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4336 Medary AveCITY OF EAGAN Remarks Addition RiVer Hills 9th Lot 8 Bik Z Parcei 1°4D 6l?i00 (780 02 Owner Q. Street-4336 M0d3Ty AV2. State Eaganmm 55122 Improvement Date Amount Annual Years Payment Receipt Date STR EET SUR F. STREET RESTOR. GRADING SAN SEW TRUNK 1273 2 ?. 1 1 SEWER LATERAL WATERMAIN WATER LATEFAL 1976 3 WATER AREA STORM SEW TRK g1Ct t}1TU UT71SVllle # STORM SEW LAT - -1976 CURB & GUTTER SIDEWALK STREET UGHT 1980 80 13.56 5 WATER CONN. 2 ?UILDINGPER. 1 2 0 3002 U M SAC O OO OZ - PARK , CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, PHONE: 454-9100 BUIIDING PERMIT Receipt To be used for DBCK ? Est. Value 9 000 Dat Site Address •3;6 lIEDNt7 ?w Lot -A Block 2_ Sec/Sub. RtVE4 p2LL.R 9Tx PBfC@I NO. Occupancy W Name -1E1tAY 6 VIBGIIiIA L 3 Address 4338 lIDAIIY A{/E ° City EnGnN Phone 894-1985 6 Name HOME ENHAIOCEpfR 2NC ,O Address S46A faS'Ri $? 61 City RwvAnK Phone R84-61C.•6 ww Name ??-, Address i W City Phone I hereby acknowlege that I have read this application and state that the information is correct and agree to comply with all applicaptff State of Minnesota Statutes and C,ity ol Eagan Ordinances. / Signature of Permite?'3'--?--{ y11,LL,.,,., + -Es,t}-t? ? S A Building Permit is is4ued to: KOM EHHANCtRS INC on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. NN 55121 • """ # I w ? J63 Zoning - (ACtual) Const - (Allowable) - k ot stories Length IF' Pi1 14id4 Depih va* -%d4 S.F. Total - S,F. Footprints - On Site Sewage - On Site Well _ MWCC System - Ciry Water - PRV Required - Boosler Pump - APPHOVALS Planner _ Council -- BIdg.Ofl. _ Variance - 19097 ?H FEES Bldg. Permit Surcharge Plan Review sAC, city SAC,MCWCC W aler Conn Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment PI Road Unit Park Ded. Copies TOTAL Permil No. Pertnit Fiolder Date Telephone # WATEA SEWER PLUMBING H.V.A.C. ELECTRIC InspeeHon Date Insp. Commenls Footings I FoundaUon . Framing Rooting Rough Plbg. Rough H[g. Isul. Fireplace Final Htg. Orstat Test Final Plbg. Plbg. Inspector - Notify Plumber Const. Meter Engr./Plan 81dg. Final Deck Ftg. Deck Final 9/ S f 1 nw Well Pr. Disp. CITY of EAGAN BUILDING. PERMIT owna= C..t....... - .K?.........-- -- ?--? ................... Addrese cp=.gan:y .....?A.6..A........ ?... .....7.............,.? Sutlder ..................... ?iC?pF1.Q............. .................................... Address ..... ?t«.4)....&.oq.. .............'.... ? N.2 3944 3795 Pilot Knob Road Eagan, Minnesofa 55122 459-BI00 Da:e ?!(w?.'??-f ••.T.,?,Es..' Ssories To Be Used For . ? at 9cL, . Fron2 soR Depih Heigh! Est. Cos! ' Permi! Fee // 4 ;; Aamarks ? r LOCATION 44 Slreel, Road or other DescsipYion at Location I ? I 81oek I Addition or Trac! This permit does not aulhorize ! use of sireets, roads, alleys'or sidewalks aor does it give the owner or Lis aqen! the right to ereate any situation which is a nuisaace or which preaents a hazard !o the heallh, safety, eonveaieaee aad qanaral welfare !o anyone in the community. THIS PERMIT MUST BE, ?K T REMI WHILE THE WORK IS IN PRO . /p This is to certify, ihaY.. ,../.f?+ .N .. ... . ....... .. . .has permission !o erec3 a .???i..? r?.. , ,?._upoa the above described pr ise subjeci io the provisionC s bf all applicable ' ances for 33Se Ci E ??of agan .-°--._....?......- ............................. PerC___!2fr.d ?7:!:5-_.....l....__._.._.. .• •:•• ••..........._........................... yor Suilding Inspector ?- /';'v Er' "%`; %ls vmo, CITY OF PAGi±N 3795 Pilot Knob road Eagrn? i!i_r.ne::eca 55122 r'E??T raoa; 853 The City of Eagan he-reby EA a;:its to Ray td. Welter 8eatincCo_ of r2pls. 55407 a, HEATING Permit for: (Owner) Windsor Dev. Corp. _?_ 432*4 - .- & a-t 4336 Medary Ave. , pursuant to application d-ated ?_, 6/2fl 76 ,__ Fee Paid: $40.00 datod this 30 day cl 1.00 8/C June ; 1 ;76 _ Building Inspectoi• Meehanical Permits: Bid To ta.l: . f - 6;)-. CIT`Y' 0F P.AUAN 3 (;.,D Pi).ot Knob Road Ea.g:an, Minne.sota 55 122 PEPLIT The Cit,y os Sagan hereby graiits to _ MiM?gon pl,+rnt,inc_oo_ of 12201 Mirinetonka $lvd.- --- a. pI.UNIDIIAIG Permit for: (Owner) Windsor nev aorn ._..?_ 3b a? , pursuant i,o application dated Silled Fce ?----S 0.00 dF>ted this __2f_ day of __May > 19 76-°- 1.50 s/c Statement #873 Fluing Irispertoj.' DZe::nariical Perm_its: bid Totai, 9" CITY OF EAGAN • 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PH()NF• d54_Aif)fl . BUILDING PERMIT DECK & To be used for 3-SEASON PORCH Est. Value $9, 000 Site Address 4336 MEDARY AVE Lot $ Block 2 SeGSub. RIVER HILLS 9TH Parcel No. W Name JERRY & VIRGINIA MCCLURE 3 Address 4336 MEDARY AVE ° City EAGAN Phone 894-1985 ZF Name HOME ENHANCERS INC ,o,¢ 04 Address 5460 145TH ST W ? City SAVAGE Phone 884-6106 ? W Name ??-, Address 10-1 City Phone I hereby acknowlege that I have read this application and sta that the intormation is correct and agree to comply with all applic State of Minnesota Statutes and of Eaga Ordina s. Signature of Permite A Building Permit is issued to: HOME ENHANCERS INC on the express condition thal all work shall be done in accordance with all applicable State ot Minnesota Statutes and City of Eagan Ordinances. Building Official Receipt # ?--' Date MAY 22 , 199-L_ N° 19097 15 S51 OFFICE USE ONLY Occupancy ? FEES Zoning - (Actual) Const - (Allowable) - S of Slories Le„gtn Porch 14x14 oePin Deck 4x14 S.F. Total _ S.F. Pootprints - On Site Sewage - on site weil _ MWCC System _ City water - PRV Required - Booster Pump - APPROVALS Planner _ Council 81dg.Of1. _ Variance - 81dg. Permit surcnarge Plan Review snc, city SAC,MCWCC Water Conn Water Meter Acct. Deposit S/W Permit S!W Surcharge Treatment PI Road Unit Park Ded. Copies TOTAL 108.00 4.50 1.50 114.00 & o ? p ?? pv ? 5041 Request Date Fire No. Rough-in Inspection Requiretl? ? Aeatly Now-L;?Will Notity Inspecta ? -70U f]Xes ? No When Ready? I C31censed contractor O owner hereby request inspection of above electrical work at: bb Atltlress (Street, Box of Roule No.) City . `?3 ?, ? 4-ti7 Section No. Township Name or No. Range No. County Occupant (PRINn Phone No. Ppwer Supplier Atldres5 Eledrical Contractor (Company Name) Contrector's License No. S. ( U G n I le_C LCLA C+ 7 ?F ?S Mailing Atltlress (Contractor or Owner Making Installation) 8 v1^Jc O Authorize0 SignaNre (Conlractor/Owner Making Inslallation) Phone Number `2?„?_. a?0 CI ?JeLY MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Grigga-Mitlway Bldg. - Room 5773 BE ACCEPTED BYTHE STATE BOARD 7821 Univeralty Are., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS Plrone (612) 642-0800 ENCLOSED. p REQUEST FOR ELECTRICAI INSPECTION ee-oopooyi-oe ??G-`?ff/ ? See insbuCtion5.i9r compieting ihis form on back of yellow copy. ? ??y? ? 'Xf Below Work Covered by This Request ew Add Rep. TypeoiBuilding AppliancesWired EquipmentWired . Home Range Temporary Service Duplex Water Heater Electric Heating Apt Building Dryer Other (Specify) Comm./Industrial ' Furnace p Farm Air Condiiioner Other (specity) ConiraMwS Remarks: Compute Inspection Fee Below: # Other Fee # ServiceEnVanceSize Fee # Circuks/Feeders Fee Swimming Pool 0 to 200 Amps Transformers q6ove 200 _ Amps Above 700 _ mps Sigf15 IriSpectorS Use Only: TO L Ircigation Booms ?6 •Q ?p ? Speciat Inspection Alarm/Communication THIS INSTALLATION MAY BE O SCONNECTED IF NOT Other Fee COMPLETED WITNIN 18 kl"THS. I, the Electrical Inspector, hereby ti h h b Rough-in Rate Q/ 6 _??V • ry t cer at t e a ove inspection has been made. Fi„ai . OFFICE USE ONLV . This request void 18 moMhs irom I IIII II III II III IIIII II I I I II II) IIIII 8P1 Q UotversityAve. , Rm S-?1I8 A? Pau PMNT55?10 4 * 4 4 3 6 8 7 *-n?,e (sjz) sa2-0soo. ?l9??r(p cl, Home up ex Apt. Bldg. Other: New Addn mmercial I shial Farm Remod e air Air Cond. Tg. Equip. Water Htr. Load Mgmt. Other. D er Ran e Elec. Heat Temp. Service "k" above the work covered by this request. Enter remarks in ihis space ond on the back of fhe whife copy only. Calculate Inspection Fee - This Inspection Request w'rll not be accepted without the correct fee: Other Fee # Service Errlmnce $ae Fee # Circuits/Feeders Fee Mobile Home Park Stall 0 to 200 Amps 1 24 9 to 100 Amps ..C1? Street Ltg./Traffic Sig. Above 200 Amps Above 100 Amps Transformer/Generator INSPECTOR'susEONLV TDi?[- Sign/Ouiline Ltg. Xfmr. F Alann/Remote Confrol Swimming Pool at I ins ecled Me elechiml instollation descn6ed herein on Me dates stoted I hneb mhi N Irrigation Boom i Rough-In oore Special Inspecfion Investigative Fee Final ? 1 y f?'d_ THIS INSTALLATION MAY BE ORDERED DISCONNECT96 IF NOT COMPLETED WiTHIN 18 MONTHS. 2 4 4 3 6 87j OFPICE UONLY This requast void 78 months from validation date pnnted in ihis 6oy?? bY/ ? `i? 57 b C PLEASE PRINT OR TYPE / kS, ? ? C>4CJ Requesl Dak kough-in inspeclion requi ? Yes o Inspeciion Othar Than Rough-In: Ready Now 0 Will Call ? Zy 476, (You must tall ihe inspeclor when ready) Date Ready: I, 0 licensed coniractor 0 owner hereby request inspedion of the above electrical work at: Job Address (Sireel, Box, or Rou No.) City ? Zip Code Section No. Township Name or No. Ronge No. Fire Na. Counly ????e?rrre?i n Occu nt ? plwne n ???/?t% Power Suppllar qddress Eledrim) Conhactor (Compony Name) ConMactor li<ense No. Masler Lic. No. (Plant Elec1. Only) Harrison Electric, Inc. CA00808 Mailirg Address (Contmdor or Owner Performing Inslallaflon) 2525 Nevada Ave. N.-Ste. #301, Golden Valle MN 55927 AuMarized Sigrroluie (Conha r ar Owner PeAortn' g Installation) Phane No. ? : 5,44-3300 6/95 STATE BOAHD COPY • SEE INSTRUCTIONSON BACK OF VELLOW COPY ,..r.- -.,..,.,_.._._....-......?.M-.- - WATER SERVICE PERMIT YILLAGE OF EAGAN 3795 Pilot Knob Road PERMIT NO.: .-1980 DATE: 5125/76 Eogan, MN 55122 Zoning: RT - No. of Units: 1 Win Owner: Address: Site Address. dZZ? MoAa j181012 RH 9 Plumber: 00 pd 205 Me r No.: . Connection Chazge: Size• '`' Account Deposit -- billed 873 10.00 eader No.: . Permit Fee: • 50 billed 873 1 ogr to co ply with the Villoge of Eogae Surchazge: 60.00 pd y O?d(?es. Misc. Chazges: . Total: gy Date Paid: Date of Insp.: Insp.: - .,.,, vaLaoE oF Ea6aN SEWER SERVICE PERMIT 3795 Pilot Kno6 Rood PERMIT NO.: 2738 Eogan, MN 55122 DATE: 5/25/76 Zoning: RZ No. of Units: 1 Owner: wi nAcor Mv [`o+^j L, Addreas: Site Address: 4126 Mptiarv Ave - L8 82 RH 9 Plumber: 'j'bmmpc.pn P7 »mhi ng CO - 5/21/76 #3002 100.00 pd I ogroe ro cempty wit6 the Yilhge of Eagae Connection Chazge:350.00 pd O?dinonees. ACCOUnt Deposit: Pernut Fee: 10.00 billed 873. Surchazge: • 50 bi.lled 873 BY: Misc. Chazges: Date of Insp.: Total: Insp.: Date Paid: (?64? 7q ? 2004 RESIDENTIAL BUIILDING PERNIIT APPLICATTON City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 - - - - -- - -- -Telephone # 651-675-5675 FAX # 651-675-5694 -- 7o'T New ConsWction Reauirements RemodellReoair Reau(remenfs 3 registered site surveys showing sq. ft. oT lot, sq, ft of house; and all roofed areas 2 copies of plan (20°h maximum lotcoverage allowed) 1 set of Energy CalculaUons for heated additions ?.: 2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks 1 set of Energy Calculations Add'rfion - indicate i(on-site septic system 3 copies of Tree Preservation Plan if lot platted atter 7/1193 ' Rim Joist Detail Options selection sheet (bldgs with 3 or less units Date G c)(-4 Site Address D k) Description of Work Multi-Family Bldg Construction Cost $ 5 D U q - or) UnitlSte # Property Owner Telephone #!((9U ? ) ?r?? -y? ? Contractor KMA HUMh Jr;KV1l:r;J, 1N(:. Home Depot Installed Sa1es Aflflress 3200 Cobb Galleria Pkwy.Ste. #200 State _ Atlanta, GA 30339 763-542-8826 BG20268257 ip City Telephone # ( ) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Energy Code Category - Minnesota Rules 7670 Cate orv 1 _ Minnesota Rules 7672 (?l submission type) • Residential Ventilation Category 1 Worksheet . New Energy Code Worksheet Submitted Submitted • Energy Envelope Calculations Submitted Have you previously constructed a building in Eagan with a similar plan? Y N If so, 25% plan review fee applies. - - Licensed Plumber Mechanical Contractor Sewer/Water Contractor Telephone #( Telephone # ( I hereby apply, for a Residential Building Permit and aclrnowledge that the i ?knlish?' iletie ? d accurate; that the work will be in conformance with the ordinances and codes of the of Eagan and the tate of MN Statutes; I understand this is not a permit, but only an application for a perm d work is n without a permi ; that the work will be in accordance with the approved plan in the case c requires a review and appkoal of plans? , / ,.-? pplicant's Printed Name pplicant's Signature 1 5a -3yS?- (a0 Y'7 Cjsa _ ?Sy _q9o I - _ _ ?? rirepiace(s) _ u _ 1 _ G OFFIC'E USE ONLY Sub Types ? 01 Foundation ?- 07 05-plex - ?. 13 16-pfex ? 20 Pool-- --- -- El- 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-ptex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 04. 02-plex ? 10 08-plex ? 18 Deck 0 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 Pibg_Y or _ N ? 25 Miscellaneous Work Types ? 31. New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding ? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 33 Alteration ? 37 Demolish Building* ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement 'Demolition (Entire 81dg) - Give PCA handout to applicant Valuation Occupancy MCES System Census Code Zoning City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bldgs Length Fire Sprinklered Type of Const • Width REQUIRED IN5PECTIONS _ Footings (new bldg) _ FinaUC.O. _ Footings (deck) _ FinaUNo C.O. _ Footings (addition) _ Plumbing Foundation HVAC Drain Tile Other Roof Ice & W ater Fi nal _ Pool _ Ftgs _ Air/Gas Tests _ Final _ Framing _ Siding _ Stucco _ Stone _ Br ick Fireplace R.I. Air Test Final _ Windows _ _ _ Insulation _ _ Retaining Wall Approved By: , Building inspector Base Fee Surcharge Pian Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total ? Installed- Siding and Windows LIlVIITED POWER.OF CUUN'1'Y UF COBB STATE OF GEORGIA KNOW ALL PEOPLE BY THESE PRESENTS: ATTORNEY THAT I, David N. Katz, a resident of Montgomery County, Pennsylvania ("Principal"), and a licensed contractor of RMA Home Serviccs, Inc., DBA Home Depot InstaIled SaIes loca±ed at 66011r1ende[ssohn Aver_-LTe North, Go?uen Vul?ey, MINT 55427, having a license number of BC- 20268257, do hereby appoint, name and constitute Elder-Jones Building Permit Service, Inc. ("Agent") as my true and lawful attorney-in-fact and do authorize and grant said attorney-in-fact for me and in my name, place and stead the power to execute, acknowledge, sign and deliver (in such form as may be required by the municipality) a permit application, or any other instrument(s) which may be necessary arid appropriate, in order to obtain the proper permit(s) from the City of Eagan, Minnesota for the installation, maintenance and repair of windows and siding (the "Work"). - The powers conveyed to the Agent by this Lirnited Power ofAtto:riey are limited solely to the expxess povvers delineated herein ancl apply solely to the Work. This LimiT.ed Power of Attorney shall expire arid automatically be revoked on the 21st day of May, 2004, which date is one year from the execution hereof. Further, the powers conveyed by this Limited Power of Attorney may be revoked by Principal at any time by express revocation and shall also be revoked by the Principal's death, disability, incapacity or incompetence. IN WTTI'NESS WHEREOF this Limited Poiver ofArtomPy is e_.?ecuted this 21st day of May, 2003 Qavida N. Katz SWORN TO AND SUBSCRIBED BEFORE ME by David N. Katz on this 21st day of May, 2003. ? Notary P ic in for the State of eorgia My Commission Expires: January 21, 2006 396816.0 Proudly sold, furnished and installed by RMA Home Services, Inc., a Home Depot authorized contractor. 3200 Cobb Galleria Parkway, Suite 200 • Atlanta, GA 30339 • Phone (770) 779-1300 • Fax (770) 984-0709 • Toll free (800) 79-DEPOT o•44 108•00+ 4•50+ 1•50+ fA 114•00* 1 0£3 ° U0+ 4•50+ 1 • 50-r 114°OO-r { 1991 BUIAIN ?? AP LICATION CITY OF EAGAN WAY SINGLE FAMILY DWELLINGS MULTIPLE DWELLINGS COMMERCIAL 2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL 3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PLANS 1 SET OF ENERGY CALCULATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS 1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS # OF RENTAL UNITS # OF FOR SALE UNITS PENALTY APPLIES WHEN: TYPING OF.PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY OF MONTH IN W1iICH REQUEST IS MADE. LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED. NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED. PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED. PERMIT MUST SHOW A LICENSED PLUMBER. ? To Be Used For-3-, 4AValuation: ?_ ?• Date: Site Address l/]4kct?r? 9000? OFFICE USE ONLY Lot 0 Block 2 Parcel/Sub P\\VE4Z HII.LS ITN NT,;m>tT1oIV Owner `?l t V/???` ;"r._ ?c??+-iP ? Address L{? ckr?, ?a e- City/Zip Code ?'?,cc?t Mrn 5S /a,P-- Phone Contractor f?po?t e??j2at ? e s?S <.1-dt? Address City/Zip Code S'a,0cs-4.t- 'J?5 372' 4 7- Phone 'Wp - ( - ? ? ()G / f3 ( -? dS? Arch./Engr. Address City/2ip Gode Phone # Occupancy Zoning Actual Const Allowable # of stories Length 1''oRLki Depth p EC-K S.F. Total Footprint S.F. R3 l4Xl 9 X14 On site sewage` On site well MGICC System _ City water _ PRV , Booster Pump _ APPROVALS Planner Council Bldg. Off. bS S" Variance FEES Bldg. Permit Surcharge Plan Review SAC, City SAC, MWCC Water Conn. Water Meter Acct. Deposit S/w Permit S/W Surcharge Treatment P1. Road Unit Park Ded. Trail Ded. Copies SUBTOTAL Penalty Lot Change TOTAL )08.00 Z/. 570 -?---?= ? At'ti agrees that all work shall be done in accordance with (Signature of Contractor) all applicable State of Minnesota Statutes?and City of Eagan Ordinances. ,. . o V/\ L- UA`% ? • ?? «? :.? 1 L4 x!u = 196 ? yd = 17 Ipao lf3 •yo 0 2 ?OnO ` 6 ? ?soos-3 L BL f:ITY USE ONLY ? o2 SUBD Add-on furnace ? yyoG- ??o - ?? e(?,O?,OJ6 Sl 31995 MECHANICAL PERMIT (RESIDENTIAL) ? CITY OF EAGAN Add-on air exchanger, i.e. Vanee system, etc. 3830 PILOT KNOB RD EAGAN, MN 55122 (692) 681-4675 RECEIPT #: -?3 ?JD DATE: °2 °29 7 Please complete for: ? single family dwellings ? townhomes and condos when permits are required foreach unit New construction Add-on air conditioning Date: o1-ot7-SG ? Minimum Fee: Add-on/Remodel (existing residence on y $ 20.00 ? ? HVAC: 0-100 M BTU 24.00 Additional 50 M BTU 6.00 ? Gas Outlets (minimum of 1 required @$3.00 each) ? State Surcharge TOTAL SITE ADDRE OWNER PHONE #: 4 - /y es INSTALLER NAME: V SEDCWICK „j-, I N W. STREET ADDRESS: L910 WENTWONTH AVE. S0. 881-90Q0 CITY: STATE: ZIP: PHONE #: ( .S' 10 C4, CITY USE ONLY L BL RECEIPT #: SUBD. DATE: 1995 MECHANICAL PERMIT (COMMERCIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 PiPase complete for: ? ali commercial/industrial buildings. ? multi-family buildings when separate permits are !]43 required for each dwelling unit. DATE: CONTRACT PRICE: WORK TYPE: NEW CONSTRUCTION INTERIOR IMPROVEMENT DESCRIPTION OF WORK: FEES: ?$25.00 minimum fee ql 1% of contract price, whichever is greater. ? Processed piping - $25.00 ? State surcharge af $.50 per $1,000 of r i fee due on all permits. CONTRACT PRICE x 1 % PROCESSED PIPING STATE SURCHARGE TOTAL SITE ADDRESS: OWNER NAME: TELEPHONE #: TENANT NAME: (IMPROVEMENTS ONLY) (NSTALLER: ADDRESS: CITY: STATE: ZIP• - PHONE #: A SIGNATURE: SIGNATURE OF PERMITTEE CITY INSPECTOR MASTER CARD Permit No. Issued Issued To Owner Contractor BUILDING .? c? I PLUMBING .3? • 7G CESSPOOL - SEPTIC TANK WELL ELECTRICAL ? HEATING GAS INSTALLING gs3 _ o_ SANITARY SEWER O7HER 07HER Ifems Approved (Initial) Date Remarks Distance From Well FOOTING ? SEPTIC FOUNDATION CESSPOOL FRAMING TILE FIELD FT. FINAL ELECTRICAL HEATING DEPTH OF WELL GAS INSTALLATION SEPTIC TANK CESSPOOL DRAINFIELD PLUMBING ? WELL SANI7ARY SEWER Viofations Noted ?- on Back COMMENTS: -a9- STRUCTURE AND LAND USED AS i[ COMPLIANCE INSPECTION REPORTS TO BE USED ONIY IN EVENT OF OBSERVED VIOLATIONS PERMIT NO. DATE OF INSPECTION CONDITIONS OF CONSTRUCTION AT THIS INSPECTION ? NO EVIDENCE OF NON-COMPLIANCE OBSERVED. ? ACCEPTABLE SUBSTITl1T10NS OR DEVIATIONS. NON-COMPLIANCE. BUILDER WILL COMPLY WITHOUT DELAY. ITEMIZED AND DESCRIBED AS FOLLOWS: ? NON-COMPLIANCE. BUILDER DOES NOT INTEND TO COMPLY. ? COMPLETION OF CERTAIN IMPROVEMENTS WILL BE DELAYED BY CONDITIONS BEYOND CONTROL. ? REINSPECTION REQUIRED REINSPECTION REVEALED DATE OF REINSPECTION CERTI FICATION - I cenify that I have carefully inspected the above in which I have no interest present or prospective, and that I have reported herein all 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. F-I ALL IMPROVEMENTS ACCEPTABLY COMPLETED BUILDING INSPECTOR COMMENTS: DATE 23 WINDSOR DEVELOPMENT CORPORATION May 20, 1976 Mr. Dale Peterson City of Eagan 3795 Pi1ot Knob Road Eagan, MN 55122 Dear Mr. Peterson: RE: Lot 8 B1ock 2 River Hi11s 4336 Medary Avenue Enclosed please find a check for building permit appLication and fees as allocated on the check stub in the amount of $1,027.50. This home will be a Model 75-20 elevation A, and will contain the following: - Finished family room - Patio door dining room with sundeck 8 x 10 - Fireplace - family room - Appliances - Ceiling vaults - living room, dining room & foyer with beams - Brick front Attached also find a copy of the proposed plot plan. Sincerely, WINDSOR DEVELOPMENT CORPORHTION ? ??...,? ? (?1%??..?ti?.? Warren R. Anderson Vice President ? WRA/Cj Enclosures ? ,. A4;.? SUITE 192, 4660 WEST 77TH STREET, EDINA, MINNESOTA 55435 • PHONE (612) 831-0717 ? .??- ,* :, r s f:' ?o'? Q ?lD? ? ?i??i'i.0i? 1?F; I1 c- .?Cl x ? , ?;? ? r +??? ? ..? . =?` ? ? .. . _ . _t _ ,,, ._ < ?'i ?.. ?.: ,i - _ ,...p ?._ b ` ?' , ?? ? ? , - ? , s? r? . . _ ? ' -:-? ? - , , .? ?>„?fi {?1?,..- ?-? PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA143038 Date Issued:05/31/2017 Permit Category:ePermit Site Address: 4336 Medary Ave Lot:8 Block: 2 Addition: River Hills 9th PID:10-64400-02-080 Use: Description: Sub Type:Residential Work Type:Replace Description:Furnace 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 - Christophe R Fjelstad 4336 Medary Ave Eagan MN 55122 Lofgren Heating & Air 5708 Upper 147th St W Suite 106 Apple Valley MN 55124 (952) 431-5811 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA143846 Date Issued:06/29/2017 Permit Category:ePermit Site Address: 4336 Medary Ave Lot:8 Block: 2 Addition: River Hills 9th PID:10-64400-02-080 Use: Description: Sub Type:Residential Work Type:Replace Description:Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener). 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 - Christophe R Fjelstad 4336 Medary Ave Eagan MN 55122 Preferred Plumbing 6400 High Point Trail Prior Lake MN 55372 (952) 447-5761 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA164047 Date Issued:09/17/2020 Permit Category:ePermit Site Address: 4336 Medary Ave Lot:8 Block: 2 Addition: River Hills 9th PID:10-64400-02-080 Use: Description: Sub Type:Reroof Work Type:Replace Description:Does not include skylight(s) Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please print pictures of ice and water protection and leave on site. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Valuation: 5,000.00 Fee Summary:BL - Base Fee $5K $118.00 0801.4085 Surcharge - Based on Valuation $5K $2.50 9001.2195 $120.50 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 - Christophe R Fjelstad 4336 Medary Ave Eagan MN 55122 (612) 581-1320 Excel Exteriors Inc 6230 10th Street N, Unit 420 Oakdale MN 55128 (651) 414-0919 Applicant/Permitee: Signature Issued By: Signature