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3819 Westbury DrAPR -11-2011 11:46 FROM:SMSM 7637854937 TO:6516755694 P.2'2 411N11' CityofEaali 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink Permit e: PemnI Fee: Dete Received: Staff: 2011 MECHANICAL A`,�PERMITAPPLICATION _J Date: Site Address: 15. I Y V �'ST OI t any l ‘Pe—, Tenant:.. <hNNA' S� "4 P-•C`�+✓\ 44c h': 1 Suite 5: J RESIDENT 1 OWNER Name: ", .g Q,/,r� Address f City / Zip: Phone: CONTRACTOR Name: F�li�Yl l 0 1 e t= -a h� License #: 6 e9Sq 7 Address: 1))e `3,W.,i-g City: di, c.I 0. I 6 State: PIN V__ zip: ...5-.4.39., . - . =Phone: 7 (G, 5 - 7c 1 - l _ Contact i sEmail: 111 V c •2. f doti . `._ TYPE OF WORK New )L Replacement Additional Alteration Demolition _ Description of work: _ _ NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened by City Code. Please contact the Mechanical inspector for Information on permitted screening methods. .....-- PERMIT TYPE RESIDENTIAL \/ Furnace _ COMMERCIAL New Construction Interior Improvement Air Conditioner _ Install Piping _ Processed Air Exchanger _ Gas ,-.— Exterior HVAC Unit Beat Pump _ Under / Above ground Tank (_. Install/ , Remove) L 1 (- - r I. .,,..11 Other �+E i+" ,,_ eovIng tank(s), cal for inspection by Fire "• VViten Inatallinghm Marshal and Plumbing Inspector RESIDENTIAL FEES: 555.00 Minimum Add-on 1n{'8 ca' or alteration to an existing unit (includes burned out appliances, ductwork, eta) (includes — no (1\C L --J( 55.00 State Surcharge) f�'�C� 55.00 State Surcharge) $_ : 2" 4)0 TOTAL FEE 595.00 Fire repair (replace COMMERCIAL FEES: 575.00 Underground tank 555.00 Minimum (includes Installation/removal OR State Surcharge) $10,010, surcharge is $ 5.00 ;surcharge increasers by $.50 for each $1.000 Permit Fee requires a $ 5.50 surcharge) Contract Value $ x 1% = 5 Permit t=ee - It the Permit Eee is lees than l=ee N. $ Surcharge If the Permit tee is > 510,010, 0.0. 0 $10,010.$11,010 Permit $ TOTAL FEE qAL}, B1 FcRE YOU Clic. Call Gopher State One Call at (851) 41140002 for protection against underground Utility damage. Ceti 48 hours before you Intand to dig to receive locates of underground utilities. www.e)phsrstp egglesaU,grg I hereby acknowledge that this Information is complete and accurate; that the work will be in conformarnCe with the ordinances and codes of the City of Eagan; that i understand this Is not permit, but only an application fora permit, and work of to start without a - rnhil-, that the work will be In accordance with the approved plan in the case of work which requires a review end approval of plan x v ‘‘ \CA. IN"\\DedAS Applicant's Printed Name FOR OFFICE USE Reviewed By: Data: Required inspections: _Under Ground _ Rough In fur Test _Gas Service Teat In-itoor Heat Final Exterior HVAC Screening inspection , • CITY OF EAGAN 9664 3830 Pitot Knob Road, P.O. Box 21-199, Eagan, MN 55127 PHONE: 454-8100 - BUILDING PERMIT Receipt Te b, wed fer SF DWG/GAF2 Est. Volue $62,000 Date NOVEMBER 5 19 84 SiteAddress 3819 WESTBURY Erect EIK Occupancy R3 Lot 5 Block j S-1sub. WESTBURY 2 Remodef ? Zoning Percel No. Repair ? Type of Const. Enlarge ? No. Stories 6 Name JOSEPH MILLER CONST Move ? Lenyth 5 z Address demolish ? Depth 38 ~ City F I ohe Grade ? Sq. Ft. Approvob Fees , F SAME Name oU Address Nssessment Permit ' u~ City Phone Woter 8~ Sew. Surchorqe 31 . 00 0 ti Police Plnn check 159.5 W W Name Fire SAC 525.00 ti y1 Address Enfl. Water Conn. 4 7 Q ~ W City Phone Plonner Water Meter 6 3. 0 0 Council Rocd Unit 2 b9-0 I hereby otknowledge thot I have read this opplicotion ond stote that gldg. Off. a[*a (copy) 1 V u the inlormution is correcf and ogree fo tomply with all applicable APC Tatal , ' Stote of Minnewto Sfatutes and City of Eagan Ordirpnces. Var. Qate Sipnoture of Permiftce l A Buildin9 Pertnit is issued to: JOSf MILLER CONST on the express condition thot oll work shall be done in accordonte(+Nw-ol opplicoble S~tate of Minnesoto Statutes ond City of Eagan Ordinances. r Buiidinq Officiol - - ~ ~L - - -j ~ Permit No. Psrmit Holdsr Dats Plumbing H.VA.C. Electric Softener Inspection Date Insp. pther r Footinys k ~ P U(~ (.J ~i O l~ G~ P Foundation Framing Rough Plbg. Rough HVAC Inwlation Final Plbg. Final HVAC r Final ~ Cert/Ocx. Water Describe Location: YYell Sewer Pr. Disp. CITY OF EAGAN ,f J983 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHON E: 454-8100 BUILDING PERMIT Receipt# - To be used for Est. Value Date J1' LY io 19 Sfite Address OFFICE USE ONLY Lot Block ' Sec/Sub. '''JTTj~ 2t'U On Site Sewege _ Occupancy MWCC System _ Zoning Parcel No. On 5ite Well _ Type of Const City Water _ (Actuaq a Neme (Allowable) w * of Stories 3 Address Length O 12 Depth City Phone S.F. Total , p NBme Footprint S.F. o~ Address APPROVALS FEES ~ City PhOne ' Assesaments Permit a Surcharqe ~ WaiedSewer ~ W Name Police _ Plan Review _ z Address Fire _ SAC, Ciry vZ Engt _ SAC,MWCC i W City Phone Planner _ Water Conn. Council _ Water Meter I hereby acknowledge that I have read this appllcation and state Bldg. Off. _ Road Unit that the information is corcect and agree tocomplywith all applicabfe APC _ Treatment P1 State of Minnesota Statutes and City of Eagan Ordinances. Variance _ Parks Copies Signature of Permittee TOTAL ° A Building Permit is issued ta: on the express condition that all worlc shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official Parmlt No. Permit Nolder Date Tslsphone Plumbing H.V.AC. Electric Softener Inspection Data Ins . Comments Footings I S Footings II 7' Foundation Framing Roofing Rough Plbg. Rough Htg. Isul. Fireplace Final Htg. Final Plbg. eldg. Final Cert Occ. Temp. LP Deck Ftg. Deck Frmg. 4,0 Well Pr. Disp. ' ^ CITY OF EAGAN ~ ^ ~ 3830 Pllot Kneb Road, P.O. Box 21-199, Eagan, MN 55121 PHON E: 454-8100 BUILDING PERMIT Receipt ~ To be used for Est. Value Date • ' ' ,19 ' Site Address OFFICE USE ONLY Block SeGSub. On SRe Sewage Occupancy Lot MWCC System Zoning ParCel No. On Slte Well (Actual) Conat a Name i Tt.; 5! 1'r: f NAhCY `)L~F+:t CitY Weter (Allowable) w A PqV Required * of Stories 3 Address Booster Pump Length Z~ 0 City Phone Depth ~ , p Name S.F. Total _ AY t. Footprint S.F. o u Address U ~o City Phone APPROVALS FEES Engr./Assess. Permit • . , ~ y~W Name W ~ Planner Surcharge ~ ~ Address W. W City Phone Council Plan Review Bldg. Ott. SAC, City I hereby acknowledge that I have read this application and state that the Variance SAC, M WCC information is correct and agree to comply with all applicable State of Water Conn. Minnesota Statutes and City of Eagan Ordinances. Water Meter Signature of Permittee Road Unit A Building Permit is issued lo:_ Treatment P1 on the express condition that all work shall be done in accordance with all Pa~s appiicabfe State of Minnesota Statutes and City of Eagan Ordinances. TOTAL Building Officiai_ Psrmit No. Psrmit Holder Date TeIephons # Plumbing H.V.A.C. Electric ;,~%%r~~~ '~:td1 • /'L-L iC~.~_>` `5~,.., i z' Softener Inspectlon Dste Insp. Comments Footings 1 • Footings II Foundation ~ yov ~~~~1~7 ~,6 • . :v~ce,~ ~ . Framing o i Roofing Rough Plbg. ' Rough Htg. Isul. ' Fireplace Final Htg. Final Plbg. Bldg. Final f IZ Cert Oca aLC- Temp. LP Deck Ftg. Deck Final Well Pr. Disp. CITY OF EAGAN ^ I n 3830 Pibt Knob Road, P.O. Box 21-199, Eagan, MN 55121 k, ~ 12045 BUILDING PERMIT PHONE: 454•8100 Receipt # FOUrIDATiUtJ Tobeuaadtor ADDi.TIOir' Est.Value $1,000 Date JUNE 4 1986 SiteAddress 3819 WESTBURY DR Erect ? Occupancy Lot-S_ Block 1 Sec/Sub. h1F5TBURY 2ND Remodel ? Zoning Parcel No. Repair ? Type of Const. Addidon 0{ No. Stories a Name DEN?yIS A PETERSON Move ? Length ; Address S~E Demolish ? Depth ° 454-0152 Int. lmpr. ? Sq. Ft City Phone Install ? °C Name SAME Approrab Fses o 00 i Address Assessment Permit $17•501 ~ Ciry Phone Water & Sew. Surcharge •50 ~ Q Police Plan Review F = Name Fire SAC x n Address Eng. Water Conn. < W CitY Phane Planner Water Meter Council Road Unit Iherebyacknowledgethatlhavereadthisapplicationandstatethatthe Bidg.Off. 6/3/86 Tr. PI. information is correct and agree to comply with all applicable State of Minnesota Statutes and City ot Eagan Ordinances. APC Perks Signature of Permittee Var. Date Copie ~ Total A Building Permit is issued to: 13ENNIS A PETBRSON on the express conditlon that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official ~ ~ g a m ~ ; ` t e ,o 3n •r Q r ~ x r _ ~ ~ ea¢i n m ~ C1 Mr n ~ ~ - 2 0 ~ v O g N ~ r s 04 cf ~ v ~ r e ~ ~ ~ x CITY OF EAGAN Remarks Addition WESTBURY SECOND ADDITION Lot 5 Blk 1 Parcel 10 83651 OSQ Cll Owner street 3819 Westbury Drive State Eagan, MN 55123 Improvement Date Amount Annual Years Payment Receipt Date STREETSURF. A~kAik 1986 2850.Q 0 0 2850.00 C010009 1-21-85 57. 5 STREET RESTOR. GRADING Water area 1986 133.79 8.92 15 133.79 C SAN SEW TRUNK 1985 325-24 91 6.8- 15 303.56 A015001 12-28-84 SEWERLATERAL 1986 5008.73 1001.75 5 5008.73 C010009 1-21-85 Watermain 1986 65.29 4.35 15 65.29 C010009 1-21-85 WATERMAIN A 1984 50.8 3.3 44.11 A015001 12-28-84 WATER LATERAL 1986 WATER AREA 1984 136.9 9-13 15 118.70 A015001 12-28-84 *Services 1986 STORM SEW TRK ` 1986 142.05 5 710.24 C010009 1-21-85 STORM SEW LAT 1986 CURB & GUTTER 51DEWALK STREET LIGHT Road Unit 260.00 WATER CONN. 470.00 " BUILDING PER. ri r n r. SAC 59500 PAR K INSPECTI4N RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued (612) 681-4675 SITE ADDRESS: ~ ' ' " ~ ' ' APPLICANT: (i~llN'/ fll: , • ~l ~~I~11~ PERMIT SUBTYPE: TYPE OF WORK: INSPECTION . , i ~ ~ Permft No. Pertnft Holda Date Telephona M ELECTRIC PLUMBING HVAC Inspectlon Date Insp. Comments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP80ARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL BSMT R.I. BSMT FINAL DECK FTG 9 ~ DECK FlNAL ~ ~ INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: ~ . ~ ~ ~ ~ ~ ~ ~ 3830 Pilot Knob Road Permit Number. Eagan, Minnesota 55123 Oate Issued: ~ ~ r . ~ ~ ; ' ~ (612) 681-4675 SITE ADDRESS: APPLICANT: ~ IJt ! l,l~1, Iiit NM 1 PERMIT SUBTYPE: TYPE OF WORK: ' I~IM i ~~~il ~ vli il ''I's INSPECTION D• • DA 14 f;l F - ~ L J PermR No. Permit Ho{der Date Telephone # . S/IN PLUMBING HVAC ELECTRI 03 ELECTRIC Inspection Date ]:I=n.p. Commems Footings I Foundation Framing Roofing Rough Plbg. Rough Htg. Isul. Fireplace Firrel Htg- Orsat Test Final Plbg. Pibg. Inspector - Notity Plumber Consl. Meter EngrJPlan Bldg. Fnal Deck Ftg. Deck Flnal Well Pr. Disp. O ~ ~ Receipt 1GIECHANICAL PERMIT Permit No. ' CITY OF EAGAN .q 7 Fee Fill in numbered spaces S/C Type or Print legibly Tot. 1. Date 2, Installation Cost 3. Job Address LotBlk. ~ Tract' ~ 4. Owner 5. Contractor Phone 6. Address 7. City State Zip 8. Building Type: Residential fa Commercial ? Ir.stitutional 13 9. Work Description: New ? Add [~7 Alter ? Repair ? 10. Describe Fuel Type 11. No. Equinment STU - M. Ea. No. EQUipment CFM Forced Air Air Handling: Mfg. Boilers Mech. Exhaust Mfg. Unit Heater Mfg. Other Air Cond. Mfg. 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 Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 Receipt 1MECHANICAL PERMIT Permit No. CiTY OF EAGAN Fes FiII rn numbered spaces S/C TyQs ar Prinf /eglb/y Tot. 1. Date 2, Installation Cost r ; ~ ~ 3. Job Address Dglk./ T/ ~ ~ 4. Owner ~ . I 1`~ 1\' 1~ `t ( 5. Contractor Phone L' 6. Address 7. City Stete 1 Zip - ~ 8. Building Type: Residential Commercial ? Inatitutional ? 9. Work Description: New Q- Add ? Alter O Repair ? , ; t 10. Describe Fuel Typer'_ 11. No. Fquinment BTU • M. Ea. No. Equipment CFM Forced Air Air Handling: Mfg. • " ~ ( ~ Boilers Mech. Exhaust Mfg. Unit Heater Mfg. Other Air Cond. Mfg. Gas, Piping Outleu 12. I hereby certify that the above information is true and correct, and I agree to comply with af I ordinances and Codes governing this type Qf work. Signed : c. , -i - for , , , _ , . _ R gh Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 Receipt PLUMBING PERMIT • Permit No. CITY OF EAGAN ' Fae ' Fill in numbered spaces S/C Type or Print legib/y Tot. 1. Date 2. Installation Cost f 10, 3. Joh Address )LI~ot Blk. Tract 4. Owner ~ ' - 5. Contractor ' ~ I t `t Phone 7'...,i 6. Address 7. CitY State Zip 8. Building Type: Residential O` Commercial ? Institutional O 9. Work Description: New Add ? Alter O Repair O 10. Describe 11. No. Fixtures No. Fixtures Water Closet t ~ ~f Cesspool/Drainfield Bath tubs Septic Tank Lavatory -r 141- ~ Softner Shower ` 7•" Well Kitchen Sink Urinal/Bidet Other ~ Laundry Tray Floor Drains Drinking Ftn. Slop Sink Gas Piping Outlets 12. 1 hereby Certify that the above information is true and correct, and I agree to comply with all ordinances and code3 governing this type of work. , Signed : ` . for% Rough f inal Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 I • : CITY OF EAGAN N_ 14 2 9 7 3830 Pilot Knob Road, P.O. Box 21-198, Eagan, MN 55121 BUILDING PERMIT PH ONE: 454-8100 Receipt# -1 D To be used for ADDITION Est. Value $19, 000 Date OCTOBER 13 1987 Site Address 3819 WESTBURY DRIVE OFPICE USE ONLY Lot 5 Block 1 Sec/Sub. WESTBURY 2ND OnSiteSewage - Occupancy MWCC System _ Zoning Parcel No. On Site Well _ (ACtuap Const a Name DENNIS PETERSON/NANCY DEAN cirywater _ (Allowabie) z Address SAME PRV Required _ # of Stories ° City Phone 454-0152 6ooster Pump _ Length 16 Depth 14 , o Name RELIABLE BUILDERS INC S.F.7otal ~Q Address 2575 FAIRVIEW AVE FootprintS.F. ~ City ROSEVILLE phone 639-0761 APPROVALS FEES Engr./ASSess. Permit $156.50 ~W Name 9.50 _ = Planner Surcharge Address 78.25 Q W City PhOne Council Plan Review Bldg. Off. SAC, City I hereby acknowledge that I have read ihis application and state that the Variance SAC, MWCC information is correct and agree to comDlY with all applicable State of Water Conn. Minnesota Statutes and City an dina es. Water Meter Signature of Permittee 12jl?4-9~ Road Unit A Building Permit is issuetl to:RELIABLE Ri'TT.TIF.RSTNC- Treatment P1 on the exOress condition that all work shall be done i n accordance with all applicableStateofMinnesot3[.6(~a tu~[esandC_ityp/q'] EaganOrdinances. Parks BuildingOtficial 0~--~-Y /l O~.,D TOTAL ~244.25 S CITY OF EAGAN - r - 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 N2 12045 PHONE: 454-8100 BUILDING PERMIT:FOU Receipt# To be used for ADD Est. Value $1r 000 Date JUNE 4 ,~y 86 ~1 SiteAddress 3819 WESTBURY DR Erect 13 Occupancy Lot 5elock 1 Sec/Sub. WESTBURY 2ND Remodel ? Zaning Parcel No. Repair ? Type of Const Addition M No. Stories W Name DENNIS A PETERSON Move ? Length Demolish ? Depth o Address SAME Int. Impr. ? Sq. Ft Ciry Phone 454-0152 Install ? o Name SAME APProvals Feea address Assessment Permit $17.50 ~ Ciry Phone Water & Sew. Surcharge .50 Police Plan Review t z Name Fire SAC ~ a Add.ess Eng. Water Conn. a W Ciry Phone Planner Water Meter Council Road Unit Iherebyacknowledgethatlhavereadthisapplicationandstatethatthe gldg.off . 6/3/86 Tr.PI. infvrmation is correct and agree to comply with all applicable State of Minnesota Statutes and Ciry of Eagan Ordin'aAnces. APC Parks Signature of Perrn'tta= ~~~r lY Z~~ Var. Date Copies..~ Total al~ vu A euilding Permit is issued to: DENNIS A PETERSON on the express conditlon that all work shall be done in accordance with all applicab^le Stat!e f Minnesota S tutes a C' of Eagan Ordinences. Building Ofiicial / X if ~ CITY OF EAGAN N! 13 9 8 3 . ' 3830 Pilot Kno6 Road, P.O. Box 21•199, Eagan, MN 55127 BUILDING PERMIT PHONE:454•8100 a ~ Receipt# Tobeusedfor DECK Est.Value $10,850 Date JULY 28 1987 Site Address 3819 WESTBURY DR OFFICE USE ONLY Lot 5 Block 1 Sec/Sub. WESTBURY 2ND OnSiteSewage _ Occupancy MWCC System _ Zoning Parcel NO. On Site Well _ Type of Const City Water _ (ACtuap a Name DENNIS DEANS (Allowable) w # of Stories ; Address SAME Length 0 City Phone 454-0512 oeptn S.F. Total , p Name AMRE Footprint S.F. 0Q Address 1935 CTY RD S2 APPROVALS FEES ~ Ciry ROSEVILLE phone 631-0450 q$$essments _ Permit $100.50 Water/Sewer Suroharge 5 _ 50 W W Nafl7e Police _ Plan Review 50.25 FW _A Address Fire _ SAC.Ciry u Engr. _ SAQ MWCC aw City Phone Plenner _ WaterConn. Council _ WaterMeter I hereby acknowledge that I have read this epplication end state BIdg.Ofl. _ Roaa Unit thattheinformationiscorrectandagreetocomplywithallapplica6le APC - TreatmentPt Stete ot Minnesota Statutes an City of Eagan 9Minance Variance _ Parks ~L Copies Signature of Permittee T TOTAL LS . 2 A Building Permit is issued to: AhRE ' on the express condition that ail work shall be done in accordance with all ap icable State o inpesota Statutes and City of Eagan Ordinances Building Offlcial - 0 t ~ CITY OF EAGAN N? 9664 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 4548100 .~h BUILDING PERMIT Receivt # Te M uwd fer SF DWG/GAR Est.Volue $62,000 Date NOVEM ER 5 19 84 SiteAddress 3819 Wh'STBURY Erect ?X Occupancy R3_ Lot 5 Block 1 sec/sub. WESTBURY 2 qemodel ? 2oning Parcel No. Repair ? Type of Canst. V Enlarge ? No. Stories W Name JOSEPH MILLER CONST nnove ? Lanyth 52 = Address 18133 CEDAR AGVE SO Demolish ? oepth 38 ~ City FARMINGTWone 431-2001 Grade ? Sq. Ft. SA14E ADProvals Fees o Name OU Address Assessmeni Permit ' ~ City Phone Water &$ew. Surchurge 31 . 0 0 Police Plan check 1,.59.50 ~w Name Fire SAC 52 5_ 00 T~ Address Erp. Water Cann. a 7 n_ 00 p W City Phone Plonrror Woter Meter 6 1 - n n < Council Rwd Unit 9 1; n . nn I hereby ocknowledge thot I have read ihis application ond stote that gldg.Off. 10/5/84 M*x C~ ~ 1. 00 the inlormation is correct and ogree to comply wirh all opplicoble APC Taal ~ Stofe of Minnetota $totutes ond Ciry of Eogai Ordi nces. Var. Date Slpnoture of PermiMee L2L~nn A Buildinq Permit Is issued to: JOSS MILLER CONST on fha express condition thai ull work sholl be done in accordoncewif" applicobje4tat~~e77 of M''innewta Smtutes ond Ciry of Eopan Ordirwncea. Buildirq OfflNot ~ ALL CONTRACTORS MUST BE LICENSED WITH THE CITY OF EAGAN Y ~ /jc~r~t ~y~-(~' INCLUDE ~ SETS OF PLANS, /J/ '7 ~ ( o 0 CERTIFICATES OF SURVEY 5, r SET OF ENERGY CALCULATIONS To Be Used For: Valuation: (pZ qOO, E-11 Date: 2-q_gq Site Address: ,38/~ r,t~ ~ 2 • • Lot:(5 Block:l Sect/Sub: Erect: X Occupancy: Q•Qj Parcel Remodel: Zoning: (~-1 Repair: Type Of Const: Owner: Enlarge: $ Stories: Move: Length: Address: Demolish: Depth: 3g City/Zip Code: Grade: Sq. Ft.: Phone p: Contractor: m,~~pn ~ Address: ~ Assessments: Permit: City/Zip Code: Z(~ ~^later/Sewer: Surcharge: / Police: Plan Rev.: 15°I•5D Phone #c 431-2001) Fire: SAC: '~->25, Engr.: Water Conn: 47p.a Arch./Eng: Planner: Water Meter & 3.!-' Address: Council: Road Unit: 2.6,0,°= Bldg_ Off.: /D S Parks: a City/Zip Code: APC: 2 coPieS Phnna$ - jr~ Variance: ~ lI 8 a6 ~O RESIDENTIAL BUILDING PERMIT APPLICATION I 3,7S 53VT_0 CITY OP EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 651-681•4675 New Construction Reouirements RamodellReoair Reouirementa • 3 registered site surveys showing sq. R. of;oL sq. ft. of house; and all roofed areas • 2 co0ies of plan (20% maaimum lot coverage allowed) . I u( of Erieqy Calculations for heated adaitions . 2 copies of plan showing 6eam S window sizes; poured found design, atc.J . 1 site survey for extenor aGditions 8 decks • 1 set of Energy Calculalions . Indicate if home served 6y seplic system for additions • 3 coDies of Tree Preservation Plan if lot piatted after 711193 . Rim Joist Oetail Options selection sheet (hidgs with 3 or less units) DATE VALUATION ~!1000 SITE ADDRESS 38 ~ 9 wMfAU4,A ~l/K. MULTI-FAMILY BLDG _Y XN TYPE OF WORK fIREPLACE(S) _ 0_ 1_ 2 APPLICANT &K-DOF Ar)Wl (Q ( Dr9 . STREET ADDRESS SO S .L 'N/ CITY STATE MZIP SS~ TELEPHONE # CELL PHONE # 1r1~'j"~10~'7I~b/~qV"Oan'SVY PROPERTYOWNER /\IG~G(if _PPCv120 TELEPHONE#k5L COMPLETE THIS SECTION POR "NEW" RESIDENTIAL BUIIDINGS ONLY Energy Code Category _ NfINNIS01'A RULES 7670 C:YfLGOR1" l MIVV GSOT:A RCLLS i6i`.~ (v submission type) • Residential VenGlation Category i Worksheet Submitted • New Energy Code Workshee[ Submittetl • Energy Envelope Calculations Submitted Plumbing Contractor. Phone Plumbing system includes: _ Water Softenec _ Iaavn Sprinkler Fee: S90A0 'Water Hcatei' Vo. of R.I. Baths No. of Baths 1#- Mechanical Contractor: Phone b[cch.mic,il scs[cm includcs: :~ir CondiUOnins; I-Ical Rccovcn Svstcm Sewer/Water Contractor. Phone • I hereby acknowledge that I have read this application, state that the information is correct, and agree to compiy with all applicable State of Minnesota Statutes and City of Eagan Ordi a e. Slgnafure of Applicant OFF[CE USE OvLY Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4/02 OFFICE USE ONLY 0 01 Foundation ? 07 OS-plex 0 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 06-plex ? 76 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi O 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4•sea.) ? 33 Ext. Alt - SF ? 04 02-plez p 70 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi ? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04•plex ? 12 12.plex Plbg_Y or_ N ? 25 Miscellaneous ? 31 New ? 35 int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (81dg)' ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement `Demolition (Entira Bldg only) - Give PCA handout to applicant Valuation Occupancy MC/ES System Census Code Zoning City Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bidgs Length fire Sprinklered Type of Const Width REQUIRED INSPECTIONS _ Footings(new bldg) FinallC.O. _ Footings(deck) FinaUNo C.O. _ Footings (addition) _ Plumbing _ Foundation HVAC _ Drain Tile Other Roof _ Ice & Water _ Final _ Puul _ Ftgs _ Air'Gas Tests _ Fina] _ Frarrung _ Siding Stucco _ Srone _ Fireplace _ R.I. _ Air 1'est _ Final _ Windows (new:'replacement) _ Insulation _ Retaining Wall P,pproved By , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S&W Permit 8 Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total , "Certificate for: Joe Miller Construction Arcadia lI "E" _ DELMAR H. SCHWANZ UND SUNVEY00.5. IMC AnQ.s,a,rtl UnOM lawx of TM SYIr M NmMMs 14750 SOUTH R08ERT TRAIL ROSEMWNT. WMi1E80TA 56068 P110NE 6I2171176Y SUNVEYOR'8 CffRTifICATE Propoaed garage floor elevation to be 18 inches above curb as per Joe Miller. ~ _889_5 _ House restaked September 28, 1984 e1°, ~ / Williams Bros. Pipeline Co. Easetnent Doc. No. 493206 I s 3cale : 1 inch ~ , \ •,g 0 Peet ~ Drainage 8a~ e eeea ( - 'uty ~easements • as.eo ; - - %I e:60.0 ~ ~ Y ~,o i? . ~ I M~ h I hereby certlfy that this is a true.4nd correct ~ representation of the following described tract of land: ~ Lot Block 1, WFSTBURY SECOND ADDITION, as wilT".be on file and of record in the office of the County Recorder, Uakota County, Mlnnesota. NOTE: No property cornera set aa of this date: Auguat 280 1984 Revised to ahow the location of a proposed house not ataked: 8-29-84 MINNESOTA REGISTRATION NO. 8825 ~ t WL4 CITY OF EAGAN 3830 PILOT KNOB RD - 55122 1985 BUILDING PERMIT APPLICATION (RESIDENTIAL) 881-4675 New Construrlion Reouirements RemodeVR@pair Requiremenfs ? 3 registered site surveys ? 2 mpies of plan ? 2 coples of plans (include beam & window sizes; poure0 fid. design; etc.) ? 2 site surveys (exterior eddkions 8 dedcs) ? 1 eirergy calalations ? 1 energy wlculations for healed addkions ? 3 wpies of tree pmsarvation plan 'rf lot platted aRer 7/1193 requirad: _ Yes _ No DATE: 'a- - ? S CONSTRUCTION COST: DESCRIPTION OF WORK: -p~- r- k STREETADDRESS: 2 b'!9 LuQSr~~rY ~R• F 61~bfq, LOT 5- BLOCK SUBD./P.I.D. PROPERTY Name: AWATe rSQN lsen Nr-S Phone `z` " o<s Z OWNER .a.. Gt~ ~sP3 Street Address• -3krQbbQ srb01 v 21"? . City: S-z;4~:a9 a, State: Af No_ Zip: S S"'r 3 CONTRACTOR Company: Phone Street Address: License City: State: Zip, ARCHITECT/ Company: Phone ENGINEER Name: Registration #Street Address• City: State: Zip: Sewer & water licensed plumber: Penalty applies when address change and lot change are requested once permit is issued. I hereby acknowledge that I have read this application and state that the information is corred and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY C`~~~~~~E 'DD Certificates of Survey Received _ Yes _ No MAY 0 4 1995 Tree Preservation Plan Received _ Yes _ No OFFICE USE ONLY i` r... ~,«...y BUILDING PERMIT TYPE 0 01 Foundation o 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish ? 02 SF Dwelling ? 07 4-plex ? 12 Multi RepaidRem. 0 17 Swim Pool ? 03 SF Addition ? 08 8-plex ? 13 Garage/Accessory ? 20 Public Facility ? 04 SF Porch ? 09 12-plex ? 14 Fireplace ? 21 Miscellaneous ? 05 SF Misc. ? 10 _-plex :1<15 Deck WORK TYPE A~r-31 New ? 33 Alterations ? 36 Move ? 32 Addition ? 34 Repair ? 37 Demolition GENERAL INFORMATION Const. (Actual) Basement sq. ft. MC/WS System (Allowable) Arain level sq. ft. City Water UBC Occupancy sq. ft. Fire Sprinklered Zoning sq. ft. PRV # of Stories sq. ft. Booster Pump Length sq. ft. Census Code. 4- Depth Foatprint sq. ft. SAC Code aL Census Bldg i Census Unit O APPROVALS Planning Building Engineering Variance Permit Fee Valuation: $ ~ Zoo Surcharge Plan Review License MCNVS SAC City SAC Water Conn. Water Meter Acct. DeposR S/W Permit SNN Surcharge Treatment PI. Road Unit Park Ded. Trails Ded. Other Copies Total: % SAC SAC Units . . . _ . , .T . _ . _ X l . . . , Certificate fors Arcadia lI "E" Joe N.iller Construction Hki 81/39 y,0 - i7&y DELMAR H. SCHWAIVZ 1AN0 CIINVEYOAi 111C ~ Aro•sWrn unan l+rS nl TM GMe M MinnnM* . 675~UTH ROOERT TNAIL ROSE40UNT. MINN[SOTA 55M MIOME i12 473-11FIND ~ SUNVEYOR'3 CENTIFICATE '1k £ NNhProposed garage floor elevation to bn ~ 18 inches above cnrb as per Joe Nliller. 889.5 ~ ~ Scale: 1 inch m 50 feet i O Denotee iron monun:ent ~ I o Denotea set wood hub N igilliame Bros. Pipeline Co. Vy Eaeement Doc. No. 493206 n\ / ~m tln~ ! t" \ y 1~~ ~ 'A ~ ° ~ ~e p9o ~I i 4 ~ 8 , 3'Y ~ 2y r i- 1 6AP. b '1°D 9g9,3 B~•y5 ~ '°Na+f~F s ~ e rainape % ~ Nn K qo~LuR6 " ~I3~5 : - r ',T ~r.t+• ~.A Pk~vE _ _ ..zo• n.~f S~EO_ IT - ~ ) i _ llb - Y6 • 3/ ~-/t fj ' re~> Denotes proposed elevation o, ro Denotes existing elevation W ~e.i I I herPb,y rertify that this is a true and correct represeatation of Lot 5, Block 1, 'dESTBIIRY SECOMD ADDITION, accoadiAg-to the recorded plat thPreof, Dakota qoumty, Minnesota. Also showinp., the location of a proposed houpe as staked thereon. October 15, 1984 MINNESOfA REGISTRATION NO. 8625 PERMIT cR4048 - CITY OF EAGAN 3830 Pilot Knob Road PERMIT TYPE: PermitNumber: BUILDTNG Eagan, Minnesota 55122-1897 025566 (612) 681-4675 Date Issued: 0 5/ 10 / 9 5 SITE ADDRESS: 3819 WESTBURY DR LO7c 5 BLOCK: 1 WES76URY 2ND P.I.N.: 10-63651-050-01 DESCRIPTION: Beiilding Permit Type DECK Building Work,,Type NEW , , ; REMARKS: FEE SUMMARY: Base Fee $30.00 Surcharge $.50 Total Fee $30.50 CONTRACTOR: OWNER: - qpplicant - PETERSON DENNIS 3819 WESTBURY DR EAGAN MN 55123 (612)663-6869 I hereby acknowledge that I have read this appla.cation and state Lhat tha information is correct and agree to comply with all applicable 5tate of Mn. ~ Statutes and City oP Eagan Ordinances. ~ APPUCANT/PERMITEE SIGNATURE ISSUE S ATU PERMIT c~- ~3 0 CITY OF EAGAN ~ .-~3 /f y~ 3830 Pilot I~nob Road PERMIT TYPE: L D I N G Eagan, Minnesota 55123 Permit Number: 0 2 4 5 9 5 (612) 681-4675 Date Issued: 0 9/ 2 3 J 9 4 SITE ADDRESS: 3819 WESTBURY DR LOT: 5 BLOCK: 1 WESTBURY 2ND P.I.N.: 10-83651-050-61 DESCRIPTION: (ABOVE GROUND) Br~ilding'-,P,ermit Type SWIM POOL Building Wo'Ir_k Type NEW \ / \ ~ jlb , / Ji~i~~ Ci~ LJ 1\~~ i , REMARKS: FEE SUMMARY: VALUATTON $40000 Base Fee $63.00 Surcharge $2.00 Total Fee $65.00 CONTRACTOR: OWNER: - Applicant - PETERSQN DENNIS 3819 WESTBURY DR EAGAN MN 55123 (612)454-0152 S hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Mn. L 5tatutes and City of Eagan Ordinances. J ~PLICANT/ RMITEE SIGNATUR~ ISSUED URE I~ ` C17Y OF EAGAN ~ 1994 BUlLDlNG PERMIT APPLICATION 14A 681-4675 SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy calcs. COMMERCIAL 2 sets of architectural & structural plans, 1 set of specifications, 1 copy nf energy calcs. Penalty applies: 1) when permit is typed, but not picked up by last working day of month in which request is made, 2) address is changed or 3) lot change is requested once permit is issued. Date Valuation of work ~.2 Oo SiteAddress:_ 3P/`t Le>eST6LrY STREET St1ITE H Tenant Name: (commercial only) l LOT BIACK ~ SUBD. P.I.D. # LD-Vf~~ outU~ Descri tion of work: 06V e Gtd vwd PO oL The applicant is: ,J$'Owner ? Contractor ? Other (Deseribe) Name ~-e7'R_rSoN ,6 -eni we- 'S A4 Phone Property LAST FIRSi Owner pddress 3&i y r.e-~ s id d STREET STE M City E•9 sy4w State S" Af Zip 5 3 Company Tti e160oL 5 To v P Phone IJS!- 77 7 p Contractor Address r9'Po c-kri51-f e,v.se.w i¢v2 License # Exp. City w~esr sr~ A+" 1, 5tate W w Zip 5-3"if,F Architect/ Company Phone Engineer Name Registration # Address " City State Zip Sewer & water licensed plumber Processing time for sewer & water permits is two days once area has been approved. 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 5tatutes and City of Eagan Ordinances. Signature of Applicant: Qe~.-~ 4 OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish ? 02 SF Dwg. 11 07 4-Plex ? 12 Multi. Misc. ? 17 Swim Pool L! 03 SF Addition ? 08 8-Plex ? 13 GarageJAccessory ? 18 Comm./Ind. ? 04 SF Porch ? 09 12-Plex ? 14 Fireplace ? 19 Comm./Ind. Misc. 0 05 SF Misc. ? 10 Multi. Add'7. O 15 Deck ? 20 Public Facility ? 21 Miscellaneous woR?c nrPe ? 31 New ? 33 Alterations ? 35 Tenant Finish 0 37 Oemolish O 32 Addition 0 34 Repair ? 36 Move GENERAL INFORMATION Const. (Actual) Basement sq. ft. MWCC System (Allowable) lst F1. sq. ft. City Water UBC Occupancy 2nd F1. sq. ft. PRV Required Zoning Sq. Ft. total Booster Pump # of Stories Footprint Sq. ft. Fire Sprinkler Length On-site well Census Code Depth On-site sewage SAC Code Census Bldg APPROVALS Census Unit Planning Building Assessments fngineering Variance REGIUIRED INSPECTIONS O.Site ? Footing 0 Framing 0 Insulation ? Wallboard ? Final ? Draintile ? Fireplace Permit Fee veu,st;«,: g ~2 C7 d Surcharge Plan Review License MWCC SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment P1. Road Unit Park Ded. Trails Ded. Copies Other Total: SAC % SAC Units , - - „ Certificate fors Arcadia lI "E" •Joe N.il'.er Construction ° Bk+ 81/39 y,, 3 - /7!y DELMAH H. SCHWANZ 14ND SUAVfrOwi INC wroMe.r~ unarr uwS nl TM C44I t+MmrqnU L475~U7H ROBERT TFAIL ROSE40UNT. MIMNlfOTA 6500~ MIOMt {i7 ~Y17N SURVEYOR'i CEIITIFICATE ,1K. { ~ 18 inches ea ~'~hProposed parage floor elevation to bn N N above curb as per Joe lAiller. 889.5 ~ Scalec 1 inch - 50 feet ~ O Denotes iron monua:ent ~ I o Denotes set wood hub w N ~ y9, ~ --y ~ igilliama Bros. Pipeline Co. Eaeement Doc. IVo. 493206 i= p / ~m 0n~ Cr~ NV. 8s ,A g . 44 z 7 ~GAe.~b b 6$9' 'Iq5 _ ,~p No~rE .9 ~ 3 88 . rainaFe and9 ~ Utility Easemer~ A_ / Nr F T°r N 93ra Y--- ~ w• ,~~A ae ~ VE Z° S r szaj • - I ' /75,yf/ Denotes proposed elevation ml Denotes existing elevation w I hereb,y certify that this is a true and correct represe~tation oP Lot 5, Block 1, WESTHURY SECOND ADDITION, accordift,to the recorded plat thareof. Dakota ~oumty, Minneeota. Also showinP the location of a proposed hou$e as staked thereon. October 15, 1984 MINNESOfA REGISTRATION NO. 8825 4 • ~ ~ • Y 1987 BUILDING PERMIT 9PPLZCATION - CITY OF EAGAN SINGLE FAMILY DWELLINGS IACLDDE 2 SETS OF PLANS, 3 CERTIFICATES OF SIIBOEY, 1 SET OF ENERGY CALCOLATIOHS NOTE: ADDRESSES FOH CORNEF LOTS - CONTRACTOR/HOME04iNER MDST DESIGAATE WHICH ADDRESS IS DFSIRED. NO CAANGfiS WILL BE ALIAWED ONCS BQILDING PERMIT IS ISSOED. MUL.TIPLE DWELLINGS - RESIDSNTIAL RENTAL ONITS FOR SALE UHITS INCLUDE 2 SETS OF PLANS, CERTIFICATB OF SDRVEY - CHECB iiITH BLDG. DBPT., 1 SET OF ENERGY CALCULATIONS CONIMBRCI9L INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS, $2,000 LANDSCAPE HOND r7 To Be Used For: ~ Valuation: d Date: I Site Address OFFICE OSE ONI.Y Lot ~4- Bloek On Site Sewage_ Oceupancy MWCC System Zoning Parcel/Sub On Site Well ~ Type of Const City Water (Aetual) Owner -Dc-h/Nl (Allowable) --Z ,y Of of Stories Address #S ~Length Depth City/Zip Code v? Xk/ S.F. Total Footprint S.F. Phone 9PPROVALS FSFS Contractor Assessments Permit se Water/Sewer Surcharge /0 jg~ Address Police Plan Review So- Fire SAC, City City/Zip Code ~SjG~Jt~~ Q~/N, J,51j3 Engr SAC, MWCC 6` L~~ Planner Water Conn Phone ~ Council Water Meter ~ Bldg Off Road Unit Arch./Engr. APC Treatment P1 Variance Parks Address Copies TOTAL City/Zip Code Phone lk 1986 BQILDING PEHMIT APPLICATI09 - CITY OF SAGAN HOTSs 9LL CONTRAClOES MOS? BE LICENSED {iITH T9E CITY OF EAGAN SIRGLE FAlIILY DiIEI.LIAGS INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS MOLTIPLE DTiiE[.LINGS - HESIDENTI9L RENTAL QNITS FOH SAL6 ONITS INCLUDE 2 SETS OF PLANS, CEETIFIC9TE OF SDBVSY - CHBCB IiITH BLDG. DBPT.9 1 SET OF ENERGY CALCOLATIONS COAMRCI6i: INCLODE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS, $2,000 LANDSCAPE ND ~F~.l pN Cr~j ~Y~ To Be Used For: I44JlT/O AJ Valuation: O/D00- Date: Site Address 3 5-,lq lliRs'g ui OFFICE USE ONLY Lot ,S Block ( Erect _ Occupancy Remodel Zoning Parcel/Sub Repair Type of Const u Addition n # of Stories Owner b.2N'VzS f~ , &-TP1Son1 Move Length Demolish Depth Address .3fl! Q tv-e 57-60~ Int.Impr. _ Sq Ft Install City/Zip Code c54~:*Pv Phone V%F~E -ol.SJa- 9PPROVAIS FEES o Contractor Assessments Permit ~ Water/Sewer Sureharge Address Police Plan Review Fire SAC City/Zip Code Engr Water Conn Planner Water Meter Phone Council Road Dnit Bldg Off Treatment P1 Areh./Engr. APC Parks Variance Copies Address TOTAL ~ 5= City/Zip Code Phone Ik HOTE: ADDRESSES FOR COAHER LOTS - CONTRACTOR/HOMEOiiNER MIIST DESIGN9TE WHICH ADDRESS IS DESIBED. NO C9ANGES SiILL BE ALLOWSD ONCE HUILDING PERMTL IS ISSIIED. / . . ° Certificate for: Areadia lI "E" Joe N,iller Construction ; Bk: 81/39 DELMAR H. SCHWANZ~ IAND CIIRVEYOMG iMC - Rwco~erM Unnn lawS nl TM GW M M~ld 075~UTN ROSERT TNAIL ROSE40UNT, MIMNt50TA 550!! PIIOME i1242L17K ~ h~ SURVEYOR'SCERTIFiCATE ~ Q Proposed parage floor elevation to bO 18 inches aboue curb as per Joe M!iller. 889•5 Scale: 1 inch = 50 feet O Denotee iron monun:ent ~ I ? Denotes set wood hub N 1gilliama Bros. Pipeline Co. Easement Doc. IVo. 493206 n r~ m tlD'~' C~ . 'I O 60 ~o qo. \ eBN 4 ~ 6 . 3y e °~cs I \ ~ 644, b b g9°~' ~ q4 Nous[ .e ~ 88 . IIDility ~Easeme T°~LUR6 . 934 'o _ ~ ~ ~b• PQ I ve s~~ x j ~ db - r~ - 3/ t3 I ' /75.yf/ ~q8~y - '~I0„Iq ~ ~ Denotes proposed elevation m rP Denotes existing elevation I herPb,y r.ertify that this is a true and correct represe~tation oP Lot 5, ?lock 1, WESTHURY SECOND ADDITION, accoadtft-to the recorded plat th?reof. Dakota ooumty, N!innesota. Also showinp., the location of a proposed"hou8e as ataked thereon. October 15, 1984 MINNESOTA REQISTRATION NO. 8625 ~ . ~ ~ 9 . _ 4 1987 BOILDING PERhILT 6PPLICATION - CITY OF EAG6N SINGLE FAMILY DWELLINGS 7NCLIIDE 2 SETS OF PLANS, 3 CERTIFICATES OF SQRVEY, 1 SST OF ENERGY CALCULATIONS NOTE: 6DDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOiiNEE MQST DESIGHITE WHICH ADDRESS IS DFSIRED. NO CHANGfiS WILL BE ALLOWED ONCS BIIILDING PERMIT IS ISSUED. M[?LTIPLE DiiELLINGS - RESIDENTIAL RENTAL iT?1ITS FOR SALE OAiTPS INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SIIRYEY - CHECB HITH BLDG. DEPT., 1 SET OF ENERGY CALCULATIONS COMMERCI6L INCLUDE 2 SETS OE ARCHITECTiIRAL & STRUCTURAL FLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS, UGO $2,000 LANDSCAPE BOND To Be Used For:~ Valuation:Date: Site Address 35 +A ZS~~o.^~~f . oa OFFICE OSS ONLY cW- Lot s Block ~ On Site Sewage_ Occupancy R-3 MWCC System Zoning 2-~ Parcel/Sub On Site Well ~ Type of Const ,JII City Water (Actual) V-N Owner I 1 JPd111~ ~ f~~l'et' So r-. af~Alilv i)Pavt (Allowable) 1~-N 7 ~ # of Stories Address Dep~h T h City/Zip Code S.F. Total Footprint S.F. Phone -ojs Z APPROVALS FEFS Contractor I%vjer`•; StjC. Assessments Permit /S/o,SO x Water/Sewer Sureharge , O Address Z~ ? C. j-`~ir Ui e~y,} ;ryy'le Police Plan Review B7 , 7S Fire SAC, City City/Zip Code ~se-VA2.. /'~d ~j~113 Engr SAC, MWCC Planner Water Conn Phone 07 CF• 1 Council Water Meter Sldg Off Road Unit Arch./Engr. APC Treatment P1 Variance Parks Address Copies TOTAL City/Zip Code Phone # ~ c.io~J -r - , yxr~~ Z."'~ 1 4 k~Sl~ = z I7 yi3 X yy= 14S17Z . 1 2/84 CITY Or EAGAN 1111~ ~ APPLT_CATION FOR PERMIT • ~ SEWER AND/OR WATLR CONNECTIODT (PLElISE PRIHT) 1) PP.OPE.'TZPY ApDR.SS: A =L DEyCRIP'PICV: ~a f llG / (Iot/Block/Stixivisicn or TaY Parcel I.D. Ntz-ter) ~ I'r' ^;IS'_=:G DAT^ OF Oi2T_GM?eli. PDC LT --^•7I:r./PDOFOS7-) C•S: 0 R-1 SL;GL: FPMSLY ? R-? DLP= (7wO L^?ImS) ? 2-3 'ICr,;ti,vCricg (,rr.?o^. + LlrITS) ( U;VZ^_~) ? ..--F AP:-..t?'_'r`iT/CC:1)Ci-tiT;T;,M ( L^:I_S) ? CC:~^fE?CL3I./RE:'r7IL,/OrF'IC:: Q 1'CliST?.La.L Q I\STS^u'TIONAL/G:JER~^= 2) A?P=C..`T iPLEaSE `rnirlf) tuV•'E: ALeREss: crrz. STaTE, zz?: f~o~~.,~r~< fo r w1d sSo ~ 2NeLNE : Y3l act~/ 3) Fu:•ffiER. lPLcdSE PR/INO FOR CITY USE 04LY ~yL: ~jY N/041~j ~~Klslpiv5 ZNt_ ' PLUN~fPS LICENSE: ADDRESS: /y.txg 3'~~v~ hJ ~`j active CITY, STATE. ZIP: ~ p!y iseA Ezpired ° ~ ''dwacn ~ Q Not of ReGOrd PHC^E: 5S9- 3(,7a PLUYBER LILENSE N~7d(y~$ Jf3 ar ni[ia 4) OC~.^CpF1N'r/Crz,rER NPME (PLEASE PflIAi) : ADDF2ESS= CITY, STATE, ZIP: Sq,w- A ,Z PHO^IE: 5) INDIG",TE '&IICfi PERidIT ZS BEING REQUESTr'.,p; ~ CONNEC.TION 'IO CITY SE.*riER ~ COMdDC:IQV 1O CITY :•IATER ? 1ER (PLLr`,SE DFSCI2IIIE) 6) Pi:DIC:,:: C::c: ~ PLElSE EiOID APPROVID PERMIT FOR PICi:-UP BY ONE OF A'EOV E ? PLFi,SE ~ML APPRCVED PER%LIT 'PJ 1, 2, 3, 4 A6(NE (Circle one) 7) siC=RE: (JAU.1d ~~i DazE: ived G. 85~ o1alMArss f~ i sat lY:afta ~~a ?R ~aiaa as i s rFSai:~ a s f!!+laeiy~~ S f~ !~c ate~a>+~~.. FOR C I T Y U SE ON:,Y < PERMIT ISSUED , Frrs' cF:ItR ?J=1T^' (rNCL:::)E SII?C::~,RGE) +5 WATER PERI"[Z'1 (I`.CLUDc ^liRCHAc2GE) WATER METER/COPPERHORN/OUTST.^,~ R°.`-.D: 3 $ WATER TAP (INCLL'DE COR?ORATION STCP) s SE,•iEY TA? / $ ~a? ACCOUNT DF.P(1SIT - WA^rR $ 7 a• a---~ WAC $ sPc $ TRUvx cJATER assEsS;,F:;T $ T:~L:IR SEL'JER ASSLSStIFNT $ Li,:ERI,L BEivEFIT/TRUNK SE:•iE4 $ LATERulL BENEFIT/TRUNi{ WATt'R $ OTHER ' $ TOT?L $ A".pL':VT PAIDjREC°I?T ; ~,17~1 cJ DOES OTILITY CON.IECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? ~ YES IF YES, THEN n"PERMIT FOR ;VORK WITHIN ~ PUBLIC ROADWAY" MUST BE ISSUED BY TfiE NO ENGINEERING DIVISION. LIST AS A CONDI- TION, SUEJECT TO THE FOLLOWING CONDITZONS: APPROVED BY: TI':Lc: DP.T°: am,=aON wON Dc+W wcM w~~Wp§ w.aOR WsiM" w4W 0c60iaIPAG APR -20-2011 14:06 FROM:SMSM 7637854937 TO:6516755694 P.2'2 t3asm 13•5o:10 NfT GPS FT 88.7 °F 02 10.4 CO EFF 89.6 4Pm AT °F EX/A CO2 COaf co* ACO FMK#: / Ct 86.8 % . 5.9 • 15 ppm 7 ppm PPM Pkv5z. r5 3ict eteie.54-444,- # 00782503 EAGAN WATER SERVICE pERAiTT Road, PMii' No . _ 5813 1 II -7--84 : _ DATE: c. a# Units: -owner; Joseph : Miller Constrlsotion e iKdcTtess 3819 Westbury` 13 131 Westbury 11 fi 'lyinouth Plbg r`°hio.: Connection Charge: 470. : _ 1500 pd si Account deposit: , . _ ' Reader 1�0.: Permit- %ee: 10.04 Fd 1 agree tg with the tOy ell Eagan Surcharge. ; • 5t"� Ordinaniats. misc. Charges.' 63 .00 • ' _ met Total: and horn By Dote Paid: Date .Insp.: // Insp.: ,; 61-y N SEWER SERVICE: �R txneb Road 7002 21199 ` .pagan 55121 DATE: .� Zoning: No. of Units: 1 ; ; . Owner: • e. 1' Con . .: u _, Address: t t Site Address: 3819 liestb L5 31 Weitbury IX ` Plumber Pl ou b th P ` 1/5/e4 4 1Ou. , ltd ...f to comply with the City of e n n �: 425 00 'p t i noes. Tp pp ir—" . . r ., Permit Fee: e T r t . 6 By Mioc. Chartres: Dote of ` ° w- f Total: Insp.: / am/ G/l rr"� -. Datb Paid. PERMIT City of Eagan Permit Type:Building Permit Number:EA174112 Date Issued:12/27/2021 Permit Category:ePermit Site Address: 3819 Westbury Dr Lot:005 Block: 001 Addition: Westbury 2nd PID:10-83651-01-050 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:One Window/Door Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Valuation: 1,500.00 Fee Summary:BL - Base Fee $1500 $62.50 0801.4085 Surcharge - Based on Valuation $1500 $0.75 9001.2195 $63.25 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 - Dennis Peterson 3819 Westbury Dr Saint Paul MN 55123--307 (651) 231-9351 Minnesota Rusco 5010 Hwy 169 N Brooklyn Park MN 55428 (952) 935-9669 Applicant/Permitee: Signature Issued By: Signature