3860 Westbury Dr
. PERMIT k 4!
PLUMBING PERMIT RECEIPT # '
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE:
CONTRACT PRICE: PHONE: 454-8100
Site Address BLDG. TYPE , WORK DESCRIPTION
Lot Block k;lL_ SeciSub ` New
M~1U! , Add-on
ki Name Comm. Repair
~ Address Other
c Ciry Phone RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
NO. FIXTURES TOTAL
Name J Water Closet -$3.00 $
` Bath Tubs - $3.00
3 Address ' Lavatory - $3.00
p City ~C•~ .L~4f , Phone `LLra`7k' - ' Shower - $3.00
- ; , i- Ki?chen Sink - $3.00
FEES UrinaliBidet - $3.00
COMM/IND FEE - 1°rb OF CONTRACT FEE Laundry Tray -$3.00
APT. BLDGS - COMM RATE APPLIES Floor Drains -$1.50
TOWNHOUSE 8 CONDO - RES. RATE APPLIES Water Heater -$i.50
MINIMUM - RESIDENTIAL FEE - $12_OA Whirlpool - $3.00
MINIMUM - COMM/IND FEE -$20.00 Gas Piping Outlets -$1.50
STATE SURCHARGE PER PERMIT - .50 (MINIMUM - t PER PERMIn
(ADD $.50 S/C IF PERMIT PRICE GOES Softener -$5.00
BEYOND $1,000.00) t Well - $10.00
- Private Disp. - $10.00
Rough Openings - $1.50
SIGNATURE OF PERMITTEE+ FEE:
STATE S/C:
FOR: CITY OF EAGAN GRAND TOTAL• f c2• ~
REACTIVA.9ED R7ft BAM~M 12/86 . . .
, CITY OF EAGAN 9 3 3
3830 Pilot Knob Road, P.O. Box 21•199, Eagan, MN 55121
PHONE: 4548100
eU1LDiNG PERMIT R~~a #
T• M wed fs. 3F DNG/GPIR Est. volue ;62.000 Date_func~n t 1IL-
5ite Addrea 3860 iiTBSTBURY N1vC,' Erect Q Occupancy Ri
Lot _It_ Block 4 Sec/Sub. WgR'i'gi7RY 189P Remodsl r~ Zoning s1
Parcel No. Repair ? Type of Const. ~
Enlarge ? No. Stories
W Name J~B MIX+i+RR CONST 4
psmolish ? Depth
~ q~r~, 18133 CBDAR AtTL ~
Grode ? Sq. Ft.
City FARMIA1GTOr1 Phone 431--2001 Install ?
E Appeorak Fo*s
, Name ~
~u A~~ Assessment Pe?mit 0
u~ Cit Phone WoMr b Sew. Surchorpe 31. ~Q
Y
b Polite Pian Review o
~W Neme Fin SAC gZ5.~0
Address Enp. Woter Conn. _5~D0
~ W City Phone Plonrwr Wofer Meter _6.3..00
Cowxil Rood Unit ZgO - do
I Ixrehy ocknowledya fhat I how read this opplicution ond state thot gldg, pf{2/21185 T• p• 132.00
the inloimotion is torrect ond ogree to comply with all applitoble APC Total Z i 009 • S0
Stote of Minnesoto Statutes ond Ciry of Eoflan O?dinonces.
Var. Dete
Siynotum of Pennittes
A Buildinfl Permit Is +ssued to: JOB MILLBR COIiBT on tlu exprosa condition thol
oll work sholl be donw in aaordonce with oll applicable Stote of Mlnnewta Statutas end City of Eayon Ordinoncts.
9ufldinp Officiot
Pomk No. Pormit Holdn Deta Tsiephorn ~t
Plnmbin0 ~ ~ ~ IlS ~d~~UJ
H.v..n.c. - Co llQ 1~ ~ r ZZ
Ebetric 10 &4-.~L.
3c~-
$oitener
Inspeetion Data Insp. Othp
Footinys •
Foundatan
Framinp r D ON
Roofing
fi N
Rouyh Plbq.
Rouyh HVAC
Inwlation LLA
Final Plbp. Q. -
Finsl HVAC
Final
c..voa.
YYanr Dosc~ib+ Location:
~-/-y~ -
1MNI ~•C.h. vP Yo~/T Fl~ rfii/~EQ nA. - rco
Sevrer d(,Q C~'~O- T'iw- L'~'~'
Pr. DisP• O-
Q~ Sp S O.C' _
e---p c-4.zv - l- G S~i-Ifl ti 0
CITY OF EAGAN Remarks Addition WEST$URY FIRST ADDITION Lot 8 Blk 4 Parcel 1n 93650 080 OrF
Owner Street 3860 Westbury Drive StateEagan, MN 55 173
Improvement Date Amount Annual Years Payment Receipt Date
STREETSURF. ' 1986 2850.0 570.00
STREET RESTOR.
GRADING
Water area 1986 133.7
8.92 15 133.79
SAN SEW TRUNK
A~ nm
407.15 ~ SEWER LATERAL 1986 5008.73 1001 if
Watermain 1986 65.29 4.35 " "
WATERMAIN p 1984 68.71 4.58 15 59.55 " "
WATER LATERAL 1986
WATER AREA v 1984 184.92 12.33 if
*Services 1986
STORM SEW TRK 1986 71 142.05 5 710.24 STORM SEW LAT 1986
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 500.00
gUILOING PER. 993$
SAC
PARK
Receipt I~~}~•'~.% ~ PLUMBINGPERMIT ParmitNo. ~
CITY OF EAGAN .
Fee
Fill in numbered spaces S/C
Type or Prin[ legibly Tot. '
1, Date 2. Installation Cost
~
~ 111 .f'
3. Job Address Lot Blk. 7ract
4, Owner - 1
r
5. Contractor - Phone
6. Address '
7. City State Zip ' B. Building Type: Residential ~ CommerCial ? Institutional ?
9. Work Description: New El Add O Alter ? Repair ?
10. Describe
11. No. Fixtures No. Fixtures
Water Closet Cesspool/Orainfield
Bath tubs Septic Tank
_ Lavatory Softner
Shower Wel l
Kitchen Sink
Urinal/Bidet Other
Laundry Tray
Floor Orains
Drinking Ftn.
Slop Sink
~ Gas Piping Outlets
12. I herebY certify that the above information is true and correct, and 1 agree to
comply with afl ordinances and codes governing this type of work.
Signed : ' for
Rough F inal
Inspections: Date Insp. Ddte Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454$100
Raceipt MECHANICAL PERMIT Permit No.
CITY OF EAGAN
Fee. ~ Fill in »umbered spaces S/C
Type or Print /egiblY ToL
1. Date 2. Installation Cost
3. Job Address - -Lot Blk. ' Tract
4. Owner
;
5. Contractor Phone -
6. Address "
r
7. City ' 5tate ZiP -
8. Buiiding Type: Rasidential ? Commercial 13 Institutional 0
9. Work Descxiption: New C] Add ? Alter ? Repair ?
10. Descri6e Fuel TYPe •
11. No• ~pI STU • M. Ea. j Evuiament CFM
Forced Air Air Handling:
Mfg, < Boilen Mech. Exhaust
Mfg. Unit Heater
Mf9.
Other
Air Cond.
# Mfg.
Gas, Piping Outlets
12. 1 hereby certify that the above +nformation is true and correct, and 1 agree to
aomply with alt 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 464-8100
~ CITY OF EAGAN No 9938
. • 3830 Pilot Knrob Raad, P.O. Box 21•199, Eagan, MN 55121
PHONE: 4548100
BUILDING PERMIT Receipt #
Te M wad fer SF DWG/GAR Est. Value $62,000 Dore MAR_CH 1 , 19$5L
SiteAddreu 3860 WESTBURY Erect EC OccupencV R3
Lot 8 Block 4 Sec/Sub. WESTBURY IST Remodel ? Zoning R1
Repeir ? Type of Conat. cT
Parcel No.
Enlarge ? No. Storie5
JOE MILLER CONST wlove ? I.sngtn 54
W Name Demoliah ? Depth 40
~ Address 18133 CEDAR AVE Grade ? Sq. Ft.
City FARMINGTONpho„B 431-2001 mstau ?
AOYrerels Feas
o Name SAME
~u Address Asseument permit 19.00
u~ Cit Phone Water 8 Sew. Surchorye 31 . 00
y Police wan Review 159.50
~W Name Fira SAC 525.00
Address Enp. Water Cqnn. ~Q..Q.i0 0
i Z. City Phone Vlanner Woter Mater --b-1-00
CounNl Raod Unit 180 00
I hereby ocknowledge thot I hove recd this applicotion ond sfale that gldg. Off. Z ZI 85 T• P• 132 . 00
the inlormotion is correct and ogree to comply with all opplic le APC Total $2. 009.50
Stota of MinMwta Stofutes and ity of Eaqan rdirwnces. Var. Date
Sipnoture of Permittee
A Building Pemit Is issuad ro: JOE MIL ER GONST - on ths enprcss wnditlon thal
oll work shcll be done in accordance with oll~op1plicoble Stat of i wta Statutes ond Ciry of Eapan Ordirwnces.
Buildirq Officlal ~ /
`
ALL CONTRACTORS MUST BE LICENSED WITH THE CITY OF EAGAN ,
INCLUDE El SETS OFrPLANS,
SETTOFIENERGYOCALCULATIONS
To Be Used For: Valuation:~ Date:
Site Address: -m6Q '~~9~(~~L CflZ.aGO•~ • ~
Lot: 00 B1ock:y Sect/Su6:`~?~~ Erect: X Occupancy: Q-3
Parcel Remodel: Zoning:
Repair: Type of Const: ~
Owner: Enlarge: # Stories:
Move: Length: 54_
Address: Demolish: Depth: ¢p
City/Zip Code: Grade: Sq. Ft.:
Phune
Contractor.
Adaress: 011/ .3 &~t~? Assessments: Permit: 3?°I.'~
City/Zip Code: Water/Sewer: Surcharge: 31
Police: Plan Rev.: 159,-~x
Phone Fire: SAC: 525,`O
Engr.: Water Conn: g~-
Arch./Eng: Planner_ Water Meter (03,°%
Address: Council: Road Unit: 2gp.~
Bldq. Off.: 2.1 Parks:
City/Zip Code: APC: 2.~'
Variar.ce:
2005 RESIDENTIAL BUILDING PERMIT APPLICATION ~ ~ ~ . C)C)
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construction Renuiremenfs RemodeUReoair Reouirements Qflice Use OnW
3 registered ske surveys showing sq. of lot sq. ft. o( house; and all roofed areas 2 copies of plan CeR of Survey Recd _ Y_ N
(20°k maximum lat coverage allowed) 1 set ot Eneqy Calculadons for heated addHions Tree Pres Plan Recd _ Y_ N,
2 copies of plan showing 6eam 8 wiridax sizes; poured found design, elc. 1 sBe survey for additions & decks Tree P2s Required Y _N
1 set of Energy Calala0ons Addition - indicefe ilan•site sep6c system On-stle Septlc Syslem _ Y_ N
3 copies of Tree P2servatlon Plan'rflot platted after7/1193
Rim Joist Detail Options seledion sheet (buildings wiN 3 or less unAS)
Date r~ / _I / Construction Cost
SiteAddress 10Q-~~LI iJf UnidSte#
Description of Work KQ. ~-p- 2I~o La 5 _
Multi-Family Bldg _ Y X N Fireplace(s) x0 _ 1 _ 2
T`
Property Owner ~~:vt,8 QR~1 ~`b~/~ Telephone # ( ut~) / ! `f
Contractor
Address City
State Zip Telephone # ( )
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheel
(Jsubmissiontype) Submitted Submitted
. Energy Envelope Calculations Submitted
In the Iast 12 months, has the City of Eagan issued a permit for a similar plan based on a master planZ
_ Y _ N If yes, date and address of master plan:
Licensed Plumber Telephone )
Mechanical Contractor Telephone # ( )
Sewer/Water Contractor Telephone # ( )
I hereby apply for a Residential Building Petmit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City af Eagan and the State of MN
Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a
permit; that the work will be in accordance with the approved plan in the case of work which requires a review and
approval of plans.
C-~w~,a r\,- am c~Q.1~ ~
Applicant's Printed Name App ' ant's Signature
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 05-plex O 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 EM. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 Eat. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex PIbg_Y or _ N ? 25 Miscellaneous
Work Types
? 31 New O 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Addition ? 36 Move 8uilding ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building* ? 43 Reroof ? 46 WindowslDOOrs
? 34 Replacement •DemoliGon (Entire 81dg) - Give PCA handout to applicant
Valuation Occupancy MCES System
Plan Review 100% or 25%
Census Code Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new hldg) Final/C.O.
_ Footings(deck) _ FinaVNo C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tesu Final
_ Framing _ Siding _ Stucco _ Stone _ Brick
_ Fireplace _ R.I. _ Air Test _ Final _ Windnws
_ Insulation ^ Retaining V?all
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
Certificate for:
Joe Miller Const, Arcadia lI
' 18133 Cedar Ave. So. - Elevation A
Farmington, Mn. 75024
DELMAR H. SCHWANZ
, LANOSVRVEVOR S, , KJC,
RpitUrW Untlb Laws of The Sbla of Minnasota
2878 - 1 TREET W. - 80X M ROSEMOUNT, MINNESOTA 55068 PHONE 612 423-1769
SURVEYOR'S CERTIFICATE
~
00 17av
9
~ ,z
~ti
N L~ •V
~ ip ^vo~,~w h~0 ~ / gji
\
.3 ~ '000~~ \ \ • ~ - a~/
ti
71e S/K
~ J
~Il /J ~~~.T o b'
s4 a ~ ~9 ~ / v
Plan 93035 • \ \
Arcadia lI Elev. A
Walkout
'y A,~' U = Yroperty corner
Flip lwidth of hse, from j o= Set spike at setback
Change
2fi feet t0 28 feet. ~ K~Z•/= ExistinR elevati.on
Proposed drainage dire::tion
PLEASE REVIEW ELEVATIONS. 8~0 9~Z ° Propoaed elevation
Proposed garage floor elevation
I hereby certify that this is a true and correct representation of the following
described tract of land:
Lot 8, Block 4, WESTBORY FIRST ADDITION, according to the recorded plat thereof,
Dakota County, Minnesnta.
Also showing the location of a proposed house as staked cliereon this 5th _
day of Feb. , 19 85 •
. fl
j;'!, z
~ MINNESOTA REGISTRATION N0.8625
_
z/a4
~
CITY Or EAGAN
APPLICATIv.I FOR PE?2MIT
SEWER AND/OR WATER CONNECTION
(PLEASE PRINi) 1) PROPETIY ADDRESS: _ 3110/0 /.ts7-' 6rr"-y
r_Fra?. DESG2I?TICN:
(LOt/Blbc}c/Subdivisicn or Tax ?arcel .D. NUnber)
~ T'r DAT' 0F Oi2IGi IAL :iiIL.DD,:G
1I: T_S
:<ar;
PPESr T ..^;7rZTVDT?OPOSM- LS: R-1 SL~GLF. FP"nSLY
? R-2 DU= (7WO L'NITS)
? R-3 'ICtv-TII?Ci;SE ('!"FT= + L':7Z:S) ! LNI"_'S)
? R-4 ar: .Y7=nr/ce::Da-slrM ~ u-NZzTs;
Q CCijTff_.~CL7,L/RE^,AZL,/OFFICc:
? mDCS=L.
(3 NSTITC,'PIO:tAI,/GG'~IE.R,~nT.~;T
2) APPISG?JiP (PLEASE PftL'If)
NAhE:
a~DREss: Ie/3 -3 A•~
CITY, ST'%TE, ZIP:
PxOiNE:
3) PEumm (PLEASE PRiNi) FOR CITY USE ONLY
NA1'¢•:
PLUMQERS LIC£85E:
ADDRESS: IY,~b' ,)3iJ Attive
CITY, STATE, ZIP: Expired
PHONE: ~-~M 7 ~ Not of Recard
36 75J PLUMBER LICENSE N_2o45 , yy3
a nitia
q) C=ANT/dv2,TM (PLEASE PRINT)
I~ME:
ADDRESS:
CITY, STA'Ir, ZIP: 5y~n~ ,9s C,l~
PHOiVE:
5) INDIG"ITE W[-]ICH PERMIT IS BEING REQUESTID:
~ CO.INEC.TION T'J CITY SETr]ER
~ C0.'`]NEC:IO,I 7O CITY WATEft
~ ~'[1ER (PLLr'15E DES=E)
6) IPa'DIG.:: C.+E:
? FI.EaSE f?OZD APPR(7VEA PE[2,MIT FOR PZCI:-UP BY ONE OF ABGVE
~ PLFiASE N*ATL APPH(JVID PERt1IT 'Iq 1, 2. '3, 4 A£OVE
(Circle one)
7) SICmauRE: ~~{~s~a~/e7/VtsQsx~ DATE: MN4
.7fr SJ
. . .
! R oF:iliwPSJi i~ l~1 Q l~ig~ta f~ ~a Iae ti~ai~ ar O ef rf.~.ii :a a at ~.lalf~-f~s~.r fl S re ~ataK~
FOR C I T Y U S E ON;,Y `
PERMIT " ISSUED
FELS: $ ~a.SD SE:^iER PLB`1rT (I`1CLi;DE SU°CFiaRGE)
$ SB WATER PERPIIT (I:.Ci,iiDE SliRCHAr-2Gt,)
$ WATER METER/COPPERHORN/OUTSIDE REr1D: R
$ WATER TAP (INCLL'DE CORPORATION STCP)
$ SE;GER TAD
$
$ ACCOUNT DF:POSIT - F7ATER
$ wac
$ ~-z~s- sp c
$ TRVVK SVATER ASSESS.-!ENT
$ TRGNK SE[9ER ASSESSbl°`IT
$ LATERAL BE:IEFIT/TRUNK SEWER
$ LATERAL BENEFIT/TRUtiK S4ATER
$ OTHER '
$ TOTAL
$ ArIOUNT PAID/qECEIPT R sa <L o G
DOES UTZLITY CONNECTION REQUZRE EXCAVATION IN PUBLIC RIGHT OF WAY?
C~ YES IF YES, THEN A"PERMIT FOR WORK WITHIN
~ PUBLIC ROADWAY" MUST BE ISSUED BY THE
NO ENGINEERING DIVISION. LIST AS A CONDI-
TION.
SUBJECT TO THE FOLLOWING CONDITIONS: '
APPROVED BY: plC,.d
TI:LE:
DAT° :
~y ~
c.tV oF es~e~an
3830 PILOT KNOB ROAD. P.O. 80X 27199 ~ pEA 8LOM9uiSt
EAGAN. Iy11NNE50TA 5519 M~ PHONE (612) 45d$100 - TMOMaS EGAN
lAMES A. SMITH
DATE: Jbar7v rr+onnns
February 28, 1985 TNEODOPE WnCHTER
cowci Memoen
THCMAS HED6E$
GN a~sro*o
VAN
, SPECIAI, ASSESS}fENT SEIRCH CEUGENE?rC•e.N ER9EKE
Requested by: DAKOTa COUNTY ASSTR9CT C0. RE: 410 83650 080 04t,
1250 Highway 55-P.O.Box 456 Lot 8, Block 4
asting, :IN 55033 Westbury lst
H s
3860 Westbury Drive
Enclosed hereia is the search which you requested made on the above described property.
Kir.d of Lmnrovement Runs BeQinnine, Ori inai Amount Balance Due
Swr Trk 15 yrs. 1985 $ 436.23 $ 407.15
Wtr Mn 15 yrs. 1984 68.71 59.55
Wtr Area 15 yrs. 1984 184.92 160.26
Street 5 yrs. 1986 $2850.00 These amounts were levied
Wtr Area 15 yrs. 1986 133.79 1-15-85. To pay off-follow t i
Lats 5 yrs. 1986 5008.73 formula: $Amount x 11% - 365
Wtr ?2n 15 yrs. 1986 65.29 x number of days since 1-15- 5
S S Trk 5 yrs. 1986 710,24 Questions-Call Spec. Assessm't
I further certify that according to the records of said office, the following improve-
ments are contemplated or pending after having been approved and are now in the process
of planning or completion.
,
Kind of Imnrovement Aooroximate ?ate of Comnletion Anoroximate Cost
NONE
WAIVER • -
Neither the City of Eagan nor its employees guarantees the accuracy of the above infor-
mation which was requested by the oerson or persons indicated. Nor does the City or its
employees assume any liability for the correctness thereof. In consideration for the
supplying of the indicated information in the above form and for all other consideratio
af any nature whatsoever, any claim against the City or its employees rising therefrom
is hereby expressly waived. Levied assessments to be paid to the CITY OF FAGA.Y,
3830 Pilot Knoh Road, P. 0. Box 21199, Eagan, fL"1 55121. ,
Very truly yours,
Donna Muench
SPECIAI. ASSESSMENT DIVISION
THE LONE OAK TREE...iHE SYMBOL OF SiRENGTH FWO GROWiH ~N OUR COMMUNITY
y I~
2000 BUILDING PERMIT APPLICATION (RESIDENTIAL)Cj
CITY OF EACAN
3830 PILOT KNOB RD - 55122 ''~I U
651-681-4875
Naw Conshuctlon Reaulremenls . RemodeVReoalr Reaulrefesal6
a 3 reylsteretl sIfe wrveya ahowing sq. fl. ol lot. a4 fl. of twuae 2 coplea of plan
and gg roofed areas t20% maMmum b1 covemae albwedl 1 sef of energy cdculaNOns br heated addlHons
> 2 Coples of plans (show beam & window sizea: poured 1ntl. tl9dqn: etc.) 1 site survey fOr extedor addlNOns & tlecks
> 1 aet ol enerpy cdcWalbna
> 3 coplss of hee pteservallan plan N loT plaMetl aller 7/1 /9J
DATE: *"a -dt-o CONSTRUCfION C05T: 5"41
DESCRIPTIONOfWORK: IutrOa RCYbb'F NOUSZ. 44CW QIG
STREET ADDRESS: 2-D (0 WCS+brY Y.
LOT: ~{L BLOCK: SUBD./P.I.D. M: WtS~611ikn1i I.~~
49
Name: RAYAO) ?h -,Toh n Phone
PROPERTY LOst Fire
OWNER
SkeetAddress: 3$00 wLS+b&q IJt"
cny 154 4a?1 stare: vm r1 z10: y=3
SELA ROOFING & REMODELING Phone 3 ~
Company:
.
IOR (area code)
COMRACTOR ST. LOUIS PARK, MN 55416 l
Sheet Address: ID #0001060 Llcense # Osd ExP~-~ r
City State: Zip:
ARCH(TECT/
ENGINEER Company: Name:
Telephone C ( )
Street Address: Regbhation
City State: ZiP:
Sewar/water licensed plumber (H Installirw sewarlwaterl: Pho"e ~J
I hereby acknowiedge thaf I have read thb applicalbn, atate ttwf 1he Infortrwtion is rtect, gree lo comply wHh all app6wbie Sfatf
of Minnesota Slaiufes and CNy of Eagan Ordinances.
Sigiwture of Applicank
OFFICE USE ONLY
Certificates of Survey Received ^ Yes - No Tree Preservation Plan Recefved _ Yes - No _ Not Required
OFFICE USE ONLY
BUILDING PERMIT SUBTYPES
? 01 Foundation ? 07 05-plex O 13 16-plex ? 21 Porch (3-sea.) ? 31 Ext. Att - Multi
? 02 SF Dwelling ? OS 06-plex 0 17 Garage ? 22 Poroh/Addn. (4-sea.) ? 33 Ext. Aft - SF
? 03 01 of _ plex ? 09 07-plex ? 18 Deck ? 23 Porch (screened) ? 36 MuIG
? 04 02-plex ? 10 08-plex ? 19 Lower Level ? 24 Storm Damage
? 05 03-plex ? 11 10-plex ainq Yor_N ? 25 Miscelianeous
? 06 04-plex _ O 12 12-piex ? 20 Pool ? 30 Accessory Bldg.
WORK TYPE .
? 31 New ? 36 .Move,BlBg. - . ? 43 Reroof . ,
? 32 Addition ? 37 Demolish (Bidg)' ? 44 Siding
? 33 Alteration ? 38 Demolish (Interior) C3 45., Fire.Repair .
? 34 Repair ? 42 Demolish (Foundation) ? 46 Windows/Doors
" Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
SAC Code ° # of Stories sq. ft.
No. of Units " Length sq.-ft.
No, of Buildings Width Footprint sq. ft.
Const. (Actual) Basement sq. ft, Census Code
(Allowable) Main level sq. ft. - MC/ES System
UBC Occupancy , sq. ft. City Wa.ter
Zoning sq. ft. BoosterPumw
PRV
Fire Sprinklered
MISCELLANEOUS INSPECTIONS ? Stucco/Stone
APPROVALS
Planning 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
% SAC
CITY O! EAGAN WATER SERVICE PERMIT
3830 Pilot Knob Road 5995
P. 0. Box 21199 PERMIT NO.:
Eagan, MN 55121 DATE: 3/26/85
Zoning: R1 No. of Units: 1
Owner: Joe Mi 1 pr Cnnst
Address:
Site Address: '1R60 WPsthiiry Drive T.R R4 Wasthiiry 1st
Plumber: Plymouth Plumbing
Meter No : 3 t / W0 Connection Charge: 500.00 pd
Size: GI g V-0 Z t Account Deposit: 15.00 pd
Reader No.: 0 9. 1 -' Z 2-1 ZC .--- Permit Fee: 10.00 pd
1 agree to comply with the City of Eagan Surcharge: . 50 pd
Orrdinances. Misc. Charges: 132.00 pd
S.l Lo .9 P y " `F " X S Total: 63.00 pd meter
By 1- 04 Li Date Paid:
Dote of Insp.: 1
S- ?- bs
CITY OF EAGAN SEWER SERVICE PERMIT
3830 Pilot Knob Road 7184
P. 0. Box 21199 PERMIT NO.: 3/26/85
Eagan, MN 55121 DATE:
Zoning: R1 No. of Units: 1
Owner Joe Miller const
Address:
Site Address: 3860 Westbury Drave L8 B4 Westbury 1st
Plumber: Plymouth Plumbing
3 -1 -85 49850 100.00 pd
1 agree to comply with the City of Eagan Connection Charge: 479.00 pd
Ordinances. Account Deposit: 15.00 pd
Permit Fee: 10.00 pd
Surcharge: _ 50 pd
By Misc. Charges:
Date of Insp.: Total:
Insp.: Date Paid:
Use BLUE or BLACK Ink
r - - - - - - - - - - - - - - - - -
I For Office Use
; Permit
1 t 1~~~ j
CIla
of EaEd I a5
I Permit Fee:
3830 Pilot Knob Road I I
Eagan MN 55122 ; Date Received: ;
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff: I
I I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 7/10 3 Site Address: -3,8 6 O W -PS ~ Lw t\~ Unit M
Name: 2;f O v _ L &,t p a,~Lrfl Phone:
Resident/
Owner Address / City / Zip: g b C7 u_ ~S 9'.bufy Dr 4%, -r-
Applicant is: Owner Contractor
Type of Work Description of work: i dl
Construction Cost: 7 n q a Multi-Family Building: (Yes / No
Company: -r AV_7:J~- /h k , A- -f- Contact: Let 1Y
Contractor Address: , S ev i )P ( /q t, f City: v /
v
State: M,/U Zip: S S ) 0 Phone: 6=C/-;2 1 q~
7 ' ! ` -7..1
License IZ G q,2693 Lead Certificate g3 1 /O O ob
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE. Plans and supporting documents that you submit are considered to be public information. Portions of
the information maybe classified as non-public if you provide specific reasons that would permit the City to
conclude that they are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.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 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 L~rr~L ,P ct x
Applicant's Printed Name Applicant's Signature
Page 1 of 3
06/03/2015 09:02 FAX 8662507897 PLUMBING, HVAC, ELECTRIC f�001/001
Use�LUE or BLACK Ink
� For 61'lioe lJs� — — —,
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(� Of � �
I�t� � ���: l22;
�� � ,
3�36 Ptl�Krwb Road � Pennn Fee: I
Eagan MN 551� � �
Phons:(651)E75-5�75 i Date Rec�ived: �
Fax:(�51)�75-56�94 � S� I
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�1�MECNA►N#CAL PERMiT�►PPLfG�1T�(?N
❑ Pt�ase submit two(2)sa�ls of ph�ns with all commercial�plications. ,
�acs: 06/Q2/9 5 ��ress: 386b Wsstburv Drive
��
TenAnt: g��;
Nam.: Mic�eal Arruda P��; 3167U8�4397
ac�s i cny i z�p: 3860 Westbury Drive
�n,e: Vinzar�t Rlumbing and heatin�] u�nse#:
�: 541 N Wheeler St �;h,, St. Raui
S�: MN Z�. 55104 �: 6516442700
�: Pachfia Lee Ema�i: Pachia�rinz�antmn.com
_NeH► �Replac�ment _ndd�ional _luterabon �errxx�lition
D�io�Of wOf'k:
RESI�EIYTIAL C�RC/AL
Fwmace _New Consbuc�On InQerior improvement
�Mr Ca�ditioner _InstaN Piping _Processed
—��°� _Gas _Extaior HYAC Unit
,_Fi�Pwnp _Under/Above
ground Tanlc (_Ir�Q!_Remove)
,�OM�e�
RES/GENT/AL FEES
�60.00�Add or altera�cm tu an existing unit(includes a5.00 S'tata S�ucharge)
5400.00 Resider�tial Nsw(includes 55.00 S#ate Surcharge) =a �.� TOTAL FEE
GO�RCIAL FEES
conaract vah,e s x.o,
�55.��f�s 11�Um�n
�?'0.�Untl�r�round tanic I��oNromov� =S Pennit Fee
'1f co�act vahu is LESS 1#i�i}0.�10,Surc�erge=s5A0 a ���e
"'N conVa�t�alw is GREATER tl�en$�0.010,Surcharge=CoMract Value X;0.0005 a �
"'If tlie proj�valuation is o+rer i1 rndlan,pi�se carq for Surcha�ge =a TOTAL FEE
��►Y�e tF�t tl�is 4�arn�on!s oomPleDe�d ao�xsats;that�e waic wYl be in wNh ths ordkqr�ss and ccdes of the C�y of
�;awt� �is ncc.a�nnR�nut onlyy an appucaUa,ta a psm,��and wo�lc��� a . tne walc vMil�be in accorde�ce
plan in the d work which tsq�es a roview and spproval of pqx�a.
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Ap�a�t's Pri�d N� x
�Pp�
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA172318
Date Issued:09/24/2021
Permit Category:ePermit
Site Address: 3860 Westbury Dr
Lot:008 Block: 004 Addition: Westbury 1st
PID:10-83650-04-080
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507)
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Michael & Emily Arruda
3860 Westbury Dr
Eagan MN 55123
Genz Ryan Plumbing & Heating
2200 West Highway 13
Burnsville MN 55337
(952) 767-1000
Applicant/Permitee: Signature Issued By: Signature