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1120 Westbury Path1,11/' City of Eaaau 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 ddd Use BLUE or BLACK Ink e60O Permit Fee: Date Received: Staff: C) 2011 RESIDENTIAL BUILDING PERMIT APPLICATION %�`! Et y-iy al Date: 1-1—-Zb t Site Address: 1110 Wa,StintA Unit #: RESIDENT / OWNER Name: N i cY - I ko re-jAn.. Phone: (05 I —210 I — 9114 /a Address / City / Zip: U I2.0 wnS` 10/.A. Al � 3 Applicant is: X Owner Contractor TYPE OF WORK Description of work: —Thar I C_ Construction Cost: . --,$CSU Multi -Family Building: (Yes / No ) CONTRACTOR Company: Contact: Address: City: State: Zip: Phone: License #: Lead Certificate #: Does this project require Lead Remediation? 0 Yes IA No (see Page 3 for additional information) If no, please explain: In the last 12 months, Yes If COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING has the City of Eagan issued a permit for a similar plan based on a master plan? yes, date and address of master plan: _No Licensed Plumber: Mechanical Contractor: Sewer & Water Contractor: Phone: _ Phone: Phone: E: Plansand su o pc f a �iou ubi�rr o io the informatro r ma • e via` tie • as n- . u rf you e s • fi •i • o at they ar?e iradeecre. » ..,. ,.,.. . conclude ths 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.000herstateonecall.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. Page 1 of 3 1 I ao 1,,o6A9t,c4uf Pk_ DO NOT WRITE BELOW THIS LINE t9z3 SUB TYPES Foundation Single Family Multi 01 of _ Plex _ Accessory Building WORK TYPES New Addition _ Alteration Replace Retaining Wall DESCRIPTION Valuation Plan Review (25%_ 100% ✓ ) Census Code # of Units # of Buildings Type of Construction Fireplace Garage Deck Lower Level Interior Improvement Move Building Fire Repair Repair �3Y REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) Foundation Drain Tile Roof: _Ice & Water _Final Framing Fireplace: _Rough In Air Test Insulation Sheathing Sheetrock Reviewed By: Porch (3 -Season) _ Porch (4 -Season) Porch (Screen/Gazebo/Pergola) _ Pool Siding Reroof Windows Egress Window Storm Damage Exterior Alteration (Single Family) Exterior Alteration (Multi) Miscellaneous _ Demolish Building* Demolish Interior _ Demolish Foundation Water Damage *Demolition of entire building — give PCA handout to applicant Occupancy ,UL Code Edition ftCV 7 Zoning �D Stories Square Feet Length Width Final RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL 57 g- MCES System SAC Units City Water Booster Pump PRV Fire Sprinklers Meter Size: Final / C.O. Required Final / No C.O. Required HVAC Other: Pool: _Footings Air/Gas Tests Final Siding: _Stucco Lath _Stone Lath _Brick Windows Retaining Wall: _ Footings _ Backfill _ Final Radon Control Erosion Control , Building Inspector iG ?-0 04c It, 6 A,9" ?O Page 2 of 3 Certificate For: ' oseah M. Miller Construction • 1 8133 Cedar Avenue South Farmington, MN 55024 f/moo u��+bey 0�- DELMAR H. SCHWANZ LAND SURVEYOR So IPC., Registered Under Laws of The State of Minnesota Plan 83-102 Arcadia I 2978— 146TH STREET W. — BOX M ROSEMOUNT, MINNESOTA 55068 PHONE 612 423-1769 1 3 4 SURVEYOR'S CERTIFICATE oi 21 r -r Scale: 1 inch = 30 feet O= Proposed elevations 0 = Set wood hub 0 = Property corner = Proposed'drainage Proposed garage floor elevation 6,)0,/ ter._ EAGAN REVIEWED BY: j IONS DIVISION I hereby certify that this is a true and correct representation of the following described tract of and: Lot 3, Block 4, WESTBURY FIRST ADDITION, according to the recorded plat thereof, Dakota County, Minnesota. Also showing the location of a proposed house not Staked thereon as of July 25, 1984. House staked , 19. A r r A • r 1. ? i REGISTRATION CITY OF EAGAN SEWER SERVICE PERMR 3$39 Pilot Knob Road P. O. Box 21799 PERMIT NO.: G~'~` Eagan, MN 55121 pqTE: - Zaninp: R1 I Joe M1.11er Cpngr No. of Units: Ckvnsr: Address: Site Address: 1120 Weetbu Path L3 $4 Westbu lst Plumber: Y~ut ~ 7-25-84 44484 . IGar• to eewoy .dM eh. caer of f.'.¦ Connaccton (],orge; 425.00 pd o.ur.woa. /keourK Dapostr. 15.00 pd P.rmit F"; _ 10. 20 ud surcharpe: .50 pd BY Misc. Chorpes: Dote of Insp.: Totol: Insp" Dote PcM: CITY OF EAGAN WATER SERVICE PERMIT ' i 3830 Pi1ot Knob Road P. O. Bbx_ 21199 PERMIT NO.: 57(,7 Eagan, MN 65121 DATE: Zoninp: - J0~ ~ No. of Unlts: 1 Owrw: i t ; ib /dd~ 11 p wes - 3 B4 67astbur lat i mber: ° ` r No.: ' riection Cho~e: U 470.00 d Si ~ \~~i' : ~ lA~ooimt Deposit: , n ReO'd°' • . Pertriit Fee: • 1~ome eo oomapy with NN Cky of lo.w SurclwrDe: ~t Mix. Charyes; 63.00 pd meXer Totcl: BY Date Pcid: j % Dota of Insp.: Imp.: I , CITY OF EAGAN • 3830 Pilot Knob Rosd, P.O. Box 21•199, Eapn, MN 55121 j PHONE: 4548100 • 1 eUILDING PERMIT Rece+a T• M wwa hr SF DWG/GAR Est. value $57, 000 Date JULY 27 19 89 I~ SiteAd 1120 WESTBURY Erect Oocupancy R3 Lot ~ Block SOC/Su6. S BURY ST Remodel ? Zoning JRJL Parcel No. Repair ? Type of Const. Enlargs ? No. Stories W N~e JOS MILLER CONST INC Move ? Le?~tn 5 ~ CEDAR AVE osmolfsh O Deptn 35 Addresa City FARMINGTON phone 54- 753 Grade ? Sq. Ft. Name SAME Awweh E"s ~ Address Assessment Permit -TOT.oo City Phone Woter b Sew. Surchorye 28.50 Poliu plcn c1?eck 152.00 tW Name Ffn SAC 525.00 x43 Addreu Enp. Water Conn. 470.00 t W City Phone Plonnsr Woter MeMr 63.00 Countll Road Unit 260.• 00 I hercby acknowladye thot 1 how rood this opplication ond stote that gldg, pff. parks A~ ,r~~ ~ ~ the information is torrect ond ogree to comply with all applicablo Stob of Minnesoto Stotutes and City of Eogon Ordironcss. , Var. Date Sipnctun of Permitta A Buildiny PeRnit Is Isswd w: JOS MILLER CONST INC o„ the e,press conditlon t1w+ oll work sholl •be done in ocwrdonce w+eh ou opplioobi• Store af AAjnr,esoro Sracutea ond CtH of Eagan O.dinnnc.:. Bulldirq OffiNol ~ Pwmit No. Pwmk Holdw Dab Plumbirp 'J U ~e,-'V~ • ~ H.VA.C. LI ~L~ C fi, r\+YL I ~s I"11 Y q - -,1 ~ < < ebctric 4q 4 • d l IgY ".Sb sorc«w Iropection Dm Insp. Othw Footinp - ? 6 Foundation Frarniny Rough Pib¢ . ~ Rough HV ~ Iroulttion Fiewl VIb4 ~ Finsl HVAC i ~ Fiosl g ~ II Cart/QCC. D-tc~ibe Loeation: I Wow - Well S~w~r ~ h. DWp. i I Receipt ( I ~ ~ U PLUMBING PERMIT Permit No. C CtTY OF EAGAN Fge .4) 'Gy Fill in numbered spaces S1C 11-~.) Type or Print legibly ,rot. 1. Date 2. Installation Cost ~l.otBlk. ~ 7ract 3. Job Address AWO 4. Owner 5. Contractor Phone 6. Address 7. City State Zip 8. Building Type: Residential Q}-'Commercial ? Institutional ? 9. Work Description: New Q~-'~Add ? Alter ? Repair 0 10. Describe 11. No. Fixtures No. Fixtures I f Water Claset Cesspool/Drainfield ~ Bath tubs Septic Tank Lavatory f Softner Shower ~ Wly Well ~ Kitchen Sink ~ I Urinal/Bidet Other ~ Laundry Tray Floor Drains Drinking Ftn. Slop Sink ~ Gas Piping Outlets 12. I hereby certify that the ahove information is true and correct, and I agree to caomply with aN ordinancrs and codes governing ihis type of work,., . Signed : for f ``-..v, lia,~ Rough Flnal ~ Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CiTY OF EAGAN 454-6100 L/"1 ~ Rsceipt MECHANICAL PERMIT Permit No. ( CITY OF EAGAN . FN Fill in numbered waces S/C Type or Prini /egrbly Tot 1. DetC 2. Installation Cost 3. Job Address r_ Lot Blk. Trect 4. Owner < < ' C - r ~ 5. ContractoF,' , Phone - ~c ` 8. Address ' 7. City i IL State j Zip . _ ~ 8. Building Type: Residential Ll Commerciel ? Institutional ? 9. Work Description: New B" Add ? Alter ? Repair ? 10. Describe Fuel Type ' - ` 11. No, Eauioment BTU - M. Ea. No. Eouiament CFM I ' Forced Air ~ C ` Air Handling: Mf9• ~ ' C~C"~ ~ Boilers Mech. Exhaust Mfg. Unit Heater Mfg. Other Air Cond. Mfg, Gaa, Piping Outlets ~ 12. I hereby certify tfiat the above information is true and correct, and I agree to comply with all ordinanoes and codes governing this type of work. M ~ Signed: ' for Rouyh Finsl Inspections: Date Insp. Date Insp. This is your permit when numbered and epproved. Approved CITY OF EAGAN 464-8100 qTY OF EAGAN Remarks 'f,7%' Additi WESTBURY FIRST ADDITION 3 4 on ~oc e~k Parcel 10 83650 030 04 owner saeet 1120 Westbury Path state Eagan, NIIV 55123 Improvement Date Amount Annual Years Payment Receipt Date STREETSURF. 1986 2$50.0 2$50.00 C010006 1-21-85 STREET RESTOR. GRADING Water area 1986 1 133.79 C010006 1-21-85 SANSEW TRUNK 98/ 1985 436.23 29.08 15 436.22 C009807 10-31-84 ~SEWERLATERAL 1986 5008.73 1001.75 5008.73 C010006 1-21-85 [datermain 1986 65.29 4.35 1 65.29 C010006 1-21-85 WATERMAW ~ ~ WATERLATERAL 1986 WATER AREA 42~ *Services 1986 . STORMSEW TRK ~ 1986 710.24 142.05 5 710.24 C010006 1-21-85 ~ STORM SEW LAT 1986 CURB & GUTTEfl SIDEWALK STREET LIGHT Road Unit 260.00 1k44980 7-27-84 WATER CONN. 470.00 11 11 9UILDING PER. #9342 11 SAC $25.00 PARK CITY OF EAGAN N9 9342 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55127 PHONE:4548100 p p.l BUILDING PERMIT Recetpt 7o be uwd fer SF DWG/GAR Esr. Value $57,000 pote JULY 27 19 84 SiteAddress 1120 WESTBURY PATH Erect ~ Occupancy R3 • Lot 3 Block 4 Sec/Sub. WESTBURY ZST Remodel ? Zoning T- Parcel No. Repair ? Type of Const. V Enlarge ? No. Stories Name JOS MILLER CONST INC Move ? Lenyth 50 ' Z 18133 CEDAR AVE Demolish ? Depth3,L ~ Address Grede ? Sq. Ft. City FARMINGTONPhone 454-4753 SAME Avvrovols Fee. =o Name 30 .O( Assessment Permit a~ Address u~ City Phane Woter & Sew, Surcharpe 2 8 . 5( Police Plan check 152.0( w Name Fire SAC 525. 0( Address Enp. WaterConn. 470.0( u 'W City Phone Plonner WoterMeter6.3•0( Council Rood Unit 2 fin - 0( I hereby ackrqwledga fhot I have read this apDlicotion ond state fhat Bldg. Off. Parks fhe inlormotion is correct and ogree fo comply with all opplicable APC Total State o} Minnesota Stotutes and City of Eagan Ordinonces. Var. Date Sipnafure of Permittea A Building Pertnit Is issued to: JOS MILLER CONST INC on the expreu conditlon Ihat oll work shall be done in occordonte it all opplica e St e o Minnewta Stat~ s and Ciry of Eaqan Ordinances. Buildin0 Ofiicial ~ 6 - . 5~x.~ D awwe. ss.c. ar pI.,n,,. 1 ,sas pLn q/.7•varsum ~ . &TSIDIir, PIIA4T tPPLTCM" ~ ~t o~' ~Y ~~~w' S. ~ t~w U . ~raa 2. T,, He osea F+or valuaarr~ aea aeaar stte ncl~^ess: a~ 62 J~` fZ-3 Lot Sl.adk Sec•/S~' ~ Erect ~~y . paioel Aepslr nn Say lhtilsrgs TYDe O! Oort' - SL ~ /tac3M 0?rtW: A6drsul ~ D.veh s • City/ZiP QDde: r vnam APPFOMS ' gurcheige %el Oontrac.~ear: Pblioep~ - l 522~ Address: ''7 - City/`LiP PYre ~ . ~ o Ffia~e t ~j - Planner M°Cst.' llet°r IC ilMd`UAit 2~00 - Arch,/E,y, s~.ay. of Amress: APC . at7r/Zip Code: / U4 7;S-0 ' P'hane # . CertiPicate For: lost•ph M. Mi I lcr Construction . . K1'S3 tiedac Avenuc SoutL Farmiu{;ton, pit: 551124 A 1; Plan 83-102 Arcadia l DELMAR H. SCHWANZ IANOSUAVEVORSf I0G, ~ RapntveC Untln lawf of TMe Sble o/ Minnnou ~ 2978 - 145TH STHEET W. - BO7f M ROSEMOUNT, MINNESOTA 66088 PNONE 612 4211789 SUHVEYOR'S CERTIFICATE I I r _77077 Scale: 1 inch = 30 feet -r - ~ = --;v. - . • ( ~ ° ~ Proposed elevations 4 ' ? = S2C WOO(~ EIUb ~ ~/.O ! i.o a eP~n~SF`~ ( O = Propcrty corner = Proposed"drainage c 1 1!j Proposed garage floor elevatio Xq ~ I r ~ 1- - ~ - - ~-EA -~r,:;-.` - I huneby curLify LiiaC [his is a Crue and cnrrdct ropresentaClon oC llie Lulluwing dc•scribed trnct of lnnd: I.ot 3, I?luck 4, WESTRl1NY FCR57' 4DUCCiON, accordiug to tho rucnrdced plat chereof, Unkota (:uunlv, itinni150ta. A7so showing the locatinn uf a propnsed }~oi~ye not mCaked Cheee~un as oF July 25, 1984. ~ V{nuso s[akud `.I~NhIES0T4REG157R4TipNNl1 Hti!~ RESIDENTIAL BUILDING PERMIT APPLICATION aS~ CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 651-681-4675 Naw_Gonntructlon Reoulremenh RemodeUReoair Reauirements • 3 registered site surveys shmving sq. ft. of lot, sq. ft of hause; and all roofed areas • 2 coDies of plan (20%maximum lot coverege allawed) . 1 sel of Eneyy Calculatiore for heated additions • 2 copies of plan showing beam 8 window s¢es; poured found desgn, etc) . 7 site survey kr exterior addNons 8 decks • 1 set at Energy Calculations . Indicate if homa served by septic system foradditians • 3 copies of iree Preservation Poan if lot platted after 111193 • Rim Joat DeUil Options selectlan sheet (Mtlgs wAh 3 or less uniLS) DATE O.OCk •O Q VALUATION I lTI I-J ~ SITE ADDRESS I I a C~ U.~Q ST~Lr( c~~C~`~V'~ MULTI-FAMILY BLDG _ Y _ N TYPE OF WORK~Iop1Il 9 FIREPLACE(5) _ 0_ 1_ 2 APPLICANT Renewal By Andersen, Inc. STREET ADDRESS 1920 County Rd. "C" West STATE_ZIP TELEPHONE # ~Roseville, MN 55 t 13 FAX # 1651-264-4777 - License # 20130983 PROPERTYOWNER-'V)n'(~2~1f~~ TELEPHONE4{LqS~J•SZI~I~ COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNBSOTA RULES 7670 CA'1'EGORY 1 MINNLSO"1'A RULES 7672 (J submission type) • Residential VenGlation Category 1 Worksheet Submined • New Energy Coda Worksheet Submined • Energy Envelope Calwlations Submitted Plumbing Conhacfor: Phoiie # _ Plumbing system includes: _ Water Softener _ Iawn Sprinl:ler Fec: $90.00 _ Water Heater _ No. of R.I. I3aths _ No. of Baths Mechanical Contractor. Phone # Mechanical system includes: _ Air Conditioning Fec: $70.00 Hcat Rccovcry Systcin Sewer/Water Contractor: Phone # I hereby acknowledge that I have read ihis application, state ihaf the iny6rmation is correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Or i(iances. SlgnatureofApplicanf, ~.4A~1 OFFICE USE ONLY Certificates of Survey Received Tree Preservation Plan Received _ Not Required _ Updaled 4/02 J OFFICE USE ONLY ? 01 Foundation ? 07 05-plex ? 13 1Eplex ? 20 Pool ? 30 Accessory Bidg ? 02 SF Dwelling ? OB 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi O 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-ptex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi ? OS 03-plex O 11 10-plex 0 19 Lower Level ? 24 Stortn Damage ? 06 04-plex ? 12 12-plex Plbg_Y or_ N ? 25 Miscellaneous ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Additlon ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)• ? 43 Reroof • ? 46 WindowslDoors ? 34 Replacement •Demolitlon (Entire Bldg only) - Give PCA handout to applicant Valuation Occupancy ' MC/ES System Census Code Zoning Ciry Water SAC Units Srories 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) _ FinaUNo C.O. _ Footings (addition) _ Plumbing Foundation HVAC Drain Tile Other Roof _ Ice & Warer _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final _ Framing _ Siding Stucco Srone _ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement) _ Insulation _ Retaining Wall Approved By , Building Inspector Base Fee Surcharge Plan Review MCIES SAC Ciry SAC W ater Supply & Storage S8W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Plarmit License Search ' Copies Other Tatal Cities Di it~ a1 Qualitv Control The following image represents the best available image from the original page. Every effort was made to capture the content from the original page. ~~.~.r~•... auu 1L.JV cnp 101) oll +44100 t(C:ttSRAy"IyYGC1UlSt(iltfry fmuuzit re . . runo 7, 200I . city~ of Eagan 3836 Pilot Bnob Road . EaSen. MN 55322 To Whom It May Conccrn; Elder Jones ie authouzed to priil bnilding permits far Renewal by .Mdersm Please allow Elder Jones to prm•ide this ser"vicc for us in Eagan. Yhis guthqrizatian 9g valid for eny dace beyond 6/6101; un61 a11`enewa! by Andersen W theCity. manam exprewy revakes it in wiicing I request this authocizaflon be eccepted axpedidously, as to not delay in the proeessing of ottr buildinS Pcj=b aay fus@ter. Plcasc caII mc If thcto u+c my qncstione.. I can be contacted at 763-502-4706. _ , . , a . Your immqdiebe eltmtion to thLs maticr is apprectazed, KmUaond R. Rau rion Managcr Ronewal by Andmsaen Corporaflon • C's.: Karn-F,Tc}Pr Innea G - 7-~c7oj OFI 0 , N~wy a„~~~ M' Received Time Juo. 1:01PM ~ RESIDENTIAL ~ BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT N668RD, 1 4675 N MN 55122 651 I I 3- New Conetructlon Reauirementa flemodeUReoalr Reauirements • 3 regi5lerBd see surveys Showing Sq. fl. of bt, Sq. tt. 01 houSB; and all r00f6d areas • 2 copias o1 plan (200% maximumbtcoveregeallowed) • lsetolEnergyCalculationslorheatedadditbns • 2 copies of plan showvng beam 8 win0ow sizes: poured lound desgn, etc.) • 1 s8e survey for eMerbr add'Aions 8 decks • 7 set of Energy Calculatqns • InGicate'rf home servetl by seplic system foraddrtbns • 3 copies of Tree Preservation Plan H lot platted atter 711/93 • Rim,bist Detail Optbns selectbn sheet (bWgswiN 3 oi less unHS) DATE VALUATION SITE AR~DqR,E~SS MULTI-FAMILY BLDG _ Y X N NPE OF`V~IO hajC,~ Gl~,~0LCIS(K, FIREPLACE(S) _ 0_ 1_ 2 ~ APPLICANT An,c_ri"IGctn STREET ADDRESS J-',J-`l 7 6160ll~~ 40G. CITY 30'_hS U r 1 12 STATE AM ZIP 5~r3 3 ~ TELEPHONE # 77,17-61Sl CELL PHONE # FAX # 7s-1-1 70 7 ~ PROPERN OWNER LJ C) ree-f-, TELEPHONE # ts '4#Sy` COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNFSOTA RULTS 7670 CA1'EGORY l MIVNFSO'P.A RtiLFS 7672 (d submission type) . Residential Ventilation Category 1 Worksheet Submitted • New Energy Cotle Worksheet Submitled • Energy Envelope Calculations Submitted Plumbing Contractor: _ Phone # Plumbing system includes: _ Water Softener _ Lawn Sprinl:ler Fee: $90.00 _ Water Heater _ No. of R.I. Baths _ No. of Baths Mechanical Conhacfor: Phone # Mechanical system includes: _ Air Conditioning ree: $70.00 Heat Recovery Sys[em Sewer/Water Conhactor: Phone ri I hereby acknowledge ThaT I 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 OrdinanceN~~ Signature of Applicant el 4K,~. -----------------------------___._~..r._._.~.__.._~_~~_ OFFICE USE ONLY Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4/02 OFFICE USE ONLY ? 01 Foundation ? 07 OSplex ? 13 16plex ? 20 Pool ? 30 Accessory Btdg 1 ? 02 SF Dwelling ? OB 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi 0 OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-piex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (FOUndation) O 45 Fire Repair ? 33 Alteration 0 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement 'Demolition (Errtire Bldg onty) - 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 W idth REQUIRED INSPECTIONS _ Footings(new bldg) _ FinaUC.O. _ Footings (deck) _ FinaVNo C.O. _ Footings (addition) _ Plumbing Foundation HVAC Drain Tile Other Roof _ Ice & Water _ Final _ Pool _ Ftgs _ AidGas Tcsts _ Final _ Framing _ Siding Stucco Stonc _ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacemcnt) Insulation _ Retaining Wall Approved By , Building Inspector Base Fee Surcharge Plan Review MGES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total 1 2/84 ~ i CITY Or EAGAN oc APPLICATION FOR PERP4IT V • SEWER AND/OR WATER CONNECTIODT (PLEftSE PNINT) i !-~O PROPEFZI^! ADDRESS: &f0 - LdcSf" tS K h y ~.JGS~~ 4 tiy r.Frar. DESC2IPTICV: (Int/Block/Subdivisicn or TcLc Parcel I.D. Nhmi;,~,er) ~ gS'_'n.[.•CP'iZE, Drli=. 0_° ORIGiIAi., ciiII.DL:G ==__-1IT ISsz::'~Y=: :-'=r -e~; PDIESLT Z~=Nr,/P.?OPOS=E) L'SE: R-1 Si;GL: cPYSLY . ? R-2 DUPL{ (7%0 [,i?ITS) ? R-3 ZCFv~iE-ICJ~E ('SI'p~.F"-. + L':IITS) ( (JPIITS) ? R-4 APAR'?'~•"P/CO_aCi-.I`:IL~1 ( U~IZTS) ? CCl'-MERCL'-~L/RETAII,/OFFICc: ? Iti'DUSTIUAL Q IPiSTI'PuTIONAi,/GGVE,N^fE\7 2) APpLIC ~7r ~p (PLEASE PRlfii) I~'~SE: JdG. ADDRESS: ~13 3 L°tcPoh yUc S, CI'I'Y, ST=, ZIP: F~4yiftalrp 4 J SSeI~/ . PHOLNE: 431- aTOO/ 3) PLOcIEE2 ~'l (PLEASE PRiNi) fOR CITY USE O4LY MO Wr4 P/ K'h 6; F+G Z rC~ - PLUMBERS LICEtiSE: ADDRESS: /Y.~ ~ 8 ~3)- Av... 1?. my~_, Active CITY, STATE, ZIP: /'JjI!(J ,s;j YY/ 0 Ezpired -MTSicn Q Hot of Record PHOLNE: SS9- 3C7.r PLU,MBEfi LICENSE Ny7bLSl~'!3 o~1P ~ a nitta 4) OCC[IPAN'r/aq[,I&Tt DIAME (PLEASE PHI~~T) : ADDRESS: CITY, STATE, ZIP: 5°qM~ C2 ] Pf iONE : S) INDIC= [df-IICH PERPJLiT IS BEING RfQUESTLD: ~ CONNEC.TION 'IO CITY SEVIER ~ Cb N .ION 'IC) CITY hTA'PL:? ' ? dMII2 (PL.T11SE DFSCRIBE) 6) ITN:DIG,::: C.lE: ~ PI.EaSE f'.OID APPP,OVm PER.'~LIT FOR PICi:-UP BY ONE OF ~1BGVE ? PL£115E 6AIL APPR(7clm PER:%uT 'IO 1, 2. 3, 4 ABqVE (Circle one) 7) SICM'IG'RE: DATE: 67e.7X S.' 03e AW V! OI:R~M}ajO ~Nwi . . FOR C I T Y U S E ON;,Y PE4MIT = ISSUED F°rs= $ io s-O SE i•iER °ERMrT (I`IC'L:= SUP.C'~i?RGc.) $ ~D• WATER PERP1ZT (IiICL'JDE SiiRCF?Ac2GL.) $ 6-3,r •--d WATER METER/COPPERHORN/OUTSIDE REr;DcP, $ WATEP. TAP (INCLUDE CORPORATIOiV STOP) $ SE:dER T~P $ /3.-~--d ~r~~,i;_i•r .._=Gci= $ ACCOUNT DFpCiSIT - F7ATER $ Wi,C $ SAC $ TRGNIK WAT°R ASScSSh?E?iT $ TRli?:?{ SEPiER ASSLSSDIE'.`!T $ LATtRAL BEi•IEFIT/TRUPIR S-?':: R $ LATE?2r1L BENEFIT/TRUNK WAT°R $ OTHER ' $ TOTAL $ `-3 0~ ad P,1,10I:VT PAID;'RECEIPT R •-1 DOES UTILZTY CONNECTION REQUZRE EXCAVATION IN PUBLIC RIGHT OF WAY? ~ YES IF YES, THECI A "PERh1IT FOR 140RK WITHZN ~ PUBLIC ROADWAY" MUST BE ISSUED BY THE 0 NO ENGINEERIrIG DIVZSION. LIST AS A CONDI- TION. SUEJECT TO TF{E FOLL0:9ING CONDITIONS: • APPROVED BY: TZ:LE• DATE : e- f~ • ~y c.,tv cF eagan 3830 PILOT KNOB ROAD. P.O. BOX 21199 - BEq BICMOUiSt EAGFN. MINNESOTA 55121 n+wn PMONE: (612) 454$100 THpMnS EGAN JAMES A SMIiH JERRV TF10MF5 DATE 7 iHEOOORE wACNiER October 29, 1984 c~,,,1e11,ce„ iHL`MAS I+EpGES CiN /~-^SrtOttl EUGENE VAN OvERdENE SPECI.II. ASSESS}lE^IT SF~IRCH O~y 0.. Requested by: DAKOTA COUNTY ABSTRACT C0. RE= Westbury First Addition 1250 Highway 55-P.O.Box 456 Lot 3, Block 4 Hastings, ;IN 55033 1120 Westbury Path Enclosed herein.is the search which you requested made on the above described property. Kind of Imorovemenc Runs Beeinning Orieinal rlmoun[ Balance Due Siar Trk 15 yrs. 1985 $ 436.23 $436.23***, Watermain 15 yrs. 1984 68.71 59.55 Water Area 15 yrs. 1984 184.92 160.26 i I further certify that according to the records of said office, the following improve- ments are contemplated or pending after having heen approved and are nov in the process of planning or completion. Kind of Imorovement Anproximate Date of Comoletion Anvroximate Cost Utilities 1985 $6058 Street 2687 WAIVER: Neither the City of Eagan nor its employees guarantees the accuracy of the above infor- mation which was requested by the person or persons indicated. Nor does the City or its employees assume any liability for the correctness thereof. In consideration for the supplying of the indicated information in the above form and for all o[her consideratio of any na[ure whatsoever, any claim against the City or its employees rising therefrom is hereby expressly waived. Levied assessments to be paid to the CITY OF EACAN, 3830 Pilot Knob Road, P. 0. Bix 21199, Eagan, MN 55121. Very truly yours, SPECLAL ASSESSM£NT DIVISION 1HE LONE OAK TREE...iHE SYMBOI OF STRENGTH AND GROWTH IN OUR COMMUNIN 2000 BUILDING PERMIT APPLICATION (RESIDENTIAL) ~ bo• 50 CITY OF EAGAN ~q' I~ ~~lC l o 0 3830 PILOT KNOB RD • 55122 657-681-4675 ~ New ConshucMOn Reaulremenh „ Q~ 19(°l sd Bemodel/Reoair Reaulremenh ~ G..f ~ ? J reglateretl site surveys showing sq. 1f. of lot, sq. fl. 01 Iwuse 2 coDles of plan and gff rooled areas (2QX ma)imum lot coveraae allowed) 1 set ol energy calculatlons for heatetl atltlltlons > 2 coples o( plans (show beam & wlntlow sizes; poured fnd. tlesign; etc.) 1 sife suney lor extedor adtllNOns 8 tlecks Nh > 1 sef of energy calculations > S coplea of tree presenaNOn plan If lot plaftetl aHer 7/1/93 DATE: -7 I I"1 I OO CONSTRUCTION COST: aD, D00 DESCRIPTION OF WORK: fiIn.t S~n RQ l~[W1YXl~ If mulN-(amily bldg., how many unlfs9 SiREETADDRESS: 1120 lae-S~b~ PQ+fi I EQqaun U.-tgJ• 551d,3 ~ n LOT: ~ BLOCK: + SUBD./P.I.D. M: V&S'{"I4L1MI 1~1 4 VICICG*0-0 Name: DakeS '00Vl.Zr'1 Phone#: PROPERTY Lan Firsf OWNER 1 SheetAddress: ZQ wCst'bLJ?Ll/ PGt-4-h ciy Eo state: m/f z,a: 551 a3 Company:_ Phone a: (area code) CONTRACTOR Sheet Address: License # Exp. CMy Stafe: Zip: ARCHITECT/ ENGINEER Company: hJLA Name: Telephone C(/ ) Sheef ddress: ReglshaHon C rCly State: Zip: gh-~, Sewer/water licensed plumber (Ii installina sewerfwater): D'1'LU.n PVO PI UMb1 ?1 Phone U a 4 i,+`i Hh qhw Aye,4 tc,e.tn ~c~ I hereby acknowledge that I have read Mis application, sfafe thatthe in ortnation cortecf, and agree to eompry wflh a0 appGwble Sfate of Minnesota Statutes and Cify of Eagan Ordinances. Signafure of Applicant: OFFICE USE ONLY Certificates of Survey Received _ Yes _ No Tree Preservation Plan Received _ Yes - No _ Not Required OFFICE USE ONLY BUILDING PERMIT SUBTYPES ? 01 Foundation ? 07 05-plex 0 13 16-plex ? 21 Porch (3-sea.) ? 31 Ext. Att - Muld ? 02 SF Dweliing ? 08 06-plex O 17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 Ext. Alt - SF ? 03 01 of _ plex O 09 07-plex ? 18 Deck ? 23 Poroh (screened) ? 36 MuRi ? 04 02-plex ? 10 OB-plex )0 19 Lower Level ? 24 Stortn Damage ? 05 03-plex ? 11 10.plex PIbg4.Yor_N ? 25 Miscellaneous ? 06 04-plex ? 12 12-ptex ? 20 Pool ? 30 Accessory Bldg. WORK TYPE # 31 New ? 36 Move Bldg. ? 43 Reroof ? 32 Addition ? 37 Demolish (Bidg)' ? 44 Siding ? 33 Alteration ? 38 Demolish (Interior) ? 45 Fire Repair ? 34 Repair ? 42 Demolish (Foundation) ? 46 WindowslDoors • Give PCA handout to applicant for demoiition permit . GENERAL INFORMATION SAC Code 0 I # of Stories sq. ft. No. of Units Length sq. ft. No. of Buildings ~ Width Footprint sq. ft. Const. (Actual) Basement sq. ft. Census Code y.? (Allowable) Main level sq. ft. MC/ES System UBC Occupancy sq. ft. City Water Zoning sq. ft. Booster Pump PRV . Fire Sprinklered MISCELLANEOUS INSPECTIONS ? Stucco/Stone APPROVALS Planning Building /P-A- Engineering Variance Permit Fee Valuation: $ $O00 Surcharge Plan Review 7a6A 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 Units % SAC 3 L~ L BL CITY USE ONLY ) j~/ RECEIPT#: 1I SUBD. C^ 1. RECEIPT DATE: /7"II _ vU PERMIT# U/ 2000 PLUMBING PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 651-681-4675 Please complete Sor. ~yina.lP famiiv dw=ir.,..< J ? townhomes and condos when permits are required for each unit ? backflow preventer for underground sprinkler system FIXNRES EACH # TOTAL Alteretions to existing dwelling - minimum fee $ 30.00 Describe: Bath tub $ 3.OD x = $ Floordrain 3.00 x = $ Gas piping outlet ` mmimum - 7 3.00 x = $ Hot tub/spa 3.00 x = $ Kitchen sink 3.00 x = $ Laundry tray 3.00 x = $ Lavato 3.00 x = $ Septic System new/refurblshed • requires MPC lic. 75.00 X = $ Septic S stem abandonment 30.00 x = $ RPZ new instailationlrepaidrebuim 30.00 X = $ Rough openin 1.50 x = $ Shower 3.00 x = $ Under round sprinkler if dwelling is under construction 3.00 x = $ Undergroundsprinkler rfexistingdwelling 30.00 x = $ Water closet 3.00 x = $ Water heater 3.00 x = $ Water softener If dwelling under construction 5.00 x = $ Water softener if existing dwelling 30.00 X = $ Waterturnaround 30.00 x $ State Surcharge .50 $ .50 Total ~ e ~e~' • Reminder.• Call for inspections of alterationsy~'e~. wa~heat , wa~ r ft e, tc. -------------------------------------------------------------t' Lxl~---a~ -~.~--~_n_ here6y adcnowledge that I have read this application, state that the information is ecl, and agree f o wmpy w a I applica I e an ordinances. It is the apPlipnYs responsihility to notify the property owner that the City of Eagan assumes no liabiliry for eny damage used by the City during Rs nortnal opera6onal and maintenance ac[ivities to the facilities co structed under thi ertnit wit 'n City property/nghtoi-wayleasement. SITE ADDRESS: V C! ilZ OWNER NAME: : P v~ nGi TELEPHONE (AREA CODE) INSTALLER NAME: ~Y / 146 \ G ~ TE EPHONE I ~ (AREA CODE) STREET ADDRESS: r2 CITY: & STAT ZIP: SIGNAT F P RMITTEE c".1 RESIDENTIAL BUILDING PAlD WIAY 13 20% . Permit Application ~ City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5674 New Construc6on Reauiremenis RemodeVReoair Reauirements OKce Use OnN 3 registered site surveys showing sq. fl of IoL sq. ft. of house; and all mofed areas 2 copies ol plan CeA of Survey Recd (20 h maximum lot coverage allowed) 1 set of Energy CalculaGons (or heated addi6ons Tree Pres Plan Recd 2 copies of plan showing 6eam 8 window sizes; poured found design, etc. 1 site survey for addilions & decks Tree Pres Nol Reqd 1 set of Energy Calculations Addrtion - indicate iloo-sde septic sysfem _ On-site Septic System 3 copies of Tree Preservation Plan if bt platted after 711193 Rim Joist Detail Op4ons selectlon sheet (bldgs with 3 or less uniLs ~ i~2 Date O ~ / Construction Cost ~ Site Address f IAQ w,QSL~t(Jt.~.. ath~ f-I aK $5 ) d'~ UniUSte # Description of Work Aj~ Mul[i-Family Bldg _ Y v/ N Fireplace(s) 1 _ 2 Proper[y Owner L)B'L(,W //(,(,Lp,n Telephone k(6~J 1) Contractor IJI / , T(~. ~~61W 0" ' Address u/1f{) CitV State Zip 653/3 Telephone 9$z) 9.3J` '~(p(p~f COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Mmnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672 Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet (J submission rype) Submitted Submitted . Energy Envelope Calculations Submitted f~ n nI7 r; - Licensed Plumber kilephone J lll~ I:IA`~~ JI~ Mechanical Contractor i IJ~elephone ~ Sewer/Water Contractor BV_ `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. --t'( L Q J I~~h-S ( Applicant's Printed Name ApplicanYs ignature OFFICE USE ONLY Sub Types , ? 01 Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? OB 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 EM. Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screenlgazebo) O 36 Multi Misc. ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous Work Types ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement 'Demolition (Entire Bldg) - Give PCA handout to applicant Valuation Occupancy MClES 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 _ Foo[ings (new bldg) _ FinaVC.O. _ Footings (deck) _ Final/No C.O. _ Footings (addi[ion) _ Plumbing Foundation H V AC Drain Tile Other Roof _ Ice & Water _ Final _ Pool _ F[gs _ Air/Gas Tes[s _ Final _ Framing _ Siding Stucco Srone _ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacemen[) _ Insulation _ Re[aining Wall Approved By_ Buildina Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total öëö ðü ÿ þýý ðûüûü úýýüüøý ë ñ üý ú ñàñ þýö þýüûúùîý Ý ò ûúùöø ùîý Ý ò Þý ù ô ïý ô ëýü ã ÿþ ù ÿáäß ý ã ôîáõùô ßæêê õú þý ë îèæêäêä ôïóï öòñ ùù ãëöë ûë àü þ üý úë óôãöñ ãö áàñßñ ë üúø ë ëì ë ùù ëëé ô ôùúøëùùüþ éã þý òúé í ê ùù÷ ôþ ý ýúþ ý