4624 Westwood Lane - ' \
. •
' *.4
W'"lificate uf cccupanc~
~iti) of Cfagan
! IZOaxtwent a~ lauffb'ixg 3*40ectisK
This Certificate issued pursuant to the requirements of the Uaiform Building Code
j ~ cenifying that at the time of issuanre this structure was in compliance with the various
ordinances of the City regulating buildireg construction or use. For the fol[owing:
. ~
ux cimifiatio,: SF I1fJG sidg. rermic No. S567
powpancy'ry,pM RUM I 7doing pisuict PDJR3 Type Const. VAl
Owner of BuildinS Q C p}acS TA1^. Adthass
Building Addtess Loewiry
~~'1 ~ ~ ~
u~:
B • of~ci~
POST IN A CONSPICUOUS PLACE
_ ~ "
if
INSPECTION REC4RD
CITY OF EAGAN PERMIT TYPE:
, 3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
SITE ADDRESS: APPLICANT:
PERMIT SUBTYPE: TYPE OF INORK:
~
. .
. . . .
I
~I
~ PumR No. Psrmk Holder Dab Telephone A 'I
ELECTRIC ~aW , CP/g „~f ~oZQ~ I
PLUMBING Q ~ 4/,2 9~j rJ 3(/7f
~HVAC
te, 11T&-~ i , . C W-ZG S07 - 3
Impectlon Date In . Comments
FOOTINGS S11,2
FOIIND
FRAMING
ROOFING
ROUGH
PLUMBING
P`BG
AIR TEST
ROUGH c ~
HEATING -
GAS SVC
TEST -1a
INSUL A$ 4e
GYP BOARD
FIREPLACE lp~( r
FIREPLACE
AIR TEST
FINAL PLBG
v 7'
FINAL HTG r ^ J~
! /J
ORSAT
TEST
BLDG FINAL ev:
~
BSMT R.I.
BSMT FINAL
DECK FfG
oV
DECK FlNAL
v
C710
0~°~n'~14 4 11%0
Request Data ' Fire No. Ro h-In inspection Req r Inspection Other TTan Rough-in
%~j_ • (YOV must call inspecrof w en ready) ~ Reatly Now ~,Will Nolily Inspecmr
b ' 7 Yei` ? N. Date Fead
I~Tlicensed contractor ? owner hereby request inspection of abova electrical work at:
Job Atltlress (Streel, Box or lioule No.) EePhoneNo
~~g~f /i/ifS'i ~~o Q!-~ Ld.lr Seclion No. Township Name or No. Range No. Occupant(PRINT) 2
Power Supplier AOtlress
-~F('1 f''62 N? //?6-7-0/1/
ElecViWl Conlraclor (COmpany Name) GonVactor's License No.
/ii,,`Y_>-' Gd
Malling Atldress (COmrector or Owner Making Installacion)
,fP2 i3k /i1`~'
AuIDOrized SignaWre (COnlrecloqOwner Making (nslallalion) Phone Number
36,z-~~17
MINNESOTA $TATE BOARD OF EIECTRI THIS INSPECTION REQUESI' INILL NOT
Griggs-Mltlwey BIEg. - Room 5428 BE AGCEPTED 8Y iHE STATE BOARO
1841 Unlversity Ave., SL Paul, MN 5 00 UNLESS PROPER INSPECTION FEE IS
Phonel612j6C3A800 I . ENCLOSED.
f I
~l(a ~~,~cG REQUEST FOR ELECTRICAL INSPECTION eOe-v ooooi-os
~ See insimctions for competing mis form on back of yeliow copy. ~ O.y ~j
"X" Below Work Covered 6y This Request ~
Nev Add Rep. Type of Building • Appliaoces Wired Equipment Wired
Home Range Temporary Service
Duplez Water Heater Electric Heating
Apt. Building Dryer Load Management
Comm./Industnal Furnace Other Specify)
Farm Air Conditioner
Oner (specity) ConVacror's ftemarks: Compute Inspection Fee Below:
# Other Fee H Service Entrance Size Fee # Circuits/Feeders Fee
Swimming Pool ( 0 to 200 Amps 0 to 100 Amps
Transformers Above 200-Amps Above 700 -Am s
Si ns inspecrors usa orry, TOTAL
Irrigation Booms 3 p)ONNECTED f~
S ecial Ins ection ~na / D
Alarm/Communication THIS INSTALLATION MAY BE 0 IF NOT
Other Fee COMPLETED WITHIN 18 MO S. '
I, Ihe Elecirical Inspector, hereby Rouqn-m . oa~ ~ , J
ceAity that the above inspection has Final oe /
been made.
OFFICE USE ONLV
TMS eequest voitl 18 months from
~ ~oS46
006151 413,~ J_ 0~ Xw~ ~
Request Date Fi N¢ Fough-In ins ' n Requlred Inspectlan Other Than Roug~-In
` i7 (VOU must csll inspeclor hen reaGy) eaCy Now _ Witl ti Inspector
o~ `r ? Yes No te Reatl
Ilicensed contractor ?owner hereby request inspection of above electrical work at:
Job Atldress (Slreet, Box or Roule No.) Ciry
'416a O~F ~ ZA,41,F F.a914
5ection No. I Township Name or No. Panga No. County
Occupan~(PRINT Ph3one No..
3v
Powet Supplier Adtlress
A -0
46V fsd4~1 /Al~TO~
Electricel Contractor (COmpany Name) Contrector's Licanse No.
~s S ~ - f1~ ~(a3 l~
ailing As (COnlmclor or Owner Making Installafon)
2 x
Aolhon tl' Wre (COmraclrnlOwner Makin Inst ion) Phone NumOer
;/O -2
MINNESOTR STATE BOAflD Of ELECTRICRY THIS INSPECTION REdUEST WILL NOT
GNggs-IAIEway Bldp. - Haom 5128 q BE ACCEPTED BY THE STATE BOARD
1821 Univeniry Ave., SL Paul, MN 55100 Jl'i • UNLESS PROPER INSPECTION FEE IS
ihom (612) 642-0800 ENCIOSED.
S~/~ I REQUEST FOR ELECTRICAL INSPECTION -o
`"EB-ooooi9
O 1 51? Sea insimctions br rompleting this torm on back ol yellow copy.
-"X"gelow Work Covered by This Request
Ne Rdd Rep. Type of Building Appliancas Wired Equipment Wired
Home Range Tamporary Service
Du lex Water Heater Electric Heating
Apt. Building Dryer Load Management
Comm./lndustrial Furnace - Other (Specify)
Fartn Air Conditioner
Other (spxify) Conirectors Remarks:
Compute Mspection Fee Belaw:
# Other Fee # Service Entrence Size Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Am s 0 to 100 Am s
Transformers Above 200 Amps bove 100 -Am s
Si ns inspector's use Only: TAL
Irrigation Booms 0 :rVi
Special Ins ection
Alarm/Communicatlon THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Electrical Inspector, here6y Rough-In oate
cerlify that the above inspection has Finei oate
been made. ~ •~--9'SG
OPFICE USE ONLY
Thls repuest voitl 18 monihs Imm
Address 4624 WESIWOOD LANE Zip 5512,2_
Lot 2 Blk 4 Sub o[K UIFF rorm aro
.
THESE 3TEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION.
Date: g ) ~ Yes. No Inspector.
Final grade (6" from siding)
Permanent steps (gazage)
, Permanent steps (main entry) ~
Permanent driveway
Permanent gas ~
Sod/Seeded grass
TraiUcurb damage
Porch
Basement 5nish ~
Deck ~
Please verify with the buildet the removal ofroof test raps from the plumbing system and the shuaoff of water supply to
the outside lawn faucet before freeze potential exists.
Contact engineering division at 681-4645 before working in rightof-way or installing underground sprinkler system. ~
Whice - City Copy Yellow - Resident Copy Pink - Contractor Copy
2005 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Consimcfion Reauirements RemodeVRepair Reauiremenis Offce. Use Ort14
3 registered site surveys showing sq. fl. of lot, sq. ft, of house; and all roofed areas 2 copies o( plan Ced oF Suroey Recd Y, , N
(20% mazimum lot coverage allowed) 1 sel of Energy Calculations For heated additions LteePr05 Plan Recd _Y ,,._N;
2 copies of plan showing beam & window sizes; poured found design, etc. 7 sile survey for additions & decks iree Pres Reqmred Y N.
lsetofEnergyCalalations Addifion - indirafeifonsitesepficsysfem 66-sde5epficSystem "Y 3 capies of Tree Preservation Plan if bt platted aker 711193
Rim Jois1 Detaif Options selection sheet (buildings with 3 or less units)
~
Date _x/ 3' c) Construction Cost
Site Address Ay ~,;i y I.J e c~ W o o d ~ h_ Unit/Ste #
Description of Work p h
Multi-Family Bldg _ YX N Fireplace(s) _ 04 1 _ 2
Property Owuer 12J k PY't ef' a Telephone 5SZ) gg a~ 777 C7
Contractor 8 e CP O ca/ ern _
Address I~ 11].'~ C4 r v Pr City N I''Y) S V I ~
State Zip Telephone # (9S'Z)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesofa Rules 7670 Cate~ Minnesota Rules 7672
Ene~gy Code Category , Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(J submission type) Submitted Submitted
. Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review
fee applies.
Licensed Plumber Telephone )
Mechanical Contractor Telephone )
M ~
Sewer/Water Contractor Telephon i-#•);~ u
I hereby apply for a Residential Building Permit and acknowledge that the info tion is:~Qe an accurate;
that the work will be in conformance with the ordinances and codes of the Ci of Eagan e of MN
Statutes; I understand this is not a permit, but only an application for a permit, 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. ,
c,U L GnC en ~e~~
Applicant's Print d Name Applicant's Si atur
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 Accessory 81dg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (&sea.) ? 31 Ext. Alt - Multi
? 03 01of_plex ? 09 07-plex ? 17 Garage p 22 PorchlAddn.(4-sea.) ? 33 Ext.Alt - SF
? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? OS 03-plex ? 11 10-plex ? 19 LowerLevel ? 24 Storm Damage
O 06 04-plex ? 12 12-plex Plbg_Y or_ nl ? 25 Miscellaneous
Work Types ?1~ C ~~I~'~5 ~tf
P 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Adddion ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building' ? 43 Reroof ? 46 WindowslDoors
? 34 Replacement •Demolition (Entire Bldg) - Give PCA handout to applicaM
Valuation 16i Occupancy 771 3 MCES System
Census Code Zoning P D City Water
SAC Units Stories ~ Booster Pump
# of Units Sq. Ft. Z~IO PRV
# of Bldgs Length Fire Sprinklered
Type of Consi X! ~J Width
REQUIRED INSPECTIONS
Footings(new bldg) Final/C.O.
~ Footings (deck) ~j FinaUNo C.O.
~ Footings (addifion) _ Plumbing
_ Foundauon HVAC
_ Drain Tile Other
Roof Ice & Water Final Pool Ftgs Air/Gas Tests Final
Z° Framing _ Siding Stucco _ Stone _ Brick
Fireplace -r R.I. AirTest yD Final _ Windows
~j Insulation _ Retaining Wall
Approved By: -11W 04 , Building Inspector
-
Base Fee \
Surcharge ~/O/~T I ~ee O~, fX) 0
Plan Review ,
MC/ESSAC ~arzc~~ ~t 13~zy.o~
City SAC
Utility Connection, Charge j e~k2 pUc~~
S&W Permit 8 Surcharge p~
Treatment Plant n ~ 0 R /3, ~~e~
License Search (p/Zp jp,7 '71 ifM) eA DJ AA j O De4,
Copies ri/1 Io ~4 ~ F ~:ST i~ Z` X/0 I
Other
Total
CITY VC iiVM '
" EiSERIOR ENYELAPE lVERAGE IU' COi[PUTATZOH
oxtiES: o b Q r o
SITE ADDRESS: , 4~ a4 w~s-r ~po9 ~r~~ L a g 4 P1Z
cowraecroa: ~_a,xE: 3' 30- OS" Paoxe:
G
DeLermiae vorkia6 aWare fooLage of each:
1. Total exposed wall area ...aQ• ft• x•11 _ ( v" 2. Total roof/ceilirZg area I 7 7 y a9• n•; x.026
Total ezposed xall area above flooe = ~ 3
8• TOti81 W811 R1ndOB area
b. Total door area
! c. Total aliding glass area
. 3
d. Total fireplace ti+all area
e. Total xall framing area (average 10f)
f. Total net wall area ahove floor • ~ 7 _
8• TOt.21 rLIO jOiSt area 0 aZb~Sotal esposed foundatioa'area = ~-2 ~
' h. Total foundation uindow area
J. Total net foundation area above grade
Determiae 'Ut value of each vall aegment:
xopf
b x 'U' 114 - `~•4
c: 3 ~f z ,U,
-
ai x ~u~ .097 - 9 ,
I e. I U,
I . g: - X lUg .ofF~
' h, x 'U, e -
x'u' .o7G = 10_3
3 . Total =
If item i3 is the same as or less than item /1, you have met the intent of SBC
6006(c)2.
~ Total esposed roof/oeiling area
'
• 3. Total akylight area
k. Total roof/ceiling framing area (average 10%) J 7 7y!
1. Total net insulated roof/eeiling area
OVER a .
~
~
~
• ' M Determipe IUl value tor eac6 roof/aeilin8 sePenL:
.
• J. --~-r z +U'.~
k• ?I~I~N._ : out .oa6 y-s •
- r
1.~~
u,
Total = -
+I .
' If total of /4 ia the aame as or less than #29 you have met the intent of SSC
'
6006(c)1
~ Elternate Huilding Enrelope De3i6o
7o ntilize the total envelope system methods the values established by the sum..
of Items 43 snd +4 $hall not be greater than the aum of Items I7 and /2.
70 +2.~' ° ~14-k
, . T-
3. b_-.
;I
z .
~
M2422 endototNeighto DMN 56120
~ ` 1i911~lR~ l„o &,nqcym • a„L E*W~g (612) 681-1614 F/UL681-5488
O~ -t~ ~N~•-~~ N1tl1i~'S 625 titghwuy 10 tJ.E
6lalne, MN 53434
* .p *'k (612) 783r1880 FAX:783-1883
Certificate of Survey~ #or: (JCP Ha11~ES. INC.
4624 wESrNOOa uu+~
R ED
~ -
By
Ta ~ ~:f,tT~r:.,,>'~`~r~i,~ i~L~'`7~'• ~~T.
~ ~IA^it% AD7D
F.
OF PE O~'~
T ~
ELEV.=s61.4Z ~
!t ~7 62.1;
S C
4
S1.
W hzt,
~~ol
" r- 963.3 ~w ~ S
t+ 7 i ~tj .~i}Fr F
1n tr3 ~jF ~9 + 5 I
R1 ~i , 954
J' ~ ~ p r J ~ ~ra~$
2
~ ~ ~ l.d g 7
' i Sk~ E V95Di5 3 3 ~ .
v ~
G )
~ ~t - 961.11 ~ 952i"4.
Q to
'
I C)
~ r Z a~/s~ r°
' ~ p ~ z° s? N / ~'~i~: ( f q~
N
I ¢ 4 /
~ ~ MJ d' 2 r~
~ ao 855.2
E1-EC ~i y~+Y x 943,9 ~
V L~'
982-5 12.111 ~roP oSe~ . ~
55.72
81.22,00 G1
u ~
BENCH AtARK
TOP CF PIPE
ELEV.=851.38 ~ E ,y ~ ~ •,~,i C. ' '
I ZL:~
Po ReVa 13: , ~ • S 5
No1S vNOPdSEO caw[s srqhM pEx cttMdo H.nw sC ocP NaAES. Mc. PR
MDiE: auLuns (AMMoNS SMowH nRE- wR noMarTu 144b vGtncnt tACnnon LQWEST ROOR CIEVATiON:
Ci SIItUCYUHE3 dA:Y. 5fE ARCFiIlECR7Al P1M15 Fut tttn_dNG IlJD -
rarron1101+ uIMEnsia+s Mniw FLook eLEvanaw: ~
rt~rdt 7tre surtne~utt oF soxs to sawom nME srcarlc HwsE GARAGE SLAB EL[VAl10ht:
ip!'U3m Js ear tr~s REaPtM7snAU'IY oP n~e wRVEr(AR.
EVATIW
COCE3 NDS ~41RMtT TO 97DW FASEAIf.~l1`~~ OiNER IIiAN7l DOD.00 4E~4~ ENISIINC EL
S
FIUSE SHW~H OM 1NC RFt'ARDEU F'LAT. OW~ ) ~D~S PROi'OSEf EIEVAUUM
ocrroTes onaeAcR ~wn unun enseMe+r
LSCALELj0)A0x0rA-lCLUNlY, B SPEpFlC `3qLJ MVESRGATd1 NAS BFE7~ (7[MIPIEtE.O QN n's Lai BY lNE G
IkliRAC7Ct MUS7 YE~Y OftIVENAY OF51CN. DENDffS ORAN7ACE iIAW OFECIIG1
EIRINC$ ^~bWll ARC BA""D ON AN ASSUMED DA7UY ~NO~ M~EN1
pEMOIES UF'FSEt HUA
RERY C~.RTiFY t0 OCP FIOMES. ING. '111A7 1HI5 IS A TRUE AND C012RECT REPRESENiA710N OF A
Y OF THE BOliN0AR1rS OF:
2, BL4CK 4, OAK CLIFF P4Nd 2ND ADDtT10N
r~ couNrY, MINNESOTA
ES NOT PURPOR'C TO 3HOW 1MPROVEMENTS OR ENCHROACIiMENTS, EXCEPT AS SHOWN. AS SURVEYED BY ME OR
R MY DFRECT SUpER11IS16N 'MIS 251H DAY oF APRIL 19g5. p t.john P PIONEEft ENCtNEERIN~4r L[ : 1 1HCH = 30 FC[T ^C. Lerson. LS. Reg. No. 1 828
i-.,..-~--------_.~-'-'--_.-~.
. T~ MH 'RE-~ .
: BLD= ,'o'" . 4 : •
. • - '
20.30` . . . / : . ' . . ~ ~ ~ 3 8LC-'.$~~'e'" '
960.'30 : . . . . . 18.90'
RE ~
=6.~
~ BLD= 5 ' •
: 17. 5 . . . . . . . . . . . . . . g55 4p" .
'0 . ~3-~-
. . . . .
. --t-
~ 6F4 PROPOSEQ • ; : a
STM SWR 1 0
~ •
~ . : .j : .
. . , . y....~~...: •
j. : . : ~ : ;
/ . . : . PR ~ OPOSFD : , . , •
. 6,. DIP; WM
. . .
. . : . . ,
y . . . CL: 52:
~ . : . . i
• . . . . . . . -E
:7.:5': MIN; . . . . . : . ; -
~
. :
:COVER . . : : : ~ .
. . .
. : . :6'RT • : .
. .
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: . ~ - . .
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0.72 ,
35 0-9-
+$q, w:
. .
.
. . . ,
.
.
. 72': . . .
•
. . . .
PVC.: PVC : ; . . .
• SDR: 35 0-9-*41 SDR 26 0-9-469 f82:-8 PVC, . . . . 82',8" PVG,
: 0.35 I . . 0.22 ; . SDR 26: @-~~d%I 50R 26 @ O.$-~~
. . ~ ~~8, ~ .
• . . : . : _ : ' : . . : : : : . p~C
; . . • : ' : : :
~WL~::CITi'OFEAGAN:DOESOi ~{i,~, . :
.
~'Fi~: e~CC
M
l1F?!1CV` - . . '~AC1~E~ . : . . . . . . . . : : . ' i .
. ~ Af~'.~iQi'3: CL ~j oF--U7iLi~v i~e~ . . . . . . : . . . . . : . . . . ~ ~
A710MS. TM[S r~r ~ : ~
Arion~s
PUPP f: ,
r°Or' v S r
U., ~ ~ • : ! : .
~I,iVG 17:y~ Qc ^
'6 DIp 'vVM.
. . . . . . . . . . . . . ~ . . . . . . . . . . . .
L.. . . ~ fL
I.. . . . . . . . . . . . . . . . . : . . . . . . . . . . . . . . . . . . . . . . :
. . ; . : ~
. . , . . ~ . .
~ . . . ~ . .
• ` ~ crn oF FacAx
EEI'ERIOR ENYELOPE lYERAGE IU* CO!lPUTA?ION
oWa?ES: O C P H ~{"t ~ S~ T R U 5 0
siTE anaaess: 4G24 WE-5-r- vJoo,p L 2 94 P1Z
CONTEACiOA: VAfZLE.Y (--DNS7r-G`f'- DASE: PHDNE:
Determine rorking aquare tootege of each:
1. Total exposed wall area 31 5a aq, ft. z.11 = 3~~•~
2. Total roof/ceiling area ((O3ro aq. ft. x.026 - 1 a~ S
Total ezposed xall area above floor = a 7J lll
a. Total Wa11 Window area 466
b. Total door area ~ 7
c. Total aliding glass area 4 O
d. Total fireplace xall area
e. Total wall framing area (average 10%)
~SS I
f, Total net wall area above floor a$33
g. Total rim joist area a b 2 7'otal ezposed foundation area e ) S ~o
h, Total foundation window area ^
I. Total net foundation area above grade T
Determine IUI value of each wall aegment:
e~ ~ x l0t . 3-g- I E; S-1
b x lug .1-4 = 90 -'F
C. x out ~4
a. : lug _
e. ~ x 'U' .097 - 7e2r . 3'
f. 2533 x gUt .0 4-s
9. ;Lb2 x 'U'
h, x 'U' _
i. l2 F,Z_ zIu' .076 = l0.3
3 . .....................................1 55 TOLH1 = 3 ~e Jr
If item 13 is the same as or less than item 07, you have met the intent of SSC
6006(c)2.
Total ezposed roof/eeiling area = I~ 3 CS
J. Total akylight area
k. Total roof/ceiling framing area (average tOt) 1 6 3. 6
1. Total net insulated roof/ceiling aree I-4 7V_4
OYER
Determine vUl value ior eacA roof/ceiling sepent:
. :
J. x 'U, =
k. 161 3_6 :,u, .026
i. I 47~. ~ x9 ut . o aa = 3 a.
u . roo.i = 3 ~e 7
~ It total of /+1 ia the aame as or less than 02, you have met the intent of SHC
6DD6(c)1..
Alternate Building Envelope Design
io utilixe the total envelope syatem method, the values estaDlished by Lhe sum..
of Items 93 and /4 shall not be greater than the sum of Items #1 and /2.
2. `t2•.S =
3. 347.5 +4. 3CS•7 = 3S
2
~ PERMIT
~~,`'CIYY OF EAGAN LR. ~O ~~I
3830 Pilot Knob Road PERMIT TYPE:
BUILD
Eagan, Minnesota 55122-1897 Permit Number: 0
2 5 S 6 7 N G
(612) 681-4675 Date Issued: 0 5/ 12 / 9 5
SITE ADDRESS:
4624 WESTWOOD LANE
LOT: 2 BLOCK: 4
OAK CLSFF POND 2N0
P.I.N.: 10-53576-020-04
DESCRIPTION:
Bui1d'ing'A,ermit Type SF DWG
Building Wock\Type NEW
; UBC (lccupsncy ~ R-3 U-1
` Construction Type V-N
iZpnir~g - PD R-3
~
Building Length 66
Huilding Width 48
` Buildirtg stnries 1
.
~
i s
j( p r
t
REMARKS:
PRV S& W PLBR - B J M PLBG -
FEE SUMMARY:
VALUATION $123,000
Base Fee $720.00 MISCELLANEOUS $1.892.50
Plan Review $468.00 Total Fee $3,992.90
Surcharge $61.50
SAC $850.00
SFlC % 1@0
SAC Units 1
5ubtotal $2,099.50
CONTRACTOR: - Applicant - sT. Lzc. OWNER:
VARLEY CONST JOS 13346034 0003249 0 C P HOMES INC
16800 SHZELDSVILLE BLVD 8609 LYNDALE S 101-B
FARIBAUl7 MN 55021 BLOOMZNGTON MN 55428
(507) 334-6034 (612)881-0127
I hereby acknowledge that I have read this epplication and state that the
infiormation is correct and agree to comply with all applicable State of Mn.
L Statutes and' City of Esgan Ordinances. ~
~ ~ ~ ?n R~ 'r,~.l ~
APPLIC NT/PE ITEE SIGNATURE ISSUED SIG RE 11
. ~
3830 PILIOT KNOB RDN 55122 z6tf 1995 BUILDING PERMIT APPLICATION (RESIDENTIAL)
681 -4675
New Conshuetion Reauiremenfs &gmodel/Reoair Reauirements
? 3 registered ske wrveys ? 2 copiea of plen
? 2 copies oi plans (include beam 8 window sizea; poured fnd. design; eto.) ? 2 ake surveya (exlerior additions 8 dedcs)
? 1 energy cekuladons ? t energy calwlations for heated additions
? 3 copies W troe preaervatloqplan ff lot platted after 7/1193
required: _ Yes x No
DATE: 5/2195 CONSTRUCTION COST: $jao noo
DESCRIPTION OF WORK: New Residence
STREET ADDRESS: 4624 Westwood Ln.
LOT z BLOCK 4 SUBD./P.I.D. Oak Cliff Pond, 2nd Add. 10-53576-020-04
PROPERTY Name: OCP Homes, Inc. Phone 881-0127
OWNER 8609 Lyndale So. #1't99B
Street Address•
Ciry: Bloomington State: MN Zip:55420
Joseph P. Varley Construction, Inc. 507-334-6034
CONTRACTOR Company: Phone
Street Address: 16800 Shieldsville Bivd. License nnn'19aa
City: Faribault ' StBte: MN Zip• 55021
ARCHITECT! Company: Phone
ENGINEER
NeRle: C:mvar flimnnd Registration #Street Address- 2332 eourne
City: _ St. Paul State: MN Zip; 55108
Sewer & water licensed plumber: BJM Plumbing Penalty applies when address change and lot
change are requested once pertnit is issued.
I hereby acknowledge that I have read this application and state that the infortnation is correct and m ~to comply with all
applicable State of Minnesota Statutes and City of Eagan Ordinances. J eph P ns ruction, Ind.
Signature of Applicant: I~Z..
/
OFFICE USE ONLY ~
Certificates of Survey Received Yes _ No MAY 0 3 1995
Tree Preservation Plan Received Yes No
~ .
OFFICE USE ONLY ; • 4,:;~~ 4; ~ ~
.
BUILDING PERMIT TYPE ~
0 01 Foundation o 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish
C)2~ 02 5F Dweliing o 07 4-plex ? 12 Muiti RepaidRem. ? 17 Swim Pool
0 03 SF Addition o 08 8-plex o 13 Garage/Accessory ? 20 Public Facility
0 04 SF Porch o 09 12-plex ? 14 Fireplace o 21 Miscellaneous
0 05 SF Misc. 0 10 = plex ? 15 Deck
WORK TYPE
cp~ 31 New o 33 Alterations ? 36 Move
0 32 Addition o 34 Repair ? 37 Demolition
GENERAL INFORMATION
Const. (Actual) f-6~ Basement sq. ft. MC/WS System P<
(Allowable) Main level sq. ft. f/XS City Water ~
UBC Occupancy 3 i sq. ft. Fire 5prinklered
Zoning sq. ft. PRV
# of Stories sq. ft. Booster Pump _
Length !v!a sq. ft. Census Code.
Depth ~18 Footprint sq. ft. SAC Code G~
Census Bldg ~
Census Unit ~
APPROVALS
Pianning Building Engineering Variance
Permit Fee Valuation: $
Surcharge 7 ~ Coara c
Plan Review > 3~ / 3 = y g o0
License ok7r> -
MCNNS 5AC Z~i~' S 7= 9 9 2 ~ 1 S k 2-_ .
City SAC
WaterConn.
Water Meter y ~ ?O S~_ ^=d~~
Acct. Deposit ~?,4- i7 ~ ~ y r
S/W Permit
SNVSurcharge
Treatment PI. S20
Road Unit yy -
Park Ded. • ~ ~ y ` ~
Trails ZZ
Ded. 13 = 2
0 Sz s
Other
COpI@S Ler,-~r - Ur~
To~l: rr = 2 t y ~
~
OOY
% sAC ioo Z ~
SAC Units
--'..-ry - - - - -2422 Eaterprise brlve
Mendolo Heighto, MN 55120
* PID11~lR (612) 681-1914 FAX:881-9488 I
u,u suRVEvOns • a+L cMOmums
* 011 r9lq! La'6 "wwm• tAN°SCAK A'tl11CS 625 Hlghwoy 10 N.E.
~ 8lalns, MN 55434
(61R) 783-1880 FAX:T83-tN3
Certificate af 5urvey for: OCP HOMESw INC.
aszn wESrMoa LANE
l~~
ByA ~
Da ~ .'3~:G Dr.P~
EAGAN El Gri`TI.~~
BENCH MARK
=Kt TOP 0F P9PE
ELEV.=961.42
}1 ~ 4iR { t/
v ww ez.,:
v4 ~
1691+ 5 op~ • ~ I
~_*26 W
~ ~ ~ 72 r~ 954~
~ 5A /~SERVICE ~ 959.0 g •~,a~
~ ~ • ~r ~ EkEV=950r~
~ ~ 95 $~6"4.
Q 963.4
~ Z?' ~
I ~ ~ N,~; •3,~ } e. 948.4
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~0__ 2 J23 Nj ~ 942.6 ~
N r~` %p
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955.2 J-~, r - I
949. x 943.9 ~
J aea.5 az.f~ co
~ y N
I r~ ~ 55.72
Z
E ~'~l f o4 850.21
s~~ r~8-E izzoo
B£NCN lAARIC rl ~ 4~ 1~
TpP pF PIPE J
a.FV.=sst.3a 3~~ 1 E\N
p p t-,, r- r_~ . . !
ollUaVa ~L1-
NOIEc FOoPO6ED cRAacs sqYM PEx cRlMiiN6 Klw aY: 6CP HaMCS N¢ PRQFQ5ED NOl15E EJLrVA7tON
NOiE: 9UlllNO OIMENSLOMS S110W11 AF7E FOR IIORRONTN- Ano vennM uxara+ LOWES7 ROOR [IEVAIiDN:
a SINlLC1UPoE3 dA.Y. sEE MC{qIECRULL. PuN5 FoR BIALIJIMC lJJD roufrtfhUM °""Erl'SMF MAiN FLOOR E1EVAlION:
N07E: NO 91'[qFlC w.*B MK.6nGATM7N NAS 8F17a CAEIiKFiFA PN Am La1 BY SHE
SUnVEM fHE suffr,eiu7Y oF smLs ta svrrwrr nHE sreaftc HwsE GARAGE SLAB ELEVATIOht: G4f • L ,
rkoroSYD IS xor ItC RLWoNMurv OF IMe surevtraR. i
Notc: s cEamv~uW oaes voz niarncc ro s~+ow ~st:t~*ns nn~Ert nIrui x ooo.ao O~MOIES EKISYIIiC ELkVA710li
~w ~
7FqSE SNOFN ON 7HC REiCdiDED 1'LAT. [ 09f1.00 ) OF]MU7E5 PROPO5FD ELEVATON
- OENOTFS pRMNAGH M!D UiR1TY flISEMQIT
k('11E CON7kACTOR MUST VWY ORIVEMAY DE5ICPL DENOiE5 ORNNA6E ilAf9 OIREMKN ~
MOTE: EIE,WINGS SHCANI ARE BASm OM AN ASSUYED DA7UY -C- txNOus NUMUMEHI ~
---~j-- pp701E5 bRF5E7 NU8 I
WE HEREOY CERTiFY YO OGP NCNAES. INC. 7HAT 11415 }S A TRVE AND Cd12RECT REPRESEN7A710N OF A ~
$URVEY OF THE BOUNDARIE$ OF:
1 LOT 2, BLOCK 4t OAK CLIFF POND 2ND ADOtT10N
DAKOYA COUNIY, AhINMESOTA
lT nOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCHROACHMENTS, EXCEPT AS SHOVM, AS SURVEYED BY ME DR
~ UNDER MY D{RECT SUPERVISION THIS 25TH DAY OF APRIL. 1996•
t.~"' ~
51 4 Ep PIONEER ENYNEERING, A.
y f
SCALE : 1INCH = 30 FgE7 John C. Lerson. LS. Req_ No. ti 28
i^~-c-r _ - .
10'd ~
LOT BtrRVEY CBECxLIBT FOR RESIDENTZAL
~ BIIILDING pERMIT 11PPLICATION
~ PROPERTY • pAi=
~ Y
Dite of 8urveys ~Lz.i~93-
DOCIIMENT 8T xnaM X~-
.
/
/
0 • Registered Lnnd Surveyor aignaturs and company
13 • Building Permit Applicant
P0 • Leqal description
D • Addreae
~ • North arrow and bar scale
HC • House type (ramblar, valkout, cplit w/o, Qplit entry,
lookout, etc.)
~~,I 0 • Diractional drainaqe arrows vith slope/gradient t.
GY n D Proposed/exiating aewer and water services
ID~~~- 0 • Street name
~ D 13 • Driveway ~
ELEVATIOIiB
Exlstlna
w'0 0 • sawer service
M--13 0 • 7,ot corners
fY~O 0 • Top of curb at the driveway
D" D 0 • Elevations of any existing adjacent homes
ProDOSeQ
@~~ 0 • Garage lloor
0 • First floor
B~ D 0 • Lowest exposad elevation (walkout/window)
• Property corners
0 D • Front and rear of home at the toundation
pQNDING f?REAS [if aofllieablel
~ ~ D • Eement 2ine
13 flC' D - HwL
0 • Pond # designation
D • Emergency Overilow Elevation
DiMEN8201Ps
~ n 0 . Lot lines
Riqht-of-way and street width (to back of curb)
E' n 0 • proposed home dimensions including aay proposed decks,
overhangs greater than 21, porchas, etc. (i.a. all C~D 0 . structures requiring permanent lootinqs)
Show all easements of zecord and any City utilities within
D a . those easements
Setbacks of proposed structure and setback of adjacent
O ~ ~ existing homes
Retainin 11 re rements, it any
Aaviewed:
me / ate
'Octobar 1992
ST~~
\ M S£wrR 6"-45' BEND •
~ • MH ~ STA, 5+-5+g7.`.o-~-
3 4+23.88
' 5-0+38 MH ~ STA. ~-r,~.~_ WV-<950.29
CS-963,1
6"-22 1/2' BEND
,
ANT 5ei5'',
" TEE ,1\- - ,
,.DIP, Ci~'52 ~ RET. ALL
EL~
6.0 5'~(>
~ ~r<L ,
HYC
611G. V.39' 6„x
x 6~~ TEE 12'-
, .5- ,1 o
s.5 fi
iz
CLEAN 0 iT GND
F TNH
<o MH ~ STA. 5'
~ 4
3' 07 S-0+48
S-0+67 INV-947.50 RET. WALL----~~~~~
~ INV-950.50 ~S-958.7`,
CS-963.6 . ° : •
~-r-CLEAPJ OUT
6+82.31
MH ~ STA.
5 1.30 L
73
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5-0+76 '.,CS-94 3.8
INV-947.79 ~ O
CS-962.0 POND AP-10 7
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F 17
~5.02 p YHE- CiTY
30.2 C~ C~!r DOcS ixi'(
i "'G ~U/';r?A~J~_crz
~;~CUR6ICY ,
GT 6,N'Q/ON ELEV~T (VS.7HISTY LaCATfOfVS
~
' ll~t=un~ r6A7'tOM URPpSES DF'~'fl IS FOr~ .
~PC~i~'?i~S ~ 0,°.LY _
U..I IT:-SHOULG A~~D
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416aaq /5.so
2004 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
Date C~ / ! _CLI
Site Street Address ~ Io Unit #
Property Owner "l 1 ~~u V7V ` b' Telephone # 7~D
contracto6,~)V 6A ,`e.~ f I ~5 Q~.`q~ L Telephone #T.~~ . .0 G/~~P~
`l~~ YIi Cihq~llt~J+ State~L ZipW
Address ~
The Applicant is: _ Owner ~ Contractor _Other
Alterations to existing dwelling $ 50.00
_Add fixtures to rooms, excluding water softener and water h k rt2 nr f~ ~ M f~ D
LS l~7 LS LI L5
_Septic System Abandonment SEP 0
_Water Turnaround (add $121.00 if a 5/8" meter is required) 9 Z004
Other:
~ Water Softener _ Water Heater $ 15.00
replacement _ additional
Lawn Irrigation System RPZ_ new _ repair _rebuild $ 30.00
State Surcharge $ 50
Total $J~-~--J
I hereby appiy for a Residential Plumbing 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 plumbing codes; that I understand this is not a permit, but only an application for a
permit, work is not to start without a permit and work will be in accordance with the approved plan in
the event a plan is required to be reviewed and approv .
~
~~"l
Applicant's Printed Name A p icant's ignature
2005 RESIDENTIAL BUILDING PERMIT APPLICATION
Crty Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construaion ReauiremeNS RemodellReoair ReauiremenLS Office Use Onlv
3 registered site surveys showing sq. ft. of lot, sq. R. of house; and all rookd areas 2 copies of plan Cert of Survey Recd _ Y_ N
(20%maximum lat coverage allowed) 1 set of Energy Calculalians for heated additions Tree Pres Plan Recd Y _N
.
2 copies of plan shawing 6eam & window s¢es; poured found design, etc. 7 sRe suNey foraddNOns 8 decks T2e Pres Requiied _ Y_ N
isetotEnergyCalculations AddiG'on - indicatei(on-sitesepfmsysfem On-site Septic System _Y _N
3 copies of Tree Preservation Plan it lot platted after 711193
Rim Joist Delall Options selec6on sheet (buildings with 3 or less units)
i
Date Construction Cost ~S U, o U
SiteAddress y62y WBSjm?vDi) L,ti Unit/Ste #
Description of Work Dow J v-~S7-i4A-i-5
Multi-Family Bldg O1( ~ N Fireplace(s) _ 0 _ 1 _ 2
PropertyOwner 5'0V {~j20 Telephone#((,s/) £'S~SZ-777D
Contractor ILt-P 001 ~`~LJ97/'cr7lo1J
Address {2- 711 S j>MV1'1,0l11P City W PY-7 ?K}L-LQ-'7
State yYl Zip S S/3 LJ Telephone #(cJSa) N2 3-el 2 1 6
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv I Minnesota Rules 7672
Energy Code Category , Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(Jsubmissiontype) Submitted Submitted
• Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review
fee applies.
Licensed Plumber Telephone ) 1
Mechanical Contractor Telephone
~AN 0 3 Z005
Sewer/Water Contractor Telephone )
y
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.
~1?9vh~S ~KILCO/~6 0
ApplicanYs Printed Name pp icanYs Signature
OFFICE USE ONLY
Sub Types
? Ot Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool 0 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 EM. Alt - Multi
? 03. 07 of _ plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screenlgazebo) ? 36 Multi Misc.
? 05 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 ? 35 Int lmprovement ? 38 Demolish lnterior ? 44 Siding
? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building* ? 43 Reroof ? 46 WindowslDoors
? 34: ReplaCement 'Demolition (Entire Bldg) - Give PCA handout to applicant
Valuation Occupancy MCES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bidgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings(new bldg) _ FinaVC.O.
_ Footings (deck) _ FinaVNo C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests Final
_ Framing _ Siding _ Stucco _ Stone _ Brick
_ Fireplace _ R.I. _ Air Test _ Final _ Windows
_ Insulation _ Retaining Wall
Approved By: , Building Inspector
Base Fee
Surcharge
Plan Review
MCIES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
CITY USE ONLY
L ` BL ~ RECEIPT
SUBD. ak n DATE: A`~ 9'S
I/U
1995 MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
? New construction Add-on furnace
Add-on air conditioning Fireplace conversion (to existing fireplace)
Date: g5
FEES
? Minimum Fee: Add-on/Remodel (existing residence only) $ 20.00
? HVAC: 0-100 M BTU 24.00
Additional 50 M BTU 6.00
? Gas Outiets (minimum of 1 required @$3.00 each)
? State Surcharge .50
TOTAL a4'So
:
SITE ADDRESS:
OWNER NAME: N(A f2l_PHONE
INSTALLER NAME: I.aT.,
STREET ADDRESS: 2~_L
CITY: STATE: Yl'1 Q~. ZIP: PHONE
t_ _
.
CITY USE ONLY
L BL RECEIPT
SUBD. DATE:
1995 MECHANICAL PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete for: ? all commercial/industrial buildings.
? multi-family buildings when separate permits are gq1 required
for each dwelling unit.
DATE: CONTRACT PRICE:
WORK TYPE: NEW CONSTRUCTION INTERIOR IMPROVEMENT
DESCRIPTION OF WORK:
FEES: $25.00 minimum fee 2E 1% of contract price, whichever is greater.
Processed piping - $25.00
State surcharge of $.50 per $1,000 of pzlnA fee due on all permits.
CONTRACT PRICE x 1 %
PROCESSED PIPING
STATE SURCHARGE
TOTAL
- - -
SITE ADDRESS:
OWNER NAME: TELEPHONE
TENANT NAME: (IMPROVEMENTS ONLY)
INSTALLER:
ADDRESS:
CITY: STATE: ZIP:
PHONE
SIGNATURE:
SIGNATURE OF PERMITTEE CITY INSPECTOR
CITY USE ONLY
, L ~ BL ~ RECEIPT
„D
SUBD. ak ~ DATE: ~ ~O2 95
1995 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
FIXTURES EACH NO. TOTAL
Shower 3.00 x I = 3
Water Closet 3.00 x ~ _
Bath Tub 3.00 x
Lavatory 3.00 x 3 =
Kitchen Sink 3.00 x 3
Laundry Tray 3.00 x 1 = 13
Hot Tub/Spa 3.00 x =
Water Heater 3.00 x 3
Floor Drain 3.00 x ? _ -3
Gas Piping Outlet * minimum - 1 3.00 x (o
Rough Openings 1.50 x =
Water Softener 5.00 x ~
Private Disposal Dakota Cty. license 20.00 =
U.G. Sprinkler * home under const. 3.00 =
Alterations * to existing 20.00 =
Water Turn Around 20.00
STATE SURCHARGE .50
TOTAL ~o e'Z- S°
SITEADDRESS: ~4-^--
OWNER NAME:~
INSTALLER NAME:
STREET ADDRESS:
CITY: z4q-- ~w.~•.~ STATE: ZIP:
PHONE ( ) 7 7 ~ , lf/77 _
ST GNA I U~ ~11I
cirr use oNLv
L BL RECEIPT
SUBD. DATE:
1995 PLUMBING PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete for: ? all commercial/industrial buildings.
? multi-family buildings when separate permits are not required
for each dwelling unit.
DATE: CONTRACT PRICE:
WORK TYPE: NEW CONSTRUCTION ADD ON REPAIR
DESCRIPTION OF WORK:
FEE: $25.00 minimum fee or 1% of contract price, whichever is greater. State surcharge of $.50 per
$1,000 of permit fee due on all permits.
CONTRACT PRICE x 1%
STATE SURCHARGE
TOTAL
SITE ADDRESS:
TENANT NAME: STE. #
OWNER NAME:
INSTALLER:
ADDRESS:
CITY: STATE: ZIP:
PHONE
SIGNATURE:
APPLICANT CITY OF EAGAN
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 4624 Westwood Lane
Lot: 2 Block: 4 Addition: Oak Cliff Pond 2nd
PID:10- 53576- 020 -04
Use:
Description:
Sub Type: e- Reroof
Work Type: Replace
Description: House & Garage
Census Code: 434 -
Zoning:
Square Feet: 0
Comments:
Fee Summary:
Valuation: 3,000.00
Contractor:
Property Claim Solutions LLC
4655 Nicols Rd, Suite 202
Eagan MN 55122
(651) 994 -2028
Applicant/Permitee: Signature
PERMIT
City of Eaan
BL - Base Fee $3K
Surcharge - Based on Valuation $3K
Construction Type:
Occupancy:
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.
$88.50
$1.50
Total: $90.00
- Applicant -
Owner:
Robert F Bro
4624 Westwood Lane
Eagan MN 55122
Permit Type:
Permit Number:
Date Issued:
Permit Category:
0801
9001
Issued By: Signature
Building
EA090094
07/07/2009
ePermit
I hereby acknowledge that I have read this application and state that the informa
of Minnesota Statutes and City of Eagan Ordinances.
on is correct and agree to comply
h all applicable State
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA111027
Date Issued:06/10/2013
Permit Category:ePermit
Site Address: 4624 Westwood Lane
Lot:2 Block: 4 Addition: Oak Cliff Pond 2nd
PID:10-53576-04-020
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Kris Oien
3670 Dodd Rd
Eagan, MN 55123
Fee Summary:PL - Permit Fee (WS &/or WH)$55.00 0801.4087
Surcharge-Fixed $5.00 9001.2195
$60.00 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 -
Robert F Bro
4624 Westwood Lane
Eagan MN 55122
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature