4644 Westwood Lane ~
,.~?:.•~~-:r
Wertificate of Cccuoanc~
WU4 of
2"arbarur of 8ri[iixg ~a~ectisx
This Certificate issued prersuanl to the reqwiremtrtts of the URifarm 8uildireg Code
certifying that at the time of issuance this structure was in compliance with the various
onfinartces of the CiJy regulaiing building canstrrrction or use. For the following:
ltse Classification: SF TLI: Bidg. Permia Ho. 958M-
OoaVaocy Type R3/U I Zoaing Distria VN Type Conw. PI1/R3
Unrcr of 6uilding FIM INC Addiest 8609 Y.YNMj? AMR 39).MW
&elding Add~ss 4644 WLSIwpm TJ11a? l.ocaliry
1 Daa:
~ 8udding OWwW ,
POST IN A CONSPICUOUS PLACE
INSPECTION RECQRD
CITY OF EAGAN PERMiT TYPE:
3830 Pilot Knob Road Permit Number.
Eagan, Minnesota 55122-1897 Date issued:
(612) 681,4675
SITE ADDRESS: APPlICANT:
, ~ i, ~ ! !
PERMIT SUBTYPE: TYPE OF WQRK:
INSPECTION .A . .A
7 • , , ~ i I . i . I ! I . , I
il!vt; 1 141,
Permit No. Permk Holder Date Telephone #
ELECTRIC
; PLUMBING
HVAC
Inapsction Date Inap. Comments
FOOT1lVG5 I,/., fl/ .Sv d
FOUND
.
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
SNSUL
AV 9s" /lZ
GYP 80ARD
FIREPU4CE ~
FIREPLACE
AIR TEST
FINAL PLBG
CJK N
FINAL HTG ~ tI
ORSAT Il /r
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECK FfG 1 p _
DECK FINAL lwS Q5+
y~5~%
0-~, 7 ~51 11~ 6w 1 L '`~/~5 'toj Fteques[ a[e Fire No. oughdn Insp€ction red Ins ctlon Other Than Fough-In
(YOU must calt inspe r~ihen reetly) Ready Now gWill Notify Inspeclor
Ves U No oate fleatly
IKlicensed contractoi ? owner hereby request inspection of above electrical work at:
Job Address (SVeet, Box or Route No.) Ciry
q&1'4q lr~7gf' LAAII~ EAG,C4
Seclion No. Township Name or No. 7an9e No. County
(,~a0 K 0 l o~
Occupant(PRINT) Phone No.
//,di2tEf' G'~Ms % 3311160?y
Power Supplier Atltlress
F,4 FOG VZ K,'%tlf IDN
Eleclrical ConUactor (Company Name) ConVaclo/s License No.
1.77e,A--7S7-V7Z~ EGEcT2ic- cA o 0-38
Mailing Address (Contractor or Owner Making Ins Ilation)
1~Z2a. 3(pc lfzf ttil~dT~2k'~ctE ~'N r~o~.G'
ANhoriietl Siqnature (COMradodOwner Makin Installafion) Phone Number
36~- 99'Y7
MINNESOTA STATE BOARD OF ELECTPICRYI 111111111111111 THIS INSPECTION REOUEST Will NOT
Griggs•Mitlway Bltlg. - Room S128 BE ACCEPTED BV THE STATE BOARD
1821 Univereky Ave., Sl Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS
Phone(612 642-0800 ENCl0.SED.
~ REQUEST FOR ELECTRICAL INSPECTION es-oaona'i~~-ayys
7 See insimMlons for completlng this form on bark of yeAOw copy
! "X"
p5 410S~-'
Below VYork CoKered by This Request Ne Add Rep. Type of Building Appl"dnces VAred Equipment Wired
Home Range Temporary 5ervice
Du lex Water Heater Electric Heating
Apt. Building Dryer Load Management
Comm./Industrial Fumace Other (Specify)
Farm Air Cond'Rioner
Other (spaclly) Conhactor's Remarks:
Compule fnspection Fee 8efow:
# Other Fee # Service Entrance Size Fee # CircuitslFeeders Fee
Swimming Pool 0 to 200 Amps D' 1,2110 to 100 Amps OS `
Transformers Above 200 Amps Above 100 ~Am s
Signs insPectors usa omy: TOTAL
Irrigation Booms L~ Ia~ ~
S ecial Inspection "
Alarm/Communication THIS INSTALLATIDN MA 5CONNECTED IF NOT
Other Fee COMPLETED WITHIN 76 MONTH
1, the Electrical Inspector, hereby Rou9n;n ~ oa~e certify that the above inspection has Finai C~ oate ' i
been made.
OFFICE USE ONLV -
This requestvoid 18 months irom ' .
Address 4644 wesnWoD r,nrE Zip 5512 3
Lot 7 Blk 4 Sub oax ct= PoND 2ND
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECI'ION.
Date: Yes No Inspectot:
Final grade (6" from siding) ~
Permanent steps (garage)
Permanent steps (main entry) ~
Permanentdriveway ~
Permanent gas
Sod/Seeded grass i/
TraiUcurb damage ~
Porch
Basement finish ~
Deck
Please verify with the builder the removal of roof test raps from the plumbing system and the shuboff of water supply to
ihe outside lawn faucet before freeze potential exists.
Contad engineering division at 681-4645 before working in right-of-way or installing underground sprinkler system. ~
White - City Copy Yellow - Resident Copy Pink - Contractor Copy
2006 RESIDENTIAL PLUMBING PeRnnir aPPUCarioN
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifcations to existing residential dwellings.
Date ~ / (O 1 ~_~p~L(~(';
SiteStreetAddress~~I t9,1lC~Si'?p Unit#
Property Owner ( ~k111(~(iP) ffCK sCin Telephone # ((f~) ) 638` ~,S 9.3
~
Contracior I pavof S Telephone #&50, i3~D~G
134 (`i
Address l CityState 4N Zip SSl~3
The Applicant is: _ Owner ~ Contractor _Other
Septic System _ New _ Refurbished Submit 2 sets of plans and MPC license Includes County fee
$ 100.00
Per as-buiit $ 10.00
Alterations to existing dwelling $ 50.00
_ Add ptumbing fixtures. This fee includes installation of a water softener and/or water
heater at the same time. lf you are insfaNing onlv a wafer softener and/or water
heater, do not complete this section; move to the next section and check the
appliance(s) you are installing.
_Septic System Abandonment
_Water Turnaround (add $130.00 if a 5/8" meter is required)
Other:
Water Softener ~ Wafer Heater $ 15.00
_ new ~ replacement
Lawn irrigation _RPZ _PVB _new _repair _rebuild $ 30.00
State Surcharge $ 50
Total s I5-,50
I hereby apply 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 a oved.
Applicant's Printed Name Applica Ys Signature
( ~j `~c?
9TY OF EAGAN PERMIT
31TPilot Knob Road PERMIT TYPE: B U I L D I N G
IkADDRESS: gan, Minnesota 55122-1897 Permit Number: 0 2 5 8 8 6
2) 681-4675 Date Issued: 0 6/ 2 6/ 9 5
4644
WESTWOOD LANE
LOT: 7 BLOCK: 9
OAK CLIFF POND 2ND
P.I.N.: 10-53576-070-04
DESCRIPTION:
Biiilding` Permit Type SF DWG
Building Wbrk Type NEW
iUBC Occupancy', R-3 U-1
' Constxuction Type VN
Zoning Pp R-3
Building Length 61
Building Width 46
Buid~tling stories 1
,S,qu,a;re Feet - 2,126
ii
REMARKS:
PRV 5&W CONTRACTOR - BJM PLUMBING
FEE SUMMARY:
VALUATION $137,000
Base Fee $1,072•25 MISC FEES $1,892.50
Plan Review $375.29 7ota1 Fee $4,258.54
Surcharge $68.50
SAC $850.00
SAC % 1@0
SAC Units 1
Subtotal $2,366.04
CONTRACTOR: - Applicant - ST. Lzc. OWNER:
VARLEY CONST JOS 13946034 0003249 OCP HOMES INC
16800 SHIELDSVILLE BLVD 4644 WESTWOOD LANE 101B
FARIBAULT MN 55021 BLOOMINGTON MN 55420
(507) 334-6034 (612)881-0127
I hereby acknowledge that I have read this application and state tMat the
infiarmation is correct and agree to comply with all applicable State ofi Mn.
L 5tatutes and City ofi Eagan Ordinances: ~
'APPLICANT/PERMITEE ISSOEDB SIG CURE I
l
' CITY OF EAGAN
1995 BUILDING PERMIT APPLICATION (RESIDENTiAL)
B
681-4675
New Censtrudion Reauirements RemodeVReoair Reauiraments
? 3 registered site surveys ? 2 copies oi plan
? 2 copies of plans (indutle beam 8 window s¢es; poured frM. design; etc.) ? 2 site surveys (ezterior addNOna 8 dedcs)
? 1 energy calalatbns ? 1 energy calaufations kr heated addttions
? 3 copies M tree preservatioylan N lot pletted after 711/93
required: _ Yes _ No
DATE: 6/13/95 CONSTRUCTION COST: $140.000
DESCRIPTION OF WORK: New Residence
ST~ET ADDRESS: 4644 Westwood Ln.
Oak Cliff Pond, 2nd Add. 10-53576-070-04
- ~ BLOCK 4 SUBD./P.I.D.
LOT
OCP Homes, Inc. 881-0127
PROPERTY Name: Phone
OWNER 8609 Lyndale So. #°P01B
Street Address-
Ciry: Bloomington State: MN ZiP; 55420
Joseph P. Varley Construction, Inc. 507-334-6034
CONTRACTOR Company: Phone
Street AddfeSS: 16800 Shieldsville Blvd. LiCenSe 0003249
City: FaribauR State: MN Zip. 55021
ARCHITECT/ Company: Phone
ENGINEER
Name: Grover Dimond Registration
Street Address- 2332 Boume
Clty: St. Paul State: MN Zip: 55108
Sewer 8 water licensed plumber. BJMPlumbing . Penalty applies when address change and lot
change are requested once permit is issued.
I hereby acknowiedge that I have read this application and state that the information is cortect nd agr wmply with all
applicable State of Minnesota Statutes and City of Eagan Ordinances. J~\Q~ . Varley on ct\ Inc.
Signature of Applicant:~ ~ ~ 1
OFFICE USE ONLY ~~~ENED
Certificates of Survey Received V Yes _ No J U N 15 1995
Tree Preservation Plan Received Yes V No
OFFICE USE ONLY
BUILDING PERMIT TYPE
0 01 Foundation o 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish
~ 02 SF Dwelling ? 07 4-piex o 12 Multi RepaidRem. ? 17 Swim Paol
? 03 SF Addition o 08 8-plex o 13 Garage/Accessory ? 20 Public Facility
0 04 SF Porch ? 09 12-plex o 14 Fireplace ? 21 Miscellaneous
? 05 SF Misc. ? 10 = plex ? 15 Deck
WORK TYPE
,Q-'-31 New ? 33 Alterations ? 36 Move
? 32 Addition ? 34 Repair ? 37 Demolition
GENERAL INFORMATION
Const. (Actual) ~Z?-4 Basement sq. ft. 5-9 y MC/WS System oL
(Allowable) Main level sq. ft. i, loYo City Water _r~<
UBC Occupancy !?-3 u-~ sq. ft. Fire Sprinklered
Zoning sq. ft. PRV yrs
# of Stories , iw/as~.. sq. ft. Booster Pump
Length a0-&7 sq. ft. Census Code.
Depth IV6• Footprint sq. ft. SAC Code ai
p e Census Bldg i
zb ~ Census Unit /
APPROVALS s.sxs '
Planning Building Engineering Variance
Permit Fee Valuation:
Surcharge
Plan Review
License
MCNVS 5AC
CRy SAC C~s Z K z/ =`~Z zyy z(. 37 = S/L
Water Conn. ~yx y ~ ~ Gyuz~ ' ~
Water Meter z, 3,1,
s'
Acct. Deposit yy x 37- yog S1J ~/,c i~_
S/W Permit
SNV Surcharge 7 Sy z " ~s O(vY
Treatment PI. +c v z~
Road Unit - ~J
Park Ded. ~ ~
s
Trails Ded. / lo yo Xs~= ~bi
Other
Copies
7?`(
Total: 1,6 yO
% sAC ~ • s K$> " ~y ~ /
SAC Units <yK y~ . ~Nz
s 9Y Kas~ ` 3~,85 °
A ' 2422 Enierprise pryva
~l~ Mendotv iieights, MN 65720
* PIONWIR • ~,E~ (612) 881-1914 FAX: $81-9488
96fi@ygdr n-8 W+o PtMMEfffog• 1~ 825 Highnoy 10 N.E.
Blalrve, F6N 55434
(012) 783-18$0 FAX: M-1$8.3
Gertificate af 5urvey for: 0 cP F{dMES, INC.
4644 YYE'STWOOD LANE
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Ha`IE: 'FHIS CER11F1CASE flUES N07 PUR/'ORT TD SHOW EM"EME" nTNfR 7HAN % WD.[)O DET101E5 E%151kI0 EIkVAlION
iNOSE 5riGxN orv 7"e. HEGbF2ED PLAT, l 00¢OO ) PFNtl7ES PROP06E0 4.lEYNY1CRs
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~B DENp7E'S OFFSET HU0
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SURVEY OF THE BOUN[1RkIES UF:
LQT 7, Bl.{}CK 4, OAK CLIFF PbND 2ND ADdITION
DAKOTA COUN7Y, MIMNES07A
i7 DOES NOT PuRPORT Tfl SHiSW IMPROVE:MEF77S OR [WCElRQACihAENTS, EXCEPT AS SHONRJ, AS SUHVfYEO BY ME OR
UNOER MY OIR[CT SUPERy570N 7FIIS FSiN CYAY OF aUME, 1995-
~ONEFR E INE[RING ~ P_A
2'j
SGAIE ; i INCN - 30 FF[T f~...~.-..
n, .5. fteg. No. 11)d2ff
.9RA `.1320t3.15 C. Larso
~ IAT 8?RVEY CHECICI.IBT FOR RESIDENTIAL
"i 8U2LnIIJG PERMZT 1?2PLICATION
S ~ pROPERTY LEt3A
~ ~ ~ aat• o! aurvsy:
~ § ~ DOCIIMENT BTANbs,3tns
0 • Reqistered Land Suzveyor signature and company
LY ? 0 • Building Permit Applicant
6~? ? • Legal description
~ D • address
0 • North arrow and bar seale
? 0 • House type (rambler, walkout, cplit v/o, split entry,
~ lookout, etc.)
6 Q ~ Directional drainaqe arrows with alope/qradient t.
0 • Proposed/exitiinq aswer and water services
. 0 • Street name
V0 • Driveway
ELE4ATION6
Zxistinc
II'~ D _ Sewer cervice
ID' ? 0 Lot corners
D • Top of curb at the driveway
D • Elevations of any existing adjacent homes
Pzoposed
• Garage floor
: First floor
~EI D Lowest exposed elevation (walkout/window)
rr'~1 0 • Property corners
fl' n n • Front and reaz of home at the foundntion
PONDING llREAB (3f aeolieab2e)
0 5~~ • Essement line
~ (Y ? • NwL
n a~ n • HaL
• Pond # desiqnation
D id' D • Eanerqency Overflow Elavation
DIMEHSiO1Q6
• Lot lines
n Ci ? • Riqht-of-way and street width (Lo back of curb)
0 • Proposed home dimensions includinq any proposed decks,
overhanqs qreater than 21, porches, etc. (i.a, all
stzuctures requirinq permanent footings)
0 • Show all easemeats of record nnd any City utilities within
those easements
D • Setbacks of proposed structure and setback of adjacent
existing homes
fl 0 • Retaininq wall requisements, if any
Reviewed:
Name / Date
OCtOber 1992
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~ _ . EZTERIOR ENYELBPE IVERAGE Stl' COltMY7TON
OWNER: OCP H oM S FAgi p
SITE =REW: _j(o4 4 Wesr r.JQn2 "t.A,.E 7g 4 P11:
corraicroe: v~Ft~ Dnn PWM
Detrermina roekiog square lootage of eaoba
1. Total expoaed wali area 203 aq. !'t. z.ti a~;Z
2. Total reof/ceiling irea aq, ft, _.026 e
Total expomsd .ou area .m.e rloor . 2 ~ ,3 2
8• Total aall ?rindow area 3
3
b. Total door area
c. Total aliding glass area
d. Total t3replaee vall area
Total wall frsming 8Tl8 (aV8P1$Q ID%) ~e.
"
f. Total rtet aall •rea above floor
g. Total rim foist area
• Total etposed fOUadaLion area s )3r
h. Total foundation aindorr area....................... -
1• TOLBI 11lt. TOYIICBLSOA aTla aLOYE gTadl...
~
- AGLQ7miM SUl Val1l0 Of laCD VBZZ E!vlAL2
346 x Out 1-7
b. B'S x 'W
C. . x OU~ _ .4q s
d. X SVl e
. e. x ~Ul
f. Y ~U,
8. 1 76 x't!'
h. r-~- I ~U' a I. Jy1~ _ IU* .076 ~ ss 3~
3 .
Total .
If item 03 ia the same as or leaa then item O10 yon have meL the latenL oT SBC
6006(o)2.
1btt2 tzposed rooi/oeilio` area e ! 64t)
' J. Total sky116ht area -
k. Total roof/aeiling framing area (average 10%)
2. Total aet inauleLed roof/eeiling area
OVER
, Determine Ip' talus Tor eaeL roof/oeiling aepenL:
' " _ fpt
k. z' U' ° 4_3
j476 : ouo . oaa = 3 Q-5
4. Tbtal a 3 6. a
If total o! #0 ie the aame aa or leas Lhan /29 you have met the inteat of SSC
60D6(c)1..
ilteraate 8uilding Eeveiope Dasiso
7o uLilizs Lhe LoLal envelepe ayatem method, the valuea estabiished by the aum,
of Items f3 and iY aha21 not oe greater tbsn the aum of Itema I1 and 02,
31 a .2. -42•6 s 3.5 ,6
3. 3t5.8 36.8 , 35.-q.co
z
I
L BL cirr use oNLv
~ RECEIPT
SUBD. DATE: 18
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
F!XTURES EACH NO. TOTAL
Shower 3.00 x I_ = 3
Water Closet 3.00 x 3 = y
Bath Tub 3.00 x I = 3
Lavatory 3.00 x
Kitchen Sink 3.00 x ~ = 3
Laundry Tray 3.00 x = 3
Hot Tub/Spa 3.00 x _3
Water Heater 3.00 x _J_ = 3
Floor Drain 3.00 x 3
Gas Piping Outlet ' minimum - 1 3.00 x _j F
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 exisfin9 20.00 =
Water Turn Around 20.00
SiATE SUrZCFiARGE .50
TOTAL -i~ 4o. So
SITE ADDRESS:
OWNER NAME:
. INSTALLER NAM4-h
STREET ADDRESS: q~ -
CITY: STATE: ~h ZIP: ~SJa 1
PHONE 4277
~T(~"NATQRF- 6F PER
CITY USE ONLY
L BL RECEIPT
SUBD. DATE:
7995 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 Q2t 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 r i 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
L BL ClTY USE ONLY
~ d RECEIPT
/l
SUBD. ZO ~ DATE: / LL
7995 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: " 1 'Y /91 S `
FEES
? Minimum Fee: Add-on/Remodel (existing residence only) $ 20.40
? HVAC: 0-100 M BTU 24.00
Additional 50 M BTU 6.00
? Gas Outlets (minimum of 1 required aQ $3.00 each)
~ State Surcharge .50
TOTAL 445-0
51TE ADDRESS: ~-~Zt-'nca>
OWNER NAME: Vft-O-A rV a~ . PHONE
INSTALLER NAME: :Iky-m
STREET ADDRESS:~ )-l-F- _)3 6~~6
CITY:LL) 1, )a )P S7ATE: ?Yl U ZIP:
PHONE (,'jZ1~I) - , ~
c
CtTY 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 commercialAndustrial buildings.
? mufti-family buitdings when separate permits are gp# required
for each dwelling unit.
DATE: CONTRACT PRICE:
WORK TYPE: NEW CONSTRUCTION INTERIOR IMPROVEMENT
DESCRIPTION OF WORK:
FEES: ~ $25.00 minimum fee 4L 1% of contract price, whichever is greater.
• Processed piping - $25.00
State surcharge of $.50 per $1,000 of rmit fee due on all permits.
CONTf2ACT 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
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City of EaQall..,�
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-575
Fax: (651) 675-569
Use BLUE or BLACK Ink
For Office Use
Permit # /
Permit Fee:
Date Received:
Staff:
2011 RIDENTIAL PL NG PERMIT APPLICATION
Date: /42,1/// Site Address: q f J��i 1,0C,C)d
-1361-{"P
Tenant:
Suite #:
RESIDENT I OWNER
Name: fin - 4-6 CKg.)Gk` Phone: (5,1) 6 're - 3:'3
Address / City / Zip: '
CONTRACTOR
Name: l'.)t—eq 11 1 Pt-ca ``5' License #: (2/) 3 77`1 - Pill
Address:�V"t t&ie6 f F �-e City:
-7
State: /11/ Zip:. Phone: r -33S-- 11 c1
Contact: A N Email:
TYPE OF WORK
_ New Replacement Repair Rebuild Modify Space Work in R.O.W.
_
Description of work: keiVette 5C.t44-tip po. ti -c7 cire,6s .'I -c, 0.c.., rs c4<
PERMIT TYPE
RESIDENTIAL
Water Softener
Water Heater
Lawn Irrigation ( RPZ / PVB) Add Plumbing Fixtures ( Main / Lower Level)
_
Water Turnaround
Septic System
New
_
Abandonment
RESIDENTIAL FEES:
$55.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)
$35.00 Lawn Irrigation
$55.00 Add Plumbing
*Water Turnaround
$105.00 Septic System
$95.00 Fire Repair (replace
(includes $5.00 State Surcharge)
Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge)
(add $166.00 if a 5/8" meter is required)
New ($10.00 per as built) (includes County fee and $5.00 State Surcharge)
burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge)
TOTAL FEES $
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities. www.qopherstateonecall.orq
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Ea. 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
ac..r nce with thprov:d .Ian in the case ojyvork which requires a review and approval of pla s
Lir) y
x
Applican
x
Applicant's Sig
FOR OFFICE USE
Reviewed By: Date:
Required Inspections: Under Ground Rough -In Air Test Gas Test Final
Use BLUE or BLACK Ink
F-----------------
I For Office Use 1
j Permit City of EaV~ I aS
I Permit Fee:
3830 Pilot Knob Road i=fl /31/j~
Eagan MN 55122 Date Received:
I I
Phone: (651) 675-5675
Fax: (651) 675-5694 1 Staff: I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit
Name: 6 Me xi IF12 L r K-6, aY,\ Phone:
Resident/
Owner Address/ City/ Zip: g6tq V/esc~aAC~ Lie4`3a.~ r-~y~e 5512-Z
Applicant is: Owner X Contractor
Type of Work Description of work: `love c,,•.- `fie 2 a'~
oa
~C )
Construction Cost: c~ 6 L (~c7 Multi-Family Building: (Yes /No
Company: r- Contact: 25'T_&-~e,.NN~)t
Contractor Address: 1 0-7 UD LYvt Ja, 13e M City: F ) 50 r., State: 1'y-,~ r1 Zip: SS qa O Phone: 9,!5 - FM ` J's
License 8G O -OZ 3 3-7 Lead Certificate Y1 -339L-
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that the are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.ora
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must a completed within 180
days of permit issuance. t
x
Applicant's Printed Name plicant's Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA155984
Date Issued:06/11/2019
Permit Category:ePermit
Site Address: 4644 Westwood Lane
Lot:7 Block: 4 Addition: Oak Cliff Pond 2nd
PID:10-53576-04-070
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:One Window/Door
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 1,500.00
Fee Summary:BL - Base Fee $1500 $62.50 0801.4085
Surcharge - Based on Valuation $1500 $0.75 9001.2195
$63.25 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 -
Steven A Erickson
4644 Westwood Lane
Eagan MN 55122
(651) 688-9393
Window Concepts Mn
291 Eva St
St Paul MN 55107
(651) 905-0105
Applicant/Permitee: Signature Issued By: Signature