3861 Westbury Lane
CITY OF EA0/1N WATER SERVICE PERMIT
M0_ "lot K nob RoM 7 2 F 'z
P. Cj. Bok 21199 PERMIT NO.:
Ep~n, IMN 55121 DAl'E: •'+-2- ~F ,
ZoMnp: - Fi No. of UMts: 1
Owner: _ Joe Miller Const .
Addnm
Sitr Mdnm 3361 Westbury L.slle LI :•'esz6urv 1
p~umber 'Iiltner "iumhir,
Maw No.: _3 76 /f/ F.-r- Connecflon Chorpr 50r). 00rd
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CiTY OF EAGAN SrAm somci POW
3830 Pilot Knob Rwd
P. O. Box 21199 PERMIT NO.: Esgan, MN 55121 DATE:
/~~~~~''~`D: Na of UNts:
\/~I: /1 W ron:
$Ih I,ddIsIi: - - - i
PlLnnber. _
1 Nm h460WIF wMU fv GeY of MMm Corxwcfion Chow; ' •
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BY Mhc. Choros:
DoM of Intp.: Total:
I^sp.: DeM iold:
CITY OF EAGAN
3830 PRot Knob Road, P.O. Box 21-199, Eayan, MN 55121
' PHONE: 454-8100 -
BUILDING PERMIT Receipt #
To be wsd ro. SF Di?G/GAR Esc value oace •~=1: 13 , ~s L~ tSiteAddress .>`61 ;~i'~='~.•'' i,.•, Erect 1:3 Occupancy
Lat Block t Sec/Sub. Remodel ? Zonina ~.1
' Parcel No. Repair ? Type of Consi~Addition ? No. Stories
a r. : . . . • . . : _ : ~ Move ? Length ~ i
Name
Demolish ? Depth ~
; Address Int Impr. ? Sq. Ft
~ City . , ` . Phdne 4 34 - 2 (i ('1 Install ?
a ; , APProvsb FNa
= o Name
Address Assessment Permit
City Phone Water & Sew. Surcharge U- 50
Police Plan Review
8w 5w Name Fire SAC ~ i ~.l!}
Z n Address Eng. Water Conn. '
ig City Phone Planner Water Meter
Council Road Unit •
1 hereby acknowledge that I have read this application and state that the gldg. Off. Tr. PI. information is correct and agree to comply with all applicable State of
Minnesota Statutes and City of Eagan Ordinances. APC PBrkS
Var. Date Copie
Signature of Permittee TotEtl • " y • v .
.
A Building Permit is issued to: on the express condition that
ail work shali be done In accordance with all appliCable State of Minneso ta Statutes and City of Eagan Ordinances.
Bullding Official ! ~ r, -
• Poi mit No. PNmM No1dM Da/s TMphone N
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L - - _ _ - _ i
ERMIT#.
PLUMBIN6 PERMIT RECEIPT # v/ 17
CITII OF EAGAN
3t90 PILOT KNOB ROAD, EAGAN, MN 55121 DATE
CONTRACT PRICE PHONE 454-8100
Site Address BLDC3. TYPE WORK DESCRIPTION
Lot.~ Block Sec/Sub
es. New
m Name ~ Mult Add-on
s Address Comm. Repair
c City ~ - Phone " Other
NO. FlXTURES TOTAL
Name Water Closet - $3.00
c Address Bath Tubs - $3.00 p City Phone Lavatory - $3.00
Shower - $3.00
~ Kitchen Sink - $3.00
"
FEES Urinal/Bldet - $3.00
COMM/IND FEE - 195 OF CONTRACT FEE , L.aundry Tray -$3.D0
MINIMUM - RESIDENTIAL FEE - $10.00 1_Floor Drains - $1.50
MINIMUM - COMM/IND FEE -~.00 i Water Heater -$1.50
STATE SURCHARGE PER PERMIT - •50 Whiripool -$3.00
(ADD a50 S/C IF PERMIT PRICE GOES Gas Pipfng Outlets -$1.50
BEYOND $1,000.00) Softener - $5.00
Well - $10.00
Privete Disp. - $10.00
Rough Openings - $1.50
SIGNATURE OF PERMITTEE pEE;
STATE S/C:
FOR CITY OF EAGAN CiRAND TOTAL: ~`~I S U
'
PERMIT i CITY OF EAGAN FEE
~ 0 ' J0 MECHANICAL PERMfT S/C
RECEIPT # 454-8100
- ~ `1 ( MINIMUM RESIDENTIAL FEE - =10.00 + $.SO TOTAL
DATE - ~ U`~~ MINIMUM COMMERCIAL FEE • $20.00 + $.50
1. Bidg. Type: Res --l-,:::~'6omm Inst 2. New Add Alte : r Repair
~ 1 ' , i I \
3. Total BId Price 4. Job Address -12
Lot I~Iqck Sec s fbu 5. Owner- ~ ~ 1 - b ~ ~ ~ 1
6. Contractor ,D Ec
(Name) ~ ~ (Streeq i~1~Y) (ZiP)
7. Contractor Phone #
J RESIOENTIAL HEATING - 01-100,000 BTU's -$24.00. Each additional 50,000 BTU's or haction - $6.00
RESIDENTtAL COOLING - 01-24,000 BTU's - $12.00. Each additional 6,000 BTU's or fraction = $6.00 MODIFICATIONS/ALTERATIONS -$10.00 minimum fee
L-FiEATING VENTILATING HOT WATER STEAM ~AIR COND.
41R PIPING PROCESSED PIPING AIR HAND. EQUIP. REFRIG. -
iL- RES. GAS PIPING OUTLETS - $1.50 TANKS: LP. UNDERGROUND OTHER
COMM./INP. RATE - 1% OF TOTAL BID PRICE PLUS =.SO ST 1'E SURCHARGI~ FOR EACH $1,000 OF FEE.
. ,
Signecl:
Appr(#ed Inspections: Date Rough Insp. Date Final Insp.
PERMIT #
PLUMBING PERMIT RECEIPT k &3
qTY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE
CONTRACT PRICE PHONE 454-8100
Site Address 7" ~ BLDG. TYPE WORK DESCRIPTION
Lot ~ Block Sec/Sub /
LA, Res. -iz New ?
~ Name Mult Add-on
Addres Comm. Repair
.E City Phone Other ,
,
NO. FlXTURES TOTAL
~ Name Water Closet - $3.00 s
; Address Bath Tubs - $3.00
p City Phone Lavatory - $3.00
.
Shower - $3.00
FEES Kitchen Sink - $3.00
COMM/IND FEE - 1% OF CONTRACT FEE Urinal/Bidet - $3.00
Laundry Tray - $3.00
MINIMUM - RESIDENTIAL FEE - a10.00 Floor Drains -$1.50
MINIMUM - COMM/IND FEE - 20.00 Water Heate? - $1.50
STATE SURCHARGE PER PERMIT Whirlpool -$3.00 '
(ADD $.50 S/C IF PERMIT PRICE GOES ~Gas Piping Outlets - $1.50
BEYOND $1.000.00) So(tener - $5.00 ~
~ Well - $10.00
~ Private Disp. - $10.00
Rough Openings - $1.50
SIGNATU OF PERMITTEE FEE
STATE 3/C:
1-
FOR CITY OF EAGAN GRAND TOTAL: J
1160
1985 BUILDING PERMIT APPLICA2ION - CITY OF EAGAN
NO'fE: ALL CONiR6CiORS MUST BE LICENSED NITH iHE CITY OF EAGAN
83 -10/6 INCLUDE 2 SETS OF PLANS
.1 CERTIFICATES OF SURVEY
rt~g OF ENERGY CALCULATIONS To Be Used For: _/Utj Valuation:Date: o~-~/~~"d SO
Site Address: 3d"UI Lui!~"~o/ i OFFICE USE ON(.Y
Lot: 13 Block oL Sect/Sub rJ r,;?VErect ~ Occupancy
Remodel Zoning (Z•I
Parcel 0 Repair _ Type of Const ~
C16 ~ ~ Addition I1 of Stories
O~mer Move _ Length
3 / Demolish _ pepth
/ (,a
Address scInt.Zmpr. _ Sq Ft
~ Install
City/Zip Code~?L!/liirwrl~y"~, -
Phone 31,2,pb / APPROYALS FEES
Contractor C~Q,yr~ Assessments Permit
Water/Sewer Surcharge
Address Police ~ Plan Review (52>'
Fire SAC 57S
City/Zip Code Engr Water Conn S o0
Planner Water Meter (p3.SO
Phone Council Road Unit 7-9 O,
Bldg Off Ii1.86 Treatment pl 15(0.
Arch./Engr. APC parks
Variance Copies
Address TOTAL
City/Zip Code
Phone 0
CITY OF EAGAN N p 11606
_ 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE:454-8100 P bc~ra~
BUILDlNG P~RMIT Recei t p
To be used for SF DWG/GAR Est. Value $61,000 py1e MARCH 13 1986
SiteAddress 3861 WESTBURY LN Erect Occupancy R3
Lot 13 eiock 2 SeGSub. WESTBURY 3RD aemodei ? zoniny R1
Parcel No. Repair ? Type ol Const v
Addition ? No. Stories
m Name JOSEPH MILLER CONST titove ? Length di
z 1 133 CEDAR AVE SO Demolish ? Depth48
3 Address Int.lmPr? SQFt
° Ciry FARMING''tQpe 431-2001 Install ?
a SAME APProvals Faes
i o Name
$a nddress Assessment Permit 31 .00
a 1-0.5 0
" Ciry Phone Water 8 Sew. Surcharge
~I Police PlanReview~'Q0
F W Name Fire SAC 575.00
i Address 5~~.~~
u ~ Eng. Water Conn.
aw Ciry Phone Planner WaterMeter 63.50
Council Road Unit 290.00
Iherebyacknowledgethatlhavereadthisapplicationandstatethatthe Bldg.Off.3/11/86 Tr.PI. 156.00
informauon is correct and agree to comply with all epphcable State of ,
Minnesota Statutes antl 'ty of EVan Or,di~ aces APC Parks
Signawre ot Permittee Var. Date Copies
Total $2, OR4 np
A euilding Permit is issued ro: OSEPH MILLER CONST on the express condition that
all work shall be done in accordance ith a a able State f Minneso Statutes and City ot Eagan Ordinances.
Building Official
~
CITY OF EAGAN Remarks
Addition 1.4-95S"T$U~Y T~~RI) APD.N. Lot 73 Blk 2 Parcel 7~4 8165 130 02~i
Owner Street 3861 Westburv Lane Staty Eagan, MN 55123
1133 Westbury Circle
Improvement Date Aqnnual Vears Payment Receipt Date
STREET SURF,
STREET FESTOR.
GRADING
SAN SEW TRUNK ;P4 85
-17
SEWERLATERAL
watermain ?gffffr 1984 49.90 3•33 15
WATERMAIN 1986 33 • z. z 15
WATER LATERAL
WATEF AREA 9,oz 19 4 134.24 8.95 15
water area 1986 69.38 .6 1
STORM SEW TRK ~s 1986 368.28 73 . 66 5
STORM SEW LAT ~ 1C~ J~C~1 . 0Q Cj . 20 5
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER.
SAC
PARK
.v
TRI'LAND CO. SITE PLAN FOR:
SURVEYI,NG JOSEPH MILLER
SERY~S CONSTRUCTION, INC.
4M McoLs Roao
Eq'(;AN, MIM4SffA 65122
N
I
. x:. i Q7 . SCALE. I"=
~~F• 12
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, 9'
• e- , ' 1400st 6 LOT q
RY 13 ~ =$a c
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FROPEM. 4 RIPTI N
° i~~.~`?~:hK(Sa,.;• `~"~ry~
s; 'WroMSOIa
6` ~~%'v''''.: - . .:t' '^~t. _ '
j ptippOSED OARAOE FLOOR ELEVATION • 10110
RROP0.SED FIR9T FLOOR ELEVATION =
: ' • i+fiOPOSED 9ASEMENT FLOOR °
. , . k~:,._ ELEVAT) ON
±~'~t•,i;
$POT
NOTE' VERIFY ALL FLOOR HEIGHTS WITH
RWI ON &=mcmm
FINAL HOUSE PLANS
~...k:~::.. Go or
•"iA~+or,tr y~~ " r mp
"id~ef supshrW ~illp a duir B?adley . renson, Mn. R*q. No. 19235
undK tM e : 3 /.n 6iG -
RpWere0 Lwd Dat
of tM State of; Ml ~nM~ata
************i*******f#ii**#*t#*#{#**
. . F
CITY OF EAGAN * ~Cn.Pj.ATTo .~°F~
* APPROVAL OF PERMT.
~ APPLICATION FOR PERMIT *
. * INSPDGTION oF SEFgR AbID/OR V7ATII2 ;
~ ,*F INSTAUMIONS WIIS, NdP BE SQ]E3D,-
SEWER AND/OR WATER CONNECTION i'ifID UNPIL PII2MIT HAS BEEN
* APPRWID.
*
rt
. *,r+f+t:+*+**a,~*,..*t~.++r**.**~.tt*+*~;
P ease Prin
1) PROPERTY ADDRESS: ~ ~
LEGAL DESCRIPTION:
Lot Block Subdivision or Tax Parcel ID )
IF EMSTING ST72CGZL~RE, DATE OF ORIGINAL BL'ILDING pII2MIT ISSL'ANCE:
PRFSENP ZONING/PROPOSID LSE: (Nbn Year
Cl C0I"1MERCIAL/RETAIL/OFFICE m R-1 SINGLE FAMILY
Q IAIDCS2RIAL Q R-2 DL'PLEX ('Iwo L~nits )
f-I INSTI'IL'TIONAL/GpVERNhIEN'r ~ R-3 'IOWNHOC~SE (Three + Units) ( Units)
~ R-4 APARTMa7f/COrIDOMINIC'D1 ( Units)
2) yy~ /
NANfE: /i/i L< <lq /
ADDRESS: -
CITY, STATE, ZIP:
PHONE:
3) NAME: For City Use
Pliunbers License:
ADDRFSS : Active
~ CITY. STATE, ZIP:_ Expired
Not recorded
PHONE: Q'~9 _ c~ s a G MASTER LICENSE# -37G d/'~~
St Initial
4) •u • • i~•
NAME:
. ADDRFSS: '
CITY. STATE, ZIP:
PHONE: .
5) ~ i r. r• : o • :ti.
~ CONNF.CTION 10 CITY SEWIIt ~ Cpb7NE(.TZON '1O CITY WATER ~ OTE~R .
6) PI,EASE HOLD APPROVED PEE2MIT FY)R PICK-UP BY ONE OF ABC7VE
~ PLEASE MAIL APPROVID PERMIT 70 1, 2, 3, q, p,BpVE
(Circle one) "
7) r,. u•• - - Q"~
, • ' 7' • Y' ~'I" ~ • U • I' •M•
1 Y . . ~ . • ~ ~ • 51
~ . •~1• I:n •1' I ::r •:I•,(~J~ 1 1 1' ~ ;p' • ~ II
C+ M ~
f .
. FOR CITY USE ONLY PERMIT # ISSC'ED
7~,I- S- 'il
Pd w/Bldg. Permit FEES:
$ $ SEWER PERMIT (INCLUDE SURCHARGE )
$ $ WATER PERMIT (INCLUDE SORCHARGE)
$ $ WATER METER/COPPERHORN/OI'TSIDE READER
$ $ WATER TAP (INCLC'DE CORPORATION STOP)
$ $ SEWER TAP
$ $ C ACCOUNT DEPOSIT - SEWER
$ $ IS l~~ ACCOUNT DEPOSIT - WATER
$ C' - C $ WAC
$ ~ I s• ~e, $ sAc
$ $ TRUNK WATER ASSESSMENT
$ $ TRUNK SEWER ASSESSMENT
$ $ " LATERAL BENEFIT/TRC'NK SEWER
$ ' $ LATERAL BENEFIT/TRUNK WATER
$ /•S G• l' $ WATER TREATMENT PLANT SC7RCHARGE
$ $ OTHER:
$ ~ / ~ S I• t O TOTAL
RECEIPT RECEIPT
DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
F--j YES IF YES, THEN A"PERMIT FOR WORK WITHIN PC~BLIC
ROADWAY" MUST BE ISS[7ED BY THE ENGINEERING
E2 NO DIVISION. LIST AS A CONDITION.
SUBJECT TO THE FOLLOWING tONDITIONS:
APPROVED BY: ,L,, -7;-7
TITLE:
DATE :
!
LS LI ~ ~ ForOffice_Use ~
I
I
Cit of Ea an HMAY 18 2009 Pe~~~*
1
~ Pertnit Fee: ~ ?O , ~
3830 Pilot Knob Road ~i
Eagan MN 55122 ~ Date Received:
ac/
Phone: (651) 675-5675 ~ I
Fax: (651) 675-5694 I Starr: i
2009 RESIDENTIAL BUILDING PERMIT APPL.ICATION C'a.~lc(SI~1'
Date: S y 09 'Site Address: 38 6I lNESrBvRy L,v
Tenant: Suite
RESIDENT/OWNER Name: Di4U/n 1nIrR &/N Phone: L5-1-
Address / Ciry ! Zip:
Applicant is: _ Owner _ Contractor
TYPE OF WORK Description ofwork. Rep/tice f1eck /74i S /Q4m0,£0 BY -sT44M. Aep/f cc sfA,i
I''+' ^re /e R,z/~fv.?, R~p~,~.ee ckii+q iQPp /at< /liin Tol $r
Construction CosT Multi-Family BuilBing: (Yes _ I No
To r
CONTRACTOR Name: License
i ~
Address
City State: Zip.
Phone: Contact Person:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateqorv 1 Minnesota Rules 7672
En@f9Y Cod6 . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
Category Submittetl Submitted
(4 submission type) • Energy Envelope Calculations Submrtted
In the last 72 months, has the City of Eagan issued a pertnit for a similar plan based on a master plan?
_Yes &ryo If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contrector: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specifc reasons that would permit the Cify to
conclude that fhe are trade secrets.
I hereby acknowledge that this information is complele antl accurale; that the work will be in confortnance with the ordinances and codes of the City of
Eagan; Ihat I understand this is not a permit, but oniy an application for a permit, antl work is not to start without a pertnR; ihat lhe work will be in
accordance with the approved plan in the case of work which requires a review and approval o( plans.
x ~ JiiL/p ,=R 61!l x '
Applicant's Printed Name ApplicanYs Signature
. Page 1 of 3
~ •
~
DO NOT WRITE BELOW THIS LINE ~
SUB TYPES
_ Foundation _ Fireplace _ Porch (3Season) _ Stortn Damage
Single Family Garage Porch (4-Season) Exterior Alteration (Single Family)
_ Multi ~ Deck _ Porch (ScreenlGazebolPergola) _ Exterior Alteration (Multi)
01 of Plex LowerLevel Pool Miscellaneous
Accessory Building
WORK TYPES
_ New _ Interior Improvement _ Siding _ Demolish Building'
_ Addition _ Move Building _ Reroof _ Demolish Interior
Alteration Fire Repair Windows Demolish Foundation
~ Replace _ Repair _ EgressWndow _ WaterDamage
_ RetainingWall 'Demolitionofentirebuilding - glvePCAhandouttoapplicant
DESCRIPTION
Valuation Occupancy -L-h~ MCES System
Plan Review • Code Edition 2a27 SAC Units
(25%_ 100%~ Zoning City Water
Census Code Stories Booster Pump
# of Units Square Feet PRV
# of Buildings Length Fire Sprinklers
Type of Construction Width
REQUIRED INSPECTIONS
_ Footings (New Building) _ Sheetrock
_ Footings (Deck) _ Final / C.O. Required
_ Footings (Addition) ~ Final I No C.O. Required
Foundation HVAC
Drain Tile Other.
_ Roof: _Ice 8 Water _Final _ Pool: _Footings _Air/Gas Tests _Final
_ Framing Siding: _Stucco Lath _Stone Lath _Brick
Fireplace: _Rough In _Air Test _Final Windows
_ Insulation Retaining Wall
Meter Size: Erosion Control
~
Reviewed By: Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge 0 ~
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Pertnit & Surcharge
Treatment Plant
Copies f7Q
TOTAL (Zgm TD~T
Page 2 of 3
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PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA176749
Date Issued:05/31/2022
Permit Category:ePermit
Site Address: 3861 Westbury Lane
Lot:013 Block: 002 Addition: Westbury 3rd
PID:10-83652-02-130
Use:
Description:
Sub Type:Air Conditioner
Work Type:Replace
Description:
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507)
210-0754.
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 -
Conrad W & Natalia V Peterson
3861 Westbury Ln
Eagan MN 55123--207
(651) 497-0268
Home Energy Center
2415 Annapolis Lane N #170
Plymouth MN 55441
(763) 476-1990
Applicant/Permitee: Signature Issued By: Signature