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3809 Westbury Dr41,°". City of Earn Date: 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 CON Use BLUE or BLACK Ink Date Received: Staff: 2011 RESIDENTIAL BUILDING PERMIT APPLICATION e -e/2( l It Site Address: 360c7 vies -T. -Et -Go -17 �� t `� Unit#: RESIDENT / OWNER Name: Tc 3*- ' Ai- A-kit.o2sL / Phone: f9.7 4 ---Cl. 3 P--7 ,t Address / City / Zip: 5861 Vial i��p7 N E - c P� . /- (J , Applicant is: X Owner Contractor TYPE OF WORK Description of work: R.E6r-' j d 4 Construction Cost: Multi -Family Building: (Yes / No K ) CONTRACTOR Company: � r 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) In the last 12 months, Yes No If 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: Licensed Plumber: Mechanical Contractor: Sewer & Water Contractor: Phone: Phone: Phone: NOTE: Plans'and supporting documents -that you submit are considered to be public information 'onto r§ E. the information may be classified as non-public ifyou, provide specific reasons that would permit the City to . conclude=tha't they are trade secrets:,: P 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_ e work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. x 7 ' ,t/'d Applicant's Printed Name x Applicant's Signatur Page 1 of 3 RBACTIVATED FOR DECK 6/$6 AND$RSON RESIDENfiyCITY OF EAGAN 0 Pilot Knob Rosd, P.O. Box 21-189. Esgsn, MN 55121 PHONE: 4548100 BUILDING rERMIT Rocela ~ To w wmd fer • - Est. Volue pae -7 . 19s: Site Addrea ' Erect ~ Occupancy Lat Block ~'/Sub. t~ 7`` Y Rsmodel ? Zoning Pereel No. Repair ? Type of Const. Enlarge ? No. Storias Move ? Length ~ Nsme 50 Demolish ? Depth ' Address . Grsde ? Sq. Ft. City Phona Ci Install ? Nsme App.srols fea gtu Asseasment Permit u~ City~ Phorro Woter d~ Stw. Surchorpe Poliu Plan Review J tW Name Fin SAC 'f ~W zO Add?ass Enp. Woter Conn. tW City Phone Plonntr Water Mehr Coixwil Rond Unit I heroby acknowledfle that I how road this oppliwtion and stote that Bldg• OH• tM information Is correct and oqree to comply with oll opplicobie APC Total ' Stoh o{ Minnesoto Stotutes ond City of Eoqan Ordinonces. Var. Dats 5ipnotun of PemwttN A Buildinq Permit ts isswd ro: . on the expnu conditian thoi oll work sholl be dorw in oocordor+a with cll opplicobl• Stah of Mirvywta Statutes ond Gty of Eaqan Ordinoncea. duiWieq Offlcld ~ f/! s ~ ~ T T 11 ~ Q 9 ,y 71 T 11 ~ ~ S ~ mz < 4r n A 4r ~ 14 N ; ° ~ s O ~ , CITY QF EAGAN ; 3830 Pilot K n o b Road, P.O. Box 21-199, Eagan, MN 55121 i_r) 78*7 PHON E: 454-8100 BUILDING PERMIT Receipt # To be used for ~1110T Est. Value Date ,19 5ite Address 3804 ii'$ tT$UldY 0RIVE OFFICE USE ONLY Lot , Block 1 Sec/5ub. WE'' ~~B~{RY '~Nb On Site Sewage Occupancy MWCC Systam Zoning Parcel No. On Site Welf (Actuaq Const m Name STIPItEL14 H• ANDERSZ", Citywater (Allowable) W S PFV Required # of Stories 3 Address 0 City Phone 437--43$4 {W; Booster Pump Length Depth , p Name Iq452-3297 (NY) S.F.TOtal ~ 4 Address Footprint S.F, ~ City Phone APPRUVALS FEES $3<<.t'30 u rc Engr./Assess. Permit F W Name 1.00 Z Address Planner Surcharge Q Z Clty PhOne Council Plan Review aw Bldg. Off. SAC, City I hereby acknowledge that I have read this application and state that the Variance SAC, MWCC information is correcf and agree to comply with all applicable State of Water Conn. Minnesota Statutes and City of Eagan Ordinances. Water Meter Signature of Permittee 'N Road Unit A Building Permit is issued to: STi&PH-IP1'1 ANj$jtS5?K Treatment P1 on the express cond ition that all work shall be done in accordance with al I TOM { COp)?) .50 applicable Slate of Minnesota Statutes and City of Eagan Ordinances. Building Official TOTAL ~3s. ~I Parmit No. Permit Holder Data Telephone * Plumbing Q C'd s Q i F ~ s o H.V.A.G. Electric Softener InspeCtion Date lnsp. Comments Footings I Footings II Foundation Framing Roofing Rough Plbg. Rough Htg. IsuL Fireplace Final Htg. i Final Plbg. Bldg. Flnal Cert Occ. Temp. LP Deck Ftg. Deck Final Well Pr. Disp_ • . , PERMIT # PLUMBING PERMIT RECEIPT tt CITY OF EAGAN 3836 PiLOT KNOB ROAD, EAGAN, MN 55122 DATE: CONTRACT PRICE: PHONE: 454-8100 Site Address " " ' i t"' ' ` k BLDG. TYPE WORK DESCRIPTION Lot Block ~,SeclAub Res. New 4-t.'~ Mult. Add-on ~ Name N ~ Comm. Repair R Address It ka ~1 Other c Ciy Phone~ - 'p RES. PLBG. ONLY - COMPLETE THE FOLLOWING: - NO. FIXTURES TOTAL Name Water Closet - $3.00 $ Bath Tubs - $3.00 c Addr2sS rT (J~-~ y 2 • Lavatory - $3.00 o eiH ~ A ~ Phone 7 Shower - $3.00 Ki?chen Sink - $3.00 FEES Urinal / Bidet - $3.00 COMM/IND FEE - 1°r6 OF CONTRACT FEE Laundry Tray -$3.00 APT. BLDGS - COMM RATE APPLIES Floor Drains -$1.50 TOWNHOUSE & CONDO - RES. RATE APPLIES Water Heater -$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 Softener -$5.00 BEYOND $1,000.00) Well - $10.00 Private Disp. - $10.00 Rough Openings - $1.50 SIGNATURE OF PERMITTEE ' FEE: ' STATE S/C: FOR: CITY (1~ EAGAN GRAND TOTAL: " ~ Reaipt , MECHANICAL PERMIT Penriit No. f CITY OF EAGAN ' , FN fill in numbered spaces S/C TyPe or Prinr legibJy Tot . f t. Date 2. Installation Cost 3. Job Addreu fLar ~ Blk. r Trsct 4. Owner , i 5. Contractor phone 6. Address 7. City ltite Zip 8. Building Typr Residential Cj Commercial ? Institutional ? 9. Work Deseription: qerv O AW ? Aliar O Repair O 10. Drsrribe Fuel TYDe ' 11. N~o EauW=nl B TU - ML Ea. NI& _ Equiameni CFM Fvrced Air _ Air Handling: Mf9• . ~ Balers - Nlech. Exhauct Mfg. Unit Hester Mfg. Other Air Cond. Wffg. Gas, Piping Outlets 12. I hereby certify that the above inf,ormation is true and correct, and I agree to oomply with all ordinances end codes governing thia type of work. S'igned : for Rouph Final Inspections: Date Insp. Date Insp. This is your pe?mit when numbered and approved. Approved CITY OF EAGAN 45"100 - r ; Reoeipt ' PLUMBING PERMIT Permit No. " r CITY OF EAGAN Fes Fill in numbered spacea S/C ~ Type or Prinr legibly Tot. F 1. Date 2. Installation Cost ~ 3. Job Address Ltit Blk. Tract , r 4. Owner 5. Contractor Phone 6. Address ~ 7. City - a_ , _ State 2ip 8. $uilding Type: Resideniial-0 Commercial ? Institutional ? 9. Work Description: New ^Cl Add ? Alter ? Repair O 10. Descrihe 11. No. Fixtures No. Fixtures Water Closet Cesspool/Orainfield Bath tubs Septic Tank Lavatory Softner Shower Well Kitchen Sink Urinal/Bidet Other ° Laundry Tray Floor Drains Drinking Ftn. Slop Sink ~ Gas Piping Outlets 12. I hereby certify that the above information is true and correct, and l agree to comply with all ordinances and codes governing this tYpe of work. ~ ~ Signed : % for Rough Final t lnspections: Date Insp. _ Date Insp. F This is Your permit when numbered and approved. Approved CITY OF EAGAN 454,8100 ~ CITY OF EAGAN Remarks 1 1~~ / '7) 1) Addition WESTBURY SECOND ADDITION Lot 3 e1k 1 Parcel 10 83651 030 01 Owner street 3809 Westbury Drive State Eagan, MN 55123 Improvement Date Arnount Annual Years 1(6 Payment Receipt Date STREET SURF. ~ 19H(j'=`' Z A01 6q 7-15-85 STREET RESTOR. GRADING Water area 1986 133.79 8.92 19 .1 79 A01586 -1 5AN SEW TRUNK 0 SEWER LATERAL V.0*11 1986 500$ 15008, 73 Watermain 1986 65.29 4.35 15165.29 WATERMAIN b-RrR 1984 50.89 3.39 15 144 /I WATERLATERAL 1986 WATER AREA ~jWjb-7 1984 136.9 9.13 1 * Services 1986 STORM SEW TRK 1986 710.24 142. 10 STORM 5EW LAT 1986 CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. n n BUILOING PER. SAC PARK This request void~,~ 18 nwnths (rom E 14 0 3 5:<3 Fequest Da~e Fire No. Ro h"ilnsuer.tion Ne ' etl? Reatlv Now Q Will Notif¢ Inspec- .~"~~u Yes ~No tor When Readv ? icensee Eleclrical Conlractor I hereby requast inspection ot ebove Owner elecvical work installed a[: Svee[ Address, dox or Route No. Ciry 809 ~,t/Gsz~ u 2 . ~-~J clmn o. Townshi0 N,~me or No. Range No, Comny Occupant (PfiINT) . Phune No. Power Supplier Atldress ~ ,.M~N~ Electrical Cnnvactor ICompany Nama) Ca~trar,mr's License No. MailinA p.tlJress (Coniraclor or Owner Making Instailation) Au[horized a re ICon loi~Own ~ Makiny InsWllationl Phone Nu~m1ber ^ ,ve ' L S~ri" ~d MINNE TA TATE 90 OF LECTflIGITY THIS INSPECTION HEQUEST WILL NOT Gr igg M' ,ey Bidg. - Noom N•191 BE ACCEPTED BY THE STATE 60APD ~ 6510C UNLE55 PPOPEN INSPECTION FEE IS 1821 liiversitv Ave.. Sa. Pnul, MN ENClO5E0. Phone 16121 642-0800 REQUEST FOR ELECTRICAL INSPECTION E~B-0}0/0/ , Sae instructions Jor compleling this brm on back of yellow mpy. U/tO(.e ~ E 1035 ~X'" Below Work Covered by This Request Adtl Rep. Typa oi Builtling ApOliancea Wired EquiVmem WireA Home Range Tomporary Service Duplex Water Heater Lightiny Fixtures Apt. Building ?rye, EleCtriC Heaim Commercial Bldy. Furnace Silo Unloader InAustrial Bldg. Air Conditioner Bulk Milk Tank Fallil O[hHr Der,iFy ihnr ISpeclfy) t er pcu y Oth2r Othcr ompute /nspecUOn Fee Below M Fea ServiceEntrancaSiza 9 Fea Faxders/Subleaders k F5e Clrcuits U to 200 qmps 0 to 30 qm s 0 to 30 Am s Above 200 Am ~s 37 to 100 Amps 31 to 100 Am s Swimming Pool Above 100_Amps Ahove 100_Amps Transtormers Irrigation Booms Partial,Other Fee Signs Special hispecUOn S ,Z TOTAL F Aem3rks ~ Gy, ~ „ V flough-in I, the ElecLi Inspecloq hereby certily thxt the ahove Final ~';1e~ ` ~ne0ection has Deen pasaa. mis reauest roie 18 monlRS rrom This ~eques, void~1 18 months from /S'17 .D 36719 Hequest Dat¢ Fire No. ouph-In Inspection _ RepuireA? ~Ready Now~W~a~ ill NotifY 1~spec- ?Yes o When PeadY lcensed EIecVical ConVactor 1 hereby reqaest inspaction ot ebava ,Q bwner electrical work instellad et: Street AdAress. Boa or Route No. C'tY 38o t r •44l ectron o. Townsnip Name or o. Ran9e No. Counly DA kov4 OccuDantlPfllNTI Phone No. Power SupOlier l ' Atldress Ele cal Contractor ICOmuany Namel Convar.tor's License No. ~roTflE~s o~/ e MailinB.4dJress ICOnVactor or Ownee Making Instailationl 1902 kF S'f ~ Ss a Authorized Si ture IC ~~ract Owne akinB st Ilatiun Phone Number MINNESOTA STqTE BOAND OF ELECTqICITY THIS INSPECTION PEQUEST WILL NOT Griges-MidwaY Bldg. - Noom N-191 BE ACCEPTED BV THE STA7F BOAND 1827 Universitv Ave.. St. Peul. MN 65104 UNLE55 PPOPEN INSPECTION FEE IS ENCLOSED. Phone (612) 642~0800 9/f/7j5~7 ; SQUESTuFOR EL~ECo Ro eA e I n~sP«m o10neck ot veuow coov. ' Ee-00007-06 ry ~ 77~s~ D J 6 71 9 "X" Below Work Covered by 7hrs Request Add Rep. 7ype ol Buileing ADPlinntea WireC Equiument Wiretl Home Range Temporary Service Duplex Water Heater Liqhtiny Fixtures Apt. BuilAing Dryer Electnc HeaLn Commercial Bldg. Furnace Silo Unloader Industrial Bldg. Air Conditioner Bulk Milk Tank Farm tnrr peu v _tnm ISnacHyl [ n~ su~dry omer ompute lnspection fee Below p Fee Service EnVanceSima M Fee Fexders/5ubfeetlers a Fep Clrcuits• 0 to 200 Am s 0 to 30 qm s 0 tn 30 Ani s Above 200 qmps 31 to 100 Amps 31 to 100 q y Swimming Poal Above 100_Am s Above 100_AmUs Transiormers Irngation Booms Partial.'Other Fee Signs Speciallnspection Nemark o TOTAL E u~e~^ HouBh-in Dnte 1,the Ele ^r. . Insoector, hereby cerlily thet the abave Final i ins0ection has been made. Thia repuesl voiE 18 montlre trom This reaues[ wid A~~ G~ Z ~ ~~~s~~6 ' ~ w 3a.sa flequest Date Fire No. ~uph-~i~n,' bo^ ~~0y Now ~11 Notity. Inspec- 5 ~Y¢s ?No lor When ReadY TOLicensed ec[riwl CanVa:tor , 1 herebY request impectim ot above wner ebclriol wvork hstalled at 5[reet Address, Box or Ibute Na. Gry,}- ~~`O f7' ~4° ur G R a~`1 cuon o. TownshiD Name a Na nge o. C nty Occu ~ t (RIINT) Phone No. t ` ' 2j/o Po r pli EI i Con ra m ICanVaw 1 ac~or s License N~ s ~ MeilinB AtlOress lC tor m OYwer Ya ' nsTai ationl z t A G~ Auth rized SiBm ICunva ~ r Yakinq 1 lation) re Nunb¢r YINNESOTA STATE BOAIm OF EIEC7RICIlt THIS INSPECTION pEUUEST MILL NOT C.ripys-Midway 81dg. - Ibm N-191 BE ACCEPiEU Blf 7NE STA7E BOAM 1821 University Ava.. 5t. Psul, ~~104 UNLEffi PROPEN INSVECTION FEE IS ENCI~D. Phoere 16121 2972771 Kt1UEST : tCT10N EB'°°°°'-°° l1,),, Sea i~si~to.s tor c..._ th:s tom m hsek uf rella eoPV- W~(L~K ~ 28846 ""'YF" Below Work Covered by This Request qCtl Rep. - TrYe of BuiWipp AVOliencas RbW EoW~t Mired Home Range Temporary Service Duplex WaiL4 Heater Lighting Fixtures Apt Buildirg Dryer Electric Heatin Conmercial Bldg Funkice Silo Unloader IrMkstrfal Bldg. Air Caditiater Bulk Milk Tank Faml hrr Pec~ ther (sVeciN) [her Swwifv Oiher Othet ompute fispection Fee Below Y Fae SarvieeE~anes5¢s k Fee Feedcrs/^sUbleeJere x Poe Circuits 0 m200 0 to30q 22- 5 tn30Am m Ahove 200 Amps 31 to 100 AaW 31 to tOQ Amps Swimning Pool Above 100_ A"Ws Above 100_Am ' Transtormers Irrigation BoarE Partial'Other Fee Signs Special Inspection S ~ TOTRL fEE flemarks 3;?-Jro flouBh-in ( Dale ~ ~ 41 1. M. Elechiwl ' Itapector. MrobY ~ cerli/y tlnt 1M abuve Final Date impeclion has been nwmauaM roiatemmuwtmm , CITY OF EAGAN ~1 - 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55721 N? 1rj7$ e BUILDING PERMIT PHONE:454-8100 Receipt# 'F gCo 4y To be used for BASEMENT Est. Value $1, 500 Date OCTOBER 26 19 88 Site Address 3809 WESTBURY DRIVE OFFICE USE ONLY Lot 3 Block 1 Sec/Sub. WESTBURY 2ND OnSiteSewage _ Occupancy MWCCSystem _ Zoning ParcelNo. OnSitaWell _ (AduaqConst a Name STEPHEN M. ANDERSEN Giry Water _ (Allowable) W PRV Required # ot Stories 3 Address S~ - o City Phone 497-4384 (W)_ Booster Pump _ Length Depth , o Name SAME 452-3297 (H) s.F.rotai ~ a AddreSS Footprint S.F. i- Ciry Phone pppROVALS FEES $34.00 ~ W Engr./Assess. Permit WW Name 1.00 ~ Planner Surcharge i z., Address Cit ' Phone Council Plan Review aw Y BId9. OIL SAC, City I hereby acknowledge thet I have reatl Ihis application and state fhat ihe Variance SAC, MWCC inbrmation is correct and agree to compty with all applica6le State ol WaterConn. Minnesota Statutes and City o Eaga~n( Ortlina~nces. Water Meter Signafure of Permittee Road Unit A Building Permit is issued to:--$TF-RHEN--ANDfiLiSEN- Treatment P1 oniheaxpresscondilionihatallworkshallbedoneinaccortlancewithall *g,yg (copy) .50 applicable State of Minnesota Statutes and City Eagap Ortlinances. TOTAL 35.50 BuildingOfficial - CITY OF EAGAN N2 10 9 8 5 ~ 3830 PiIM Knob Road, P.O. Box 21-198, Eagan, MN 55121 PHONE:4548700 BUILDING PERMIT Receipt # Ta M uwd far S" Ix"1G/GAR Est. Value $57 000 Dare 14AY 7 ~q 85 SiteAdd 3809 WESTBURY DR. Erect 11 Oceupencv Lot rys 91ock ~c/Sub. WE R ND Fiemodal ? zoning Repair ? TVVe of Conrt. V Parcel No. Enlarge ? No.Stories JOE MILLER CONST move ? Lengeh 41 W Name Oemolish ? Depth 3$ z~ ~ A~mF 18133 ARMINGTON CEDAR 43 AVE 1-20 SO D1 G~ade ? Sq. Ft. City Phone Install ? SAME AOVrsralf Feas Name .QO Zu Assessment Pertnit Address ~ City Phone Water d Sew. Surchorge 2$ • 50 PoliCe Plan Fieview 152.00 Name Firc SAC 525.00 W MKAddrass Erq. Water Conn. 500, O O P~ W City Phone Planrror Warer Metar 63,~ Q - Council Road Unit 99n _ nQ I hercDy ackrowladga that I have reod fhis applicotion and stnte tFrot 81dg. Off. 5 3$ S T. p-_ ~13 2. ~0 C tHe inlormotion Is correct ond ogree to comply with oll opplicabla APC 7ota1 ~?i i~~`s Stota of Minnesota Statutes `o]n~d ~"Ci~ty, ~of Eaflan Ordironus. Var. Date Sipnatum of PermiMee w Bullding Perm+t Is isswd to: 30E MILLER CONST pn the expmys conditlon Ihot oll work sholl be dona in occordance with oll oppli Stofa of Mi ne2 }ses ond Ciry of EoOan Ordinancea Buildinp Officlal - ~c ~ca' ,.12$~jA 2006 RESIDENTIAL BUILDING rExNUZ arrLrcaTiorr ~ City Of Eagan 3830 Pilot T{nob Road, Eagan MN 55122 Tetephone # 651-675-5675 FAX # 651-675-5694 New Construdion Requiremenis RemodeVFteoair Reouiremenis Office llse Onlv 3 regisffired site surveys showing sq, ft of lot, sq. ft. of house; and all roofed areas 2 copies of plan showing footings, beams, pisfs CeA pf Surv2Y,Recd ~Y _ N (20°h maximum lot wveraqe allowed) 1 set of Energy Calculations for heated additions Tree Pres Plan ReCd :Y _ N. 2 wpies ot plan showing beam & window sizes; poured found desgn, etc. 1 site survey for addRbns & decks Tree Pres Requved 7 N iseto(EnergyCalculaGons AddRion - rndicafeNon-sifesepUcsystem On-siteSepbcjSystem _'Y N,. 3 wpies of Tree PreseNalion Ptan it bt platted afler 711143 Rim Joist Detail Oplions selection sheet (buildings with 3 or less unBs) Minnegasco mechanical ventilation fortn . y ? Date 2_ / 3 b / C) k) Construction Cost Site Address -~`l~~ lof? UniUSte # Description of Work G~` puJ ~v- ~9~ l~ wdJ w A-1( $ x 1.5 Multi-Family Bldg _ Y~ N Fireplace(s) _ 0_ 1 _ 2, . Property Owner `j tevc ~ ~ /}Ed3 avf~ ~-fl-g Fw? Telephone # ( (n V ) y~d "329-7 Contractor ICJ ~CM Ss~'7~ ~ -ZN c-- Address ti- "s-0 O~ C~- w City ;.P State Zip 5~5-0S -7 Telephone # (?$~j ) -2 `fv- 7 6 K ~ COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672 Energy Code Category . Residential Ventilation Category 1 Waksheet • New Energy Code Worksheet (4 submission type) Submitted Submitted • Energy Envelope Calculations Submitted In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _ Y _ N If yes, date and address of master plan: Licensed Plumber Telephone # ( ) Mechanical Contractor I' Telephone ) Sewer/WaterContractor Telephone#( ) I. I hereby apply for a Residen lial ldirig Permit and acknowledge that the information is cornplete 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 far 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. , Applicant's Printed Name ApplicanYs 5ignature DO NOT VVRITE BELOW THIS LINE Su6 Tvpes ? 01 Foundation ? 07 05-plex ? 13 1Eplex ? 20 Pool ? 30 AccessoryBldg ? 02 SF Dwelling ? DS D6-plex 0 16 Fireplace ? 21 Porch (3-sea.) ? 31 Exf. Alt - Multi ? 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 (screen/gazebo) ? 36 Multi Misc. ? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-piex ? 12 12-plex tft 25 Miscellaneous ;Work.Tvpes : 1 . . ? 31 New ? 35 Int Improvement ? 38 Demolish Interior O 44 Siding ? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 33 Alteration ? 37 Demolish Building* ? 43 Reroof ~ 46 Windows/Doors ? 34 ReplaCement `Demolition (Entire Bldg) - Give PCA handout to appftcant Descripti011: Water Damage _ Yes Valuafion Occupancy K- 3 MCES System Plan Review 100% or 25% Census Code q.~ q Zoning -P-J) City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bldgs Length Fire Sprinklered Type of Const Y_ Width REQUIRED INSPECTIONS _ Footings(new bldg) Sheetrock _ Footings(deck) FinaUC.O. _ Footings (addition) ~ FinallNo C.O. Foundarion HVAC Drain Tile Other Roof _ Ice & Water _ Final _ Pool Ftgs Air/Gas Tests Final )d Framing _ Siding _ Stucco Lath _ Stone Lath _Brick _ Fireplace _ R.I. _ Air Test _ Final _ Windows _ Tnsularion _ Retaining Wall Approved By: Building Inspector - Base Fee • Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge 5&W Permit & Surcharge Treatment Plant License Search Copies Other Total 1985 BUILDING PERMIT APPLICAYION - CITY OF EAGAN NOTE: ALL CONTRACTORS HUST BE LICENSED YITH THE CITY OF EAGAN INCLUDE 2 SETS OF PLANS 3 CERTIFICATES OF SURVEY 1 SET OF ENERGY CALCULATIONS 5~,000- ° To Be Used For: ~ Valuation: . Date: Site Address: OFFICE USE ONLY Lot: J Block L Sect/Sub W Erect X Occu anc P Y R-3 _2 No Remodel Zoning R-1 Parcel /1 Repair _ Type of Const ~ Enlarge ll of Stories Owner Move _ Length 41 Demolish Depth 36 Address Grade Sq Ft City/Zip Code Phone APPROYALS Contractor (1440_ Assessments Permit Water/Sewer Surcharge ~.$O Address Police Plan Review Fire SAC SZS. ° City/Zip Code Engr Water Conn ~ 1I Planner Water Meter 6 3.°-0 Phone Council Road Unit 28p.'~ Bldg Off j?f Parks Arch./Engr. APC Treatment P1 132.= Variance c Address TOTAL ~J /011~• S~ City/Zip Code Phone 9 V [i.~ vJ- a.4 V - • ;oseph M. Miller Const. Co. 18133 Cedar Avenue South - Fbwmington, Minneeota 55024 DELMAR H. SCHWANZ LAND CURVFVOR$ INC awn.r.r~ uler. L aws nr inr 5dtr N Mmnnnta 11750 SOUTH ROBERT TRAIL ROSEMOUNT. MINNESOTA 55088 PMONE 61$ 1211789 11 ~C j~GdTT ~G~v SURVEVOR'S CERTIFICATE /-I Z. z~ 9 32.7q i¢4 Of E' dc./q NB9-99-io~.J ~qa. DrainRge and °Utility Eaeemen ~ ~ Scale: 1 inch ~ 30 feet ~ O Denotea iron monument M O Denotes set wood hub N 47.4~ ( N89• 39-o7E ~Z Proposed elevation ~ Existing elevation rq ~ r~ 6~ ~~~"5 5EM a ~l ~11~~ E EP y m I hereby certify that this is a trup ~ ~ 25 14 repreaentatlon of Lot 3, Block 1, ~ +o ~p wEqTgURY SDCOND ADDITION, according w„ ~,~oPosEO ~ ~ T0P to the recorded plat thereof, Dakota CouGty, Minnesota. N~~ ry,~~ufE ~ f~ 6 G QM t~ ,4 s la pr~ o e q~~ ~ ~ r ~ ~ I qpR 2 9196 ( : b o p1.6/=7oPN~r ' 1 991$q,. ' NOEes: o JI 1<1 Plan 83-106 Plan le flipped 'I N 21 3) Proposed garage floor elevation from ~ Development Plan s 892.5 y0 S9• ~z 4) Houae staked 4-23-85 R s6!'P=~' ~ a~a l 4 ~ gqa,~ . ~v~s>/lurzy o ' ea6 MINNESOTA REGISTRATION NO. 8625 Dlri~E ° 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN 3830 PILOT 55122 l4 S.~~ Q'&S-'ZZ New Consirueflon Reaulremenfs Remodei/Reoah ReaulremeMs D 3 regbtered ske suneys showing aq. H. of lof, sq. R. of house 2 coples of plan and 21I roofed areas (2046 maximum lof ceveroae allowed) 7 set ot anergY calcnlaNons Sor healed addHions ? 2 coples of plans (show beam a window sixes; poured Ind. design; ete.) 1 alle wney for exfedor addlNOns J. decks ? 1 sei of energy calculallons ? S coplea of hee presenaHon plan 91W plalted aMer 7/1/93 ' DATE: L~GI9 CONSTRUCTION COST: ZS DESCRIPiION OF WORK: AddiLaL'\ STREET ADDRESS: '3 t O UR Y LOT: ~ BLOCK: ~ SUBD./P.I.D. "A~ ~QA a n Name: 14 n 04.R8or,) sTtllc Phone +c I^ Ys Z-.3L 9:2 PROPERTY Last Fkg OWNER StreetAddress: 3909 t_s-~£ST BV2y bk~ v CffY ALJ t`x-) State: )14kl . ZIP: T)a6i~ ~oMa Company:14tlT-' CpCnCJ- -~,,t,C. Phone#: 6[2 (°3p~ a~SS (area code) CONiRACTOR Sheet Address: 95-V O1t!707- l.t>- License #-N6 6 6 Exp. Z 001) City State: 0/0. Zip: ARCHITECT/ ENGINEER Company: Name: Telephone area code ( ) Shedt Address: Regisfration Cryy Sfate: Zip: Sewer 3 water Itcensed plumber (reauired for new constructbn onN): PenqlFy applies when pddress chonge ond lot change is requested once permN Is Issued. I he'reby acknowledge ihat I hove reod this applicaflon, aiate thaf fhe informaflon Is ect, and agree to comply wRh all appllcabl Stat,s of Minnesota Stafutes and CMy of Eagan Ordinanees. Signature of AppUcant._~ . OFFICE USE ONLY _ Certificates of Survey Received ` Yes _ No AUG I 8,`~9 Tree Preservation Plan Received _ Yes ! No _ Not Required -1~----- OFFICE USE ONLY . , BUILDING PERMIT TYPE ? 01 Foundation ? 06 4-plex ? 11 10-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 02 SF Dweliing ? 07 5-plex ? 12 12-plex ? 17 Garage JJ9~ 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 ? 18 Lower Level ? 24 5torm Damage O 05 3-plex ?'10 8-plex ? 15 Lodging ? 20 Pool 25 Miscellaneous woRK nrPe ? 31 New ? 35 Tenant Impr ? 39 Gas Line Only ? 43 Siding/5offits/Fascia )3". 32 Addition ? 36 Move Bldg. ? 40 Gas Insert ? 44 Windows/Doors 0 33 Alteration ? 37 Demolish Bldg' ? 41 Wood Stove ? 45 Fire Repair ? 34 Repair ? 38 Demolish (Interior) ? 42 Reroof " Give PCA handout fo applicant for demolition permit GENERAL INFORMATION Const. (Actual) 5f-i Basement sq. ft. ( eI 2 Census Code (Aliowable) 5^1 Main level sq. ft. I°LZ SAC Code o I UBC Occupancy R 3 sq, ft. No. of Units Zoning r-T sq. ft. No. of Bldgs ~ # of Stories 2 sq. ft. MC/ES 5ystem Length l(v sq. ft. City Water Width l Z Footprint sq. ft. Booster Pump PRV Fire Sprinklered APPROVALS Planning Building l V Engineering Variance Permit Fee Valuation: $ Surcharge ~.UU Plan Review I-l 2-~L ( 12X - l`I'z License y~~ MC/ES SAC l°12~ ~ 2y = Q~a,oo e-' City SAC Water Conn. a.aWater Meter TiS~kL % I S, I l08 - Acct. Deposit S/W Permit S/W Surcharge Treatment PI. ,i Park Ded. Trails Ded. - Other ' Copies Total: '~Lt `E;, L ~ SAC Units % SAC - WESGOTT ROAP - j DRAINAOE AND IJTILIl"Y EASEMENT ' 14 47-k 3/4" ~ ON ~ ' ~ ~ , , ~ , WILLIAMS f5R05. I ~ t1i PiPELINE EASEMENT l z I Dllt PROP05ED ~ - - - - ~ = ' ~ ~ ttGtJSE ADDITION ~ ffUTURE 8'Xi2' DEGK DY OWNER EXI~--i !N,r^, ~ ~f j ~ 1 t1U,J6E I51 ~ I~( W , IN~I ~ C~AeA6 ~ m INFO;ZMATION GONTAINED ON I Tt16 DRAWINO TAKEN FROfvl SLARVEY PREPARED f5Y DELMAR ft SGMWANZ PLAN ND. 83-IO~v WESTDURY , DfZiVt C~/QC~fR~G~I UY r D;E 11. , o - 11o1 fi'J!LDING lNSPECTION'S DEPT, ~ 1988 BUILDING PERMIT APPLICATION - CITY OF EAGAN SINGLE FAMILY DWELLINGS I*~'-'-'.oa: 2-cF'FS-6F pLANS-o-74~E'A'FTF~-ICATES OF SURVU~: OF ENERGY CALCULATIONS NOTEs ADDRESSES FOR CORNER LOTS - CONTRACTOA/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BDILDING PERMIT IS ISSUED. MULTIPLE DWELLZNGS RENTAL ONITS FOR SALE UNITS # OF UNITS INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECR WITH HLDG. DEPT., 1 SET OF ENERGY CALCULATIONS CONAfERCIAL INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET (SF SPECIFICATIONS AND 1 SET OF ENEAGY CALCULATIONS To Be Used For: ;>PtS~~I'~!~ ( Valuation"'y~- Date: Site Address 3Frdl ()2. OFFICE USE ONLY k-- Lot ~ Block On site sewage_ Occupancy p MWCC system 2oning Parcel/Sub rr/- 4- On site well Actual Const City water Allowable Owner m) PRV required _ !F of stories Hooster Pump _ Length Address MM N2, Depth S.F. Total City/Zip Code Iss k~-3 Footprint S.F. Phone APPROPALS FEES Contractor Engr/Assess Permit Planner Surcharge Address Council Plan Review Hldg. Off. SAC, City City/Zip Code Variance SAC, MWCC Water Conn Phone Water Meter Road Unit Arch./Engr. Treatment P1 Parks Address Copies TOTAL City/Zip Code Phone lt ° " ~ 1 ~ t C;`~`~ ~ 2/84 ~F,_ ; ~ ` CITY Oe EAGAN ~ ~ '~:C~~ ~ ~ APPLICATZON FOR PERMIT SEWER AND/OR WATER CONNECTION (PLEASE PRINT) 1) PROPERT'Y ADDRESS: 3~O ~j ~ f~~F,~ r~c~,~w DE..~przev: 3 1 (Lot/Block/Su~aLVision or 'rax Pascel I.D. Lltu7iber) ~ I"r =.~;I~'~'=:G S'_T'~CCP':'~E, DATE O~' ORIGi ?AL u;Ii.llL`:G °.~:•'I: ISS~?tiG.: i` ~ PF~Sc-`..+?' ~:^.:Ti:F:/?'??OPOS~~J' II~': ? R-1 Si~;GL: FP~ISLY Ll R-2 CUPI....~"{ (TCp L`~:ITS) ? R-3 TCF.~.i~?CiJ~E (??~D^ + li:IITS? ! II~IIZ'S) ? cZ-4 A^r?R'!"~^]T/CG;S~C4'SiIL~1 ( Wi ITJ) ? CC}~M~CL1L/RF.':AIZ,/OF:'ICc: Q ~1'Cli5?,Tat, Q ~`75TI'IL'I'IO:VAL/Gvv'~`M~.'n.'T 2) ppp~~~~ (PLEASE PAI~Yi) NAi•~: Sec ~~Clr' a,nn~ss: ~~/33 C~:l/,~w ~1~c_ CIT`_', ST?:T~'. ZIP: ~~„_~~v ~U SSo~~ Pxo~: ~f31- / 3~ p~~ffi~ ~ME. {PLEASE PR1NT) ~ fOR CIiY OSE ONLY ~~/y~w.r-t, P/~.~,d ~ isf PLIIMBERS CE45E: PDC~E~S:-~! `~.?,?13 a3+^cP-~4u~ it/ ~ - - Active CITY~ STATE ZIP_: - Rlya~o~~~~ ~ ~ J3 Y'~ ~ i' Expired % ~ ~Aar-r, Q Hot o etord ~ PHOiVE:_-s,sy-,j/75 PLUHBER LICENSE /f f`~ - - a°t~" mS - . _ _ _ - a ~ nt' 4) ~'C;jap,iyT/Cr~-~~ (PLEASE PRI4T) NAME: AUDRESS: ,S9a~c J4s ~lio ~ CITY, STATE, ZIP: P}iC?~7E: 5} ~,~pIG*~TE ~yHICH PERtiLiT IS HEING RE~UESTLD: ~ CODINEC.~PION TO CITY SE,TriER ~CON~IFCSION 1t7 CITY WATER ? dPE~R (PL,£~SE DESCRIBEI 6) ~DIG,.~ C::r.:~_ _ _ - - - - _ . CJ ~ aSE.=f?OID-APPRf7VED PER.'~iIT FOR PZCF:-L'r BY-ONE'QF }SF~£-- - ? PI£i+SE MAIL APPROVED PEP~iST TrJ 1, 2, 3. 4 AFOVE (Circle one) 7) SI(,.`~TLiiE: _ GL./~}~o2c~/)c~ DATE_ /y/.4-9~~P !~S . ~e ~e aa~w~~e:~ r s acaa~ra a~ e+rnrasara ar s s~sas7:~ a w r.eaae!~srs ~r a~~asr~saae,r FOR C I T Y U SE ON;,Y PE?2MIT " ISSUED F°LS: $ SE:^iER ncT2"!rT (I`IC:.[:D: SUAC4?RGE) $ O.}U WATER PERI4IT (INCiUDE c-iiRC:3ARGE) $ WATER METER/COPPERHORN/OUTSIDE READER $ WATER TAP (INCLUDE CORPORATION STOP) $ SESdER TAP $ $ ACCOtiNT D.F.POSIT - F)AT°R $ --s-017. ao WAC $ O SAC $ TRli,IK WATER ASSESS??E27T $ TRliNK SEWER ASSESSMEDiT $ LATERAL BENEFIT/TRUNK SE?•::,'R $ LATERtIL BENEFIT/TRUNK SVATER $ v • pTHER ' $ TOTAL $ AMOL'NT PAZD; RECETPT 4 J/ 7j-,7 DOES i7T2LITY CONNECTION REQUIRE EXCAVATION IN PUBLZC RIGi-IT OF WAY? ~ YES IF YES, THEN P, "PERMIT FOR `r]ORK WITHZN PUBLIC ROADWAY" MUST BE ISSUEO BY TFiE O ENGINEERING DIVZSION. LIST AS A CONDI- TION. SUBJECT TO THE FOLLOWING CONDZTZONS: ' APPROVED BY: TITLE: ' DAT°: ~ me ~ncw wt-ra wpw wEa w mw "Imm w"+ rum ptmw =i~ ~ ~ as ae wiw w±a Pcm aa si-o w m r - - - - - - - - - - - - - - - - - For Office Use Permit 17 City of Ea al 47' r, 0 Permit Fee: l V 3830 Pilot Knob Road Eagan MN 55122 Date Received: Phone: (651) 675-5675 Fax: (651) 675-5694 Staff: 2009 RESIDENTIAL BUILDING PERMIT APPLICATION L'3/~ Date: Li Site Address: Tenant: Suite RESIDENT I OWNER Name: S l Y A,n1.6, P_s Phone: lay f ° 4S 2 Address/City/Zip: 31°C W c-s't '4 An. 7kC,,kM MN ~S( 2.-S Applicant is.. Owner Contractor TYPE OF WORK Description of work: c I i ti S C 3 O uS E Construction Cost: Multi-Family Building: (Yes / No r- CONTRACTOR Name: 3 Z--F License Address: City: State: Zip: Phone: Contact Person: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING _ Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672 Energy Code • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet Category Submitted Submitted ('l submission type) • Energy Envelope Calculations Submitted 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 City to conclude that they are trade secrets. 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 unerstand this i of 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 wait he appro d n in the case of work which requires a review and approval of plans. Applica t,7s Pri t Name Applicant's Signature Page 1 of 3 F r + �r s€ e tau"- ` ",., Iy a '{y7 "tar R ac1 P&PMJT tip 2 , 3 73 1 DAIS. • —IT —$ t► of Units: I Jo M3IIsr Coast. Add ` ilest 'Dt;-L3;11 ► 2 pl P youths 5+-6 -85 I 51453 It7U.U0pd !s ear tlts Cllr gees 425.00pd t~ mss. ,` ttr 15.00 r , Fee. 10.00 polo of,,'" .�s� Tk • 1 . ' i ZAV5-- . .` �• Dote Paid: 4,11 City of Eagan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 r Use BLUE or BLACK Ink For Office Use Permit #: 10357 r� d� Permit Fee: tO11 Date Received: LO N1 i3 Staff: a13 2013 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: 6,11 > rl3 Tenant: N Site Address: E S'0 AI i Suite #: .� Resident/Owner Name: 5-%e.V� j4ruc��,�%� -5`7 Phone: %Sf Li S 2 Address/City/Zip: Ree? Wt'S-bury blie. L4 -AN A-/ cct 2S =COmtlactOr� Name: License #: Address: City: State: Zip: Phone: Contact: Email: Type of Work New Replacement Repair Rebuild Modify Space Work in R.O.W. — —_ Description of work: mil Type; RESIDENTIAL Water Heater Water Softener X Lawn Irrigation (_ RPZ / PVB) Add Plumbing Fixtures ( Main / _ Lower Level) _ Septic System Water Turnaround New Abandonment RESIDENTIAL FEES: $60.00 Water Heater, $60.00 Lawn Irrigation $60.00 Add Plumbing *Water Turnaround $105.00 Septic System Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge) Turnaround* (includes $5.00 State Surcharge) and $5.00 State Surcharge) TOTAL FEES $ (includes $5.00 minimum State Surcharge) Fixtures, Septic System Abandonment, Water (add $200.00 if a 5/8" meter is required) New ($10.00 per as built) (includes County fee 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.org 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 under tand this is n• 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 wit hith approv: d pla the case of work which requires a review and approval of plans. x Applicant's x S i c V€ Applicant's Signature FOR OFFICE USE Required Inspections: nder Ground Rough-1Air Test _Gas; T Motu o Construction,, Inc 8p50 gOth court west 6ortf ftokl, MN 55057 j t Oct A(4 -rgctR- a r\ J i : 4 $ . D 2. ,`tom X I IrvAs ••/'\)G 1r 1 X fx-revitt) ?4 ' rvb rfllt ,165-6-Hk REVIEWED DATE 3' DP:. BOLDING INSPECTIONS SMOKE DETECTORS SIRE REQUIRED Q* _QINa, GLINTAINING LOCATE SMOKE w m m OnW cn SSIZZ59Z56 NOIl0naLSNO0 O>1ZIOW I> m OCT-3�-2014 13:0a FROM:TP.EBILFOUNDATION SYS 3205938720 T0:16516755694 P.2�10 r , -�,.. . . � Use BLUE o�B�ACK Ink � For Offica uso ~� � , � �� 7, . .:_.>' � PORnlli: �� j I � I lt� 0� ��ll � � �� Po�„�Foo: 1 � � 3830 Pilot Knob RoAd � ;,a�;r� , , E�gan MN 66122 j Dato Received: j Phone:(661)676•6675 � 1 Fax:(651)675-5694 I Staff: � I � �o��, �-----__�_,�______.� �,�'R�SIDENTIAL BUILDING PERMIT APPLICATION Date: � 3ite Address: :S Unit�1: Neme: �.�Q, �C�Jl�J4�L. Phone: �o�—��—�s�� Resident/ � Owner Address I City I Zip; � � , n � Applicant is: Owner Co�tractor Type of Work Description of work: K�YI�� U)C� C�.IrQIJ'1�'U.,_,��,K.�2��tsis�i� �4�}j,� .r Construction Cost: 5 � Multi-Famlly Building:(Yes !No� .. � Compan,y:��'Qhl I Contact:.��1'(,5�"�Yl� Contractor �dress:��S I�.S I'1LO\J � 2, Ciry: �'Tt,.i'll'lo'�L,O� State:�_Zip:��,�____ phone: �O �� $7 a.R Llcense u:�C.�y��G Loatl Cerrincatp�: �A-T� /e��-g—� If the project is exempt from lead certiflcatlon, pleaSe explain why: (soo Pago 3 for edditionel informetion) COMPL�TE THIS AREA ONLY IF CQNSTRUCTING A NEW BUILDING In tho last 12 monthe,has the CIry of Eagan issued a pennit tor a aimllar plan ba9ed on a mastar plan? ,_,,,,Yes „�No If yes,date and address of master plan: 1.Iconsvd Plumber: Phono: Mechanlcal Contractor: Phona: Sewer 8�Water Controctor: Phono: NOTE:Plans and support/�g documencs that you submit are consldered to be pubflo iMormation. Portions of ttie jnforn,atlon may be class/f/od as non pubnc If you prov/de specl(!c ressons that would permit,the Clry to conclude that ihe are trade aecrets. CALL B��ORE YOU DIG. Ceu GopherSmta Ono Can a�(s51)a6e.00o2►or pro�ectlon apelnst underground uti�ity damage. Can ae houro before you Intend to tlig to recaiva locaces o�underground ulilitles. w�,yw�q�qre��go�,�r,�� I hereby�aknowlodqo Ihot thia infortnation is compleie and accurale;that the work wiil be in conformence with the ordlnanoes and codas of the C�ty ot � Eapan; that I undArrttand 1hiA ig not a pnrtnit, bul only an applicolion for a ponnit, a�d work I¢not to¢tart withoul a perm(t; lhat the woAc will be.ln eccordance with the approvoQ plen in d1e case of work whlch requinee a review and epproval af plens. Extarior work authorlxed by a Dullding permtt loeuad In eccoraan�a wlth tN6 Mlnnefote Stete Buildiny Coda muat 6o complocad wlthln 160 days o!permik isauanco, � Y CJlnrrs�►;ne Sm i�-�, x��i�,.�. �`��.' ApplicanYa Printed Nemo Appllcant'.Slgnature Pa�e 1 of 3 , _. . 3�� p 5��-j�r �( DO NOT WRITE BELOW�f'HIS LINE ��" p ��CP SUB TYPES I Foundation _ Firepiace _ Porch(3-Season) _ Exterior Alteration (Single Family) ' _ Single Family _ Garage _ Porch(4-Season) _ Exterior Alteration (Multi) _ Multi _ Deck _ Porch(Screen/GazebolPergola) Miscellaneous , _ 01 of_Plex _ Lower Level _ Pool _ Accessory Building '� WORK TYPES � ' i _ New _ Interior Improvement Siding Demolish Building* ', _ Addition _ Move Building _ Reroof _ Demolish Interior i� _ Alteration Fire Repair _ Windows _ Demolish Foundation �i _ Replace ! ' Repair _ Egress Window _ Water Damage I'I _ Retaining Wall 'Demolition of entire building—give PCA handout to applicant I DESCRIPTION � Valuation G?9D Occupancy ,r�G -�. MCES System ' Plan Review Code Editivn �,rtr7 SAC Units `� (25%_ 100% ti) Zoning pa City Water '' Census Code �3� Stories '�- Booster Pump •- #of Units / Square Feet �- PRV � #of Buildings / Length � Fire Sprinklers --- Type of Construction J�� Width --^ REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings (Deck) Final l 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 ase ee .--- Surcharge Plan Review �7 .�--- MCES SAC City SAC Utility Connection Charge S&W Permit& Surcharge Treatment Plant Copies �_�,3' TOTAL Page 2 of 3 PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA171543 Date Issued:08/20/2021 Permit Category:ePermit Site Address: 3809 Westbury Dr Lot:003 Block: 001 Addition: Westbury 2nd PID:10-83651-01-030 Use: Description: Sub Type:Residential 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 - Stephen & Barbara Andersen 3809 Westbury Dr Saint Paul MN 55123--307 Champion Plumbing 3670 Dodd Rd., #100 Eagan MN 55123 (651) 365-1340 Applicant/Permitee: Signature Issued By: Signature