3921 Westbury Way
CITY OF EAGAN smm SMKE PERM +
3830 Pilot YCnob Road ? ~~~7
P. O. Box 21199 PERMIT NO.:
Eagan, N.N 55127 DATE; l t--? :
•
ZonInO: ~ No. of Unlti: ~
Owner.
Add?ess:
Sttt Addresr 3921 --4--5t::)i , rv -rzy
PiW11bAr
I aw. !e eomm1y wob tw cM, ii ag.. connKti«i aww: k l 5. L 0'-'c!
Aooount peposit;
Pamdt Fw:
SurrHorpe;
BY Misc. Cinrpm
Dote of Inap.: Totol:
Irup.: Dvh Pdd:
~ - - - - - -
CITY OF EAGAN WpTO SERVICE PERMIT ~
~ 3830 Pilot Krwb Road '
j P. O. Box x:1" , PERMIT NO.: '
; Eagan, MN' 55121 D^TE:
,
~ Zonlrg: _ No. of Ur?its: '
f OwrMr. F7'oI2'!e; F?
AddMm: ~
I ~t'R ~'~wfM~: 37L1 ~ Sl~ ~ I
, Pluniber. ~;~t'~ r r ~ • , i
~ Mattr No.: -5 49 3o ~ i SJO.OO: r;~ '
~ SEze: " , ' 15.QO•>_: j
~ Reod~r No.: 09rm 9'/ ~S S6 Poerrrdt Fee. 10 . OUrx; I
. - ;
;
1 qrN ft sswpy? wNb Nw Citi of aYN¦ surchorpr . 501Y3
~ ?Ntsc. Chory.s: 132.OOixi '.:fi I
Total: 63. ('Cv,: ? r~ie1.-•,:~
~ BY Doft Poid: I
, Doft of Insp.: 7..7-
~
~
CiTY OF EAGAN 10790
3830 Pilot Knob Road, P.O. Bax 21-199. Eagan, MN 55121
PHONE: 454-8100 ,
; aviLoING rErtMIT RKeia ~
T• M wW lm o' UWG; 3Aii Est. V ue ,0(` Q Dore Jli it: r J;' I= 19 c S
Site Address 39s"'.1 WFSTI3 t1 I: Y Erect 6a Occu pancy
~ot Block ~ ~/Sub. :3ESTg~'RY 4 Remodel ? Zoning
Repair ? Type of Const. ~
Parcel No. AddRion ? No. Stories
i R;.:t,.`'i'IER MIUWES`' H0I4F:.5 PMove ? l.ength 4 i,
°t N°mg Demolish ? Depth
~ Addreas 39J S:I.F3 tA'l~:t•i Ili~titi E: Intlmpc ?
~:AG.NN 454-0 9 ;i sa. Ft.
City Phone Install ?
Name Aopeo•ab - -Fees
u~ Address Assessment Permit 0.00
Woter 6 Sew. Surcharye 29. 51!
F City Phone
~W N~a RIC~iARL CH.ARL I FR Fin police P ~IeC Review
4~ Addreu .14103 1' Enp. water Cona 5 0~.~, l.
~ W City `s ' ' Phone 4 3 " - Plonrw Water Meter 63 . C ~ CoWxil Road Unit 280. 1l : )
( hercby ocknowtedgo that I how read this appl ication and state thot gldg_ pff, tl /13 /8 Tr. PL 13 2. 0 J
the inlormation is correct and aqree to comply with oll opplicable
Stuh of Minnesota Stotutes ond Gry ;of Epyan Qrdironcss, '4PC Paeks
Sip~ofun of Pem~ittN ' ? C' . AL-' • , • . Var. Dats CoPias
,Alrnw~ ,:3^. I?c~~;:, ; Total
A BLaiIdiny Pertnit Is fssusd to: on the expnss conditlon Iho+
oll woric sholi be done in otoordonte wifh oll opplicoblo StoM of Minnesoro Statutes ond Uty o3 Eaqan Ordinarxes.
~ BuUdinp Official - -
L
Pormit Mo. PwmR Holdw Deft TNopltom #
Plumaino 9 ~v
H.V.A.C. ~ U
iefecto
Soiterw
Iropoetion Daa Insp. Othw
Footln4~ ~ tt~~
Footlnps 11
Foundation
Framinp o /S 5 -.6 r
ROOflnq
Aougn Piby.
Rough Htp.
Inwl.
Finplaa
Flnal Htp. 44-1 ) ,
Final Plbq. -SS ti
Final
Cert/0ee. LG~~
W~~ DKCribm Loeation:
W~ll
Swr~r
Pr. Dlsp.
I Ruwpt ;
MECNAHICAL PERMIT Permit No. ~
CITY OF EA(iAN
FN
Fl!! !n rwmb"d iporcw SJC
7Yw or Prlnt /pibly ToL
i
1. Dib J / g /6j Z. (rKUllatlOfl CiOit
7
~
i
3. JobAddrea 3921 b~:,-=; 44t Blk. = Trsct
a
~
4. OMnNr rrcntier C~j;nod.nle~ '
ti
' b. Coritracto? i ,-Phone
~
6. Addreu :i.~uG Y,:: ;
7. Gty :pStste Zip
8. Building Typa: Hesidential Commercial ? Institutionsl 0 I
9. Work Description: Naw 11 Add ? Alter ? Repair ?
i
10. Desaibe FYYI I ypE LSaS `'Jl ~
~ 11. No• Fnaljpffwpi BTU - M. Ea. No. Equiament CFM j
Forced Air Air Handlinp: ~
Mfy.
80, 0Ui'
Boi len
Mech. Exhaust
Mfy. . _ . Y ~ .
Unit Haater ~
Mfy. Other
Air Cond.
Mfg.
Gas, Piping Outlets
~ 12. 1 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 f inal
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454$100
Receipt PLUMBING PERMIT Permit No.
CITY OF EAGAN
Fee
Fill in numbered spaces S/C
TYpe or Print legiWy
Tot J`,•'~_
1. Oate 2. Installation Cost ~
3. Job Address,3l t 1. Lot Blk: fract
, fi
4. Owner 7
~
5. Contractor4 Phone
6. Address 3bi)u
7. City 4:A,,;'A;e State Zip~S i,_ ~
8. 6uilding Type: Residential ~ Commercial ? Institutional O
~
~ 9. Work Description: New 14 Add ? Alter ? Repair ? ~
I
~ 10. Describe ~
r
11. No. Fixtures No. Fixtures ~
- - ~
~ Water Closet ~
Cesspool/Drainfield
~ Bath tubs Septic Tank ~
i
~ Lavatory Softner j
_L Shower Well ~
~ Kitchen Sink '
Urinal/Bidet Other ! I
Laundry Tray l. c. ~
Floor Drains
Drinking Ftn.
Slop Sink
Gas Piping Outlets i
~
!
12. I hereby certify that the above information is true and correct, and I agree to
oomply with all ordinances and codes governing this type of work.
Signed: for ~
~ Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 464-6100 ~
~
. CITY OF EAGAN N? 1079 O
3630 Pilot Knob Road, P.O. Box 21•199, Eagan, MN 55121
PHONE:4548100
BUILDING PERMIT Reteipf ~F
Te yo umd fm SF DWG/GAR Est. VaIue +559, 000 pote AUGUST 13 19 SS
SiteAddreu 3921 WESTBURY WAY Erect }CI Occupancy R3
6 1 WESTBURY 4 Remodel ? Zoning R1
Lot Block Sec/Sub. Repair ? TypeofConst. V
Paroel No.
Atldition ? No. Stories
FRONTIER MIDWEST HOMES CORP Move ? Lenqtn 40
W Name Demolish ? Depth ¢ ]
z 3908 SIB MEM HWY #E
~ Address -0433 Int lmpr. ? Sq. Ft.
City EAGAN Phone 454 Install ?
$AME ApOrorals Fees
F Name
o" Addrees Atseument Permlt $ 310.00
Vf- City Phone WOter85ew. Surcharge 29.50
Police PlanReview 155.00
GW Nme RICHARD CHARLIER Fi.e
Y. SnC 525.00
r= Address 14103 GARDENVIEW CT Erp. Water Conrt 500.00
~
~W City A.V. Phone 432-5492 planmr WaterMeter 63.00
Council RoadUnit 280.00
I hercby acknowledqe fhot I how rcod this applicotion and stote fhat Bldg. Off. 8 13 8 Tr. PI. 132.00
fhe inlormotion is correct ard ogree to comply with ol apPlicoble APC Parks
Smte of Minrxwta Srotutas an Ci~of aga rdi a es.
% Var. Date Copies
Siprwturo of Permiftea e Total +51, 994.50
A Building Permir is Iuued to: FRO TIER MI WEST HOMES m the axpmss conditlon that
all work sholl be dona in occordonce wit II opplimble Stote o Mirmewla Statutes ond Ciry aF Eopan Ordinoncef.
Builelrq ofriciol _ ~~~t!=
-
~_.-.-uf' EAGAN Remarks
Addition WES'PBURY 4TH ADDN. Lot B1k ~ Pa,.i 10 $3653 060 Ol
Owner Street 3921 Westbury-Bri-veU4y Stare Eagan, Mn 5512T
Improvement Dare Amount Annual Vears Payment Receipt Dare
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK ~ 19 5 2 LF•2~ / 17. 1 15 °2 (v,.5 /{0// .3
SEWER LATERAL
waterniain 19 , 51• 4 i 3.45 15 5-~y' ~4oiG~/~3 /o/zL d~
WATERMAIN 90~ 19 y 5.29 4.35 ~-r7 P0 16 7~ /0 /Z
WATEFi LATERAL
WATER AREA 20 1 3•1 9•2~] 15 /a,. 63 V? 3 /o ~sYIs.f
water area 1 g 1 ~ 8.92 1 133.79 ~ G y73 io /z z(d S'
STORM SEW TRK 19g 71~.2fy /].(42.0 7/U ' oZ /f O/(p C~~`j /O L 2ld,}^
STORM SEW LAT 19g 7$3.56 156.71 5 b'3 -sG F+D i~ 1173 io%.zAf
CUFB & GUTTER
SIDEWALK
STREET LIGHT
Road Ut'. 54535 8/13/85
WATER CONN. 500.00 11
BUILDING PER. I0790 11
~
SAC 525.00 " "
PARK
~5t RESIDENTIAL 2 7 3 zS
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
Naw Conatruetbn Neoulremente RemodeVHeoair Reauiremente
• 3 regWered stle surveys showing sq. N. of lot, sq. fl. ot house; and II roofed areas • 2 copies of plan
(20%mazcnumlotcovemgeallowetl) • lsetolEnergyCalculaGOnstorheatedaAOAbns
• 2 copies of plan showirg beam & window Saes; poured found tlesgn, etc.) • i site suney for eMerbr add'rtions 8 decks
• 1 Set of Energy Calculatbns • Indicate rt home serve0 by septic system tor additbns
• 3 copies ol Tree Preservation Pian If bt pLetled atter 7/1/93
• Rlm,bi51 Detail Opibns selection sheet (bltlgs wilh 3 or less units)
DATE c~ z?CJ VALUATION /S 7 7
_ ,
~a
SITE ADDRESS ~3P~ I G?FS i 43+.2u MULTI-FAMILY BLDG _Y ~ N
NPE OF WORK FIREPLACE(S) _ 0_ 1_ 2
>
APPUCANT ALC'U?'L ~.>.,•,~ivPl ~ .~i~i.?G'
STREET ADDRESSC~S-~.i ~.06n/ 1/ALL ~.~LHD CINft~w Pais ~z~(~-STATE ~N Zlp 5'S 3Y,G
TELEPHONE #95; -f'7Y - 50 ~S CELL PHONE # FAX #
PROPERNOWNER (-R"N~ Ll Fz, TELEPHONE# l S/'YSro' t ~j
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULFS 7670 CA'I'EGORY 1 MINNESOTA RULFS 7672
(4 submission type) • Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheat Submitted
• Energy Envelope Calculations Submitted
Plumbing ConhaCtor. Phone # _
Plumbing system includes: , NVater Sofrener Lacvn Sprinkler Fee: $90.00
XVater Heater No. of R.I. Baths
No. of Baths
MechaNcai Conhactor: Phon
Mechanical system includes: Air Conditioning r
D I[ Tn_ F,'~: 00
Heat Recovery System MAY 2 0 2002
U
Sewer/Water Conhactor: Phon
ey
I hereby acknowledge that I have read This application, staTe mat the Information is c ct, and agree to comply
with all applicable State of Mlnnesota Statutes and City of Eagan Ordinanc s.
Signature of Applica -
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4/02
OFFICE USE ONLY
? 01 Foundation ? 07 OS-plex ? 13 16plex ? 20 Pool ? 30 Accessory Bidg
? 02 SF Dwelling ? 08 06plex ? 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 Ext. Alt - SF
? 04 02-plex ? 10 OB-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
? OS 03plex ? 11 10.plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Yor_N ? 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 ? 46 Windows/Doors
? 34 Replacement 'Demolition (Entire Btdg only) - Give PCA handout to applfcaM
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.
_ Footinyc (deck) _ FinaVNo C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Framing _ Siding Smcw Stonc
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement)
Insulation _ Retaining WaII
Approved By , Building Inspector
- - - - - - - - - -
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Suppy & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
, .
/0770
1985 BUILDING PERMIT APPLICATION - CITY OF EAGAN
NOTE: ALL CONTRAC'fORS MUST BE LICENSED 4IITH THE CITY OF EAGAN
~TAF~oR9 INCLUDE 2 SETS OF PLANS
3 CERTIFICATES OF SURVEY
1 SET OF ENERGY CALCULATIONS
To Be Used For: 5inale Familv Valuation: 62~~ Date: 8-5-85
Site Address: 3921 W2stburv Way OFFICE USE ONLY
Lot: ,6 Block 1 Sect/Sub Erect x Occupancy R3
Remodel Zoning R-I
Parcel 11 Westburv Fourth Addition Repair Type of Const ST
Addition i I! of Stories
Owner Todd Horsaaer Move Length Qo
Demolish Depth 47
Address 2104 RiverHi115 Di'ive Int,Impr, ~ Sq Ft
Install
City/Zip Code Burnsville, Mn 55337
Phone 890-3679 APPROVALS FEES
Contractor Frontier Midwest Homes COrp. Assessments Permit 310.'=
Water/Sewer Surcharge 2q.$D
Address _ 3908 Sibley Mem. Hw. #E Police Plan Review
Fire SAC 525,"
City/Zip Code Eaqan, MN 55122 Engr Water Conn
Planner Water Meter 63.
Phone 454-0433 Council Road Unit 2gfl.'"-
Bldg Off,,5K Treatment Pl 132.°~
Arch./Engr. Richard Charlier APC Parks
Variance Copies
Address 14103 Gardenveiw Ct. 2'OTAL 5o
City/Zip Code Apple VAl1ey, Mn 55124
Phone !r 432-5492
~<~yc i ur 5
=XTCRIOR EN;'ELOPC AVCR;iG~ "II" i:01-1111?A'f1ON
, • ST~~P~+I~C~ FJG7 W~.
L ~
owNE R:
% S
SITE ADDRESS:
CONTRACTOR:_FZc4--,>
Determine working square f00t3ge cf each
1. Total exposed wall area..... ;q. f;. r 11 -co• aCy
2. Total roof/ceiling area..... _,C);(:. x.G2G = Z(M
Total exposed tvall arca abnvc flnor= ~2
i
a. Total wal) iaindow area
L. Total door area a Z
c. Total sliding glass door arca ~j -z -
d. Total i'ireplace wall area q~ S
1
e. Total wall framing area (average lOm).....
~ ~
f. Total rim joist area ..........J............ . ~,-J
9. net wall area above fioor...Z~4~ ~~c•T7',`,,...,. .
h• wall area above floor
i. wall area above floor
j. frame wall area a; _'ot:ncation
Total espcsed foundacion area=
k. Total foundation windo,a arce
l. Total net foundation area above 9rade ~ r
Deterinine "u" v~tluc of each o-r„il scgnic;it
(e.g. windorr, door, eLcfl sep,jr~te ~)all section)
y~~~~~~__7~
_ b, q~ x,.u„ 45
C. x „v -
. Z ---z , S
U„ , )
. d. q g )11 „ ~
~
' e X c)~3 ~ S • ~ rl
~ r. I-2
~,D x 11 u,. a 3 = ~'1
~0:72 Y, l'U,i
c.D
_
. h. X W.
i. ~ u~,
j, X u~~
- i
. ~ If item k'3 is the'same
X"U" as, or less than'iteai
#1, You have met.
G(•7~ inCent of S4C..6006'<(c)
, .
_ .v ~
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . To t a 1 !
:.,•.;~,,,,,5:>,
iihe~!:io: iinvclopc nvc_nqc °U° Computiclon Pngn 2 of 4 .
Totul expoced roof/cci? in9 arca = ~(O
1btu1 s1:yli.ght area .
n. Total rooI/cciling framing arca (avcrayc 107.),... 1 OI ~
o. Total net iilsulated roof/cciling ..rea........... LDetermine "U" value for eacl: roof/ceiling segment
M. - x 'U' _ n. } Q ( . (p 1: „U., ,?z 2, ~ ~
X,.U.,
C Total
Ii tota:i of 1,4 is the same as, or less t:hcin 112, you have meL Che intmtt ot'
S}sC GOOr, (c) 1.
• Alternatc Buildinq ?;nvc]ooe Desiqn
'Sb utilize tne total envelooe 's) stem method, the values estzblished by tiZe s:un of
i.tens and 114 s17a11 not be 9reater than the sum of items i!1 anc 112.
1. Z I c.D . U9 ZG. 4 I = 24 Z , S
r~
3. + 4. 73 gCn ,
~ ~
~
~
• 4)~I,I~ ;.1'f"~'IfiN;J (~/-.I~ .
~i.. .L`:'r jit, 01l ~~~~Oni1i• unil nll`1 ~VY ~i~../.~I~%~ ~
(:ail:.tr,cilt~n
+ _._....v I .
A\e
7. cio
40 ~b_lWA-,j 'G2 ~
l
i
_ i i
~
fl 'rorvie:+a o:
L{ ta • C$
~ F1Wt'r: IdALL lnlrr:i~~' nir :71ni ().G!t
PIC. n2 ci~
1
~
r
~.,------1~~ ~ . 8•.• . Jnlr:~~uC ~1:: filr.. (1.f,!1
I . . . -
. -~l 2.
I----Q/ 7• _.z.N_ 4,~~... _ _ _t ~.00
a• 7.uO
~~_ral I+ 5. ~ ~ GC-------. ___•_S~l
~C~•`i ---~-~-~'S G. }:xccrli: n: iilm i`.1'f
i•) [ nl r (1.6f1
` a~.~----•----(^~ ~•a~ -~~~_.QL~L~.I~~----- aF2~.1.~
S. 5T~f r-P ~.U
' << • ~ _ . 1--
.t' f . , d' -•---a'11 . . .
r{~~ • •4. . 4. . _PZatT.eG_]~~'v.. QP?~.EL~F^._. . .
-
~1,~
. . , - . - -
~`7' 'n r ~ L. i~s~,~~;~•~ 0.1?
• n .
~~t ~~if~v~'.~((1~, . • . 1
k~~,~ C~( r 1!(---~~ . ~ 'x' t~--~
• . ~ \ ~ , ~ • , 'v I~, I
, • ~~l ~r, ~y ~ ~ .
r t G.
G, IJ - ~
nnd
~I,' ~ ' • ' '
o n_
r,
l ~ ~ f nln:rn~•ic f iir:,il.iL ir;:I.
~ • r,no,r•/c~sLZ;:c , -
, • '~i
Construc:ion R-Valuc
Intcrior air film
0.G1 '
3 P .~R
, 3. WSUL. ~ 44.
4. Extcrio: air filn (still) O.u
YrlT Total 2- L~SB~
~ • .
~-Q 1-02 • • . _ . . ,02 .
• ~ FR~r+rr o~
~;,Ced HeaC flov 1. Interi~ir film _ 0.61
1 up - • Z
, - ~ • C. ::xtcil~: :ir ]in (sG;.l).T
~ , . . •ra,:3i
2'IG. 65 •
' - - • ^ ' ~o.l,9rRvr ri
,_,._,.,-,-..,,1•,.~-~_..n.;r-~-+~^.._,nv.%~.ry~ '
=-~T 1_ Sn~idc ~iir film 0.61
' 2. 4.
film U. 17
' l ~I ~ ~ I Tota2
Tnsidc air "ilm 0:61
~O t02
r • .
f ' ' • • • -
i Y.ec: tlov up l'vented 3- '
. 4.
• . , ' ' . ' ' Outsidc .ir film 0.17
Total
u
- 3 ~ " 1_ Inside air film
. • Y ~1..5=~.P~~ 2_ .
• , wy~_~~1,__'1?!':D-F-•J••.. ~i 3- •
"J-•~~.,_~~~/,~-''- ~-`~1~ e. Ciit'.idc air film 0.17
y - ' . / ~J i ' ~ Tota1 -
1 Vj'. , . . . . ~ . , . . ' .
~ ' ~1J ~ ' • ' ' - ' •
Ro_tc: Use a8ditional sheets if morc ~Face i:
necclccl for (jc:.:ils and calcu!atitrns.
' . ~ IienC
- ; • flov cp ~ - •
. • . .
' rir_ ¢7 •
Wnt,r,_;r.r.T_o~a: DKICK - t-1R~ f- lA~
iC: U: r,~,t ;o'f t~l!ot~un w,lll nrcn far
~ '.jP~lfll~: CUIlfilrucl.lun I._V.ll,i•;
trzia . $.t.OCIC 8" Ml r{ _I • 1!
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>
SIC i.l i-ri,.r nli (i:m r U.I'1
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,
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SGZ . PT. SK-PoSeD WA LL AR,-EA
t3LG S K, S = SZ-5
~-/Nt,-; o x S = (brw v
ruLLl t~~ x 8= t~~~
c ~ •
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CITY OP EAGAN
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~ `~APPLICATIO.T FOR PERb1IT
SELdER AND/OR WATER CONNECTIODI
' (PLEASE PfiIH!)
1) PP.OPEY?'!' ADDRESS: 3991 Wacthury way
r.Fr,21,1' D`~c~q=-°TTCV: _6 l L UIPGthi ir Fo urth Addition '
(Lot/Block/St:;divisicn or Tati Parcel I.D. NL:.-,zr) •
7'r' S?'RLC^.'L';Z. Drl^ 0_° CiZT_GMAi c`vIi :L':G
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L'S• • ~ P.-1 Si:GI.F :'F -*ffLY .
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? CCi^=,CL?L/R=I,/pr 'ZCZ
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2) APPLIcL~A7 (PLEasE petnr)
tAME: Frontier Midwest Homes Corporation
ALDRESS:, 3908 Sibley Memorial Hwy. Bldg. E
CTTY, SI'ATb', ZI°: ~ Eaqan, MN. 55122 -
,
P~ONE: 454-0433
3) pi,t,;.ism N'1IE= Star Plumbinq (PLE;.SE PR1YT) FOR CITY USE 091Y
`
, PDDRESS: 1018 Mound Springs Ter. viur.aeiExpii c:NSE:
etive
CITt, STA?'E, ZIP: gloomington, MN. 55420 ed
PHOJIE: 884-4149 No of Record
PlU.9BER LILEVSE H 3329
~
arr 1 iat
4) (x,'C[,'pp,~~]'j`/cF.ij,ER NA~IE(PLEASE PR14T)
~ iodd Horsager '
ADDRESS: ?104 Riv Hi11G Drive
CITY, STATE, ZIP: Burnsville, Mn 55337
PIiO`]E: A90-3679
5) IIVpIC:,TE WI3ZCH PERi•LIT IS BEIi:G RFX'UES'IM;
i
~ C0,INECL'I0N TO CIZ^1 SEr;FR Please mail gold copy to
~ CO:NE:CPIC:1 TC) CZTY WATER Wenzel Mechanical
3600 Kennebec Dr.
E3 0`171ER (PLZ--~.SF DESC'SBE) Ea an MN. 55122
6) P,zIG.::: C::c: .
• ? PI.: ME f?OLD APPRWFp PERmIT FLR PZCi:-LP BY O:v'E OF tlE('VE
~°i.E~+SE S'aI APPF?dVm PE=:•LIT T`J 1,'r2/ 3, 4 RBOVE
(Ci:~le one)
7) SICZ:n=pZZ: 6 C%L~ \ DATE:
~ R E~al~4)1?JY! i t~ !~:gftf~ ~ i/R p~~i i~ i ii ii:s ~ lt r~l~'.!Y/-~j 1~ i s~y .
. , y .
F 0 R C I T Y U S E O N L Y
PE°-MZT ?SSU°D
rrrS: $ r0,~] S~i:co nc?Mrm (I_`ICL::D°_ SU.°.C::n3GE) + $ /O.SU SJAT°R PEi2PtT_':` (IL:CLUD:. SiiRC:?;,-RGL) .
$ /o~uu WAT°R METER/COPPE4HORN/OUTSSDE REAGER
$ S WAT°_R TAP (INCLUDE CORPORATIQN STOP)
$ 5E:4cR TA?
$ ACCOUNT D.F.POSIT - S4ATr3
$ WAC
$ Sar.~.~ spc
$ TR[i`:iC S4ATER ASS%SS:fE.iT
$ TRCi:d!{ S'c:';'cR :~SSESS:L'riT
$ LniEP,1L BGtVLl TT/TRU,TiC S: T'iE=
S Lr+Tc?ZaL BEVE:IT/T°U.:K ?'IAT_°R
$ WATER TREATMENT PLAcVT SURCHARGE
$ OTHER:
S TOTAL
$ .-~GY~~U P.lMOU`:T °AI'J/REC°I?T
DOcS UTILITY CONNECTION REQUIP,E EXCAVATION IN ?U6LIC RIGHT OF WAY?
Y°S IF YES, THEN A "PERh1ZT FOR :aOR?: WITHItN
PUBLIC ROADSJAY" MUST BE ISSUEp BY THE
NO ENGINEERING DIVISION. LIST AS A CONDI-
TZON.
SUEJECT. TO THE FOLL0I4ING COIVDITIONS: •
APPROVED BY: TI"T L: •
DAT_°: f Il34-
r
~e ^ ~ s~ .ts .c m am ow-ow glum w w w lW=" wrN MmRa w IN--m ws* §ca *W s~ w"mw Pc.w ON sia w ~
MECHANICAL (RESIDENTIAL)
) ~ QZ~ jS Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5694
Please complete for. Smgle Family Dwellings
Townhomes and Condos when permits are required for each unit
Date- -1- /V / 6 :3
Site Address ~ Unit #
Property Owner 5L S I G~J Telephone #4S U `
Contractor STAhIA^Ry HEn7i~G & AmTOVNBIT10NING rn
410 WEST LAKE STREET
Street Address AAINN~APONS, MN 56406•299R City
State 81 2-8Q4-M58 Zip Telephone # ( )
The Applicant is _ Owner A, Contractor _ Other
Add-ou, modification or alteration to eatisting dwelling unit $ 30.00
furnace replacement
air exchanger
~ air conditioner
other
State Surcharge $ .50
To[al
I hereby apply for a Residenhal 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- iTy of Eagan and with the Mechanical at [ understand tlus is not a
pemut, but only an appff11icaho r a p t, and work is ot to s[art with a u't; that th ork 1 be in accordance with the
ap ved plan in thee of k whic requires a review nd appr ~al plan .-k/VKL
pphcanYs Printed Name Applican ign ture
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675-5675
www.cityofeagan.com
Site Address: 3921
Lot: 006 Block: 001
PID: 10-83653-01-060
Use:
Description:
Sub Type: Furnace
Work Type: Replace
Description:
�.�
o
ff IL
s:ff In Mr
Westbury Way
Addition: Westbury 4th
Permit Type: Mechanical
Permit Number: EA179586
* E A 1 7 9 5 8 6*
Date Issued: 10/11/2022
Permit Category: ePermit
111111111111111111111111111 1111 III 1111 11111171will
Comments: Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota
State Building Code).
Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507)
210-0754.
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Fee Summary: ME - Permit Fee (Replacements) $59.00 0801,4088
Surcharge -Fixed $1.00 9001.2195
Total:
$60.00
Contractor: - Applicant - Owner:
Air Express Inc Jonathan Le & Trang Nguyen
POB 490400 3921 Westbury Way
Blaine MN 55449 Eagan MN 551.23
(763) 447-3999
This permit shall be null and void if work does not start within 180 days of issuance, or if work is suspended for 180 days or more after
started.
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.
Applicant/Permitee: Signature ssued B : Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA179586
Date Issued:10/11/2022
Permit Category:ePermit
Site Address: 3921 Westbury Way
Lot:006 Block: 001 Addition: Westbury 4th
PID:10-83653-01-060
Use:
Description:
Sub Type:Furnace
Work Type:Replace
Description:See comments
Comments:10/13/22 - Contractor called to switch address from 2023 Safari Heights Trl to 3921 Westbury Way. ePermit was pulled with
incorrect address. mw
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
This permit shall be null and void if work does not start within 180 days of issuance, or if work is suspended for 180 days or more after
started.
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 -
Jonathan Le & Trang Nguyen
3921 Westbury Way
Eagan MN 55123
Air Express Inc
POB 490400
Blaine MN 55449
(763) 447-3999
Applicant/Permitee: Signature Issued By: Signature