3972 Westbury Way
CITY OF EAGAN SE" sERVtCE
~ 3830 Pilot Knob Rwc1 PmmR
P. O. Box 21199 PERMIT NO.: f•`~`'":
E+W. Mld 55121
W11'E: - Zortir+p: No. of Unlts: 7.
Owrwr. ~.w: t.~ er ~ti c7wes t
Address:
SIh Addmm- 3972 :~$1:+`~l.li
Plun+ber s.c'~ 4bn I,e1
~.71 717
~'om b Mm* w1Ui tM Clyr of yMs Conrnetion Qqpe,
QI~IINNMw ACOOUnf apONh
PorMf FM: G.
Surdwrp: • - r 'f,-'
BY Miac. Qhonpc
DaM of Irop.: Tot+ol:
Irop.: Daft Obld.
, ..ITY OF EAGAN WATM SERVICE pERMIT
3830 Pilot K npb RoW • ~
P. O. Box 21199 PERMIT NO.:
EaWns IIMN 55121 DATE:
Zonirg: Unlts:
OwrNr: - ' y
A"esr:
sn. Aedro..: 3 ' i b~e ~ ~.tzR 4 >~.,1-~ •
Plumber. St . B - ~ ;
{
Meftr No.: mugs
Sizs: rr Aacaxit Deposit• 1 S. 00:,~ j
R.~a.rn+o.: ~m 90 ~ Z(~- wrr„rt Fe,: 1e. oo,-'d !
,
I Ow.. f....* wiMi +y Ger.f h"¦ S,,,d,cr,D,; . 577~
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CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eqsn, MN 55121 ' I J~, O~
PHONE: 4548100
eUILDING 'ERMIT Receipt
Tip N UM/ fM Q Est. Val ue ,1 Oote , 19 '
Site Addrea 1Erect Q Ocwpsncy -
Lot Block Sec/Sub. : ~ Remodel ? Zoniny ^ - :
Repair ? Typa of Const. c~
Parcd No. Additlon ? No. Stories
Move ? Length
NMf~e
T Demoliah ? pepth
T
Addresf '~Q?i = ~~l': i 1L': ~'T~.i1-' Int Impr. ? Sq. Ft.
~
City PFwtie 4''4 33 Install ?
AVNwak
Name f~ FNs
Addreu Assessment Permit ' L'- • „
City Phone Woter d. Sew. Surcharpe
Polip Plan Revlew f}.1
Name Fin SAC 00
~
Addrm Enp. Water Conn. nf)
~W City Phone Plonnn WaterMeter
COtxull RoadUnR
t hereby ockrwwiedqe thaf 1 how nod this opplicotion ond store N,at Bldp. Off, L/I 2/1111-1 Tr. PL
A~
fhe inlormotion is torrect ond ogree to ComplY with ol' appllc*16
Stote of Minnesoto Stotutea and Ciry of Eaqon Ordinax6s., !
Ver. Dm Copiea
5ipnotun of Pennittu 6 ;-.r'; ,
Total
A 8uildinp Pennit is issusd to: ~ • 'r: • ' ~ - - on fM exprwtcondition Ihot
dl work sholl be dorw in oooordonce wlth all appliaoble State of Mirxmto Stotuha ond City of Eopon Ordinonas.
Buildinp Offidol
Pwmk No. Pwnk Haldw Doft Tebphow ~
H.yA.C. (Aj Qr ~
ENetrb 4 a I~r~ r ' c.,L / 3
So1t~?
Impfttion Da" Insp. Othw
Footlnps 1 Uf
FooUnpsll
, Foundeqon
Frarniny
RooAnp
Rough Plbg' wSG.,AL -6 -
Rou9h Hty. ,!Cf I
Inwl.
Finplan
Flnd Hty.
Final Plbp.
Final
CWt/Oee.
Wabr Ooscribw Loestioe: I
WNI
8ovm
Pr. Dbp.
_ ~
Reaipt MECHANICAL PERMIT PKmit No.
~
` CITY OF EAOAN
- FM
F!ll !n numbard *wcu $/C . S
~ rype w Print /plb/y -
~ Tot
,
1. Om 1114M, 2.InstNlstionCosL ~J.0
~ 3. JobAddna 39 72:, We~, t.::i!-'. WiMBik. 'i Traet
~
4. Owrw ~r.~.ti,~ n:! ci!~ • ~
I
5. Conuactor P , - Phone 5_ _ ~
g, Addnu ~ou•: L. IV,
7. Gty StoU .i1 Zip
8. 6uildin9 Type: Residential Q, Commercial ? Institutionsl D
~
~ 9. Work Desaiption: New D~ Add ? Alter O Repair O
~ 10. DnaiDe Fuel Type 1~ ,
,
,
s
I
11. No, Equipmapi BTU - M. Es. No, Eauioment CFM
Forced Air Air Handling:
Mfy.
Boiten
Mfp. Mech. Exhaust
.
Unit Heater
Mf9• Othar
Air Cond.
Mfg.
Gas, Piping Dutlets
i
E 12. I hereby certify thet the above information is true and correct, and 1 agree to
~ comply with all ordinances and codes governing this type of work.
F~ Signed' for
Rough Final
InspsCtions: Oate Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
Receipt PLUMBING PERMIT Permit No.
CITY OF EAGAN
h ! ' FN •~Li' ~O
fill in numbered spaces S/C
Type or Print ltgib/y Ta.
1. Date `2. Instailation Cost j
~
- ~
3. Job Address Lot Bik. Tract
4. Owner
i
5. Contractor Phone • : ^ '
~
6. Address
~
7. City t. , State i- -Zip ' i.
y
,
8. Building Type: Residential 15 Commercial ? Institutional ? ~
9, Work Description: New ~ Add ? Alter O Repair ? ~
10. Describe '
d
~
11. No. Fixtures No. Fixtures !
Water Closet Cesspool/Drainfield ~
~Bath tubs Septic Tank ~
a
L.avatOry Softner ~
% ShOwer Well
~ Kitchen Sink ~
Urinal/Bidet Other
Laundry Tray
L .
, Floor Drains ~
Drinking Ftn. j
Slop Sink ~
Gas Piping Outlets
a
12. I hereby certify that the above information is true and correct, and I agree to ;
comply with all ordinances and codes governing this type of work.
i
Signed for
Rough f inal
Inspections: Date Insp. _ Date Insp.
This is your permit when numbered and approved. ~
Approved CITY OF EAGAN 454-6100
]
~ CITY OF EAGAN (v0- 106 O H
' A: 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 4548100 S 37 LJ ~
BUILDING PERMIT Receipt
To 6e wd !er SF T:[nl;/(:AR Esf. Volue hl _Wh Date , 19~5
Site Addresa 3972 WESTBURY 4g:Y Erect lR Ocwpancy R-3
Lot 11 Block 3 ceC/Sie. WESTBURY 4TH Remodel ? Zoning R-1
Percel No. Repair ? Type of Conat. V
Addition ? No. Stories
Move ? l.ength
m Name F'RON.CIEE2 A'IIDWEST HC1~4ES
= 300$ $1$~~' [~'URTAT, j' #E Demolish ? Depth
~ Address Inl ImPC ? Sq. Ft.
crcY ~ vnone 454-0433 inscan ?
Avororols i•e.
o Name cnnrtv
Addresa Assesunent Permit 316.00
~ City Phone Water 8 Sew. surcherge 30.50
Police Plan Revlew 158. 00
~W Neme Firo SAC 525.00
?
~ZAddress Erq. waterConn.500_00
.Kw Ci[y Phone Plonner Water Meter _6-1-.0,0
Council RoadUnit 280_00
I heroby ackrwwledqe that I hova reod this opDlicotion and srote thar Bldg. Off. 7I12/85 7r. PI. 112-00
fha inlormotion Is Wrrect and p[ep 1o comply withy aOVli la AP~ Perks
$tate of Minnewto Stotuta ond Ci Sdn Or tfia s
~ Var. Date Copies
Sipnoturo of Permittee •
FR0N7,ZER MI Totel~.~QQQ.,-~g_
A Buildinp Permit Is issued to: I7WEST H(YviR4 on tha axprca conditlon lha+
all work sholl be done in accordonce/„,~~i'~' all qpplimM Sfote of Mi`~~ M$tafutes ard Cily o1 Ecpan Ordinances.
Bulldirq Of(Idal v~ Q~~ a
r'
CITY OF EAGAN Remarks
Addition WESTBLiRY 4414 AL1DN Lot 11 eik 3 Pa,ce, l0 83653 110 03
owner Street 3972 Westbury Way state Eagan, MN 55123
Improvement Date Amount Annual Years Payment Receipt Date
STREETSURF.
STREET RESTOR.
GRADING
SANSEWTRUNK 9/ 19 5 2 4•20 17. 1 15
s
SEWER LATERAL
watermain v~ 19 5.29 4.35 15
1 65.29
WATERMAIN a~ 19 51• 4 3•45 15 44.80
WATER LATERAL
WATER AREA 19017 19 13 •1 9•27 15
120 53
water area A 19 86 133•7 .92 15 1 3 3 7 9
STORM SEW TRK 19 ~]10.2C~. ],Ly2.O5 5 710, 24
STORM SEW LAT CJ~ 5• 1 5 7 g 3. 5 6
CURB & GUTTER •
SIDEWALK
STREET LIGHT
WATER CONN. n n 500-00
9UILDING PER.
n n
SAC 525.00
PARK
~ l5-5v
65O4pJ ?f172idb Ei1l:l1L PLtJMBING PERMITAPPLICATION
CITl' OF EAGAIV
::?30 F-11=01" KNOB ROAD, EAGAN MN 55122
651-675-5675
Please corr,~,ileie for rnodificziions ~o existing residential dwellings.
- ~
Date 5 ~ Z$ NEIS,NICK ~
0 3972 WESTBURY WAY
Site Street Address I EAGAN, MN 55123 Unit #
i (651)688-9496 i
Property Ow. r Telephone # ( ) Contractor A `~•'~r
Telephone# ( )
Q!1!lfBSc_ Gc05 k3-..' st@`s
TheApplican.:s: ..,roi ~Cor,'ac+r,r _Other
Alteretions ta exist~sig c ja;li;;y $ 50.00
_Add fixturas to i corns, er,r,;uding water sof~ener and water heater
_Septic System ,~~ar.coc-r,erit
_Water'• -r-3r,und (a,7d 5121 00 if a 516" meter is iequired)
-Other:
- i
_ Water So!'iener Water Heater $ 15.00
X «^!aram,:i; addihonal
Lawn Irrigc..io;i SysLir, :)Z__ new repair __rabuild S 30.00 ~i
State S.:scFarge 50
i
AUN 24 2004 Tota1 g I hereby appy or a;esiclertial Plumbing Permit and acknowledge that the information is complete
and accurate; that the work will t:e in :;onformance with the ordinances and codes of the City of
Eagan and the plum:;irg r,odes; th:at I understand this is not a permit, but only an application for a
permit, wor:- is noi to ;Lart , hcui a permit and work will be in accordance with the approved plan in
the event a^~a:~, r?q~~+:-•:.,.:,~ J i~ ~ nd approved.
~;.~,~v
, s
o-~ooa- °
ApplicanYs
£ ~ R~
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
New Construclion Renuirements RemodellReoair Reuuirements
• 3 registered site surveys showing sq. ft. of lot, sq ft of house, and all roofed areas • 2 copies of plan
(20%manimum lot coverage allowed) . 1 set of Energy Calculatmns for heated addNons
• 2 co0ies of plan showmg beam 8 vnndow sizes, poured found design, etc.) . 1 site suney for exterior additions & detks
• 1 set of Eneryy Calculafions . Indicate rf home served by septic system bradd'Aions
• 3 copies of Tree Preservation Plan if lot platted after 711193
• Rim Joisl Detail Optbns selection sheet (bldgs with 3 or less units)
DATE / O- I I~ U oZ VALUATION V' ooU • O"
SITE ADDRESS MULTI-FAMILY BLDG _ Y KN
TYPE OF WORK +1!" ~ ~ ~ ~ GiJ-8. FIREPLACE(S) _ 0 _ 1 _ 2
APPLICANT United Construction Inc.
STREET ADDRESS 1725 Lake Drive West CITY STATE ZIP
TELEPHONE # C'hanisisism&iN 55317 FAX #
PROPERTYOWNER kJ n) Fi S kIL' 1~ TELEPHONE#~j,SI'(O~C~'~
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNCSOT:1 RULES 7670 CATEGORY 1 MINNESO"fA RULGS 7672
(J submission type) . Residen[ial Ventilation Category 7 Worksheet Submitted . New Energy Code Worksheet Submitted
• Energy Envelope Calculahons Submitted
Plumbing Coniractor: Phane #
Plumbing system includes: _ Water Softener Lawn Spnnkler P'ee: $90.00
_ Water Heater No. of R.I. Ba[hs
No. oC Balhs
Mechanical Contractor: Phone # ' ~ r
Mccliaiical systcm includcs: tlir Conditioning Pce: $70.00
Hcat Recovery Systcm
Sewer/Water Contractor: Phone #
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 of Applicant
.
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4102
OFFICE USE ONLY
? 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
Q 03 Ot of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex PlbgiY or _ N ? 25 Miscellaneous
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bidg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)• ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement 'Demolition (Entire Bldg only) - 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) _ FinaWi o C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas I'ests _ 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
Cdy SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
. '
~
1985 BUILDING PERMIT APPLICATION - CITY OF EAGAN
NOTE: ALL CONTRACTORS MUST BE LICENSED WITH THE CITY OF EAGAN
4/~.MPTOf4 INCLUDE 2 SETS OF PLANS
3 CERTIFICATES OF SURVEY
1 SET OF ENERGY CALCULATIONS
To Be Used For: -a" Valuation: Date:
Site Address: OFFICE USE ONLY
Lot: I I Block _3 Sect/Sub Erect ~ Occupancy ~-3
I Remodel _ Zoning R-I
Parcel !1 LpAK" l.lrQD. Repair Type of Const "CL
1 Enlarge 1f of Stories
Owner Move _ Length 4-0
1 1 1 Demolish Depth q.6
Address ~a1S ~ ~.e~cY v~1CL~ Grade _ Sq Ft
City/Zip Code hMOlO \)CkQQ9.(,i
Phone y3a~qpq~ APPROVALS
Contractor Fl~iMV~e~M~t~U,Q~3} 4o'~v,-Q-~ Assessments Permit
Water/Sewer Surcharge 30 Address 3qp~ ,~jy~Q~Q~,i,; ~'~QM~•~\~ Police Plan Review
--j ~ Fire SAC oO
City/Zip Code Engr Water Conn 500. W
Planner IJater Meter r03.
Phone 5q_ bJ33 Council Road Unit ?.80
rp n• Bldg Off ~ /y ~s
Arch./Engr. APC Treatment Pl (3Z.°`-'
{ Variance
Address I q ~ 0~j ~`fen t~s2M\ ) ~w C=~ TOTAL
City/Zip Code
Phone 0 y3Z- S~~~Z
SIGMA House
SUROOEYIRIG CerNflcuPe For
ERVICESi
3908 Sibley Memorial Highway ~'r$.~FPtpe~'
Eagan, Minnesota 55122
, Phone: (672) 452-3077
upwp~ PTO.)
LD T 10
_ N _ 049.OK T
5
/~48o
7s g& 3 d
E ~ o~ Pt` 5 _ Lll
w I~~rs -N%/r=}- Io
-F;
/20
I $ ~/Qp ze,zo ~ 'r ~A cL/
1A- _
t;o,.Yy
\
0 2O
z t~ o~(D~ 12
g49 6
x
•:;:;:;d~l~; :R;•ry; .a) C^lia i~:~lJ,•';
~4 .
. I'f If ii I;
. . f ^ 4. ' '
-LEGE~YD- PHOPDSCD GARAGE fl.OOR ELEV,tl10N=
0 Denotes lrnn MorkmYnt PROPOSED (ap a/ 81oEk ELEVA(fON= 811,0
° Denotes Wocd H,Ib .Se1 PROPOSFD BASEMENI FLCYJR ELEVA110N=8(3.0
nB66.0 Oenotes Ezisfiry SFr.,t Elevafic+i Wj0
roA hOTE' Verrly alf llaor heiqhls rilh FirNI Nouse P/an;.
i, :6,,w.. /~notes Pro~seJ S{;uf E levat imi
- Denotes Dra inaye C';rrcl) a? -SURVEyORS CERTfFfCQrI(XV-,
_ _pRWTRn, ~~~~IOV r Irreby cerlr(y thaf tiris Survey, p/an or report
• Mas pre~ttd by me or urrler my direct su,[rrvision
~L4r_ ,.-~,BL(~K_3 aN ttai 1,,11 „,!u(, Nenrslercd L.aM Surveyer
uf er the laws ol Ihe Sfate ol Minresota.
----~-~-0+~_ io?J
arcordug 1v the reccrJcd Plaf flrereoJ, (
n ~ ~
r`0/SS
a Ccvnt Nirvksota -
- Y, Weyr~e D. Cordes. Alinn. ftey. No. 14675
, Paye 1 of 4
- ~ . . ~ EXTERIOR EI~`JCLOPE Al'; RAGE "II" COMFIITATiON ~/Q~~
.
OwNER: ~ nnrr ~ ' _Z,S~-~~7
SITE ADDRESS: PHO~JE:
CONTRACTOR: ~~C~yr'~E'~
Determine a~orking spuare footaqe of each
1. Total exposed wall area.....__t~L~~ sq. ft. r. .11
_ - - 1 ~1, ~
2. Total roof/ceiling area..... ~Q Q6#,'~ CJ sq. ft. x,ppb = L+ 5
~ - Total exposed wal l area abovc I loor-
~
a. Total wall window area........ ~
b. Total door area
c. Total sliding glass door are~....... " L~_
1 - .
d. ToCal fireplace wall area
~ e. Total wall framing area (average 10N)
f. Total rim joist area........
~~9: net wall area above floor.Z~1~f _ ~S~ -
~9-
h• wall area above floor
wall area above floor "
~ J frame wall area at roundation.
`
_ Total exposed foundation area=_~_
k. Total foundation window area...........
1. Total net foundation area above 9rade.........
Detcrrnine "u" valuc of cach w~~ll scgmenC
{e.g. window, door, each ;eparate wall section)
a. ~(o. ~_9-.- z , =_.-_ZC~. 71
b. . L~, x 5
~ . Q~ Z y, „ ~ , ~ S • ~L. ~
a . x ~ _
e. ~ ~.•~S X ~G? ~y , i ~
-J ~ ! _
f. j O. _ y ~d ?J =
- •
e 9 ~(o. (~'I _ X 'Z°?. Z~'t
n. x
i. X
j. X
.
k~ ~Z X~ "U" ~~Q If item H3 is the sam2~
~ as, or less than~•item:,;
1.__~. 7~ X~~~~~ _ , rI ~1, ~ou have met;:fhe'!;'`'
• intent of ' '
~ SBC..6006r•,4C ) ~
. . . . . . . . . T I~ 1~J~ ~~~;;~rz,a,,~;3,t;,~
. . . . . . . . . . . . . . . . . . . . . . . . . I ~ C f~ ~ \ \ I Y~f{ `.-.TJ ~~*)i'~~' ~
,a_ u..._.
~y,, Ex y~~rio: I:nvolopo Avcr;ugc "U" L'ompuLnCion Paye 2 0: q .
r . , • ,
ToCnl exposed roof/ccilin9 azca = zS
M. 7bta1 skyliyht area ' .
n. Total roof/ccilin, framing arca (;rocrayc lOk,)
o. Total nec insulaCed roof/cciling area...........
lletermine " U " valuc for eaGl roof/ceiling segr„ent
, M. _ x
n_ (uR.4z5 a „U„ .az~-= 2•L 3
o. 'f4a.b3 x,.~„ p Z 48
.
~ . DO tal
If total of ;14 is the seune as, or less t:han 1I2, you nave met tile intent of
SbC 6006 (c) 1.
A.lteritale fluildinq linvelooe Desiqn
Ib utilize the total envelope'system method, the values established by the s:un of
i.tems 43 and 49 shall not be greater than the siun of items Ikl and $2, 1. , 7 ~ • ~ '7 + 2. 7Z "'L 5 _ j
3• -._1-2+ 4.
~
.
,
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(,.i~~DF_ %ri • , , , ` , ~ . jr
il
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Ff~qi /CEiLI;IC. • .
' . •
Construction R-Valtic
Intcrior air film .0.61
F3 P R
~1( 11~(I'~' ' 3. -1d.~15U L. • ~ 4.
'1II I}II I^(I~I~iIIII'~I(~~ 4• Extcrio: ±ir filn (still) O.G
YE'.'T ~ ( ;i Il Total (Z 4SpO
C~
~ • .
I-Y---- 02 - . . ~ oZ ~
!nted Hea[ flov 1. Interior nir Eilm _ 0.61
up - • 2" ~
. 3- ~ ~_!l.(SyL 38.35
_ ~ ~ • 4. Extciic~r ait_filn (stil . T
Tota1
FIG. 05
. . . . U=
• _ _ . ' ' CO.L~iT/~?CT/ oy~ . '
-n_.~.~ '.v~:^,~r_"~•M-_"a-••r_~..c..~ ~ 1- In51dC aiL filtn O.EiI
- - -r---r 2
3. . • .
4.
I. 5. Out:idc air. filin 0.1"T
Tota1
L, • •
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~ CITY Or EAGAN
~~~i~ ~ AP?LZCATION FOR PERiL1IT
SEWER AND/OR WATER CONNECTIOTI
(PLEASE PRIHi)
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Frontier Midwest Homes Corporation
ADD?WSS: _3908 Sibley Memorial Hwy. Bldg. E
CIT", SI'::TE, ZIP: Eaqan, MN. 55122 •
P~ONE: 454-0433
3) pj,I,;.=? NA,LIE: Star Plumbin (PLE:,SE PAINI) FOfi CITY 115E ONLY
PDC=WSS: 1018 Mound Springs TBT. P~LUNB/EAS LILeNsE:
~ nccive
CITI, STA?'E, ZIP; Bloomin ton, MN. 55420 Exoired
A~ 'L" Q-til4ot of Record
PHOVc: 884-4149 PLU`tBER LFCE~isE N 3329 / ;
SF~rr ~n3ciT
4) OCC".'PPS1T/C*..jiI ,E"'Zi (PLEASE PR1NI)
N}4~: u\~ i L~L IV P 1 55
ADDRESS: r 5 L CT P n P 1! I. I J~1~1 . ~
CIT"l, ST;~T'G, ZIP: ~111 5 1 Z4
PHo>rE: U-)~.- 904
5) IIVDIG.TE ;4HICH PERFIIT IS BEID:G R.fIUES'PED:
~CC.:DrECPI6N TV CITY SEZ4ER Please mail gold copy to
~ CONt1EX.TIC;1 To CZTY wATr t Wenzel Mechanical
? 0-17+2 (PLGSE DFSCPSBE) ' 3600 Kennebec Dr.
Eaqan MN. 55122
• ? P7.r~SE E?OID APPROV'rD PEP:^ST FOR PI~Ci:-G'c BY OIv'E OF AFG1,'E
~°TE~+.S' ti*I ^APPPOVID PE=:•LIT T`J 1, r2/ 3. 4 r'1ECJ~E
(Ci ~5 e one )
7) SIC.;,TLR-^.;
DAT'E:
M" MAiYll~e! r sal~:aalaa~ tAOS~ar ~ s~s~"a:~a ~ rla:aya~ a~~~~saa~
FOR C I T Y U SE ON;.Y
PEp.%tI"' - ?SSUED
rrrS: $ /Q'S!i SFi~Eo TJr.~~tTi (ZVCL~~° Sli'C :~RGE)
. $ WATER PEit~lIT (Ii:CLiiD : Su3C?iA3GE) WAT°R METER/COPPE4HORN/OUTSiDE REA=
S Wr1T°R TAP (INCLUDE CORPORF,TZ0N STQP )
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$ LATERAL BEVEFIT/TRU.:K :':ATE.R.
~ p
$ WATER TREATPSENT PLANT SURCHARGE
$ OTHER:
$ T=IL
$ ~1oSS:f~ aMoe>:T PAI'J;'.rc~r°I?T R 5375 ~
D0E5 UTILZTY CONNECTZON REQUIP.E EXC.IVATION IN ?USLZC RIGHT OF WAY?
~ YES IF YES, THEN n"PERh1IT FOR :aORS WIT?-IZV
~ PUBLIC ROADLJAY" MUST BE ISSliED BY THE
~ NO ENGINEERZNG DIVZSZON, LIST AS A COC:DI-
TION.
SUEJEC'=' TO THE FOLLOIaING CONDZTIOC:S: '
/
APPROVED BY:
TZ:LE: DAT° :
p"a w4 Wie Mi" ow+ oa sr ~ ~
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 3972 Westbury Way
Lot: 011 Block: 003 Addition: Westbury 4th
PID:10- 83653- 110 -03
Use:
Description:
Sub Type:
Work Type:
Description:
Comments:
Fee Summary:
e - Furnace
Replacement
Fumace
Contractor:
Genz Ryan Plumbing & Heating
2200 West Highway 13
Burnsville MN 55337
(952) 767 -1000
Quesetions regarding elec
952- 445 -2840
Kim Renville
2200 W Hwv 13
Total:
Applicant/Permitee: Signature
PERMIT
City of Eaan
Permit Type:
Permit Number:
Date Issued:
Permit Category:
cal permit requirements should be directed to Mark Anderson, State Elec
ME - Permit Fee (Replacements)
Surcharge -Fixed
- Applicant -
Owner:
Nicholas Neis Jr
3972 Westbury Way
Eagan MN 55123
$50.00 0801.4088
$0.50 9001.2195
$50.50
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
Issued By: Signature
Mechanical
EA078764
07/12/2007
ePermit
cal Inspector,
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PERMIT
City of Eagan Permit Type:Building
Permit Number:EA113178
Date Issued:08/30/2013
Permit Category:ePermit
Site Address: 3972 Westbury Way
Lot:011 Block: 003 Addition: Westbury 4th
PID:10-83653-03-110
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 .
Jackie Terrell
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 -
Nicholas Neis Jr
3972 Westbury Way
Eagan MN 55123
(651) 251-0910
Walker Roofing Company
2274 Capp Rd
St Paul MN 55114
(651) 251-0910
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA179845
Date Issued:10/24/2022
Permit Category:ePermit
Site Address: 3972 Westbury Way
Lot:011 Block: 003 Addition: Westbury 4th
PID:10-83653-03-110
Use:
Description:
Sub Type:Furnace & Air Conditioner
Work Type:Replace
Description:
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)
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 -
Nicholas Jr Neis
3972 Westbury Way
Saint Paul MN 55123--146
(651) 688-9496
Genz Ryan Plumbing & Heating
2200 West Highway 13
Burnsville MN 55337
(952) 767-1000
Applicant/Permitee: Signature Issued By: Signature