3926 Westbury Dr
~ CITY OF EAGAN WATER SERVICE PERl1A1T !
3830 Pilot Knob Rosd .
P. O. Box 27199 PERMIT NO.:
~ Eagsrt, MN 55127 '
DATE: I
~ Zonirg: Mo. of Units: '
OiN1Q1: 1.5
i
~ ~1f~flSS: ~ R
ST4 AddYlSi: - ' '.'!a S tl~!
Plumber.
, Mabr No.:
~ ri •
S1zl: ./1u~?1'~ Dep031t:;, . . , '
Reodsr No.. l :.-pertiif Fee: . ~
I .sn.. M oo.~ wM~ f!n Citr w. surct,urQe: ~
0r4 Chorpes: j , . . Ja:.. . .
~ 0
TOtOL'
BY Dote Pbid: '
Dafe of Inap.: ' Insp,: I
~
CI7Y OF EAGAN SEWER SERVICE PERMIT
3830 Pilot Knob Road
P. O. Box 21199 PERMIT NO.:
Eagan, MN 55121 pATE; - Zonirg: Na of Units; i
Ownwr.
llddrcss:
Site /lddrou: ~'~~F ;i• ~ - ~f ~~.,~,a.:y, ~ `
Plumber. . - -
1.sn. to esmoy whr d. CIFy .f B.ge¦ Connectton Owrpe. 4 25 . U u;-x'
Odiaswea. Account Deposit: .
Pe"nlt Foe:
SurrFwryo:
BY Misc. Chorpes:
Date of I?isp.: Totol:
Insp.: Doh Poid:
. . . . .,x..' :r ...,o„ ry t , . ~ 7 ~ . .
PERMIT # ~
MECHANICAL PERMIT RECEIPT #
=GAN
3830 PIL
OT KEAGAN, MN 55122 DATE:
CONTRACT PRiCE PH01NE: 454-6100
Site Address BLDG. TYPE/ WORK DESCRIPTION
Lot i Block Sec/Sub Res ? New
L Name 1 y ;z• ~ Mufk Add-on "
~ Comm. Repair
~ Address c City 'Phone - S Other
- . w FEES
~ Name RES. HVAC 0-100 M BTU -$24.00
c Address ~ • ' 4 - ADDITIONAL 50 M BTU - 6.00
O City Phone (RES. HVAC INCLUDES A/C ON NEW
CONSTRUCTION)
1GAS OUTLETS (MINIMUM - 1 PER PERMIT) - 1.50 EA.
TYPE OF WORK COMM/IND FEE - 196 OF CONTRACT FEE
Forced Air M BTU APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE 8 CONDOS - RES. RATE APPUES
Boiler M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON R
Unft Heater M BTU REMODELS - 12.00
Air Cond. M BTU MINIMUM COMMERCIAL FEE - 20.00
Vent ' CFM STATE SURCHARGE PER PERMtT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
Gas Piping Outlets # BEYOND $1,000)
Other ~
FEE:
S/C: SIf,N T R~ F R I E
TOTAL•
FOR: CITY OF EAGAN
CITY OF EAGAN 10775
. ' 3830 Pilot Knob Rosd, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
BUILDING PERMIT aeuipt #
Te be w"d ier Est. Value Dote 19 :
Y!-* t Erect Q, Occupancy ?
Site Addresf
Let ` Blxk 5eclSub. Remodel ? 2oning `
Repair ? Type of Const. ~
Parcel No. Addition ? No. Stories
> Move ? Length
~ ,
Name . . V c' TI'
Z ~ r CE>r,_'.i*'1 Demolish ? pepth
c
~ Address ' Int Impr, ? Sq. Ft.
City Phone ~d r~ 2 + 89 3`:, Install ?
Approvals Ftis
Name
Addresa Assessment Permit - ~
City Phone Water b Sew. Surcharge - a ~
Police Plan Review
` . (1
F W Name Fin SAC
u~ Address Enq, Water Conn.
CW City Phone Plonner Water Meter
Councii Road Unit
I hercby ocknowledge that I how read this opplicotion ond stote thot Bldg. Off. 3 I'~ • Tr. PI.
the informotion is correct ond ogree to comply with oll opplicoble APC Parks
State of Minnesota Stctutes ond City of Eogan Ordinonces.
Var. Date 19 ~ • Copies
Sipnaturc of Permittes
Total
A Buliding Permit is issued to: on fhe sxp?ess conditbn that
oll work sholl be doM in acaordcnce with all cppiioable Stote of Minnesoro Statutes ond Gty ol Eoqan Ordirwntes.
Buildinp Offkiol
Permit No. Psrmk Holder Dsb TNoRhons #F
Plumbinp
H.V.A.C. /1
Electrlc ~5 Y 9 ~l s - ~
sone+..
(nspection Dste Insp. Othsr
Footings I ~
IIL
Footings 11
Foundatlon
Framing
Roofiny
Rough Plbg.
Rough Htg.
Insul.
Fireplace
Flnal Htg.
Final Piby.
Final
Cart/Occ.
Water D"e?i6a Loeation:
Well
Sewer
Pr. pisp.
PLIMABINa PERMIT Permit No.
CITY OF EAGAN Fw
fill in numbered Waces S/C
Type ar Print Myib/y Tot, - ;
r
1. Date - )y - i5 Z. Installation Cost
0:' . .
3. Job Address7.1 d L Lot Blk. Tract
r ~ .
4. Owner c., c.l . ~
b. Contractor V~ ~tPhone
6. Addmss L ~
7. City State Zip
8. Building Type: Residential Commercial O Institutional ?
9. Work Description: New IQ Add ? Alter ? Repair ?
10. Describe
11. No. Fixtures No. Fixtures
~ Water Closet Gesspool/Orainfield
1 Bath tubs Septic Tank
~ Lavatory Sonrwr
i Shower Well
i Kitchen Sink
Urinal/Bidet Other
Laundry Tray
Floor Drains
Drinking Ftn.
Slop Sink
~ Gas Piping Outlets
12. 1 hereby certify that the above information is true and correct, and I agree to
comply with 11 ordinanC,es and Codes governing this type of work.
Signed :
r for
Rouyh f inal
lnspsctions: Oate Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 4644100
1i
Ruaipt MECHANICAL PERMtT *ennit No.
CITY OF EAGAN A•
' '
` )4)I F~
fill in numbered zpacea S/C
Type or PrlnL legiblY Tolt,
1. Date 2. Installation Cost
3. Job Address l`_fv~#} t Lot 1~ Blk. Tract `
4. Ownw :~r c~ r.4L)c,
. ~
b. Conuactor i 1 o r , r ; Phorie i i L
~ Y
8. I'9Wra77 Ll'"' 1
7. City L ~ State M~ Zip
8. Building Type: Residential E3 Commercial ? Institutional O
9. Work Descxiption: New Add 13 Alter O Repair O
10. Describe Fuel Type
11. No• Eqtiipmant BTU - M. Ea. No. Eouipment CFM
Forced AirS~j. Air Handling:
Mfg. ~
Boilers Mech. Exhaust
Mfg.
f Unit Heater
Mfg. Other
Air Cond.
Mfg.
Ges, Piping Outlets
12. I hereby certify that the above information is true and correct, and I ayree to
comply with all 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 Remarks
Addition WEST$URY FIRST ADDITION Lot ]..g Blk 4 Parcel-1.0_Ei3.6.SD 14_0-04
Owner Street 392 Wegthn nrive State Eagan, MN 55123
Improvement Date Amount Annuai Years Payment Receipt Date
STREETSURF. 19$6 2850.0 O-00 I/&
STREET RESTOR.
GRADING
Water area W7 1986 133. 1. 8.92 15 !33• G~l -
SAN SEW TRUNK 07,1
SEWER LATERAL 1986 500$. ]3 , 3
~
Watermain 1986 65.29 4.35 15 5- a 9 ~
WATERMAIN D ,5 , - ,i
~ WATER LATERAL 1986
WATER AREA .,,Z ~ - l U I[J - I- 5
*Services 1986
STORM SEW TRK 1986 710.24 1 .d`I
~ STORM SEW LAT 19$6
CURB & GUTTER '
SIDEWALK
S7REET LIGHT
280
WATER C fVN.
r~ n
BUILDING PER, 10775
SAC
PAR K
11NSYLC.;'1'lUN itLUUKl)
V/CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued: • r'';;
(612) 681-4675
SITE ADDRESS: . ~ ~ , , < ~ APPLICANT:
PERMIT SUB7YPE: TYPE OF WORK: ,
INSPECTION . .A
RIZ ',We .5~
-7
na _ . . . . . ~ . . . . . . . . . . . . . ~
Permit Holder Date Telephone #
PLUMBING
HVAC
Inspection Date Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
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
METER
FLUSH
MAINS
CONDUCTIVITY
TEST
HYDROSTATIC
TEST
BSMT R.I.
BSMT FINAL
DECK FfG
[
DECK FINAL
w = CITY OF EAGAN N° 10 7 7 5
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE:454810D
BUILDING PERMIT 2eceipt #
Te ye ased Im SF DWG/GAR Est yalw $63.000 Dafe AUGUST 13 1 q 85
SiteAddren 3926 WESTBURY DR Erect EX occuPency R3
Lot 19 simk 4 Sec/Sub. WESTSURY 1ST Ramodel ? Zoning Rl
Percel No Repair ? Type of Conrt. V
.
- Additlon ? No, Storiec
GRAND OAKS DEVELOPMENT CO Move ? Lenytn 44
~
Name
~ Oemolish 11 Depth Q$
1881 SUNRISE CT
Address Int Impr. ? Sq, Ft.
cicy EAGAN phane 452-8934 instau ?
o Name SAME ADMeva6 Fns
t`~' Addresa Assessment Permit 2.00
City Phone Woter 8 Sew. Surcharge 31.50
Polica PlanRevlew 161 :00
GW Nm,,, p;,, snc 525. o0
uo Address Enp. WaterConn. 500.00
lW City Phone Plunner WaterMeter 63.00
Council RoedUnit 280.00
1 hercby ackrawledge that 1 Mw reod this applicotion ond stote that Bldg. Off. $ 13 H Tr. PI. 132.00
the inlormotion is correct ond ogree to comply with oll applicable APC Parks
Stata of Minrosota Statuta nd City E~rdi aS ncec. D Ver. MENT Date CO Copi 7otal as
$iprwtun of Pem+iffee Af, ~ CC ~~5 0
A Building Permit IS issued to: GRAND on tM exprao corditlon IM~
all work shall ba done in ocoordanee with oll oppliaob~l/yy5 t~o~te~ ~Mi,nne~` ta atutes ard Ciy ofi Eopon Ordinances.
Buildlrq OfftNal ~ ~
%LD
,a
1985 BUILDING PERMIT APPLICATION - CITY OF EAGAN
NOTE: ALL CONTRACTORS MUST BE LICENSED NITH THE CITY OF EAGAN
INCLUDE 2 SETS OF PLANS
3 CERTIFICATES OF SURVEY
1 SET OF ENERGY CALCULATIONS
To Be Used For: c.S? d-'Valuation: Sp3AM Date:
Site Address: J/,) 6 AO-t- OFFICE USE ONLY
Lot: ~ Block~ Sect/Sub ~ Erect ~ Occupancy
Remodel Zoning
Parcel li Repair Type of Const '$Z
Enlarge # of Stories
Owner Move Length q-¢
Demolish _ Depth ~
Address Grade Sq Ft
CitylZip Code
Phone dPPROVALS
Contractor 3zdZia-._ ef~ Assessments Permit 2j2 2.~
WaterlSewer _ Surcharge 1c31 . 5=
Address Police Plan Review fP
Fire SAC 525.~
City/Zip Code ~ Engr Water Conn SOO• ~
Planner Water Meter s-
Phone Council Road Unit
Bldg Off Parks
Arch./Engr. APC Treatment Pl {32.°~
Variance- ..4~
Address c c TOTAL oZ
City/Zip Code
Phone !1
r
y*~Ly~ tt~g.,.' b~~• r.., .
. . . ~~x[ ~~V ySiKY ~ 7UqnY+~~ ~ + v4 } iy
~ EXTERIOR Eld~'ELCi~'~~ s a ~
4xaF~r~
. . GRAN6.`64K$K.pEkLOPMENT CI}M!I"{1idY ~ •r ,t, .
• . ~ d'l il r1 1. 1. NIt " ' ' t ' * ^c F~ ?+i~~ {~,ak' A k.~r , , .
~.MODEL Gl'~;~i AREAhe!c~~~,';U.~, U X ARffA ,
r A v"i j• f~ ~.1~ 1n F t { , _ .
ti
' ) i;; 1 ' i,, ~.t ..Ct~f 1't t.?,,i y • REQUIRED ti , - r , . . Pi- f .
1. ' TOTAL WALL;'F1REA:: ; : ' iBQt9 •X'`. 41 • ; ' 198
• ' t,~.- ,,..,t.
2. ` TOTAL.RODF AREA, ~ 3l46,X,02b 31.096
~s•y' ~ . . tr '
ACHIEUED
AREA.':.' V U X AREA
A. W I NDOW AREp 186.66 . . 5 93.33
B. DOOR AREA 39. B„ .,077 3.0646
C. SL I DE ' QLA88' AREA , 13. 44,', • , .48 6.4512
D. FIREPl.ACE,"AREA'.k.~ 0p p
E. WALL"FRAh9E: AREA"'' 180 6041 , 7.38
F. NET WALL' AREA 1164. 1,'..1049 57.0409
0. RIM:JOIB7.-AREA ° 119.32s'= .0436 5.211072
H. FOUND WINDOW AREA k^ 0''` , O. O
1. FOUND A6DVE aRADE-: 96.48.133 13.0248
3. TOTfl43 WAti. FiREA 1BOO 185.5026
• , , _ . 'e_,. , : . .
0_ O
K: ROOF FRAME' 119.6 ' : . 032. 3. 8272
L. NET ROOF-: AREA • 307b. 4^` .'023 .26. 41
4. TOTAL ROOF ARHA 1146 30.7372 ,
.
' • -
3UM 1. +3 229. 096
$UM 3.+4. 216.2398
' -
, . ? ...Y ,Y.' . . . ' . 4:'~s n:t" . , ' ' _ . . .
.
, . .
SURVEYOF;IS CERTIFICd4TE GRAND OAKS DEVELOPMENT CO`
y rS72018`591N.
44.24
41
s i
y l
. / / .
~
.
/
19
^ '008 eZ ~ ~
~j•, 4/ ~ zz ~ti6' ! ~
co
r
g t. 4i !l ~ i(01 .
,?rt~+ . 6 - .
.3
9 '
8gZ)- . . .
DENOTES PROPOSED SURFACE DRAINAGE ~ 3O . '
O DENOTES IRON MONUMENT SET SCALE: 1 INCH = FEET
• DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR =941-3 fEET
.X000.0 DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR =$88.5 FEET
(000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP .OF BLOCK = a9 1.? FEET
I HEREBY CERTIFY TO GRAND OAKS DEVELOPMENT C0. THAT THIS IS A TRUE AND CORRECT
REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF:
Lot 19, Block 4, WESTBURY 15T ADDITION, according to the recorded plat,
thereof, Dakota County, Minnesota.
AND OF THE LOCATION OF A PROPOSED BUILDING. IT DOES NOT PURPORT TO SHOW IMPROVEMENTS.
OR ENCROACHMENTS, IF ANY, THEREON. AS SURVEYED BY ME, OR UNDER MY DIRECT SUPERVISION,
THIS 7t}}- DAY OF Auoos'f , 1985.
,
SIGNED: JAM R HILL, INC.
BY:
AROLD C. PETERSON, LAND SURVEYOR
' htINNESOTA LICENSE N0: 12294
PROJECT NO. BOOK / PA(#E J~~ES R. HII.L' INC.
85778 Planners / Engineees Sucveyprs •
FILE NA. - 8200 Numboldt Avenuo South~ ~
FOLDER ebomin9eon,nnn. 55431 612-8e4-3029
FERMIT
CITY OF EAGAN
i, 3 8 ~ 3 0 Pilot Knob Road PERMIT TYPE: B U I L D I N G
Eagan, Minnesota 55122-1897 Permit Number: 0 3 2 9 7 9
(612) 681-4675 Date Issued: 0$/ 2 5/ 9 s
SITEADDRESS: 3926 WESTBURY DR
LOTs 19 BLOCK: 4
WESTBURY 1ST
P,I.N.: 10-83650-190-04
DESCRIPTION:
BuV1~°tw`g'~Permit Type DECK
B~,ildl,Y1g "Uork 7ype NEW
G~risEts Code' 434 ALT. RESZDENTZAL
. ~ N
£
^a,_. v1
z,
~ P
~ s. scr ie,~ e '.Gsu v ""i
av '3a - sa § R~ ~r
, •'+t~4 T k . f
p~tv:.6.P'SSRIraMviCf„~? u F;S ....~vo'REM~W:REvzEwEO BY BILL ADAMS.
FEE SUMMARY:
Base Fee $50.00
Surcharge $.50
Total Fee $50.50
J
CONTRACTOR: OWNER: - Appliaant -
GOLDING LUANNE
~ 3926 WESTBURY DR
EAGAN MN 55123
~ (612)293-3442
i
Z" herob~r acknoaSedge= that, T have rea4 th3s' aRplicatzorl aatist,6,t.e.'that the ~
. infarRa~lon Is eor+"ebt anci agr`ee ta cosnpl.y w,fCh aX1 aPPlicaale StAte of Mn. ,
rS-tatute~S`"an~ C'~ty of' E&ga°r€'Ord3.nij~ty
.
~ Z
~
APPLICANT/PERMITEE SIGNATURE SUED BY: SIGNATURE ~
?Rx'ii)1.1±NG PERMIT APPLICATION (RESIDENTIAL)
. ~ CITY OF EAGAN ~ SU • ~j ~
3830 PII.OT KN08 RD -,66122
681-4675 ~ ~a.,cy) gl~ .~r~ec~ionS
New Construction Reauirements ~ RemodeVReoair Reouirements
? ".ogistered sRe surveys ? 2 copies M plan ~
? ? copies oi p ans (inGude beam & window a¢es; poured tnd. design; etc.) ? 2 sile surveys (extarior addkions 8 dedcs)^ ~(T^
? I en y alations ? 1 energy calculationa for heated addkions U n i I
.
h 3 wp oitree preservation plan H IM platted after7lt/93
equired: _ Ves No
nATE: CI g CONSTRUCTION COST;A2"JU o
!yi?. ;CRIPTION OF WORK:
5'fREET ADURESS: -3f.2 6 ~"STJLC r! e. Elaan Jv SSI Z~
LOT: BLOCK: Y SUBD./P.I.D. ~IeS~ I.S ~ ~7~7N
Name: C-70 Phone ^ o
PROPERTY Last First
OWNER Street Address: 12-1a S LCY ~~a V
City ~Q~_f•}.[u--~ State:Zip:
Company: .i 0,00-~ ~ P6one
CONTRACTOR
Street Address: License # _
City State: Zip:
ARCHITECTJ
ENGINEER Company: _ Phone t!:
Name: Registrazion tt:
Sveec wddress:
City State: Zip:
Sewer 8 water licensed plumber (new construction onty): . Penatty appiies when address chang
and lot change is requested once pertnit is issued.
1 hereby acknowledge that I have read this application snd state that the infortnation ' rrect and agree to comply with all epplicabl
State of Minnesota Statutes and Ciry of Eagan Ordinances.
Signature of Applicant: _
~[R=c~R ad~
OFFICE USE ONLY
Certificates of Survey Received ~es No
Tree Preservation Plan Recsived - Yes No _ Not Requ red
OFFICE USE ONLY - • _ '
BUILDING PERMIT TYPE
D 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish
? 02 SF Dweiling ? 07 4-plex ? 12 Mufti Repair/Rem. ? 17 5wim Pool
? 03 SF Addition ? 08 8-plex ? 13 Garage/Accessory ? 20 Public Facility
? 04 SF Porch ? 09 12-plex ? 14 Fireplace ? 21 Misceilaneous
? 05 SF Misc. ? 10 = plex A15 Deck
WORK TYPE
~ 31 New 33 Alterations ? 38 Move
? 32 Addition ? 34 Repair ? 37 Demolition
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. MC/WS System
(Allowable) Main level sq. ft. City Water
UBC Occupancy sq. ft. Fire Sprinklered
Zoning sq. ft. PRV
# of Stories sq. ft. Booster Pump ~
Length sq.ft. Census Code.
Depth Footprint sq. ft. SAC Code ~
Census Bldg
- ' Census Unit ~
SIAPROVALS
Planning Building ~ Engineering Variance
Permit Fee Valuation: $ ~
Surcharge
Plan Review
License
iviC/VJS SAi,
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
°k SAC
5AC Units
, J`~IRVEVOR'S CERT4F9CA.1'E,~`ND OAKS DEYELOPMENT CO `L! j`
~4.24
~ ee3" ..~c
/m y
~
LOT I4 ~
,9
CI)ryI
41)ry ` `
~
•J d'~ ~USF ~ , 'O nQ-v I
. . r^I}~•I ^4 2~ ' / r^ .
. ~ ?2o.~NN .
o•
• ~ ~„3?41,
i ~(0 ,
1,4
0 , .
g~ s
6 3s
~ 3p•, 9 eg8~ . .
\ o
~
.DENOTES PROP05ED SURFACE DRAINAGE '
O DENOTES IRON MONUMENT SET SCALE: 1 INCH = 30 FEET
O DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR =&91,3 FEET
.X000.0 DEN07ES EXISTING ELEVATION PROPOSED LOWEST FLOOR = 699•5 FEET
(ODp.O) DENOTES PROPOSED ELEVATION PROP05ED TOP OF BLOCK m g91,? FEET
I HEREBY CERTIFY TO GRAND DAKS DEVELOPMENT C0. 7NAT THIS IS A TRUE AND CORRECT
REPRESENTATION OF A SURVEY OF THE 80UNDARIES Of:
Lot 19, Block 4, WESTBURY 15T ADOITION, according to the recorded plat.
therepf, Dakota Gounty, Minnesota.
EAGAM
aND OF THE LOCATION OF A PROPOSEO BUILDING. IT DOES N~POD ' PROYEMENTS.
OR ENCROACHMENTS, IF ANY, THEREON. AS SURVEYEO BY~M~l,~ CF7PERVISION,
THIS 7t4}- DAY OF AvcavsT . 1985:
SIGNED: JAM ^ -jR Y r
BY:
AROLD C. PETERSON, LAND SURVEYOR
' PIINNESOTA LICENSE N0: 12294
PROJHCT N0. BOOK / PAOB JAMES R. H'LL, INC.
85778 Pianners / Engineers Surveyors -
FILE N0. 8200 Humboldt Avenue 8outh~ ~
FOLDER Bloomineean, Mn. 55431 e12-8e4-3029
1^
zisa
CITY Or EAGAN
APPLICATION FOR PERi4IT
SES•IER AND/OR WATER CONNECTION
(PLEASE PNIHi)
i) PRoD= AeDREss: G[~PSY h cl Y N Dr, ve ~
r4 l
(I.nL/31ock/Su:aivisicn or TaK Parcel I.D.
~ I'r' .-_,:IS!I:G S'T:.CC^J:ti., BAi`. 0" d2T_G11M ctiI=L~..-i _.=_111 +SJi.a^-NC-:
pn-°SL'_^ El P-1 S== F?-%ffLY .
? Z-2 LLY= (7NO U:IIiS)
? rZ-3 ^rjozz-:rt.'cr (?':?p= T-II:'c~ .
? R'4
? CCi,nIE.?C_Z/RE^.'AII?OF:'IC::
? ..T~i:C:;SiLa S,
? L1:STImTICN A I./GGV~.=,.~n~.'T
z) AP7j!C7-_.;T (PLEASE PR1iii)
N7V'1E: C`~ ra ~'1 C7 0 Gk "
ACD.RESS: /g~, I Sd/'1 YrSP G
CI"_".. S:~:T:.', ZIP: I'I
PI:ONE: L5 41 c
3) pi. u.T,~ y (P ~SE~N1Ni) FOR CITY US£ ONLY
v ~
PDDRESS: PLU°BERS lI .
ttive
CITI,,5T?.^~E, ZIP: ~P (10.1 Expi ed
of Record
PHOVE: LpLUNBER LILENSE !E
' atr ;nicia
4) OCC,''ip,D7T/C!;i;F,t2 IPLEASE PRINf J
ADD.T2ESS: ~ 611
STATE, ZIP:
PfiO`IE:
5) ZNDIGITE ::'NICH PER-LiT IS BEItiG RE(!UESTID:
EP CC.`LyF.C.TiON 'IO CITY SETrIER
~ CC :zIFxTIC:I TO CITY GIATER
? C7:c!ER (PI,USE DFSCF2IBE) '
6) ~.'OIG.~ C:W: •
. Q PT-= `-SE fIOZD APPr"MM PEFLMIIT FOR PICi:-L"P BY C:IE OF AE('VE
RN P:.E=S :7= AP ~UtJm PEP:•uT T'J 1, 2A. 4 AfiOVE
(Ci:cle one)
7) SICZATL'RF.: DATE: ~
,
R% R o1:~LawfoA:s- i~~~az~ ~ nt r+t sa a,a a~ +s 1.a ~f ..FSar.a :a a~e ~el.a-l~ ryra f~ ~e rs! ~ ec~r
~
FOR C I T Y (1S E OPILY
PGP~!I'T_' ? TCjLTrrJ .
~
~
^S• $ ~~C? SE;•;L,D DC7\4T~y^ (I"C.T....= J=:.: ^:~L)
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AI".OU.:T PAIJ/RECZZ?T
DOES UTI:.I.Y CON:IEC:ION REQUIRE EXCaVATION IN PUBLIC RIGHT OF WAY?
L YES IF YES, THE.`I n"PERb1IT FOR *rlOAK WZTHIV
PUBLIC ROADWAY" MUST BE ISSUED BY THE
.NO ENGINEERID]G DTVZSZON. LIST AS el CONDI-
TION.
SUEJEC^ TO THE FOLLOS•7ING CONDITIONS: •
APPROVED BY; l
. TI.Lc: / •
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DAT= : _ .1-d / ~ ~wiv ~ssf Nt+ ~ow so lp=Po 04 a Vcm wt m r am m
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA142134
Date Issued:04/17/2017
Permit Category:ePermit
Site Address: 3926 Westbury Dr
Lot:019 Block: 004 Addition: Westbury 1st
PID:10-83650-04-190
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Includes Skylight
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 within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Luanne Golding
3926 Westbury Dr
Eagan MN 55123
(612) 327-5387
Shelter Construction Llc
7040 Lakeland Ave N
Brooklyn Park MN 55428
(612) 849-8082
Applicant/Permitee: Signature Issued By: Signature