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3825 Westbury Dr � ,� � ' ' Use BLUE or BLACK ink r----------------� � For Office Use I • t�E��D j Permit#: ' �� ! I Clty of �� ; . as° ; I Permit Fee: �� I 3830 Pilot Knob Road �J�� t �Q'(� Eagan MN 55122 � Date Received: �- � Phone: (651)675-5675 I I Fax: (651)675-5694 I Staff: � I I 2014 RESIDENTIAL BUILDING PERMIT APPLICATION ,_l ( ,�`�1 � �( � `�,�� ,.�� - L�. �r?.�-� ��`'`�_,�lX.�SS�� Date: Site Address: � �-S� ' �' Unit#: : Name: � �` ��'� Phone:`�`'�� G �"�(c,7o Resident/ . �j �� Owner . �� Address I City I Zip: �`'�� `"`�% �� Applicant is: / Owner Contractor c y ( 1'�i � � � ��°` � � " Description of work: - �� : "� _�-� � � vf S �t� � cr�f3n.. �/ Type of Work �� r,w �-- �/ Construction Cost: Multi-Family Buiiding: (Yes /No� " Company: � Contact: COntractor : Address: City: ' State: Zi . Ph ne: Email: '; License#: Lead Certificate#: If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) 1� $� �a� 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 r�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 fhe City to conclude that fhe are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.qopherstateonecall.orq I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. �� /--- �._ X ; \ � � �_ (�.5��7�- X -�� Applican ' Printed Name ApplicanYs Signature - Page 1 of 3 'i I � , . _ � DO NOT WRITE BELOW THIS LINE SUB TYPES _ Foundation _ Fireplace _ Porch (3-Season) _ Exterior Alteration (Single Family) _ Sing�e Family _ Garage _ Porch (4-Season) _ Exterior Alteration (Multi) _ Multi _ Deck _ Porch (Screen/Gazebo/Pergola) _ Miscellaneous _ 01 of_Plex _ Lower Level _ Pool _ Accessory Building WORK TYPES _ New _ Interior Improvement _ Siding _ Demolish Building" _ Addition _ Move Building _ Reroof _ Demolish Interior _ Alteration _ Fire Repair _ Windows _ Demolish Foundation _ Replace _ Repair Egress Window Water Damage _ Retaining Wall *Demolition of entire building—give PCA handout to applicant DESCRIPTION Valuation Occupancy MCES System Plan Review Code Edition SAC Units (25%_ 100%_) Zoning City Water Census Code Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Sprinklers Type of Construction Width REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings (Deck) Final/C.O. Required Footings (Addition) Final/ No C.O. Required Foundation HVAC Gas Service Test Gas Line Air Test Roof:_Ice &Water _Final Pool: _Footings _Air/Gas Tests _Final Framing Drain Tile Fireplace:_Rough In _Air Test _Final Siding:_Stucco Lath _Stone Lath _Brick Insulation Windows Sheathing Retaining Wall: _ Footings_ Backfill_Final Sheetrock Radon Control Fire Walls Erosion Control Braced Walls Other: Reviewed By: , Building Inspector RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit& Surcharge Treatment Plant Copies TOTAL Page 2 of 3 • . ^ ,--'. ; ��t .�� s� �;��( S v�,�� -� � �� s` ��. � �� L�._ 1 � �,`_LI� � / /' \ - "�C`Jr�-�.. � '�" �� l ��i.,� C�.'�-� ,� �^`C.��s..:��^� '� �;��--��— , � � � '� � � ,� �,� ;« �� ' �`� � ( � .�� ,�` �;� .��... S L �;'�IH t � �/� ``�`( l>:.�:t, `�� -`� r �1 � �� / ( � 1 / l - K;��-v�,�`^ �t�� c�� ✓�,� ��,��,�T f � � 1 � �� ,�1�� ,i`,- L �( r ' � �,�a� �-rv�.�N t� 1'�- �i�'� )�l� ��r�� ` -� . L� ---- t'lC`l � /�'c'L�/v _� r � ��i�.� , C` _ � , � ti� CI �(,-��=� -�-��1� �_ � �-�-- ��/ ��-��s�� p � �� 1 � � �� -��.�� (.� ��.�. I��.�� Ut �� /��- �, � , t�z.�.�. _.�- �� ;��4.��_ c�,1�� l� G (�.� �� _ ��"�� y �r �`�� , �� ,�� ` � � �-�.��,��. �,�,ti •. -j'�'�L_ � � `� � �`7 `� ��° ��'` �a i��ti-� V1�� ,-%�,,�� " A 1 �, , �� . � �.��;--�,k �� t=�� . 'f � ��.1� ,.�_ � �� ,01�.��:�.,/ � , ` � `} ' (� �'� ti:f`�/ `� ��.. �,,�.�..- ��'� ��"`� G1`1`.� W�� '� �p f,� f �� / � �r,, 1C�_i1Ir II (/� ('�� iW�i�.. ` \G��'��` ,� ..` Y � ! �\ ��. �r^.'JGg�. C"'f�t:w,��....s �=� � ..�°"�� .�-. ..\�,.. _. f �c� _ ••� i �/"� ' `� / t,,��q__ �Gt:✓�-e CJ� � �1�`1 J��If'l LtJ �✓��-� ✓ � . G �. ��.� �� -=�v� �. ��;�4- ��.�_ ,� � � ��''t._� v Z.�"�. �� '� � ( � �- � � � �- �,�l� C-�1�� t � �� C"� �� S � � � /�� 1 � - � � / � � � I ��- � � � � � ��* .� � �:� L � _. ---� .f r � �v � r\ . �'.��___� . � y � � �t c�,� 1 L.,�"�c'r�l_� �v '�-_., �, 8 ,� � „,`„l� ��' ?^ � /'� �, "`�:�'`'��L �L�� `/� C,'l ,�G�� `� �7`�E/'c.,y� G+ n �'1, � ft � �-�.,,,�� t= � �� S�� - ��-� � `�--��5 �s�` � � �� i--- � C� ,�--` ; �� .r�� ~'~ACI'I'.1~~ rOR I7F.C'.~ 4J27jM7_ _ : r . , _ _ . . CITY OF EAGAN . BQB NORa7T 453-3997 3830 Pilot Knob Rosd, P.O. Box 21-199, Eagan, MN 55121 12034 ' PHONE:454-8100 - BIyILDING PERMIT Receipt # ~ Tobeus.dro. 31' DwG/V«Z Est.Value $92,000 Date JU'-+!:: 2 ,is aLb Site Address 3825 WESTBURY DR Erect ox Occupancy R3 Lat 1 Block 2 Sec/Sub. WESTBU:2Y 1ST Remodel ? 2oning .21) Parcel No. Repair ? Type of Const Addition ? No. Stories W Name 305EPFi MILLER CONST Move ? Length 50 = I$1.3 3 CED~?.R AVE $O Demolish ? Depth 35- o Address Int Impr. ? Sq. Ft City rA~?<<iI~~QN 431-2001 Install O = o Name SA.°P Appravals Fees O¢ Address Assessment Permit ~ 409.0( City Phone Water 8 Sew. Surcharge 46.01 ~ Police Plan Review 204.51 ~ W Name Fire SAC 575.01 x ig Address 500.01 Eng. Water Conn. < W City phone Planner Water Meter 63 . 51 Council Road Unit 290.01 Iherebyacknowledgethatlhavereadthisapplicationandstatethatthe BIdg.Off. 5/29/8 Tr.PI. 156.01 information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. APC Parks Signature of Permittee Var. Date Copies Totel $Zr244.Oi A Building Permit is issued to: f JOSEYFi MILi.ER CUNST on the express condition that all work shall be done in accordance with all applic le State of Minnesota Statutes and City of Eagan Ordinances. Building Ofticial ~S ' Iff f f $ 3.~ Q r s d ? s ~ : d o e, n g R i ~ a n S ~ • ` n. . , : r s ~ ~ - ~ ~ A ~ ~ ~ PERMIT # ' PLUMBING PERMIT RECEIPT # - . CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE: CONTRACT PRICE PHONE: 454-8100 Site Address • L~` cBLDG. TYPE WORK DESCRIPTION Lot ~ Block c..1 New ~ Name Mult Add-on c°c Address ' ~j"Y'• <<"' Comm. Repair c City~Phone c 26 ` Other FIXTURES TOTAL ~ Name ' „T Water Closet - $3.00 $ Z c Address ~L_Lavatory Bath Tubs - $3.00 p City ' Phone - $3.00 Shower - $3.00 Kitchen Sink - $3.00 - FEES UrinallBidet - $3.00 COMM/IND FEE - 1% OF CONTRACT FEE -T-Laundry Tray -$3.OQ MINIMUM - RESIDENTIAL FEE -$10.00 T J•'-~ MINIMUM - COMM/IND FEE _ ~00 --Floor Drains - $1.50 STATE SURCHARGE PER PERMIT _ .50 Water Heater - $1.50 (ADD $.50 S/C IF PERMIT PRICE GOES Whirlpool -$3.00 ~(1 BEYONO $1,000.00) Gas Piping Outlets - $1.50 So(tener - $5.00 Well - $10.00 Private Disp. - $10.00 i• Rough Openings - $1.50 SiGNATURE OF PERMITTEE FEE STATE SIQ FOR: CITY OF EAGAN GRAND TOTAL: , ;1: . . . ,:+F'.'u"~ l,. . : t ~ PERMIT # ' • • . • MECHANICAL PERMR RECEIPT # 62 • CITY OF EAGAN 3830 PIIOT KNOB ROAD, EAGAN, MN 55121 DATE CONTRACT PRICE PHONE: 454-8100 Site Address - BLDG. TYPE WORK DESCRIPTION LatBlock Sec/Sub Res. ` New ~ m Name Mult Add-on a Address Comm. Repair c Ciry Phone • pttyer L Name FEES c Address RES. HVAC 0-100 M BTU -$24.00 p City Phone ' ADDITIONAL 50 M BTU - 6.00 ADD-ON AIR COND. 0-24 BTU - 12.00 ADDITIONAL 6 M BTU - 6.00 TYPE OF WORK GAS OUTLETS - 1.50 EA. Forced Air M BTU COMM/IND FEE - 196 OF CONTRACT FEE Boiler M BTU MINIMUM - RESIDENTIAL FEE - 10.00 Unit Heater M BTU MINIMUM - COMM/IND FEE - 20.00 Air Cond. M BTU STATE SURCHARGE PER PEFIMIT - .50 Vent CFM (ADD $.50 S/C IF PERMiT PRICE GOES BEYOND $1,000.00) Gas Piping Outlets # Other FEE f S/C: SiGNATURE OF PERMITTEE TOTAL• FOR: CITY OF EAGAN ~ CITY OF EAGAN Remarks /~7 J~.~~ o+~/SJ gT gC.c4 Addition WESTBURY FIRST ADDITION Lot ~ Bik 2 Parcel 10 8365CL010 02 owner Street 3825 Wectburv Drive State Eagan. MN 55123 Improvement Date Amount Annual Years Payment Receipt Date STREETSURF, 1986 2850.00 STFiEET RESTOR. GRADING Water Area 1986 133.79 8.92 15 5AN 5EW TRUNK 1 8 tEWERLATERAL 1986 500$.73 1001.75 Watermain 19$6 65.29 4.35 15 WATERMAIN 1984 68.7 4.58 15 ATER LATERAL 1986 WATER AREA Q 1984 184-92 12.33 15 *Services 1986 STORMSEW TRK 1986 710.24 142.05 5 tTORM SEW LAT 1986 CURB & GUTTER ' SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. SAC PARK CITY OF EAGAN - - 3830 Pllot Knob Road, P.O. Box 21-199, Eagan, Mti 55121N2 12034 BUILDI14G PERMIT PHONE: 454-8100 Receipt # 3 To be used to? SF DWG/GAR Est. value $ 9 2, 0 0 0 Date JUNE 2 11,,86 SiteAddress 3825 WESTBURY DR Erect ~ Occupancy R3 Lot 1 Block 2 Sec/Sub. WESTBURY 1ST Remodel 0 Zoning PD Parcel No. Repair ? Type ot Const Vn Addition ? No. Stories W Name JOSEPH MILLER CONST Move ? Length 1813 3 CEDAR AVE SO Demolish ? Depth o Address Int. Impr. ? Sq. Ft Ciry FARMIN(';Wjq 431-2001 Instau ? = o Name SA14E Approvsls Fees o~ Address Assessment Permit 4 09 . 01 Ciry Phone Water 8 Sew. Surcharge 46.01 Police Plan Review 204.51 ~ Z Name Fire SAC 575.01 ~ o Address Eng. Water Conn. 500.01 W 63.5+ i City Phone Planner Water Meter Council Road Unit 2 9~- 0~ I hereby acknowledge that I have read this app ication and state that the 5/ 2 9/ 8 6 15 6. ~ I in(ormation is correct and agree to comply wi~h all applicable State of gldg.Off. Tr. PI. Minnesota Statutes and ity of €agan r~ es. APC Parks Var. Date Copies Signature of Permittee Tot81 $ 2 2 4 4. 01 A Building Permit is issued to: JOSEPH MILLER CO T on the express condltion mat all work shall be done in accordance with al pl le State of M nneso tutes and City oT Eagan Ordinances. Building Official ~ 1986 BDILDING PERMIT APPLICATIOH - CITY OF EAG6N HOTE: ALL CAPTRACTOHS MUST BE LICS9SED tiITH THE CITY OF E9GAN SIRGLS FAlQLY DiiEL.LING3 INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS M[II.TIPLE DTiELLINGS - RfiSIDENTIAL RENTAL DNITS FOR SALS ONITS ZNCLt7DE 2 SETS OF PLANS, CERTIFICATE OF SITRPSY - CHECg WITH BLDG. DSPT., 1 SET OF BNERGY CALCULATIONS COHIMCIAt INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, t SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS, $2,000 LANDSCAPE BOND 72~ . To Be Used For: Valuation: f~ Date: '7 ~ot Site Address ~380'~5 ~,1.?e~&1,12zeA, OFFICfi IISS ONLY Lot ~ Bloek ~ Erect ~ Oceupancy 93 Remodel Zoning Pareel/Sub Repair _ Type of Const Addition # of Stories 441 Owner Move _ Length ~ Demolish _ Depth ~ Address Int.Impr. _ Sq Ft Install _ City/Zip Code Phone gppgpyA[,S ggg5 Contractorqm,Q1LV' l-fl),- ,l u D A) Assessments Permit ~ ~ I c Water/Sewer Sureharge y~ Addreas `~j1 3~ ` 4.(~,~.Pl /1 l1Al-P.~]. Police Plan Aeview D, Fire SAC 57~- City/Zip Code 1~bAY) r}~,T~,~W~.. Engr Water Conn ~ Planner Water Meter r,, Phone r( 3(-43L QO { Couneil / Road Unit Bldg Off /y{ Treatment P1 / S Arch./Engr. APC -i Parka Variance Copies Address iOTAL City/Zip Code Phone 0 60TS: ADDHESSSS FOR CORNER LOTS - CONTR9CTOR/HOMEOiiNER MQST DESIGNATS {iHICH ADDRESS IS DESIRfiD. NO CHAAG&4 WILL BE ALLOWED ONCE BiIILDING PERPIIT IS ISSQED. 72 5-3 2r~° x 2Z - 57 Z ~/z =~~~f A~ 32 , CITY OF SUILDINCi DEPARTMENT ~ t EXTII2IpR ENVII,OPE AVERA(3E "Ull COMPUTATION . (To be auDmitted rrith building permit applica'tion) , One or Txv Family Dwelling Owner All Other Site Addrese ContracWr Date Phone Qo^{Ac7q,f .SL LINEAL FEET OF EXPOSED YtALL ft. above grade = ~i7>59•~'6 TOTAL EXPOSED WALL AREA SQ, FT. 0?;,qUE '.t'AI.L CONSTRUCTIOi7: "Ull Value x Area Detail TKAHaE "Ull •~-3 X SQ, FT. 1812,48 ~ 7793 (U)(A) reference dO~`~' ~fUll • 07(r, x SQ. FT. 9648= 7_3-Z (U)(p) from "u" .040 x SQ. FT. 20 . -9-?. 1 ( U) (A) attached "Uit x SQ. FT. =--(U)(A) sheeta "U" x S@, FT. _ (U)(A) uUn x SQ. FT. - (U) (A) l'1INDOWS: "U" Value x Area Diake & Type J,~601. LSMT "U" .5Z x S@. FT. J~ .ZO = $o.($(U)(p) " . " «Uf' x SQ. FT. _ (U)(A) n it uQn s SQ. FT. _ (U)(A) it of 11U11 'x Sq. F•r. _ (U) (A) 1Y?ORS: "Ull Value x Area ilz;ce & Tyve giR, IuSJL. "Ull .I¢ x SQ. FT. 47.oO = 6,5(0 (U) (A) n n ....._...rATIO 1 ~ uUe .s}7 X SQ. FT. :gZ•OD = 19•7_(U)(A) n n irjjn x S@. FT. _ (U)(A) n n x SQ. FT. c (U) (A) TOTALS 2359.l04 SQ. r'T. Zoo. Z7 (U)(A) AVERAaE "Ull TOTAL (U)(A) VkLUES z20•7-7 DIVIDED BY TOTAL ti7pLL aaEA Z3S9.(p4 AVERA(3E "Ute 9T r less for 1&2 family dwellinge ROOF/CEILING: TOTAL AREA: _ 1qI Z Detail reference "U" • 0Z 1 x SQ. FT._141z ~ 29•65 (U)(p) from IOUJI x SQ. FT. . (U) (A) attached sheete. liUlt x Sq. FT, = (U)(A) Describe onenings IIU't x SQ. FT. = (II)(A) in raof. efUlt x SQ. FT. - (U)(A) TOTpL (U)(p) ypyUES DZVIDED BY Zg (05- ToYlcLS )4/Z N,rT1966-cuk~) TO'iAL ROOF/CEILITJ(i „RZA AVF;RpGE "U .025 r ventileted roofe. . •--WALL SECTION-- Determining IO0" valuea at Roof, Wall, Rim, and Conc. Black ROOF/CEIT.I146 R VALUE S 1.) Interior Air r'ilm 0.61 2.) 5/8" ayP. sa. .56 3.) Insulation gQ;oo 4.) 5.) Exterior Air Film ,61 ( STII.L ) ~ 2 3 6 upv _ 1/R= .OZI iOTAL (R)= 4r>•7$ ~ • ~ $ WALL R VALU 9 6.) Interior Air Film 0.6$ 7.) }n C#YP. Bd. . .45 8.) Insulation 19,00 9. ) Z5/~z" 9vi(."~ ~176" 2.op. 10.) Mdsonite Siding .67 to 11.) Exterior Air Film ,17 nUn = 1/R_.._,042 TOTAI. (R)=A01 RIM (R) VALUE 12.). Interior Air,.,,klim.„ . ..0,6$. t ..w Insulation 15,00 1 14 74.) 2" Fir Rim Joist 1.88 15 15.) ~~1 $~IC.?iTe Z•o~} 16.) M eonite si ng .67 t'].) Exterior Air Film .17 _ o . • . . up" = 1/R= .Otdj C7 TOTAL .(R)=14,dA O' o = /T O . ~ FOUNDATION R VALUE 18.) Interior Air Film 0.68 ~g 19.) zi o > ' zo. ) E-d e;?TK1PPED ~A-1- /l. o0 n D~°• 9 Zl.) 12" Concrete Block 1.28 ' s n Jo 22.) Zj 23.) Exterior Air Film .17 n D' B~ • Ifpu = t/R= •07(o TOTAL (R)=/;S.I3 L ~ , . . . . . ~r - ~r ~oRK sr~c-~r„ /B 33 X ( 28t~~2f~rz4) ?,9 79•ld~., `1•~ X ( Zo+zo) ` = 380•ob . - , . . _ . . •~7~C ~9Q'-r44 ~2stZS~=- 96.q-g ~ . :83x(56t5lo+4" +4o) WI1~Pows zoX3lo=- 5.00 Z4X L4 = 4.0o X~_ llo.op 24x 4S = S. oo X 20,crP0 = 8•9- X 3= z`•ZO _ Z4X(oa = 1v.oo ~ _ 3m. oo . ; 27~.t8, _ ~•9. X 5 = 17, oo . IS¢. ,20 , ~ . ZS-oo Za ~u• = Zl.oO (o° 4z•an ~ 9~ ~ ~gT EX~ ~ 64O~i cow-L. Z (of l~ESS 96.4s It u WD,;,S H bcvKS . ..4l.00 ~~$1z•~7'~j D - _ . . 24~48=. 1,15z . l3xzv= i . . , TRI-LAND VEY NG~ SITE PLAN FoR: SERVICES JOSEPH MILLE.R 4655 NICOI.S ROAD CONSTRUCTION, INC. EAGAN, MINNESOTA 55122 NORTH SCHLG• I11= 40' o N86°461siNw - ~ -175.44 ` ~ _ ; n*~«+s. yna,rr t,uuwr 4 0 ~p 1. W O. ~ 0-1- W > Q N It ~ LOT I zs~ o - J~. N yN ~ 205.00 o W s ssra:?27• w ° 3 Lur 2 PROPERTY DESCRIPTION LOT-L, BLOCK2,, WESTBl1RY FIRST ADDITION aeordinq to iM nCardaA plat iMreot DAKOTA camty. Minnesota ` LEGEND ' o pENOTES IRON MONUMENT PROP05ED (iARAGE FLOOR ELEVATION= o pE1ipTES WO00 1UB SET PROPOSED FIRST FLOOR ELEVATION = DENOTES EXISTING SPOT PROPOSED BASEMENT FLOQR ' ELEVATION ELEVATION DENOTES PROPOSED SPOT ELEVATION NOTE. VERIFY ALL FLOOR HEIGHTS WITM r DENOTES DRAINARE DIRECTION FINAL HOUSE PLANS t h~nOSr urtHy tlat this tirwy,plan or repat wos p?epond pr me or urMer my i - direct wparvisian md fhat I am a duly p?odley J. snson, Mn. Req. No. 15235 Land ~ mrs etM Stote of M wundW tM ~f . ~p\ 2000 BUILDING PERMIT APPLICATION (REI I iTIAL cirv oF Eacani 3830 PILOT KNOB RD - 55122 : G(~~ ljo6GI 651-681-4875 New Conshuctlon R6CUlremenh S_W) Oo > 3 reglatereC dte wrveys slwwtng sq. R. of lof, aq. tt. of house 2 coples of plan and QJj rooled areaa (20% ma*jmum lot covemae allowedl 1 set of energy calculaNOns 1or heafed CddHiona n 2 copiea of plaru (ahow beam A wlrxbw akes; poured fnd. deslgn; etc.) 1 site wrvey tor extedw addNOna 8 decks > 1 sat ol wiergy calculatlona > 3 copies ol hea preservatlon plpn tt lot plaHed alter 7/1/93 pp7E; CONSTRUCTION C05f: DESCRIPTION OF WORK: T-i~'/eo4T STREET ADDRESS: 3(6a~ GI~~S7 V r LOT: BLOCK: ~ SUBD./P.I.D. t: V Y C~ I YI U r d~ ~ S 1 Name: A6 u T LQ~ Phoneu:G~/~~~Y' 5~~9 PROPERfY ~d Fi'st OWNER cT 1 Sheet Address: /~-v~S/ 3 LI city SC-,9JAJ srcre: z+a: S S 1~"3 CompunY A&,-J CC~~ 46U, /dr"A19 Phone / ~ 7U7- 6 2s (aiea code) corirw+croe sfreat naaress: 122V7 /41-Cplle:7I ucense # ?ai6938.3 Exp. ~z~r ciN 60025?/%l(e srare: /1'l~? z1p: 3 ARCHITECT/ ENGINEER Company: Name: Telephone 0: ( ) Sheet Address: Regishafion City Stafe: Zip: Sewer/water licensed plumber (If installina sewedwaterS: Phone I hereby acknowledge ttaf I have read this appGcaHon, aFa1e Ihot 1he informafion is cortect, and a ee to compry wHh aq apPlica6le State of Minnesota Staiutes and CNy of Eagan Ordinances. ~ Signature of ApplicanY. OFFICE USE ONLY Certificates of Survey Received _ Yes _ No _ t Tree Preservation Plan Received Yes _ No _ Not Required OFFICE USE ONLY t.'; r•;`• r ~ BUILDING F~~I~M1,,~7rS08TYPES ? 01 Foundatiaq 07 05-plex ? 13 16-plex ? 21 Porch (3•sea.) ? 31 Ext. Alt - MuRi ? 02 SF Dwelling C5a 68 06-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Ak - SF ? 03 01 of _ plex ? 09 07-plex 0 18 Deck ? 23 Porch (screened) ? 36 MuRi ? 04 02-plex ? 10 08-plex ? 19 Lower Level ? 24 Storm Damage ? OS 03-plex ? 11 10-plex Plbg _V or _ N ? 25 Miscelianeous ? 06 04-piex ? 12 12-plex O 20 Pool ? 30 Accessory Bldg. WORK TYPE ? 31 New ? 36 Move Bldg. ? 43 Reroof ? 32 Addition ? 37 Demolish (Bldg)' ? 44 Siding ? 33 Alteration ? 38 Demolish (Interior) ? 45 Fire Repair ? 34 Repair ? 42 Demoiish (Foundation) ? 46 Windows/Doors * Give PCA handout to appllcant for demolition permit GENERAL INFORMATtON SAC Code # of Stories sq. ft. No. of Units Length sq. ft. No. of Buildings Width Footprint sq. ft. ConsL (Actual) Basement sq. ft. Census Code (Allowable) Main level sq. ft. MC/ES System UBC Occupancy sq. ft. City Water Zoning sq. ft. Booster Pump PRV Fire Sprinklered MISCELLANEOUS INSPECTIONS ? Stucco/Stone APPROVALS Ptanning Building Engineering Variance Permit Fee Valuation: $ Surcharge Plan Review License MC/ES SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S!W Surcharge Treatment PI. Park Ded. Trails Ded. Other Copies Total: SAC Units °!o SAC . **********#******1**4#3******#**#**# - CITY OF EAGAiV * ~ ~ ~ ; APPR(3VAL OF PEItNIIT. APPLICATION FOR PERMIT * ~ rrrsrncriort oF sERM r,rID/ox MMgt : . *f TT1CTAi7.ATTONS WII.L Mr BE SCHED- SEWER AND/OR WATER CONNECTION ~ULED UNTIL I'ERMIT HAS EM . * APPxovID, ~ * » * . **t#**h * !*!rR ***iRk#*~*~r****7r***k -~'Please ; rint _ 1) PROPERTY ADpRESS: lyX"; ~ j 0~,rv r LEGAL DESCRIPTION: - . Lot Block Subdivision or Tax Parcel ID IF EXQSTING SIRCClL'RE, DATE OF ORIGINAL B[,'ILDING PERMIT ISSUANCE: i PRFSIISf ZONING/PROPOSID CSE: (Mn Year ? CO+^'PEiC1Ai./REl'AIL/OFFICE L0--R=1-`SINGLE FAMILY rl IbIDt'STRIAI, Q R-2 DC'PI,EX (Ttm L~nits) n I~TITUTIONAL/COVaRNMENT 0 R-3 TOWNiOUSE (Three + Units) ( Units) Q R-4 APARTTENT/COAIDOMiNIUM ( Units) 2) ~ NAME-5~ aA ::T • ADDRFSS: CITY, STATE. ZIP: PHONE: 3) u NAME• For City Use P11mbers License: Act ive ADDRESS: 2 G D CITY. STATE, ZIP: F~cpired xot recoraea ~o~: v.-Cb (2, rAsTm LxcErrsEq Staff Inir.ial 4) ••~sy:u ~..~.i~• ~ NAME: ~ 1 _ ADDRFSS:- CITY, STATE, ZIP: ~ PHONE: . .5) ~ v i? r : o • oi a~ ~._cOrNEc..ziorr TO ciTSr sEwm jgl-mrrcvscrzorr To ci1^t wATEa p o~rf~a . . ~ 6) Q PI,F.ASE HOLD APPgpVED PERNIIT FY)R PICK-C~P BY ONE OF AHOVE ~PLEASE MAIL APPROVID PERMIT ZO 1, 2. 3, 4, ABOVE . 9 (Circle one) ~ 7) r ~u•- ~ . ~ 'Y~~`4~ - . « , . • r 1~ ~ e M 1 tl3~ 1 11 ' D~~ ~ I YJ~ ~1 YF.14/J~ D~ ~ 01 ~ J~ 1. ~ ' . . FOR CITY USE ONLY - PERMIT # ISSL'ED Pd w/Bldg. Permit FEES: $ $ f(57~ SEWER PERMIT (INCLUDE SURCHARGE) $ $ - 5 7% WATER PERMIT ( INCLODE SL'RCHARGE ) $ $ WATER METER/COPPERHORN/OL'TSIDE READER $ $ WATER TAP (INCLODE CORPORATION STOP) $ $ SEWER TAP $ $ /5" • ~r ~ ACCODNT DEPOSIT - SEWER $ $ . o- Z) ACCOUNT DEPOSIT - WATER $ $ WAC $ : 2 7 s-- c 1`z.) $ sAc $ $ TRL'NK WATER ASSESSMENT $ $ TR['NK SEWER ASSESSMENT $ $ ' LATERAL BENEFIT/TRC'NK SEWER $ $ LATERAL BENEFIT/TRL'IVK WATER $ $ WATER TREATMENT PLANT SURCHARGE $ $ OTHER: $ $ •_S I~ O-Z~ TOTAL RECEIPT RECEIPT DOES ?TILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? Q YES IF YES, THEN A"PERMIT FOR WORK SVITHIN PLBLIC Q ROADWAY" MDST BE ISSOED BY THE ENGINEERING NO DIVISION. LIST AS A CONDITION. SUBJECT TO THE FOLLOWING CONDITIO[VS: APPROVED BY: TITLE: DATE: 41LS ~ ~ / RESIDENTIAL BUII.DING to Z7i l O Permit Application $C1 City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Construction Reouirements RemodeUReoair Reauiremen4s Office Use OnN 3 registered sile surveys showing sq. N. of lot, sq, ft. of house; and all roofed areas 2 copies of plan Ced of Survey Rerd _ Y_ N (200% maximum lot caverage allowed) 1 setoF Energy Calculations for heated additions Tree Pres Plan Recd _Y _ N 2 copies ot plan showing beam & window sizes; poured found design, etc. i site survey for addilions & decks Tree Pres Reqd _ Y_ N isetofEnergyCalcula6ons Add'dion-indicateilon-sdesepficsystem On-site5eptic5ystem _Y _N 3 copies of Tree Preservatbn Plan if lot plaried afler 7!1l93 Rim Joisl Detail Options selecliori sheet (btdgs wtlh 3 or less uni4s Date 1 / / y3 / 03 Construction Cost Site Address (,)esf6r,c .r o 0611 U-C~ IInit/S[e # Aescription of Work I U s w ~ c - Multi-Family Bldg _ Y N Fireplace(s) )C 0 Property Owne ~IGF.A'7 hea d Telephone #(Zf15I ) L~ ~cJ - - - Contractor RMA HOME SERVICES INC. Address Ilome Deopt Installed Sales City 3200 Cobb Galleria Pkwy., Ste. #200 State Atlanta, GA 30339 ip Telephone ) 763-542-8826 13r-20268257 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672 Energy Code CategOry . Residential Venfilation Category 1 Worksheet • New Energy Code Worksheet (J submission type) Submitted Submitted • Energy Envelope Calculafions Su6mitted Have you previously constructed a building in Eagan with a similar plan8 _ Y _ N If so, 25% plan review fee applies. Licensed Plumber Telephone ) Mechanical Contractor Telephone # Sewer/Water Contractor Telephone 003 mnV ~ I hereby apply for a Residential Building Permit and acknowledge that the info ation is complete and curate; that the work will be in conformance with the ord'mances and codes of the City a8 =an~=t~Sta'te 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 aoval of plans. rk~ &-tl~JY1 Applicant's Printed Name App icanYs Signature OFFICE UaSE ONLY Sub Types ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool Q 30 Accessory Bldg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3=sea.) ? 31 Eut. Alt - Multi ? 03 Ot 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 (screeNgazebo) ? 36 Multi Misc. ? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Stortn Damage ? 06 04-plex ? 12 12-plex Plbg_Yor_N ? 25 Miscellaneous Work Types ? 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 (Bldg)* ? 43 Reroof ? 46 Windows/Doors ? 34 ReplaCement *Demolition (Entire 81dg) - Give PCA handout to applicant Valuation Occupancy MC/ES System Census Code Zoning City Water SAC Units Stories 8ooster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS _ Footings(new bldg) FinaUC.O. _ Footings (deck) FinaUNo C.O. _ Footings (addirion) _ Plumbing _ Foundation HVpC _ Drain Tile Other Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final _ Fraxning _ Siding Stucco Stone _ Fireplace _ R.I. _ Air Test _ Final _ Windows (newheplacement) _ Insulation - Retaining Wall Approved By , Building Inspector - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total ~ Installed Siding and Windows ~o~ SeN~ LIMITED POWER.OF ATTORNEY , ~ COUNTY OF COBB STATE OF GEORGIA KNOW ALL PEOPLE BY THESE PRESENTS: THAT I, David N. Katz, a resident of Montgomery County, Pennsylvania ("Principal"), and a licensed contractor of RMA Home Services, Inc., DBA Home Depot Installed Sa!es loca±ed at 660 Mendelssohn Avenue North, Golu'en Va!'e;-; NINT 55427, having a license number of BC- 20268257, do hereby appoint, name and constitute Eider-Jones Building Permit Service, Inc. ("Agent") as my true and lawful attorney-in-fact and do authorize and grant said attorney-in-fact for me and in my name, place and stead the power to execute, acknowledge, sign and deliver (in such form as may be required by the municipality) a permit application, or any other instrument(s) which may be necessary and appropriate, in order to obtain the proper permit(s) from the City of Eagan, Minnesota for the installation, maintenance and repair of windows and siding (the "yVork"). The powers conveyed to the Agent by this Limited Powe: of Attcrney are limited solely to the express powers delineated herein and apply solely to the Work. This Limited Power of Attoineyshall expire and automatically be revoked on the 21st day of May, 2004, which date is one year from the execution hereof. Further, the powers conveyed by this Limited Power of Attorney may be revoked by Principal at any time by express revocation and shall also be revoked by the Principal's death, disability, incapacity or incompetence. IN WT1"NESS WHEREOF this Limited Power of Attorney is execi-rted th:s 21 st day of May, 2003 David N. Katz S WORN TO AND SUBSCRIBED BEFORE ME by David N. Katz on this 21 st day of May, 2003. Notary P lic in for the State o eorgia b1y Commission Expires: January 21, 2006 396816.0 Proudly sold, furnished and installed by RMA Home Services, Inc., a Home Depot authorized contractor. 3200 Cobb Galleria Parkway, Suite 200 • Atlanta, GA 30339 • Phone (770) 779-1300 • Fax (770) 984-0709 • Toll free (800) 79-DEPOT City of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675 -5675 www.ci.eagan.mn.us Site Address: 3825 Westbury Dr Lot: 001 Block: 002 Addition: Westbury 1st PID:10- 83650- 010 -02 Use: Description: Sub Type: Work Type: Description: Census Code: Zoning: Square Feet: 0 Comments: Fee Summary: Valuation: 3,000.00 Contractor: Home Depot At Home Services 656 Mendelssolm Ave. N Golden Valley MN 55427 (763) 542 -8826 e- Windows/Doors Windows/Doors-New/Replacement House 434- Applicant/Permitee: Signature PERMIT City of Eaan Improvements to the home require smoke detectors in all bedrooms. If altering window openings, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required by law in ALL single family homes. BL - Base Fee $3K Surcharge - Based on Valuation $3K Construction Type: Occupancy: $88.50 $1.50 Total: $90.00 - Applicant - Owner: Brian Read 3825 Westbury Dr Eagan MN 55123 Permit Type: Permit Number: Date Issued: Permit Category: 0801 9001 Building EA089462 06/02/2009 ePermit I hereby acknowledge that I have read this application and state that the informa of Minnesota Statutes and City of Eagan Ordinances. on is correct and agree to comply h all applicable State Issued By: Signature i 4 h' - cssi,�saw.r'. F aan-cs3i*. 'fit = 2 {[. • � 1 • 'Pr JF� - a y •:_�3 fi .. ° �,-{ ,* x �� ti r> q` . „ -,,.. ,-,''.- ,,.; '' '' -1‘.. ,-.c\ \i,,,,, ,,,,,7',.p.,-e,tert!,-74.,'=.= ',,, ' ' - .-°.,-.-. , ' • , I • .. ',;,,,,.,,,'; ,' '"',' - ' -- , ..: ' ',, ,; ; * '''` ' ' , t' ' ...-.1. - ;':- ----'-'",::<1.!'..''''.".;." .4,,Fert, .:77 ;:i'-' -:::',., .,_. : :-;•_...:,.., rTkI7,:, ,.,-....;,4110"k,,-.,,,-,,..,,-;;;-:,..,-- ., .. ,.......„-„..„.4„/„, -T.,;,,,..,*,,:f-,:_. .., - . lir, ,•, - -- - .,--,,,,:-..-z -.-; :' - ,-- . , • .:,,4j.. ..f.T.,..z1, .4. $1.1A '',:'4?efi:e '' -7 ' - -.- , ...;,' 1"';'"''''' ,‘..; ..-'''''..**•,440: .. "' ' ' -" IP ,'.. '''''' ' . " ' ' ' ° ' ' ,.' 10461114.„ '''',7-: ' • ''J."' ',...".''''' , - ' '''' '''' - (" 1-4.. ''''' •V '''. 4P '-'' 4t.,4 „.,i-,,,,..,..,...-. ,,,..-:: ,.4:: ,..,,...:_,,.."-).:',:..„1„:.,-.::',,.;,.,...,,.7.:,;:-,„'- ..,.,,,,,,,,.,.., ...,,„:-„,,i4ii.,--0,„„f::0„ . . ,,t:•,, .:::,....'::,....:17.,..,,l's.::,,,'',":' ', ,, .,_,,e.' .,;:',Z .4.7.,k:-.°, 4„:40` , ., -.'-' .-.,,.- -.'.' -, :• 1- f. , -- . . • , ..„ - ' ,..,,-,'- . !,,--,:- , k . 4 i;.' :, -, . , . ' :.: - , - -.. , -.: -,,,.,--..-ftt.., -'*- ' -;,, .'",--",,,:•,,..:4-:ri'''',..'~r''.,'''".ff-: : ri ' ' '-1?)--:....,-.-=',';'-f,1 .. . 4 1: _ . Use BLUE or BLACK Ink . . r————————————————i I For Office Use � ��' � I � C�� O{'�� Permit#: � � i � , �.� � 3830 Pilot Knob Road I Permit Fee: � Eagan MN 55122 � I Phone: (651)675-5675 � Date Received: � Fax: (651)675-5694 � � � Staff: � �-----------------� 2015 MECHANICAL PERMIT APPLICATION ❑ Please submit two (2)sets of plans with all commercial applications. Date: ��i Site Address: � � � ` � � ' _ � I�I G��Ll� ��''�/ �//V s�� Tenant: Suite#: �� ,,� „� _ �z�� r„_ 51 � `��3 "`��70 �- �� Name: I ,c �r, f'�S� Phone:�� `��QW[L#3� `� —r c� �,�� Address/City/Zip: � �� S�C�3 � {� �� / a �� ` �` �� ` �� Name:�� License#: �\ , � i � �:. �� '�� Address: City: �� \ �\„ �� State: Zip: Phone: �z� � �� \�F �� Contact: EmaiL _�� ,�\ � `� �� , . New Replacement Additional Alteration Demolition �� , = �� ; ] \_ � ��/� � �' Description of work �� ✓�.,.J � 1 r v�Q �� °f �` I�OT� I�oc�f mo�n�+d and�rour�d��u��l�m�cF��i�1ica1 equiprT� �i��iquir�� d�y��ty ��F, ;;. �� :; Ca�d��*t�ases��Eactt Me+�t�antcal�ta�pec�+��f�rma�i��, r�iit��.r�� '� s�' r ,: .... .. , , �.... :.,. �� .: . . .. � � ��:, ..: . ��. � � z�� :..� , ,....,... . �,. � �" �\ � �� RES/DENTIAL COMMERC/AL �z � . �� ; �� `� Furnace New Construction Interior Improvement � ,�\ � \� � �� <�� \� �Air Conditioner Install Pi in Processed E�� ,��y� _ p• 9 ��a� � r Air Exchanger Gas Exterior HVAC Unit �� \� �� — �� ,� A � y� _Heat Pump Under/Above ground Tank �Install/_Remove) ��€ �a \� — �:� E �� F., � `�� Other ,.,� � �� RESIDENTIAL FEES $60.00 Minimum Add or alteration to an existing unit(includes$5.00 State Surcharge) $100.00 Residential New(includes$5.00 State Surcharge) _$ TOTAL FEE COMMERCIA� FEES Contract Value$ x.01 $55.00 Permit Fee Minimum $70.00 Underground tank installation/removal =$ Permit Fee "If contract value is LESS than$10,010,Surcharge=$5.00 =$ Surcharge* **If contract value is GREATER than$10,010, Surcharge=Contract Value x$0.0005 ""*If the project valuation is over$1 million, please call for Surcharge =$ TOTAL FEE I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan;that I understand this is not a permit,but only an application for a permit,and work is not to start without a permit;that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans _ X �G��f�c'r� �'� S fi�' X �""' ApplicanYs Printed Name ApplicanYs Signature ��y�r ^ 1�1�(C � �� » ��r� � � �r � VR ��W�.RJv7G '� k g�� '�`� a"T� � ,,, a� . r s � ��.\�� Z� �'C � �, .. �� '�� aa�� ` �:> � � 4 sc.- � "^a'�� `�#�C� ��I18�'�`+�I�I i� \' ��` ��YIf3WBi�� ,� ��«�w�� e � \� �rr \;�� ;, : \��: �. : :" Z� � y ., . � ��w�`�� y,r,��J� C�t;i��l ,,�.... ��h lrY� ..�� A�r , �,c;;a„,„��S�r�t�"�" 1C1'fl t � ' � +��r�g. �; � ��... �.� ,�•., N :.� PERMIT City of Eagan Permit Type:Building Permit Number:EA146520 Date Issued:10/30/2017 Permit Category:ePermit Site Address: 3825 Westbury Dr Lot:001 Block: 002 Addition: Westbury 1st PID:10-83650-02-010 Use: Description: Sub Type:Fireplace Work Type:Gas Insert Description: Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home may require smoke detectors in all bedrooms. Chimney / flue must be inspected prior to concealing. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Valuation: 3,000.00 Fee Summary:BL - Base Fee $3K $88.50 0801.4085 Surcharge - Based on Valuation $3K $1.50 9001.2195 $90.00 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 - Alicia K Jarosh 3825 Westbury Dr Eagan MN 55123 Fireside Hearth & Home 2700 Fairview Ave N Roseville MN 55113 (952) 985-6675 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA151963 Date Issued:09/19/2018 Permit Category:ePermit Site Address: 3825 Westbury Dr Lot:001 Block: 002 Addition: Westbury 1st PID:10-83650-02-010 Use: Description: Sub Type:Reroof Work Type:Replace Description:Does not include skylight(s) Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please print pictures of ice and water protection and leave on site. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Valuation: 4,000.00 Fee Summary:BL - Base Fee $4K $103.25 0801.4085 Surcharge - Based on Valuation $4K $2.00 9001.2195 $105.25 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 - Alicia K Jarosh 3825 Westbury Dr Eagan MN 55123 (612) 803-7725 Aspen Exteriors Inc 14245 St. Francis Blvd Suite 101 Anoka MN 55303 (763) 277-8869 Applicant/Permitee: Signature Issued By: Signature