3840 Westbury Lane
CITY OF EA(iAN sEWER SERVICE PERM
3830 Pilot Knob Rosd
P. O. Box 21199 PERMIT NO.:
Esgan.:rFN 55121 pATE; - ~
z~ina: nb. of unft- Owner, ."'Tt:' : ~•3.~; ~ a;~ V, (A t
ti
Address: ~
Site Addnat: 3840 571~?Stx.il.irY Li1 T L1 i.~' '•i?St!~t~~y .
Piumbsr: ==v ,}1 zrr.:~~ nc7 ~ ~
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Ori1M.w~. Aoaount Gpoatt,
Prrmit FN:
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BY Misc. Clwrpm
DaM of Irnp,: Totol:
I^sp': Dob Pbid:
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XGAN WATER SERVICE PERMIT
. .wt knob Rood
P. Qr Box 21189 PERMIT NO.i ,
Eapn, MN 55i21 OATE: ° za+inp: _ De ,'i 34,~!~ni~:
OwrNr: iY :l.'1(1
Addntw
Sft Addrsss: 3'~ r IPlumb+r. MeMr No.•
Slss: A,ooo„nf o.posir. .
R~odw No.: _CS 1.,14 q I ~ Permit Far - -
i I op'M ti wMb !w af fjilon Surcha?ps:
ari..w.m Ml.c. U,orpp;
Totol:
I BY GoM Paid:
DaM of Irap.:
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~ CITY OF EAGAN 1019g
~ 3830 Pila Knob Rosd, P.O. Box 21•199, Eagan, MN 55121
PHONE: 4548100 • ~ ,
eviLoiNa rERMIT Rece+a *
TO M w"d {e? , , rti2 Est. Value '_i u. 0 0 0 pme EjI 1 r . I 9 c r;
Site Addraw r; Y L W Erect Q Occvpancy -
Lot 1I Blaek Sec/Sub. li~"}'STR?1RY Ii Remadel ? Zoning
Repair ? Type af Const.
Pareel No. Addition ? No. Storfes
MOVB ? Lf11g[h ~ s-
,;R.:;a~: • + ,;~~~r~N~r
Narr?e
Demolish ? Depth
Address Int Impr. ? Sq. Ft.
~;45t •6934
City Phone Install ?
Nama 6 AVMovaM iNs
Addrcu Assessment Permit
Clty Phone Wnter & Sew. SurCharge
Polfu Plan Review ~
~W Neme Fir* SAC
13 Addreu Erq. Weter Conn.
'i City Phone Plannrr Wffier Meter
Council Road Unit
I Fwrcby ockrawledpo thot I iww mod thi: opplicotion and state thot gldy. ON. V 15 / s S Tr. PL 13 =
fhe intwmotion is cor?ect ond oyree to comply with oll applicabW
Stab of Minnwsoto Stotutes ond Gty of Eo9on OrdinoncAs. APC pe~
' Var. Datt C~i~
Sipnotun of PennittN ' Total
A Buildinq Ptmnit is isswd w: on tM expens aorditlon tho+
dl work sF+oll be dorw in acaordonce with all apylioable Stote of Minnewro Statutes ord City oi Eaqan Ordinonces.
, Buildirq Offitiol
Pwmit No. Pamit Ho1dM Dab TeMDhon~ s
~urnbkq Ig
H.VA.C.
EMetria
.
Sohwwr
Irapweeion Dm Insp. Wher
FoFoFnRo
Fo$HW
RoInsuL
Flrplaa
Final Htp.
Flnal Plby. fQ.
Flnal
C*rt/Oec.
WatK Qeeribe Loqtion:
WNI
8ewer
P?. Dlsp.
R"aipt PLUMBING PERMI7 Permk Na
CITY OF EA6AN F» .
r
flll !n nuin,bsiisd Wam S/C
Type or Prfnr Icofb/y Tot
1. Oate ~ - 5 - `Y ` 2. Installation Cost ~ a ~ ` •
3. Job Add?sa Lot ~ t Blk. = Tract ~
4. Owner 1Oa h • ~
6. ContractorU~i L Ls ~ '1 ('rj . ~ Phona
8. Addnss
7. Gty State ~ Zip
8. Buildiny Type: qesidentialCommercial O Institutional O '
9. Work Dtscription: Newt Add ? Alter ? Rapair ?
' 10. Desixihs
11. No• Fixtures No, Fixture ~
t Wster Closet !
Cesspool/Dninfield
Bsth tuba Septic Tank '
~ Lswtory $ohnar i
Shower Well I
Kitchen Sink
Urinal/Bidet Other
f Laundry Trsy
Floor Drains
Drinking Ftn.
Slop Sink
~ Gas Pipinp Outlsts
i
12. 1 hereby certify that the above inforrt?ation is true and corroct, snd I aprst to
comply with It ordinances and codes governiny thia type of work.
e
Siyntd:
Q~~-x ' for
Rouph Final
Impections: Date Insp. Date Insp.
This is your permit when numbered snd approved.
A~oved CITY OF EAOAN 4644100
Reaipt MECHANICAL PERMIT Permit No.
CITY OF EAGAN ~
-4 F«
' F!!J in »umbwrd;oow S/C
TYW or Prlrrt /tpib/y Tot
~ J
, 1 I
1. DaU t 3$ a 2. Irotallation Cost
3. Job Addrou L)940 lsLA.S}i kk rLot Blk. Tract
l
i
;
~ ~
4. OwnK ~,--~k rv
~
5. Contrsctor ~ I c A. c , ~1 4 Phcm
8. Addm:
7. Clty Vt I~ T_ State Zip
8. Buildin9 Type: Residential Commeraal ? Institutional ?
9. Work Desaiption: New C~', Add O Altsr O Repair O
.
10. Dsscribe Fuel TYPe ~~t! i-r r-k
11. No• EWApM= 8TU - M. Ea. No• Eauicment CFM
.
Foroed Air'!;`x Air Handlinq.
Mfg.
Boilers Mech. Exhauct
Mfg.
Unit Heater
Mfg. Other
Ar Cond.
Mfg.
Gas. P'iping Outlets
12. I hereby cartify that the above infarmation is true and correct, and I ayree to
pomRly with all ordinsnoes and codes governing this type of work.
~
Si~ad ~ for
Rouph - 4 Final
Inspactions: Date Insp. Date Irtsp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 464-8100
Rsceipt ' PLUMBING PERMIT Permit No.
CITY OF EAGAN FN
, fill in numbered spaces S/C
Type w Prini legib/y Tot.
1. Date 'l 2. Installation Cost
~ j
3. Job Address Lot Bik. Tract
4. Owner i {
5. Contractor 0~~ ky-~ i- . . e . . Phone ~
7L~
6. Address Finrkins ginneu^ i
~
It uc. tl
-0
7. City State Zip
8. Building Type: Residential ~ Commercial ? Institutional ?
y 9. Work Description: New C7 Add O Alter O iiepair O
~ . 10. Describe
' 11. No. Fixtures No. Fixtures
Water Closet Cesspool/Drainfield !
Bath tuhs Septic Tank
Lavatory $oftner ~
` Shower Well j
Kitchen Sink ~
Urinal/Bidet Other
Laundry Tray i
Floor Drains ~
Drinking Ftn.
Slop Sink I
Gas Piping Outlets
,
12. I hereby eertify that the above information is true and correct, and I agree to
oomply with all ordinances and codes governing this type of work.
;t Signed : ; ~ 'for
Rouyh F insl
Inspections: Date Insp. Date Insp.
M
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
' CITY OF EAGAN N°_ 10798
3830 Pilot Knrob Road, P.O. Box 21-799, Eagan, MN 55121
PHONE: 4548100 ,ef%i.~,. /
BUILDING PERMIT Receipt # 'y
Te M wd fer SF DWG/GAR Est. Value $56,000 pOte AUGUST 15 1985
SitaAddren 3840 WESTBURY LN Erect KI Occupency R3
11 2 WESTBURY II Remodel ? Zoning R1
Lot Block Sec/Sub. Repair ? TypeofConst. V
Peroel No.
Addition ? No. Stories
GRAND OAKS DEVELOPMENT Move ? Length 46
W Name Oemolish ? Depth ~}Q
Z Address 1881 SUNRISE CT Int.lmpr. ? Sq. Ft.
~ City EAGAN Phone 452-8934 Install ?
o Name SAME AOVrorals Feas
o" Addresa A:usvnent Permit $ 301.00
~
City Phone Warer 8 Sew. surcharge 28 _ 00
~
Police Plan Review 150.50
~W Neme Fira SAG 525.00
~W
~,Z-~ Address Enp. Water Conn. 500.00
~ W City Pnone Planner weter roteter 63. 00
Council RoadUnit 280.00
I hereby ackrawledge that I hava reud this applicahon and state that Bldg. Off. $/1 S/R S 7r. PI. 132, 0 Q
tM informotion is correcf and agree to wmply with oll apDlicabla AP~ Parks
Stote of Minnewta Statut and City f Eaqon Ordinoncez.
Var. Date Copies
$ipnoture of Permittae Total $ 1 9 / 9 .T 0
A Buildin9 Permit is issued to: GRAND KS E ELOPMENT CO m the axpmat wrditlon thav
all work shall be done in otm nce with I coble SJ G~of n ta Sfatutea and Ciry oi Eapon Ordirqncet
LL~L,
Buildfnp OHlciol -
CITV OF EAGAN Remarks
Addition WESTBURY SECOND ADDITION Lot 11 eik Z Parcel 10 83651 110 02
Owner Street 3840 Westbury Lane State Eagan, MN 55123
Improvement Date Amount Annual Vears Payment Receipt Date
STREETSURF. 19$6 2850.00 Si'
STREET RESTOR. GRADING
Sdater area 1986 133.7 8.92 15 /.;v '//.~5,
SANSEWTRUNK ~J qN (G, 113,5. '11yr,~A~7;
* SEWER LATERAL 1986 5008.73 1001 75 5 KO C L- ` (O l/ S , ~f
ldatermain 1986 65.29 4.35 15 bG.`I 1~/)~
WATERMAIN 1$4 SQ $ 3.39 1$
~ WATERLATERAL 1986
WATERAREA O 19,94 1116-9 9-11 19 I' S
*Services 1986 STOFM SEW TRK 1986 710.24 142.051 5 S~. 7: ~x 0 Ul STORM SEW LAT 1986
CURB & GUTTER
SIDEWALK
STREET LIGHT
Road Uti. 280.00 54594 8 15 85
WATER CONN. 500.00 1. "
BUILDINGPER. I0798 SAC 525.00 n n
PARK
RESIDENTIAL
BUILDING PERMIT APPLICATION
~ cirv oF eaGaN
C)
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
New Conetruetbn Heaulrementa HemodeVNeoeh Reouirementn l,
• 3 reglstereA sAe surveys showing sq. ft ol lot, sq. N. of house; and ~I rooletl areas • 2 mpies of plan ~ 7•
(20%maximumbtcoveragealbwed) • 15elofEnergyCalculatbnsforheatedaUd'AbnS
• 2 copies ol plan showing heam 8 window s¢es; poured found tlesign, etc.) • 1 sile survey for exlerior additbns & decks
• 1 set of Energy Cakulafbns • Indicate A home served by septic system br add'Aions
• 3 copies ol Tree Preservatbn Plan A lot platted etter 7!1l93
• Rim Jolst Detail Optqns seledion sheet (bk)gs w0h 3 or Iess units)
DATE VALUATION
S1TE ADDRESS 3 84' 0 S1IJur4 L N . iaN 55n5MUlT1-FAMILY BLDG _Y _N
TYPE OF WORK FIREPLACE(S) _ 0_ 1_ 2
APPLICANT
STREET ADDRESS ~e5~biAyjl G rv CIN EdG,qN STATE ZIP S5~ z 3
TELEPHONE# E7/-g94-6712 CELLPH NE# bi~- 5o3-a-L73 FAX#
PROPERTY OWNER Nfi P"C HX1 rJ R TELEPHONE # i~ 7~- y03- µ 1 7 3
COMPLETE THIS SECTION FOR ••NEW, RESIDENTIAL BUILDINGS ONLY
Energy Code Calegory MINNESOTA RULES 7670 CATEGORY 1
) • Residential Ventilation Category 1 Worksheet Submitted t Submitted
(J submission type
rf!n4y~'0~
• Energy Envelope Calculations Su6mitted 0 4 2002
Plumbing Conhactor: Phone # ~
Plumbing system includes: _ Water Softener _ Lawn Sprin . .00
_ Water Heater _ No. of R.I. Baths
_ No. of Baths
Mechanlcal Contractor: Phone N
Mechanical system includes: _ Air Conditioning Fee: $70.00
_ Heat Recovery System
Sewer/Water Conhactor: Phone #
I hereby acknowledge that I have read This application, state that the information is corr~j ~vrci agree to comply
with all applicable State of Minnesota StatuTes and City of Eagan Ordinance_s.. ~/i
Signalure of App i M~~~
-
.
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4l02
OFFICE USE ONLY
? 01 Foundation O 07 OSplex ? 13 16plex ? 20 Pool O 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
O 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) O 36 Multi
? OS 03-plex ? 11 10.plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 WindowslDoors
? 34 Replacement 'Demalition (Entire Bldg only) • Give PCA handout to applicaM
Valuation Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) _ FinaUC.O.
_ Foatings (deck) _ FinaVNo C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Ait/Gas Tests _ Final
_ Framing _ Siding Stucco Stone
_ Fireplace _ R.I. _ Air Test _ Final - Windows (new/replacement)
_ Insulation _ Retaining Wall
Approved By , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply 8 Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Capies
Other
Total
_ •
~
7985 BUILDING PERNIT APPLICATION - CITY OF EAGAN
NOTE: ALL CONTRACTORS MUST BE LICENSED WZTH THE CITY OF EAGAN
INCLUDE 2 SETS OF PLANS
3 CERTIFICATES OF SUAVEY
1 SET OF ENERCY CALCULATIONS
/
To Be Used For: Valuation: J I~Date:
.~..r~/..r.
Site Address: qo OFFICE USE ONLY
Lot: W B1ock ~ Sect/Sub Erect X Occupancy R-3
Remodel Zoning R-~
Parcel Repair _ Type of Const Q"
Addition of Stories
Owner Move _ Length 4(o
Demolish Depth 4-0
Address Int,Impr. _ Sq Ft
Install
City/Zip Code
Phone APPROVALS FEES
Contractor An aa Assessments Permit 30l `o
,r,~ \ Water/Sewer _ Surcharge 2g.
Address _[~~,,,n~p l~ police Plan Review ISO.$D
~r Fire SAC 525.°-'
City/Zip Code 7 rei _ Engr Water Conn SW.
Planner Water Meter
Phone Council Road Unit 2
Bldg Offg/J'-Sadr Treatment Pl 132. =
Arch./Engr. APC Parks
Variance Copies
Address TpTpL
.L~Z9 Sv
City/Zip Code
Phone j
• I `
~ SURVEYOR'S: CERTIFICA.TE :GRAND OAKS DEVELOPMENT C0.
N,..
4J
Z I /1i- !i~ I
Q ~ L_1J I ! l/
~
J °
~ ~ 150.00 S.89°42~27"W.
jp - 32.00 - - 40.00 N \
~ uj io 9.-00 ,r.oo
z2o ~
p GAR. g f`~
L' . F z^'.r+N^:taV"r~y r'' b i I
svs-fis^~-,,,.~uL.O I
0 20
(f) (fi /PROPOSED / $ ~ . ~
W Q p`~q i~+i MOUSE' /F~ 'pnqINAGF. 9 UTlLIT'Y EASEM£NT Q
~ ._.a..._. 1. )O O .
0 I 40.00 (PER PtA7'
~ Lfi 104 10_00 <I 10.00 T: ~ 32.00 - ' 40.00 ' ,c-~ '
150.00 S.89°42~27°W. ~ •
DENOTES PROPOSED SURFACE DRAINAGE '
O DENOTES IRON MONUMENT SET SCALE: 1 INCH = 30 FEET
• DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR = 8$9. $ FEEi'
.X000.0 DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR = g gI.p FEET
(000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK = g~Jp ,2 FEET
I HEREBY CERTIFY TO GRAND OAKS DEVELOPMENT C0. THAT THIS IS A TRUE AND CORRECT
REPRESENTATION OF A SURVEY OF THE 80UNDARIES OF:
Lot 11, 61ock 2, WESTBURY SECOND ADDITION, according to the recorded
plat thereof, Dakota County, Minnesota.
AND OF THE LOCATION OF A PROPOSED BUILDING. IT DOES NOT PURPORT TO SHOW IMPROVEMENTS.
OR ENCROACHMENTS, IF ANY, THEREON. AS SURVEYED BY ME, OR UNDER MY DIRECT SUPERVISION,
THIS IZT~ DAY OF Auhus-f , 1985.
PROPOSED ELEVATIONS WERE TAKEN SIGNED: JAM , HILL, INC.
FROM THE GRADING AND DEVELOPF4ENT
PLAN FOR WESTBURY SECOND ADDIT.ION, ~
PREPARED BY DELPIAR H. SCHWANZ
LAND SURVEYORS, INC., LAST DATED By:
8'8'84• HAROLD C. PETERSON, LAND SURVEYOR
PIINNESOTA LICENSE N0: 12294
PROJECT N0. BOOK / PAGE JAMES R. HILL, INC.
85786
Planners / Engineers / Surveyprs •
FILE NO. 8200 Humboldt Avenu• South~ ~
FOLDER eloomin9ton, Mn. 55431 612-8e4-3029
' - -
,
. ~ EXTERIOR ENVELOPE AVERAGE 'U' COMPUTATION
GRAND OAKS DEVELOPMENT COMPANY
MODEL N2 AREA U U 7( AREA
REQUIRED
1. TOTAL WALL AREA 1600'X .11 176
2. TOTAL ROOF AREA 924 X.026 24.024
ACHIEVED
AREA , U U X AREA
A. WINDOW AREA 123.77 .5 041.0UG
8. DOOFt AftEA 39.6 .077 3.0646 ' .
C. SLIDE GLASS AREA 13.44 .48 6.4512
D. FIREPLACE AREA. O O O
E. ' WALL FRAME AREA 160 .041 6.56
F. NET WALL AREA 1070.94 .049 52.47852 .
. c. F:t7 .IAiSF .AEA 106.24 .03.35 4.e3::064
H. FOUMD WFHBC]W F'RER O O O
1. FOUND A50VE GRADE 85.76 .135 11.5776
!
~
3. TOTAL WALL AREA 1600 146.6490
J. SICYLITE O. 0 0
K. ROOF FFtAME 92.4 .032 2.9568
L. NET ROQF AREA 931.6 • .025 20.79
4. TDTAL ROOF AREA ' 924 23.7468 .
~ i
SUM 1.+2, 200.024
SUM 3.+4. 170.3958
'
SCREENS 26,29&30 RERL ESTATE INOUIRY - NRME/RDDRESS/LEGRL XINGNO03
PARCEL ID: lU 83651 ilu 02 PLHT NAME: WESTHURY :'ND ADDITION
LEGAL: 11 2
HOMESTERD CARD ENTERED: 04 24 1989
FIRST DIVISION; 015710 li 06 1984
LRST DIVISION:
FEE CURRENT OWNER:
CRFIG CONDON
ELIZAbETH SERNIRK
3840 WESTPURY LN
EIa6RN MN 55123
TRfaNSFER TO SCREEN NUMBER:
PF8-SCROLL FORWRRD
; S +U ~f wy
Ve c? 0
W?10T
. , C-? Y I o
2/84
~ C=~~ i
MCITY OF EAGAN
~ .
APPLICATI0N FOR PE2ti1IT
SES•IER AND/OR WATER CONNECTIODl
(PLEASE PR[Ni)
1) PPOPF'R'?'Y ACDP.ESS: CJr
T Fr=,z. Ow.~: ~r?cV:
(Iati-BlockJSu:ciivisicn or Tac rarcei I.D. NL;.,r) ;
' ir ~,=:'=i:, DAi:. OFCiZTGV'AL ;.-'_iT
pcrcL.•~• ,,••;j•..~./~?Gr^OS~ L'S: ~ ~-1 Si:GL: :?}trl,y
? R-2 iUc7=.. ('?'.':O L^IZTS)
. ? R-3 'iC:%it.-c_(v.cr (mr-*o,^ T~.,--~
? R-4 k,Pr.F=.;T~/..CC_T~/i.iT;y -.t
? ~ti'~$ i~.Z L
Q n:STI7=1 ZC:LA I./Gv^v=,^.•
z) A~?7_ ~ i• (PLEMJ~ Pfti~if )
rr~- -7- :
ACD2°_SS:
. CT.'_'"_'. S_'rT, ZZP:
PFo'\IE:
3} pjZ,;.~~ - (PLE:,11,_Yi) FOA CITY I15E O4LY
rtAIME:
PLU!!BERS :tiSE:
PDCRESS: crQ4e ctive
CIT"L',ST?.TE, ZIP; rn y~ , - ~ Exp'red
'"~'c~ ' f Recard
. PHCVE: pLp.48ER IICE~JSE # [ o
ia
4) OCL,'T„?FS]T/C..z,.'F"2i (PLEASE PR1!IO
NAi'fE:
ADDRFSS:
CZT"!, STnTE, ZIp;
PEiO`IE:
5) IIJDIG"TE ?7HICH PERi•LIT IS BEIA:G RECUESTITJ:
~ CC:SIOV 'IO CITY SD]ER
~ CO:.".N=IG:I 'f0 CZTY S•TATE:2
? 071TR (PLGISE DFSC?SBE)
6) U:JIG,:: C:.:: .
• Q P*..F`,SE F?OID APPP,WEp PER.N+ST FOR PZCi:-L'P BY C:u'E OF ABGL'E
Eff PLASE :•i1IL APPT.?WID PM%LIT 'PJ 1. 2. jO. 4 11SpciB
ircle one)
7) SIc:;A'IL:~E: DATE: ~
w a+«wi?~a s+~ Q ~.~.as.s a~ s.+. ~.s s..~ r~ s.cs~a :a ~..e re E:a~ si.a ra ~~~saa.
F 0 R C I T Y U S E O N L Y
PEM_M.I"' " ISSUrD
_°°ZS: $ ~Q.Si> cE:•i~o Dr.7%4TT .r r-•n` o~-_._,._
- -
~
$ /O•SU SQAmca pz'?.:lZ': (IL:Cii:D: SiiRCiiAiZG'n)
SihT°R METER/COPPER??ORV/OUTS?DE REi,ucR
$ tdATE' TAP {INCLL'DE CORPORP,TIQ:7 STO??
$ SEi•:cR T.>?
$ uu ACCOi.i?:T pEnnSIT - [•?ATER
$ WnC,'
$ SP.C
$ TRL`IK W,NT°R `AS5_=55:_=_:i'?'
_ $ TRii:dl< S=i:ER :,SSESS..cciT
5 LATE3:nL Bc:vc'r'IT/TRU:`7K' SEi:ER
$ L:.:ERaL BLNLFIT/TRU.'ir ;,7AT_°j
$ ~~•-~-ov ?JATER TREATKENT PLANT SURCHARGE
, $ OTHER:
S TOT~L
$ ~ 3(/~ .,.tit7Ci.`:T PhIJi 4: CEi?T 4 ~Z/J~
D0:.5 UTZLITY CON:7ECTI0,7 REQUIRE EYCAVATION IN PUBLIC RZGHT OF [dAy?
L, YES IF YES, THE:: A"PE3D]IT FOR :•]ORR WITHZN
PUBLIC ROAD:JAY" MUST BE ISSUED BY THE
NO ENGINEERZD]G DNZSION. LIST AS A CONDI-
TION.
SU2.iECT_ TO THE FOLLO:•7Ii]G CONDZTIOC:S: •
APPROVED BY:
TI':Lc: '
DATr:
§W~1001=01f.wwww_400t4oPOWi+W"M Ot0 wtM wW:pm* w~~cWwspo Mm
City of Evan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
Permit #: te-Ad>-'1 \ej
Permit Fee:
Date Received:
Staff:
2010 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 1 bI 2(o I l 0 Site Address:
Tenant: VI CLOP $ LR.t(SU
36 L/ Q toes+ uJ Ln e.
Cent ic?ue 2.
Suite #:
RESIDENT /OWNER
Name: \J l U Ui M � rl 6 U— 2 Phone: (i/2" 702.-007
Address / City / Zip: 'It3 CIO 0.:2 1)l ll`C1 Li • FOt5a�i mo
�,, eJ
Applicant is: ( Owner Contractor
TYPE OF WORK
m +XPi'(^.r',,,_.``t ,
Description of work: ti,.) I /t1G�(il j 5 4 f5 Cl'.p\(ALIr) {r i--Pw-•a, &e 2_
Construction Cost: .-"
0(_;) . 00 Multi -Family Building: (Yes / No )
r
CONTRACTOR
Name: License #:
Address: City:
State: Zip: Phone:
Contact: Email:
COMPLETE
In the last 12 months, has
Yes If yes,
THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
the City of Eagan issued a permit for a similar plan based on a master plan?
date and address of master plan:
_No
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor:
Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information Portionsof
the information may be classified as non -public if you provide specific reasons that would permit the City to
conclude that they are trade secrets.
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.gooherstateonecall.orq
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a 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.
x A(SM• Chrifjta22.
Applicant's r nted Name L
House heating test record
Owner Nbq 6 t jeZ- Controls
Address ewe wets --1-404.4e LYThermostat 1+ VJ
City 610,iPf Valve (1‘, ,
Heat loss Date htg. inst
Sold by CenterPoint Energy
Installed by CenterPoint Energy
Electrical work by CenterPoint Energy
Heat type FA 0 Space heater
Gas line by
Unit heater
C2Ct
Other
Gas design
Make Moder�j
Serial no. NI 144144 lac.
Input Con' C;CFd v
Heat plug
Limit
Limit setting ' 8°
Fan setting
Pilot type
Pilot make
Pilot model
Pilot timing
Hs I
Pressure: Hi fire/Lo fire
Percent CO2
Input CFH CeCo
Stack temp
Percent 02
7
Percent CO as
onversion
ent Size
find of liner/size
414_42___nterPoint.
�JY
$/
WC
filters: Size/ 64:15g Number
Chimney locations: i Inside 0 Outside
Wiring Test tag )4. -
Lighting Inst """-e. Date testedo/y
Com an testin• CenterPoi t nergy
Tester's name
Chimney construction
CNP 235 (11-2008)
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA120336
Date Issued:02/03/2014
Permit Category:ePermit
Site Address: 3840 Westbury Lane
Lot:011 Block: 002 Addition: Westbury 2nd
PID:10-83651-02-110
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Joann Zinken
9320 Evergreen Blvd Nw Suite B
Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088
Surcharge-Fixed $5.00 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 -
Victor E Enriguez
3840 Westbury Lane
Eagan MN 55123
(612) 702-0677
Centerpoint Energy
1240 W River Pkwy
Minneapolis MN 55454
(612) 321-5597
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA140841
Date Issued:01/26/2017
Permit Category:ePermit
Site Address: 3840 Westbury Lane
Lot:011 Block: 002 Addition: Westbury 2nd
PID:10-83651-02-110
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.
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 -
Victor E Enriguez
3840 Westbury Lane
Eagan MN 55123
(612) 702-0677
Appliance Connections Inc
12850 Chestnut Blvd
Shakopee MN 55379
(952) 445-4803
Applicant/Permitee: Signature Issued By: Signature