4656 Westwood Lane R
S : 2 I
~ -
~
Wei.~iticate nf Cccuvanc~
WU4 of Cftgan
. ~t~c~ct ~r ~x~~g ~x~eCriex
TJus Cenificatc essrud parsuaru to the rrquirenunts of tht Uniform Bui[ding Code
certifying that at tiu trrne of issuance this stnwtur+e was in compliance wet`T'i the various
oniinances of det City rrgulating building constncction or use. For the fo!lowrng:
~ use ct=wtcatkm: SF TsWt: - swg. rermn rb. 95254_
O-UP-r TYW 13UMI Zonms DWmio PD..? - Tya Const. UN
or.a d eww.s 02 FfiM IIC Aedmu 8609 YI~IDATE S- ffiM,'m -
e,uwMe Amress 4656 ,1"s'14A'1fD T.AtgE Lowxy
' POST IN A CONSPICUOIJS PLACE
INSPECTI4N RECORD
~ CIl'Y OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675 •
SITE ADDRESS: APPLICANT:
tIINE ~ ~ ~ , . ~ rn~.
PERMIT SUBTYPE: TYPE OF WORK: .
INSPECTION . DA
~ . t. . . i ~i}'•. , ~ : , i
i i: i i I f 1 Y~ ~ . i I i S I ~ ~ j.:
' I°1 1 1~ltl I i : I!~ ,
. ~ , i . , ,
: tirtf ~
a
' .
I ~
~ J
PermM No. Partnit Holder Date Telephone #
ELECTRIC
PLUMBING 0 J 0- ~ f -7
Hvac ,/S/- 3W
InspecNon Date In . Co ments
FOOTiNGS
FOUND
<
FRAMING
? 7~t~ O ? sr~•
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST -
ROUGH
HEATING
GAS SVC
TEST
' INSUL
GYP BOARD
' FIREPIACE
FIREPLACE
AIR TEST
, FINAL PLBG -Z,JU ~I G /`6 G eo[
FINAL HTG
ORSAT (Q
TEST
BLDG FINAL 44
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
a ys
0°11.s°140 0 ~v C3 Ook ~4 11- ~ o
Requast Date I Fire No. Roug -In Inspaction Re etlIns ection OtherThen Rough-ln
1• ~7 q S. (VOUTUSt call inepector wnan reetly) ~ Ready Now ~WIII No~iiy InspeGOr .
/ ves ? No oata Read
. IX licensed contractor ? owner here6y request inspection of above electrical work at:
Jab Atltlress (Slreei, Boz or RoNe Na.) Cily
4r~sd Uias7Ly U G"Z' cQ duA/
Section Na. Township Name or No. Renge No. Counry
Occupent (PFINT) Phone No.
!/eEl~u C.~ 7 33v- 6A9G
Power Suppller AtlGress
z2.d eit 1,0e
r T•~
Electncal Conirecmr (Company Name) Contracror's Licensa No.
Meiling Atltlress (Conlracror or Owner Making Installation)
1?W,2 i3dk /.23ie LLI ~I~I~? S6
AuMOdzetl Signamra (COntraqorlOwner Ma ' q Installetian) Phone Number
3s~-M7
G~gUltl~w~'yyAltla1eSOPmS- MINBS CT Y IIIIIIIIIIII IIII IIIIIIIIIIIIIIII ENCOSEOOPERINSPECfIONPEERl6
Phane (612) 692-WOU
REQUEST FOR ELECTRICAL WSPECTION E 9~21-09,
instructions lor rompleting [his farm on back ot yelbw copy,
~J (
"X" Be/ow Work Covered by This Request
Ne Atld Rep. Type of Building Appliancas Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Electric Heatin
Apt. Building Dryer load Management
Comm./lndustrial Furnace Other (S ecify)
Farm Air Conditioner
Other(specity) ConVacrofs Remarks:
Campute Inspection Fee Below:
# Othar Fee # Service Entrance Size Fee # Circuits/Feeders Fe
Swimmin Pool 0 to 200 Amps o- 0 to 100 Amps
Transformers Above 200 Am s Above 100 _Am s
Si OS ' Inspector'e use Only: TOTAL
Irrigation Booms
S ecial Ins ection •Z~
Alarm/Communication THIS INSTALLATION MAY RD . DISCONNECTED IF NOT
Other Fee COMPLETEO WITHIN 48 MONT S. I, the Electrical Inspecror, hereby Rough-in / o~-
certity that tha above inspection has Final . ' D 5
been made.
OFFICE USE ONLY
This request voltl 18 monMS fmm
Address 4656 wesnWOon LANE Zip 55122_
I.oi ~ io Blk 4 Sub on[c CLiFF rCNm zrm
THESE I'TEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECI'ION.
Date: (O p,8 9,11, Yes No Inspecror.
Final grade (6" from siding)
Permanent steps (garage) ~
Permanent steps (main entry)
Permanent driveway ~
Permanent gas cx~
Sod/Seeded grass
Trai]/curb damage
Parch ~
Basement finish ~
Deck ~
Please verffy with the builder the removal of roof test caps from the plumbing system andthe shut-off of water supply to
the outside lawn fauce[ before freeze poten[ial exists.
Contac[ engineering division at 6814645 before working in righ[of-way or installing underground sprinkler system. ~
White - City Copy Yellow - Resident Copy Pink - ContraMOr Copy
PERMIT efo 3$& v 1
CiTY OF EAGAN j " ~ 3 - 9'5^
3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G
Eagan, Minnesota 55122-1897 Permit Number: 0 2 5 2 5 4
(612) 681-4675 Date Issued: 0 3/ 2 3/ 9 5
SITE ADDRESS:
4656 WESTW000 LANE
LOT: 10 BLOCK: 4
OAK CLIFF POND 2ND
P.I.N.: 10-53576-100-04
DESCRIPTION:
Bu,ilding P,ermit Type SF OW6
Svilding Work\Type NEW
U8C Occupancy R-3 M-1
Construction TyPe V-N
Zoning PD R-3
% 6uilding Le,ngth ~ 71
Building Width 48
Building stories 1
~
~
j~:.. _ _
REMARKS:
PRV S& W PLBR - B J M PLBG
FEE SUMMARY:
VALUHTION $135,000
Base Fee $762.00 MISCELLANEOUS $1p892.50
Plan Review $495.30 Total Fee $4,067.30
Surcharge $67.50
SAC $850.00
SAC & 100
SAC Units 1
Subtotal $2,174.60
CONTRACTOR: - Applicant - ST. I.IC. OWNER:
VARLEY CONST JOS 13346034 0003249 0 C P HOMES INC
16800 SHIELDSVILLE BLVD 8609 LYNDALE S 101-8
FARIBAULT MN 55021 BLOOMIN6TON MN 55420
(507) 334-6034 (612)881-9127
I hereby acknowledge that I bave read this application and state that the
information is corract and agree to comply with ell eppiicable State af Mn.
~ Statutes and City of Eagan prdinances. J
~j~v "~APPLI~ T/P RMI/URE ISSUEO OBT. S S~.DL/JC I I 1 f/,Y
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
"
MM41995 BUILDING PERMIT APPLICATION (RESIDENTIAL) C
681-4675
New ConsWction Reaulrements Remodel/Reoalr Reauirements
? 3 iagistered site surveY$ ? 2 copies oT plan
? 2 copies of plans (inGude beam & window saes; poured tnd. design; etc.) ? 2 sRe survays (exterior eddNona & dedcs)
? 1 energy celculations ? 1 energy calculatlons for M1eated additions
? 3 copies of tree preservation plan tf lot platted aRer 7/1/93
required: _ Yes X( No
DATE: BM6f95 CONSTRUCTION COST: _V59,990
DESCRIPTION OF WORK: Ney Reeidene„
STREET ADDRESS: 4656 WesWveetl 6n
LOT 10 BLOCK 4 SUBD./P.I.D. (1ak Cliff Ponci_ 2nd Add_ 10-53576-100-04
PROPERTY Name: OCP Homes, Inc. Phone 881-0127
OWNER
Street Address. $609 Lyndale So. #1018
~
City: _ Bloominqton State: MN Zjp; 55420
CONTRACTOR COmpany:loseph P. Varley Construction, Inc. phOtte 507-334-6034
Street Address: License
CIt/: Farihault State: nnN Zip' FFngi
ARCHITECT! Company: Phone
ENGINEER .
Name: Registration #Street Address- z~L on••---
Clty: St. Paul State: MN Zjp; 55108
Sewer & water licensed plumber. B.1M Plumbing Penally applies when address change and lot
change are requested once permit is issued.
I hereby acknowledge that I have read this application and state that the infortnation is correct and agree to comply with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Joseph P. Varley Construction, Inc.
Signature of Applicant
OFFICE USE ONLY RECEMED
Certificates of Survey Received /Yes No MAR 16 1995
Tree Preservation Plan Received Yes V No
,
1~ -
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation o 06 Duplex o 11 Apt./Lodging ? 16 Basement Finish
,0- 02 SF Dweliing o 07 4-plex ? 12 Multi RepaidRem. ? 17 Swim Pool
? 03 SF Addition o 08 8-plex ? 13 Garage/Accessory ? 20 Public Facility
? 04 SF Porch o 09 12-plex ? 14 Fireplace ? 21 Miscellaneous
0 05 SF Misc. ? 10 = plex o 15 Deck
WORK TYPE
ce,-_31 New o 33 Alterations ? 36 Move
0 32 Addition ? 34 Repair ? 37 Demolition
GENERAL INFORMATION
Const. (Actual) 0-1v Basement sq. ft. 603 MC/WS System bl-,
(Allowable) 4C-d Main level sq. ft. /~S 03 City Water ~
UBC Occupancy R-- h.a sq. ft. Fire Sprinklered
Zoning O-~ ~-7 sq. ft. PRV
# of Stories / ti~r.wr, sq. ft. Booster Pump
Length sq. ft. Census Code. Go /
Depth NS Footprint sq. ft. SAC Code a/
~~CensusBldg i
Census Unit /
APPROVALS
Planning Building Engineering Variance
~
Permit Fee Valuation: $ 351o 00
Surcharge
Plan Review
License
MC/WSSAC
City SAC Zx'~ = 7 H If x vo
Water Conn.
Water Meter 3osxy~ ° i'22'
Acct. Deposit s.s ,c a>
33 = S~a
SNV Pertnit
S/WSurcharge ~s-sX3z,s~= S~O 603,
Treatment PI. 27 = iy Tz y oys I
Road Unit lr--"-J
ParkDed. K sy~ l°/,(ogy `21,.
Trails Ded. Z~x z3.s + 4170 Other ~ ~
Copies ~7, S~
Total: tw ~
s,ac A
%
! z~_~
SAC Units ~ ,
Me d ~o N~ghts,DMN 55t2o
* ~~111Re~'! Lxo SuRvey1ft • a& EwodDo (612) 681-1914 FAX: 681-9488
~ OF1Q 11d@h hQ ~D PLAMM• LM9WF MOPWg 825 Hlghway SO N.E.
* ~ * B4oqne, MN 55434
-IK (912) 70-188a FAX783-1883
Certificote of Survey 'for: OCP H OM ES ! N C.
4855 WESTWCIDQ lRNE
95&8
i x 980.2 ~
` g~ ~ 1 qo 0
9T2a ~ 946 95T.3
6ENGY1 MARK
TOP OF PiPE 4 FT. NI6N
etzv-= sss. as--~ RET. we~i a~
'3•~~ , X. ~.ss ~-o5d~ 9~ f~ -~J
sRa (9 964S SERJICE fPER FI.AN)
j2 n~` ~'O ~ ^tb ~N1I=946A
989.1
G'
9695 ~~`3 -BEFICH MARK
~ TOP OF PlPE
964.$Q d 1 ELEV.=957.40
9~ q'/y~„, / ~ti'•
.7 957' 5
~ 953~
v 995.4 s J~
D
'Oot
]EAGAN EN tIdI: I1VG DEP'T.
'e:• p,~ l+,~ ~ ~
V i F; ' E_` ~ ~20~ I u~ Si tr F<n1 c.., r_
949. 2
~Z%~ ' ? ~~~-~.a~ ~o~o~Ia ~C~Q~JOG~~D
PHOP0.`t,'0 GRAOES 6HpyIN PER GRADINQ PUVN W, rn' 11WEa_ INC NOI~ B111lDfNG DYAENSI04 9HOMN ME FOR Hp71ZONTAL ANO YERIICAL lXlS CER7IFM.A7E DOES NOT Pi1RPOkT 70 910w EASEMkT115
LOCA770N pF 8'lRUCNf£S dNLY. SEE ARp11]EC1ifAL P(ANS FOR 6fA2ING 07}IER 1HAH 7NOSE 5NOIN/ ON 7Fg l7EIXMmEYJ PIA7.
µD FWNOhnoN dMENepNs
NM- C9N7RACIUR MUST YF7RIPY ORIVEWpY DE9167f. SCALE ' 1 INCH F 30 FEF-Y
11OTE: NO BPECEIC SOIL$ WYE6ii(7ATpN HAS BEFN CQYPL[lEP dN T1NS BEA18N6S .910W17 ARE A95UiAm
LOT 9Y'[HE "4FfpR 7Nt SUIIABYJT' OF 90A.S (0 Td1PpORT IFE
sK4vFIc ItwSE PROPG5E0 15 NOT THE RESPON51BNJtt OF lfiE 9JRUtY[a.
iW
PROPOSFD HOUSE ELEVA710N '
x oa0.da penvtee Exleting Efevution ~
( oon.oo ) penotas Propasad Elewtion Lowest F1oor EferaUan:
Oenoles 4ralnaga Ee Utiltty E'asement ,
Denvtes Drainage Flow pirectlan Ma1n Ffoor Elevotion: ~7
-le penotes Monurnenl
-a Denotes 41laet Hub Garoqe Slab Eleva?ion:
1NE HERMY CERTIFY 7O OCP HOMES VNC. THAT THIS iS A 7RUE AND CORRECT
REPRESENFATION OF A SURVEY OF THE BdUNDARIE5 OF:
LOT 10, BLOCK 4, OAK CLIFF PQFJQ 2ND AQDIT(ON
DAKOTA COUNT`f. MINNE50TA
IT D0E5 NOT PURP(1R1' T0 SHOW IMPR0I+EMENTS OR ENCNROACHMENTS. EXCEF'7 AS SHOWM, AS
SURVEYEO BY ME OR IJNDER MY OIRECT SUPERVISlON THIS Eon, MARCH, 1995.
ER ENqHEERING, P,A.
45. Re . No.79828
LOT BURVEY CBECRLSST FOA RESIDENTIAI.
ffi BIIILDING ERMIT 7?PPLICATION
~ S~ ~ BROPERTY LEGAL:
< .
Dat• of Survey:
DOCIIMENT BTANDARDS
~D Q • Reqistered Land Surveyor siqnature and company
~ D 0 • Building Permit Applicant
M--V p • Leqal description
3r 0 0 • l?ddrecs
~Vb 0_ • North arrow and bsr~ scale
0 • House type (rambler, valkout, cplit v/o, split entry,
lookout, ete.)
0 • Directional draiaaqe arrows with slope/gradient t.
0 Proposed/existing sewer an8 water services
M13 13 • street name
0 0 • Driveway
LLEVATIONS
Zgietiaa
0 • Sewer serviee
0 • Lot corners
Z-'~D 0 • Top of curb nt the driveway
.;,?D D • Elevations of any existing adjacent homes
BroDOaeQ
~D 13 • Garage floor
D • First floor
5-/13 13 • Lowest exposed elevation (walkout/window)
g~D D • Property corners
~D 13 • Front and rear of home at the foundation
POHDING AREAS fif appiieablal
~ 30~ 13 • Easement line
~ 0' 0 • IawL
7 [-Y/ D • HwL
0 • Pond # designation
~ II 0 • E7aergency Overflow Elevation
DiKEHBSOliB
D 0 • Lot lines
0 0 • Riqht-of-way and street width (to back of curb)
D D • Proposed home dimensions includinq any proposed decks,
overhangs greater thah 21, pcrches, etc. (i.e. all
structures reguiring permanent footings)
-1-13 0 • Show all easaments of reeord and any City utilities within
those easements
~n D • Setbacks of proposed structure and setback of adjacent
existing homes
7--0 • Retaining re irements, if any :
xe,?sewea: 3 ~
N e / D t
:~atober 1992 .
t,57978.1. kcH r•e9' eg llvv-yb9 97
. STA.CS-973 5
, J 5 O '
• E~ ( ' ~ Ky'.
• ' 339~ 6 _ 1.2•. Ir,
MH ~~~STA
, ~ r , ` ' ~ '8 3.06 R
HYpRA
6.^6„DIPr= CL 52 ~\24:~ ,lNV-1957~+45 ;v
. ~ , .~~.;'~T1 4,;~,! ~ 97~
GND SEL,9798
T~yH EL._gg
2.06 4 +~4:52
S.-O-F70 N
1N(~(1~/.^966:53
'\.c.
978,5 _ ',3.^~"ri ~~Qa,~1 ~~p~.`~r,
.'1
S=0.+80 O[i ~
INV=966.96 5
CS-979.5 CURB " ,,~~`'';`;"`~~tuk;:,s~rQX~•°~ fl°. ~F
. STOP
. I TYPICAL ,SERVICE~' ~ t7lVNEC'716N~S~
'THE CITYOF E A E PdOT~GUA~`riANTEC
0 :
~~T THE . ACCURACY TILIT~~~ IONS 6t , ~ . . >
,i4ND/OR ELEVATIO . THI~JVaA96E~~76F0 5-036 S„.1+~29
ItUFOWATIOlV PUR SE~S-e9:~3I Ar,D CSINV-963 20-. INV=957 74 .'INV--95
"9.75`5 C8=968 J :
PERSONS U€ING IT S ULD VY CS,-96
IfVFORMAYtON ON THE 51T
6•' .22` r14;,2 BEND-
, HYDRANT 622 1.12 _BEND~
~,~„?'.l
6 ~ x g'p TEE,
6 =6;DIP~ CL 52 " 10
GND.'.El:. 957,5
j TNK EL: g5
O 6 -11 1%2 4.~~.~,\ ~ .
BEND 152'~ 1:
~ ~t
S-1+65 I
INV-946 1242
.37
CS--957.4 76.11"
b' - 45' 11.7
FiEND , ~ ~ ? . ` ~ 2 ~ ~ 6,:,.
0. J' 56'
y
or 2a. ~4; 33.
, ~ S-1 + I1 ' MH ~ STA. 0+`66, (NV=i
INV-946.09 7.11 L
CS-957.4
cs~ ,
•d ~
~ S-1-f-50 C 0*1'8~
40
~„9456 9~'~',~
T s I~S ~ 956. 71 - I,.,~
`._FlEMOVE PLUG
CONNECT TO ' • i ` . , ' ~ ,,.>~.~"'a~ ~ ~
FXISTING g.,
WM. `J' i ,f ' ~ ~~/i Y', ~ ~L~:.~
CONTR
ACTOR TO
. . . . VER(FY.4PCATIUN,
~ .~,~U:RT:. : . : ~ . '
•~6"--22 1%2' BEND MH. ~.STA. -6-
'
57.52
1
3.84
72
1.Z
~L' r a -f1 `~'I pJ2 e j
STA
A~', ) ~ 6 1.64L
I ~ 1 { ~ • _
9&0 2 ^ ' "i
C$
! ~44~
s Cp
0"~'~JU~i
~ F
6.7; ~ INV 945ti~
9 v:-~+33: ~i 95~ 3~
M STA."'" 0+66 CS`
1-h71' S a ; r~
INV 9~45 47
957 4
~S"p+88"! ~95685~,-~
a
S-'1+50 1V=94664
~1NV=946 41 Cg956$.- CS-956.7
~
i
~e*~a~~
S
)Rt~'~0> k Y~rtz $ j?/~r~ ~ E#~GAN DO~S P~C.~1 GUF~eypT\~' /!~n'~+
r~i; F~ r 41~,~ ~ iJPN~~\/JYQ tn~^ ~ r~ ~ A+;r
UTILI~~•
~.EV#fONS. :THIS'DATA fS:.FOR ' •r~,;+
K ~ ra,
'PURPOSES' T.;
U~ING IT $HOULD VERIFY T
f? '
S6TE r, ` sa' goj
p;2lON ON 7HE 7
. . .
`.v
r . . . . . . . , . . . _ ~ ~i
° BLD to Oi
b~
19$0 96 0
y.
~yt~'
w
) Y~" ~ ? ~~~44!`[}~n~ _
~Q tt' t~' ~ . , , i ~..ylf 1 a~K~ • S~ 4 W,,~Y.~
~oE 9 75 ; z4fij
,
970~` ..'7J0 PROP4SEDa t`• ,.sr4 , ~R7~- e
~'(3 p
n . j~n WAtW.p•4 F'~~R {~T3' i~;
~ ' ' ^ . 6,> DpIFr'~~. INM ~t PRb. SE
ry C~ JL ' ' ~TkA
f`+1
C+1
. 96~-
.
. . .
.
~
~ ' ~ • CT1T OF EAGAN
EITERIOR ENYELOPE lYERAGE 'Us COMPUTAYION
ovxet: C f HDMES
sixE annaEss: L 1D g~}-
CO1PT6lCSOR: VlkRLF-Y rDNS7"~G.T- DlTE: PiiONE:
Determine working aquare footage of each:
1. Total exposed wall area sq. it. z.11 = 3-s ~
2. Total roof/ceiling erea ~ aq. ft. x.026
Total ezposed vall area above Tloor = a g ~ S
8• Total W811 Wi[1d05i area ?&JS4 L~~AC~L
b. Total door area -4- 7
c. Total sliding glass area
d. Total fireplace vall area -
.
e. Total uall framing area (average 10S) -;2 a g
f. Total net xall area above floor 195R
g. Total rim joist area a~CJ •
• Total exposed fovndation erea = 2 0 O
h. Total foundatioa window area -V
1. Total net foundation area above grade ~ O o
Detetmioe IU' value of 3 agh vall aegment:
s. ~ 19 _ tul - ~7 = ) ~
b. 4z x ' u'
c. ~p _x'U' 27•2
d, x 'll' _
. e, a8a x 'U' .097 - a7
f. I~I G3 2 x'U, R 9
g. ~ 2 o x'u,
h. : gu,
i. 2 00 : tu, .o~6
Iss 359 9
3 . Total
=
If item i3 is the same as or less than item /1, you have met the intent of SSC
6006(c)2.
Total e:poaed roof/oeiling area
J. Total akyllght area
k. Total roof/ceiling framing area (average tOf) 1 87-
1. Total net insulated roof/ceiling area
OVER
• Determine IU' valoe for eacL roof/eeiling aegoeet:
~ .
. ' J. x +pI _
k. x'U' •~a~o = 1.7 .
1. xgut :Zs. 9
Q
p . Total
~ If total of /4 ia the aame es or lesa than 02, you heve met the intent of SBC
60D6(c)1..
Alternate Huilding Envelope Design
To utilize tAe total envelope syatem method, the velues established by the aum.
of Items 03 and !4 shall not be greaLer than the aum of Items 01 and 02.
1, 3So +2. s _ i 03
s. 35`39 . -4.
2
1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN ' 3830 PILOT KNOB RD • 55122
657•681-4675
New ConstrucNon ReauBemeMs 45')6 b RemodeUReoah ReauhemeMs ~
D 3 regMered ade surveys showing sq. H. of 101, sq. N. d Mouse 2 coples ot plan
and r,ll roofed areas f20% masimum lof covernoe allowed) 1 se1 of eaergy eaieulaNons fa healed addillons
? 2 copiea of plans (show beam a window slzes; powed fnd. dealgn; efc.) 1 sMe sunay for eniedor addlNons a decW
? 1 set of energy calculaNOna
? 3 coplea of free presenaHon plan 91oT pluHed aMer 711/93
DATE: I G CONSTRUCTION COST: OOIff
DESCRIPTION OF WORK:
STREET ADDRESS:
LOT: BLOCK: SUBD./P.I.D. ~A7- CYL~
Name: A /40R.'oP a~ ~~~t ~ rnone a: 6 s/- 8~a - G 3 so
Lost Fkd
PROPERTY S
OWNER v~~a0c1
Sheet Address: qG Sb ~ ~R ^ <
City -r w Stafe: ~w. Zlp: 5- _S
Company:Od do G Phone#: 707-615-1
(area code)
CONTRACTOR
SheetAddreu: /a~V-) Ab'cv ((c t Lieense#2d~ 4 903Exp, 3'~'•
City Ir3v.ttr sd,'l/e State: 1W H Zip: 55-33'7
ARCHITECT/
ENGINEER Company: Name:
Telephone area code ( )
StreeT Address: Registraflon
City State: Zip:
Sewer 8 water Ileansed plumber (reauhed for new consfruction onN
PenaNy applfes when address change and lof change is requested once permR Is Issued.
Phereby acknowledge fhat I have read fhis application, stale fhaf the IMormatlon Is correct, and agree to comply wRh all applicabl
Stu!e of Minnesota StatuFes and CHy of Eagan Ordinanees. ~J
Slgnature of ApplicaM:
OFFICE USE ONLY
Certficates of Survey Received _ Yes _ No -
Tree Preservation Plan Received _ Yes _ No Not Required
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 4-plex ? 11 10-plex ? 16 Fireplace ? 21 Porch (3-sea.)
? 02 SF Dwelling ? 07 5-plex ? 12 12-plex ? 17 Garage ? 22 Porch/Addn. (4sea.
? 03 1 of _ plex ? 08 6-plex ? 13 16-plex ? 18 Deck 0 23 Porch (screened)
? 04 2-plex ? 09 7-plex ? 14 Apartments ? 19 Lower Level ? 24 Storm Damage
? 05 3-plex ? 10 8-plex ? 15 Lodging ? 20 Poal ? 25 Miscellaneous
WORK TYPE
? 31 New ? 35 Tenant impr ? 39 Gas Line Only ? 43 SidinglSoffits/Fascia
? 32 Addition ? 36 Move Bidg. ? 40 Gas Insert ? 44 Windows/Doors
? 33 Alteration ? 37 Demolish Bldg.* ? 41 Wood Stove ? 45 Fire Repair
? 34 Repair ? 38 Demalish (Interior) ? 42 Reroof
` Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. Census Code
(Allowable) Main level sq. ft. 5AC Code
UBC Occupancy sq. ft. No. of Units
Zoning sq. ft. No. of Bidgs
# of Stories sq. ft. MC/ES System
Length sq. ft. City Water
Width Footprint sq. ft. Booster Pump
PRV
Fire Sprinklered
APPROVALS
Planning Building Engineering Variance
Permit Fee Valuation: $
Surcharge
Plan Review
License
MC/ES SAC :
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PL
Park Ded. Trails Ded.
Other
Copies TotaL•
SAC Units
% SAC
ciTr use oNLr
L ~ Irl BL RECEIPT 39 7O2 91
SUBD. (Qak 0,&G)a4,.at o2~ DATE: `~a~I95
1995 MECHANICAL PERMIT (RE5IDENTIAL)
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:
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 Outlets (minimum of 1 required @$3.00 each)
? State Surcharge .50
TOTAL
SITE ADDRESS:
OWNER NAME: V(-~'P_ PHONE
INSTALLER NAME:
STREET ADDRESS:
CITY:~ STATE:ZIP:
PHONE
Z 1,
CITY USE ONLY y
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 a4t required
- for each dwelling unit.
DATE: CONTRACT PRICE:
WORK TYPE: NEW CONSTRUCTION INTERIOR IMPROVEMENT
DESCRIPTION OF WORK:
FEES: $25.00 minimum fee qE 1% af contract price, whichever is greater.
Processed piping - $25.00
State surcharge of $.50 per $1,000 of permjt fee due on all permits.
CONTRACT PRICE x 1%
PROCESSED PIPING
STATE SURCHARGE
TOTAL
SITE ADDRESS:
OWNER NAME: TELEPHONE
TENANT NAME: (IMPROVEMEN7S ONLY)
INSTALLER:
ADDRESS: -
CITY: STATE: ZIP:
PHONE
SIGNATURE:
SIGNATURE OF PERMITTEE CITY INSPECTOR
i
CITY USE ONLY
L ~ BL ~ RECEIPT
SUBD. 01- `Jasw. ~ DATE:
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 2
Water Cioset 3.00 x L
Bath Tub 3.00 x 3
Lavatory 3.00 x .3 = 9
Kitchen Sink 3.00 x f 13
Laundry Tray 3.00 x 3
Hot Tub/Spa 3.00 x 3
Water Heater 3.00 x -7
Floor Drain 3.00 x 3
Gas Piping OJtlet ' minimum -1 3.00 x S'
Rough Openings 1.50 x &
Water Softener 5.00 x =
Private Disposal * Dakota cty. iicense 20.00 =
U.G. Sprinkler " home under const. 3.00 =
Alterations * to exristin9 20.00 =
Water Turn Around 20.00
STATE SURCHARGE .SU
TOTAL S!J_ ~
SITE ADDRESS:
OWNER NAME: V ~
_ INSTALLER NAME:
STREET ADDRESS:
CITY: STATE: ZIP:
PHONE
STGFfATORE~ 6FPEA1Gti1"I'
CITY USE ONLY
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 n.gt 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 2ffmft 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 Eaall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
CG
Use BLUE or BLACK Ink
7:77,01371
Permit Fee: SS . W
)
Date Reece ved: /, 1
Staff:
INFLOW NFILTRATION PERMIT APPLICATION
Plumbing / Sewer & Water
Date: 4t ^ - 2 c" ( Site Address:
to h t 'tee s i-cv civ
Tenant: c- /q -i'-( E5 _a -FA c - —F -
Suite #:
RESIDENT / OWNER
Name: Jif-, - $ 5774- e -f c h4--
Phone: 15'--1 " 86-e_.— 417 2.3
Address / City / Zip: %& C (P ej€JJ3 f [�G,i L vl -
CONTRACTOR
Name: 56?.._ 14
License #:
Address:
City:
State: Zip: Phone:
Contact: Email:
TYPE OF WORK
PLUMBING (Within the building envelope)
Sump Pump Repair
SEWER & WATER (Outside the
Repair
building envelope)
Other:
Other:
DESCRIPTION
_rise_, to
i 1 (
S I K s ra. C t e i
Description of work: ,o wo v e
, ,
I kjC_ ,
FEES
$55.00 / Each (includes $5.00 State Surcharge)
TOTAL FEE $
*
*Permit fees will NOT be reimbursed by the City of Eagan. If you plan to submit I/I repair costs for
reimbursement, two quotes from qualified contractors must accompany this application. A list of contractors
can be found by visiting www.citvofeagan.com/inflow, or City Hall at 3830 Pilot Knob Rd.
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.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 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.
Applicant's Printed Name
Aplpficant's Signature
FOR OFFICE USE
Reviewed By: Date:
Required Inspections: _Under Ground _Rough -In Final
1111,//`'
City of Eagan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
r
Use BLUE or BLACK Ink
For Office Use
Permit#: /l4 / 2:7
Permit Fee:
Date Received:
Staff:
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 10f 3 /13 Site Address: 1(aS(., 0e-Sk-ulcap l v•_ Unit#:
Resident!
Owner
. ;
Name: "�
��$ a� Phone:
Address / City
Applicant is:
M-
/ Zip: L 1.5.6 LJ.e L&� a.)c.„ `..) K)
Owner IrContractor
u,=
Type of Work
Description of
Construction Cost:
wor . 4' (,A -
C2-tAl
6.2-ect Multi -Family Building: (Yes / No )
C ;
ontractor
Compa ,
I
�,---__Il /L-,.... . Contact: cs'ti-
Address: 4o
„,
(d_ % (� City:/�.-J
v4
/
53" 22
State: 7i ' •` Zip: Phone:
License #: (o3S` t' 7 Lead Certificate #:
If the project is exempt
from lead certification, please explain why: (see Page 3 for additional information)
In the last 12 months,
Yes If
COMPLETE
has the City
yes, date and address
THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
of Eagan issued a permit for a similar plan based on a master plan?
of master plan:
_No
Licensed Plumber:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
Phone:
NATE Plans and supporting documents that you submit Are considered to be public, information Portions of
the information maybe classified as non-public if yc y; provide specific'reasons that would permit the City to
cot clude;that.theyare;trade`secrets: i x
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.org
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 Codest be completed within 180
days of per it issuance.
x lGl` 1199 to Il`(
Applicant's Printed Name
x
Aplicant's Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA125097
Date Issued:07/17/2014
Permit Category:ePermit
Site Address: 4656 Westwood Lane
Lot:10 Block: 4 Addition: Oak Cliff Pond 2nd
PID:10-53576-04-100
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Andrea Preusse
4145 Sibley Memorial Hwy
Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088
Surcharge-Fixed $5.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
James E Staloch
4656 Westwood Lane
Eagan MN 55122
(651) 882-4723
Wenzel Heating & Air Conditioning
4145 Sibley Memorial Hwy
Eagan MN 55122
(651) 894-9898
Applicant/Permitee: Signature Issued By: Signature
!"
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(==$*%-+ S/,@E* ,, '8*F+- 9@,0779,)'#< '8*F+- 9@,
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA157385
Date Issued:08/16/2019
Permit Category:ePermit
Site Address: 4656 Westwood Lane
Lot:10 Block: 4 Addition: Oak Cliff Pond 2nd
PID:10-53576-04-100
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
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: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 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 -
James E Staloch
4656 Westwood Lane
Eagan MN 55122
Renewal Andersen
1920 County Road C West
Roseville MN 55113
(651) 264-4777
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA169148
Date Issued:05/17/2021
Permit Category:ePermit
Site Address: 4656 Westwood Lane
Lot:10 Block: 4 Addition: Oak Cliff Pond 2nd
PID:10-53576-04-100
Use:
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675-5675
www.ci.eagan.mn.us
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
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
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 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 -
James E & Susan K Staloch
4656 Westwood Ln
Eagan MN 55122--402
Renewal Andersen
1920 County Road C West
Roseville MN 55113
(641) 264-4088
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA172148
Date Issued:09/16/2021
Permit Category:ePermit
Site Address: 4656 Westwood Lane
Lot:10 Block: 4 Addition: Oak Cliff Pond 2nd
PID:10-53576-04-100
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
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: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 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 -
James E & Susan K Staloch
4656 Westwood Ln
Eagan MN 55122--402
(651) 356-5286
Budget Exteriors
8017 Nicollet Avenue South
Bloomington MN 55420
(952) 887-1613
Applicant/Permitee: Signature Issued By: Signature