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3921 Westbury Dr CITY OF EAGAN SEWER SERVICE PERMIT 3830 Pilot Knob Road - P. O. Bax 21199 PERMIT NO.: Eagan, !NN 55121 DhATE: ZordnD: ' No. of Unita: ~ Owner: !'rand f!ilf s Tiev. Addrcss: Site Addreu: \;fe$tl'ury JriV£? 65 :C'3C~7:l~V Zet - Plumber. . , 1.i3y Syi?1~.+a; i.Ltr? 24 _?5 100.f)()p.' , 1 pm to ee~wPh willi !M Ciep of iavo C.onnschon Chorpe: 425 . mOn~ Ordinesom /looount Deposit: ,j ~~}t~nd P.rmit Fae: Surclwrpe: ' n'.~! BY Mtsc. Chorpas: Date of Irqp.: Tatal: Insp•: Dcte Poid: IL CITY OF EAGAN WATER SERVICE PERMIT 3830 Piloti Ktoob Road P. Box 21199 PERMIT NO.: Eagan, MN 55'?l - _ DATE: - ~ Zoniny: . : No. cf llaits: pw,,w; Grand Oaks Tlev. Ilddross: Slta Addrcss: r_ .#t ury 5 t Plurnber. Meter No..3 .S~ cf rys' . . P~.: Ctanr"se2tion.Qro Stze: ~ _ . _ xrormt Depostt: !i UU~( , Reoder No.: _ V IY1 4~7 S' ly -ermit Fee: 1 p~w !e oo~aplp ~riM~ 11e Gtr oi Ery~a 'Surchorge: .~~i1 Ordiw~sor. Misc. Charpes: ` . p . Total: 63.07P me r ~ By u-- Dot• Roid: Dat od/ f Ir+sp.: S Irnp.: . CITY OF EAGAN 10g9$ • 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 eU1LDING rERMIT Receipt # Te M rwd iw ',iF L:F 4-1;iR Est. Vclue $7 6 0 G C Date '0 19 S ite Address ;Q~I G"_'`' T R i i F, Y Erect Occupancy Lot j Block 5 Sec/Sub. Remodet ? Zoning Percel No. ~ Repafr ? Type of Conat. Addition ? No. Stories Move ? Length • W Name Demolish ? Depth ; Address •l , , • Int Impr. ? Sq. Ft. b City Phone Install O Name Aporovala Fees ~ au Address Assessment Permit ; i) u°4 Water a Sew. Surcha e -1 L' ~ City Phone re Police Plan Review _ ` t5 Name Fire SAC ~ z U0 Addres$ Enp. Water Conn < Z. City Phone Planner Water Meter Council Road Unit `7 ' o ci I hereby ocknowledqe thot 1 hew rood this upplicntion ond stute thot Bldg. Off. Tr. PL l' the informotion is torrect and ogree To comply with oll epplitoble APC Stote of Minnesoto Stotutes ond City of Eogan Ordinonces. ~ Perks Var. 0ate CoDles Sipnoturc of Pertmittes tal t~ . A Buildin Permit is issued to: ~ fl xpress condiNon thoi oll wo?k shall be done in accordonce wifh all oppliooble Stote of Minnesoto Stotufes and City of Eapan Ordinonce:. 9uildinQ pfficiot Pwmit 1110. Pormh Holdw Dob TeIephone ~ Plumblnq ' k L U ~r _ i H.VA.C. ElKtrie C t! . At-7 . 1 1615 j 5 ~ BoftMar Irnpection Da" Insp. Other Footinys I Footings 11 Fourtdatfon Fnminp ~ UJ g Rooiing Rouph Plbg. Rouyh Hty. Insul. Fireplace Final Ht9. Final Plbp. Final / Csrt/Oee. _ Wstsr D"cribe Location: WNI Sewor Pr. Dlap. Raceipt MECHANICAL PERMIT Permit No. ' CITY OF EAGAN Fee ( V j~.( Ff1J in numbered spsces S/C • Type or PrJnt legiblY T" ~ 1. Date 2. Instaltation Cost ~ _ • ' ' ' 3. Job Address.' Lot i Blk. ~ Tract ~.*4~ Owner ~ i 1 1 r-f_ a S. Convactor 1((x -Ph0flQ s. naarM ~ 7. City State 2ip ~ t - ~ 8. Building Type: Residential )ZI Commerciai O Institutianal D 9. Work Description: New.f5. Add ? Alter O Repair ? 10. Des~xibe t~~ • FuelTyps;~`~.;t,;'r 11, N°• E,quit=*_ BTU - M. Ea. No. Eauioment CFM Foroed Air Air Handling: ~a <<~ Mfg. ' Boilers Mech. Exhau:t Mfg. Unit Heater Mfg. Other Air Cond. Mfg. Gas, Piping Outlets 12. I hereby certify that the above information is true and correct, and I aflree to cbmply with aU ordinances and codes governing this type of work. ~ Signed : r1 - ' - ' for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454,8100 Rswipt PLUMBING PERMIT Permit No..~ CITY OF EAGAN Fee 4"~ Fil1 in numbered s,paces S/C Type or Princ legib/y Tot. r 1. Date t- 23~ 2, Installation Cost - ~ 461 .3~a I 3. Job Addresste,-cS46u?-~j dr;:'c Lot Blk. Tract 4. Owner i 5. Contractor Phone 6. Address ~ 7. City A& J:State iv/N- Zip= 8. Buiiding Type: Residential A~ Commercial O Institutional ? 9. Work Description: New.Q] Add ? Alter ? Repair ? 10. Describe L~r>> ~ i i?9 -T ~ 11. No, Fixtures No. Fixtures ' Water Closet Cesspool/Drainfield ~ Bath tubs $eptic Tank l.avatory Softner Shower Well ~ Kitchen Sink Urinal/Bidet Other Laundry Tray ; Floor Drains Drinking Ftn. Slop Sink Gas Piping Outlets 12. I hereby certify that ihe above information is true and correct, and 1 agree to comply witwall ordina5ge nd codes governing this type of work. Signed: i;,~/~r, , for Rouyh F insl Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 Receipt PLUMBING PERMIT Permit No. ~ CITY OF EAGAN Fee I I ! Fill in numbered spaces S/C Type or Piint legibly Tot. 1. Date 2. Installation Cost 3. Job Address Lot~Blk. Tract 4. Owner ~ l + 1 5. Contractor Phone 6. Address 7. City State Zip 8. Building Type: Residential ? Commercial ? Institutional ? 9. Work Description: New Cl Add ? Alter C) Repair ? 10. Describe 11. No. Fixtures No. Fixtures Water Closet Cesspool/Drainfield Bath tubs Septic Tank Lavatory ' Softner Shower Well Kitchen Sink Urinal/Bidet Other Laundry Tray Floor Drains Drinking Ftn. Slop Sink Gas Piping Ouflets 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 Finel Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 CITY OF EAGAN Remarks 1SSq s- a'Li1 Addition WESTBMY FIRST ADDITTON Loc I Rik 5 Parcel 10 93650 n1(1 Q,5 owner 5treet 3921 Westbury Drive scaee Eagan. MN 55123 Improvement Date Amount Annuai Years Payment Receipt Date STREET SURF. 49 1986 28 •6'R GO ~33 ~f STREET RESTOR. GRADING Water area 1986 133.79 8.92 15 /d . G'D t dJ.r SAN SEW TRUNK 1985 436.23 29.08 15 '3 7d',O SEWER LATERAL 1986 5008.73 CO ( Watermain 1986 65.29 4.35 1 GO• WATERMAIN U 68.71 4.58 15 ' CD / P ~ WATER LATERAL WATER AREA 1984 194-92 12.33 15 C ,,3 /iza *Ser STORM SEW TRK i CQ /I -1986 710-24 14905- dc STORM SEW LAT 1986 CURB & GUTTER ' SIDEWALK STREET LIGHT WATER CONN, n n BUILDING PER, 30992 SAC 155-610 PARK CITY OF EAGAN N°_ 10 9 9 8 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 ~ BUILDING PERMIT PHONE: 454-8100 Receipt #F Te M wad far SF DWG/GAR Est. Volue $76,000 pote SEPTEMBER 19 19$5 SltaAddress 3921 WESTBURY DR erect occupancy R3 RemOdel ? Zoning R1 Lot 1 Block 5 seclsuh. WESTBURY 1ST Percel No. Repair ? Type of Const. V Additlon ? No. Stories GRAND OAKS DEVEL CO Move ? Lengtn 50 Z Name Demolish ? Depth 4$ ~ Address 1$$1 SUNRISE C'' Intlmpc ? Sq.Ft. City EAGAN pnone 452-8934 instell ? SAME Avwo•als Faes g Name ~s Add~e Assessmenr Permit 361.00 ~ City Phone Wafer 8 Sew. Surcherge 38.00 Police Plen Review 180-50 GW Name Fire SAC 525.00 ~W 500.00 I~ Address Eny. WetBrGOnn. 'W City Phone Plonmr watarMeter 63.00 Councll Roed Unit 280.00 I hereby ocknowledge fhat I have reod fhis aDDlicotion ond stote that gldg. Off. 9/18/85 Tc PI. 132.00 the inlormotion is correct and ogree to wmply with all applicable APC Sfote of Minnesom 5lotut d i[y o Eayan rdirwnces. , Parks Var. Date Copies Sipnature of Permittee , 079.50 A Building Permit Is issued to: 16RAND O KS DEVEL CO on the etxprcss cordiflon thot oll work shall be dorx in cccordance with all opvliwbla State of Minnewta Statutes and City af Eagan Ordirwnces. Buildirp Officiot RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 651-681-4675 NewConstructionReauiremenh RemodellReoairReouiremeMS 7,3 .~S • 3 reglstered sRe surveys showing sq. fl. of lot, sq. h. of house; and all roofed areas • 2 copies of plan °'1 ~ (20%maximum lot coverage allowed) • 1 set of Energy Calculatbns for heated additbns • 2 copies of plan showing beam & window sizes; poured (ound design, etc.) • 1 site survey for exterior addilions 8 decks • 1 set of Energy CalciAations • Indicate'rf twme sened by sepGc system for addiUOns • 3 copies of Tree Preservatian Plan if IW platted after 711193 . Rim Joisl Detail Options selection sheet (61dgs with 3 or less unBS) DATE ~ - /Z - 0 2 VALUATION Q I~. SITE ADDRESS 32,21 I~£SIAURI,l MULTI-FAMILY BLDG _ Y _ N TYPE OF WORK a-~ooc - RF 'S+ 7)£ FIREPLACE(S) _ 0_ 1_ 2 APPLICANT //tCO?E ifao~.vC 'V•o d ~Sl L) STREETADDRESS G~S83~EvkN?.si~ djtn swTr ~3u CITYEDENPenabc STATEMIVZIP653`i6 TELEPHONE # -57y-~5o3,5-CELL PHONE # FAX # 2Sa - 27y - /`u 8 y PROPERTYOWNER T1~i iRA .j T Lr TELEPHONE# &-52'915'6 'y`l5? COMPLETE THIS SECTION FOR "NEW" RETIDENTIAL BUILDINGS ONLY Energy Code Category MINNI'S07'A RULES 7670 CATEGORY 1 MINN E (J submission type) • Residential Ventilation Category 1 Worksheet Su6mitted • Ne ~y ~1~Vacs~et~U m ed . Energy Envelope Calculations Submitted II JUN 1 2 2002 ~ Plumbing Contractor: Phone # _ Plumbing syslem includes: Water Softcner _ I.awn Sprinkler BY _ Waler Heater No. of R.I. Baths _ No. of 13aths Mechanical Contractor: Phone # Mcchanical systcm includes: Air Conditioning Fee: $70.00 _ Heat Rccovery System Sewer/Water Contractor: Phone # I hereby acknowledge that I have read this application, state that the information is c rrect, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances i Signature of AppOcant ~ OFFICE USE ONLY Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4102 OFFICE USE ONLY ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. AIt - SF ? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch(screened) ? 36 Multi 0 OS 03-plex ? 11 10-plex O 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)• ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement •Demolition (Entire Bldg anl» - 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 bldg) FinallC.O. _ Footings(deck) FinaUNo C.O. _ Footings (addition) _ Plumhing _ Foundation HVAC _ DrainTile Other Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final _ Framing _ Siding Stucco Stone _ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement) _ Insulation _ Retaining Wall - - Approved By , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total 1985 BUILDING PERNZT APPLICATION - CITY OF EAGAN NOTE: ALL CONTRACTORS M1UST BE LICENSED WITH THE CITY OF EAGAN INCLUDE 2 SETS OF PLANS ~ CERTIFICATES OF SURVEY 1 SET OF ENERGY CALCULATIONS To Be Used For: ~Q- Valuation: Date: J O J -3 Site Address: 22 l L(Jy„d ~ OFFICE USE ONLY ~ Lot; ~ Block 4) Sect/Sub ~ Erect ~ Occupancy Remodel _ Zoning Parcel 4I Repair _ Type of Const ~i ~ h M, n~ Addition , 1l of Stories Owner Move _ Length 150 Demolish ~ Depth 43 Address Int.Impr. _ Sq Ft Install City/Zip Code Phone APPROV9LS FEES Contractor Q'AJ Assessments Permit -3&11 Water/Sewer Surcharge Address Police Plan Review ~So Fire SAC Fi7 S City/Zip Code ~ Engr Water Conn cclo• Planner Water Meter (p3• Phone 23471 Council Road Unit ZgO, Bldg Of~Treatment P1 13z. Arch./Engr, APC Parks Variance Copies Address TOTAL City/Zip Code Phone lk l ; ; SURVEYOR'S. CERTIFICATE ~ GRAND OAKS DEVELOPMENT C0. ~ . . - - ~9( ~ s E N ~ ~v,,~, Te~,~y \ . ~08ry R.s~ .•4(! /O ~sSg `~S9 , 5a R~ N Op ,o LOT l~, ~ M o~;a~•z 4q 0100S 400 1 ~3 . ~ ti "O~sF • .h • ~~q 4 i ~O H` Gt~9p soo . z ry ~ o- (0 ~ ~ _ ~24 0 . . , --K- DENOTES PROPOSED SURFACE DRAINAGE / O DENOTES IRON MONUMENT SET SCALE: 1 INCH = 3v FEET * DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR = 89o.5 FEET .X000.0 DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR = Sa7. ? FEET (000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK = 6909 FEET I HEREBY CERTIFY TO GRAND OAKS DEVELOPMENT C0. THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF TNE BOUNDARIES Of: Lot 1, Block 5, 4JESTBURY FIRST ADDITION, according to the recorded plat thereof, Cakota County, Minrlesota. 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 P4Y DIRECT SUPERVISION, TNIS 11T1+ DAY OF JUNLt , 1985. PROPOSED ELEVATIONS SHOWN ARE SIGNED: JAME R. HILL, INC. AS TAKEN FROM THE GRADING AND DEVELOPPIENT PLAN FOR WESTBURY BY DELPQAR H. SCHWANZ, LAND SURVEYORS, INC., LAST DATED 10-2-84. BY: HAROLD C. PETERSON, LAND SURVEYOR FIINNESOTA LICENSE N0: 12294 PROJECT NO. BOOK / PAGE JpMES R. HILL, INC. 65G-7 2 Planners / Engineers / Surveyors FILE NO, 8200 Humboldt Avenue South• FOLDER Bbomington,Mn. 55431 e12-884-3029 ~ ` fa A!s „f*~t'•+pia . . S ~ . F~we . EXTERIOft 'EN'Oi~~~d~l 7qT~Ns ~ a 1 y;i'lt,a~.y:?'a• ..i, i.~F "13~'~~~k~~a~'~$,F~,4+o-.r , , 7 ORANe-:4AK8'~ QEVEI.DPMENT : Cp14P~5ldY . i . , r. a y . .,s.. r y MODEL,., Q'~~:,'s UX AREA . . . Y. .n I i.`11' ~Tu ~u~? n ~6:>$•? ? • . . t r..riY~;'~~ { , . , _ t • REOUIRED , 70TAL WALt,'''AREA 1BRV X`.111 ' 198 2. TOTAL, ROOF ARIEA ; • .1196, X.026' 31.096 1 ` i . . : . ' . ; ,..r,,, r; , - ACHIEVED AREA U U X AREA ;t . . .4' "A. WINDOW AREA:*~ 186.66 ' :+Y .5 93.33 B. DOOR AREA 4 ` 34. 8 .,077 3.0646 C. SLIDE'OLA88'.AREA 13.44~,,, .48 6.4512 D. FIREPI.ACE,"AREA' ; 0 . p ' 0 . E. WALL'FRAME.pREA_`'" 180:. ..041 . 7.39 . F. NET WALL AREA 049 .'57. 0409 0. RIM.-JOIST AREA 119.52;' .0436 5.211072 H. . FOUND W I11DOW AREA ' , . 0 O 0 I. FDUND ABOVE ORADE 96.48. .135 13.0248 3. TOTAL9 WALL AREA. 1800 's . 185.5026 , _ F. . . . J. SKYLITE'r,.. p. 4 K: ' ROOF FRAME°.I 119.6- ,.032. ; 3.8272 L.' NET ROOF AREA 1076.4 ."025 .'.'26.91 . . . ' . ..'.'1, ,i . . . . . : , 4. . TOTAL ROOF AREA" '1196. . 30.7372 ' ' ' - . . . , . . . ' r..s . . • , . . SUM 1.+2.', 229.096 . SUM 3. +4. ; ~ . • ' , , . ' 216.2398 . . ..F , .t:', ' . . . . . ' ~'p,fl. . . . . . . . . •v. ,M"'~' w,~~.•i. i' . . • . ` ~ ~ . C3tV oF aSilgca1 3830 PILOT KNOB ROAD, P.O. BOX 27199 BEA BLOnn9u157 EAGAN, MINNESOTA 55721 " M~ PHONE: (612) 454-8100 n40MnS EGAN JAME$ A SMITH JERRY rHOMAS DATE: THEODORE WACHiER June 4, 1985 C~a `n.~ THpMAS HEDGE$ CitY Atlmrvsvota EUGENE VAN OVERBEKE SPECIAL ASSESSMENT SEARCH GwCierc Requested by: jJNIVERSAL TITLE INSURANCE CO. RE: WeStbury 1St, Lot 1, Block 5 14500 Bur'rhaven Drive 3921 Westbury Drive Suite 159 Fagan, MN 55123 Burnsville, MN 55337 Parcel # 10 83600 010 05 Enclosed herein is the search which you requested made on the above described property. Kind of"Imnrovement Runs SeQinning Oriainal Amount Balance Due $torr.l Sewer Trank yr5 s 19$ 050 0.21~ P50 0.21~ otreet 5 yrs 1y8~ .00 .u0 water Area 15 yrs 1986 $133•79 $$133•79 Sewer TY1ank 15 yrs 1985 $436.23 $407.15 Sew, Wat & Stm Sew Lats 5 yrs 1986 $5008.73 $5008.73 Watermain 15 yrs 1986 $65.29 $65.29 Waterrn3in 15 Yrs 1984 $68.71 $59•55 Water Area 15 yrs 1984 $184.92 $160.28 * NOTE: all 1986 assessments are due with interest £rom Jan 15, 1986 at .11% annual. 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 ImDrovement Approximate Date of Completion Approximate Cost ' NONE WAIVER: Neither the City of Eagan nor its employees guarantees the accuracy of the above infor- mation which was requested by the person 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 consideration of 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 EAGAN, 3830 Pilot Knob Road, P.O. Box 21199, Eagan, MN 55121. Very truly yours, SPECIALASSESSMENT DIVISION ~~/:n_ ~t'~•~ iHE LONE OAK TREE...THE SYMBOL OF STRENGTH AND GROWfH IN OUR COMMUNITY 1999 BUILDINC PERMIT APPLICATION (RESIDENTIAL) 3~~9~ 3830 PILiOT KNOB RD - 55122 651-681-4675 New Conshucfton Reauiremenh Remodel/Reoair Reaulremenh D S regirtered sHe surveys ahowing sq. tt. of lot, sq. R. of house 2 copies o1 plan and ~I roofed areas (20% maximum lot coveraae allowed) 1 sef of enmgy calculafions lor healed addHfons ? 4 coples of plans (show beam 6 window sues; poured fnd. de:ign; etc.) 1 sHe eurvey for exterlor addBlons a decW ? 1 set of energy calculalions D 3 coples oF free presenaTlon plan H lot plalted alfer 7/7/93 DAiE: --5 1 Z. 1 IZ q~ CONSTRUCTION COST: DESCRIPTION OF WORK: STREET ADDRESS: LOT: ~ BLOCK: S SUBD./P.I.D. Name://Ilw)l~~~ fJLI Phone#: ~4C7o- PROPERTY Lus? Ftrd OWNER ,q StreetAddress: ~9/a1 W C-ri%~1 '02 Cify State: M JKJ Ztp: SC/a~ Company: sr~~ Phone (area code) CONTRACTOR Sfreet Address: L(cense # Exp. Cify Sfate: Zip: ARCHITECT/ ENGINEER Company: Name: Telephone area code ( ) Street Address: Registratfon City State: Zip: Sewer d, waler Iicensed plumber (reavired for new conslructlon onlvl: PenaMy apptles when addreas change and lot change is requested once permH is issued. ' i hereby acknowledge ihat I have reod fhis applicaflon, state that the fnformatlon is correct, and agree to comply with all appl(cabl ' Sfate of Minnesota Statutes and City of Eagan Ordinonces. n • Signature of Appllcant: -///1 LLt OFFICE USE ONLY Certificates of Survey Received _ Yes _ No L ~ ' , _ Tree Preservation Plan Received _ Yes _ No _ Not Required OFFICE USE ONLY BUILDING PERMIt TYPE ? 01 Foundation ? 06 4-plex ? 11 10-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 02 SF Owelling ? 07 5-plex ? 12 12-plex ? 17 Garage ? 22 Porch/Addn. (4sea. ? 03 1 of _ plex ? 08 6-plex ? 13 16-plex ? 18 Deck ? 23 Porch (screened) ? 04 2-plex ? 09 7-plex ? 14 Apartments ? 19 Lower Level ? 24 Storm Damage ? 05 3-plex ? 10 8-plex ? 15 Lodging ? 20 Pool ? 25 Miscellaneous WORK TYPE ? 31 New ? 35 Tenant Impr O 39 Gas Line Only ? 43 SidinglSoffits/Fascia ? 32 Addition ? 36 Move Bldg. ? 40 Gas Insert ? 44 Windows/Doors ? 33 Alteration ? 37 Demolish Bldg.* ? 41 Wood Stove ? 45 Fire Repair ? 34 Repair 13 38 Demolish (Interior) 12~42 Reroof * Give PCA handout to applicant for demolition permit GENERAL INFORMATION Const. (Actuai) Basement sq. ft. Census Code (Allowable) Main level sq. ft. SAC Code UBC Occupancy sq. ft. No. of Units Zoning sq. ft. No. of Bldgs # of Stories sq. ft. MC/ES System Length sq. ft. City Water Width Footprint sq. ft. Booster Pump PRV Fire Sprinklered APPROVALS Planning Building Engineering Variance Permit Fee Valuation: Surcharge Plan Review License MC/E5 SAC City SAC Water Conn. Water Meter Acct. Deposit SNN Permit S/V11 Surcharge Treatment PI. Park Ded. Trails Ded. Other ~ Copies Total: SAC Units % SAC 2/84 CITY Or EAGAN I APPLICATION FOR PERLtiIIT 11111 SEWER AND/OR WATER CONNECTIODI (PCEASRIHi) ~n 1) PROPETY!Y ADDRFSS: - l k ~ -E LF.G.aL. D`'.= =?TIC:I: (Iot/Block ubciivisicn or aX Parcel I.D. Nber) ! S'r' SIprC^.~,TtE, DaTE OP' ORT.Gi^.IAL ciiIL^l`:G :=;;5'~^ ISS";?::G: P'ESL7 Z:^`Er-/?~OPOSF7 US: R-1 SZ;GZ: :Pn= - ? R-2 DLTP7~..'Y (T%o LTIITS) ? ^n-3 ':~.Cr,TCr (?S~.W + L'~7ITS) ( Wi IS) ? i2-4 AL^-yR=-VT/CC.S)Ci.MIIU,I ( CriITS) o ca~TEFcTAL/RFiAIr./oFFzc:: ? I~i'DL`STRIt1L ? LNSTI'ILTZOJLAL/GGVE..'RNn1E_'\'T Z) A?PLIG=VT ~ (PLEASE PRiYT) NAME: ADD.'Z°_SS: _/~~C~ SUh 0'/ C~ C • C=. ST,:', ZZP: PfiONE: 3) PLU:T$t,"?, 1 (PLEASE PflINi) FOR CITY USE ONLY I`Aa''E: I/QIIAc,, e~ilt/1/A~Vv.C PDDRE55' ~Cj C YC~ P~ I..C r~ .p ~H LTE9SE: . Q Activ CIT`l, ST?.TE, ZIP: ~ C} cct u~~ m/l 5 Sr O~ 0 E;G ed PHOD7E: PLUMBER LILENSE N of Record arr ni -3 4) OCL.'UPANT/C!vilE'2i AIAME: (PLEASE PRINi) PDDRESS: CTTY, ST:.TE, ZIP: . PFi(?YE: 5} - INpIGATE WHICH PERhLIT SS BEING RDXE„'PLp: - ~ CL':SIF.CfION 'IO CITY SaIER ~ COh'IVF7LTIC.I 'IO CITY WATER ? d'i'(m (PLPIISE DESCF2IBE) ~ 6) P,:DIG,:::. C2.c: , ? PLEaSE f?OLD APPRWEp PERMLiT FOR PICI:-UP SY ONE OF ABOVg ~ PLF.aSE APPRoVEa PERMLT 1O 1. 2. IP. 4 ABOVE J, (Circle one) 7) 5IazmL"RE: DATE: ~ ~ i • U- - / ~ i~ ~ • • ~f Q~'~~A i~ i f~ l~:Ofc~! t A~i iRi#~ b/ i f 1~FS~i:a a~ ~R 4ll~-1~1y! f f~ ! R ia ~~y F O R C I T Y U S E O N L Y PERMIT ISSUED ' Fr..r. $ IC>'SV pT:^D Ar~\4Tm ~ •"~c• S II_ICL:;,.._. SU°CH?RGc) $ 11G~C•WA'j`ER DFRD(TT (IrvCLUDL JURCH.,.RGL) $ 63U6 WATER METER/COPPERHORN/OUTSIDE READ.-;iZ $ WATER TAP (INCLUD£ CORPORATIO:] STOP) , $ SESvEF T~P "ACCOliNT DFPOSIT - I•IATER $ WAC $ SP.C $ TRliNK WATER ASSESS:'?E::T $ TRiiiv?C SE:vER ASSESS:•tE?iT +S LATEP.nL Br.:IEFIT/TRU`IK SE::TER $ LA:ERaL BENEFZT/TRUNK S+1AT°R $ ~IL WATER TREAT:tENT PLANT SURCHARGE $ OTHER: $ TOT?L $ `~3 `'C' AMOL\T PAID/qEC°I?T R DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? ~ YES IF YES, THEN n"PERMIT FOR 140R?C WITHZN PUBLZC ROADWAY" MUST BE ISSUED BY THE [-7 NO ENGINEERING DIV:SION. LIST AS A CONDI- TION. S[JBJECT TO THE FOLLOSJING CONDITIONS: ~ APPROVED BY: TI.LE: • DAT°_: , r City of Eap 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5685 Email: planning(a.citvofeauan.com For Office Use Permit #: �( Date Received: 2011 ZONING PERMIT APPLICATION ✓ Please submit a set of scaled drawings with the application. PLANNING, setbacks Approved: Notes: ace covera - oreland zoning, bluff zonelsetbacks, etc Date of Approval: J LL/% ( Staff: ii VoL'1 o Revised Plans Approved: Yes / No Date of Approval: Staff: ENGINEERING Grading, drainage, utility easements, wetlands, erosion control, improvements in the Right -of Way, Approved: Notes: Yes / No Date of Approval: Staff: Revised Plans Approved: Yes / No Date of Approval: COMMENTS Staff: G:\Building Inspections\PERMIT APPLICATIONS \2011 \2011 Permit Applications Use BLUE or BLACK Ink For Office Use City of Eaan ai-A-ri\:` ::::e:' I L./0 3830 Pilot Knob Road 1111 1 2011 Eagan MN 55122 Date Received: -7-/9 -l' Phone: (651)675-5675 Fax: (651)675-5694 Staff: -2017 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 7 161 i I Site Address: 39.2._) wec-> �pcJ•� 1 Unit#: Name: ML tut r L l ay\ Phone: Resisent/ ; � _ Owner Address/City/Zip: 3(\ W S c C , L-c\ok \ t V� Applicant is: Owner Contractor Type of Work Description of work:�e c Construction Cost: r I CCC.) Multi-Family Building:(Yes /No \/) Company: V\ \ -C( C iv\-, t-AC c_AA Contact: Address: --1C)40 l Gx\-e\Gk vCkv� .rS �CDn#Tactor State:u"\ !V Zip: �j Phone: X912 -�yq nail: MaA-4-(stQ fSik License#: (93a.230\ Lead Certificate#: If the project is exempt from lead certification, please explain why: 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-publicif 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.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 �t C_ Q' 7-1�f\ ��J x i /OP Printed NN me 4pplicant's Sig . e Page 1 of 3 PERMIT City of Eagan Permit Type:Building Permit Number:EA148251 Date Issued:03/16/2018 Permit Category:ePermit Site Address: 3921 Westbury Dr Lot:001 Block: 005 Addition: Westbury 1st PID:10-83650-05-010 Use: Description: Sub Type:Siding Work Type:Replace Description: Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please leave printed pictures of house wrap on site for the final inspection. When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to ensure maximum ventilation to attic. Call for final inspection after installation. 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 - Theodore Mcmillan 3921 Westbury Dr Eagan MN 55121 (651) 248-9746 Custom Remodelers 474 Apollo Dr Lino Lakes MN 55014 (651) 784-2646 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA150023 Date Issued:06/18/2018 Permit Category:ePermit Site Address: 3921 Westbury Dr Lot:001 Block: 005 Addition: Westbury 1st PID:10-83650-05-010 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Valuation: 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 - Theodore Mcmillan 3921 Westbury Dr Eagan MN 55121 Applicant/Permitee: Signature Issued By: Signature For Office'0— C , i� Permit#:_•S E AG N Permit Fee: (�J• 7"; Date Received: 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651)675-5675 I TDD: (651)454-8535 1 FAX: (651)675-5694 Staff: buildinginspections a(�cityofeagan.com L 2019 RESIDENTIAL BUILDING PERMIT APPLICATION G Date: y =�� Site Address: Unit#: Name: Teti �ineic,.. i0a4 G ) II G(?) Phone: (05/c9174(O Resident/ Owner Address/City/Zip: jc�/ tt./ � 4i) Applicant is: /I Owner Contractor Type of Work Description of work: F720/1+" 019100/0, ot- L)eif2 I'6" 17a & 1clan Construction Cost: r Multi-Family Building: (Yes /No ) Company: Contact: Contractor Address: City: State: Zip: Phone: Email: License#: Lead Certificate#: If the project is exempt from lead certification, please explain why: 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-public if you provide specific reasons that would permit the City to conclude that they 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.citvofeaqan.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 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 . plans. x fiad_as' Applicant's Printed Name Applicant's Signature r For Office Use : � � + E�• Permit#: CV PI �� • Permit Fee: I �� + I rIECEIVE `7-5- 49 Date Received: 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5n94 APR 0 5 2019 Staff: 'JpC�J buildinginspectionsacityofeagan.com 1./P." J ' 2019 RESIDENTIAL BUILDING-PERMIT IT APPLICATION Date: ii/61/ Site Address: O cia l llJ e #611/ Unit#: Name: /6;261 #- L 1 Yl C &. f 1 . 1 1\(qtr-) Phone:'(amu/ 0�� T7 c' J Resident/ Owner Address/City/Zip: c /7 at' W Applicant is: V Owner Contractor ✓ '�,E ?I L(tit (/ ' ; _Cl Type O WOCk Description of work: ` /t'1 _i ,„:. Y1 Construction Cost: �J 55g, s/ ✓ Multi-Family Building: (Yes /No,J Company: c Contact: Contractor Address: City: State: Zip: Phone: Email: License#: Lead Certificate#: If the project is exempt from lead certification, please explain why: 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 publjjc information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City i&conclude that they 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.citvofeaqan.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 not to start with it a permit; that the work will be in accordance with Lthe lapproved (plan in the case of work which requires a review and approval f plans. �� ii�y � x ,,'idQ. /r l 11 C►-) x G c:�f'141h� i'r(G� e-e Applicant's Printed Name Applicant's Signature .--4DO NOT WRITE BELOW THIS LINE l €S 1Jd`-✓ \-)r 4) Y)-- SUB TYPES Foundation Fireplace Porch(3-Season) Exterior Alteration(Single Family) — _ Single Family Garage — Porch(4-Season) _ Exterior Alteration(Multi) Multi F Deck — Porch(Screen/Gazebo/Pergola) _ Miscellaneous 1 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 ga °l � Occupancy .,1R -1 MCES System Plan ReviewCode Edition Adbfa' SAC Units (25%_100%!/ ) Zoning ,PD City Water — Census Code '/311 Stories _ -- Booster Pump .. #of Units / Square Feet PRV #of Buildings I Length Fire Suppression Required Type of Construction ,,t1} Width REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings (Deck) Final/C.O. Required Footings (Addition) Final/No C.O. Required Foundation Foundation Before Backfill HVAC_Service Test Gas Line Air Test_Hood Roof:_Ice &Water _Final Pool:_Footings _Air/Gas Tests _Final Framing 30 Minutes 1 Hour Drain Tile Fireplace:_Rough In Air Test _Final Siding:_Stucco Lath _Stone Lath _Brick_EFIS Insulation Windows Sheathing Retaining Wall:_Footings_Backfill_Final Sheetrock Radon Control Fire Walls Fire Suppression:_Rough In_Final Braced Walls Erosion Control Shower PanOther: Reviewed By: , Building Inspector RESIDENTIAL FEE‘9 Base Fee '73 Surcharge Plan Review y 7 MCES SAC City SAC Utility Connection Charge S&W Permit& Surcharge Treatment Plant Radio Meter Read Copies TOTAL Page 2of3 , , -31)- We � - / V .•)-. ) SURVEYOR'S. CERTIFIC-ATE GRyAND OAKS S DEVELOPMENT CO. t q( F .//°N 4/( 4:76.0 \ 45;•/ iF `S r h` ,o o 3.34 ,S Qr 49 t... �� , ''< psi LOT 4 --- .,:;: �� . S i •,..-- -• 'i!)• • c8C, / _ o c 2 0 • 7) 4 p C)•2) N 'QR " •• • �s el., a% ��- . ,. ry---"----- N ;,\889,, � °"'`7.0p Ir.00 4744 L-1.. ! 6' t3ga,Z�soo o �; 4 % / a 40 "'z -- s ' EAGAN ' . / g,>, -� ` - • RFS `' ,=VVED ' hio .. . EIS(:: — / 886 DATE: / -/k/ q .p) ;r...: iiONS DIVISION /U,�n-A o E�u.�I��G No 2 4 P iv )1)- P.9/1- , —.1— DENOTES' PROPOSED SURFACE DRAINAGE 1 b 4[Sf�MS �fl O DENOTES IRON MONUMENT SET SCALE: 1 INCH = 3v FEET • DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR = 890.5 FEET X000.0 DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR 8B57.' FEET (000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK = 690.9 FEET I HEREBY CERTIFY TO GRAND OAKS DEVELOPMENT CO. THAT THIS IS A TRUE AND CORRECT ' REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF: Lot 1, Block 5, WESTBURY FIRST ADDITION, according to the recorded plat thereof,. Dakota County, Minnesota. 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 MY DIRECT SUPERVISION, THIS 1174 DAY OF JuN ( , 1985. • PROPOSED ELEVATIONS SHOWN ARE SIGNED: JAME R. HILL, INC. AS TAKEN FROM THE GRADING AND DEVELOPMENT PLAN FOR WESTBURY BY n DELMAR H. SCHWANZ, LAND SURVEYORS, (1:2,104et� INC. , LAST DATED 10-2-84. BY. HAROLD C. PETERSON, LAND SURVEYOR MINNESOTA LICENSE NO: 12294 • PROJECT NO. BOOK / PAGE JAMES R. HILL, INC. SS Co-7 Planners / Engineers /. Surveyors FILE NO, 8200 Humboldt Avenue South. FOLDER Bloomington, Mn. 55431 612-884-3029