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