1124 Westbury PathCARSON
SIDING & WINDOWS
6910 - 38th AVE S.E. • ROCHESTER, MN 55904
(800) 221-7111 • (507) 288-7111
FAX: (507) 288-6702
City of Eagan,
Larson Siding and Windows of Rochester, MN (state contractor #1482) verifys that the work at 1124
Westbury Path, Eagan, MN has been completed and up to code. We verify that we have flashed all (4)
four sides of each window at the address with an 1 1/2" flange.
Thanks,
Tim Meyeraan
Vice President
Larson Siding and Windows
507-288-7111 ext. 19
Jun.27. 2011 2:35PM LARSON SIDING & WINDOWS No.2781 P. 1/3
GA -S LA.ia
Date:
Cit of Eta! e.le.
3830 Pilot Knob Road
Eagan MN 65122
Phone: (651) 675-6675
Fax: (651) 676-5694
Tse
_71(1
Use BLUE or BLACK Ink
NOP:
Permit#:
Permit Fee:
Date Received_
qg
Staff:
2011 RESIDENTIAL BUILDING PERMIT APPLICATION
6 z 7 2 b / site Address: // 2 %Cel" 4 Unit 8:
J
RESIDENT 1
OWNER
Name: Iia l/vGt' 40f' 54err/ # 3734/1 54014 Phone: ‘Cf— _. go‘ ,
t` LA- / /
Address I City / Zip: / 2- T L*at( �T 4
Applicant is: Owner Contractor
TYPE OF WORK
l/ir?r / -
Description of work. �'�`:: ` �> s • "jMr an 4g tits. 4,1,0' rA �°�
�
✓
Corjstrucdfon Cost= 4" /114 5.'O Multi -Family Building: (Yes ---- / No )
CONTRACTOR
Company: c--A./t r I14, 4/18( /r+04contact: , 5+t«v 4141 t:e ill
6? /0 3Vi^ / Se City_ / c� 4CS'�4'r
�Address:
5'd'7' 2$'$?/!/
State: I A " Zip: 559 O 9r Phoneg12493262104/24112040.6
-~
License # / T 2 Load Certificate #: 1:—/ / 2"
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
in the last 12 months,
Yes _No If
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
has the City of Eagan issued a permit for a similar plan used on a master plan?
yes, date and address of master plan:
Licensed Plumber.
Mechanical Contractor
Sewer & Water Contractor.
Phone:
Phone:
Phone:
Nine Plans and supporting documents that you submit ane considered to be public information. Portions of
the information may he classified as non-public if you provide speciffc reasons that would permit the City to
conclude that theyOre *TWO $4901' .
CALL B FORE YQU. 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. ww.coopherstateonecall.orq
I hereby acknowledge& that this Intonation is Complete and emanate; that the work will be in conformance with the ordinanooS and codes of the City_ of
Eagan; that 1 understand thlS is not a pemut, but only an application for a pexme, and work is not to start without a permit; that the work wal be in
accordance with the approved. plan in the case of work ehIch requires a review and approval of pians.
n-tnger %
x'im
v
Appttcant a Prinfed Nam)
Sig
tg
A IicanCa
Page 1 of 3
~ CITY OF EAGAN SKM SuVm PBUM
3830 Pilot Knob Road
P. O. Box 21199 PERMIT N04: ~ 3~``
Eagan, MN 551;1 pA~ ~ - ~ ~
ZDni^o' No. of Unih:
Owner , osep i er
Address:
Sin Addmsc + t ury atn 1.4 B est bury
plumber ymout umb nF Lnc.
I - . ,c
~d I
"WIf wil6 !M Cihr oi ~m ConrAKHon aarge; 425.00
I OrliM.as. Account Depoew 1~. O,~pd ,
~ Permlt Fw: r' ` I
i Surchor+pe. . y pr.
II By Mim Charpm ~
f Dote of Irup.: ToNol:
~
~ I"six: ' Dote Pald:
CITY OF EAGAN WATER SERVICE PERMIT
3830 Pilot Knob Road i;119
i P. O. Box 21199 PERMIT NO.:
Eaqarr MN 55121 qATE: 35
`'ti
Zoninp:
Ownwr: Joaeph Nl6~er~~ 4'" ~ • ~
~m~ '1lifBS ~
1124 Wea ~ify Patii-L4 B4-14e;sUniry 1 plumber. :'.lvrnoutti P1uc6in- Inc f
Mew No.• 3 Connectian Charps: 5C0. UO ad
- A~an,t Depostr: 15.OOv~i
Reode No.: -/!1 L. 02f 7' Pertnit Fee: l0. 00pd
1o~ te a~pl~r wp6 fM CMp of Ep~w Surcho~t: . 5~ F'"
Onl Misc. Charo.s: 132.00 ~d ~
~ Totpl; 5 3. 00 !(i ma r,=I-
8y Dcte Poid:
Dote of Insp.: Inq.:
G 7 85
, 1 , •"L. • -
PERMIT #
MECHANiCAL PERMIT RECEIPT # '2
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE:
CONTRACT PRICE: PHONE: 454-8100
Site Address ~ 14 's " BLDG. TYPE WORK OESCRIPTION
Lot Block. 4 Se~/Su Res New
• M ult Add-on
~ Name ` Comm. Repair
Address t 'e Q
~ Other
c City Phone 412-tlll
FEES
Name RES. HVAC 0-100 M BTU -$24.00
c Address LA) e J't ~ ~ c+ 7-/, ADDITIONAL 50 M BTU - 6.00
3 R(RES. HVAC INCIUDES A/C ON NEW
p City Fa~- Phone - S o ir' CONSTRUCTION)
GAS OUTLETS (MINIMUM -1 PER PERMIn - 1.50 EA.
TYPE OF WORK COMM/IND FEE - 146 OF CONTRACT FEE
Forced Air M BTU APT. BLDGS. - COMM. RATE APPLIES '
TOWNHOUSE 8 CONDOS - RES_ RATE APPLIES
Boiler M BTU -It MINIMUM RESIDENTIAL FEE - ALL ADD-ON 8
Unit Hester M BTU REMODELS - 12.00
r Con._ M BTU MINIMUM COMMERCIAL FEE - 20.00
-STATE Sl1R_CFIARGE P~Ei PERMIT - 50_
~ P~AM(fi PRfCE -
Gas Piping Outlets # BEYOND $1,000) ~
Other
FEE
5° -
S/C: ' M EE
TOTAL
7*~
FOR: CITY OF EAGAN _
CITY OF EAGAN
.
3830 Pilot Knob Road, P.O. Box 21-199, Espan, MN 55121
PHONE: 4648100
eU1LDING rERMtT Rec.e+at ~F -
To M~ 1~r Est. Volue ~ 7, l: -1' C' pate o•? L 1 r 19L)_
1124 ';iESTF(3?Y Ereet Ll Occupeney
Site Addrpu
LOt Block swr/~..b, i,l I': :i !JP, Y I. RKnodel ? ZOniny f:.1
PrcN No. Repair ? Type of Const. V
Enlupe ? No. Storia
,C P•t? F;.c,r~ CCNST Move O l.enpth
~ EN*m* Gmalish ? Depth 3 5
::.~iJ' 1~~,s6C Gnde ? Ft.
, Phons Inttall ?
~ Name APMo"b fen •
~ Addrou Assessmnt Permit atiq
~
~ city Phone woter & Sew. surchorge 23, 5 0
~ Poliu Plsn Review 'i 2• 4 0
W
~ Narne Fin SAC ~
W
Addrw Enp. Wafer Cann.
a~ City Phone Plorrrr Wcter Mebr
Counc.il Rood Unlt
I heeieby ocknowlodye thot 1 how rood this applicotion ond sto» that Bldy. Off.
fhe inlorrnofion is oorrect ond oqne to canply wlth oli opplicoble
A~ Toul
Sroh of Minnesoco Stetufes and Gty of Eoqon Ordinonces.
Vw. Wte
Si9nofuro of Pennift«
A Suildinq Ptr+nif it iuwd to: 43`.t CO an tM expma tadltbn Ihor
oll work shoU be dorn In accorda+ce with oll appliooWe Stole of lWevasoto Stoeuta ad Gfy of Eopan Ordinonus.
/uildinp Offkiol _
Pwmk No. hrmft Holdw DOb T* hon* *
~umbing z ~ r a y.os~
H.vA.c. 5?~ Cc;?•.~w ( C-d ' lo -
sofa~».
Irapeetion Oa" Imp. Otha
Footinp
Foundation
Fnmie9
RooHny
Rou4A Pft
Rouqh HVA
lmultti°n r
FinN Plbg
Final NVAC
Finol
c«vooa. C o 4
wm. DNerfbe Loestiaer
Wrll
8wrw
P~. Dhp.
Rooeipt i MECHANICAL PERMIT Pennit No.
CITY OF EAGAN
FN.
Fill in rwmbered waccer S/C {
ryps or Print legibl y TcrL j
~
1. Date > 2. Installstion Cott ;
~
3. Job Address ~~11 Lot ' Bik. Tract ;
4. Owner
1
b. Conuactor ' Phone ~
1
,
~
6. Address
~ 7. City State Zip ~
I
8. Buildinq Type: Residsntiel Q- Commeraal O inttitutional ? i
i
psir
9. Work Desaiption: Naw 0 - Add O Alter 0 Re 0 ~
. =i
I
; 10. Oesaibe Fuel Type 1
~
11. No• EquWmmt BTU - M. Ea. No. Eauioment CFM
- ~
; Forad Air A ir Handlinp: 1
~ Mfg•
Boilns Mach. Exhaust ~
Mfg. ~
Unit Flater
Mfy. Other ~
A1 r Cond.
Mfp.
Gat, Piping Outlsts
12. 1 heroby certify thet the above information is true and oorroct, and I aprse to
oomply with all ordinancas and codes goveminq this type of work.
Signed' • ~__e. for
Rouph Final
Inspactions: Date Insp'. Date Insp.
This is your psrmit when numbered and approved. ~
APProved CITY OF EAaAN 464•8100 j
Repipt PLUMBING PERMIT Pennit No.
CITY OF EAGAN -
Fee
fill in numbered apvacss S/C
Typs a PYini /eyibiy TOL
1. Date 2. Installation Cost
3. Job Address ' Lot Blk. Tract "
4, Owner
6. Contractor Phone
6. Address
7. City State Zip
8. Buitding Type: Residential O Commercial ? Institutional ?
9. Work Description: New O Add O Alter O Repair ?
10. Describe
11. No. Fixtures No. Fixtures
~ Water Goset Cesspool/Dra+nfield
F Bath tubs Septic Tank
Lavatory Softner
ShOwer Well
Kitchen Sink
Urinal/Bidet Other
Laundry Tray
Floor Drains
Drinkinp Ftn.
E Slop Sink
Gas Piping Outlets
12. I hereby certify that the above information is true and oorrect, and I agree to
' comply with all ordinances end codes governing this type of work.
Signed : for
Rouyh Final
Inspections: Date In:p. Date Insp.
This is your parmit when numbered and approved.
Approved CITY OF EA(iAN 4544100
CITY OF EAGAN N2 1 0 1 0 1
3830 Pilot Knob Road, P.O. Box 21•199, Eagan, MN 55121
PHONE: 4548100
BUILDING PERMIT ReceiPt #
Te M mnd fw SF DWG/GAR Est. Value $57,000 pate APRIL 15
SiteAddreu 1124 WESTBURY PATH erect C}t occuPancv
4 Block 4 cec/Sub. WESTBURY I Remodel ? Zoning Rl
Lot
Percel No. Repeir ? 'fype of Conat. V
Enlarge ? No. Stories
JOE MILLER CONST ~'love ? Lengtn 50
~ Name Demolish ? Depth 35
Addrees 18133 CEDAR AVE SO Grede ? Sq. Ft.
city FARMINGTON pnone 431-2001 Install ?
Neme SAME Avnrorab Fees
Z~
JU4 0
ou A~rm .~ssessment Permit '
V? Citv Phone Water 3 Sew. Surcharpe Z 8- S 0
~ Police Plan Rewew 192 _ 00
°L Neme Firo SAC 525 _ 00
~W
Atldrefe Enp. WaferConn. 500 nQ
4 W City Phone Plonner Waler Meter c -1 n Q
Councll Raod Unit 9Rn np
I hercby ocknowledga that I hove raod this applicotion and stofe that Bldg. Otf. 4 I S $ rJ T. P. 132 _ 00
tM inlormolion is correct and ogree fo comply with oll up0lic A~ Totel 1 qRd Sfl
Stota of Miniusoto Stotures an 'ry of Eaqo rdirances , ~zl Var. Date
Sipnafuro of PermiMaa ~
A BulldinQ Vermit Is iuued to: JOE MIL R CONST-eb on tha a:Dress conditlon Ihot
oll work sholl be doro in accordance with ailV Ip~pp~ imb~le ate o inte Seotutes ond Ciry of Eopan OrdinanceL
Bufldlrq Of/icfal ~"O-~n A
_cnvAN Remarks /?/f// rl:~i~
~ WESTBURY FIRST ADDITION
Addition Lot 4 Blk 4 parcei 10 83650 040 04 ~T
owner screet 1124 Westbury Path state Eagan, MN 55123
Improvement Date Amoun[ Annual Years Payment Receipt Date
STREE7SUFF. 1986 2$5~. 2850.00 A015801 -1
STREET RESTOR.
GRADING
`,+N7 133.79 11
SAN SEW TRUNK 1985 436.2 0 .1 11
SEWERLATERAL 1986 500$.73 5008.73 " "
W ~ 4 65.29 If
WATERMAIN &Z 1994 15 59-55
WATER LATERAL 1986
WATER AREA 12 33 15 160 . 28 It
*Seryirpt;
STORMSEWTRK 1986 ]10.24 142.010.2 11
* STORM SEW LAT 1986
CURB & GUTTER
SIDEWALK
STREET LIGHT
Road Unit . 50913
WATER CONN. ,
BUILDING PER. ZOLOI.
SAC
PARK
2004 RESIDENTIAL BUILDING PERMIT APPLICATION
L 14 City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construction Reauirements RemodeVRewir Reauirements Office Use OnN
3 registe2d site surveys showiig sq. fl. of lot sq. R. of house; and all roofed areas 2 oopies of plan Cert of Survey Recd _ Y_ N
(200h mazimum lot cove2ge allowed) 1 set of Energy Calcula6ons for heated addillons Tree Pres Plan Reod Y_ N
2 cnpies of plan showing beam 8 window sizes; poured found design, etc. 7 site survey for addrhons & decks Tree Pres Required _Y _ N
15elofEnergyCalculations Addifion - indiceteilon-sifesepficsystem On-siteSepticSystem _Y _N
3 copes of Tree Preservation Pian 'rf lot platted after 711193
Rim Joist Detail OpGons selection sheet (bldgs with 3 or less unils
Date / /b / Dq Construction Cost ~~Z~J
SiteAddress _112-V W~:3/3-4y Unit/Ste #
e l~. N1
Descrip[ion of Work 645 1)5(_
Multi-Family Bldg _ Y~ Fireplace(s) _ 0CD _ 2
PropertyOwner Telephone#((p4V ) 'KZ'$0(o~
Contractor L F~ ? ~~L~ ~ E l"~
Address MSI> W~ 1~jy /~j City 1011664-S
State Zip ~W3Y? Telephone # ( 9SZ) ~J'V7~
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Code Category . Residential Ventilation Category t Worksheet • New Energy Code Worksheet
(Jsubmissionlype) Submitted Submitted
• Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar planZ _ Y _ N If so, 25% plan review
fee applies.
Licensed Plumber Telep
Mechanical Contractor Teleph MAY ]~'•0 2004
Sewer/Water Contractor Teleph ne )
B
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 d work is not to start without a
permit; that the work will be in accordance with the approved plan ' the case f ork thich requires a review and
approval of plans
~
0 o~
ApplicanYs Pnnted Name Appli ant's Signature
OFFICE USE ONLY ' -
Sub Types
? Ot Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 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 Porch/Addn. (4-sea.) ? 33 E#. 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 Pibg_Y or_ N? 25 Miscellaneous
Work Types
? 31 New O 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Addition ? 36 Move Building ? 42 Demolish FoundaGon ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement 'Demolitlon (Entire Bldg) - Giva PCA handout to applicant
Valuation Occupancy MCES System
Census Code Zoning City Water
SAC Units Stories Baoster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) _ FinaUC.O.
_ Footings (deck) _ FinaVNo C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & Warer _ Final _ Pool _ Ftgs _ Air/Gas Tests Final
_ Framing _ Siding _ Stucco _ Stone _ Brick
_ Fireplace _ R.I. _ Air Test _ Final _ Windows
Iusulation _ Retaining Wall
Approved By: , Building 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
~
~
7985 BUILDING PERMIT APPLICATION - CITY OF EAGAN
NOTE: ALL CONTRACTORS MUST BE LICENSED WITH THE CITY OF EAGAN
INCLUDE 2 SETS OF PLANS
3 CERTIFICATES OF SURVEY
1 SET OF ENERGY CALCULATIONS
,a~. ~
5-
To Be Used Eor: Valuation: ~ Date: 3-Iq46
Site Address: 1124 Vf Q, OFFICE USE ONLY
Lot: ~ Block 4 Sect/Sub f-'Erect X Occupancy
~ Remodel _ Zoning ~-I
Parcel li Repair _ Type of Const ~
Enlarge IJ of Stories
Owner Move Length ~U
Demolish Depth 37-
Address Grade Sq Ft
City/Zip Code
Phone APPROVALS
Contractor Pud" Assessments Permit
Water/Sewer Surcharge 28 $O
Address Police Plan Review
Fire SAC SZS
City/Zip Code Engr Water Conn ~cb.
Planner Water Meter
Phone Council Road Unit Zgp.
Bldg Off _q?arks
Arch./Engr. APC Treatment Pl
Variance
Address TOTAL
City/Zip Code /
Phone ll
_ . , . . . . ~
;v~ ~ . ••~h[...~.'n.: .
_r~u_~..._~_._.~.~._.__.._.r.~__...~..:?r..f:s~.~.a
~ ~Certifiaate fort Bk: 81/74
Joe Millsr Const. Co.
18133 Cedar Avenue soutR
Farnington, Mn. 55024
DELMAR H. SCHWANZ
{.ANDSUNVEVOR 5, IU(„
RpIrtMW UnYb Laws 01 Th*Ststo O/ Minnosot•
lY)! - 146TH STREET W. - SO% M RO{EMpUNT, MINNESOTA 66088 VHONE 612 4231769
SURVEVOR'S CERTIFICATE
~ T B w~Y ~?°rTH
0 ~ToPG.eb To~~`+R+ m
/6a. s A1z,7
-J6500 ~B9°4Z Z7"li( 1) Plan 83-102 Arcadla I
Elevation D
2) Pront eetback stakes
are on baeement
r a t~ ! I o ~ Plait.
. Tpp Oua _ . y I
te~ldb
2Y
Z,
1 Prpp" I ,
• . ` 0' ~ ,"u0ara6e
Neu" I
•fS,<J ..;'jt¢ ` ..i' . .
,
~ *~'-1~ '~I ~ ~ ~
s., . I UP _ . . _ . - . . _ _ .
~ ti InG
O - Property corner "
p
g g J~ p O- Set wood hub
~ , Q ~ Q =J - Existing elevation
Proposed elevation
: o V1 ~
LAT '
?l.?T'f
; Ik•',: ~ ~ E0~5 `Wl~JT ~ r,'' '
885-7 ~ Proposed garage floor elc:vation
.i. . ' ~ V V S59O4%,Z-1M ry ~
f
I hereDy ceztify [hat thia ia a true and correct representation of the following
described tract of land:
Lot 4, Block 4, WESTBURY FIRST ADDITION, according to the recorded plat thereof,
Dako[a County, Hinnesota. ~
Aleo ehoving the,location of a proposed houae as ataked thereon this ThlZ`d
, day of ;pril , 19 85 .
.
, ,
~
P
~ 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
cirr oF EncaN
~ L 3830 PILOT KNOB RD - 55122 (o - j c7 ~
651-681-4675
New Conshuctlon Reaulrements Remodel/Reoalr Reaulremenh
? 3 reglslered sNe surveys showing sq. R. of lot, sq. R. ot house 2 copia of plan
and QII roofed areas f20% maximum lot coveraae albwed) 1 sef of energy calculaflons for heated addRlonf
? 2 coples of plans (show beam 3 window sKes; poured fnd. deeign; etc.) 1 fHe survey for exterlor addNlons a decb
> 1 3ef of energy calculatlons
i 3 coplef of hee presenaNon plan fl lot platfed affer 7/1/93
DATE: Y g CONSTRUCTION COST:
DESCRIPTION OF WORK: /ti e' roo~ ~ E4Y O 7 "r SAiD1f W\- CQ-QA }'Vk, GL--A ~C.
STREET ADDRESS: s`i u r
LOT: ^1 BLOCK: ~ SUBD./P.I.D.#k: WI-~
Jd~v.So~ .Dav1':4' Phonelk:(6y"/~ -o°dG-~
Name:
PROPERTY last Ptrs1 n
OWNER ~ f\
Sheet Address:
City kG v~ State: Zip:
Company:krh ~ia~ Phonelk: yS3~~y~0 _
(area code)
CONTRACTOR
Sfreet Address: License 16 9 70 3 E~Cp. 3 3~
~77y~ 06 ?F
City ha ~ rrovF State: ZiP: S~36F
ARCHITECT/
ENGINEER Company: Name:
Telephone #1: area code ( )
Street Address: Registration
City State: Zip:
Sewer S water Ilcensed plumber (reaulred for new eonsfructlon onN):
Penalh/ applies when address change and lot change Is requested once permM Is issued.
I hereby acknowledge that I have read thls appllcaflon, state fhat fhe InformaNo t, a d agree to comply wMh all appUcabl
State of Minnesota Stafutes and CMy of Eagan Ordinances.
i
Signature of Applicant
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No
Tree Preservation Plan Received _ Yes _ No _ Not Required
OFFICE USE ONLY ,
BUILDING PERMIT TYPE
? 01 Foundation ? 06 4-plex ? 11 10-plex ? 16 Fireplace ? 21 Porch (3-sea.)
? 02 SF Dwelling ? 07 5-plex ? 12 12-plex ? 17 Garage ? 22 Porch/Addn. (4sea.
? 03 1 of _ plex ? 08 6-plex ? 13 16-plex ? 18 Deck ? 23 Porch (screened)
? 04 2-plex ? 09 7-plex ? 14 Apartments ? 19 Lower Level ? 24 Storm Damage
? 05 3-plex ? 10 8-plex ? 15 Lodging ? 20 Pool ? 25 Miscellaneous
WORK TYPE
? 31 New ? 35 Tenant Impr ? 39 Gas Line Only ? 43 Siding/Soffits/Fascia
? 32 Addition ? 36 Move Bidg. ? 40 Gas Insert ? 44 Windows/Doors
? 33 Aiteration ? 37 Demolish Bldg.` ? 41 Wood Stove ? 45 Fire Repair
? 34 Repair ? 38 Demolish (Interior) 0 42 Reroof
' Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. Census Code
(Allowable) Main level sq. ft. SAC Code
UBC Occupancy sq. ft. No. of Units
Zoning sq. ft. No. of Bldgs
# 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 Units
% SAC
z/sa
~
CITY OF EAGaN
APPLICATI^vN FOR PERMIT
• SEWER AND/OR WATER CONNECTIODI
(PLEdSE PRINi)
1) PP.OPER'I^L ADDRESS: 11,2 `I
t.Fr=,L DE..~IPTICN: y c/
(LOt/Block/St:bdivision or TaY Parcel I.D. N=ber)
~ I"r DaT' O° OR?G, IAL ci;IiCS::G :.j_j5:
PDFS= zTriF;/'-~.°.OPOSED US: ? R-1 Si•;GL: FPMffLY
? R-2 CUPT = ('!r;a L^?ITS)
0 R-3 1Cr:-,L,~?CUcr (mc= + LMITS) ( L~II"S1
? :Z-4 LIMITSi
Q CCi•n=CI'yL/RE.':FiIL?0i-`'ICE
? L\'DliST?,LyI,
? INSTI:L'I'I0:]AL/GOVTERN~~=T
2) APpLiG yT (PLEASE FRlfii)
N7t4E: O<-
n.neREss: Z.51133
CITY, STATF.', ZIP: ~-y¢H,,, evs~a? /ylt) 65o171,
.
PHOLNE: `f3/ -,'w'j /
3) PLL?lE?ER r----- - - - (PLEASE- PRlNiJ FOR CITY USE O4LY
NPl : !'KO 4. 11~j lu m 4s i N Tr.-c.- /
PIUHBERS LICEBSE:
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Active
CITY, STATE, ZIP: ~~.y yte4~, NI? S,S'yly/ Expired
Not of Retord
PHONE: 6-57-36-26 PLUMBER LICENSE N jo6S /y/3
arr ntcia
Q) O=p,NT/a,7NER N71ME: (PLEASE PRttlT)
ADDt2ESS: su~
CIT'!, STATZ, ZIP:
PHONE:
5} II`1DZC11'I'E WE{ICI3 PERNIIT IS BEI\G REQUESTID: ,
CE CU"INECTION 'IO CITY SD1ER
EL COmNEC:IQ:1 'IO CITY T9ATL:R
? U"i[1ER (PLL'ASE DESCf2ZBE)
6) PidDZG=M C:+E: -
tj-PLEaSE f?OID ApPRWID PEFL'rLIT FOR PZCF:-UP BY ONE OF A&NE./
? PLEY1sE ^AIL RPPROVED PFF:-uT M 1. 2, 3, 4 AFOVE
(Circle one)
71 SICM[.°RE: DATE: a~/~;(,z6y $'S
OR~! AiI-YOA i~ i~l o lY.aaF~ ! i I'f iii~Fa~Y M s~~s~:~ a 1e !l:1R:a YliFi a~!~ i aRia[aw
F 0 R C I T Y U S E O N L Y
PERMiT ISSUED
F°-'35= $ I0•SU SEi•iER Pj:a>11m IS`]CLi;D° SU°C-?.RGc)
$ /CJ.S U WATE-1, PERl}1T_m (IiiCL'uDE SI;RC??ARGc,)
$ ~a~•v0 WATER iyETER/COPPERHORN/OUTSIDE READER
$ WATER TAP (INCLUDE CORPORATZON STOP)
$ SE;iER T.aP
$ A-1 ?U nC_-C'i;:~'=' :~Z-,GSi_ -
$ /.S°O ACCOliNT D.F.POSIT - Wr`,TE3
$ __S-00. U-0 WAC
$ -5:2 S -o U Sr`_C
$ TRlii•]K fdATER ASSESSi•!E:;T
$ TRCi't:K SE?;ER ~lSSESSbiE?iT
$ LA:EPr1L BE:•iEFIT/TRU`iK SEWER
$ L?.TE4rlL BENEFIT/TRUNK IdAT°R
S ~~.2.0 U OTHER '
$ TOTAL
$ ~r~,IuU AMOli:v'T PAIDjRECEI?T
DOES UTILITY CONNECTION REQUIRE EXC;VATION IN PUBLIC RIGHT OF WAY?
~ YES IF YES, THEN A"PERMIT FOR ;aORK L9ITHIV
PUBLIC ROADWAY" MUST BE ISSUED BY THE
[;;~NO ENGINEERING DIVZSION. LZST AS A CONDI-
TION.
SUEJECT TO TEfE FOLLOS9ING CONDITIONS: •
APPROVED SY: ~
TITLE:
DATr :
~
CITY USE ONLY
L 8L ~ RECEIPT#: I3SSr77>
sUao. Vve.C ~b ur~ ~ S r RECEIPT DATE: g g' OV
PERMIT # u~ ~ a z
2000 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAC.AN
3830 PILOT KNOB RD
EAGAN, DIIi 55122
651-681-4675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
D backflow preventer for underground sprinkler system
FIXTURES EACH ll TOTAL
Alterations to existing dweliing - minimum fee $ 30.00
Describe:
Bath tub $ 3.00 x = $
Floor drein 3.00 x = $
Gas iping outlet ' minimum - 1 3.00 x = $
Hot tub/spa 3.00 x = $
Kitchen sink 3.00 x = $
Laundry tra 3.00 x = $
Lavato 3.00 x = $
Septic System newireturbiahea • requires MPC Iic. 75.00 x = $
Septic S stem abandonmenl 30.00 x = $
RPZ new installationlrepair/rabuild 30.00 X = $
Rough opening 1.50 x = $
Shower 3.00 x = $
Under round s rinkler if dwelling is under constiuction 3.00 x = $
Under r0und Spfinkler if existing dwelling 30.00 X = $
Water closet 3.00 x = $
Water heater 3.00 x = $ 3-00
Water softener If dwelling under conatructlon 5.00 x = $
Water softener ir exisetn9 dweuine 30.00 x = $
Watertumaround 30.00 x = g
State Surchar e .50 g 50
TOtal $
Remfnder: Call for inspections of alterations, i.e. water heaters, water softeners, etc.
I ~ereby adcnowledge that I hava read this appliwtion, steta that fhe Infortnation Is corrod, anC epree to comply wiN all applicable City of Eagan ordinances.
N is the appiiwnt's rasponsibility to notify the property owner that tha City ot Eagan essumes no liability for any damages causad by the City during its
nortnal oparetionat and maintenance activifias lo the tacilitias constructed under thie pertnit within Ciy property/righ4of•wayleasement.
SITE ADDRESS: JOHNSON, SHERRI
1124 WESTBURY PATH
EAGAN, MN 55123
OWNER NAME: : _ (ssi) asz-eoss TELEPHONE
(AREA CODE) '
INSTALLERNAME: ~10R05LOm FL MPSI 1 l.U TELEPHONE 60 R27' `103Z!~
C
STREETADDRESS: f-.LLS ~?LC ~70 (AREA CODE)
.
CITY: MlAJ AJ EA}~2OL-~ STATE: IOAJ ZIP: 5SJ08.
~
SIG~Pfl~I'URE OF PERMITTEE
z _<A 3a.s~
2005 RESIDENTIAL MECHANICAL PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete for. single family dwellings & mwnhomes/condos when permits are required for each unit
Date 7 / J* / / Z4 os-
Site Address ~~2 y WC S,~4 4~ L(.~'<s 169,&*4 Unit #
Property Owner r(/ A~j j 4 h^'yTelephone # ( ~pJ'I ) YS'-L - pa 6 G
Contractor ANGFLL AIRE. IVC.
-IZZOU Nico et vM Street Address BUf11SVlllB, MN SM City
,
State Fax: 952-74842W " Telephone # ( )
Bond /3 Y7~2z / Expires: 4 ZZ~Or
The Applicant is _ Owner X Contrac[or _ Other
Add-on or al[eration to existing dwelling unit $ 30.00
4_1 furnace _Additional -A-Replacement
air exchanger
~ airconditioner _New ~Replacement
other
State Surcharge $ .50
Total
I hereby appty for a Residential Mechanical Permit and acknowledge that the information is complete and accurate; that [he work will
be in conformance with [he ordinances aod codes of the City of Eagan and with the Mechanical Codes; that I understand this is not a
permit, but only an application for a permit, and work is not to start without a permi[; that the work will be in accordance with the
approved plan in the case of work which requires a review and approval of plans.
y ~7TJle 2". ct n
Printe'd Name ApplicallA Signature
Lr~ ;EP 2 0 2005 'lllll
---J
2005 COMMERCIAL MECHANICAL PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telep6one # 651-675-5675
Please complete for. commerciaUindustrial buildings
multi-family buildings w•hen separate pertnits are not requirod for each dwelling unit
Date
Site Street Address Unit #
Tenant Name (ifapplicable) Previous Tenant Name
Property Owner Telephone # ( )
~ : ~ •
Contractor Y~ .3r~~ ::A . ,
~tl118';. ~S
Street Address City
d.r,'1p•- r
State Zip si~;Lelephone )
Bond Expires:
The Applicant is _ Owner _ Con[ractor _ O[her
Work Type
New Construction _ Underground Tank _ Install _Remove "see below
Interior Improvement _ Install Piping _Processed _Gas
Nature of Work:
"When instalJing/removing underground tank, call for inspection by Fire Marshal and Plumbing /nspector
Perrt1il F¢C5: 570.50 Underground tanA installalion/removal
$50.50 Mrnimum (includes State Surthargc)
ar
Convact Value $ x I% Permit Fee
• If ep rmit fee is $1,000 or Iess, add 5.50 ~ $ State Surcharge
If e~rmit fee is over $1,000, add $.50 for
every $1,000 pe rmit fee $ Total Fee
I hereby apply for a Commercial Mechanical 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 wi[h [he Mechanical Codes; [hat 1 unders[and [his is
not a permit, but only an application for a permit, and work is not to start without a permir, that the work will be in accordance with
the approved plan in the case of work which requires a review and approval of pians.
Applicant's Printed Name ApplicanYs Signamre
Approved By: , Inspector Date:
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA115789
Date Issued:09/30/2013
Permit Category:ePermit
Site Address: 1124 Westbury Path
Lot:004 Block: 004 Addition: Westbury 1st
PID:10-83650-04-040
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar.
Pictures are not acceptable in lieu of inspections.
Carbon monoxide detectors are required by law in ALL single family homes .
Marcia Johnson
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 -
David P Johnson
1124 Westbury Path
Eagan MN 55123
Lindus Construction
879 Hwy 63
Baldwin WI 54002
(715) 684-4647
Applicant/Permitee: Signature Issued By: Signature
City of Eapu
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651).675-5694
RECEIVED
MAR 2 8 7n14
Use BLUE or BLACK Ink
For Office Use
Permit#: 21 ( t
Permit Fee:
Date Received:
Staff:
2014 RESIDENTIAL
PLUMBING PERMIT APPLICATION)
Site Address: [(Pi W/h 1€'L44 PQ / rn- �, d"5Tegi
Date:
Tenant:
Suite #:
Address +City / Zip:
Address:
1801 50th Street East
State: MN Zip: 55077
Phone:
_ Rebuild _ Modify Space _ Work in R.O.W.
Description of work:
RESIDENTIAL
Water Heater
Lawn Irrigation L. RPZ / PVB)
Septic System
New
Abandonment
Water Softener
Add Plumbing Fixtures (- Main / _ Lower Level)
Water Turnaround
RESIDENTIAL FEES:
$60.00 Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)
$60.00 Lawn Irrigation (includes $5.00 minimum State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5:00 State Surcharge)
*Water Turnaround (add $200.00 if a 5/8" meter is required)
$115.00 Septic. System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge) kern:' TOTAL FEES $
CALL BEFORE YOU DIG. Call Gopher State One CaII 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. gooherstateonecall.orq
I hereby acknowledge that this information is complete and accurate; that the work wit 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.
4l//, nil
Applicant's Printed Name