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3918 Worchester Dr CITY UF EAGAN Formit No: Date: ~ 3830 Pllci Knob Roa# B>P'Fla 1 z01 Date: , P.Ok Box 21199 EaA, MN 55121 I ~ Owner. c~sle~ Gonet . ~ SiteAddress: l~ orChester rT'ivi: ? _ t?l'f~ oF~;rr• ~ I Plumber: _'•?`'+cIc~v~ller I'1u;~t;i:..: ~'r I ' MWCC: 550. QCW ZoNng• ' Ciry Chg: No. of Units: ; Acct Dep: 5 ' 0 I agree to comply with the Cityr of Eagan ~ ~ Permit Fee: Ordinances. Surcharge: a Misc.: By ~ SEWER SERVICE PERMIT ' i CITY OF EAGAN Permtt vo: DBte: 3830,PNot Knob Road ~ Meter No: Sizec ' I P O• L ix 21199 Resder Nb: Date: Eaqsn, MN 55121 :'esley Conat. Owner. Site Address: 3918 Worchester rive 1.19 11 1111a of 4tr Plumber_ Bruc1.m:eller Plesmbin, Conn. Chg: P' Zoning: - ACCt D@p: ~ ~•~~l~+c? NO.Oi U11itS: 1 Permit Fee: Surcharge: ' SoFf-I I ayree lo compryi wlth rbo City of Eaqsn Tr. Plant ' 04. ~0pd Ordinances. Meter. F7 fl~Z;Od ; Misc.: By WATER SERVICE PERMIT ~ .rti.. i'~~!~~'~°~~ts ~p••r CIT,t vR r-ACiAN Permit Na - . Datec 363t`P;bl Knob Roai Meter No: 7 Sizec P.O= 9ox 21199 Reader No: 0 ~ Date: ~ Eagan, MN 55121 ~ l•lesley r'o~1:~t . ~ Owner. SiteAddtesx 3918 t,iorcl.eeter T; iv I1'7 r1 ;lil l c nf S nna-- Plumber Brucl:mueller nlumhing ~~,P ' Conn. Chg: ning: Acct Dep: Z 5 0~~ of Units: ~ Permit Fee: 11~ :00~~ ' ~.~{~al utilift6S Surcharg~ •~~i~CI_1A"compiy wlfh the Cft of Eagan Tr. Plant ' ~ - OrdfnancN. Meter. Re,anM1 D C n RYaG ~-,Ot4 ~ Misc.: WATER SERVICE PERMIT - o GASH REMPf - 0 . ClTY OF EAGAN ! . '830 PIIOT KNOB ROAD EAGAN, MINNESOTA 55122 ' DATE X, 19 ~ i • Rceeiven AMOUNT & ooLLwws .e ? CASH ~ CHECK .o~ iyd- , .•1 y~~~~ / . [ ,ruN coo¢ AMOUNT Thank You s v VYhite-Payers Copy Yellow-POStinp Copy Pink-File Copy BLDG. PERMIT N0. ''r 01-3230 ' Bldg. Permit CC) 01-3422 Plan Check ~ 01-3445 Surch./Adm. 01-3446 SAC/Adm. 01-2155 Surcharge 47-3860 Road Unit 20-2275 SAC 20-3865 Water Conn. 20-3868 Water Trmt. 20-3716 Water Meter 20-2252 Acct. Dep. 20-3713 Water Permit 20-3743 Sewer Permit 79-3866 Sewer Conn. ~Y-Y-3855 Park Ded. 1 i TOTAL ' CITY QF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Ea9qn, MN 55121 ~ ' PH ON E: 454-8100 ' BUILDING PERMIT . Receipt To be used for 5Y UWG/CAR Est. Value $83•1100 Oate FEBltUA[tX 1 19 8$ ~ 3918 WO~2CltgSTEtt pk OFFICE USE ONLY ~ Site Address R3 Lot 19 Block i Sec/Sub. HILLS Og 5TONE- On Sne Sewaye Occupancy I Parcel No. SRI DGE MwCC Syatem y zontng ~ on sne weu (ncn,aq const ~ biI:SL.~Y COlN$T'RUCTION City Water x (Allowable) ya oc Name i 9401 XYLOli 50 PRV Requlred * or scories Address ~ City ~P~ PhOne 94~70ga ~~terPump Length ~ Depth ' , o Name SAHE S.F. Total ~ ~ Address Footprint S.F. I- City Phone pPPROVALS FEES ~ Engr./Assess. Permit 5"'oo ! Name 41.~ ~ Z Planner Surcharge x- Address a= Cit * PhonB Council Plan Review 2g3•W e W Y Bldg. Off. SAC, City 100•w .i I hereby acknowledqe that I have read this application and state that the Variance SAC, MWCC 550• 00 information is Correct and a9ree to comP1Y with all aPPfica6le Stete of ~s ~ . Minnesota Statutea and City of Eagan QrdjnenGes. Water Conn. ; , Water Meter L7. 5iqqaYyre of Permittee ~ Road Unit A BuHding Permk is issued to: lrES1.EY Cl1`!t'C i' _7'j.QN Treatment P1 an th"xpress condition that all work shall be done in accordance with all P~r~ applicebb Stete of Minnesota 5tatutes and City ot Eagan Ordinances. TO7AL . Building Official . . CITY QF EAGAN . ~ 3830 P(lot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHON E: 454•8100 BUILDING PERMIT . Receipt ~ To be used for Est. Value Date W;i ,19 Site Address OFFICE USE ONLY Lot BIOCk - S@C/Sub. Ll":~ UF 'iTnPet- On SRs Sewape Occupancy K i: MWCC System J' Zoninq Parcel No. On Sits Well (Actual) Const a Name ' Y Ct lti5 ~ i'.CtT I; City Water ~ (Allowabte) ; Address PRV Required * of Stories Phone ~ter Pump Lenyth ~ City Depth , p Neme S.F. Totei ~ ~ Address Footprint S.F. ~ City Phone APPROYALS EEE8 ~ W Ndme Engr,/Asaess. Permit Planner Surcharge Address ~ Cit Phone Council Plan Review Y Bldg. Off. SAC, Clty I hereby aCknowledge that I have read thia application and state that the Varlance SAC, MWCC info?mation ia correct and agree to comply with all appliCable State of Water Conn. Minnesola Statutes and City of Eagan Ordinances. Water Meter Signature of Permittee Road Unit A Building Permit is issued Treatment Pi on the express condltfon that al I work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordfnances. Parks TOTAL Building ONicial_ - Perrnit No. Permlt Flolder Dab TeIephone ~ Plumbing H.V.AC. Electrlc Softener In"ction Date Insp. Commenta Footings I ~ LIJ - Footings II Foundatfon Framing Rooffng Rough Plbg. Fiough Htg. J , isui. i 3 -~S -a'!?To..(~. Fireplace Final Htg. Final Plbg. ~ Bldg. Final Cert OCC. Temp. LP Deck Ft¢ DACk Final Well Pr. Disp. PERMIT # _ . } MECHANICAL PERMIT RECEIPT # CITY OF EAGAN d~ 3830 PILOT KNOB ROAD, EA(iAN, MN 55122 DATE: CONTRACT PRICE PHONE: 454-8100 Site Address BLDG. TYPE WORK DESCRIPTION LOt ~BIOCk Sec/Spb Res, L" New L' Mult Add-on Name m Addr s6170 , Comm. Repair Other c Ci X--e- l Phone lO ~5q -1 ` FEES ~ Name - RES. HVAC 0-100 M BTU -$24.00 c Addr /0 ADDITIONAL 50 M BTU - 6.00 p City Phone ~y~ 7~ 1 (RES• HVAC INCLUDES A/C ON NEW CONSTRUCTION) 93 y 2t GAS OUTLETS (MINIMUM - 1 PER PERiYIIT) 1.50 EA, TYPE OF WORK COMM/IND FEE - 196 OF CONTRACT FEE Forced Air M BTU ZS' &'o APT. BLDGS. - COMM. RATE APPLIES TOWNHOUSE & CONDOS - RES. RATE APPUES Boiler M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON & Unit Heater M BTU REMOOELS - 12.00 Air Cond. M BTU MINIMUM COMMERCIAL FEE _ 20.00 Vent ~ CFM STATE SURCHARGE PER PERMIT .50 (ADD $.50 S/C IF PERMIT PRICE GOES Gas Piping Outlets # BEYOND $1,000) Other FEE: 3'S• y v S/C: SIGNATURE OF PERITTEE ~ TOTAL• " 0') FOR: CITY OF EAGAN , . PERMIT # ; , . PLUMBING PERMIT RECEIPT IF CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: CONTRACT PRICE PHONE: 454-8100 ' i ~ r~. BLDG. TYff WORK DESCRIPTION Site Address % < Lot ~ Block ~ SeclSub Res. New • Mult. Add-On m Name Comm. Repair ~ Address Other c City 'Phone 'RES. PLBG. ONLY - COMPLETE THE FOLLOWING: NQ. FIXTURES TOTAJ. Name Water Closet - $3.00 $ ' Bath Tubs - $3.00 c Addresi T.Lavatory $3.00 p City Phone ~ c ~ ~ Shower - $3.00 Kitchen Sink - $3.00 ~ FEES Urinal/Bidet - $3.00 COMM/IND FEE - 1% OF CONTRACT FEE ' Laundry Tray -$3.00 r' APT. BLDGS - COMM RATE APPLIES ~Floor Drains -$1.50 % J TOWNHOUSE 8 CONDO - RES. RATE APPUES ' Water Heater -$t.50 MINIMUM - RESIDENTIAL FEE - $12.00 Whirlpool - $3.00 MINIMUM - COMM/IND FEE - $20.00 ~ Gas Piping Outlets - $1.50 STATE SURCHARGE PER PERMIT - .50 (MINIMUM - 1 PER PERMIT) (ADD $.50 S/C IF PERMIT PRICE GOES Sottener -$5.00 BEYOND $1,000.00) Well - $10.00 ; -Private Disp. - $10.00 - ~ - C Rough Openings - $1.50 SIGNATURE OF PERMITTEE FEE: STATE SlC: FOR: CITY OF EAGAN GRAND TOTAL• ` ' ` f~~rtif tr~tp ~uf (~rru~~nr~ ~qtitp of eagan iBppmtptpttf A~ ~tbWg JmVPtnDtt Tliis Cerrifrcate issued pursuant ro the requireraertts of Sectton 306 of the Uniform Brrtlding Code cernfying tluit at lhe ttme ojissuance rhis slructure was in corripliance wrth the various ordinances af the City regulating buildfng construction or use. For rhe following.• Umcbmfimlim SF DWG/GAR ~ ~~t No 14596 O-Ups--y Tnx R-3 Zmiiul DkUid R-1 r-" V-N Ow= of 8u&ww WESLEY CONSTRUCITION Ad&m 9401 XYLAN S, MPIS 8, • 39 WORCHESTER DR local;ry L196B1,HIIIS OF SIQMIiID(E i~ aa: JANUARY 4, 1989 ~ ~ I , P03T IN A CONSPICUOUS PLACE ? CITY OF EAGAN N_ 1 4 5 9 6 .,3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHON E: 454-8100 BUILDING PERMIT Receipt# S`~O I To be used for SF DWG/GAR Est. Value $83,000 pate FEBRUARY 1 19 88 Site Address 3918 WORCHESTER DR OFFICE USE ONIV R3 Lot 19 Block 1 Sec/Sub. HILLS OF STONE- On Site Sewage Occupancy Parcel No. BRIDGE MWCC System X Zoning Rl OnSiteWell (ACtual)Const Vn WESLEY CONSTRUCTION Citywater X (Allowahle) Vn c Name ~ Address 9401 XYLON SO PRV Reqwred _ x ot Srories o City MPLS Phone 944-7092 BoosterPumP _ Length 46 Depih 50 ¢ Name SAME S.F.TOtal 0 zl~ Oa Addre55 FootprintS.F. ~ City Phone pppROVALS FEES $ Engr/ASSess Permit 506.00 ~w ww Name 41.50 t z Planner Surcharqe x~ Address Q w City Phone Council Plan Review 1253.00 00.00 Bldg. Off. SAC, City I hereby acknowletlge ihat I have reatl this application antl state thai the Variance SAC, MWCC 550.00 intormation is correct and agree to comply with ali applicable State of Water Conn. 550.00 Minnesota5tatutesandCityofE~0 an rdna es. Si9nature of Permitree ~ ~ Water Meter 67.00 RoadUnd _3 25,._00 A euilding Permit is issuetl ta-WESLEY-CONSTRliLTION- Treatment P1 _204, 00 on ihe ezpress condition t hat al I work shall be done m accordance with all applicable State of Minnesota Sf tes and City pF agan Ordinances Parks BuildingOfficial ~ TOTAL $2.596.50. JThis reqaest voftl 18 nnnths Iwm D 93961 Request Dale Fre o. Reup~r~nInsVeclion ~qeady Now~Will Noufv Inspec- ~ ' ~e14. ^-~l ~~es ?NO tor When Heatly ~ L,censed ElecVical Contmetnr I hereby repuest ~nspaction of ebove ? Owner elect.icel work snstalletl at. Sveet Addiess, Bo,, or Route No. Utv 3lF/$ 40 RC/FES TF/2 b/1/!/L FiCGeFlti/ ecImn o. TownshiD n'ame or No. Ringe No. Cowrty Le r/q co~,r~ / f/ic~ s o S~r.~-tF,6.ar6 b.¢.~oT,~ OccupanllPRINTI Pnont Nn. 1,LI ESL 4 NSP -D 5Z7 Power SupUlier Adtlress iPKe 6wn'i6~ To.~J Elecincal CnnVactor (COmuanY Namel Conlractor's License No. E. e yo 7 6' - 3 Mailinp AAJress IContracmr or Owner Making Instailauon) 6 ~ ~~r~ S~ Authonzed SiB a1u1e ICon,vac~or~Owner Making In talla1ionl Phone; Numbe, a - 3SS-s' MINNES TA STATE BOAND OF ECTRICITV TMIS INSPECTION PEQUEST WILL NOT Griges-Midwey Bldg. - Xoom N-191 8E ACCEPTED BV THE STATE BOAFD 1821 Universilv Ava.. SL Peui, MN 55104 UNLESS VFOVEF INSPECTION FEE IS Phone (612) 642-0800 ENCLOSED. ~~dq r s 2005 RESIDENI'IAL BUILDING PERNIIT APPLICATION 70 ; City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone 4 651-675-5675 FAX # 651-675-5694 ~ x New Construction Reauirements RemodellReoair Reavirements Office Use OnN 3 registe2d srte surveys showing sq. ft. ol l04 sq. ft. of house; and all roofed areas ? 2 aDies oi plan Cert at Survey Recd _ Y_ N (20% maximum lot wverage allowed) 1 set of Energy Calculations for heated addMons Tree Pres Plan Recd _Y _ N 2 wpies of plan showing beam & window s¢es; poured found design, etc. LI site survey for additions 8 decks Tree Pres Required Y_ N, 1 sel of Energy Calculations Adddiar - indicefe Aon-sfte septic system On-s@e Septic System _ Y_ N 3 wpies of Tree Preservalion PWn if lot platled afler 717193 Rim Joist Detail Options seleqion Sheet (6uJdirgs wAh 3 or less uniLS) Date~/ ~ ConstructionCost a~eox ~~26)OU Site Address 3 9 r g WarC heS ~e-i- . FAG a v. Unit/Ste k Description of Work 7 eLIC c"M 231, Multi-Family Bldg _ Y(-\ N Fireplace(s) _ 04 1 _ 2 PropertyOwner uvoLQz c4-TU'v'Ie- I IC _C~ -{Ya l> Telephone#(6 Tf) ~clY-O3 R~ Con[ractor Address City~ State Zip Telephone~ ( ?O', ~ ) 1,2„_J COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW ~ BUJLDl G - Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672 Energy Code Category , Residential Ventilation Category t Worksheet • New Energy Code WoACSheet (Jsubmissionrype) Submitted Submitted • Energy Envelope Calculations Submitted Have you previously consiructed a buiiding in Eagan with a similar plan2 _ Y _ N If so, 25% plan review fee applies. Licensed Piumber Telephone ) Mechanical Contractor Telephone ) Sewer/WaterContractor Telephone#( ) I hereby apply for a Residential Building Permit and acknowledge 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 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. Wa d e- S-i~-a a~- Applicant's Printed Name Applicant's Signature OFFICE USE ONLY Sub Types ; -1 ? 01 Foundation O 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dweiling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi ? 03 Ot of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF O 04 02-plex ? 10 08-plex pD 18 Deck ? 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 O 25 Miscellaneous Work Types ? 31 New O 35 Int Improvement ? 36 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 (Entlre Bldg) - Give PCA handout to applicant Valuation ^ Do o. - Occupancy R`3 MCES System Census Code q3Y Zoning /1 -1 City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bldgs Length Fire Sprinklered Type of Const 1(a Width REQUIRED INSPECTIONS Footings (new bldg) FinaUC.O. ~ Footings (deck) 147 FinalMo C.O. _ Footings (addition) _ Plumbing Foundation HVAC Drain Tile Other Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tesu Final _ Framing _ Siding _ Stucco _ S[one _ 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 Utiliry Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total „ 4 WESLEY CONSTRUCTION `ibR'S CERTIFICATE _ WESCOTT ROAD ?~'qI d I,vo~c~hzs-kr `D~, 0 n m'r SS J Z 3 (I ~ (~SJ-9g~~- 038g 85.00 N 89°59'25" E ~~9~•y) f~E* w r02 ~b I n FE @UTlL/TY 1/~ DRAlNAGE V^ 713 8 SEMENT PER PLAT 5 ~ e pQ 0.r.~ s~PO'~D96UQ B~ISPEC~`:r ~ ~vv~ X(o ~ ~z ~ I LOT 19 \G~ ~ w ~ l~ V O ~ g ' Z` 19.50 46.0 " 19S ' i 2 i / - pPROPOSED HOUSE p 0 ~ 0 I / /cmv 0 \J to 0 4 0to 1 0 ~ o ~ 14.0 O~ J - J N voi - - - IO.Orri i N I GAR. M (a)ti2) ~ M 0 i ~ ..19.50.. 22.0 - - - 19.50. ' ~ s ~0 Z~ ~ 5 o ° o '0w1~~<''~ 0 O W M M ~ ! (3cl? ~ - 0:', s o - ;i (b97. ` 85.00 N 89°59'25° E • h N N N WORCHESTER DRIVE DENOTES PROPOSED SURFACE DRAINAGE ' O DENOTES IRON MONUMENT SEf SCALE: 1 INCH - 30 FEEf • DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR -)oo.5 FEET X000.0 DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR - 80J1,1 FEET (000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK- qao.°, FEET , WE HEREBY CERTIFY TO WESLEY CONSTRUCTION THAT THIS IS A TFiUE AND CORRECT REPRESENTATION OF ~4 SURVEY OF THE BOUNDARIES OF; Lot 19. Block I, HILLS OF STONEBRIOGE.~ accordlnp to the recorded plat thereof, Dakota County, Mtnnesoto. ' IT DOES NOT PURPORT TO SHQW IMPROVEMENTS OR ENCROACHMENTS, EXCEPT AS SHOWN. AS SURVEYED BY ME OR UNDER MY DIRECT SUPERVISION THIS DAY OF FP-Pif~okP.ti ,199$• REQUEST FOR ELECTRICAL INSPECTION Es-ooooi-os ~ 1 Seo insRUCtions lor comoletinB this torm on Oack of Vellow coFV. V~ 9 3 9 61 "X " eeloW Work Covered by 7his Request Adtl Rap. Type al Bmltlina Applioncea WtreC Equiyment Wired ev4 Home Fange Temporary Service Duplex Water Heatei Liyhliny Fixiure5 Apt. 8wlding Dryei Electnc Heabn Commercial Bidy. Fumace Silo Unlonder InAustrial Bldg. Air Conditioner Bulk Milk Tank Parm Dth., oei., v ih,, (Sucaiv) t qr succi y t m Othw ompute Inspect(on Fee Below p Fee ServteeEntraneeSize tt Fee Fexders/5ublenJers b Fne Cvcwts 0 io 200 qm ~si~ 0 ta 30 qm s ~ L' 0 ta 30 An:> Above 200 qlpy 31 to 100 Amps $ - 31 to 100 Am s Swimming Pool Above 100_Amps Above 100_Amps TransrormeB Irngation Boonus ParLal.'Other Fee Signs Speual InSpeCtion S nema,ks ,5y SC TOTAL 'O'1 I/ flough-in ^ ? ~I. the EI v" Inspector, horpby certrlV thet the above Final (nspoctmn has been meda. F~ ThIereQuesivolOlBmonUutmm Ft1 1988 BUILDING PERMIT APPLICATION - CITY OF EAGAN ~SINGLE FAMILY DWELLINGS ~ ~ ~ f/a INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS NOTE: ADDRESSES EOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL HE ALLOWED ONCE BUILDING PERMIT IS ISSUED. MULTIPLE DWELLINGS RENTAL QNITS FOR SALE UNITS 0 OF UNITS INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECK WITH BLDG. DEPT., 1 SET OF ENERGY CALCULATIONS COMMERCIAL INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTU[iAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS < . • ~.i F' i To Be Used For: Valuation: 8?J~DOO- Date: 3~ Site Address g,~.(dtif OFFICE USE ONLY L Lot ~ Block ~ On site sewage_ Occupancy R- 3 MWCC system ? Zoning ~ -1 Parcel/Sub tiGe G On site well Actual Const v-N ~ City water ? Allowable V-M Owner PEiV required _ li of stories Booster Pump _ Length S/(, ' Address J' ~r Depth SO' S.F. Total City/Zip Code Footprint S.F. Phone APPROVALS FEES Contractor Engr/Assess Permit 506.00 Planner Surcharge 41,5 O Address Council Plan Review Z53. 00 B1dg. Off. ~Z S SAC, City 100100 City/Zip Code Variance SAC, MWCC SSU, o13 Water Conn 5 S O, C)o Phone Water Meter 6 7,oo Road Unit S,o0 Arch./Engr. Treatment P1 ;r?u nJ Parks Address Copies ~ City/Zip Code TOTAL Phone II !/AL uA T,o - , . , GAgA ?2IX22= =~~SL~~(~ L SSdy 3.smT z,~ xqG• Iz(?~x4= 1Ko3Z 13Srn-r ~o )k J - yo z-t ; - oU~S 13~~z S9 l~- ~ZB~~ SURVEYOR'S CERTIFICATE WESLEY CONSTRUCTION WESCOTT ROAD o 0 n n (03,4 . 85.00 N 89059'25" E ~399.y~ ' N gF~ ORAINAGE A UTlLlTY 1/~ EASEM£NT PER PLAT 5 3 3 I LOT 19 ~ M Y, ~ ~ 0 (Aj o o Z,` 19.50' 46.0 Z I- - O /of SED HOUSE p 0 I- - r~ 0 \ J In o I o/ o 14.0 ~ ~ - - IO.OM ~ N GAR. M (~J02) M /T I I t 19.50 22.0 ~ ijp 1\1 p s L ~p•i't:r.'Z~~ S O +•i~a1 Q \ ~ O o :.w. s,,•:3 0 . 1~ 4. i'.i w 1n 2 ' 85.00 N 89°59'25° E ~ n n N N _ WORCHESTER DRIVE _ f- DENOTES PROPOSED SURFACE DRAINAGE O DENOTES IRON MONUMENT SET SCALE: 1 INCH - 30 FEEf • DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR - Joo,$ FEET X000.0 DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR -$%j,'J FEET (000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK - goo.9 FEET WE HEREBY CERTIFY TO WESLEY CONSTRUCTION THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF.A'SURVEY OF THE BOUNDARIES OF; L:ot 1.9, Block 1, HILLS OF STONEBRIDGE accordinp to the reco[ded plat thereot, Dakota County, Mtnnesota,~IT DOES NOT PUFIPORT TO SHOW IMPROVEMENTS OR ENCRQACHMENTS, EXCEPT AS SHOWN. AS SURVEYED BY ME OR UNDER MY DIRECT SUPERVISION THIS 31zi) DAY OF PROPOSED ELEVATIONS SHO4;N 6fERE Siui~ED: i?E5~ FiILL, ifvC. TAKEN FROht THE DEVELOPMENT PLAN FOR HILLS OF STONEBRIDGE, PRE- BY, PARED BY PIONEER ENGINEERING AND LAST DATED 5-26-87. . HAROLD C. PETERSON, LAND SURVEYOR MINNESOTA LICENSE NUMBER 12294 , . ' v x ~ k., r m o ~~o o ~ es ~R. H~i~r '~nc. O~m.r,7 ~ ~ ~ a T o mo ~ . ~o m ~ kPLANNERS / ENGINEERS / SURVEYORS Ot~JAMES,AVE..S. • BLOOMINGTON, MN. 55431 • 612-884-3029 o . p . . . . . . .i. . . . . ~ EXTERIOR ENVELOPE AVERAGE "U" COh1PUTATION 041NER SITE ADORESS LoT B)oc.k 1. , . - CON'iRACTOR okffl6 DATE PIIONE y~2-S/B3 Determine working square foota9e of each. 1. Total exposed wall area e20 76' sq. ft. x_1L = C$_3~_.~ 2. Total roof/ceiling area sq. ft. x_026 Total exposed wall area above floor a. Total wall window area 1~/~2S b. Total door area c. Total sliding gtass door area ,34!2 d. Total fireplace wall area - e. Total wall framin9 area (average 10%)............. ze f. Total net wall area above floor g. Total rim 3oist area 130 Total exposed foundation area = _1Q(y h. Total foundation window arca - i. Toal net foundation area abcve grade Determine "U" value cf each taall segment. a. A//, aS x"u" , ff = 69"2z b. _~M 77 X „u„ , i23 _ = yG C: ~o X t.u., 70 d. - X "U" e. x "u" f. x olull 9. /3D X ,lu„ 20 . n. - X „u„ • i X ~lull 3 ° ! • ~ If item q3 is the same as, or less° than item +41, you have met the interit of SBC 6006(c)2. . ' wnii scrr:oNS - licYTE: Use 15% of opaque wall.azea fbr - frame constrnction - - - Censtruction - - - - R-Valae film 0 6 2.' ~ 2 ~ ~IG~? .Y.~ 3, S z,=nclies soft woocl 4, 2. j 5. ~x F~ z~r~oifrG , f / BASIC 6. Exterior a3r film = 0.17 wns.r. Tota1 Q= FIG. N1 ' '1'OpVIEIi OF ggMig WALL l. Intcrior air film 0•68 s . z ` ~o r.rfe.• ya 3. s/z` 3iBS~,t~rl ~0-6 . ' 4. 2Y't7_ -9/zf P/ ~ 06 nriv:?E .5i 6, Exterior air film 0.17 FIG. $2 ToWl ~ 1. Interior air film 0.68 " r/3f/,~ ZlI ~ r.~/ r^ 3. / ZG ~GG>LG'SO/1 Af tl. z t ~~i iyF 1.GG 5. & Peziptiezal • --QQ • 6. Exterior air film 0.17 Total y ?{•i~ `»---------v . ~ ~'.r . • ' d j r ~1' v •V ~ " ' ~ 1. Interior air film 0.68 ~ `l~ ;A• ~ • . -l; . . . FOQ:;~3~TICN A e 2 /,GJ . c . : • s. 12* F'P~.I. , •q. . ' 4. ~ U • „~p t S. ~ jr •n • ' r , ! - 6. Exterior air film 0.17 ._i} . . : Total ?113 SLAS ON GRADE . • . 'r . . r . • /~F ~r . . , , ` . • , :~,,=r, • ~ri _R~A,~ 1rr~.:~ . ~ ~ , • : , • : , Y,•• FIG. NO ffl k 6, p `(//1/ FIG. N3 ` > X X . • d _ : _ ' , NO'CE: Indicate type, "r" value, deoth and , • ' ~ placenent of insulation. o~ - b ' Page Three ROOP/CEILING Conntruction R-Value 1. Intcrior air film ' 0:61 Z 3. . 4. F,xtezior air film (still O.ZI VEti'T Total 3%i61 Vented Heat flov up . . . FIG. $5 . ~ 1. Intetior ai film 0.61 Z. 3. 4. Er.tcriur ai fil sti , ~ . . . . otal ~ ~Y.eat floW up , ; vented• ..FIG. N6 . . . . - 3 In:,i.de i.r tilm 0.61 2• ' 3• . ; ~ ~ 4. ar.?•Y~~}J'-.s •e::.:: .:.1.;'..:;;•,•;•.•• 5. Outs .ir. fl 0.17 t~: . Total 1 1. 2 . ` . . . NON-VEh'fED NoCe: ' Use ndditional sheuts if more space i. . • neee?ecl for details and calculalions. ' . Heat • . , flov up ' • FT.r,. .47 • ' Total expased roof/ceiling area Total skylight area ~ - k. Total roof/ceiling framin9 area (average 10%)... /311,2- 1. Total net insulated roof/ceiling area........... /,20- Oetermine "U" value for each roof/ceiling segment. J. _ X liull k. x louli 672-6 = 3 yq 1111 i45;i( s 2 0 1•; x 11V 4 ..................................Tota1 = ~3, 6 If totaT.of q4 is the same as, or less than #2, you have met the intent of SBC 6006(c)1. Alternate Building Envelape Design To utilize the total envelape system method, the values established by the sum of items N3 and #4 shall not be greater than the sum of items N1 and N2. 1. -2.28. 3,G + 2. 3y,69 =.?6 31 .25- 3. + a. 33.~9 = ~i3, ss .~r,hJ~~9'T ~x.~ C~rrr ~-~C•%~i'f~d , . . - 1999 BUILDING PERMIT APPLICATION (RESlDENTtALI CITY OF EACAN 3830 PILOT KNOB RD - 55122 / ~ 651-681-4675 New Conshuctlon Reauiremen}s RemodellReoaic Reaukements ? 3 registered sHe surveys showing sq. It. of lot, sq. fl. of house 2 coples of plan and all roo}ed areas [40% maximum lot coveraae allowed) 1 set of energy calculafforo for heated addNions ? 4 copies of plans (show beam 3 wlndow sizes; poured ind. dealgn; etc.) 1 sNe survey lor e erior addHlons S decks D 1 set of energy calcvlafions ~6 C~ C~ q D 3 copies of hee preservation plan H lot plafled alfer 7!1l93 ~o~i `q H L V ~ DATE: CONSTRUCTION COST: DESCRIPTION OF WORK. SiREET ADDRESS: J ! ~a ~D'Q~ ~ '~G LOT: 01 BLOCK: ~ SUBD./P.I.D.#: •~~/V~Y~D1-~4 Name: &,4~y Phone GSJ"687' `~-Z S~T PROPERTY La- Fun OWNER .3~~g (,V02Ghb~RT't ~~+~cs Sireet Address: ciiy 4,Aj state: tn~ zip: sSIZ3 Company:_ 4Z-1,- c- I Phone#: 'el y $g'S~ DO (area code) CONTRACTOR Street Address: ~/S g 3 eurP ~R- license #AD 1317/1 /6 Exp. City ~u.?~t1SJi 1 ~E State: ~'jln) Zip: ARCHITECT/ ENGINEER Company: Name: Teiepnone area code ~ j Streefi Address: Registratfon N: Cify Stafe: Zip: Sewer 8 wafer llcensed plumber {reauired for new conslrucffon onlv Penalty applles when address change and lot change Is requested once permfl Is fssued. , - I hereby acknowledge that 1 have read fhis application, state that the Information is cortect, and agree to comply wifh all appllcabl Stafe of Mlnnesota Statutes and Cify of Eagan Ordinances. Stgnature ot Appllcant: OFFICE USE LY RECEIVED Certificates of Survey Received _ Yes _ No Npl/ 10 1999 Tree Preservation Plan Received - Yes - No _ Not Required BY, OFFICE USE ONLY BUILDING PERMIT NPE ? 01 Foundation ? 06 4-plex ? 11 10-plex 0 16 Fireplace ? 21 Porch (3-sea.) ? 02 SF Dwelling ? 07 5-plex ? 12 12-plex O 17 Garage ? 22 Porch/Addn. (4sea. ? 03 1 of _ plex ? 08 6-plex ? 13 16-plex ? 18 Deck ? 23 Porch (screened) ? 04 2-plex ? 09 7-plex ? 14 Apartments ? 19 Lower Level ? 24 Storm Damage ? OS 3-plex,.,. ? 10 8-plex ? 15 Lodging ? 20 Poot ? 25 Miscellaneous WORK TYPE 31 New ? 35 Tenant Impr ? 39 Gas Line Only ? 43 Siding/Soffits/Fascia ? 32 Addition ? 36 Move Bldg. ? 40 Gas Insert ? 44 Windows/Doors ? 33 Alteration ? 37 Demolish Bldg.• ? 41 Wood Stove ? 45 Fire Repair nAa Ra~.~nair n 38 C-mc!ish - (t^:~„cr} C 3^ f s. i~Gvv ' Give PCA handout to applicant for demolition permit GENERAL INFORMATION Const. (Actual) Basement sq. ft. Census Code (Allowable) Main level sq. ft. SAC Code UBC Occupancy sq. ft. No. of Units Zoning sq. ft. No. of Bldgs # of Stories sq. ft. MC/ES System Length sq. ft. City Water Width Footprint sq. ft. Booster Pump PRV Fire Sprinklered APPROVALS Planning Building Engineering Variance Permit Fee ~rQ-.~ S Valuation: $ D'D Surcharge ZI - ~ o Plan Re•rievi License MC/ES SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit ' SIW Surcharge - Treatment PI. , Park Ded. Trails Ded. Other Copies Total: SAC Units % SAC I.OT,/ .1 BLOCK _.L SUBD. ZLLL 4f kAJW RECEIPT # 4907 DATE 1995 CITY OF EAGAN IRRIGATION PERMIT (FOR BACKFLOW PREVENTER) COMMERCIAL INSTALLATIONS: FORM MUST BE COMPLETED BY LICENSED PLUMBER Date: al,i w 9S Commercial GPM Residential (boulevards) GPM Exist'ing residential Area/address to be irrigated• 2 GH 6 S TE 2 DR, _ Installer: D~ L-0 ~ P L u Ma/ A/ G C'wner ? Plumber ~ Street address- Ja Ia- 9 y ru S r, City, state 8 zip code: (3 Lo o M),., orow , s.syaS Phone S9'1-65& 6 Owner Name• G A R v vn i T c}f Street addresq- City, state & zip code: Phone Irrigation contractor, if different than installer: f~ 00 A c) T , Telephone ! O O l;iereby acknowledge that I havz read this applfcatlon, state that the information Is correct, and agree to comply with ali applicable City of Eagan ordinances. It fs the applicanYs responsibility to notify the property owner that the City of Eagan assumes no Ilability for any damages caused by the C'sty during its normal operatfonal and maintenance activities to the facilities constructed under thts permit within Clty propertylrlght-of-wayleasement. t ln~ 4.tj"^7~ O-~uti. en- ApplicanYs signature Title Approved by: Date: PRV ? Yes 0 No New service ~Yes O No Meter Size & Cost Fees due: _ Caiculated by: PROCEDURE FOR IRRIGATION SYSTEMS - 1995 An Irrigation permit is required - please contact Protective Inspections at 681-4675. Fees Commerclal proJect: $25.50 irrigation permit to cover installation of backflow preventer. $50.50 water permit fee oniv if new service is installed. $300.00 per tap if installed by City. Residential project: $20.50 irrigation permit to cover installation of backflow preventer. $50.50 water permit fee if new service is installed. $750.00 ~er connection - WAC. $372.00 per connection - water treatment facility. Existing residence: $20.50 irrigation permit to cover instaflation of backflow preventer -(not required if backflow preventer previously installed). Meter charge: If gallons per minute are less than 25, a 1" meter will be required at a cost of $170.00. If gallons per minute are more than 25, a 2" turbo with strainer wili be required at a cost of $800.00. This information is to be supplied by the designer of the system. No meter will be sold before all sewer and water tnspectfons are compiete on a new service. If new service lines are not reauired, one check may be written for meter and pormit costs. Receipt will be coded to 20-3716 (meter portion only) with pink copy forwarded to Utiiity Billing Clerk. The installer is to contact Protective Inspections at 681-4675 for inspection of the inside water line 3nd backflow preventer. The Public Works Department may be reached at 681-4300 for water turn-on and set and seal of the meter. Inspection hours are 8:30 a.m. to 3:30 p.m. Monday through Friday. Requests for A.M. inspections should be made on the preceding work day. Requests for PM inspections will be accepted until 12:00 noon. CITY USE ONLY L 1 BLr ~ RECEIPT _//Cr~ O oJ 5 I SUBD. RECEIPT DATE: U PERMIT # 1999 PLUM$INFc ~ERMIT (RESIDENTIAL) crrY oF Faa,aiv 3$30 P[LOT KNOB RD ~ F-Afi}4N, MN 55122 (651)6$1-4675 Please complete for: > single family dwellings , > townhomes and condos when permits are required for each unit : backflow preventer for underground sprinkler system FIXTURES EACH # 7OTAL Bcii i iU y d.UO - X Floor drain 3.00 x = $ Gas i in outlet ' minimum - i 3.00 x = $ Hot tubls a 3.00 x = $ Kitchen sink 3.00 x = $ Laundr tra 3.00 x = US ~ Lavator 3.00 x = ~ Minimum fee alteretions to existin dwellin 30.00 x = Private Dis osai S stem newlrefurbished ' re uires MPC iic. 75.00 x = Pri vate Dis osal S stem abandonment 30.00 x = $ li RPZ new installation/re air 30.00 x = $ ! Rou h o enin 1.50 x = $ Shower 3.00 x = $ Under round s rinkler if dwellin is under canstruction 3.00 x = $ I Under round s rinkler if existin dwellin 30.00 x = $ Water closet 3.00 x = $ ^ Water heater 3.00 x = $ alj~"•~'O Water Softener if dwellin under construction 5.00 x = $ ' Water softener if existin dwellin 30.00 x = $ I Water turnaround 30.00 x _ $ State Surchar e 50 $ i 50 Total $ Reminder. Ca11 for inspections of aizerations, i.e. water neaters, water sotteners, etc. -~---~------ha------ read - -a--- - I hereby acknowledge that I ve this appli- - cation, state- -that- the -information- is- -covect, n-d agree- -to -co-mply -with -all applicable City of Ea9an ordmances. tt is lhe applicanCs responsibility to notify the property owner that the City of Eagan assumes no hability for any damages caused by the Ciry during its normal operahonal antl maintenance activities to the facilities constructed under this permit within City propertyfright-obwayleasement. i SITE ADDRESS: 371F OWNER NAME: : TELEPHOME (AREA CODE) INSTALLER NAME: /„r TELEPHONE #6lL SS-/ aArF_ STREET ADDRESS, cq6 do (AREA CODE) il ~ CITY: STATE: ZIP: I GNATURE_~ PERMITTEE I I APFLI.^,ATION FOR PERMIT_- :NME= PAYNErr oe FM nT TIM oF ~ APPLICATION DDFS NOT C06F y . ~ SIZIVI'E APPRGJAI.OF PERbIIT. ~ y SEW ER AND/OR W ATER CONNECTION ; INseEMau oF MqER ainloR wnTER : ieasrntinriaNs wna, r,or as scfvcn.m ; . . a lINi'IL PIIiPIIT HAS BEQi ApPROVID. ' a i dtV ~ Of CC1• C8n ~ - ~ (PLFASE PRINT 1) PROPERTY ADDItESS: 3 ~.~.tY LBSrL DFSCasprioN: Z- cj Lot B ock S vision or Tax Parcel ID I IF EXISTING STRCCTORE, DATE OF ORIGINAL BUILDING PERMIT ISSOANCE: i Nlont Year I PRESENT ZONING/PROPOSID USE: i Q CONIlIIEftCIAL/RETAIL/OFFICE IJ? R-1 SINGLE FAMILY ~ Q INDOSTRIAL ~ R-2 DOPLEX (3tao L'nits) Q INSTITUTIONAL/GOVERNMENT ~ R-3 TOWNHOL~SE (Three + Cnits) ( 'Lnits) Q R-4 APARTMENT/CONDOMINIOM ( ICnits) 2) NAME: AnDREss: ojyi~/ ~r~ ~o•i ~{vc~ ~ i CITY, STATE, ZIP: ~ PHONE: ~ For City Lse 3) ' i ~ NAME: Pl re im License: aoDREss: 37~;~ /'e.l/ l/l/~;r-e0 J..- Active E~cpired CITY, STATE, ZIP: V j S%~ 2 I Not recordec PxoNE: C~~ - G 2y c~ MASTER LICENSE # 3 z 3 6 sta In~T- 4 ) NAME: , . ADDRESS: I CITY, STATE, ZIP: ~ PHONE: 5) ~ CONNECTION TO CITY SEWII2 ~CONNECTION TO CITY WATER O OTHII2 I 6> /S * THE GpIi7 COPY OF THE PII2MTT WILL SE SENf DIRECI'LY 7l7 PUSI,IC WORKS 1n FACILITATE MEI'ER PIQC-DP. y PLEASE ALTAW 2W0 WORKEWG DAYS FOR PROCFSSING. SOMEONE FROM 1YlE CITY WILL C06TIAGT YOU IF 1RIERE ; * ARE pNY PRORLEhLS. ' e ,~,t,t**~**+**+***t***x*t***xw,t*~t**t~***:r**t**,r,r+,t,t*,trt~r*+***+~**tt~r+~,t+**x+~*******,t**~**t~*+*,t+**; ' Cities Digital Quality Control The following image represents the best available image from the original page. Every effort was made to capture the content from the original page. FOR CITY USE ONLY , PERMIT # ZSSC'ED Pd w/Bldg. Permit FEES: $ S • _-SEWER PERMIT (INCLUDE SURCHARGE) $ $ WATER PERMIT (INCLUDE SL'RCHARGE) $ (7' $ WRTER METER/COPPERHORN/OI,'TSIDE READER $ $ WATER TAP (INCLUDE CORPORATION STOP) $ $ SEWER TAP $ $ / ACCOUNT DEPOSIT - SEWER $ $ ACCOUNT DEPOSIT - WATER $ ~ S $ WAC $ $ sAc $ $ TRUNK WATER ASSESSMENT $ $ TRUNK SEWER ASSESSMENT $ $ LATERAL BENEFIT/TRUNK SEWER $ $ LATERAL BENEFIT/TRUNK WATER $ $ WATER TREATMENT PLANT SURCHARGE $ $ OTHER: $ TOTAL RECEIPT RECEIPT DOES UTILITY CONNECTION REQUIRE EXCAVATION IN P[JBLIC RIGHT OF WAY? ~ YES IF YES, THE[V A"PERMIT FOR WORK WITHIN PUBLIC Q ROADWAY" MUST BE ISSUED BY THE ENGINEERING NO DIVISION. LIST AS A CONDITION. SUBJECT TO THE FOLLOWING CONDITIONS: • APPROVED BY: /l . ~ , • : , TITLE: ~ DATE : / . • ~ I 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: 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit to,: Contractor Name: L 3 FOE- .5.-14--0 p„O Phone: (6S) J is 67 Address / City / Zip: NYCIP I g L)cs rc et€ f r fl'v' Applicant is: Owner Description of work: ontractor Construction Cost: Multi -Family Building: (Yes / Vo ) Company: /0 4 Y S NICk tta f3 ,qL Contact: /Zc9te— Address: `Q 0 O 7o - piC City: _�Fg ("DJ e. State: 1/1Z Zip:�5 Phone: V6 &) "(es-- 0 s e3 License #: .IAC S (ThirLead Certificate #: 44 T- / O 0 3 d b " If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) 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: Sewer & Water Contractor: 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 Cali 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 anc 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 authori days of permit i x a building p mit issued in accor nce. Applicant's -Printed -Name tto - s ith the Minnesota St st be complete80 App cants -Signature Page 1 of 3 PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA173018 Date Issued:10/25/2021 Permit Category:ePermit Site Address: 3918 Worchester Dr Lot:19 Block: 1 Addition: Hills Of Stonebridge PID:10-32990-01-190 Use: Description: Sub Type:Residential Work Type:Replace Description:Furnace Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507) 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 - Mohiuddin Khan 3918 Worchester Dr Eagan MN 55123 B&d Plumbing & Heating 4145 Mackenzie Court NE St Michael MN 55376 (763) 497-2290 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA178160 Date Issued:08/03/2022 Permit Category:ePermit Site Address: 3918 Worchester Dr Lot:19 Block: 1 Addition: Hills Of Stonebridge PID:10-32990-01-190 Use: Description: Sub Type:Water Heater Work Type:Replace Description:Standard Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Please call Building Inspections at (651) 675-5675 to schedule a final inspection. 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 - Mohiuddin Khan 3918 Worchester Dr Eagan MN 55123 Champion Plumbing Llc 3670 Dodd Rd., #100 Eagan MN 55123 (651) 365-1340 Applicant/Permitee: Signature Issued By: Signature