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3902 Westbury Dr CITY OF EAGAN WATER SERVICE PERMIT 3830 Pilat Knob Road s•:; P. O. Br -x 21189 q PERMIT NO.: Eagan, MN 55121 D/?TE; 6-11- ~ 1 Zoniny: 1 No. of Units: ~ Owner: an~" Jaics Addross: Site /lddrou: 3902 4;eSC r-1rr . t•:cstburv t PltRnber. , .1 rr ~ a, , , - Mster No.: ~ ~'t~Snnsction Clarge: 501? . 00 pd Size: .,d r~teode. No.: m+it Fee: lU. UUpci 1 pne fe e=ih MNb !iw Ciry of Erwn Surcharqe: . 50 pd p,~.,,.~, Misc. Choro.s: 132.00 nd o~,Q Totol: 61.0n T)`~ meter gy ~ . J1,c, •',~iJ1~,.l~tJ~l Date Paid: Dote of insp.: f Irap.: CITY OF EAGAN SEWER SERVICE PERMIT 3830 Pilot Knob Road 7~,F'? P. O. Box 21199 PERMIT NO.: Eagan, MN 5512i ~ATE: 1 ~ing; No. of Units: ~~r. :;dnd ~ak8 i Acidrem ' ~ 3902 ~7estbur Drive L15 B4 Westbu 1 Si rib ' $ e7 Plurr?ber. f 6-4-85 52412 ~ ! 425.00 pd 1 qm fa eemr!!~ wM0 fiw CWp d t011s¦ Conneetion OwryNes . ~ OeaiMwa~a Acaount DePOdt: . pd Pormlt F«: . P ! Sur+ctwrge: i 8y Misc. Charpsv i Date of inap.: Tatd: ~ Irop.: Onft Pold: ~ - I'. Cch4ra&I CITY Of EAGAN 4 3830 PiJot Krwb Road, P.O. Box 27•799, Eagan, MN 55121 PHONE: 454-8100 BUILDING PERMIT Re«iat .f te w wd far Est. Value - Dare 19 Site Address ~ Erect ? Occupancy L4t Block SaclSub. Remodel ? 2oning Parcel No. Repair ? Type of Const. Addition ? No. Stories Move ? Length cc Name _ Demolish ? Depth Address Int Impr. ? Sq. Ft. ~ City Phone Install O Name Aporovah Fees Assessment Permit Su Addresa City Phone Woter b Sew. Surcharge ~ Politt Plan Review / PW Name Firo SAC i~ Address Enq. WaterConn. ' u i} 5: W City Phone Plonner Water Meter Council Road Unii ( hereby acknowledge thot I haw rood this applicotion ond stnfe that gldg. Off, ~ Tr, PL ihe inlormotion is torrect and agree to comply wifh all opplicoble APC P~rks Stote of Minnesoto Srotutes and Ciry of Eapon Ordinances. Var. 0ate ~pie8 Siprwturc af Pertnittat ~ . . 7otal h Building Pem+it Is issued to: an tFx axpress condition thol off worlc shoN be done in otowdante with oll applimbla Stote of Minnesota Stotute: and City o? Eapan OrdinonceL 8uildinp Officiol Permit No. Permit Holde? Daft Tslephona ~ Plumbinq l~ (p r r- H.VA.C. ~ I ENctric Softemr Irspsction Data Insp. Other Footingsl Footings 11 Foundation Framing 6 ~ l~ h ~"t Yo a ~ Roofing Rough Pibg. • -L `~7 E~- Rough Htg. ~ ~ St_% lnsu4 E~ ~j f ry,s,~~ r,vv - PO Fireplace ~..ri .u~.t9 - .S IY Qe.c,k- 11-.Af -Y 7 E. Final Htg. ~ Final Plbg. Final _ S Cert/Occ. Water ~ocation: Well Sewer Pr. Disp. Reoeipt PLUMBING PERMIT • Permit No. CITY OF EAGAN Fee ' lC t j' t% fill in numbered spaces S/C Type or Print legib/y Tot. 1. Date SS 2. Installation Cost : 3. Job Address Lot~ ' ~ Blk. 7ract ' / J 4. Owner , -t j 5. Contractor A% fl:'r n Phone 6. Address 7. City State - ' Zip 8. BuildingTypt: Residential l~Commercial ? Institutional ? 9. Work Description: New 0" Add ? Alter ? Repair ? 10. Describe 11. No. Fixtures No. Fixtures Water Closet Cesspool/Drainfield _L Bath tubs Septic Tank x Lavatory • , ~ Softner ~ Shower s~ Well ' Kitchen Sink Urinal/Bidet Other Laundry Tray Floor Drains Drinking Ftn. Slop Sink r j _ 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 : fol- Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-6100 Reaipt pAECHANICAL PERMIT Permit No. CITY OF EAGAN . Fee Fil1 in aumbemd spaces S/C Type ar Prin[ legibly Tot t. Date 2. Installation Cost 3. Job Address Lot , Blk. Trsct 4. Owner ' 5. Contractor + Phone • I - 1, • ~ 8. Addreu 7. City State '_1 i•- 2ip 8. Building Type: Residential Q Commercial O Institutional ? 9. Work Description: New "Ll Add ? Alter ? Repair O 10. Describe Fuel Type 11. No. Equioment STU - M. Ea. No. Eouioment CFM Forced Air Air Handling: Mfg. Boilers Mech. Exhaust Mfg. Unit Heater Mfg. Other Air Cond. Mfg. GaS, Piping Outlets 12. I hereby oertify that the above information is true and correct, and I agree to comply with all ordinanoes and codes governing this type of work. Signed : for Rouqh Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EA(;AN 464-8100 Receipt ~ PLUMBING PERMIT Permit No. _ CITY OF EAGAN Fee Frll in numberect spaces S!C Type or Print legibly Tot ~i ~ 1. Date 2. Installation Cost ' 3. Job Address Lat Bik. Tract ~ 4. Owner _ - , 5. Contractor Phone 6. Address 7. City State Zip S. Building Type: Residential 0 Commercial ? Institutional 0 g. Work Description: New Add ? Alter O Repair ? 10. Describe 11. No. Fixtures No. Fixtures Water Closet Cesspool/Drainfield Bath tubs $eptic Tank Lavatory ~ $oftner Shower Well Kitchen Sink Urinal/Bidet Other ~ Laundry Tray Floor Drains Drinking Ftn. Slop Sink Gas Piping Outlets , 12. I hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. ` Signed : , for Rough F inal Inspections: Date Insp. _ Date Insp. This is your permit when numbered and approved. Approved CtTY OF EAGAN 454-8100 CITY OF EAGAN Remarks Oi J"-1/., "-,ell frg 1, e Z r~ -pZ 61, Addition WESTBURY FIRST ADDITION Lat 15 eik 4 Parcel 10 83650 L150 OLF Owner street 399.2 y,egtbury Pr~..v.e_ state Fctg3Ay MN 55123 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. ;,986 2850.00 ti850.00 7-23-85 STREET RESTOR. GRADING water area 1986 133.79 8.92 15.133.79 A015842 7-23-85 SAN SEW TRUNK 436.23 29.08 1 1407.15 A015842 -Z -8 SEWER LATERAL 1986 5008.73 1001 .]5 5008.73 -AQ15842 7-23-85 Watermain ,"by 65.2 4.35 1 65.29 A015842 7-23-85 WATERMAIN 1986 59-55 A15842 -2 -8 WATER LATERAL 1986 WATER AREA 160.28 1$ 2 *Services 1986 STORMSEWTRK 1986 .,°-7J.0,.~~ 142.05 5 10.2 A1- g 2 -2 -g ~ STORM SEW LAT 1986 CURB & GUTTER ' SIDEWALK STREET LIGHT Road Unit • WATER CONN. . --10346 BUIIDING PER. SAC 525.00 PARK INSPECTIaN RECURv CITY OF EAGAN PERMIT TYPE: ~ 3830 Pilot Knob Road Permit Number: , Eagan, Minnesota 55122-1897 Date Issued: (651) 681-4675 SITE ADDRESS:' APPLICANT: ~ ~•t1(ly fil: PERMIT SUBTYPE: TYPE OF WORK: INSPECTION . .ATE INSPTR. F L Permit Holdar DaM Telephone # EWER/ WATER PLUMBING HVAC Inopecdon Deh Insp. Commenb FOOTINGS FOUND FRAMING ROOFING !°`7 ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL DOMESTIC METER IRRIGATION MEfER FLUSH MAINS CONDUCTIVITY TEST HYDROSTATIC TEST BSMT R.I. BSMT FINAL DECK FfG DECK FINAL CITY OF EAGAN N° 10 3 4 6 3830 Pilot Knob Road, P.O. Box 21-799, Eagan, MN 55721 PHONE: 4548700 BUILDING PERMIT aeceicr * ~ Te b, wd far SF DWG/GAR Est. Value $70,000 pOfe JUNE S 1 y S5 SiteAddresa 3902 WESTBURY DR erect ooa,Pancy La 15 Blxk 4 Sec/Sub. WESTBURY I Remodel ? Zoning -RI- Percel No. Repeir 0 Type of Const. V Addition ? ' No. Stories Move ? Length 5 0 GRAND OAKS 9 Name Z 1881 SUNRISE CT Demollsh ? Depth 48 ~ Address InL Impr. ? Sq. Ft. c;tv EAGAN rnooe 452-8934 ineteu ? "e'"e $AME ApprevaM Feat g ~ su Assessment Permit 343-00 S Add'e" 35.00 ~ City Phone Woter 3 Sew. Surcharga PoNu PlanHevlew 171.$0 GW Name Firo snC 525.00 r Address Enp. waterConn. ~.:00 ~W City Phone Vlonrror WeterMeter ___63~0 0 Council Road Unlt 280 _ QO I hemby ockrrowledga fhat I hove reod this applicotion ond sMfe thot Bldg. Off. f) 8$ 5 Tr. PI. 139- O O the inlormation is correcr and agree to mmply wirh oll applicoble APC Parka Stats of Minnesota Stotut and Cify of Eog n Ordinonces. Var. Date Copies Sfprroturo of Permittaa 7otal $2.049.50 A Buflding Permit Is luued to: GRAN O EL MENT CO ~ tha expmas tondltian ihat oli work shall he doro in xcordmKe with all lim St nrcaota Statutes ard City of Eopan Ordinances. Buildirp Off{dal ra4 RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 651-681-4675 New Construction Reauirements RemodellRenair Reauirements • 3 registered site surveys showing sq. fl. ol loG sq. fl. of house; an0 all roofed areas . 2 copies of plan (20%mazimum lot coverage allowed) . 1 set of Energy Calalations for heated additions • 2 copies of plan showing beam & window sizes; poured (ound design, etc.) . 1 sile survey for extenor additions & decks • 7 set o( Energy Calculations . Indicale if home served by sep6t system for additions • 3 copies of Tree Preserva4on Plan it lot platted after 711/93 • Rim Joist Detail Options selection sheet (6ldgs wilh 3 or less units) ~ _DATE Z6,21 VALUATIO'$ 51TEApDrDR-ESS 0 2~~~t( h~( MULTI-FAMILYBLDG _Y -`N~ TYPBGF~W {~C~ ~Me~ ~JI S(DC_ FIREPLACE(S) _ 0 11 _ 2 APPLICANT STREET ADDRESS I27,(17 N icoL (C'~ 4vC CITY STATE_M_ ZIP C'f 31 TELEPHONE #°1SZ707 b`j,S'i CELL PHONE # FAX #A~5~eo_?~~ PROPERTYOWNER 'CA/rl Sk-mrnon$ TELEPHONE# i`~( (~Wb' ar30 COMPLETE THIS SECTION FOR NNEW" RESIDENTIAL BUILDINGS ONLY ~rl rF, Energy Code Category _ >-IIVNtSO'1'A RUI.ES 7670 CA'1'ECORY t NII. j1e14i~Cc ORpL F:Sn7n(i72 ~I~I (d submission type) . Residential Ventilation Category 1 Worksheet Submitted N u~Bl~ksu3et 5ilti itted . Energy Envelope Calculations Submitted u By Plumbing Contractor: Phonc # Plumbino sysLcm includcs: _ Watcr Soltcncr Iawn Sprinklcr Pcc: $90.00 Watcr Hcatcr No. oF R.I. 13alhs No. ol` Baths Mechanical Contractor: Phone # Vlcchanic<d systcm includci: Air Condilioninn Pcc: $70.00 Hrat Rccorciy Scstcm Sewer/Water Contractor: Phone # I hereby acknowledge that I have read this application, state that the' m' n is correct, and agree to compiy with all applicable State of Minnesota Statutes and City of Eagan rdinances. Signature of Applica t OFFICE USE ONLY Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updaled 4/02 OFFICE USE ONLY = - ? 01 Foundation ? 07 OS-plex ? 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 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Stortn Damage ? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous ? 31 New ? 35 Int Improvement ? 38 Demolish (Interiar) ? 44 Siding ? 32 Addition ? 36 Move Bldg. O 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement 'Demolition (Entire 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 Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS _ Footings (new blde) FinaU'C.O. _ Footings (deck) FinaUNo C.O. _ Footings (addirion) _ Plumbing Foundation HVAC Drain Tile Other Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final _ Framiug _ Siding Stucw Stone _ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement) _ Insulation _ Retaining Wall Approved By , Buiiding Inspector Base Fee Surcharge Plan Review MGES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total 3v 1985 BUILDZNG PERMIT APPLICATION - CITY OF EAGAN NOTE: ALL CONTRACTORS AUST BE LICENSED FIITH THE CITY OF EACAN INCLUDE 2 SETS OF PLANS 3 CERTIFICATES OF SURVEY 1 SET OF ENERGY CALCULATZONS To Be Used For: ~_1 _ Valuation: Date: 9 Site Address: 396 OFFZCE USE ONLY Lot: lf~ Block q Sect/Sub db / Erect X Occupancy ~-3 Remodel _ Zoning ~-I Parcel Il Repair _ Type of Const ~ Enlarge II of Stories Owner ~%A/~/ 0 P~54^'T Move Length 5O Demolish _ Depth 4-5 Address Grade Sq Ft City/Zip Code Phone APPROVALS Contractor ~~Q~/7j Q7¢KS Assessments Permit Water/Sewer Surcharge Address Police Plan Review yO Fire SAC SZS, City/Zip Gode Engr Water Conn 5~.'-° Planner Water Meter c03, S-0 Phone Council oad Unit 2gp.`= Bldg Off Parks Arch,/Engr. APC Treatment-Pl 3r(,.°-= Variance Address TOTAL ao City/Zip Code Phone # , SURVEYOR'S CERTIFICATE ~ GRAND OAKS DEVELOpMENT C0. F ~ . 390 O . . { 1 OA.^O 4e0 0' . C. ~7,. °0 30 ~ O \ 33 r ip 3 /O / . . • y , ~ f 26.\ ~ ,.;;'E>Y / O\ , . . `C/ v8o ~ o o`~ /30 0~ 0 3 ° J ~ co ~ ~ DENOTES PROPOSED SURFACE DRAINAGE O DENOTES IRON MONUMENT SET SCALE: 1 INCH = 30 FEET • DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR = 654,o FEET X000.0 DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR = agI,t FEET (000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK = 854,4 FEET I HEREBY CERTIFY TO GRAND OAKS DEVELOPMENT C0. THAT THIS I5 A TRUE'AND CORRECT REPRESENTATION OF A SURVEY Of THE BOUNDARIES OF: Lot 15, Block 4, WESTBURY FIRST ADDITIOPJ, according to the recorded . plat thereof, Dakota County, F4:nnesoia. AND Of THE LOCATION OF A PROPOSED BUILDING. IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCROACHMENTS, IF ANY, THEREON. AS SURVEYED BY ME, OR UNDER P1Y DIRECi' SUPERVISION, THIS 4 i N DAY OF JuNF- , 1985. SIGNED: JAMES R HILL, INC. ~ n ~ 6Y: '.v~i~*1 HAROLD C. PETERSON, IAND SURVEYOR PIINNESOTA LICENSE N0. 12294 ' PROJECT NO. BOOK / PAGE JqMES R. HILL, INC. 85654 Planners / Engineers / Surveyors FILE NO. 8200 Humboldt Avenu• South FOL DER gbomlngton, Mn. 55431 812-884-3029 . ~ " • . : . EXTERIOk ENVELOPE.AVERAGE 'U' COMPUTATIOIV GRAND OAKS DEVELDPMEIVT COMPANY MODEL Q• AREA U U X AREA ~ FtEQU I RED i. 70TAL WALL AREA 1800 X.11 198 2. TOTAL RDOF AREA. 1196 X.026 31.096 ACHIHVED AREA U IJ X AREA A. W I NDOW HFtEA 186. 66 .5 93.33 9. DOOFt AFtEA 39.6 .077 3.0646 C. SLIDE GLASS AREA 13.44 .48 6.4512 D. FIREPLACE AREA O 0 0 E. WALL Ff2AME AREA 16q .441 7.38 F. NET WALL AREA , 1164.1 .049 57.0404 Ca. RIM JOIST AREA 119.62 .0436 .°i.211672 H. FOUND WINDOW AREA O 6 0 1. FOUND A50VE GRADE 96.48 .135 13.0248 3. TOTAL-WALL AREA 1800 185.5026 J. SKYLITE ' d 0 O K. ROOF FRAME 119.6 .432 3.8272 L. h1ET ROOF AREA 1076.4 .025 26.91 4. TOTAL ROOF AREA 1196 30.7372 9UM 1.+2, 229.096 SUM 3.+4. 216.2398 PERMIT CITY OF EAGAN 3830 Pilot Knob Road PERMIT TYPE: Permit Number: N U I L D I N G Eaqan, Minnesota 55122-1897 034071 `(651) 687 -4675 Date Issued: SITE ADDRESS: ~902 wFSrPURV nR L.pT; 15 6lCiCK: A WES`C"BUh'Y 1ST P.T.N.: 10-83650--150-04 DESCRIPTION: REaooFiReszOE euitainq'nermit TVpe sroRm oAmflre Bu:ildiny Work~ Tvpe REFfaIft ; Certsus Coda 434 ALT. F2ESTDENTIAL . REMARKS: FEE SUMMARY: CONTRACTOR: - Appzicant - Si. LTr,. OWNER: CHRISTIANS INC 14702001 3712 SIMMONS SAMUAL 1480 PARK R1:7 3902 WES76URY fJR CNANHASSEN MN 55317 EAGAN MfJ 55123 (612) 479-2001 (051) I hereby acknowledge Y.hat I have read th5:s anplicaCi.on and state thst the infarmation is correct and agree to compl.y w.iT.hall appllcatrle 5'Cate af Mn. L STatutes and' City af Eaqan Drdinances. ~ ~ APPLICANT/PERMI7EE SI6NATURE %GSUED BY: SIGNATURE 1998 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAM ~`4~-1 I 3830 PII.OT KNOB RD - 55122 e81-ae75 New Conatrudion Reauirements RertrodeVRecair Reauirements ? 3 registeretl sde suneys ? 2 copiea of plan ? 2 copiea of pWns (inGude beam & window s¢es; pourod fid. tlesgn; eta) ? 2 site surveys (exterior adaitions 3decks) ? 7 energy rakulations ? 1 energy plalations for heated adddions • 3oopies of tree praservation plan if lat Platted aRer 7l7193 repuired: _ Yes _ No DATE: f / - ZL CONSTRUCTlON COST; DESCRIPTION OF WORK: l~e EG6 ~ s-~-or' CA~~M.a P) ~j~ STREET ADDRESS: 3q0'Z LJ eS-~-(J Ctr `i ~ LOT: BLOCK: SUBD./P.I.D. Name: S: MlhooS SUM~~~ ! Phone NA• PROPERTY Last First OWNER suen aaaress: 3q o z QSe Ra-b,~--., City ~~-ru:o-r-. State: Zip: 'SS ( Z 'S Company: (f Phone ~ 7 0 - ZC~ I CONTRACTOR L Street Address: / L4 ~IYsr License # ~ '7 ! Z city C~lCnillt~Cv-SSe/1 staze: zip: ~S 31 `7 ARCHITECT/ ENGINEER Company: Phone Name: Registration Street Address: Ciry State: Zip: Sewer & water licensed plumber (new constrvction only): . Penalty applies when address diang and lot change is requested once permit is issued. 1 hereby aeknowletlge that 1 have read this application and state that the infortnaGon is correct and agree to compy with all applicabli State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY Certificates of Survey Received _ Yes _ No Tree Preservation Plan Received _ Yes _ No _ Not Requi OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish ? 02 SF Dwelling ? 07 4-pVex ? 12 Multi RepaidRem. ? 17 Swim Pooi ? 03 SF Addition ? 08 &plex ? 13 Garage/Accessory O 20 Public Facility ? 04 SF Porch ? 09 12-plex ? 14 Fireplace ? 21 Miscellaneous ? 05 SF Misc. ? 10 _-plex ? 15 Deck WORK TYPE ? 31 New ? 33 Alterations ? 36 Move ? 32 Addition ? 34 Repair ? 37 Demolition GENERAL INFORMATION Const. (Actual) Basement sq. ft. MC/WS System (Aliowable) Main level sq. ft. City Water UBC Occupancy sq. ft. Fire Sprinklered Zonin9 sq. ft. PRV # of STories sq. ft. Booster Pump Length sq, ft. Census Code. Depth Footprint sq. ft. SAC Code Census Bidg Census Unit APPROVALS Planning Building Engineering Variance Permit Fee Valuatian: $ Surcharge Plan Review License MC/W5 SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Pertnit S/W 5urcharge Treatment PI. Park Ded. Trails Ded. Other Copies Total: % SAC SAC Units i i.:r II 2/89 • I y_'~ ~ V, I CITY OF EAGAN APPLICATION FOR PERMZT SESVER AND/OR WATER CONNECTIO,i (PLEASE PRINT) i) PROP= aonREss: 14J e,s + U rn ~ v 2 rFraI. DESQ2IP'PIC:I: I J `o G (Ir~t/21ock/Subdivision or Tax arcei I.D. Ninnber) ic ~{I;:'=_:G ST?.LTC1L:'L~, Drl I-E GF CRIGi:AL EUIIr^.L`;G F~*,ST T_SSZ;a.~C_°• i FRES-`_17 Z^.`I1^::r/T?C_°CSED iS': 9 R-1 S~-NGILL. FkuSLY ? R-2 CUPLE{ ('Ih'0 ULqITS) ? R-3 ZY7•v'NHOiiSE (THF2F^ + UVITS) ( UiIITS) R-? APP.R'I.T-E~:'P/C^vN'DC1%L..T~'IU~i { Wi ITSi ? CCk~.?2CTAL/RETAIL,/OF'FICE ? L\mL'ST'i2I?.L Q INSTITCPI'IONAi./GO)arZLZIEbTr 2) APPLIC-~NP . (PLEASE PRIYi) ct t-t ADDRESS: I ~ fS~j•~P_ - G-~: ' . r CITY, ~ATE, ZIP:,~ PxoNE: ~ - 3) PLL7,ffi~ ~~IE: )a P(PL"cASE EELN!) FOR CITY USE ONIY r^ PWMBERS L 45E:ADDRE55: ~LC~ G G' P!~ K I~[. 1.1 ~P Attive CITY, STATE. ZIP: S"j s a Expired ~fSiait'~- Necord PHONE: jj t pLl1MBER LICENSE N 4) OCCJ}.~kW/Cr,,zIp',j (PLEASEPAIN1) NAM: ADDRESS: CITY, STATE, ZIP: PIIO*iG: 5) INDICATE L+1[iZCIi PEr,hLiT IS BEII`G REQUESTID: ~ Q,''~,-IF.CfION 'IO CITY SES']ER ~ CC:1'.QECi'ICN 'IO CZTY WATER ? OTEER (PLEASE DESCRIBE) 6) L`:DIG -1. C:E: ? PLE1SE E:OID APP??WID PER,tiLiT FOR PICi:-UP BY ONE OF ABOVE W°Z.EASE `AIL APPROVc^D`PEtZ~LiT 'It~ l,j 3, 4-11BOVE ~f- - (6ircle one) ~~~7) sicMT-IRE: DaTe: ~~e a:~a+f.isi~ a~ ~e ~.e~a~e:a+~ s wa~ ~:s:~ rs ai s r;saca r~ a ri ~ f.a:rrs3-~ aa a~ ~t ik~es~asr c F O R C I T Y U S E. O N L Y PERMIT ISSUED FEL'S: $ S°EP nrv%TTT (T„CL„-.,- Si, 'R. , .i ~_-iARGE) $ 5-U WATER PER14IT (INCLUDE SURCHARGE) $ o4i I^1ATER METER/COPPERHORN/OUTSIDE RE?.DER $ WATE?? TAP (INCLUDv- CORrCRATIOV STCP) $ SE:4ER 'I`sn $ ACCOUNT DEPOSIT - ScTPER $ ACCOUNT DEPOSIT - WATER $ S~d`v c''rJ WAC $ sac $ T4UVF 1`IATE.U. ASSESSi-:E:IT $ TRliN:: SESIER ASSLSSMENT $ LATEP.AL BENEFIT/TRUNK SEWER $ LATERAL BENEFIT/TRUNK WATER $ 3~ `o ~ OTHER $ TOTAL $ ~ `~v AMOUNT PAID/RECEIPT GGU~ DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIG'riT OF WAY? YES ZF YES, THEN A"PERMIT FQR WORK WITHIN PUBLIC ROADWAY" M[7ST BE ISSUED BY THE NO ENGINEERING DIVISION. LIST AS A CONDI- TION. SUIIJECT TO TfIE FOLL0:9ING CONDITIONS: APPROVED BY: ~ TITLE: DATE: - , 1 For Office/Use -/5--- a. r r Permit#: , ‘,..„. ,„,,g,, E AG A N %.,„.... ....., Permit Fee: /6 s-- Dr Date Received: 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 Staff: buildinginspections('7cityofeagan.com L 2018 RESIDENTIAL BUILDING PERMIT APPLICATION Date: -z., 1g Site Address: 3Q0Z weS bvvr DI-4 ° Unit#: • 1 Name: 3C&j 1 (At. t 5 i rn Knots Phone: La i 2 IZo —/ZSS Resident/ Owner Address/City/Zip: 390z LA.)es-t-bt-t-burl flc-w e ) 0 4 A- I ACL SS'i z , " i Applicant is: Owner Contractor Type of Work Description of work:�'c"r-o ff-- Re.— RGEr--7C. c•6 Construction Cost: Y�� Multi-Family Building: (Yes /No ) Company: 1 'fey A l\ RnO�, 4j Ivv p)t�%fht n5 Contact: /QA k Lott-SAe-t�r'C4- Address: 22.2iA 5'f:,ctiTY Aite_ City: Ma,plCink oO i aril Contractor l�5 l_75��93$er, • State. '" Zip:'S•—I Phone: Email:11C`1, -5'(c1f'�'f 40 Frei tl' WIA V \/ License#: 6 C 73?I' • Lead Certificate#: -K-16-14" IS_00 Z 5-7 If the project is exempt from lead certification, please explain why: i-- (:), C-..i ry O n I , 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: Fire Suppression 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-.ublic if .u •rovide s•ecific reasons that would•emit the Cit to conclude that the are trade secrets. You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeagan.com/subscribe. 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. CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.orq I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is of to start withormit; that the work will be in accord nce with the approve plan in the case of work which requires a review and approval • .,-n s' Applicant's Printed Name Applicant's ignature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA151458 Date Issued:08/24/2018 Permit Category:ePermit Site Address: 3902 Westbury Dr Lot:015 Block: 004 Addition: Westbury 1st PID:10-83650-04-150 Use: Description: Sub Type:Residential Work Type:Replace Description:Water Softener Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener). Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087 Surcharge-Fixed $1.00 9001.2195 $60.00 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Samuel J Simmons 3902 Westbury Dr Eagan MN 55123 Benjamin Franklin Plumbing 5718 International Parkway New Hope MN 55428 (612) 238-9709 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA159148 Date Issued:11/22/2019 Permit Category:ePermit Site Address: 3902 Westbury Dr Lot:015 Block: 004 Addition: Westbury 1st PID:10-83650-04-150 Use: Description: Sub Type:Residential Work Type:Replace Description:Standard Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener). Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087 Surcharge-Fixed $1.00 9001.2195 $60.00 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Samuel J Simmons 3902 Westbury Dr Eagan MN 55123 (651) 688-2130 Noah Acquisitions Llc 5718 International Pkwy Brooklyn Park MN 55428 (612) 822-5292 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA160028 Date Issued:02/07/2020 Permit Category:ePermit Site Address: 3902 Westbury Dr Lot:015 Block: 004 Addition: Westbury 1st PID:10-83650-04-150 Use: Description: Sub Type:Residential Work Type:Replace Description:Furnace & Air Conditioner Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Please call Building Inspections at (651) 675-5675 to schedule a final inspection. 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 - Samuel J Simmons 3902 Westbury Dr Eagan MN 55123 (651) 688-2130 Blue Ox Heating & Air Llc 5720 International Pkwy New Hope MN 55428 (612) 238-9709 Applicant/Permitee: Signature Issued By: Signature