3866 Westbury Dr41111'
tyofEaaall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
Date Received:
Staff:
2010 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: Site Address: 3866 VJ @S4 OcJ4y Dr.
Tenant: % °//5S Ockr0nbrut,tr.
RESIDENT / OWNER
CONTRACTOR
J
Suite #:
Cv
Name: AG rssck. I3c t•cn 14uarrl Phone: 657- 9?4-/' O Z EP 3
Address / City / Zip: 3 Eirs4 Wo.54-baly DP. EGtec.n 567 3
Name:Am/fa/1m ..Lnl$ rfet5 O` inn License #: QS'8 /.3/ ePI
Address: / /^I SOS Pc c c t
s S 1` /V a City: /` r`o P c Ke
State: in n Zip: SS" .3 7 2 Phone: 9S2 - L/(4 ea L/ /
Contact: / h fGle.l le Email:
TYPE OF WORK
PERMIT TYPE
_ New ,replacement _ Repair _ Rebuild _ Modify Space _ Work in R.O.W.
Description of work:
RESIDENTIAL
Water Heater
Lawn Irrigation ( RPZ / _ PVB)
_ Septic System
New
Abandonment
Sater Softener
Add Plumbing Fixtures ( Main / Lower Level)
Water Turnaround
RESIDENTIAL FEES:
$55.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)
$35.00 Lawn Irrigation (includes $5.00 State Surcharge)
$55.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge)
*Water Turnaround (add $166.00 if a 5/8" meter is required)
$105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge)
$95.00 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge)
TOTAL FEES $
CALL BEFORE YOU DIG. Call Gopher State One CaII at (651) 454-0002 for protection against underground utility damage.
Call 48 hours hefore you intend to dig to receive locates of underground utilities. www.gooherstateonecall.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.
x t7to /14 cte41.1A
Applicant's Printed Name
x—
Applicant`s Signature
FOR OFFICE USE
Required Inspections: __Under Ground ,_Rough -In Air Test _Gas Test _Final
Reviewed By: Date:
~.~..,^rr,r~ riaR sl 1! r87
1,56-c~r,6~CITY OF EAGAN
5..r?72 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
BUILDING PERMIT Receipt # '
To be used for •"~)Wr/CAR Est Value $63,000 Date APRIL 2 19
':;66 P7,_.STBITRY ;7R
5ite Address Erect Lf Occupancy
`!'HU?2Y 10,1' Remodel ? 2oning
Lot Block c/Sub.
Parcef No. Repair ? Type of Const. t+
Addition ? No. Stories
¢ Name `(VE'PF MILLx'T2 CU?+.ST Move ? Length aa
W Demolish ? Depth FEDAR ; Address r~ Inl Impr. ? Sq. Ft
° Ctty 431-2001 Install ?
_ 0 Name APProvals Fees
Q Address Assessment Permit
~ City Phone Water & Sew. Surcharge -
Police Plan Review ~ ~ •
~ = iVame Fire SAC 57 S• '
~ ~ Address Eng.
Water Conn. • '
=
< W City Phone Planner Water Meter •
Council Road Unit
I hereby acknowledge that I have read this application and state that the q/~ 1.~'<<6
information is correct and agree to comply with atl applicable State oI Bldg. Off. Tr. PL
Minnesota Statutes and City of Eagan Ordinances. APC Parks
Sisnature ot Permittee Var. Date Copies
r f?t ~
MLzLr.FR ::nS~Totai ~
A Bullding Permit is issued to: on the express candition that
all work shall be done in accordance with all applicable State of Minnesota Statutes and Cily of Eagan drdinances.
Building OHicial
~ PermN No. PwmR Holdw Dats Telephona k
PIum6ing ! V 3 5
~ . .
M.V.A.C. 7-3
Elotfflc
Softener
Inspecdon Date Insp. Comments
Foonngi l
Faodnqs ll
Faundation
Framing f rYl 1 5(~ ` f! ~ e~a Pl ~ T~D
RooNny
Rough Plbp.
Rouph Ht9.
Insul. ~Z-
Finplace
Flnal Hty.
Flnsl Plbg. ~ - ~
Bldg. Ftnal ~
Cert. Oec. 3`9
.
, C. Ti, i r) - 3_ Goe4; C, tcx-E
U
Dsck Ft9•
Dack Frmq• 12~ ~
WNI a - T ~
Pr. Disp.
1~'
.
, • . ,
PERMIT # CITY OF EAGAN FEE -
MECHANICAL PERMIT
RECEIPT # r 454-8100 S/C -
MINIMUM RESI.DENTIAL FEE - $10.00 +$.50 TOTAL
DATE ((7' MINIMUM COMMERCIAL FEE - $20.00 + $•50
1. Bldg. Type: Res Comm Inst 2. New ° Add Alter Repair
3. Total Bid Price 4. Job Address
Lot ~Block T~ Sec r 5. Owner
6. Contractor'..
(Neme) , / ~ ~ v (Streeq ' (Ci1Y) (ZiP)
7. Contractor Phone #
RESIDENTIAL HEATING - 01-100,000 BTU's -$24.00. Each additiona150,000 BTU's or fraction -$6.00
AESIDENTIAL COOLING - 01-24,000 BTU's -$12.00. Each additional 6,000 BTU's or fraction -$6.00
MODIFICATIONS/ALTERATIONS -$10.00 minimum fee
HEATING VENTILATING HOT WATER STEAM AIR COND.
~AIR PIPING PROCESSED PIPINC3 AIR HAND. EQUIP. RtFRIG.
~ RES. GAS PIPING OUTLETS - E1.50 TANKS: L.P. UNDERGROUND OTHER
COMM./IND. RATE r 196 OF TOTAL BID PRICE PLUS $.50 STATF, SURCHARGE FOR EACH $1,000 OF FEE.
Signed: Ct ~ i E C- - for
Approved;' Inspections: Date Rough Insp. Date Final insp.
, . PERMIT # _~033
• PLUMBING PERMIT RECEIPT #
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE:
CONTRACT PRICE PHONE 454-8100
Site Address >qe' BLDG. TYPE WORK DESCRIPTION
Lot Block ~ Sec/ b
~r Res. > New ~
m Name - Mult Add-on
m Address Comm. Repair
c City _ Phone`.° -Other
NO. FIXTURES TqTAL
Name Water Closet - $3.00 s ~
c Address Bath Tubs - $3.00
p City Phone ' Lavatory - $3.00
Shower - $3.00
FEES Kitchen Sink - $3.00
COMM/IND FEE - 196 OF CONTRACT FEE Urinal/Bidet -$3.00
Laundry Tray - $3.00
MINIMiJM - RESIDENTIAL FEE - $10.00 ~ Floor Drains - $1.50 MINIMUM - COMM/IND FEE -~.00 Water Heater -$1.50
STATE SURCHARGE PER PERMIT - .50 Whirlpool -$3.00
(ADD $.50 S/C IF PERMIT PRICE GOES ' Gas Piping Outlets -$1.50
BEYDND $1,000.00) Softener - $5.00
Welt - $10.00
Private Disp. - $10.00
~ Rough Openings - $1.50
SIGNATURE OF PERMITTEE FEE
STATE S1C:
FOR: CITY OF EAGAN GRAND TOTAL• •
CITY OF EAGAN Remarks /
Addition WESTBURY FIRST ADDITION Lot 9 Blk 4 Parcel 10 83650 090 04
Owner Street 3856 Westhury nrive State Eagan, MN 55123 _
Improvement Date Amount' Annual Years gS Payment Receipt Date
STREET SURF. 1986 Z$ Jr,
STREE7 RESTORfjQL
GRADING - "
Water area,,' 1986 133.fi3j',, 8.92 15.
SAN SEW TRUN 436 29.08 15 , i3'
~ 5EWERLATERA ~ 1986 5~~
1001-79
Waterm
ain 1986 65.
4.35 19
WATERMAIN 1984 68.71 4-58 15 Jr 55
WATER LATERAL -
WATER AREA
1984 2
*Services
STORM SEW TRK 1986 710.24
* STORM SEW LAT
CURB & GUTTER '
SIaEWAl.K
STREET LIGHT
WATER CONN.
BUILDING PER.
SAC
PARK
~ p~CITY OF EAGAN
- 11728
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 Np
f--~1 PHONE:454-8100
BUILDING PERMIT Receiptq 7,7
7obeueedtor SF DWG/GAR Est.Value $63.000 Date APRIL 2 ~y86
Site Address 3866 WESTBURY DR Erect 6 Occupancy R3
Lot 9 elock 4 Sec/Sub. WESTBURY 1ST Remodel ? Zoning Rl
Parcel No. Repair ? Type of Const V
Addition ? No. Stories
JOSEPH MILLER CONST Move ? Length 45
= Name
18133 CE AR AVE SO Demolish ? Depth dF
o Address Int. Impr. ? Sq. Ft
Ciry FARMINCprg&W 431-2001 install ?
Name SAME Approvals Fees
a
o
$p nddress Assessment Permit $ 322.00
~ Ciry Phone Water & Sew. Surcharge 31. 50
Police PlanReview 161.00
Fw Name Fire SAC 575.00
Address 500.~~
330 Eng. Water Conn.
a w city Phane Planner Water Meter 63 . 50
Council Road Unit 290.00
Iherebyacknowledgethatlhavereadthisapplicationandstatethatthe gldg.Off. 4/1/86 7r. PI. 156.00
information is correct and agree to comply with all applicable State of
Minnesota Statutes and City of Eagan Or i ences. APC Perk3
~ ~ Var. Date Copies
SignatureoiPermittee - Total $2.099.00
JOSEPH MILLER CONY
A.Builtling Permit is issued to: _ on the express condition Mat
all work shall be done in accorda with I a ' le Sta €Minr~a fa Statutes and City of Eagan Ordinances.
~
Building OHicial n t
/
2004 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
Date I I
Site Street Address ~,-od ? Unit #
Property Owner TiP/l Telephone # *W)/`'6S = /a o ~
Contractor r..~ T/elephone #
Address ,U?VL,4rQg zl-r-So City State 4l Zip
The Applicant Is: _ Owner _ Contractor _Other
Alterations to existing dwelling $ 50.00
_Add fixtures to rooms, excluding water softener and water heater
_Septic System Abandonment
_ Water Turnaround (add $121.00 if a 5l8" meter is required)
Other:
WaterSoftener C-Vqa~ter Heater $ 15.00
_ replacement _ additional
Lawn Irrigation System RPZ_ new _ repair _rebuild $ 30.00
State Surcharge $ 50
Tota~ LAPR g/s
I hereby apply for a Residential Plumbing Permit and ackno ation is complete
and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan and the plumbing codes; that I understand this is not a permit, but only an application for a
permit, work is not to start without a permit and work will be in accordance with the approved plan in
the ev a plan is required to be reviewed and approv `
ApplicanYs Printed Name Ap IicanYs Signature
. ~
1985 BUILDING PERMIT APPLICATION - CITY OF EAGAN
NOTE: ALL CONTHACTORS lNST BE LICENSED i1ITH THE CITY OF EAGAN
MODEL 65- (Cr~ INCLUDE 2 SETS OF PLANS
.1 CERTIEICATES OF SURVEY
1 SET OF ENERGY CALCULATIONS •
C03.000
To Be Used For: Valuation: Date:
Site Address: ?!f/ OFF CI E USE ONLY
Lot: 9- Block ~ Sect/Sub Erect ~C Occupancy ~
Remodel Zoning 12,(
Parcel / Repair 1 Type of Const ~w
Addition Ik of Stories
Ocmer Move _ Length 45
Demolish , Depth 4~,
Address Int.Impr. _ Sq Ft
Install ~
City/Zip Code
Phone APPROVALS FEES
Contractor~~ ~ Assessments Permit 3 Z2,
C Water/Sewer ~ Surcharge 3l' S-°
Address af~.3 Police Plan Review Ifol.
Fire SAC 575
City/Zip Code Engr Water Conn C o.
Planner Water Meter (,,3 5=
Phone Council Road Unit 'LrtO.
Bldg Off;S b Treatment P1 I>G,.
Arch./Engr. APC Parks
Variance Copies
Address TOTAL =0 y
City/Zip Code
Phone II '
TRI-LAND C0.
SURVEYING SITE PLAN FORO.
SERVICES JOSEPH MILLER
4655 NICOLS ROAD CONSTRUCTION, INC.
EAGAN, MINNESOTA 55122
N \
SCALE I"=30'
y
a 6 ~ .
Y
w~
~ N 54017' 33" W
m,0 ; 140.00 N O M. ? 1 NT N
y ~J O
~ ~ . ~r~•.. N A ~hr 24'
~
CT '
' Z
~ 12 0
_..r m ~ LOT 9I ST
v g~ oON
~ I ~
0 N
-4
m 30 ~
,o -
140.00 "
N 54°17'33W
F
1 yl / : 1
9a
O~
PROPERTY DESCRIPTION
LOT_, BLOCK_,
WFSTBLIRY FIRGT ADDITION
occordinq to tbe recorded plat thereof
DAKOTA Ca?mq, Minnssota
LEGEND
o DENOTES IRON MONUMENT PROPOSED 6ARAGE FLOOR ELEVATION= 107~°°
o DENOTES WOOD HUB SET PROPOSED FIRST FLOOR ELEVATION=
DENOTES EXISTING SPOT PROPOSED BASEMENT FLOOR =
ELEVATION ELEVATION
DENOTES PROPOSED SPOT
ELEVATION NOTE* VERIFY ALL FLOOR HEIGHTS WITH
~ DENOTES DRAINAGE DIRECTION FINAL HOUSE PLANS
l hersby certify ihaf This turvey,plon ar
rsport was preporod by me or under my 1. -
direct supervision and that I am a duly Bradley enson, Mn. Req. No. 15235
; Repistered Land Surveyor undsr the .'V2 1R~
: Laws ot the State of Minnesota Dote •
~
_ .
;
' ' • CITY. OF BUILDIN(3 DEPARTh;ENT
r k:XTERIOR ENVk3.OPE,AVMGE "U 's COFIPUTATION
(To be submitted with building pormit applicatloa)
One or Tva Family Dwelling Owner
All Other Site Addrasa
Contractor So~F_pd /~iLF..Q 0415T. Date Phone
#$s-loo
LI[v6kL ; EET OF 7
E?C'O:;ED 6'tALL ~EE <</o,e,r ~ly~ET~ tt. above grzde < z, O}g,00 U
TOTAL i;;C'OSiD 13ALL Ak'r.A SQ. FT.
0?n,:,UE ;7i.LL CJi:SP'r.D:TIJt:: "U^ ValUe x Area
Detail FA- AN7E flUit •0,f 3 x SQ. FT. 1(05Z.Z0. 740¢ (U)(A)
re:erence Cct~,e• "U" •07(a x SZ. FT. Wa48= 7.33 (U)(A)
from "U" .040 x SQ. FT. 1l9•5Z= -?./0 (U)(p)
attacned "U" x Sq, FT. _ (p)(a)
sheets "u" x 5:;,. FT. _ (U)(A)
"Ult x Sn, FT. - (U)(A)
'.7I1:D0',75: "U" Value x Area
Aia:ce & Type I1JSVL• dS.PV'T "UP' . 4$ x SQ. FT. ~•oo (U)(A)
"u" x SQ. FT. - (U)(A)
? fr nQn x Sq. FT. - (U)(A)
u °Un X SQ. FT. - (U)(A)
T1JOR5: ^[f" Valiio x Groa
:ia:ce & Tyue ~i'rt • IA,5.vL. nUn •14 x SQ. FT. q' •bo (U) (A)
" " 847i o "U" . 47 x S: . FT. Z•oo =
A)
uuu x SZ. FT. _ (U)(A)
n n _ upn x SQ. FT. - (U)(A)
TOTAI.S Zogg.oo SQ, r-T. /S3•g3 (U)(p)
AVERA4E "Ull
ToTai. (u)(a) vr.t.oES JS3.~~ _
- , 073
DIVID:iD BY TOTAL :71.LL kRr:A Zogg oo ~
AVF;kAC3E itUt~ ,115 r less for 1&2 family dwellinga
ROOF/CEILINCi :
T9TAL AREA: IOOZ ~
Detail reference •oZl x SQ. FT. /OOZ = Z/•o~j- (U)(p)
from x SQ. FT. = (U)(p)
attached sheeta. IIUII x SQ. FT. - (p)(p)
Describe oneniags IOUll x SQ. FT. - (U)(A)
in roof. x SQ. F.T. - (U)(A)
TOTAL (U)(p) VALUES DIVIDED BY TTA{Vj
~ t
'f0`iRL R00?/CEI ,Ii:G :.l;Ep ~ppZ.C,0 • OZ f
AVER„GE "U ,025 for ventilc:ted roofa. -
i
~
?
~oRK yWE E-r
14.5o X~38t38+34+34) = Z~OSB•~~
Co?1e .
.G7K ~38*38t-34t34~ = Y(o.`FS ~r
~lrn-Tors
. 83K (,38+38t34t3¢~ ~ I19•SZ ~
1~/i~1Aow S
Ibx3&= 4•o x 4= llo.oo
loK3& = 5, 0 X (o= 3o. 00
24x 3&= rv.o x 4~ zqL.0c,
zox49; =(P.7 x 4= z&. so
z4)c 48 =$.o J( q. = 3z, ov
/28• So ~
Icvp~S
3 ° sn.. w/5.c
Zg' $7c.- SE,e = 21, o0
/o= PAT/o = ~fz,oo
A_
ERv/a~
Z,oeF oo Z4 X 3 S= q2
GESS co~lc. q~.gs 9 x lo = 90
1~ ~P~~rJ• u4•sL
n wDw's lzs.go -St3S:8o l,002.00
Daorz?s 9l•00
1~ ~SZ. Zo ~
-wtt.L=sscnoa--
Determining 1,U11 values at Roof, Wall, Rim, rand Conc. Block
S ROOF/CEILIN4 R VALU]
1.) Interior Rir r•ilm 0.61
2.3 5/8-1 ayp. Ba. .56
j.) Insulation
4.1 4¢,p0
5.) Exterior Air Film .bl
~ 2 3 ISTILL)
f 6 nIIn = 1/R= .0al LOTAL (R)= 4s.7r~5
I _
O WAI,L (R Vf,LUr
6.) Interior Air Fila 0.68
lJ 7.1 P GYP. Sd.
.45
8.) Insulation 1q.C~o
9. ) ~ y~~ $ut(.T- Ri7E Z,04
10, ) iitasonite Sidino .67
l0 11.) Exterior Air rilm .17
l l
npn o 1/R= TOTAL (R)=Z3,0/
RIM R VALUE
12.) Interior Air r'iLu 0.68
13.) Insulation /9.00
14.) 2" Fir Rim Joist 1.88
IS 15.) zs/3Z+ 8vrv-R,~e z,oq.
16.) Maeonite siding .67
17.) Extorior Air Film ,17
. „
. • . . IiIIu = 1/R= .04d TOTAL (R)=z4.g¢
~ FOUNDATION (R) VALUE
180 Iaterior Air Film 0,68
zl . . ~g 19 . 3
Jo 20. >P-1 f S-rRIPPEA 1l • o0
n • 9 21.) 12" Caacrete Block 1.28
22.)
63 ."b 23.) Exterior Air FSlm .17
~ -
"Ull = i/R= , 07l0 TOTai. (a) =13.13
~
, ~*********#*********##!***#**#t##***
C I T Y O F E A A i~ PA~'~ OF k~E AT 1~ pF :
* APPI,2CIATION DOESS NUr CONSPI7STlE
*y APPROVAL OF PFRNIIT. :
~ APPUCATION FOR PERMIT
~ . * iNSencriorr oF' sE~t r,rro/Ot ~~t ;
* IPS'LALLs+'T'TONS WIIS, NOT BE S(;fE4- ~
SEWER AND/OR WATER CONNECTION UITM PERMIT HAS EM ;
. . . . * APPROVID. ;
>
. rt~*+,r*t***~*~~+e*,tr~~r,exa*x*+**:k,rx,t*~
P ease Print
1) PROPERTY ADDRESS: ,~jG6 ,Cl~
LEGAL DESCRIPTION:
Lot Block Subdivision or Tax Parcel ID )
IF EXISTING SIRCCICRE, DATE OF ORIGINAL B[.'ILUZNG PERMIT ISSCANCE: - ~
i
(MOn Year)
PRFSEDTi' 7ANING/PROPOSID C'SE: •
Q C0~','A'E2CIAL/F2ETAIL/OFFICE ~ R-1 SINGLE FAhffLY
r7 I6IDOSTRIAL Q R-2 DL'PLEX (Ttoo Units)
~ INSTI'ii'TIONAL/GOVERDIlNE,'NT ~ R-3 TC))WNHOUSE (Three + Units) ( Onits)
. Q R-4 APARTMENT/CONIDOMINIL~M ( -Units)
Q74.~~
2)
NA["g'+: 6 B . _
• ADDRESS:
CITY. STATE, ZIP:
PHONE:
3) • u N~. For City Use
Plimibers License:
ADDRFSS: Active
CITY, STATE, ZIP. ~Pised
i Not recorded
PHONE:_5t~7.` - 0,57D E MASTER LICIIVSE# St~tial
; Q) ~a • ~ i~• _ ' ~ NAME:
ADDRFSS: •
CITY, STATE, 2IP:
PHONE: .
5) ~ ~r• ; ~ a: • : a • o~ -
~ CONNECI'ION T0 CITY SEWFT2 1SL1 CONNEC.TION 10 CITY WATER ~ OTHER ' .
6) ."071" ~ PLEASE HOLD APPROVID PERMIT FOR PICK-UP BY ONE OF ABOVE
PLEASE MAIL APP PERMZT TO 1, 2, 3, 4, ABOVE
(Circle one) 7) r n u• • L,,~, 1,~. • .)/i
' • `1: • i' :I: ~ ~ ~ 1' t~' •l ? I:t• . i~ I• Y71' • Ib . . . • ~ 1
• I. • 1+. 1 1 :7 M:1• •,tlD~ 1 /1 ~I' ~ t~' :A' • 1 :
+ \
_ . ~ . •
. FOR CITY USE ONLY
PERMIT # ISSOED
Pd w/Bldg. Permit FEES:
$ $ /0- S L SEWER PERMIT (INCLLDE SURCHARGE)
$ $ /D S G WATER PERMIT ( INCLC'DE SI'RCHARGE )
$ $ WATER METER/COPPERHORN/OC'TSIDE READER
$ $ WATER TAP (INCLC'DE CORPORATION STOP)
$ $ SEWER TAP
$ $ ~Sl~ lJ ACCODNT DEPOSIT - SEWER
$ $ ACCOP[VT DEPOSIT - WATER
$ •~l' O . P n $ WAC
$ $ SAC
$ $ TRUNK WATER ASSESSMENT
$ $ TRUNK SEWER ASSESSMENT
$ $ LATERAL BENEFIT/TRPNK SEWER
$ $ LATERAL BENEFIT/TRUNK WATER
$ A5 $ WATER TREATMENT PLANT SURCHARGE
• $ $ OTHER:
+S_ 12- S d TOTAL
y v ~~-/d'3
RECEIPT RECEIPT
DOES UTILITY CONNECTION REQUIRE EX:AVATION IN POBLIC RIGHT OF WAY?
Q YES IF YES, THEN A"PERMIT FOR WORK SVITHIN PLBLIC
Q ROADWAY" MUST BE ISSLED BY THE ENGINEERILVG
NO DIVISION. LIST AS A CONDITIO[V.
SUBJECT TO THE FOLLOWING CbNDITIONS:
APPROVED BY: ,(~kle-f C~ TITLE:
DATE :
a"' �' ,�+ ' ,t oho- r v .,,,.‘„,,it-'4.- ,--..° :.:7,1:;:,':%:.
...lie,„,,. ..• . *�"�' le ,M, ✓
X dfi_1F`4 � o ✓r. RR d. : s
ka s- ; 4
Y ., 3
t ' - ,
C('1: c
Pte[
• _T 1 8b 4,1499 t$ATB:
51190v, Mot 55
Z : _ No of UMts
J se Miller COX St. Co,'
Qwner _.._
�►ddre O ri d, Wear . '° le t
Sits g , I ear Pltsmb�t
�' '"'. 4_ ! :. 6114‘,,,, . LOO.
1 «Airily 'tall '' of 475.0
N,
- . rkog ,
By , . � . , 1
- Jm *r.,.
II
1,100..
`' 'P
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA124435
Date Issued:07/01/2014
Permit Category:ePermit
Site Address: 3866 Westbury Dr
Lot:009 Block: 004 Addition: Westbury 1st
PID:10-83650-04-090
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
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 by law in ALL single family homes .
Kelly Meyer
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 -
Thomas S Barenbaum
3866 Westbury Dr
Eagan MN 55123
Hause Construction, Jg
P O Box 206
Bayport MN 55003
(651) 439-0189
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA130307
Date Issued:04/16/2015
Permit Category:ePermit
Site Address: 3866 Westbury Dr
Lot:009 Block: 004 Addition: Westbury 1st
PID:10-83650-04-090
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Applicant: Lisa Skogen
5660 Memorial Avenue North
Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088
Surcharge-Fixed $5.00 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 Omomo
3866 Westbury Dr
Eagan MN 55123
(651) 600-2567
Hoffman Refrigeration & Heating
5660 Memorial Ave. N
Stillwater MN 55082
(651) 439-5770
Applicant/Permitee: Signature Issued By: Signature