3927 Westbury Dr
CITY OF EAGAN WATER SERYICE PERMIT ~
3830 Pilot Knob Road
P. O. Box 211S9 PERMIT NO.:
Eagan, MN 55121 DATE:
Zoning: No. of Units:
ner: '.°'.i12e i
u ~
rCSS~
Site Addrcss: v,I"~ ` S=i;ur ~ 1
Rlumber. ' 'fC' ( c~'rlt~"r`
!~ter No q 470.00 ~~a
~ S Connect~ori CFiarfle: f
f goL t A E r~•~~,e."1~ 1 J.~~ ~ f1i1
-
SiZe: p
Reade No.: L- 6,36 00- Permit Fee: 1D.OQ pd
,
i yrM to ee~eol~r vrill~ tM Cit~r of E*g~n Surcharge: S~
Or/iwena~. Misc. CF+oryes• pd m~: t~>
~ - Total: .
gY Date Paid: '
Date of Insp.: Insp.:
CITY OF EAGAN SEINER SERVICE PERMIT
3830 Pilot Knob Road 7 014
P. O. Box 21199 PERMIT NO.:
Eagan, MN 55121 pATE; 11-1S-a4
Zoning: ' No. of Units:
~ Owner. 30c Aiiller Ganst
Addross:
Site Address: 3927 Westbjry 'Drive L2 AS IJeatburv 1
, Plumber ?'Lvr.;out_Z PJ.br
46858 00 p
1 pm w eene*y whU dn Cihr of Eeson Connection Choqpe: 425 . 00 nd
Ordineear. Account Deposit: 5, p_.._.
Permit Fee: 10.'J p
Surctwroe: .5o p
gy Misc. CFtorpex
Date of insp.: Tatal:
~ I„sp,; Doh PWd:
.
, CITY OF EAGAN j. 9564
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
~ PHONE: 454-8100
BUILDiNG PERMIT Re«+ar #
Te be wwd fm SF DWG/GAR Est. Value $7 7,0 0 0 pate OCTUBER 5 , 1 9 8 4
SiteAdd~sa 3927 WESTBURY DR Erect L3 Occupancy R3
Lot L Block SeclSub. Remodel ? Zoning RL
Parcel No. Repair ? Type of Const, V
Enlarge ? No. Stories
W Name JOS MILLER CONST INC Move ? Lenyth 42'
~
Address 18133 CEDAR AVE SO Demolish ? Depth 46 City FAROlINGTON Pnone 431-2001 Grade ? Sq. Ft.
Name SAjujg ApProvals F*es
~
~i Address Assessment Pertrnt 38.50
~ City Phone Water a Sew. Surchorpe
Police Plan check 18 2. D 0
U°W` Name fire SAC 525.00
~W
Z~ Address Eng. Water Conn. 4 7 0 • 0 0
~W City Phone Planner WoterMeter 63.00
Councll Rood Unir 260.00
1 hereby acknowledge that 1 hove read this applicotion cnd state thot gldg. Off. 10/1/84 M*( COiJ17 ) 1. 00
the intormation is correct and cgree to comply with all opplicable APC ~ Total r ~3 . J~
Stata of Minnewto Statu`t_e/ pnd City ot Eaqan: Ordirances~
Var. Date
Sipnnturo of Permittee
A 8uilding Permit Is issued to: JOS MILLER CONST INC on the express condition ihot
all work sholl be dona in accordorlee with all opplionble $tote of Minnesota Stotutes ond City of Eoflon O?dinonces.
_ ~
- i
Buildinp Officiol L k_- r
Parmlt No. Permit Holdsr Date
Plumbfnp ~57 /l'1c.a,,r r
H.vr?.c.
Electric
Softener
Inspection pate Insp. Other
Footings . ~
Foundstion
Framing
Rough Plbg. ~
Rough HVAC
Inwlation ~C •Yy
Final Plbg.
Final HVAC
Final /9
Carc/Ocs. ~
Water Deuribe Location:
YMelI
Sewer
Pr. Disp. -
Receipt -i MECHANICAL PERMIT Permit No.
CITY OF EAGAN
Fee
FiII in numlered spaces S/
C Type or Print /eg/bly Tot. - ~ ~
1. Date 2. Installation Cost '
1 ( ~ f • J '..C!}+,.~ • • t_
3. Job Address 1~~ 1 Lot~, Blk. Tract -
:
4. Owner
5. Contractot`-r Phone
6. Address • ~ ' ~ ~ / ; C/ ~
7. City State ij Zip
8. Building Type: Residential ~ Commercial ? Institutional ?
9. Work Description: New 0--- Add ? Alter O Repair 0
10. Describe Fuel Typb
11. No. Eauinmenc 8TU - M. Ea. No. EQUiament CFM
Forced Air ~ I`r'~ Air Handling:
Mfg. `S
Boilers Mech. Exhaust
Mfg,
Unit Heater
Mfg. Other
Air Cond.
Mfg.
Gas, Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply' with all, ordinances and codes governing this type of work.
Signed : for
Rough Flnal •
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
, . -
Receipt PLUMBING PERhAIT. • Permit No.
CITY OF EAGAN
- Fee o ~ -
FiU in numbered spaces S/C
Type or Prrnt Jegib/y
Tot. -s,
1. Date,,' 2. Installation Cost.t
r1
3. JStSAtJdress '~~C~L"K,~+-. Lot - Blk._ ~ TractLG
r q
4. Owner
5. Contractor ! Phone ? ~ ~ ~ ' •
6. Address
7. City 5tate Zip
8. Buitding Type: Residential Commercial ? Institutionai ?
9. Work Description: New Add El Alter ? Repair O
10. Describe
No, Fixtures No. Fixtures
^ Water Closet Cesspool/Drainfield
~ Bath tubs Septic Tank
Lavatory ' !$oftner
' Shower f '`s Well
~ Kitchen Sink
Urina1/8idet 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 Final
Inspections: Oate Insp. Date tnsp.
This is your permit when numbered and appraved.
Approved CITY OF EAGAN 454-8100
CITY OF EAGAN Remarks id 1~P~
Addition ~STBURY FIRST ADDITION' Lot 2 Blk ~ Parcel 14 $3659 029-9~ '
Owner Street 3927 Td,eG+-1»•r3~~ive State Eagan, MN 55123
Improvement Date Amount Annual Years ; Payment Receipt Date
STREETSURF, 1986 2850.00 2850.00 C010163 2-19-85
STREET RESTOR.
GRADING
SAN SEW TRUNK _2
~ SEWERLATERAL 1986 5008.73 i
n n
WATERMAIN if 19-q4 68 71 4- !R 5 .55 WATER LATERAL 1986
WATER AREA Q n n
*Services 1986
STORMSEWTRK 19$6 710.24 142.0
* STORM SEW LAT 1486
CURB & GUTTER '
SIDEWALK
STREET LIGHT
LO-5-84
Road Unit 520.00 #46858,47166 10-19-84
WATER CONN, 940.00 if
BUILDING PER. #9569 9631
SAC lO O.OQ
PARK
RESIDENTIAL
BUILDING PERMIT APPLICATION
it qqLio CITY OF EAGAN
3830 PILOT KNOB RD - 55122
651-681 -4675
lew Construction Reaulremenh RamodellReoair Requiremenq
3 ragistered site surveys showirg sq, fl. of lot, sq. ft of houu; and all roofed areas . 2 copies of plan
(20% maximum lot coverage allowed) . 1 sel of Emrgy Calculalions for heated additions
2 copies of plan shawing beam & windax sizes; poured tound design, etc.) • 1 site survey for exterior additions 8 decks
1 set of Energy Calculatbns . Indicale rf home served by septic system for additions
3 copies of Tree Preservation Plan if lot platled after 7/7193
Rim JoiSl Detail Options seleclion sheet (bldgs with 3 or less units)
)ATE l(/ MO VALUATION
IOB SITE ADDRESS v I~
F MULTI-FAMILY BUILDING, OW MANY UNITS?
'ROPERTY OWNER . Dfivid ( e.
'YPE OF WORK 604 I - ID FIREPLACE(S) _0 12 3
kPPLICANT PHONE # . ~ • TJ I ' l/
kDDRESS N M ZIPCODE 'J~~ Z
'AGER # CELL PHONE # FAX # lC'~I • ~7J~
NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY
Energy Code Category _ MINNESOTA RUI.ES 7670 CATEGORY 1
(check one) - Residential Ventilation Category 1 Worksheet Submitted
- Energy Envelope Calculations Submitted
_ MINNESOTA RULES 7672
- New Energy Code Worksheet Submitted
Plumbing Contractor. Phone
Plumbing System Includes: Water Sofiener Lawn Sprinkler Fee: $90.00
Water Healer No. oFR.I. 13atlis
No. oF Bahs
Mechanical Contractor: Phone #
Mechanical System Includes: _ Air Conditioning Fec: $70.00
Heat Recovcry System
Sewer/Water Contractor: Phone #
~ r,
i" ~ P LL~ U Ijl ~
UI a6ove information must be submitted prior to processing of application. ~ a I
'~c~~f
hereby acknowledge that I have read this application, state that the information is corr , and agree to co with
sll applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applican
;ertificates of Survey Received _ Tree Preservation Plan Recei d _ Not Required _
Updated 1101
OFFICE USE ONLY
7 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 Eut. Alt - Multi
] 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 PorchfAddn. (4-sea.) ? 33 Ext. Alt - SF
] 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
] 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
] 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
7 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
] 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
7 33 Alteration ? 37 Demolish (Bldg)* ? 43 Reroof ? 46 Windows/Doors
] 34 Replacement "Demolition (Entire Bldg only) • Give PCA handout to applicant
/aluation _ Occupancy _ MC/ES System
;ensus Code Zoning City Water
iAC Units Stories Booster Pump
Jbr. of Units Sq. Ft. PRV
dbr. of Bldgs Length Fire Sprinklered
'ype of Const W idth
REQUIRED INSPECTIONS
_ Footings(new bldg) _ FinaUC.O.
_ Footings (deck) _ FinaUNo C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile
Roof Ice & Water Final Other
_ Framing _ Pool _ Ftgs _ Air/Gas Tesu _ Final
_ Fireplace _ R.I. _ Air Test _ Final _ Siding Stucco Stone
_ Insulation _ Windows (new/replacement)
Approved By , Building Inspector
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
3ase Fee
iurcharge
'lan Review
AClES SAC
;ity SAC
Nater Supply & Storage
3&W Permit & Surcharge
-reatment Plant
llumbing Permit
Aechanical Permit
.icense Search
:opies
Jther
i otal
CITY OF EAGAN M 9569
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55127
PHONE: 4548700 ~0
BUILDING
PERMIT 2eceipt #
Te ba awd fer SF DWG/GAR Et. Volue $77,000 pa1e OCTOBER 5_- 19 84
SiteAddresa 3927 WESTBURY DR Erect IN Otcupency R3
Lot 2 Block 5 Sec/Sub. WESTBURY 1ST Remadel ? Zoning Rl
Parcel No. Repair ? Type of Conat. V
. Enlarge ? No. Stories
W Name JOS MILLER CONST INC Move ? Length 42
~ Address 18133 CEDAR AVE SO oemolish ? oepth 46
Citv FARMINGTONvnone 4 3 1 - 2 0 0 1 Grsde ? sy.Ft.
-
a Name SAME ~AVVrovals Fep~es
ot Address Assessment Permit 3~'f ~ V 0
City Phone Water &$ew. Surchnrpe 38.50
~
Police Plan check 182 . 0 0
. ~W Name Firo SAC 52$._0 0
Address Enp. WaterConn.470.00
~W City Phone Planner WoterMeter 63.00
Council Road Unit 260.00
1 hereby otknowledge that I have read this ap0lication ond stote thaf gldg. Off. 10 1$Q Db-4cic ( copy ) 1. 00
the inlormation Is correcf and ogree to comply with oli opplicoble APC Total $1, 903. 50
Stafe of Minnewta $fotutesoPd City o Eaqan dirwnces~
„A/i • Var. Date
Sipnoture of Pertnittee ~
A Building Permir Is issued to: .TOS MILLER CONST INC on tha express condiHon ihai
oll work sholl 6e done in acmrda wlt II applicoble ote of innewto Statutes nnd Ciry of Eoyon Ordinancea.
Buildiny Officful
~
oF EMN nwwao 2..e. ar p2w*,.
~ a r~r/ i .so. ~ M/.l•vaesc.~ a ' .
~ .7 J Lo~ wTiIDItVC: PEwT ArQr.tcATDOta _ I.+t of amzW Olcaaxatscne. .
To se vsea For *)J) ~ vaitat3«, n.c.
site Adxese: .3qz7 IAJ/IU- QW-' oerzm ose cwx
~ ec.-t Q°'°'.7~
Iot ~ 91odk Lr
Paroel i: f a;F ]1].tEr ~on1n4 R- I
Aepair 8ise Eom
~
Onnsr: bepth
City/Zip Qx1e: ~
Phone t: APPI`5 -
~se 3to 00
Oontractor:
Adc]resa ~,f AtI - /~D • tas ~ s~ ~ $O
Poliae Platn Cl~sclc ~ ~ 2 .
CitY/ZiP Godee Ci Fire Si1C 52~
Em. mabw Gtonr?.
Phcne plmow 1qt6or iieter, [03.
p~l Ao~d tMit 2&0.
l~./~,q.: y 3/°~-D D/ s1ac,. of . 1:6.- Z caPrES
lldftess: , AVC -
CYty/Zip Ocr]e: •
pn«,e 0
- , d,
9
Surveg and Certificate For:
Joeaph M, Miller Conat.
1,5133-Cedar Avenue So.
Farmington, MN 55024 80/40
DELMAR H. SCHWANZ Model 84-136 Walkout
unosuavEVOR 5, IWC,
RpisterW UnfIM Laws o/ TM SblO W Mlnnewta
2978 - 146TH STREET W. - BOX M ROSEMOUNT. MAMEKTA 6606a P1MME 012 423-17M
` SURVEYOR'SCERTIFICATE
R
~
, Sr D
tVE
7 a_ f Z
e_
~ o z 9 s 7 $84 m ,Q~
o
to ~
i-. i 37 Z I S in -
~`y V l~ ~ ~io - u•,,?DP NuB = '
~ _I 1~, .
PKpPOSE P
; Z6 Na+sE- " ~
- 3 I~ cale ~ ~ ~n~h =30
u~
Xq ~ ~
^7 / g W v\ ToPHae'
~ I~ u`~i 8~9•9S
'X/ ~d (;4' 0 = Property corner
p= Set wood hub
= Existing elevation
= Propoeed elevation
10 /
`?f 1^ 0 Nl,7/
= Proposed garage floor elevation
Ry4 -?oo.oo ~E:' aC)°s.'io" u/ ~ gg6
I hereby certify tha[ this is a[rue and correct repreeentation of the folloving deacribed
tract of 1and: Lot 2, Block 5, WESTBURY FIRST ADDITION, according to tFe recorded plat thereof, Dakota '
County, Minnesota. Also showing tVie location of a proposed house ae staked thereon this 2t day of
i9 94. MINNESOTA HEGISTRATION NO. 9525
4'I i3 ,45
~ 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EACAN
3830 PILOT KNOB RD - 55122
651-681-4675 1
New Construdion Reauiremenfs Remodel/Reoair Reauiremen}s
? 3 regislered sHe surveys showfng sq. H. ol lot, sq. fl. of house 2 copies of pian
and all roofed areas (20% maxlmum lof coveraae allowed) 1 sef oF energy calculations for heated addNions
> 2 coptes of plans (show beam 6 window sfzea; poured Fnd. design; eic.) 1 sBe survey tor exteriu addMions 8 decW
1 set of energy calculations
> 3 copies N tree preservatlon plan ff lot plaMed aNer 7/1/93
DATE: "1 Io~I IGI I CONSTRUCTION COST: ~~TJ
DESCRIPTION OF WORK: TOIr oa oL-ir00f hOUSe. a(1GI AQYGIA e~
STREETADDRESS: 39 r9,4 UJPS"HbUt!-I Dr
IOT: BLOCK: LJ~ SUBD./P.I.D.
Name: Kn1 pt, DnVIA Phone#: b5i upz~-
PROPERTY Last Flrst
OWNER
Street Address: J59o~~ ~ t~'F h[.{ 12~ Dr
City Eaaan State: Zip:
,.Company: Phone
~ HORIZON MUUFING (area code)
CONTRACTOR ° ~,~,~~~y~,~
Street Address: 1222 ~,.~j License #~~exp.
Burnsville; MN 55337
City State: Zip:
ARCHITECT/
ENGINEER Company: Name:
T2isFhane n: area cc.^!a ( i
Street Address: Registration
City State: Zip:
Sewer & water Iicensed plumber (reauired for new constructlon onlv):
Fuenolty applies when address change and lot change is requested once permit is issued.
I hereby acknowledge that I have read this application, state that the Information is correct, and agree to comply wlfh all applicable
`etate of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY RFCEI~TE~1
Certifcates of Survey Received _ Yes _ No ppR 3 0 1999
Tree Preservation Plan Received _ Yes _ No _ Not Required $Y:--_------1
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 4-plex ? 11 10-plex ? 16 Fireplace ? 21 Porch (3-sea.)
? 02 .SF Dwelling 07 5-plex 0 12 12-plex ? 17 Garage . 22 . Porch/Addn. (4-sea.)
? 03 1 of _ plex. 0 08, 6-plex ? 13 16-plex 0- 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 0 20 Pool ? 25 Miscellaneous
WORK TYPE
? 31 New ? 35 Tenant Impr 0 39 Gas Line Only ? 43 Siding/Soffits/Fascia
? 32 Addition ? 36 Move Bldg. ? 40 Gas Insert ? 44 Windows/Doors
? 33 Alteration ? 37 Demolish Bidg. ? 41 Wood Stove ? 45 Fire Repair
? 34 Repair ? 38 Demolish (Interior) ? 42 Reroof
GENERAL INFOF2MAl'ION
Const. (Actual) Basement sq. ft. Census Code
(Allowable) Main level sq. ft. SAC Code
UBC Occupancy sq. ft. No. of Units
Zoning sq. ft. No. of Bidgs
# 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/ES SAC
City SoC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
SNV Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other '
Copies ,
~
Total:
SAC Units
% SAC
ml
1994 MECHArTICAL PERMIT (RESIDENTIAL)
CITY OF EAGAN
3530 PILOT KNOB RD
EAGAN MN 55122
(612) 6814675
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS WHEN PERMITS ARE REQUII2ED FOR EACH UNTI'.
- - - - - -
NEW CONSTRUCTION
~ ADD-ON A/C
AJD-ON FURNACE
FIItEPLACE INERT
DATE W
FEES
HVAC: 0-100 M BTU $ 24.00
ADDITIONAL 50 M BTU 6.00
GAS OITI7.,ETS (MINIMUM 1 @ $3.00 EP.CH) _
ADD-ON/REMODEL (ExisTIlVG CONSTRUCT[oN) $ 20.00 STATE SURCHARGE .50
TOTAL _x __LfO
SITEADDRESS:,y3Z~~7 LL5 ZZGl,1-? 61-1 G1'e
OWNER NAME: 6A /l i ,Q TELEPHONE
INSTALLER: Y'~ At° Jife!f. T C
/
ADDRESS: ~
CIT'Y: STATE: 4,161 ZIP CODE:
TELEPHONE (P ~ 0 ~
SIGNATLTRtt OF PERM E
.,.o..`:r%.x:'??xa... .,...,:'.'.:.R`Ym:,:.~;•¢;_¢i.,.~.r:ssrex.i:cxs'.:s~::s:;:.:...:.<,.,«,;... .-x.:yn~;.~~:>,:w t5ia;'x,,.
e s$ ;g,F § .r 3£4 e ~s~ A ¢Y : .£x~':fi ~r~w~aT Ks~, £ '+£'„4z ?v` ~ 3•N~<E
1994 MECHANICAL PERMIT (COMMERCIAI,)
C1TY OF EAGAN
3830 PIIAT KNOB RD
EAGAN MN 55122
(612) 6814675
PLEASE COMPLETE FOR ALL COM1viERCIALdINDUSTRIAL BUILDINGS. ALSO COMPLETE
FOR APARTMENT BUILDINGS OR OTHER MULTI-FAMILY BUILDINGS WHEN SEPARATE
PERMITS ARE NOT REQUIIZED FOR EACH DWELLING UNTf.
DATE: CONTRACT PRICE: $ ~
NEW BUILDING
INTERIOR IMPROVEMENT
WORK DESCRIPTION:
FEES
1% OF.r: ~I±d~i~' FEE $
PROCFSSED PIPING: $25.00
MINIMLTR'I FEE: $25.00
STATE SURCHARGE $.50 FOR EACH $1,000 OF FEE.
TOTAL $
S11L' l1LLRCn7S: ~ .
OWNER NAME: TELEPHONE ~
TENANT NAME: (n2xovEtvEtvTS oxr.Y)
INSTALI,ER:
ADDRESS:
CITY: STATE: ZIP CODE:
TELEPHONE
SIGNATURE OF PERMTI'I'EE CITY INSPECTOR
I
ME ~ 2/84
i
~
~ CITY OF EAGAN
APPL,CATION FOR PERMIT
• SEWER AND/OR WATER CONNECTION
(PLEASE PRINi)
1) PROPEfrI'Y ADDRESS : 3 fc s f,/,, ~eot
r.Frnr DESCRIP'PICN: '4o 74-.2 , j
(Ipt/Block/Subd.ivision or Tax Parcel I.D. NuTber)
%ZS'_"=;G S?7,L'C^':^~E, DAT Ox' OiZTGi dAL riiILD1::G °=T ISS~;VNC::
~
PR.F'SL:':' --2.:7Iir'/PP'OPOS7-) US: ~R-1 SiNGLE FP-MILY .
? R-2 DLT= ('IStiO UNZT5)
? R-3 ZC;:~1iII?C`L7SE (T'fTREE + II`]ITS)
? R-4 AFA221-r-y'P/=Ci.,1INIC7m ( Wi ITS)
? CaMIMERCLAI,/REiAIL,/OFFIC:.'
? Itii'DL'STRIAL
? NSTIT[,'TIONAI,/GGVERrP,'T
2) App== (PLEASE PftINT)
NAME: :roL
ADDREss: 18133cc.0~osf .4a~ S•
CITY, STAT:.', ZIP: u g-/eA-) SS 0`1--/
PHO~: -~u/
3) PLU.IBER yPLEASE PPINT) FOR CITY USE ONLY
NPME: RKY/MI 4G,44 4I~ Li' i.? i SL4--
ADDFtESS: ,3f~,0 PLUHPERS UCEYSE:
IfU'- Fl~ Active
CITY, STATE, ZIP: p~y,ye..L.1/Nd ys 10~1 Q Expired
PHO?IE: S$~' 3(e t ~ Not of Record
PLUMBEH LICENSE # ,)O6SA/ -j
a nitia
4) QC'CC~~ppNr/a•n,IER AIFYME: (PLEASE PRINT)
ADDRESS-
CITY, STATE, ZIP: I(s <2.)
PHONE:
5) INpICI1TE SVHZCH PF.RMIT IS BEING REQUESTID:
~ CONNF.CTION T'J CITY SESr1ER
~ CONNECI'ZQN 'IC) CZTl' WATEF2
E] a17TR (PITASE DESCRIBE)
6) INDZG,TE C.+E:
PIEaSE F?OID APPRWID PER,+7IT FOR PICF:-UP BY ONE OF ABOVE
? PLEl'15E h71.IL APPROVED PER:tLiT TJ 1, 2. 3, 4 AFiOVE
(Circle one)
7) s1QI~Tirx: -(?.,,.~c~/~auQe~.~ Dr.TE: ,vmu r~ 8~'
.
RiR~IAFJO i~ ?r a EY:as~c~ ! s IYts:a~IFii~ i#i ~i ~f.ii'a:~ a lt ~ El!}~tr~~ ~1 Y~ ~IS ~ii~~s~i~ :
F 0 R C I T Y U S E O N L Y ~ PERMIT ISSUEO
~
FEES : $ SEr jEB ncBMrm ~ -
(I_ICLi;DE SU.o.C_c-.aRr.,c.)
$ PQ-L'o WATER PERP'[IT (IiICL'JDE SliRCfiARGE)
$ Z` P-,tq WATER METER/COPPERHORN/OUTSIDE READER
$ WATER TAP (INCLUDE CORPORATION STQP)
$ SET,dER TAP
$ J.J d--O --_COC:i'?' _,Z?CSl_
$ ACCOUNT DFPOSIT - FIATER
$ -J7~/J -4--~ WAC
$ SAC
$ TRUNK WATER ASSESSPIENT
$ TRli:]K SESdER ASSESSMENT
$ LATERAL BENEFIT/TRUNK SEiIER
$ LATERAL BENEFIT/TRUNK SVATER
$ OTHER '
$ TOTAL
$ /O<~ ! APSOUNT PAID/REC°IPT
DOES UTILITY CONNECTION REQUZRE EXCAVATION IN PUBLZC RIGiiT OF WAY?
YES IF YES, THEN ;y "PERMIT FOR 4VORK WITFiIN
PUBLIC ROADWAY" MUST BE ISSUED BY THE
NO ENGINEERING DIVZSION_ LIST AS A CONDI-
TIOLV.
SUBJECT TO TEIE FOLLOWING CONDITIONS: '
APPROVED BY:
TITLE:
DATE : 11 / lo ~ ~
2007 RF,SIDENTIAL BUILDINC~i PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan NIN 55122
Telephone 9 651-675-5675 FAX 9 651-675-5694 -
New ConsWctlan Renuiremenls RemadeUReoair Reauirements OHice Use Onlv
S regalered site surveys shavmg sq. ft of lo[, sq. R. of house; and a11 roofed areas . 2 copies of plan showing tootings, beams, joisfs Cerl of Survey.Recd Y_ N
(20°kmaximumlotcoveraqeallowed) lsetafEnergyCalcula6onsforheffiedaddi6ons SoilsReport _Y _N
1 Soils Report if pmposed bwlding is to he placed on disWrbed soil 1 sile survey for additions & decks Tree Pres Plan Recd, _ Y_ N.
2 copies of plan showing heam & vnndow sizes; poured fauM desigq etc. AddiGon - indreate ifon-site sepfic system Tree Pres Required. . Y _N
lsetofEnergyCalculations On-site5ephc$jstem_Y._N
3 capies of Tree Preservation Plan if lot platted after 711H3 _
Pom Joist Detail Optlans sNection sheet (builNngs wilh J or Iws units)
Minnegasco mechaNcalventila6an form
Plans are considered ublic information unless ou state the are trade secret and the reason. ,
Date// /05 l 07 n ConstructionCost 9 r~JD~ -
Site Address 3 "~/017 6U2 ~ .V2/ Unit/Ste # .
EA S
Description oT Work AcS
Multi-Family Bldg _ Y N Fireplace(s) 4 0 _ 1 ` 2 Property Owaer v /e zGi? Telephone # (6
Contractor sI- pnC
Address /5lR(, o2/CS~''~ ,~'f E City_ /ilA3~,il1 r C
State Zip Telephone#(6S/ ) !X? 7'/.$SD
•8
G ! -7-7, 37
COMPLETE THIS AREA ONLY IF CONSYRUCTING A NEW BUILDING
-Minnesota ~Rules 7670 Cateeorv 1 _ Minnesota Rules 7672
Energy Code CategOry . Residential Venlilation Categary 1 Worksheet . New Energy Code Worksheet
(d submission rype) Su6mitied Submitted
. • Energy Envelope Calwlations Submitted
In the last 12 months, has ihe City of Eagan issued a permit for a similar plan based on a master plan?
_ Y _ N If yes, date and address of master plon:
Licensed Plumber Telephone )
MechanicalContractor Telephone#( I
Sewer/WaterContractor Telephone#( )
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a
permit; that the work will be in accordance with the approved pl n in the case of work which requires a review and
approval of plans.
2OW/_P/
Applicant's Printed Name AppIicant's S' ture
DO NOT WRITE BELOW THIS LTNE
Sub TVpes
? 01 Foundation ? 07 05-plex ? 13 16-piex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3•sea.) ? 31 Ext. Alt - Multi
? 03 Ot 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(screen/gaze6olpergola) ? 36 Multi Misc.
? 05 03-plex 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex ? 25 Miscellaneous Work Tvpes
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair 33 Alteration ? 37 DemoVish Building' ? 43 Reroof ? 46 WindowslDoors
? 34 Replacement 'Demolition (Entire Bldg~ -Give PCA handout to applicant
De5C1'ipt1011: Water Damage_ Yes
Valuation Occupancy MCES System
Plan Review _ 100% or _ 25%
Census Code Zoning City Water
SAC Units Stories BoosYer Pump
# of Units Sq. Ft. PRV
# of Bidgs Length Fir6 Sprinklered
Type of Const Width
REQUIREDINSPECTIONS
. Footings (new bldg) _ Sheetrock
Footings(deck) _ FinaVC.O.
Footings (addition) _ Final/No C.O.
Foundation _ HVAC
Drain Tile Other
Roof Ice & Water Final _ Pool Ftgs Air/Gas Tests Final
Framing _ Siding _ Stucco Lath _ Stone Lath _Brick
_ Fireplace _ R.I. _ Air Test _ Final _ Windows
Insulation _ Retaining Wall .
Appraved By: , Building Inspector
Base Fee
Surcharge
Plan Review
MGES SAC
City SAC
Utility Connecfion Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA107797
Date Issued:10/29/2012
Permit Category:ePermit
Site Address: 3927 Westbury Dr
Lot:002 Block: 005 Addition: Westbury 1st
PID:10-83650-05-020
Use:
Description:
Sub Type:e-Windows/Doors
Work Type:Windows/Doors
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:JoAnne Burr
990 Lone Oak Road Ste. 114
Eagan, MN 55121
651-905-0105
Valuation: 500.00
Fee Summary:BL - Base Fee $500 $40.00 0801.4085
Surcharge - Based on Valuation $500 $0.50 9001.2195
$40.50 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 -
Bryan M Knipe
3927 Westbury Dr
Eagan MN 55123
Window Concepts MN
291 Eva St
St Paul MN 55107
(651) 905-0105
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA108595
Date Issued:12/19/2012
Permit Category:ePermit
Site Address: 3927 Westbury Dr
Lot:002 Block: 005 Addition: Westbury 1st
PID:10-83650-05-020
Use:
Description:
Sub Type:e - Water Heater
Work Type:Replace
Description:Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Kris Oien
3670 Dodd Rd
Eagan, mn 55123
651-365-1340
Fee Summary:PL - Permit Fee (WS &/or WH)$55.00 0801.4087
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 -
Bryan M Knipe
3927 Westbury Dr
Eagan MN 55123
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA117287
Date Issued:10/16/2013
Permit Category:ePermit
Site Address: 3927 Westbury Dr
Lot:002 Block: 005 Addition: Westbury 1st
PID:10-83650-05-020
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 .
Ashley Harrington
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 -
Dallas J Nicol
3927 Westbury Dr
Eagan MN 55121
Cedar Creek Construction
23383 Redwood Ct NW
St Francis MN 55070
(612) 564-6888
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA132638
Date Issued:08/26/2015
Permit Category:ePermit
Site Address: 3927 Westbury Dr
Lot:002 Block: 005 Addition: Westbury 1st
PID:10-83650-05-020
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.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
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 -
Dallas J Nicol
3927 Westbury Dr
Eagan MN 55121
Angell Aire
12253 Nicollet Ave S
Burnsville MN 55337
(952) 746-5200
Applicant/Permitee: Signature Issued By: Signature