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3939 Westbury Dr . - . . CITY OF EAGAN SEWER SERVICE PERMR 3830 Pilot Knob Road 70r,9 P. O. Box 21199 PERMIT NO.: Eagan, MN 55121 DATE: i 3' ~ Zonirq: Rl No. of Units: 1 pwMr, Gr8s1d Oake Dev Addrcss: 51te Addmsr 3939 Weatburv Drive L4 BS Weethbrv ,1 Plumber. `iurt F1bR AV ii-7-F~, 47557 10000 • 1 .om ro.e.ob wr& tY. cNy ef g.v. co?w»ala, ao.pe: 425.00 pd Ordt..sa.. Aaount Deposif: 15.00 d Permk Fee: 10. 0 pd Surcharge: .50 pd By Misc. CFarpm Date of I rnp.: Total: inap.: DaM Pdd: CITY OF EAGAN 1NATER SERVICE PERMIT 3830 Pilot Knob Road , p q, C 21199 PERMIT NO.: , Eagan, MN 55121 DATE: ~Zoninp 1 of Units: ~ OWfMr: ,_T::aT3Q l~'1} MdrAfS: SFh ~dCt'lSS: ^ C~ ~ ' ~•bi1Z ~ D~'1'r~.' , ~YPSt2~UrY 1 _t"'` k7'L . \ unber. or Na 1" rJAt*Chorys: ~ ; O• 0`) pd ~y ~ 5. 0() pd Siu: Acoount De t: Reoder No.: l1 X L~ 34, Pemvt Fae: 10 . 00 pd .50 pd 1 yne te eaephr wMh fw Ciry of Eqyew Surcharge. r, i. 00 d meter od .o... ~ 3~6 9/7 31 Mix. c?a~: P ` Taai: g Dcte Paid: ~ Date of Inap.: - ~rop..--- - - - - r' CITY OF EAGAN 1Y 9f'jr`'rj 3830 Pilot Knob Road, P.O. Bax 21-199, Eagan, MN 55121 PHONE: 454-8100 BUILDING PERMIT Receipr To be wed ier SF DWGZ GAR Est. Vulue 70, 000 pote NOVEMBER 7 , 19 84 SiteAddreaa 3939 W.STHi)RY i]RTVF. Erect 41 Occupancy R-3 lot _4 Block 5 Sec/Sub. WFSTBLIRY 1_ST Remodet ? Zoning R- Percel No. Repeir ? Type of Const. V Enlarge ? No. Stories of Name GRAND OAICS DEV. Move O Length rL tu Address 7623 UPPER 167TH Demolish ? Depth 4 A_ City T4AI;EVILLEphone 432-6561 Grade ? Sq. Ft. Name SAME AVO?ovals Feet S~ Assessment Permit 3 4 3. 0 0 Address ~ City Phone Water b Sew. Surchorpe 35 _ 00 Poiice Plon check 171 _ 50 ~W Name Firo S/~C 525 _ pQ Add?ess Eny. Water Cortn. ,4 Za.,~O ~W City Phone Planner WaterMtterfi A - 0 0 Councii Rood Unit 2?n - n0 I hereby ocknowledge thot 1 have reod this opplicotion ond stote that gldg. Off. 11f 7/84 Parks 260.00 tF?e information is correct and ogree to comply with oll opplicoble APC Total 1 867 5O Stote of Minnesoto Stututes and City of Eagon Ordinor?cea. i . ~ Var. Date Sipnoture of Pertnittee " . - A Building AeRnit is issued to: GRAND OAKS DEV CO. on tM exprcs cor?didon thai oll work sholl be donq in accordorxe wlth all opplicoble Stote of Minnesota Statutes and City of Eayon Ordinonces. Buildinp Offlciol A ' ~ ~ PKmit No. Pwmit HoWar Dab Plumbin9 H.VA.C. • ~ ; ~ )1 ~ ~j~ 4 ~c"J _ !~C Elect?ic Softener Inspection Date Insp. Other Foot;ngs 1II ~L),z Foundation Freming Rough Plbq. y Rough HVAC ~ Inwlation Final Plbg Final HVAC Final C9P[/OCG. v wf Water Descri6e Location: VYell - Sewer ' Pr. Disp. Raoeipt PLUMBING PERMIT • Parmit No, CITY OF EA"GAN Fee - Fill in numbered spaces S/C - Type or Print legib/y Tot. - 1. Date 2. Installation Cost 3. Job Address Lot Blk. ` Tract 4. Owner 5. Contractor Phone 6. Address 7. City State Zip 8. Building Type: Residential 13 Commercial ? Institutional ? 9. Work Description: New Add ? Alter ? Repair ? 10. Describe 11. No. Fixtures No. Fixtures - r - Water Ctoset Cesspool/Drainfield % Bath tubs Septic Tank I ~ - Lavatory ~ Softner ~Shower Well Kitchen Sink Urinal/Bidet Other ' Laundry Tray Floor Drains Drinking Ftn. Slop Sink Gas Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed : for 1 Rough Finsl Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 Receipt MECHANICAL PERMIt Permit No. - CITY OF EAGAN Fee • F Fill in numbered spaces S/C Type or Prini /egib/y Tot. ~ ! . ~ • 1. Date C"/ 2. Installation Cost , 3. Job Address L 1/'; Ilaz'ry L' Y. Lot Bik. - Tract 4. Owner 19 ~OG ~ s ~5''v = ~~'f/ •~i 5. Contractor ~1~'~ sh ~ ' ~tn ' ~i• / Phone 6. Address , 7. City State 2ip 8. Building Type: Residential LEI- Commercial ? Institutional ? 9. Work Description: New Br Add ? Alter O Repair ? 10. Describe Fuel Type 11. No. Eauinment 8TU - M. Ea. No. Equipment CFM ? Forced Air~ 42~- Air Handling: ~ Mfg./,-, ty Boilers Mech. Exhaust ' Mfg. ~ Unit Heater Mfg. Other Air Cond. Mfg. Gas, Piping Outleu 11 i ~ 12. I hereby certify that the above information is true and correct, and I agree to comply with all qrdinances and codes governing this type of work. A ' Signed : for Rough Flnal ~ Inspections: Date Insp. Date Insp. , This is your permit when numbered and approved. ~ Approved CITY OF EAGAN 454-8100 ~ 0 , ~ ~~i CITY OF EAGAN Remarks ,I i1,4 ' Addition Z''ESTBURY FIRST ADDITION Loc 4 Blk 5 Parcel in St1kSfl n40 ns~- owr,er Street 3939 Westbury Drive state Eagan, MN 55123 Improvement Date Amount Annual Years Payment Receipt Date STREETSURF, 1986 2850.60 2850.00 C010152 2-5-85 STREET RESTOR. GRADING Water area 1986 133.79 8 92 1 133.79 C010152 2-5-85 SAN SEW TRUNK 1985 436.23 29.08 15 407.15 C010153 2-5-85 ~ SEWERLATERAL 1986 500$.73 1001. 5008.73 C010152 2-5-85 Watermain 1986 65.29 4.35 1 65.29 C010152 2-5-84 WATERMAIN f6)71 1984 68.71 4.58 15 59.55 C010153 2-5-85 ~ WATERLATERAL 1986 WATER AREA v 160.28 C010153 2-5-85 *Services 1986 STORMSEW TRK 1986 710.24 142.05 710.24 C010153 2-5-85 ~ STORM SEW LAT 1986 CURB & GUTTER ' SIDEWALK STREET LIGHT Road Unit 260.00 #47567 11-7-84 WATER CONN. 470.00 " " BUILOING PER. #9675 11 SAC 525.00 11 ' PAR K CITY OF EAGAN N? 9675 3630 PiIM Knob Road, P.O. Box 21•199, Eagan, MN 55121 BUILDING PERMIT PHONE: 4548100 Receipt * .75-& 2 Te M wad he SF DWG/ GAR Est. Volue 70, 000 Dote NnVF.MRF.R 7 , SiceAddreu 3939 wFqmnpgv nglvF e.mt KI Occupancy R-3 Lot4-Black 5 sec/sub. WESTRCTRv 1ST Remodel ? Zoning R-1 Paroel No. Repair ? Type of Const. V Enlerge ? No. Stories Name GRAND OAKS DEV. Move ? Length q p_ = b Address 7623 UPPER 167TH Demolish ? Depth 4 R Grede ? Sq. Ft. - City LAKEVILLEphone 432-6561 ~ SAME AOVrovab Faes tpqr Name O` Address Assessment Permit ~ a"3 - n 0 u~ City Phone Water & Sew. Surchorgs -4 S n0 Polica Plon check 171 5 Q tW Neme Fira SAC rgt n0 'i z Addrms Erq. Water Conn. 470 $0 iW City Phone Pianner WoterMeter63 QQ Council Road Unit 2:79 Q 1 hereby acknowledge that I Mve read this opplication and state that gldg. Off. 1~1 7R Parks 26n_ n n fhe inlormation iz torrect and ogree to comply with cll aOPlicoble Stote of Minnewta Statu and Cit o fqan pp~~dinonces. APC Taal l~p,ccon ~J• $iqrwtura of PermiMeer Var. Date ~y A BWlding Permit is issued to• GRANn OAK&RV Cfl _ on fhe exprefs conditlon Ihot all work sholl 6e don n a rdanee itChI o,ll ,appN'm.ble State of Minnewfa Statutes ond Ciry ot Eopan Ordironces. Buildirp Offidal ~1 ~v~~ ALL CONTRACTORS MUST BE LICENSED WITIi THE CITY OF EAGAN a~ ~•I ~p,.~ ~ A n ~ INCLUDE Q SETS OF PLANS, ~ Od~'~'~' Q CERTIFICATES OF SURVEY SF Pu G-,aR. ~ SET OF ENERGY CALCULATIONS To Be Used For: ~ Valuation:I,'L Date: - 5 - Site Address: 313 DL • • Lot:4 Block: 5~-Sect/Sub:ttloAA /S~ Erect: X Occupancy: Parcel Remodel: Zoning: 2-I Repair: Type Of Const: ~ Owner: LkL,,,~ Enlarge: # Stories: Move: Length: ~ Address: Demolish: Depth: City/Zip Code: Grade: Sq. Ft.: Phone fl: Contractor: d Qp,,ks ~ Address: ']b 2'~ -1 ~ Assessments: Permit: City/Zip Code: ~~~K,~ Water/Sewer: Surcharge: Police: Plan Rev.: ~ Phone 143LLeS~~ ~ Fire: SAC: SZl-' Engr.: Water Conn:~ Arch./Eng: Planner: Water Meter H3°" Address: Council: Road Unit: ~ Bldg. Off.: j~ Parks: m4tj City/Zip Code: APC: Variance: ^ 200 4 IRESIDENTIAL BUII.,DING PERMIT APPLICATION =1~ City Of Eagan , 3830 Pilot Knob Road, Eagan NIlV 55122 Telephone # 651-675-5675 FAX # 651-675-5694 o New Consfniction ReauiremeMS RemadeUReoair Reauirements 3 registered site surveys showing sq. it of lot sq. ft of Iwuse; and all roofed areas 2 copies W plan (20% maximum lo[ coverage allow~ 1 set of Energy Calculations for heaffid addNOns pfammilvel 2 copies of plan showmg beam & window sizes; poured found design, efc 1 site survey for additions & decks 7 5et of Enefgy Ca~ulaGons Addition - indirafe i(on-slfe sepfic system 3 copies of Tree Preservation Plan'rf lot pla@ed afler 711f93 Rim Joist OetaB Opfiore selection sheel (bidgs with 3 or less unitc Construction Cost Qq Date SiteAddress 3Of sr '1 wUsTQuRy Die• UniUSte # cAC~AIy pM/J• Z Description of Work ?Od k Multi-Farru'ly Bldg _ YXN Fireplace(s) _ 0 _X 1 _ 2 PropertyOwuer RD22ye'fp IFL~gEt4v a Telephone # (66/) 9U -L/ Conhactor ~,~q,~.~~~~ Address .l'~ ?"1 W M 'C3 %4 r~y Qf-' City Ells~AI, Sfate N1N Zip _C35ka,3 Telephone#(60SI) 41S4 'SDa'f Cz-Lt~+ (&st ) ,C;a COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Ivlinnesota Rules 7670 Categorv 1 _ Minnesota Rules 7672 Energy Code Category . Resldential Ventilation Category I Worksheet • New Energy Code Worksheet (Jsubmissiontype) Submitted Submitted • Energy Envelope CaIwlaNons Submitted Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review fee applies. (~,-',(~2n Licensed Plumber Telephone ~ JUt 1 3 2004 Mechanical Contractor ' Telephone ) Sewer/Water Contractor Telephone ) I hereby apply for a Residential Building Permit and aclrnowledge 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 pernut, 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. tLL t- . V, 4 -Z-Da- - ApplicanPs Printed Name Applicant s Signature OFFICE USE ONLY ' y 1^ . Sub Types f ? 01 Foundatfon ? 07 05-plex ? 13 16-plex x 20 Pool ? 30 Accessory Bldg O 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 37 Ext. Alt - Multi O 03 01 of_ plex ? 09 07-plex ? 77 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex O 10 OS-plex 13 18 Deck ? 23 Porch (screen/gazebo) ? 38 Multi Misc. ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plhg_Y or _ N ? 25 Miscellaneous Work Types ? 31 New ? 35 Int Improvement ? 36 Demolish Interior ? 44 Siding x 32 Addition ? 36 Move Building 13 42 Demolish Foundation 0 45 Fire Repair ? 33 Alteration ? 37 Demolish Building* ? 43 Reroof ? 46 WindowslDoors ? 34 Replacement `Demolition (Entire Bldg) - Give PCA handout to applicant Valuation Occupancy ~-3 MCE5 System - Census Code Zoning D City Water - SAC Units Stories - Booster Pump - # of Units Sq. Ft. - PRV ~ # of Bldgs Length - Fire Sprinklered - Type of Const Width ~ REQUIRED INSPECTIONS _ Footings (new bldg) FinaUC.O. _ Footings (deck) Final/No C.O. _ Footings (addition) _ Plumbing _ Foundation HVAC _ Drain Tile Other Roof Ice & Water Final ~L. Pool Ftgs y~ AidGas Tests ~Final _ Framing _ Siding Stucco Stone _ Brick _ Fireplace _ R.I. _ Air Test _ Final _ Windows _ Insulation _ ReTaining Wall Approved By: , Building Inspector - Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Eonnection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other , Total " POOL PERMIT - APPLICATION SUBMITTAL REQUfREMENTS aadres5: `3~39 l,~es+~ u Applicant Name: d ~ GENERAL INFORMATiON ~ o 'z f~ ? O Applicant - name, address, phone & fax numbers, signature ~ ? ? Property owner name J~ Legal description and address of property .~J O 0 North arrow, scale (1" = 30' or 40') and date jd Location and name of all strests adjacent to properiy Site Plan drawn to scale showing location of house, pool and other existing or proposed strudures ,eJ Directional drainage arrows (existing and proposed) ELEVATIONS Existin ~ ? ? House comers jd` ? ? Property corners ?A ? On property lines at point of ineasured dimension to pool (see below) ? Jd ? If applicable, ground elevation at each end of retaining walls and at wall's greatest height Proposed ? 0 ? Finished pool deck comers Top of retaining walls (if any) and at each different elevation (if it changes) ? J~ ? Pool bottom (or max depth) DIMENSIONS Existina f~ ? ? All property/lot lines Proposed ~J ? ? Pool ? A ? Pool plus integrated deck/patio 0 Shortest distance from outside edge of pool deck to lot lines and house Reviewed: Yi I ~ + 7/ 0¢- Name Date 6:FORMSJPoo1 Pami[ CherklisU06-02-04 _ _ . . ~AC-?aw ~M~, ss~a3 L.~~Al, f~5~'.21 Pl~b~ : WEST?3ulLY I S~AroP`I lphi ~ LoT 4, BLacic S _ _ - ----------~°x~ ~ . ~ ~XIST?~iG , N o~s~ ay s~~~~ W W I ~i ~ ~AP~?~ 4~ f2l XSh~ ~ ~ 7~XX. X~X15~i n~ h £~eva~ioN ~ ~ `tZo ~~tz~ ~ ~~~w r~.EN~O ~4aa.~s3Y c~'~'~~y ~a~;s rK' n~ D%2AaAnr4k wels ?gePP.k:ev ey r1E o6~ uovEwiz MY DtrzEu s%.~viON oa aNt) cs. a,-'rK-ic 0~.+0 (.u1KpQd'~ ~~S4a`c~aN v F e~IgT~N~r C~z.oR~ r~o+R..nn,4'?oa . , JEYORYS CERTIFICATE 6RAND OAKS DEVEIOPMENT C0. , aya~ WESTBURY DR1VL S89055'10"W 70.00_ in ~ R~~ • ' ~s) / , Y jo W Q,' o 0 m 5 W: 5 0 0 ~.r ) 122.001 ~0 PROPOSED ELEVATIOPJS SHOWN O~~ ARE AS TAKEN FROM THE GRADING AND DEVELOPMENT PLAN ~ 3 S a.oo o FOR WESTBURY PREPARED BY ~ Ze.°~ ~ o DELMAR SGNWANZ,L.S., AND a~ °o jpqOPO~SE~co ~ r p LAST DA7ED 7-30-84. ~ 1 i\ N HOU E 4. o0 CB/ 'O i-- ~ p I ~ 0 Li 0 O ~J U) ~ LOT 4 5 ORAINAGE A UTILlTY 5 ~ ~ EASEMENT PER PLAT . ~ ~ - - %S 89°55'10° W 70.00-' 4 DENOTES PROPOSED SURfACE DRAINAGE O DENOTES IRON MONUMENT SET SCALE: 1 INCH = FEET • DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR = S 3•S FEET X000.0 DENOTES EXISTING ELEVATION PROPOSEO LOWEST FLOOR = 891- o FEET (000.0) DENDTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK = 894-2 FEET I HEREBY CERTIFY TO GRAND OAKS DEVELOPMENT C0. THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF: Lot 4, Block 5, 41ESTBURY 15T. ADDITION, according to the recored 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 P1Y DIRECT SUPERVISION, THIS 25THDAY OF OCTOBER, 1984. _ ` SIGNED: JAMES f~ HILL, INC. ~ ~ BY: Hp'ROLb C. PETERSON, LAND SURVEYOR PIINNESOTA LICENSE N0. 12294 PROJECT NO. BOOK / PAGE JAMES R. HILL9 INC. 84944 planners / Engineers / Surveyors FILE NO. 8200 Humboldt Arenue 8outh FO L D ER ebon+inatoN Mn. 66431 412-884-3029 r- SURVEYOR9S. CERTIFICATE GRAND OAKS DEVELOPMENT C0. 2W WESTBURY ORlVL S 89°55'10"W 70.00- N9.ay ~ 0 m 5 ~ 5 0 ~ a z2.oo ~ p PROPOSED ELEVATIOPdS SHOWN GaR/ m ARE AS TAKEN FROM THE r1r) j m N f' ulGRADINC, AND DEllELOPMENT PLAN 1 0 3 S 4,00 i o FOR WESTBURY PREPARED BY 2e'001 i o p DELMAR SCNWANZ,L.S., AND $E ~ i LAST DATED 7-30-84. °o~jaaoPO HOU E N I ' I L J O~ / 6 0 _ ~ ~ (696.5) C 890~) to O I ~ Q -J LOT 4 5 ORAINAGE a UT7UtY 5 ~ ~ EASEMENT PER PLAT . r in %s ss°55'ro" w 70.00-' ~ DENOTES PROPOSED SURFACE DRAINA6E O DENOTES IRON MONUMENT SET SCALE: 1 INCH = FEET * DENOTES IRON MONUMENT FOUND PROPOSED GARAGE F100R = 8 3•8 FEET X000.0 DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR = S91•0 FEET (000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK =1594•2 FEET I HEREBY CERTIFY TO GRAND OAKS DEVELOPMENT C0. THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF: Lot 4, Block 5, WESTBURY 1ST. ADDITION, according to the recored plat thereof, Dakota County, Minnesota. AND OF THE LOCATION Of A PROPDSED BUILDING. IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCROACHMENTS, IF ANY, TNEREON. AS SURVEYED 8Y ME, OR UNDER MY DIRECT SUPERVISION, THIS 25THDAY OF OCTOBER, 1984. ~ SIGNED: J11ME5 R/ HILL, INC. • av : ~.,:r.. . H OL C. PETERSON, LAND SURVEYOR PIINNESOTA LICENSE N0. 12294 PROJECT Na. BOOK / PAGE JAMES R. HILL9 INC. 84944 planners / Engineers / Surveyors FILE HO. 8200 Hum6oldt Avonue 8outh FOLDER eloomin9toe, Mn. 66431 612-884-3029 r . . . e • . , • . ' ' . . 3:f;. . . EKTERIOFt ENVELOPE AVERAGE 'U' COMPUTATION . - GF{AND OAKS DEVELOPMENT COMPANY . . . . . ' . . :;y,.C MODEL Q AREA U U X AREA ; ftEQUIRED 1. TOTAL WALI. "AREA 1800 X'' 11 198 6, - : 2. TOTAL ROOF AREA 1196,X.026 31.096" ACHIEVED " ,.'•:r AREA U U X AREA'' , A. WINDOW AREA 186.66 .5 93.33': ' B. DOOR AREA 39.8 .077•. 3.0646 C. SLIDE GLASS AREA 13.44 .48 6.4512 D. FIFtEPLACE AREA O O` O E. WALL FftAME AREA 180 .041 7.38 - F. NET WALL AREA 1164.1 .049 :57.0409 ' G. RIM.JOIST AREA 119.52° `.0436 5.211672 „ H. FOUND WINDOW AREA O O• O ;:r r iI. FOUND ABOVE GRADE `96.48 .135 13.0246 - ` . ' r, 3. TOTALtWALL AREA , 1840 , 385:5026 ' 4; . J. SKYLITE O ' p rt 0: K. RODF FRAME 119.6 .032, 3.8272' L. NET ROOF AREA 1076.4 ."025 26.91 4. TOTAL ROOF AREA 1196 30.7372 . . , • . ' . . ~ ~ a . . SUM 1 . +2. . , 229:096 5UM 3.+4. - 216.2398 . . ' ' ( aill •.i rtp.ti ' Y . t . . • yt 1 . :a< t S . . • . . . . r , . ,y * - . , r. . ~ • ~ . : t ' f ¢ 1 t~ sJi't 'S p 't y'. . i e 1 s d ?4~ S} - + e4r -t . _ . r~' r y Y . . • a ' r x i w,. . . '-t k ~ii 9 1 •1 ~ . . . . . . . . x k +1 h SrAe.. `y- ^ r~ " = . . . . _ ' , . ,y s ' • i . ' . ' , y6,: 1 ' • z/84' . CZTY Or EAGAN t : APPLICATION FOR PERMIT ~ • SEWER AND/OR WATER CONNECTIOrT (PLEASE PRINT) , 1} PI20PEf=ApDRE55: 3 C'7 3q (dP S 7- ,b!)Jt aDr I Vc~ r ` r.Frar• DESCFIPTICN: o f q /Q c tt1PS7~b~i~.~ (Ir~t/Block/SubcYivision or Tax Parcel I.D. N r) IF W;zST_::, sITWC7_7,~E, naT o5t =uIAL EuzrDr::c p=-_%s: _e>-, PRESE."P ~,;TIPr,/PT?OPOSETJ L'S: 19 R-1 SINGL: cPNSLY 0 R-2 DUPL,~.`"{ MWO UNITS) Q R-3 'IC'l.IN-?CY?SE (T-I?R= + li:]Z:S) ( LiVI^_'S) ? 12-4 ACART_''E%7T/C=a'Slj7.~'1 ~ UNITS) p cOf"1MEPczNL/RET1aIz?0FFzc:: ? Izmus~~, ? INsTZ=orAr,/Gcv^TL%E~,7 2) APPI,I= (PLEASE PRINT) NVAE: ~rano~ C1 AanREss: I'J o n P r 16 rzz^r, sTATE, zzP: L,c k1_v.%/e /Yl.~ - SS"'ovy ~ PHCNE: L13.) _Gi., SJIn I - ER r PLEASE PRINT~ FOR CITY USE 04LY - PlI1N8ER5 lICE4SE: ADDRE55: _/'r}9 70 /,5-/-~, Z'd =Active CITY, STATE, ZIP: P p`LO vG(lle W~ Expired ~ASia~7 Q Not of Ae~ord - PHONE: PLIIMBEF IICENSE a nitia q) Oc(.,vpANT/aINER NAME (PLEASE PHINi) : , ADDRESS: ry, e, ` CI'?'Y, STATE, ZIP: PHONE: 5) INpIG",TE W[iICH PERNLLT IS BEING REQUES'I'Ep: ~ CONNECrION 'IO CITY SEWER ~ CbNDIFf TION TO CZTY ATA'PER ' ? OT[TER (PI.EASE DESCRIBE) 6) IIQDIC%= 0:z: - El PLEaSE F?OID APPRWm,PERMIT FOR PZCIC-Up BY ONE OF ABC'VE M PLFASE %*AIL APPROVED PERm:Li 'ID 1,, 2, J1 4 AFOl7E •(Ciscle one) ~ 7) sr~mzv~:, , nATe: ~ -\j . • F 0 R C I T Y U S E O N L Y PERMIT ISSUED , FEES : $ / e• S G SE:^iER TJ°RMIm ( I`ICL:;D_- SU°CH:ARGE) , WATER PERr1IT (INCL'JUE SliRCFIARGn) WATER METER/COPPERHORN/OUTSZDE READER S WATER TAP (INCLUDE CORPORATION STOP) S SE;VER TAP $ ACCOliNT D.F,PpSIT - P1AT.°_R $ WAC $ SP.C $ TRliNK WATER ASSESS24ENT $ TRliVK SEWER ASSESS:IEAIT $ LATERAL BENEFIT/TRUNK SE:'7ER $ Q LATERAL BENEFIT/TRUNK WATER $ OTHER ' $ TCTAL $ f~e ~AMOIINT PAID/RECEIPT 71 DOES UTILZTY CONNECTION REQUZRE EXCAVA2ION IN PUBLIC RIGHT OF WAY? YES IF YES, THEN A"PERMIT FOR 'RORK WITHIN ~ PUBLIC ROADWAY" MUST BE ISSUED BY THE NO ENGINEERING DIVISION. LIST AS A CONDI- TION. SUBJECT TO THE FOLLOWING CONDITIONS: ' ~ APPROVED, BY:~~e-e DATE: /_.V -~.4C 1 6516871393 Date: Thomson Reuters City of Eaau 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 CP1 Yr-/, p4twccS- 5;V2A Gr( 232 0227 t1>li'1 kA 6r( 2 q i( Wry 01:13:44 p.m. 05-24-2012 1 /4 Use BLUE or BLACK Ink For Office U7 Permit #: Permit Fee: v11sL(z, 8s3i Date Received: Staff: 3/s+th 2012 RESIDENTIAL BUILDING PERMIITAPPLICATION 2 �2 f+ ' Site Address: 37. 7QW m, v '4 ' Y, ` Unit#: RESIDENT I OWNER Name: 5.44A -f IT A4/A9 MO RAA Phone: 65-7'I 727Z - f _ D nn q t�&t4i Zip:,3 7'3 ! ��T!8vtiW MN/a t22 Address / City I J KOwner Applicant is: Contractor TYPE OF WORK Description of work: IZ.CAi0VLAt 7) 1 O /4.16 £4J4 t- K T-CS6'✓/r 1/ /1M Construction Cost: LE$,S #I view — Multi -Family Building: (Yes / NoK ) CONTRACTOR Company: Contact: Address: City: State: Zip: Phone: License #: Lead Certificate #: If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) l LC 1564-r fin/ fn ii In the last 12 months, _Yes _No If Licensed Plumber: Mechanical Contractor: Sewer & Water Contractor: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING has the City of Eagan issued a permit for a similar plan based on a master plan? yes, date and address of master plan: Phone: Phone: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information maybe 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 gopherstateonecall.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. 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. x (! AM r44 Al144✓ Applicant's Printed Name ant's5ignature Page 1 of 3 6516871393 Thomson Reuters 01:14:01 p.m. 05-24-2012 2 /4 DO NOT WRITE BELOW THIS LINE SUB TYPES Foundation Single Family Multi 01 of Plex Accessory Building WORK TYPES New Addition Alteratio Replace Retaining Wall DESCRIPTION Valuation Plan Review (25%_ 100% ) Census Code #of Units # of Buildings Type of Construction _ Fireplace _ Garage Deck Lower Level Porch (3 -Season) Porch (4 -Season) Porch (Screen/Gazebo/Pergola) Pool tk)(2i- 100 rl Storm Damage _ Exterior Alteration (Single Family) _ Exterior Alteration (Multi) Miscellaneous Interior Improvement Move Building _ Fire Repair Repair 0 in V 3 REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) _ Footings (Addition) Foundation Drain Tile _ Roof: _Ice & Water Framing Fireplace: _Rough In _Air Test _Final Final Occupancy Code Edition Zoning Stories Square Feet Length Width ?( Insulation Sheathing Sheetrock Reviewed By: Siding Reroof Windows _ Egress Window Demolish Building* Demolish Interior Demolish Foundation Water Damage 'Demolition of entire building — give PCA handout to applicant eitx-l)-201 MCES System SAC Units City Water Booster Pump PRY Fire Sprinklers Meter Size: Final I C.O. Required Final/ No C.O. Required HVAC _ Gas Service Test Other: Pool: _Footings Air/Gas Tests _Final Siding: _Stucco Lath _Stone Lath Brick Windows Retaining Wall: _ Footings _ Backfill _ Final Radon Control Erosion Control Gas Line Air Test , Building Inspector RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL 1/164// L49 -e --t- %6 Page 2 of 3 r City of Eagan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use Permit #: /01) / Permit Fee: � Date Received: *4'2 7 Staff: &I L INFLOW & INFILTRATION PERMIT APPLICATION ,/'Plumbing / Sewer & Water tL&S 4tuv Date: LD- - (.e - % 3- Site Address: 3 13q O) /v. Tenant: Suite #: RESIDENT} OW :; E Name: � / � M /ai Phone: 66/ -&di --7? 7d Address / City / Zip: 3 c I3`\ G4_s u CONTRALTO' --•---.___ License #: Address: ""`--- • -__ City: State: Zip: Phone: Contact: Email: O�FFW # PLUMBING (Within the Sump Pump Repair building envelope) SEWER & WATER (Outside the building envelope) Repair � Other: Other: DESCRIPTION Description of work: 41u 6 (5-1 FEES $60.00 / Each (includes $5.00 State Surcharge) TOTAL FEE $ CPO D ' * *Permit fees will NOT be reimbursed by the City of Eagan. If you plan to submit Ill repair costs for reimbursement, two quotes from qualified contractors must accompany this application. A list of contractors can be found by visiting www.citvofeagan.com/inflow, or City Hall at 3830 Pilot Knob Rd. 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.dopherstateonecall.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. jn r 4,4 /t/tOt/Z 44/ Applicant's Printed Name x Applicant's ign—ure F Required Inspections: " Under Ground ` Rough -In _Final (1111. City of Eaall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use Permit #: Permit Fee: Date Received: Staff: Z Z 2014 RESIDENTIAL BUILDING PERMIT APPLICATION Esq Date: �I j4 � �� Site Address: Y1 � �,j��C;Ayr (,f A I Unit#: Resident/ Owner . Name: \,v\, -,r) 0 Phone: Address / City / Zip: Applicant is: Owner Contractor Type of Work Description of work: S I L U to L �\ 1 i 1j ) rtira 6 l # C(vR. 40Construction Cost: 6 o� 6 Multi -Family Building: (Yes / N6- ) Contractor Company: J -._v • , . • 1 I 1 •A.l%tai3 Contact: 1/1 + Al r' / 1 Address: \ rkt2 1( \ ir\ C L. City: ii;vt f V rvt h' ' ? N State: YYIqN Zip: '5 /C) Phone: V) / 1) 57 5 License #: ' 'J( Lead Certificate #: If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) ,, e COMPLETE THIS AREA ONLY IF CONSTRUCTING In the last 12 months, has the City of Eagan issued a permit for a similar plan _Yes No If yes, date and address of master plan: A NEW BUILDING based on a master plan? Licensed Plumber: Mechanical Contractor: Sewer & Water Contractor: Phone: Phone: 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 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.Qopherstateonecall.orci 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. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be corn eted within 180 days of permit issuance. x OMPI, 1141 Da,,r ma k Applicant's Printed Name x T a4/1111-1 Applicant's Signature Page 1 of 3 Use BLUE or BLACK Ink � For Office Use ~T I C�� O� j Permit#: / �� i y �a�aIl � Permit Fee: �o�� 3830 Pilot Knob Road � , /�S�� Eagan MN 55122 � Date Received:� � Phone:(651)675-5675 I e�� I Fax:(651}675-5694 I Staff: I I I `��__..___�__.___�.__J 2014 RESIDENTIAL BUILDING PERMIT APPLICATION Date: �°�5 �3°�Y Site Address: 3�I��I Wes�6�7 �� u��t#: Name: W�� u-�g 0 �an� Phone: Resident/ ' �wner ' adaress i c�ty i z�p: 3`�7� S�a�e v�e-�.,� (;l v� �arf �:61 . s C °�9 ��S Applicant is: Owner X Contractor Description of work: �.2. - �a o-F Type of Work Construction Cost:�� OG G Multi-Family Building: (Yes /No X) Company: l��cLGrG QGcGfG �57a�a.�-`d.� Contact: �b �P�G�r' C011t�aCtOf: Address:�p?Lr �l�� /G[c�1�, IJ� City: ��n� La�� State:�Zip:J'rJ�' d<y Phone: �J" �-335-3 ��mail: b'¢G�G��clG�:51-�o."�an��o'�ry•o',�. Cd License#: Lx�lv7.5��v�a Lead Certificate#: If the project is exempt from lead certifiaation, please explain why: (see Page 3 for additional information) COMP�ETE 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: NOTE:Plans and supporting doctrments`that yaa subm�t are considered to be public infomration. Portions`ot' the information may be c/assified as nc►n-pubtic if,you provide sp�citic reasons�►at wauld perr»it the Cii�to canctude that the ar�tratle 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.qopherstateonecall.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 1 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. Exterior work authorized by a buildi�g permit issued in accordance with the Minnesota S Building Code ust be completed within 180 days of permit issuance. X �oP.� �j�� X Applicant's Printed Name Appli anYs Sig tu Page 1 of 3 kramer mechanical 6514621434 p.1 // Use BLUE or BLACK ink f�Gu 5 � L 2'( � Fo�Office Use ^--------I �,c � L,� ��j�, � ' �S �p C -�/ i Permit#: /� l v� � City of �� 1 � � . � � � Permit Fee� I 3830 Pilot Knob Road Gl'L�� L`��` ��0 � i � �/ I Eagan MN SS122 I Date Recei�ed� � � Phone: (651)675-56T5 � Staff: � � Fax: (651)675-5694 !----------------; 2014 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: / s �� Site Address: ��.� � �'v��«`{� �f Tenant: Suite t�: � ResidentlOwner � Name: Phane: � � Address 1 City/Zip: � �-- � Name: /`��Z�' /�/G-�/1 �/�C License#:�/ `�31 S� z � � Address: �G �-/ T-Q��i/�.� //��/� U��' City: ��G(G 1� � ContracEor � € ; State:��Zip: �� 7 Phone: � ��' �.�i � � � r � � � // / � � g Contact:_ /�-�G/� EmaiL• 1�/"u/7cr/7c`laitrG��X�`7GG�i�GM� .,.�.�� _.—_.�.__._.„__�. _,. i � A � _New �,Replacement ,�Repair _,Rebuild _Modify Space Work in R.O.W, � Type of Work a — � � Description ot work: t�� E � � RESIDENTfAL � � � Water Heater � � 4 `{ Water Softener � � _�awn Irrigation�RPZ!_PVB) E "— — Permit Type „ � � _Septic System E ___.Add F'lumbing Fixtures�Main/ Lower Level) � � New ' Water Tumaround > i 1 E � Abandonment i � _�._.- --- q — � REStDENTIAL FEES: � � S60.OU Water Heater,Water Softener,or Water Heater and Softener(includes$5.00 State Surchar9e) � $60.OU Lawn Irrigation(includes$5.00 minimum State Surcharye) � $60.00 Add Plumbing Fixtures.Septic Svstern Abandonment,Water Turnaround'(includes$5.00 State Surcha�ge) � "Water Tumaround(add$200.00 ii a 5/8"meter is required) � ; $115.OU SeptiC SYStem New($10.00 per as built)(includes County fee and$5.00 State Surcharge) � � TOTAL FEES$ � CALL BEFORE YOIf 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 utitities. �roww.aoaherstateonecafl.orq l hereby acknowledge that this informatio�is complele and accurate;that the work will be in confortnance with the ordinances and codes of the Ciry of Eagan; that 1 untlerstand this is no[a permit, but only an application for a permit,an�work is not to start without a permit;that[he woric will be in aCCOrdance with the approv plan in the case of work which requires a review and approval of pla�s. X � ��/< <�� X �.� �� App icarrt's Prinled Name Applicant's Sgnature �OR aFFICE USE Reviewed By: Date: Required Inspections: Under Ground Rough-In Air Test Gas Test Final MeEer Related Items: Mefer Size Radio Read Staff: � Use BLUE or BLACK Ink r----------------_, I For Office Use � Y ' � Permit#: I�`-[�� Clty of E�� ] � � � Permit Fee: (f � 3830 Pilot Knob Road RECEfVED � �/ � Eagan MN 55122 � Date Received: � -(' � Phone: (651)675-5675 AUG 0 4 ��14 � � Fax: (651) 675-5694 I Staff: � I i I 2014 RESIDENTIAL BUILDING PERMIT APPLICATION Date: �-� �� Site Address: 3°� 3�/ "��`'�`�u'� � J�tV�- Unit#: Name: � V�t'►�L' /V� �l T G Phone: Resident/ �I / �1 v� ��,f/�:Gl, sC a�7/ Owner Address/City i Zip: ,?T�� S��U��-w � Applicant is: Owner Contractor Description ofwork: ��a�•�,�.`n� + j.,S�„1��`c,-�{ �r?/w.,� baf�a,�,-� y�N �y, L�ac..�r- L�v�� Type of Work Construction Cost�5�o�� Multi-Family Building: (Yes /No�� Company: ��(.C�� Duc�C- �;��w�`o� Contact: T�ob gC��r" COtltt'aCtOr Address:(o�n7� �76�� Gc�� C•`�2, City: �!'�-O ��5 State:��Zip: S�/ Phone: �5� �,38"��/�mail: ��aG�Oac�25��10.� �h@�`�*a�L• � License#: � �o Z�3�O�P Lead Certificate#: If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) �ti`'6-t- ,`ti � b U� 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: 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 specific reasons that would permit the Cify 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.qopherstateonecall.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. Exterior work authorized by a building permit issued in accordance with the Minnesota St uilding Code must be completed within 180 days of permit issuance. X �0��^—�� X �'',r.-.� ApplicanYs Printed Name Applic nYs Si ature Page 1 of 3 DO NOT WRITE BELOW THIS LINE , SUB TYPES Foundation _ Fireplace _ Porch (3-Season) Exterior Alteration (Single Family) �( Single Family _ Garage _ Porch (4-Season) _ Exterior Alteration (Multi) _ Multi _ Deck _ Porch (Screen/Gazebo/Pergola) Miscellaneous _ 01 of_Plex _ Lower Level _ Pool _ Accessory Building WORK TYPES _ New _ Interior Improvement _ Siding _ Demolish Building* _ Addition _ Move Building Reroof Demolish Interior � Alteration _ Fire Repair _ Windows _ Demolish Foundation _ Replace _ Repair _ Egress Window _ Water Damage _ Retaining Wall *Demolition of entire building—give PCA handout to applicant DESCRIPTION Valuation �Ob� Occupancy '��G�, MCES System Plan Review Code Edition � J�S$G 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) Meter Size: Footings (Deck) Final/C.O. Required Footings (Addition) � Final/ No C.O. Required Foundation HVAC_Gas Service Test Gas Line Air Test Roof: _Ice &Water _Final Pool: _Footings _Air/Gas Tests _Final � Framing Drain Tile Fireplace:_Rough In _Air Test _Final Siding:_Stucco Lath _Stone Lath _Brick � Insulation Windows Sheathing Retaining Wall: _Footings_ Backfill_Final Sheetrock Radon Control Fire Walls Erosion Control Braced Walls Other: Reviewed By: , Building Inspector RESIDENTIAL FEES Base Fee L�S� � ��'��Je-G�� Sr��4.� Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit 8� Surcharge Treatment Plant Copies TOTAL Page 2 of 3 kramer mechanical 6514621434 p.1 Use BLUE or BLACK Ink r-----------------T � For Office Use � Clty of�a�a� I Pertnit#: i��3�� ; � �, , 3830 Pilot Knob Road � Permit Fee: � Eagan MN 55'E22 � � Phone:(651�675-5675 � Date Received: I Fax:(651)675d894 � � j Staif:_ 1 I 2014 MECHANICAL PERMIT APPLICATION Q Please sub it two(2)sets of plans with all commercial ap i'cations. Date: ��% �� Site Address: 3�i'3� ��•%S�/�G•�Y �{./� Tenant: Suite�: ^ 6 S � Resident/Owner � Name: Phone: �__ � Address/Ci /Zip: � ----�—°--r ; � Name: l�%?��_!�/�C'7�i!?1 l�. ��cense#: ��CU 3�'�� Address� ��r� o,-�l h�i� ✓�� "' l� . �. 1 COfltf'dCtOP ' � � -� City: � �'c � ' � ` /� � ' State: Zip: S 5(%7 j Phone: �5�%b�"�z�% 7 � ; ; , ; Contact:_3��f`1�ii1?�� Email: /. ,�,� .;,r. < ��: � �id>dC��N'� � F � New �Replacement �AddRional _Afteration Demolition I .�� i i Type of Work DescripEiort of work: � � � f '� � NOTE: Roof mouneed and ground mounted mechanical equipment is required to be sc►eened by City i $ Code. Ptease contact the Mechanical Irtspector for informatron on permitfed screening methods. b � RESIDENTIAL � � F � ; COMMERCIAL � � , _Fumace i _New Construction +Interior Impmvement i � Air Conditaner ' f � Permit Type � — 1 _Install Piping ,_Processed � � g _Air Exchanger � � i j _Gas Extenor HVAC Unit 3` `' Heat Pu ; Under/Above round Tank^ � / � 'L ' 9 (_Inslan!_Remove) � a � �Other : •�W✓ ? ; RE"S/DENTIAL FEES � . j � $60.00 Minimum Add or alteration to an existing unit(includes$5.00 State Surcharge) /�1 �� E $'i00.00 ResiQential New(i�cludes$5.00 State Surcharge} _$ !�(/ tOTAL FEE � � COMMERCIAL FEES s ! Contract Value$ x.01 � � $70.$55.00 Permit Fee Minimum 00 Underground tank insiallationlremoval =$ Permil Fee f � _ � lf contract value is LESS than$f 0,010,Surcharge-$5.00 � � "If contract value is GREATER than$�0.010,Surcharge=Contract Value x$U.D005 -$ Surcharge' � 1RRIf the project valuation is over$1 milli�, please call for Surcharge ' _$ TOTAL FEE 1 I hereby acknowledge that this infoRnation is camplete and aocurate;that the work will be in conformance with the ordinances and oodes of the City of Eagan;thal I emdersEand this is not a pertnit,but only an applicaFion for a permit,and work is not to start without a permit;tha!the work will be in accordance with the approved plan in the case of work which requires a review and approval ot plans. � X /'�<i`� 1��71� � �, Appficant's P�inted Name Appficant's Signature FOR OFFICE USE Required Inspections: Reviewed By: Dabe: Underground Rough fn _Air Tes[ Gas Service Test _In-floor Heat Final HVAC Screening PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA162102 Date Issued:06/26/2020 Permit Category:ePermit Site Address: 3939 Westbury Dr Lot:004 Block: 005 Addition: Westbury 1st PID:10-83650-05-040 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. Please call Building Inspections at (651) 675-5675 to schedule a final inspection. 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 - Mohamed Y Mohamed 3939 Westbury Dr Eagan MN 55123 Hero Plumbing Heating & Cooling 3110 Washington Ave N, Suite 100 Minneapolis MN 55411 (612) 827-4674 Applicant/Permitee: Signature Issued By: Signature