3824 Westbury LaneCity of Rap
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
Permit #: N\pc:) \\
Permit Fee:
Date Received:
Staff:
2010 MECHANICAL PERMIT APPLICATION
Date: :-%/1 %G Site Address: 3 ii.o7q -.244/ w
Tenant: Suite #:
-J
RESIDENT / OWNER
Name: ei40) j ii? usl(,/ Phone: 'i5// ..`21.r0
Address / City / Zip: e?q Gelt..hJ ! vJ 4`1"), d 4-' 557>x3
CONTRACTOR
Name: 191u2p.12s? Y79.4. �,tol- License #:
Address: �.0Slp iZ 40V1A40Atafr 131-1,7-5 City: 27t
State: »H,r/ Zip: �dj Phone: y5/ 47/675- .13.7.>"
Contact: df/j11-%---- Email:
TYPE OF WORK
New >--Replacement Additional Alteration Demolition
Description of work: �,A,0114' .,...-Z.,
® s s s S a a s s s
RESIDENTIAL
_,,urnace
Air Conditioner
P a .. -`' �� m a a
COMMERCIAL
New Construction Interior Improvement
PERMIT TYPE
_ _
Install Piping _ Processed
_
Air Exchanger
_
Gas Exterior HVAC Unit
Heat Pump
_
Under / Above ground Tank ( Install / _ Remove)
Other
** When installing/removing tank(s), call for inspection by Fire
Marshal and Plumbing Inspector
RESIDENTIAL FEES:
$55.00 Minimum Add-on
or alteration to an existing unit (includes
burned out appliances, ductwork, etc.) (includes
$5.00 State Surcharge)
$5.00 State Surcharge) $ 5-37 TOTAL FEE
$95.00 Fire repair (replace
COMMERCIAL FEES:
$75.00 Underground tank
$55.00 Minimum (includes
installation/removal OR
State Surcharge)
$10,010, surcharge is $ 5.00
surcharge increases by $.50 for each $1,000 Permit
Fee requires a $ 5.50 surcharge)
Contract Value $ x 1%
_ $ Permit Fee
- If the Permit Fee is Tess than
Fee = $ Surcharge
- If the Permit Fee is > $10,010,
(i.e. a $10,010-$11,010 Permit
= $ TOTAL FEE
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. CaII 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.
Applicant's Printed Name
CITY OF EAGAN SEWER SERVICE PERMIT
3830 Pilot Knob Road
P. O. Box 21199 PERMIT NO.: c 7 i"
Eagan, MN 55121 DI1TE: -
Zoninp: No. of Units:
Owr?er. o.iri r s
Mdress:
57te AMrets: ~E''= 3L hU I:
PIurnbe?: i a~.i_ c 4. 1' i i 7':}• i r:
~ 1-> . 'I 1~'~;.~r~~,•;1 M~ h~ ph wiN !M CJ1p of Iow¦ Corxmtion 0wrpe: 7`• ^.-T-
ORdiNwas. Atoount Depait;
Pem* Fn:
Sureharpe: 5 itis„9
BY Misc. CMrpes:
Dafe of Irup.: ToM:
InsP•: Daft Poid:
ciTV oF.EACAN WATER SERVICE PBtMIT
383.0 Pitof Knob Road -
P. d. Box 21199- PERMIT NO.:
~ Eagan, MN 55121 DATE:
i ZoninQ: ` No. of Units:
Owrwr. !:rand Oak.s
; Addroa:
Sft Addmn: 3824 kestburq 1_arce i.? -2 Westburs; II
PItme r. Va11e PlumhinF~
~ Meftr No.• -370107
Siu: 'goc-I'I - . ()Opd
Raader No.: 63 A( Y 419 6 ~~?t1~ 0 d
1 r~ e..~.h ~ N. ckrw NE o.~• . So a
~E1. 1:;6.0opa 'IT
gy Doto Poid:
Uirte of Insp.: Imp.:
I - 7- S--FG
CITY OF EAGAN ` 119 ~ 4
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 1~..-
PHONE: 454-8100
BUILDING PERMIT Receipt
To be used tor SF UWG/GA,Z Est. value $bl + 0V0 Dete 14AY 14 .19 86
SiteAddress 3824 Wi;STBURY LiV Erect L~ Occupancy
Lot 7 Block ` SeclSub. Y'1' 'rBJKY 2tiD Remodel ? Zoning
Parcel No. Repair ? Type of Const y.-'j
Addition ? No. Stories
¢ Name V''~r1A:7 UtitCS llf:VF:L CC) Move ? length 48
z 1681 b U:7'tZ .I SE C'' Demolish ? Depth 44
; Address Int Impr. ? Sq. Ft
° Ciry rAGA-N Phone 452-8934 Instal? ?
o Name Si-1uli; Approvels Fees
v¢ Address Assessment Permit ~ 6• U U
30
~ Ciry Phone Water & Sew. Surcharge • 50
Police Plan Review~~V0
~
~ Z Name Fire SAC 5. OU
Water Conn. 500.00
Address En9,
< W City Phone Planner Water Meter 63 . 50
Council Road Unit 290.00
I hereby acknowledge that I have read this application and state that the Bldg. Off. 5/14 S 6 Tr. PI. 156.00
information is Correct and agree to comply with all applicable State of
Minnesota Statutes and City of Eagan Ordinances. APC ParkS
Var. Date Copie
Signature ot Permittee % % ' / - Total i • 00
" ~
GRAND OT~CS D~:VF"}LO?t~l1:NT CO
A Building Permit is issued to: on the express condition that
aIl work shall be done in accordance with all applicable State,of tiAinnesota Statutes and City of Eagan Ordinances.
Building Official
1 ~
PrrmN No. PKmit HoWw Date TN~phone M
Plumbfny / I ~
IH.V.A.C.
111
EWctrk Gl~ ~
So1lener
Impactloe Dsh Imp. Commenb
Footl~gs 1
FooHnysll
Foundatlon
Framiny 4 p
p~~9
Rouyh Plbg.
Rouph Htp.
Insul.
FinpW"
FMM Hfq. 3i w
Final Plby.
Bldy. Final
Cert.Occ.
Deck Ftq.
Dock Frmy.
Well
Pr. Dlsp.
PERMIT #
PLUMBING PERMIT RECEIPT #
ClTY OF EAGAN ~
i 3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE
CONTRACT PRICE o~5 v u PHONE: 454-8100
Site Address `i a ` 5~ ~ BLDG. TYPE WORK DESCRIPTION
Lot~Block ~ Sec/$ub
L,,./ r 4 a- c Res. ~ New V
m Name 1--:4t el I Mult Add-on
~ Address (j < < ~ Comm. Repair
~ Ciry C,~ Phone ~Other
Name ~ ( s~~ 5 NQ. FIXTURES 3TOTAL
~ r Water Closet - $3.00 $ ~j -
c Address ' ' ~ Z =Bath Tubs - $3.00
p Ciry Phone `J S N- ~Lavatory -$3.00
:2_Shower - $3.00
FEES ~-Kitchen Sink - $3.00 3
COMM/IND FEE - 1% OF CONTRACT FEE Urinal/Bidet -$3.00
ZLaundry Tray - $3.00 ~ r
MINIMJM - RESIDENTIAL FEE - $10•00 1 Floor Drains - $1.50
MINIMUM - COMM/IND FEE - 20•00 =yyater Heater - $1.50 ' • ~ '
STATE SURCHAFiGE PER PERMIT - .50 Whirlpool -$3.00
(ADD $.50 S/C IF PERMIT PRICE GOES I Gas Piping Oudets -$1.50 ~
BEYOND $1,000.00) Softener - $5.00
Well - $10.00
Private Disp. - $10.00
CUIC_, L ~ ~0----~ =Rough Openings - $1.50
SiGNATURE OF ERMITTEE FEE 7' L_~'
STATE S/C: S U
FOR: CITY OF EAGAN GRAND TOTAI:
aI . 'z-
. . ~PERMIT #
MECHANICAL PERMIT RECEIPT #
CITY OF EAGAN
_ 3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE
CONTRACT PRICE: PHONE: 45I-8100
Site Address BLDG. TYPE WORK DESCRIPTION
Lot V Block SeclSub I - .
Res. New
m Name Mult Add-on
Address
~ _ Comm. Repair
c City Phone Other
_ Name FEES
c Address - RES. HVAC 0-100 M BTU - a24.00
p City Phone - ADDITIONAL 50 M BTU - 6.00
ADD-ON AIR COND. 0-24 BTU - 12.00
TYPE OF WORK ADDITIONAL 6 M BTU - 6.00
GAS OUTLETS - 1.50 EA.
Forced Air M BTU COMM/IND FEE - 1% OF CONTRACT FEE
Boiler M BTU MINIMUM - RESIDENTIAL FEE - 10.00
Unit Heater M BTU MINIMUM - COMM/IND FEE - 20.00
on . M BTU STATE SURCHARGE PER PERMIT - .50
Vent CFM (AQD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
Gas Piping Outlets # ~
Other /
FEE ; -
S/0 SIGNATUAE OF PERMITTEE
~f ~ TOTAL•
~ FOR: CITY OF EAGAN
CITY OF EAGAN Remarks U-%= I dc~'
Addition WESTBURY SECOND ADDITION Lot 7 BIk 2 Parcel 10 83651 070 02
Owner Street 3824 Westbury Lane State Eagan, MN 55123
Improvement Date Amount Annual Years Payment Receipt Date
STREETSURF, 1986 2850.00 570.00 5
STREET RESTOR.
GRADING
Water area 1986 133.79 8.92 151
SAN SEW TRUNK
SEWERLATERAL 1986 5008.73 1001.]5 5
Watermain 1986 65.29 4.3
WATERMAIN
WATER LATERAL 1986
WATER AREA 1984 136.96 9.13 15
*Services 1986
STORMSEW TRK 1986 7I0.24 142.05 5
STORM SEW LAT 1986
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILdING PER.
SAC
PARK
y . . . ~ t w . } .
~ CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 N2 11944
~/G~
-
BUILDING PERMIT PHONE: 454-8100 Receipt p ~ l
To be used for SF DWG/GAR Est value $ 61 ,0 0 0 Date MAY 14 jy 8 6
3824 WESTBURY LN R3
Site Address Erect ~7 Occupancy
Lot 7 Block 2 Sec/Sub. WESTBURY 2ND Remodel ? 2oning R1
Parcel No. Repair ? Type of Const V-Kl
Addition ? No. Stories
Z Name GRAND OAKS DEVEL CO Move ? Length 48
18 81 SUNR I SE CT Demolish ~ Depth d d
o Address Int Impr. ? Sq. Ft
city EAGAN Pnone 452-8934 Install ?
_ ~ Name S~E Approvais Fees
Address Assessment Permit $ 316 . 0 0
City Phone Water & Sew. Surcharge 30.50
~ Police Pian Review 158. 00
W W Name Fire SAC 575. 00
=~~-y Address 500. ~ ~
Eng. Water Conn. 63 . 50
i W Ciry Phone Planner Water Meter
Council Road Unit 290.00
I hereby acknowledge that I have read this application and state that the Bld9 off. 5 14 $ 6 Tr. PI. 156.00
information is correct and agree to comply with all appficable State of
Minnesota Statutes and ' of Eagan d' nces. APC Parks
C7„ Var. Date Copies
5ignature ot Permitt Total $ 2? Q 8 9• 0 0
A Building Permit is issued to: GRAND O tS D OPMEN CO on the express condition thet
all work shall be done in accordance with all applicable Stat f Minnesota S t tes d i oi Eagan Ordinances.
Building OHicial
SCREENS 26129.W30 REAL ES7RTE ING!IJIRY - NRME/ADDRESS/LEGRL XINFNU03
PARCEL ID: 10 83651 070 02 PLAT NRME: WESTHURY eND ADDITION
LEGRL: 7 2
HOMESTEAD CARD ENTERED: 02 17 1999
FIRST DIVI5ION: 015710 11 06 1984
LAST DIVISION:
FEE CURRENT OWNER:
TERRY COMMERFORD
3824 WESTHURY LN
EAGRIV MN 55123
TRRNSFER TO SCREEN NUMBER:
PF8-SCROLL FORWARD
4~9; S(~.AJ ~ hwy eSmn1T'
J
p~~~.~.( a3 a n cT y ,e/cL)
90
.
S - aa
*x~xxxxxxxxxxzxxxxxxrxrxr::: xrxxrxaw
*
C ITY O F E G A i~ *~E' PAYMh~Tr OF FEE AT TIME OF ~
* APPL.ICA7'ION DOFS D]OT amsmSTIE
APPROVAI. OF PERbII'r. ~
APPLICATION FOR PERMIT * *
INGpE'TFON OF SEt= AND/O2 tMER *
~
7MMar.raMONS WII.L NOT BE SCFID}-
SEWER AND/OR WATER CONNECTION ~ ~ ~M PERMIT HAS BEEN ~
. * APPROVID. ~
~
»
_ . *****~rr~***,e**,r*~~****************,r*
P ease Print)
1) PROPERTY ADDRESS : r A-,
LEGAL DESCRIPTION: 1-0 ~ 7 ~ ~ I
Lot Block Subdivision or Tax Pa el ID )
IF EXISTING STRL'CMME, DATE OF ORIGINAL B[IILDING PERMiT ISS['ANCE:
~
PRESENf ZONINGfPROPOSID LSE: (Nbn ear
~ CONA7ERCIAL/kETAiL/OFFICE ~ R-1 SINGLE FAMILY .
Q IAIDLISTRIAL Q R-2 DT'PLEX (Ztoo Onits)
~ INSTI'ILTIONAL/GO~ r7 R-3 'IOWNHOUSE (Three + Units) ( Lnits)
~ R-4 APARTMEN'P/COAIDOMIDIILT4 ( Units )
2)
NAPE: 7 Q r1 CJ h
ADDRESS: /gj1 'S U h V- l5'
CITY, STATE. ZIP:
3) NAI-E• p For City Use
_ f ~ C~ P1umUers License:
ADDRESS:_ (n ~ D C r~,e k a v~ -e Active
t FScpired
~ CITY. STATE. ZIP: `j O?c4 cy\ O,N Y- _ Not recorded
pxorE: ti MASTER LICENSE# Staff ETitial
4) • i~NArE:
P,DDRFSS: .
CI11', STATE, ZIP:
PHONE: .
5) n r• • a• : a - o~ -
CONNECTION 1O CITY SSWER ~ CONNECf'ION TO CITY WATER C] OTFIER .
6) • • r n PI.EME HOLD APPROVED PER["IIT FY)R PICfC-UP BY ONE OF ABOVE
PI,EASE MAIL PROVID PERMIT TO 1. 2119), 4. }1BpVE
(Circle one) C')J_
'1' • Y' c ~ ~ ~ ~ t~ • D :1• n A Y~1• . . .
• r. M • ~ " M:I• •,NA~ 1 / 1 DI' • 3~' • M1 . .
. FOR.-CITY USE ONLY
PERMIT # TSSUED
Pd w/Bldg, Permit FEES:
$ $ /n C7 SEWER PERMIT (INCLUDE SURCHARGE )
$ $ /('i- 5-?D WATER PERMIT (INCLDDE SPRCHARGE)
$ $ WATER METER/COPPERHORN/OUTSIDE READER
$ $ WATER TAP (INCLLiDE CORPORATION STOP)
$ $ SEWER TAP
$ $ ACCOUNT DEPOSIT - SEWER
$ $ ACCOONT DEPOSIT - WATER
$ , j ei ea • d Z~ $ WAC
$ S 7S~- $ sAc
$ $ TRLNK WATER ASSESSMENT
$ $ TIWNR SEWER ASSESSMENT
$ $ LATERAL BENEFIT/TRUNK SEWER
$ $ LATERAL BENEFIT/TRUNK WATER
$ $ WATER TREATMENT PLANT SDRCHARGE
$ $ OTHER:
$ /1~~ Y' S L $ l/-~' TOTAL
RECEIPT RECEIPT
DOES UTILITY CONNECTIdN REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
71 YES IF YES, THEN A"PERMIT FOR WORK WITHIN PUBLIC
Q ROADWAY" MUST BE ISSLED BY THE ENGINEERING
NO DIVISION. LIST AS A CONDITIOIV.
SUBJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY: (Slr ~~2.0
TITLE:
DATE:
' 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAfiAN
9 ~ 3830 P (II.UT'KNOB RD - 55122
U
681-4676
New Construction Reauirements RemodaVReoair Reauirements
? 3 registered site surveys ? 2 copies of plan
? 2 copiea of plans (include beam 8 window sizes; poured fnd. design; etc.) ? 1 sfte surveys (exterior additions & decks)
? 7 energy wlculations ? 7 errergy calculations for heated additlons
? 3 copies of tree preservation plan if lot platted after 7/1193
required: _ Yas _ No
DATE: _6 - 2 3-9 cI CONSTRUCTION COST: S ~ [l/JU-Oc)
DESCRIPTION OF WORK: ? C'fiwo'~~ ~V~ra~L
STREET ADDRESS:
LOT: _7 BLOCK: a SUBD./P.I.D.
, . .
Name: Phone e~~l ~Sf J z 6G'%
PROPERTY Lazt First
OWNER / /
Street Address: ~J F 2~ W~'$7 (~(,tifi~- L
City State: a5-IC-3 Zip:
Company: Phone#: l,/2 3?~ ~~j'S~
CONTRACTOR Exp.
Street Address: License # ~
City ~ PL6 State: Zip:
ARCHITECT/
ENGINEER Company: Phone
Name: Registration
Street Address:
City State: Zip:
Sewer & water licensed plumber (new construction only): . Penalty applies when address
ch ~ ge 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 with all applicable
State of Minnesota Statutes and City of Eagan Ordinances.
Signature ofApplicant:
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No
Tree Preservation Plan Received _ Yes _ No _ Not Required
OFFICE USE ONLY
BUILDING PERMIT TYPE
0 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish
? 02 SF Dwelling ? 07 4-plex ? 12 Multi Repair/Rem. ? 17 Swim Pool
? 03 SF Addition ? 08 8-plex ? 13 Garage/Accessory ? 20 Public Facility
? 04 SF Porch ? 09 12-plex ? 14 Fireplace ? 21 Miscellaneous
? 05 SF Misc. ? 10 = plex ? 15 Deck
WORK TYPE
0 31 New ? 33 Alterations ? 36 Moye
? 32 Addition ? 34 Repair ? 37 Demolition
GENERAL INFORMATION
Const. {Actuap Basement sq. ft. Census Code
(Allowable) Main level sq. ft. SAC Code
UBC Occupancy sq. ft. Census Units
Zoning sq. ft. Census Bldg
# 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 SAC
Water Conn:
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded. }
Trails Ded.
Other
Copies ~ •
Total:
% SAC
SAC Units
+1 3~ 1986 BIIII.DING PEAMIT gPPLIC6TI0N - CITY OF SAGAN
NOTS: ALL CONTRACTORS M[TST BE LICENSSD 1iTTH THS CITY OF EAGAN
SINGLE FAHIILY DiiEL-t_naGS
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OE SURVEY, 1 SET OF ENERGY CALCULATIONS
HOLTIPLE DWELLINGS - RESIDfiNTIAL BENT6L QNITS FOE SALS ONITS
INCLUDE 2 SETS OF PLANS, CfiRTIFICATE OF SDRVSY - CHE(:B WITH BLDG. DSPT.9
1 SET OF ENERGY CALCULATIONS
COPIlML9CIAI: INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS,
$2,000 LANDSCAPE BOND
To Be Used For: .5 ~ Valuation: &(Tc~ Date:
Site Address OFFICE II3B ONLY
Lot ~ Block ~ Erect ~ Occupaney ~
Remodel + Zoning
Parcel/Sub Repair Type of Const
Addition # of Stories
Owner Move ~ Length ~
Demolish _ Depth
Address Int.Impr. _ Sq Ft
Install
City/Zip Code ~
Phone APPBOYALS FEffi
Contractor Assessments Permit 3/6
r ~ Water/Sewer Surcharge ~j, ~
Address Police Plan Review
F1re SAC
City/Zip Code Engr Water Conn :-TpD
Planner Water Meter ~ ~ O
Phone "T Council Road Unit ~U _
Bldg Off Treatment P1 / S(o
Arch./Engr. APC Parks
Variance Copies ~
Address TOTAL
City/Zip Code
Phone S
NOTE: ADDEESSES FOR CORNER LOTS - CONTRACTOR/HOMEOiiNEB MOST DESIGNATE iiHICH ADDRBSS
IS DESIRED. AO CHANGES WILL BE ALLOWSD ONCB BIIILDIBG PERMIr IS ISSIIED.
~
.aIJRVEYOR~S CERTIFICATE GRAND OAKS UEVELOPMENI' C0.
I L_ \J I
30 I I Z
. ~
0 W
I M
~ ~ 150.00 S89°42'27"W Q
" ~ 30.00 • 48.00
I; '
W ; ~ s1050 io.so-•;i Z
r -
Z W 10 I lo W 0
Q M I ; a 26.0
J 4 ° LOT ~
f- y r, Z
} ~ -~-.(L o/o x
~ 22A a= a N W
7) w
m Q DRf , Y~r N u7~y_„ aa I $ v
L O,w,^ 22.332567 v Cf~ IA '
~ ~ --------;1 io t0 M
.~IO.50 10.501. 1
W -
3 " 3000 _ ~ _ 48.00
150.00 S 89°42'27" W J' O
~ Z
. I ci
I 30 I ~
O
I I .
DENOTES PROPOSED SURFACE DRAINAGE
O DENOTES IRON MONUMENT SET SCALE: 1 INCIi = 30 FEET
• UENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR = ggq.3 FEET
.X000.0 DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR =$g,I.5 FEET
(000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK = 084,1 PEET
I tIEREBY CERTIFY TO GRAND OAKS DEVELOPMENT C0. THAT THIS IS A TRUE AND CORRECT
REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF:
Lot 7, Block 2, WESTBURY SECOND ADDITION, according to the recorded
plat thereof, Dakota County, Minnesota.
AND OF TFIE LOCATION OF A PROPOSED OUILDIN6. IT DOES NOT PURPORF TO SIiOW IMPROVEMENTS.
OR ENCROACIIMENTS, IF ANY, TIiEREON. AS SURVEYED BY ME, OR UNDER MY DIRECT SUPERVISION,
THIS 14TN-DAY OF MAy , 198(,.
PJOTE; SIGNED: JAME HILL, INC.
GRADES SHOWN WERE TAKEN FROM THE
GRADING & DEVELOPMENT PLAN FOR
WESTBURY 20 ADDITZON, PREPARED BY
DELMAR H. SCHWANZ, LAPID SURVEYORS, gy:
INC.. LAST DATED AU6UST 8TH, 1984. HAROLD C.. PETERSON, LAND SURVEYOR
• PIINNESOTA LICENSE N0: 12294
pROJECT NO. BOOK / PA(3E JpMES R. HILL, INC.
86637 Planners / Englneers / Surveyors
FILE NO. 8200 Hum6oldt Avenue South
' FOLDER Blootnington,Mn. 65431 612-884-302e
• ' RESIDENTIAL
BUILDING PERMIT APPLICATION
~ L..( U~ CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-687-4675
New Conetructlon Beaulremenm BematleVNeoeU Heaulrements
• 3 registered sNa surveys showing sq. fl. ot lot, Sq. H. of house; and gll roofed areas • 2 copies of plan
(20% maxlmum bi cpverage allowe0) • 1 set of Energy CaMxilatlons for heated atldk'ans
. 2 copies of plan shaxing heam 8 window sizes; poureA fountl design, etc.) • t site suney for e#erior edtlAbns & tlecks
• 1 set of Energy Cakulatbns . InCicete M home senred hy aeptic sYStem tor adtl8ions
• 3 copies of Tree Preservation Plen tl bl plattetl alter 7/1193
. Rcn Jold Detail Optbns selectlon Sheet (bldgs wXh 3 or less untts)
DATE 1A VALUATION
,
SITE ADDRESS 3 LU Pujii`, j Vl _ MULTI-FAMILY BLDG _Y _ N
TYPE OF WORK Svi !gl~~ ~ fti qrrSd I ~e x U2hL_t:,qn ve 01,4 FIREPLACE(S) _ O "'1 _ 2
" rii H Cc 0 Cr.S 4 1n e- NeQ)
APPLICANT !-+ree &,p LL)yN P , )_s9 ~ lro F'resr~,0
STREET ADDRESS 3 3 CITY &~jir,~IIP STATE i1.ZIP ~-~33
TELEPHONE # 'KZ- %0'(Z`J_CELL PH E# FAX #
PROPERTY OWNER TELEPHONE #
COMPLETE THIS SECTION FOR %NEW° RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY I MINNESOTA RULES 7672
N submission type) • Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Suhmitted
• Energy Envelope Calculations Submitted
Plumbing Conhactor: Phone #
Plumbing system includes: _ Water Softener _ Lawn Sprinkler Fee: $90.00
_ Water Heater _ No. of R.I. Baths
_ No. of $aths
Mechanical Confracror fkLrP.C 1(XQ 6OV'm6f Phone # 9507-
Mechanical system includes: _ Air Conditioning Fee: $70.00
_ Heat Recovery System
Sewer/Wqter Conhactor: Phone ri
I hereby acknowledge ihat I have read This application, state that the informatlon is correct, and agree to comply
wfth all opplicable State of Minnesota Statutes and Cify of Eagan Ordinances. A
Signature of ApplicaM ~ ~ d\
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4/02
OFFICE USE ONLY ' ~ 1
? 01 Foundation ? 07 OSplex ? 13 16-plex O 20 Pool ? 30 Accessory Bidg
? 02 SF Dwelling ? 08 OB-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage O 22 Porch/Addn. (4sea.) ? 33 Ext. Alt - SF
04 02-plex ? 10 08-plex ? 18 Deck O 23 Porch (screened) ? 36 Multi
O OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
0 06 04-plex O 12 12-plex Plbg_Yor_N O 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 O 46 Windows/Doors
? 34 Replacement "Demolition (Entire Bldg only) - Give PCA handout to applicant
Valuatfon 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 W idth
REQUIRED INSPECTIONS
_ Footings (new bldg) _ FinaVC.O.
_ Footings (deck) _ FinaVNo C.O.
_ Footings (addition) _ Plumhing
Foundation AVAC
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 _ 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
CITY LISE ONLY
PERIviIT RECEII'T DATE:
.
2- 002 RESIDE1V'I'IAL MECHANICAL PERMYT AFPLICaaaTIlO1kT
crrY oF EAsAN
3$30 PILOT KNO$ RD
EA&AA MN 55122
651-6$1-4675
Please complete for: ? single family dwellings
townhomes and condos when permits are required for each unit
Date: SI a
SITE ADDRESS: ~ oly U,~ St if I4 ' L-Qa W 1- MI v?603
OWNERNAME: Ch1 IJ ku'761 n TELEPHONE#: 0.71'Y'~
INSTALLER NAME: lM I TELEPHONE -'--1 A3 - r I
STREETADDRESS: l'-l' 1`I"J t I• I~UrK,I r Ut I~ ~
CITY: STATE: ZIP: ~CC~D
Place a check mark next to the permit work type
X Add-on, modification or alteration to exis;in dwelling unit $ 30.00
• furnace replacement
.
• air conditioner
• o er
Nature of work:
32"r2 F}' ~ ~z!4 Z Tt7N
State Surchar e $ .50 `
TOt81
4SNA OF P TTEE
t/oz
, 2007 RESIDENTIAL BUILDING rERMIT nrrLicnTiorr
City OfEagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Constructbn Reoui2menis RemodeVReuair Reoui2menLS Office Use 0nlv
3 registered site suneys showing sq. ft. oi lot, sq. ft, of house; and all roofed areas 2 copies of plan showing footings, 6eams, joisGS Cert of Survey Real _ Y_ N
(200/o maximum lot coverage allowed) 1 set of Energy Calculations for heated addilions Soils RepoR _Y _ N
1 Soils Report if proposed huiltling is to be placed on distur6ed soil 1 site survey foradditions & decks Tree Pres Plan Recd _Y _ N.
2 copies of plan showing 6eam & window sizes; pouretl found design, etc. Add'N'on - indicafe if on-s8e septic system Tree Pres Required _Y _ N
1 set of Energy Calculations On-site Septic System _Y _ N
3 wpies of Tree Preservation Plan'rf bt platted aiter 711193 .
Run ,bist Detail Oplions selec6on sheet (6uildings wiN 3 or less unifs)
Minnegesco mechan&xl ventllation form
Plans are considered ublic information unless ou state the are trade secret and the reason.
Date 40, , / / Construction Cost /U U/~~ ~
SiteAddress
9-e~ 1 r~,le7~ IIniUSte #
Description of Work 6,1
Mulfi-Family Bldg _ Y g N Fireplace(s) _ 0~ 1 _ 2
Property Owner Telephone # ( )
Contractor
Address y//p City`~~,~+~~
State (~(4 Zip.G~G44-('3 Telephone#(~jrL) 7vg %6'7Z
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy COde Category . Residential Ventifation Category 1 Worksheet . . New Energy Code Worksheet
(Jsubmissiontypej Submitted Submitted
• Energy Envelope Calculations 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 plan:
Licensed Plumber Telephone )
Mechanical Contractor Telephone )
Sewer/WaterContractor Telephone#( )
I hereby apply for a Residential Building Pernrit and aclrnowledge that the information is complete and accurate;
that the wark 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. w EE! D
2007 ~Co/%
Applicant's Printed Name p icanY's Signature
~
DO NOT WRITE BELOW THIS LINE
Sub Tvpes . ~
? 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 EM. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ex[. Alt - SF
? 04 02-plex ? 10 08-plex )K 18 Deck ? 23 Porch (screen/gazebo/pergola) ? 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 !nt Improvement ? 38 Demolish Interior ? 44 Siding
A 32 Addition ? 36 Move Building ? 42 Demolish Foundafion ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building* ? 43 Reroof ? 46 Windows/Doors
? 34 ReplaCement 'Demolkion (Entire Bldg) - Give PCA handout to applicant
DesCrIDtiOn: WaterDamage_Yes
Valuation '36wd Occupancy n-3 MCES System
Plan Review * 100% or _ 25% Code Edition 215bV
Census Code /Y 3k_ Zoning p0 City Water
SAC Units ~ Stories Booster Pump -
# of Units r Sq. Ft. PRV
# of Bldgs Length / o Fire Sprinklered l"
Type of Const Width 910
REQUIRED INSPECTIONS
Footings(new hldg) Sheetrock
~ Footings (deck) FinaUC.O.
_ Footings(addirion) ~ FinaUNo C.O.
_ Foundation HVAC
_ Drain Tile pther
RooF _ Ice & Water _ Final _ Pool Ftgs Air/Gas Tesu Final
_ Framing _ Siding _ Stucco I.ath _ Stone Lath Brick
_ Fiteplace _ R.I. Air Test Final Windows
_ Insulation _ Retaining Wall
Approved By: , Building Inspector
ease Fee
Surcharge
Plan Review ,Z74~
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
LicCnse Search
Copies
Other
Tatal
4
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~ 150.00 S 89°4227" W Z
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I 30
I I
-a DENOTES PROPOSED SURFACE DRAINAGE SCALE: 1 INCH = 30 FEET
O DENOTES IRON MONUMENT SET FEET
A UENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR = gB~F•3 FEET
.X000.0 DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR 8 i.5
(000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK = a84,`) FEET
I}IEREBY CERTIFY TO GRAND OAKS DEVELOPMEN7 C0. TfiAT THIS IS A TRUE AND CORRECT
REPRESENTATION OF A SURVEY OF THE 60UNUARIES aF:
Lot 7, Block 2, WESTBURY SECOND ADDITION, according to the recorded
plat thereof, Dakota County, Minnesota.
MEOPTOSIIOW I~RVISN
DIO IF a ANY, p TNEREON. BU AS D 5UR4EYED BY OE N OR UNDER PIY DIREL'T SUP
OR ENCROACIIMENTS ON,
TIIIS 14TH-DAY Of MAj ~ 19B4,•
NOTE: SIGNED: JAM . HILL, INC. l~
GRADES SHOWN WERE TAKEN FROM THE ;
GRADING & DEVELOPMENT PLAN FOR
WESTBURY 2tlD ADDIT'ZON, PREPAP,ED BY r
DELMAR H. SCHWANZ, LAPID SURVEYORS, gy; ~
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 3824 Westbury Lane
Lot: 7 Block: 2 Addition: Westbury 2nd
PID:10- 83651- 070 -02
Use:
Description:
Sub Type: e- Siding
Work Type: Siding
Description: House & Garage
Census Code: 434 -
Zoning:
Square Feet: 0
Comments:
Fee Summary:
Valuation: 3,000.00
Contractor:
Lakewoods Remodeling
9001 E Bloomington Freeway #144
Bloomington MN 55420
(952) 888 -5550
Total:
Applicant/Bermitee: Signature
PERMIT
City of Eaan
Construction Type:
Occupancy:
When installing ventilated soffit material, remove existing soffit mate
take steps to ensure maximum ventilation into attic space.
BL - Base Fee $3K
Surcharge - Based on Valuation $3K
- Applicant -
$90.00
Owner:
Christine J Rusin
3824 Westbury Lane
Eagan MN 55123
Permit Type:
Permit Number:
Date Issued:
Permit Category:
$88.50 0801.4085
$1.50 9001.2195
Issued By: Signature
Building
EA086737
10/09/2008
ePermit
al (i.e. debris that could block vent openings) and
I hereby acknowledge that I have read this application and state that the informa
of Minnesota Statutes and City of Eagan Ordinances.
on is correct and agree to comply
h all applicable State
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA152018
Date Issued:09/24/2018
Permit Category:ePermit
Site Address: 3824 Westbury Lane
Lot:007 Block: 002 Addition: Westbury 2nd
PID:10-83651-02-070
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Includes Skylight
Census Code:434 - Residential Additions, Alterations
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 -
Christine J Rusin
3824 Westbury Lane
Eagan MN 55123
Lakewoods Remodeling
9001 E Bloomington Freeway #144
Bloomington MN 55420
(952) 888-5550
Applicant/Permitee: Signature Issued By: Signature