. ft. sq. ft. Footprint sq. ft. 16 Basement Finish 17 Swim Pool 20 Public Facility 21 Miscellaneous MC/WS System City Water Fire Sprinklered PRV Booster Pump Census Code. SAC Code Census Bldg Census Unit Building Engineering Variance Permit Fee Surcharge Ptan Rerriew License MC/WS SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment PI. Park Ded. Trails Ded. Other Copies Total: Valuatian: $ % SAC SAC Units CITY OF EACAN CA aHIGFie S TEftMTNAI_. N02 776 DATE n 07t27/98 7I1°fE: n 15.24 u;33 ID: NAMEc XiAVID C tACF:Et_[N 3210 9001 4322 MFLiF1kY AVE 34.75 E05 9001 4322 hfEl:tAfiV AVC 0.50 Total f;er_ei.pt Amaun+.: 35.25 CRO'_7539i' tJSEF{ :Cri n NANCY ?K1k7X?X k? * YF?#%?X???k?C%??k?d%nk>k?k?Xs? %kkc%??kc?kxY?s?%#a?%X?7k??k? FERMIT CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS: P.I.N.: 10-64400-066-02 DESCRIPTION: 4822 MEDARY IOT: 6 BLOCKs RIVER HYLLS 9TH SHEETROCK P s r m i t T y p e 8uild-ing?;?Wqrk Type r,i?f.ell$US CQd.E'^'?''? s ? ! _.?.? . PERMITTYPE: g?j??;tvG Permit Number: Date Issued: 07/24/g g AVE z GARAGE SF (MISC.} AL7ERATION 434 ALT. RESSDENTIAL Lz' REMARKS: PLAN REVTEWED BY JOE VOELS FEE SUMMARY: Base Fee Surcharge 7ota1 Fee #° ky P?"?" = a 1'CR A' SHEETRqCK GARflGE CEILTNG. VALUATSON $34.75 $.50 $35.25 $1,00e CONTRACTOR: OWNER: - Applicant - JflCKELEM DAVIIJ 4322 MEDARY AVE EAGAN MN 55122 (651)890-5256 1998 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD - 55122 651-4675 ? 3 ? • ?? New Construetion Reauirements 4 3 registered sde surveys 1 2 copies of plans (inGude beam 8 window s¢es; poured fid. design; etc.) ? 1 energy calculatians • 3 copies of tree preservation plan if lot platted after 7Hl93 required: _ Yes _ No DATE: ?-c-?Xl-ff RemodeURepair Reauirements -I _ :?, q - q X v ? 2 copies oF plan ? 2 site surveys (exterior additions & decks) ? 1 energy calwlations for heated additioas CONSTRUCTION COST; DESCRIPTION OF WORK:.5/?ffrOee 6.9,e.aGe? i? 74if7 ,?.ePoSe oF 4eFe"m.?c- t1eC4M((- STREET ADDRESS: y32 2 ?-???> 4?6 LOT: BLOCK: ? SUBD./P.I.D. PROPERTY OWNER CONTRACTOR Name: ?Oze?6/ G Phone #: g90 --52?`?0 Lazt Fint Street Address: ?/32 z 'IW94PY/?G c? City State: Company: SE? F Phone #: Street City State: ARCHITECT/. ENGINEER Company: S 66 ? Phone Street City State: Sewer 8 water licensed piumber (new construction ony): and lot change is requested once permit is issued. Penalty applies when address chang I hereby acknowiedge that I have read this applicadon and state that the infurtnation is correct and a9ree 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 /UC) O ? Zip: 2 Zip: Registration #: Zip: License # Tree Preservation Plan Received _ Yes _ No _ Not Required OFFICE USE ONLY BUILDING PERMIT TYPE I] 01 Foundation ? 06 Duplex ? 02 SF Dwelling ? 07 4-plex ? 03 SF Addition ? 08 8-plex ? 04 SF Porch ? 09 12-plex A 05 SF Misc. ? 10 = plex WORK TYPE ? 31 New X--33 Alterations ? 32 Addition ? 34 Repair GENERAL INFORMATION Const. (Actual) _ (Allowable) USC Occupancy Zoning # of Stories Length Depth APPROYALS Pfanning ? 11 Apt./Lodging ? 0 12 Multi Repair/Rem. ? ? 13 Garage/Accessory ? ? 14 Fireplace ? ? 15 Deck ? 36 Move ? 37 Demolition 16 Basement Finish 17 Swim Pool 20 Public Facility 21 Miscellaneous Basement sq. ft. Main level sq. ft. sq. ft. sq. ft. sq. ft. sq. ft. Footprint sq. ft. Buitding Permit Fee ? Surcharge Plan Review License MCNVS SAC City SAC Water Cann. Water Meter Acct. Deposit S/W Permit S11N Surcharge Treatment PI. Park Ded. Trails Ded. Other Copies Total: MClWS System City Water Fire Sprinklered PRV Booster Pump Census Code. SAC Code Census Bldg Census Unit Engineering Variance ? Valuation: $ °k SAC SAC Units , 7985 BUILDING PERMIT APPLICATION - CITY OF EAGAN NOTE: ALL CONTRACTORS l9UST BE LICENSED WITH THE CITY OF EAGAN INCLUDE 2 SETS OF PLANS 3 CERTIFICATES OF SURVEY 1 SET OF ENERGY CALCULATIONS To Be iJsed For: -`??'ct`v??m?Cy Ualuation: /,S()C) °-G Date: ? -i 6 5 Site Address: !32 Z 1?76L'%e Y /I v? Lot: o Block p? Sect/Sub ?? Parcel # Owner -Oql/!p C JAClC i? Address q-91 Z OFFICE USE ONLY Erect ? Occupancy Remodel Zoning Repair Type of Const Enlarge # of Stories Move Length Demolish Depth Grade Sq Ft City/Zip coae .-v ---------- 4-,C, k v Phone &?D"S Z S`(o y20 . y720 APPROVALS Contractor /p C J/?C1EE-zriz?j Address t/322-City/Zip Code C f9C?//? ??l? ?S? ? 2 Phone &3?0 ` s Arch./Engr, Address City/Zip Code Assessments Permit Sa Water/Sewer Surcharge ?°? Police Plan Review Fire SAC Engr Water Conn Planner Water Meter Council Road Unit Bldg Off J Parks APC Treatment P1 Variance TOTAL Phone # DATi'; BUILDIiVG PEPrLLT AFrLICA?Tr?? C:HECK Lot__G2 Parcel and section number Street ? iVumber Owner Address DeveloPer 22 Ad.cLress'4 Z?LtJoQa!>7?.?i?` Zone-Ordinance #52 Lot Szze??s`y- >3. / x I?'?2:?c.. /151!?- Addition Total area Platted Unplatted , Building Size % Total area occupanc3' _----- Type of ccnstruction Setbacks : Street sides 3 0? ?G Rear ? ' Sides /d ` Parking: Tota1 area Parking area setbacks: Street side Landscape approval Special Assessments: :hC charge Water areao Assessed @ $1150 .00 Unassessed ,/ If assessed: Connectian charge If unassessed: Connemction charge 4,96, a0 Lot division; Additional assessments needed Not needed Lateralss Assessed ? Not assessed Waiver of hearing: Needed. Block °oL Assessment clk? Water & Sewer Dept Tota1 spaces Rear S;.cies Bond required ? Not needed 11? Building Dept Police Dept F'ire Dept (Corrun & Ind only) , MASTER CARD LOCATION Cr ` 02 OWNER STRUC7URE AND s LAND USED AS V F ? ? e4v- -) Permit No. Issued Issued To Contractor Owner BUILDING ?3ee__ PLUMBING CESSPOOL - SEPTIC TANK UJELL ELECTRICAL HEATING GAS INSTALLING Q s? ? -?i-? - .. `-' 17 SANITARY SEWER OTHER I OTHER I Irems Approved (Initial) Date Remarks Distance From Well FOOTI NG ?,- ?- SEPTIC FOUNDATION CESSPOOL FRAMING TILE FIELD FT. FINAL ELECTRICAL HEATING DEPTH OF WELL GAS INSTALLATION SEPTIC TANK CESSPOOL I DRAINFIELD PLUMBING WELL SANITARY SEWER . Violations Noted on 8ack COMMENTS: PERMIT NO. CONDITIONS OF CONSTRUCTION AT THIS INSPECTION ? NO EVIDENCE OF NON-COMPLIANCE OBSERVED. ? ACCEPTABLE SUBSTITUTIONS OR DEVIATIONS. DATE OF INSPECTION ? NON-COMPLIANCE. BUILDER WILL COMPLY WITHOUT DELAY. ITEMIZFD AND DESCRIBED AS FOLLOWS: NON-COMPLIANCE. BUILDER DOES NOT INTEND TO COMPLY. a COMPLETION OF CERTAIN IMPROVEMENTS WILL 8E DELAYED BY CONDITIONS BEYOND CONTROL. ? REINSPECTION REQUIRED REINSPECTION REVEALED DATE OF REINSPECTION CERTI FICATION - I certify that I have carefully inspected the above in which I have no interest present or prospective, and that I have reponed herein atl significant conditions oLserved to be at variance with ordinances of the Town of Eagan, approved plans and specifications, and any specific require- ments for off-site improvements relating to the property inspected. ? ALL IMPROVEMENTS ACCEPTABLY COMPLETED BUILDING INSPECTOR COMMENTS: DATE COMPLIANCE INSPECTION REPOR.TS TO BE USED ONLY IN EVENT OF OBSERVED VIOLATIONS _ 2> 23 7,,-ellf "7' 2007RESIDENTIAL BUILDING rExMIT ArrLicaTioN City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX 4 651-675-5694 New ConsWction Requirements 3 registered si(e surveys showing sq. ft o( bt, sq. ft. o( house; and all roo(ed areas (20% maximum lof coverage allowed) 1 Soils Report 'rf proposed building is W be placed on disturbed soil 2 copies o( plan showing beam & window sizes; poured found design, etc. 1 set of Energy Calculations 3 copies of Tree Preservation Plan 'rf lot platted after 711193 Rim Joist Detail Oplions selecfion sheei (buildings with 3 or less units) /,20. e-r1 __ RemodeUReoair Requirements Office Use Onlv 2 copies of plan showing footings, beams, joists CeA of Sun!ey Recd _Y N 1 set of Energy Calculations for heated additions Soils RepoM _Y _ N 1 site survey tor additions & decks T. Pres Plan Recd _Y _ N. Addition - rndicate if on-site septic system Tree Pres Reqwred _ Y_ N On-site SepUc System _ Y T N Minnegasco medianical venUla6on form 2-3 pia.,Q arp r-nneirlprpcl nuhlir infnrmatien unless vou state theV ar'e trad ? ec?et a? nd?fie eason. Date 1s l? l C? 7 Site Address 61-Z72 f''lc`?fJGe %?G? Construction Cost 4-76d •O0 Unit/Ste # Description of Work Z?&C& ?ec`( p t- Multi-Family Bldg _ Y Y N Fireplace(s) _ 0 ?<-1 _ 2 Property Owner Tetephone # (laS1 Contractor Address State City Zip Telephone # ( ) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672 Energy Code Cat2gory • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet (4 submissiontype) Submitted . Submitted • Energy Envelope Calculations Submitted In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master pian? _ Y _ N If yes, date and address of master plan: Licensed Plumber Mechanical Contractor Sewer/Water Contractor AUG 0 u 2007 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 a review and approval of plans. T>AL)/D Applicant's Printed Name Applicant's Sign re DO NOT WRITE BELOW THIS LINE r Sub Tvaes ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bidg ?< 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi ? 03 01 of _ plex ? 09 07-piex 0 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-piex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo/pergola) ? 36 Multi Misc. ? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-piex ? 25 Miscellaneous Work Tvpes 2l/??&1 y'L10 5 c- 0'r,14?lzrrt+ /pU!'L,L tl !" tox"`C ? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding ? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair O' 33 Alteration ? 37 Demolish Building* ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement *Demolition (Entire Bldg) - Give PCA handout to applicant D25Criqti011: Water Damage _ Yes Valuation Occupancy MCES System Plan Review 100% or 25% Code Edition Census Code --- Zoning City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bldgs Length Fire Sprinklered Type of Const Width _ Foorings (new bldg) Footings (deck) ? Footings (addition) Foundation Drain Tile Roof Ice & Water Final ? Framing _ Fireplace _ R.I. _ Air Test _ Final _ Insulation REQUIRED INSPECTIONS _ Sheetrock FinallC.O. ? Final/No C.O. HVAC Other _ Pool Ftgs Air/Gas Tests Final _ Siding _ Stucco I,ath _ Stone Lath _Brick _ Windows _ Retaining Wall Approved By: 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 fl.61b ucu4 : ?le2?6 . /( 0 Co o City of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675 -5675 www.ci.eagan.mn.us Site Address: 4322 Medary Ave Lot: 6 Block: 2 Addition: River Hills 9th PID:10- 64400 - 060 -02 Use: Description: Sub Type: e - Furnace & Air Conditioner Work Type: New Description: Fumace & Air Conditioner Fee Summary: Contractor: Angell Aire 12253 Nicollet Ave S Burnsville MN 55337 (952) 746 -5200 ME - Permit Fee (Replacements) Surcharge -Fixed Total: Applicant/Permitee: Signature PERMIT City of Eaan - Applicant - $50.50 Owner: David C Jackelen 4322 Medary Ave Eagan MN 55122 Permit Type: Permit Number: Date Issued: Permit Category: $50.00 0801.4088 $0.50 9001.2195 Issued By: Signature Mechanical EA091275 09/23/2009 ePermit Comments: Quesetions regarding electrical permit requirements should be directed to Mark Anderson, State Electrical Inspector, (952) 445 -2840 I hereby acknowledge that I have read this application and state that the informa of Minnesota Statutes and City of Eagan Ordinances. on is correct and agree to comply h all applicable State íû þý ýü þýý üîü úýýÿ ë îõç í î ÿ þýö ûúù ø÷ö ô úù ø úù ø÷ö ä ÷öõ ùý ï ù ô ô ðùý ó òý ñ ïù ç ï ï ò ï ýû ïéæý ÷÷ù üýæ æ ýï ý ù éôýæ æýù ýæ ýýé ôý ûïà ý ò ûý÷ æýïï é ý ñ è ßèëëéìëéëì õú ý ý êýýè ßèéìíéîíì êýý üé ôîó öòñ ùùý õ ÷ý ýçôÞý íîôõýôø îîå ý ç õ ç åäìì þý ýåäììîî âìáî ûý÷ ýýç ýýùùýýý ý æ ïý ýý ïù÷ýýùùýû ý æå ýý ýôæþý ýð ý é ùùýö ï ý ý PERMIT City of Eagan Permit Type:Building Permit Number:EA114226 Date Issued:09/12/2013 Permit Category:ePermit Site Address: 4322 Medary Ave Lot:6 Block: 2 Addition: River Hills 9th PID:10-64400-02-060 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 . Ron Vosika 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 - David C Jackelen 4322 Medary Ave Eagan MN 55122 (651) 746-9848 Homesure Inc 2924 Anthony Lane, Suite 115 St. Anthony MN 55418 (612) 353-5781 Applicant/Permitee: Signature Issued By: Signature Use BLUE or BLACK Ink ' r__._��.��_.�.��_�__� I For Office Use i • ; Pe�,�#: � 3a�q� ; �lt� Of ��Il � t �y t�C � � Permit Fee: 1 V� • p`./ i 3830 Pilot Knob Road � I Eagan MN 55122 � Date Received:�L�� Phone:(651)675-5675 � � Fax: (651)675-5694 I Staff:�� • � � � -----------------� 2015 RESIDENTIAL BUILDING PERMIT APPLICATION Date:� �C .�S Site Address: J�� ?� ��= Unit#: Name: �!4(/�1) ��1 CIC,�L.�� Phone:�vS 1 -7`�(��G Address/City/Zip: �3�-� � �l�l�L'f�� Utr �—+4�� Z.� Applicant is: Owner �Contractor Descrlption of wo�lc: �l� ��-� C�Q—�-g� �r Construction Cost: l� ��' % • �� Muiti-Family Building:(Yes /No_) ,. , � ;. .. . Company:_11,�6��/��'�!/�Q�e �LF3� Contact:�7�E�'��if'��L�fc�/�►-" Address:��(�1 �;�� e N� . . Ciry: �l��S State��Zip: �'�� Phone:�2 � mail: License#: G�O �f-�'�D 82. Lead Certiflcate#; /��Z'= 7 2 ?!��—� If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) _ ��-�� C4MPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit fo�a simflar plan based on a master plan? _Yes _No If yes,date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor. Phone: � �, .,. � � `.• ... ,�,. . Sewer&Water Co�tractor: , , Phone: , CALL BEFORE YOU DIG. Call Gopher State One Cail at(651)454-0002 for protection against underground utflity damage. Call 48 hours before you intend to dig to receive locates of underground utilities. y�w.aooherstateonecall.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 applicatlon for a permit, and work (s not to staR 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 buliding permlt Issued in accoMance with the Minnesota State Building Code must be ompleted within 180 I, days of permit issuance. • , . , .. X � � X. �1�.—.� \ Applicant's rinted Name Applicant's Signature • . , Page 1 of 3 - �' . �'� PERMIT City of Eagan Permit Type:Building Permit Number:EA145018 Date Issued:08/21/2017 Permit Category:ePermit Site Address: 4322 Medary Ave Lot:6 Block: 2 Addition: River Hills 9th PID:10-64400-02-060 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State 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 - David C Jackelen 4322 Medary Ave Eagan MN 55122 Renewal Andersen 1920 County Road C West Roseville MN 55113 (651) 264-4777 Applicant/Permitee: Signature Issued By: Signature For Office Use • ,,. ; ; o,. E AG N Permit IA: LS—39(0 (7. Permit Fee: ©, 0 0 �1 p, 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 FEB 0 6 zu1'j Date Received: e2- (o (651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 Staff: buildinginspectionsna cityofeagan.com L 2019 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 2/02/19 Site Address: 4322 Medary Ave Unit#: Name: Dave Jackelen Phone 651-890-5256 Resident# Same as site Owner Address/City/Zip: Applicant is: Owner ✓ Contractor Type of Work Description of work: nat gas insert, connect to existing gas Construction Cost: $2,500.00 Multi-Family Building: (Yes /No 1 ) Company: Walter Mechanical, Inc. Contact: Rich Walter Contractor Address: 517 W Travelers Trail city: Bumsville State: MN Zip: 55337 Phone: 952-895-1992 Email: waltermechanical@live.com 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 lnfonnadon maybe classified as non.pubilc if you provide specific masons that would permit the City to conclude that they are trade secrets. You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeaaan.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.gopherstateonecall.orq I hereby acknowledge that this information is complete and accurate;that the work will be in co . an - h the ord' :n - nd ..es of the City of Eagan; that I understand this is nota permit, but only an application fora permit, and •. is no .start wit ape • d; .;Athe work will be in accordance with the approved plan in the case of work which requires a review and appro of x Richard Walter Applicant's Printed Name /p..Can s Signa ir'