1171 Westbury Knoll
CITY OF EAGAN SEINER SERVIC'E PERMR
3830 Pilot Knob Rosd ~7') <
P. O. Box 21199 PERMIT NO.: -
Eagan, MN 55121 ~ATE'
".i
Zonirq: No. of Units:
; ? . .l .~r t
Owrnr:
Addmss: ~
5ite Addross: 117 t,v4?s ' •i:~ :
Plumber. Qu;
~-19-':"• ' F ' '
1 pm h ee~Nl! wMh tw CM ~~n Conrwalon Charpes 4' S. 001-..-
f1 a
~
A~iMwe~a. AooowM DePOSit:
Prm+it F«: _
Surcharpr
gy Misc. Chaross:
Date of Irop.: Totol:
'nep.• Do» PoW:
~
~ - •
CITY OF EAGAN . WATER SERVICE PERM
I~ 3830 Pilot Knob Road pEyMIT NO.:
P. O. Box 21199. - -
Eagan, NiW 55121 DATE> 1 j
Za+lrq: _ i'`1 No. of,Udts:
'
/''~,R~~ •'~i~tt:~ _
V~R~. 1 il
Add1lw. 11-„ . -Tlrxva~ ti)~1:_~7 . ~.i
Ske rross: 3,00.00 i
Connection CF?orpe: ~
~ Meftr No.: !7 .G, AccoLmt DePasit: 15.OQ(>'.
I Rsadar No.. ~ S~ M g 9 9 ~ 3 Permit Fee: 1u , j~'~ 1
Surchoroe* ~
NrM te oo Misc. Charoa: 13.
1 rPb ~ e1N Citp e~ 9o¦ Ddt Paid:
O~I
Totol: '
gy
Oate of InsP.: I^sp"
R~f~r
- ~ CITY OF EAGAN 17983
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE:454-8100
BUILDING PERMIT Receipt # `To be used for DEM Est. Value *ls000 Date , 19 90
Site Address i
OFFICE USE ONLY
. T
Lot Z Bfbck Z Sec/Sub ~
Parcel Nol, ~ Qtcupancy - FEES
mc oiasm Zori^g - $25.00
W Name (Actual) Const _ Bldg. Permit -3u
o Address (Albwable) - Surcharge o
City Phone 432-7075 * of stones -
Lengih _ Plan Review
, o Name SA~ Deplh - SAC, City
a`~' Addr2SS S.F.Total -
ua SAC, MCWCC
~ Clty PhOn@ S.F. Foolprinls -
On 5ite Sewage _ Water Conn
8.) W Name On 5ile Well - Water Meter
~Z Address MWCC System
c~ ~ - aoct. Deposa
-
i W City Phone c~ry wate~
PRV Required _ S/W Permit
I hereby acknowiege that I have read this application and state that the Booster PumP - SM! Surcharge
infarmation is correct and agr io comply with all applicahle State of
Minnesota 5tatules and City E,4en OrdinBnCes. Treatment PI
Signature of Permitee ' APPROVALS Road Unit
11-
A Building Permit is issued to: Planner - park Ded.
on the express condition that all woik shall be done in accordance with all Cou^cil -
applicable State of Minnesota Statutes and Cily of Eagan prdinancea. g~, pff, _ ~OP1eS
"`4- C- < I G ~C- Variance - TOTAL
Building Otficial ~
Parmit No. Permit Holder Date Tebphone #
WATER ~
SEWER
PLUM8ING
H.VAC.
EIECTRIC
Mspection Dete Insp. Comments
Footings 1
Foundation '
Framirg
Ropfing
Rough PI6g.
Fiough Htg.
Isul.
Freplace
Final HtQ.
Fnal Plbg.
Const. Meter Plbg. Inspector - NoGfy Plumber
Engr./Plan
Bldg. Final
oeck Fty.
q'i
oedk Finai
wei
Pr. Disp.
~ : .
PERMIT #
MECHANICAL PERMIT RECEIPT # ~~`i~
CITY OF EAGAN DATE:
3830 PILaT KNOB ROAO, EAGAN, MN 55122
CONTRACT PRICE: PHONE: 454-8100 For Office U5e Only:
Site Addr~ss i 77 -~tiES'i'I;RY 1(fdOL~., BLDG. TYPE WORK DESCRIPTION
Lot Block ( $ecISub Res. y New
, .SC
Name BUR1VSY LLE HEATING Mult Add-on
Address Comm. Repair
Other
c Ciry Phone FEES
Name ERIC " RES. HVAC 0-100 M BTU -$24.00
c Address -3 'y KNa~'r' ADDi'fIONAL 50 M STIJ - 6.00
p City Phone 4 5=-'°7 07(RES. HYAC INCWDES AIC ON NEW
CONSTRUCTION)
GAS OUTLETS (MINIMUM - 1 PER PERMII) - 1.50 EA.
TYPE OF WORK COMM/IND FEE - 195 OF CONTRACT FEE
FprCed Air M BTU APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE & CONDOS - RES. RATE APPLIES
Boiler M BTU MINIMUM RESIDENTIAI FEE - ALL ADD-ON 8
Unit Neater M BTU REMODELS - 12.00
Air Cond. ~ M BTU MINIMUM COMMERCIAL FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
Vent CFM (ADD $.50 S/C IF PERMIT PRICE GOES
Gas Piping Oudets # BEYOND $1,000)
Other
FEE: "
S/C: SIGM
TOTAL: FOR: CITY DF EAGAN
F
' CITY OF EAGAN 10A 2-1
3830 Pilot Knob Rosd, P.O. Box 21-199, Eagsn, MN 55121
PH ON E: 454-$100
dUILDfNG PERMIT Receipt #
To M uwd fer ;P Esf. Volue Dote 19
Site Addren =::1":~? Erect Q Occupency
Lot Block ~/Sub. ` ~ ~'!`F; Remodel ? Zoning
y Repeir ? Type of Conat.
Parcel No.
Addition ? No.Stories
Move ? Length
Name 1(v'T'Ii''.F' 0 `
W Oemolfah ? Depth
; Address Or. Int Impr. ? Sq. Ft. • .
b City Phone Instell O
Aporova Is Fees
~ Name -
A~~ Assessment Permit
u~ CI Phone Water a Sew. 5urcharge
ty
Police Plan Review
~W Name ~•:arA ~ti.l'r•A Fin SAC
x~ Addresa , % 7i_7' Enq. WaterConn.
~W City - Phone - ~~~()2 Plonner Water Meter 'a ~ • ~
CouncN Roed Unit 1~ n• U L
i hereby acknowledge thnt I hove read this oppl icdtion cnd stote thot gldg. Off. bj Tr. PL ~ U Q
fhe informotion Is correct and ogree to comply with oll opplicobie APC Parks
Stota of Minnesoto Stotutes ond City of Eogon Ordinonces.
Var. Oate Copies
Siynoture of Permifta* Total • i~•-
A Buildiny Pennif Is issued to: ' ' Y';' , ` on the express conditlon Ihat
otl work sholl be dons in occordonce with all applicobla Stote of Minnesota Stotutes and Ciry of Eoqnn Ordinonces.
Buildirq Offkiol
•dslp 'Ad
JaMes
IIeM
:uo~leao~ aqla"p JolSM
',g
If~ld
'd41d ifuld
•8lH Ifuld
w
1?' •1nsu~
•eIN ye~a
-~1- •S9ld y6noa
suit~a
sulwai~
(_17 uol4epuno:i
11 s8ulsoozi
n7 I s6ullooj
Asyip 'dsul alea uolpodn+l
iweijo$
(Y) •~-rn•H
a,iaW„id
# auoydq*l *WQ JOPWH Muu*d 'oN MWJGd
Roaipt MECHANICAL PERMIT Permit No.
CITY OF EAGAN FN 20. 00
r ,r -
FIlI in numbered spacsa S/C .50
Type or Prini legibJy TaL 42U.50
1. Date 9/18/85 2. Inatallation Cost 'ic) '
1171 i~'estbur ~'~011 2
3. Job Address Y Lot Blk. ' Tract
4. Owner Fror. c ier Companies
5. Contractor wenzcl Mecbanical Phane 45:1-i56::
8. Address 3600 F.ennebec Drive
7. CitY Eagan State Zip 55122
8. Building Type: Residential 9( Commercial ? Institutional 0
9. Work Description: New KY Add ? Alter 0 Repair ?
10. Describe heatin6 system Fuel Type .,:.atural xuu
11. No• Eauinment BTU - M. Ea. No. Equipment CFM
XX% Forced Air Trane Air Handling:
Mfg. 80 , 000
Boilers Mlech, Exhaust
Mfg. RX Lat: tv•:n
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 ! . .-j'_~ for
Rouph Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454,8100
y Receipt t? ~r)1: _ PLUMBING PERMIT Parmit No.
" CITY OF EAGAN Fee
Fill in numbered spaces S/C ~f
Type or Prini legib/y Tot
1. Date 2. Installation Cost •
3. Job Address Lot Blk. =T~~ Tract
i
4. Owner
~
5. Contractor Phone 4 54F.S
~
6. Address si " KF'L*7r'itl•'(' '
~
7. City State Zip
8. Building Type: Residential Commercial ? Institutional O ;
~
~ 9. Work Description: New Add ? Alter ? Repair ? ~
10. Describe
11. No, Fixtures Na. Fixtures '
- Water Closet Cesspool/Drainfield
~
o Bath tubs $eptic Tank ~
° Lavatory Softner
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
Rouyh Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
CITY OF EAGAN Remarks
Addition 1AESM.jRY ){M Lot 2 Blk 2 Parce ~123
Owner Street 1171 Westbury ~ail State 'an ,
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SANSEWTRUNK ~ 246.59 A016473 10 2 8
SEWER LATERAL
waterrnain 86 65 •Z9 4.35 15 65. 29 WATERMAIN ~ • 3.45 -15 44.$0 WATER IATEFiAL 11277
WATER AREA ~ 1 20 . 53
water area g 133. 79 STORM SEW TRK • 710. 24 STORM SEW LAT 783. 56 CURB & GUTTER
SIDEWALK
STREET LIGHT
Road Uti. . 54693 19 85
ATER CONN. ~
6UILDING PER. 1- Q 2- 2- 2 ii
SAC n n
PARK
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number: 1'
Eagan, Minnesota 55123 Date issued:
(612) 681-4675
SITE ADDRESS: ; APPLICANT:
~ ~ i r~ . i+,i;f, k?~il~l t i i:~, ~,i i„ i i r~~
1,111; 4 i II
PERMIT SUBTYPE: TYPE OF WORK:
INSPECTION •
F
~
L
Permit No. Permit Holder Date Telephone ~
S/W
PLUMBING
HVAC
ELECTRIC
ELECTRIC Inspection Date Insp. Commerrts
Footings I
Foundation
Framing
Roofing
Rough Plbg.
Rough Htg.
Isul.
Fireplace
Fnal Htg.
Orsat Test
Final Pibg. Pibg. Inspectvr- Notify Plumber
Const. Meter
Engr,/Plan
Bldg. Final
Deck Ftg.
Deck Final
Well
Pr. Aisp.
t CITY OF EAGAN N° 'I O H 2 2
~ 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 .
PHONE: 454-8100 ?~l y~
BUILDING PERMIT Receipt
T. M wed fer SF DWG/GAR Est. Volue $63,000 pate AUGUST 19 lq 85
SiMAddreu 1171 WESTBURY KNOLL Erect E Occupancy R3
Lot 2 Blxk 2 Sec/Sub. WESTBURY 4TH F7emadel ? Zoniny Rl
Repair ? Type of Const.
Parcel No. Addition ? No. Stories
FRONTIER MIDFlE:ST HUMES Mave 11 Length 40
~ Name Demolish ? Oepth $
~ Address 3908 SIBLEY MEM HWY #E lntlmpc ? 5q.pt.
City EAGAN Phone 454-0433 Install ?
Avvrevali Faes
o Name SAME
~
}t Addresa Assessment Permii 322.00
City Phone Woter 8 Sew. Surcharge 31.50
Palice PlanReview 161.00
tw Neme RICHARD CHARLIER Pim SAC 525 _ 00
Address 14103 CARDENVIEW CT Erq. WaterConn 500.00
iW c~ty A_V_ phone 432-5492 Plonner waterMeter 63.00
Gauncil Road Unit 280.00
1 hereby acknowledge that I huve read this opDlicorion and stote that BIdg.Off. 8 5$S Tr. PL 132 . 00
the inlormotion is correct and ogree to wmply wirh all oODlicable AP~ Parks
Stafe of Minnezota Stotutes a City oy~Eogan Ordina ces.
i A ~ Var. Date Copies
Sionmure of Pem.ittee Cgef 7ota~ $Z.014.50
A Building Pe~nit Is Issued to: FRON IER MIDWEST HOMES on the expresf condition thai
oll work sholl be done in ocmrdance with cll opplblgQ e$tofe of inneso . mtes and Ciry ot Eoqan Ordinoncas.
Buildinp Officiol L.FF~
CITY OF EAGAN No 17983
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
G I v_-J
BUILDING PERMIT PHONE: 454-8100 Receipt # ~
1,000 JUNE 11
To 6e used for DECK Est. Value ~ Date , 19 90
Site Address 1171 WESTBURY KNOLL
LOt _Y~ BIOCk 2- S2C/SUb. ~STBURY 4TH OFFICE USE ONLY
_ Occupancy - FEES
PBfCeI N0.
' Zoning - $25.00
w Name ERIC GIBSON (AcNaqConsl _ BIdg.Permit
i Address SAME (Albwable) - Surcharqe • SO
° City Phone 452-7075 B ol Slories -
Plan Review
Len9th _
, p Name S[~I~ Deplh - SAG Cily
~a Address S.P.TOtal - SAC,MCWCC
x City Phone S.F. Footprinfs -
On Si1e Sewage _ Water Conn
W w Name On Sile Well - Water Mater
w
MWCC S lem
~ z~ Address ~ - A«t. Deposit
sw City Phone Cirywater -
PPV Requirad _ SNJ Parmit
I hereby acknowlege that 1 have read this application and stale ihat ihe 8ooster Pump - SNJ Surcharge
information is correct antl a to comply with all applicable State of
Minnesota Statutes and Ci oi agan Ordinances," 7reatmenl PI
Signature of Permit APPp~~A~s Road Unil
A 8uilding Pertnit is issued to: GIBSON P~a^^ef - Park DeO.
on the express condition that all shall be dona in accordance wilh all Cuuncil 1.00
applica6le Stale ol Minnesota Statu s i Ea_ gan OM nances. gldy, pN. = COPia$ 2.5~
U
8uildirg Official Variance TO7AL
RESIDENTIAL BUII.DING d 'S_
Permit Application .
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telep6one # 651-675-5675 FAX # 651-675-5674
New ConsWction Reauiremenb RemodeVRapair Reauiremenfs Office Use Onlv
3 registered site surveys showing sq. fL of lot, sq. ft. of house; and all roofed areas 2 copies of plan _ Cert of Survey Recd
(20%maximum lotcoverage allowed) i setaf Energy Calcula6ons for heated additions Tree Pres Plan Reod
2 copies of plan showing beam & windaw sizas; poured tound design, etC. 1 site survey for addi6ons & decks Tree Pres Not Reqd
7 set of Eneqy Cakulations Addgion - indicate i/onsife saptic system _ Onsile Septic Sysfem
3 mpies of Tree Preservation Plan if lol plalted after 7/1193
Rim Jaist Deteil Options selectian sheet (bldgs with 3 or less units
Date J~ Construction Cost 1~+ ~ U, Cft~
7 4 J~{~ UniVSte #
Site Address S
Description of Work LAJ' w ~-S ~
Multi-FamilyBldg _ YN Fireplace(s) _ 0_ 1 _ 2
Property Owner CS Telephone # `7` ( Vn_
Contractor j2d f eG ~~C T~~r aY c~e (~~dY1-S
Address a ~D S- 7-'' City
State /29n Zip Telephone #(7 (o ~~y~ 7 4 7
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Energy Code Category Minnesota Rules 7670 Cate 1 _ Minnesota Rules 7672
. Residentlal Ventilatiari Cete o t Worksheet • New Energy Code Worksheet
(J submission Type) r
rEnv ed) ~ ~ ~ Submitted
• lope'Calcula8on bmitted
4 Zoo3 V
Licensed Plumber Telephone )
lU ~1
Mechanical Contractor ~ Telephone # ( )
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 plan in the case of work which requires a review and
approval of plans. < <
e ~ ~Gi t 1~~ lJ~ V/ ~SzM
Applicant s Printed. N e A plicanYs Si ature
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool C3 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or_ N O 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Oemolish (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 . Temolition (Enttre Bldg) - Give PCA handout to appiicant
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) FinaUC.O.
_ Footings (deck) FinaVNo C.O.
_ Footings (addirion) _ Plumbing
Foundation FIVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Framing _ Siding Stucco Stone
_ Fireplace _ R.I. _ Au Test _ Final _ Windows (new/replacement)
_ Insularion _ Retaining Wall
Approved By , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
5&W Pertnit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
,
RESIDENTIAL
BUILDING PERAAIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675 5(,.
New ConeVUCtlon Beauiramenta RemoGeURaoalr HeaWremeirta
• 3 regislered s8e surveys showing sq. ft of IM, sq. ft. of house; and It roofed areas • 2 copies of plan
(20°k mazimum bt coveraga albwed) . 1 set of Energy Calculatbns Por heated addttions
• 2 copies of plan showing 6eam & whidow sizes; poured tound design, eta) • 1 stte survey for eAerbr atldNbns 8 Aecks
. 1 set ot Energy Celculations . Indkete il home servetl by septic system for addnbns
• 3 copies of Tree Preserratbn Plnn tl bt platted ailar 7/1l93
• Rim Joist Detail Optbns selectbn sheet (Dldgs wiN 3 or less untts)
DATE ~ "ALUATION $ Iy'i q I . 00
SITE ADDRESS I I,W~eS'}~~fY K?ao 11 MULTI-FAMILY BLDG _ Y l-d'
TYPE OF WORK WI YIoCWV ~2.P~aCe-u.+ev,r}'S FIREPLACE(S) _ 0_ 1_ 2
APPLJCANT ~~kftlcka,,C"' ~a~ hcti
STREET ADDRESS taa~~ NI'wl l,c'F P1PC. cSa CITY &rvmaV c 1 ItSTATE ZIP~
TELEPHONE CELL PHONE # FAX #TS2~;~DB.'~D I
PROPERTY OWNER 1 oJcC f(lllt t'bc. ,n K-S TELEPHONE #~g) 86 ~'t"~ t
COMPLETE THI5 SECTION FOR °NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 MINNESOTA RULES 9672
(4 submission lype) • Reaidential Ventilation Category 1 WoBeheet Submitted L ~ ne-yl'~$dBwo~3heat 5ubmitted
• Energy Envelope Calculations Submitted 2 8 eUtdf ~Plumbing Contractor: Phon_" I
Plumbing system includes: Water Softener Lawn Sp Fee: 90.00
Water Heater No. of R.I. Baths
No. of Baths
Mechanlcal Conhactor: Phone #
Mechanical system includes: _ Air Conditioning Fee: $70.00
_ Heat Recovery System
Sewer/Water Confracror: Phone #
I hereby acknowledge that 1 have read ihis application, state that the information is correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan Or inances. )
Signature of Appllcanf ~ Owv~J ~ vc~~
_
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4102
i
OFFICE USE ONLY - ` •
? 01 Foundatlon ? 07 05-plex O 13 16plex 0 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling 13 OS 06-plex O 16 Fireplace ? 21 Porch (3-sea.) ? 31 Fact. Alt - Muki
? 03 01 of _ plex ? 09 07-plex O 17 Garage ? 22 PorchlAddn. (4sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex O 18 Deck ? 23 Porch (screened) ? 36 Multi
? 05 03-plex ? 11 10-plex 13 19 Lower Level ? 24 Storm Damage
? 06 04plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
? 37 New ? 35 Int Improvement ? 38 Demolish (Interlor) ? 44 Siding
? 32 Addition O 36 Move Bidg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof O 46 WindowslDOOrs
? 34 Replacement *Demolkion (ErHire Bldg only) • Cive 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 Bidgs Length Fire Sprinklered
Type of Const W idth
REQUIRED INSPECTIONS
_ Footings (new bldg) _ FinaUC.O.
_ Footings (deck) _ FinallNo C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile 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 _ Ratainvig Wall
Approved By Building Inspector
Base Fee
Surcharge Plan Review
MC/ES SAC
City SAC
W ater Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
''RESIDENTIAL
~ a y4 ~ BUILDING PERMIT APPLICATION
cinr oF eacaN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
Naw Conetructbn AenulremeMe RemotleVReoalr Beggiremente
• 3 registered ste surveys showing sq. fl. ot bt, sq. fl. of house; ena II roofed areas • 2 copies of plan
(20%mazimumWtoaverageallowed) • lsetofEnergyCakulatbnsforheatetlatlONOns
• 2 aDpies of plan showing beam & wintlow sizes; poured lound dasign, etc.) • 7 stle survey for exierior addttbns & decks
. 1 set of Energy Cekuletions • Indkata If home served by septb system for addNbns
• 3 copies of Tree Preservation Plan B bt planed atter 1/1/93
. R'un Joisl DeNail Optbns seleclron sheet (bldgs w8h 3 or less units)
DATE 6' 2 `f -O- VALUATION 60' DO C~fo~"
SITE ADDRESS I V~ I w r S'J"zt,i 12-q k.nl o l. L MULTI-FAMILY BLDG ~Y ?N
NPE OF WORK F E C F-a A6 l.E FIREPLACE(S) _ 0_ 1_ 2
APPLICANT ~~.n ~tv` t~ad' 'Ncw~ e t~c c, v~ '5~ 7 61nnt l' c.~ ~'SC~fS
STREETADDRESS 1a1a1y7 Nic.o11e~1- Ktr,-- Sa ~CITYI3~..Yrsv,lleSTATEy11NZIP5S3
TELEPHONE #!'2'9o9-6y S9 CELL PHONE # FAX #as_;K_-9,i!Z" ~j~
r---~
PROPERTY OWNER ~ a D9 FOY) J2 J31'rr1 Y--S TELEPHONE # 651-6 9 6-u4 y~
°
COMPLETE THIS SECTION FOR °NEW• RESIDENTIAL BUILRINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 nr7~
(~J submission type) • Residential Ventilation Category 1 Worksheet Submitted Dv ~r~C~deLWorr'~c3h Submitted
• Energy Envelope Calculations Submitted ~ I~
JUN 2 8 2002 I ~
I~
Plumbing Conhacfor: Phone #
Plumbing system includes: _ Water Softener _ Lawn Sprinkl y - . . 0
Water Heater No. of R.I. Baths
No. of Baths
Mechanlcal Conhactor: Phone #
Mechanical system includes: _ Air Conditioning Fee: $70.00
_ Heat Recovery System
Sewer/Wafer Conhactor: Phone #
I hereby acknowledge That I have read this application, state ihat the information is correct, ond agree to comply
with all applicable State of Minnesota Statutes and City of Eagan qc~l~~ances.
' 1 \
SlgnalureofAppl~an~ ~ Jo"M~ r-
OFFICE U5E ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4102
OFFICE USE ONLY
O 01 Foundation ? 07 06plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex O 17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex O 18 Deck ? 23 PorcH (screened) ? 36 Multi
? 05 03plex O 11 10-plex ? 19 Lower Level O 24 Storm Damage
? 06 04-plex O 12 12-plex Plbg_YOr_N ? 25 Miscellaneous
O 31 New ? 35 Int Improvement ? 38 Demolish (Interior) O 44 Siding
13 32 Addition ? 36 Move Bldg. 0 42 Demolish (FOUndation) ? 45 Fire Repair
O 33 Akeration ? 37 Demolish (Bldg)` 13 43 Reroof ? 46 Windows/DOOrs
? 34 Replacement 'Demolition (EMire Bldg ony) - 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) FinaUC.O.
_ Footings (deck) FinaUNo C.O.
_ Footings (addition) _ Plumbing
_ Foundation HVAC
_ Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Framing _ Siding Stucco Stone
_ F'veplace _ 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 i
I
k5o1 q 7 `f :RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675 ~ a • ~S
New Conmructlan RecNramente BemodaVRaoalr Reoufremems
• 3 registered rAe wrveys showing sq. fl. of Wt, sq. H. of twuse; aM ~II roofed areas • 2 copies ol plan
(20% mazMUm bt coverage aliowed) • 1 set of Energy Calculalions tor heated additbns
. 2 copies of plen ahowing Ceam & window s¢es; poured tound Design, e1c.) . 1 stte survay for exterbr atlditions & decks
. 1 set of Energy Cakulatbns • Indicete N homa served by septfc system for atltlRlons
• 3copies M Tree Preservatbn Plen 0 bt plettetl eRer 7/1193
• Rim JoI6t Detail Optiam SeleCllan Sheet (bldgs wBh 3 or less untts) ~ C~a ~1 ~l-_ _ ~j
s~ V
Ji -
DATE I'-Q2-- VALUATION \
(2
SIjE` ADDRE MULTI-FAMILY BLDG _ Y N
NPEWV~K FIREPLACE(S) _ 0_ 1_ 2
APPLICANT ~ Ca r 0~ C.
STREET ADDRESS t aa~t ~ [c-dl ~ e,~ ~ d CI l2_STATE V4 IJ LP SS3 3
TELEPHONE # j-V-7A71,95~ CELL PHONE # FAX 072'~j~~~
PROPERN OWNER I d 3117 Jtt "P}7J 1~-S TELEPHONE # 65;
°
COMPLETE THIS SECTION FOR -NEW,, RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CAT$GORY 1 MINNESOTA RULES 7672
(4 submission type) • ResiOential VendlaNon Category 1 Worksheet Submitted • New Energy Code WoACSheet Submitted
• Energy Envelope Calculations Submitted
Plumbing Contractor: Phone #
Plumbing system includes: _ Water Softener _ Lawn Sprixikler Te
Water Heater No. of R.I. Baths
No. of Baths JUN 2 8 2002 j
Mechanical Conhactor: Phone a Ely
Mechanical system includes: _ Air Conditioning • •
_ Heat Recovery System
Sewer/Water Contracfor: Phone #
I hereby acknowledge that I have read this application, staTe that The Information is correct, an agree to comply
with all applicable State of Minnesota Statutes and City of Eagan Or li ces.
~
Signature oP Applican
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
ucaacad araz
OFFICE USE ONLY . .
O 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 - Mufti
O 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4sea.) ? 33 Ext. Alt - SF
0 04 02-plex ? 10 08-plex ? 18 Oeck ? 23 Poroh (screened) O 36 Multi
? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex O 12 12-plex Pibg Y or _ N ? 25 Miscellaneous
? 31 New 0 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Adtlition ? 36 Move Bidg. 0 42 Demolish (FOUndatan) ? 45 Fira Repair
? 33 Alteration ? 37 Demolish (Bldg)* ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement 'Demolition (Entire Bldg only) - Give PCA handout to applicant
Valuatlon Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Storfes Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const W idth
REQUIRED INSPECTIONS
_ Footings (new bldg) _ FinaUC.O.
_ Footings (deck) FinaUNo C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
_ Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Framing _ Siding Stucco Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (newheplacement)
_ Insulation _ Reteining Wall
Approved 8y , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
5&W Permit 8 Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
~ . D . .
,
~ v 19$5 BUILDING PERNIT APPLICATION - CITY OF EAGAN
NOTE: ALL CONTRAC?ORS MUST BE LICENSED 4IITH THE CITY OF EAGAN
~MB~VpC~E INCLUDE 2 SETS OF PLANS
3 CERTIFICATES OF SUHVEY
1 SET OF ENERGY CALCULATIONS
(v 3,GGt~ o~
To Be Used For: Single Family Valuation: 62-9498- Date: 7-31-85
Site Address: 1171 Westbury Knoll OFFICE USE ONLY
Lot; 2 Block 2 Sect/Sub Erect ~ Occupancy
Remodel Zoning ~-1
Parcel 4l Westbury Fourth Addition Repair ~ Type of Const SL
Addition 0 of Stories
Owner Mark Lopac Move _ Length Ao
Demolish Depth 48
Address 5429 Penn Ave. S Int.Impr. ~ Sq Ft
Install
City/Zip Code Mpls., MN 55419
Phone 925-9467 APPROVALS FEES
Contractor Frontier Midwest HOmes Assessments Permit
Water/Sewer Surcharge ~
Address 3908 Sibley Mem. Hwy. 4kE police Plan Review 7(o~, =
Fire SAC 525,
City/Zip Code Eagan, Mn 55122 Engr Water Conn SN.i°-
Planner Water Meter =
Phone 454-0433 Council i i Road Unit 'LEp.
Bldg Offf/,r/d5 Treatment Pl
Arch./Engr. Richard Charlier APC 1/ Parks
Variance Copies
Address 14103 Gardenview Ct. TOTAL
City/Zip Code Apple Valley, MN 55124
Phone S 432-5492
NG Certlficate For:
=Sibley House
E5 ~~d~e~~
al Highway Frontie55122 ~orporotlon
-3077
N5904°I'2(0 0E [
. . 93'l.k 2~•~e ~+J~ o
-N- S 2C9
~
~ _ X953o
VL
N
/0
Lo-f 1 /_4-hJ
a Q`
rv~
n 9"16.0 /
vrcaofod_ n
''ol I ~IOtISf
(IV
_\J / 4~ ~ rl IIII'I ~1 / Y
~Illfl~', / ~v
nv
oX
\ 3/
' y' ~ ' '••:v
WAYNE D.';#=
~ yQ _ : CORDES i
~C Q 14675 -t ;
S R
~+iurrumim~~a~o
- fND- PROPOSED GARAGE FLOOR ELEVAIION= 580,0
~ Genotes /ron Mork.vrent PROPOSED lop of Block £LEVAtION= 80U.3
m Denotes M'ocd Nib Set PROPOSED BASEMENT FLODR ELfVAllON= a_ ll
x87 ° lknotes Existiry Spo1 Elevation ~"!o
(n <r> N,Twu Llenofes Proposed Spot Elevafiiai AYJTf: Verily all floor heights with final House P/ans.
J
~---Lenofes Drainage Directicn ~RVEYORS CERTIFIC~ION.
_P~~, ~~r~~~_ 1 hereby certify ihat this survey, plan or report
was prepared by me or wxler my direct supervision
LO1 Z,BCIXI( 2 ard that 1 am a duly Registered LaM Surveyor
_ W STQUR~ /e~D01TION Lrder the /aws of the State of Yimesota.
acccrd)rIg to ihe reccrded plat thereof, !1 6~lSlas
p~.fZ ~?s~Date: r
Counfy, Yinnesota Wayne . Cordes, 11inn. Reg. No. 14675
-aye i ot 4
EXTERIDR ENVELOPE F1V_F_R_l1Gf "II" COMN _ UTATION GAJhR~~1P~~
~.,a...~-
ckNER; DA"ff
SiTE ADDRESS: PIIONE:
CDNTRACTOR: F=eCX•Me=-
Determine wor•kin, square footage or' each
Total exposed wall area..... z sq. ft. x.11 715
2. Total roof/ceiling area..... IUe?8_ _sq. ft. .026 rns
Total expesed wall arca abnve fioor ez-U~b,(e(;7-'
a. ?ot31 wall window area ( Z~'j• 3
b. Total door area 6 L-
c. Total sliding glass door area
d. 7otal fireplace wall area
e. Total wall framing area (averaye lOp} ~164o
F. Total rim joist area . . . . . __L4 ~
g. net wall area above floor...'4.
h. wall area above floor
i. wall area above floor
j. fram= wali area at foundation
Total exposed foundation area=__~~,~ ~ .
k, Total foundation window area
1. Total net foundation area above grade
Determine "u" value or" each wali seameiit
(e.g. window, cioor, each separate wail section)
a . ( t 5 ~ '
x
b. ~jdf•(o "L X „U.!'°[~
c. A. 7; "U.415 d- ~V R "U~~_~`."-_-
e. X -G 6
f• _f uti X°U" . V3 = q.
9 x „v.
h. k
i. K U., _
k _ If item q3 is the san
as, or less tharr iten
l X "U~j = ^ 1 , you have meC...ttie
, (io intent of SBC..600b~;~(G
3.
......................Total 'x
, ~t
;L;,rior Lnvnloi>c nveragc "U" CompuL-,i::ion PaJe 2 of 4 .
. ~ Total expoucd :oot/ceilin, arca
;.m. 1bta1 skylight area ~
f°n. Total roof/ceilin, f:raminq ama (avcragc 10~)... (C46 W- .
o. Total net iiisulatcd rooP/cciling .irea........... T!~~. 7L
. Determine "U" value for each roof/ceiling segment
M. ~ X "ll" _
- n, rC~9 , 6~ . a ,.U„ oZ _ Z. `o
a.Y q, Z a,.U„ ,~Z = t 't, 55
4 Total
If total cf 1~9 is the smne as, or less t:nan 1~2, you have met the int-ent of
573C 6006 (c) 1.
Alternate Buildin EnveJ.ope Desiqn
Zb utilize the total envelope'system method, the values establishecl by the s:un of
i.l'cmis 1!3 and 09 ;;hall not be greater tlzan the smn oL• items ft1 and 112.
75 + 2.
3. _1 ~1 • ~ _ + 4. 4 G.. _ _'ZO~~ taa
~
~
' : ; ~3.
leoor/cEILT\G , '
Construction R-Valtic
.
1~ • ~ 1, Intcriar air filn
2. y3
Im~~~ 4. £ ior air f:ln(still) 4 ~
_ r(~~lllli,l I~~ l Total (Z. 4 g
~
- - . • .oZ .
Hea[ floc.r ~ 1. Interloz nir film 0.61
_nted 2.
up ~ •
, 3• _Z- y-1 i,(suL. 38.35
. ' • 4. ::XCr_cin:: <ii' 1 ~i1 n isC:ll t i
-------Totat
FIC. CS
' ~ ' . ~ . ~ U=.ozq:..
- - - ~ C a.l.vr~vcri
~~il~n~~./~v~.Vl:~"ti.••r~/1~~l~.•r1~-~~KJ~!\1~iG .
~ 1_ Insidc a1.r Tilm 0.61
- ' - ~--r" . 2 _ -
% .
, 3 . • .
~ . 4•
(~~y(((}}}~(~~/J~(I~~ 'r~ S. Qutsidc air. fiLn 0.17
:~Jl~~1~~1~~~71~~ - Total
' L _ .C,~-9"/ ~ . ' ' • . '
LG Z. Insidc air Yilm ~:61
r' - 2 _ ,
'p . . , , . . . .
; 1?ccz flov up • , •vmnted 3. -
, . q_
outsidc air Filcn 0.1?
TSG. ~ o. . _ . ~ . . _ . . TotaL
• . -3 . ,i I_ Ynside air fil+n : - ' ' - 0_61
~ ._t -1"-A 2 _
S
• , . . ~ v~ _ • • ~ j. . ~ .
. ^~_J~~.1. . - • . -
•c_ t~~• l/ ~
' „ n~.;1-..., • J ~ 4 _
.r.
5. oUtsidc air film 0.17
w-.:;•~:-:-:rl~-'t".'~"' I~J~., /
TOta1 . .
t<b ~ ~ . . . ~ . . .
. , . . . . . . .
. h~,-t_~~~• . ' rioCc_ UsQ additional sheets if more ~paca i:
~ „ peeded for details and calculatians.
' . ~ Hear
. , flov .:p - - . . •
. ' ~ -
' ?Z 27 . f' . • .
~ f,,'F t'I U% W,1~~ Atl`fl IJl'
cce~r.t ru cl iVf1 1 i n~ ~ ir.~i I: ~`J.l lu.•
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PIG. tll TC VIESl OF
2 • Y . Gr~ _ ` O - ---.z~ ~
~ . . • . 3. .~wi _.~.gf~~-----~- t~--~9 . .
G. F.>:Lrr iur_ni`i_ t i 1 i.i --_-_----'---l7. 17
FIC. 42 'I'utal
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~
. . ~ PERMIT
<CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number: 024715
N
Eagan, Minnesota 55123
(612) 681-4675 Date Issued: 10 / 12 / 9 4
SITE ADDRESS:
1171 WESTBURY KNOLL
LOT: 2 BLQCK: 2
WESTBURY 4TH
P.I.N.: 10-53653-020-02
DESCRIPTION:
(GA5)
B~I.I.z.ldl y-Permit 7ype FIREPLACE
~uzlBing W'O,rk Type NEW
Y~j •
\ - I
~ fr,,.. 1 ~..1-%.._
~ti~~`J~~1~~ e-,J
REMARKS:
FEE SUMMARY:
Base Fee $25.00
5wrcharge $_50
Total Fee $25.50
CONTRACTOR: - Applicant - sT. Lzc. OWNER:
FIRESIDE CORNER INC 16331042 0001068 GI6SON ERIC
2700 N FAIRVIEW 1171 WESTBURY KNOLL
ROSEVILLE MN 55113 EAGAN MN 55123
(612) 633-1042 (612)452-7075
I hpreby acknowledge that I have read this application and state that the
inform:atibn is corwsct and agret- to comply with a11 applS:,pable State of hln.
Statutes and' City of Eagen Qrdinances.
A(ul a. 1R,01A
-
APPUCANTlPERMI7EE SIGNATUPE ISSUED BY SIGN UR~ k
~
CITY OF EAGAN
1~ 1994 BUILDING PERMIT APPUCATION ~
~ 681-4675
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies: 1) when permit is typed, but not picked up by last working day of month
in which request is made, 2) address is changed or 3) lot change is requested once permit
is issued.
Date Valuation of work ~~lO~•bC_
Site Address: I.k-f!,
STREET SU1TE #
Tenant Name: (commercial only)
IAT I BLOCK ~ SUBD. P.I.D. #
W
Descri tion of work: ~rt re S~~Y2 P
The applicant is: ? Owner O'Contractor ? Other (Describe)
Name \(a..~S4 't. LY'C, Phone y53L^
Property LAST FIRST
Owner Address \\-11
STREET SiE #
City Ca2!~!~ State r~~~ ZipSs~~-3
Company \ V~Cesic\e ~ 0- (O1C> Phone
Contractor Address a^1~A "'VL\t tACLx--' License #\Q1CE) Exp.
City State Yl-..J Zip 551~;a
Architect/ Company Phone
Engineer Name Registration #
Address "
City State Zip
Sewer & water licensed plumber Processing time for
sewer & water permits is two days once area has been approved.
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.
Signature of Applicant:
r
OFFICE USE ONLY ~
~
BUILDING PERMIT TYPE
O 01 Faundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish
? 02 SF Dwg. ? 07 4-Plex ? 12 Multi. Misc. ? 17 Swim Poo1
? 03 SF Addition ? 08 8-Plex ? 13 Garage/Accessory ? 18 Comm./Ind.
? 04 SF Porch ? 09 12-Plex ? 14 Fireplace ? 19 Comm./Ind. Misc.
? 05 SF Misc. ? 10 Multi. Add'1. ? 15 Deck ? 20 Public Facility
0 21 Miscellaneous
WORK TYPE
? 31 New ? 33 Alterations ? 35 Tenant Finish ? 37 Demolish
? 32 Add9tion ? 34 Repair ? 36 Move
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. MWCC System
(Allowable) lst F1. sq. ft. City Water
UBC Occupancy 2nd F1. sq. ft. PRV Required
Zoning Sq. Ft. total Booster Pump
# of Stories footprint Sq. ft. fire Sprinkler
Length On-site well Census Code
Depth On-site sewage SAC Code
Census Bldg
APPROVALS Census Unit
Planning Building Assessments
Engineering Variance
REGIUIRED INSPECTIONS
? .Site ? Footing ? Framing ? Insulation
? Wallboard ? Final O Draintile ? Fireplace
Permit Fee veuat;Q,; g
Surcharge
Plan Review
License
MWCC SAC
City 5AC
Water Conn.
Water Meter
Acct. Deposit
5/W Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total:
SAC %
5AC Units
. ~ ~ ~3 -1%.
1990 BIIILDING PERMIT APPLICATION
CITY OF EAGAN
SINGLE FAMILY DWELLINGS 14[TLTIPLE DWELLINGS COMMERCIAL
2 SETS OF PLANS 2 SETS OF PI.ANS 2 SETS OF ARCNITECTURAL
3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PLANS
1 SET OF ENERGY CALCULATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS
OF RENTAL UNITS
OF FOR SALE UNITS
PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY
OF MONTH IN WHICH REQUEST IS MADE.
LOT CNANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED.
PERMIT MUST SHOW A LICENSED PLUMBER.
J U W 07 RecD
To Be Used For: Valuation: (Q40 Date: (o"S-90
Site Address OFFICE USE ONLY
Lot ~ Block 2. FEES
Occupancy
Zoning
Parcei/Sub 1CO't~/+4~ Actual Const Bldg. Permit z-~
Allowable Surcharge .S~
Oconer # of stories Plan Review
Length SAC, City
Address Il~i lu¢:,}~~~ru knc,~I Depth SAC, MWCC
S.F. Total Water Conn
City/Zip Code F,kf,-N MN 5$123 Footprint S.F. Water Meter
' Acct. Deposit
Phone A 7 ~q5 7- -7b7'ai On site sewage_ S/W Permit
On site well S/W Surcharge
Contractor MWCC System _ Treatment P1.
City water _ Road Unit
Address PRV Park Ded.
Booster Pump _ Copies .Oo
City/Zip Code SUBTOTAL
APPROVALS Penalty
Phone Planner TOTAL
Council
:Arch./Engr. Bldg. Off. bf&
Variance
Address
City/Zip Code
Phone #
%
!
}
~
fl . . . . _ . . _ . . . . . i . . . .
810 MA Hous e
8URVEYINO Certlflcate For: ~
~ SER"'CEB Frontler Midwest
3908 Sibley Memorial Highway
Eagan, Minnesota 55122 Corporotlon
Phone: J612) 452•3077
NFi9°461'26;'E , 1"I#dd - CAMeRio(,E -
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-LEGEND- PROPOSED GARAGE FLOOR EIfVAIION= 880.v I
O Qenofes Irai Ilax.rrent PIdDPOSEU 1op of 8fock fLEVAfION= P1b4.3_
m fknoles Noa1 Hub Set PROPOSED BASEMfNI fLQpR ELEVAIION= flll.
ne" ° qenotes Exlstiry Spof Elevition w0
MOTE: Ver,ly a!l ll~wr heights with final Huuse P/ans.
G~noles Proposed Sput Elevalion
-Qenotes Drainage Directiai ~MLORS CERTIFIC/ITI(N_
P~~ ~~+~1~_ ! hereGy cerfify 1Mt this survey, plan or report
was prepared Gy me or u-rler my direct suyervisicn
LOf? BLCCK z ard thal I am a duly Itegisterod Larti Surveyor
~ STQU0. 7H p~7ioN uyder the lars of ihe State o/Yinresota.
/1 l
accordiny fo fhe reccr0al plal thereoi, ~ 0 1 !._U_ 61LSf8s
pa.~c~'{ Z `~asn= ~a te :
Lounty, Yimesota Wayre . CaUes, Minn. Reg, No. 14675
1 .
2
/84
CITY Or EAGAN
APPLICATIGN FOR PERAIIT ,
EIM
SEWER AND/OR WATER CONNECTIODT
(PLEASE PRINT) 1) PRO°FRTY ACDRESS: 1171 Westburv Knoll '
` LEG1L DESCu-°TTCv= _2 /.2 Westburv Fourth Addition
(LOt/Block/Si::.divisicn or Tax ?arcel I.D. LN=ber)
.-^~.iIy '=:G STn,L':.'^ ' DAT? OF Ci2IGi^.AL ui22.DI:`:G =-:.11T ISS~2.NC.:
r .
P.----S= C'•S: ~ R-1 Sz;GL: cP-%ffLY .
? R-2 CUP= ('I'CO L^1Z':S)
O cZ-3 'IC7.:~~1?rvicg + L^:I.S) ( iNI'"5)
? R-a AP1m!*t,zr/cc.ma-±Tjr~i ~ UNiTs)
p ca-±%EPcT~./RE=L?oEF zcy
? INCliS=L
? Z.`:STI:'~TIOJIAL/GC'VE?,.`~~'T .
2) . A°PLSC=;vT (PLEASE PRiM1i) .
NX•'-E: Frontier Midwest Homes Corporation
ALDRE=S= 3908 Sibley Memorial Hwy. Bldg. E.
CI'I"!, STaT;', ZIP; Eaqan, MN. 55122 •
PFO`a: 454-0433
3) PLu,,i2E:R Star Plumbinq JPLE;.SE PRIYi) FOF CITY SE O4LY
NF'"'•E=
ADD~.SS: 1018 Mound Springs Ter. CITY, STATE, ZIP: Bloominqton , MN. 55420 waic- cord
4nF :
PHOV^: 884-4149 PLUNBER LICENSE q 3329 tia
Q) pC(,`r~~pprr/Lryi?E:R (PLEASE PR!!li) (
r~: Mark Lopac
ADDRESS: 5429 Penn Ave. S
CITY, STATE, ZIP: Mols.. MN 55419
PHONE= 925-9467
S) II1DICATE :dEiICH PER;•LLT IS BEIN(7 RF?QCTESTID;
CG.Z=IOD1 TO CITY SETr7ER Please mail gold copy to
~ CbNNEcPICN 'IO CITY viATER Wenzel Mechanical
3600 Kennebec Dr.
? O:IIER (PLEASE DFSCFtZSE) Eaqan. MN. 55122
6) L":DIG, = C::c: •
. ? PT.y`,SE f?OLD APPF?OVEp PERXIT FOR PICli-GP SY QNE OF ABC'VE
~ PIEySE ";~i APPR= PEP_•1ST TJ 1,Y 3. 4 AB0~7E
(Ci_ e one)
7) SI~~TL'cZ~~.: DATE:
A:Railf~~a s r1 s l~g~ta s s/RS~i~a a~ s s sssa:a s aa r a[Jfirrss f~ s t~ aita~aca~y .
F O R C I T Y U S E O N L Y
PFD+,tim u ISSUED . ~
rrE5' ~~/SU SE:':L.D. T_~ED\1TT (INC:. ~..'?~L JU.°..!'.:rRCiL)
$ , -
~ /,•trU WATER PERP4IT (IrICLUDE SiiRCHARGc)
$ fG~oC- WATER METER/COPPE4AORN/CUTSID~ REi,DE.R
+S WATER TAP (INCLUDE CORPORATIQN STOP)
$ S.;:dER TA?
$ ~~GL ACCOIINT D£POSIT - WATER
$ WAC
$ SAC
$ TRUNK WATER ASSESS:?E:IT . -
$ TRliNK SEI4ER rSSESS:iEPiT
$ Li,TEP,AL BEivEr^IT/TRU:IK SE:?EA
$ LATt',:2aL BENr,:IT/TRU.:K WATER
$ 15d'C•~ WATER TREATMENT PLANT SURCHARGE
$ OTHER:
$ TO;AL
$ clo c- 5, 6 AM0[J`:T PAIDjRECEi?m
D0E5 fJT:LITY CONNECTION REQUIP,E EXCaVATION ZY PUBLIC RIGHT OF WAY?
L YES IF YES, THEN n"PERMIT FOR 'r]ORK WITHIN
PUBLIC ROADWAY" MUST BE ISSUED BY TY_E
NO ENGINEERING DIV:SZON. LIST AS A CONDI-
TION.
SUEJECT TO THE FOLLOWING CONDITIONS: •
APPROVED BY; ~
TZ.LE: j •
DATE:
T
-4 20 ~ 0 ;)_ooG
2065' RESIDENTIAL PLUMBING PERMIT APPLICATION
3830 PILOT K OB ROAD, EAGA
651-675-5675 ~ JAN ~ 1 2006
Plea e complete for modifications to existing residential dwellings.
Date~_/~/~~
Site Street Address 7z Unit #
Property Owner JC5i Il11Ja n/ Telephone # (aS/}-
Contractor_ ( ~ttrYlY~lt9/t~ Telephone# ~~v2)%35=76'9f~
Address Ed City, State-h2A) Zip,,i~
The Applicant is: _ Owner Contractor _Other
Alterations to existing dwelling $ 50.00
_ Adtl plumbing fictures (excludes water softener and/or water heater--complete next
section if installing these appliances).
_Septic System Ahandonment
_ Water Tumaround (add $125.00 if a 5/8" meter is required)
Other:
Water Softener _XWater Heater $ 15.00
_ new ~ replacement
Lawn Irrigation _RPZ _PVB _new ^repair _rebuild $ 30.00
State Surcharge $ .50
Total
I hereby apply for a Residential Plumbing Permit and acknowfedge thaf 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 plumbing codes; that I understand this is not a permit, but only an application for a
permit, work is not to start without a permit and work will be in accordance with the approved plan in
the event a plan is required to be reviewed and approved.
&~el- . /JZa ~
Applicant's Printed Name Aj:fpli6ant's Signat e
For Office Use
a : e.
—)—Dsq 7
P [ a -
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:
buildinginspectionsacityofeagan.com L
2018 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit#:
IName: tgC•C.Ve..2M (' t&fav1 poM:-Aarv, _..Phone: 9-k+ 3n 5 119 I
Resident/ £ • V
Owner I Address/City/Zip: 1 � �b uYn1 01-4 1
Applicant is: X Owner Contractor I
I
Type of Work Description of work: "-- °----1:c\°".\
I t
Construction Cost: S ' n Multi-Family Building: (Yes /No ) I
j Company: Contact: g
i
I
Contractor Address: City:
f
State: Zip: Phone: Email: i
License#: Lead Certificate#:
If the project is exempt from lead certification, please explain why:
i
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
IIn 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:
I
Mechanical Contractor: Phone:
: •
° Sewer&Water Contractor: Phone:
I
i 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 ifjou;proyide ecific reasons that would permit the to conclude that thee 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.cityofeaoan.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 of plans.
x N GIV,/,eo v-) ��4 C,,�1 �r^,g�.",6 x N'' N' eA^-
Applicant's Printed Name Applicant's Signature