4292 Westchester Cir
. ~
(gex#tftra#it of (IDr.rupttnry
titp of (Eagan
m,epwbmd a# luioing jwprtiorc
This Cerrificate issuerlpursuant to the requirements of Section 306 of the Uniforni Building
Code cerdJyinB [hat at t/re time ojissuance tlus stnwtun wrrs 1n complianwe with the fnrious
ordbwncYS ojtlre City regulaung building construction or use For the followutg:
use Chwifiouioa SF DbJG 64 P=k N& 1778
0-"-7 tYa R-3MI zoaict as~ RI rym ^^'r' VN
owwdewm.~a~O~JN Bi~LS ~ 15136 GAL,A~CIE AVE, APP[E VAI~EY
4 2 WESTUE " SIER CIR~',.[,E Lo=fity L 12, B4, HAWIfDM WOODS
~
• < , ~ ~ ~ n.,~ 02/22/43
Rwk~n 0"~
POST IN A CONSPICUOUS PU1CE
~
INSPECTIUN RECORD I Control No.
~ CITY OF EAGAN PERMIT TYPE: so' ~tolM'}
3834 Pilot Knob Road Permit Number: 001 l i 8
Eagan, Minnesota 55123 Date Issued: 11 / 12 J92
(612) 681-4675
SITE ADDRESS: Ld r t 12 y ~yr ti, 4 APPLICANT:
4:'92 WESTCNESTE"ii CIR OZMUN 9LORS IMC
KANT'HbRNE NOODs (612) 431-6000
PERMIT SUBTYPE: TYPE OF WORK:
'~F trtdri Nl~1+1
INSPECTION •
t~)0f i Nil FRAM t N6
INSUT A1 i[iM FINAI
F ihL.p i A i: f
kFMAht;^y: pItSJ S S W coN'[RACTOH t'E INF PiFle
~ r• y LL ~~F ~ - ~
~ ' N . . -t. ' t~r~i~ ~°~+~r~' '7~V _ ~ ~ . _ r - Y~- ~ . .
%
?~c~a~w °
PermR No. Pennh MoW.r DaN Tskphone i
. SI1N
PLUMBING
yvnc
ELECTRIC 1- c
ELECTRIC
Insp~etio1 Dqla kwp. CommeMi
Footings I , k_gz
Fovndatfon 4p
Framinp / j i
R°°fi"g
R0ugh Pbg' ~
Rough Htg. ~
Fgepkm
Rr,a, ?ng. ~
Orset Test
Fnal Plbg. Plbg. Inapector- Notify Plu ber
co~c. r~cer + e
EngrAnan
8ldg. Flnal J162a,~
Deck Ftg.
Deck Final
wm
Pr. Disp.
Address 42q2 wesraEs~ cigrT.F, Zip 5512_3
Lo2 12 Blk 4 Sub HAwttiotW [aoons
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECITON.
Date: 02/22/93 Yes No Inspector: w fj
Final grade (6" from siding)
Permanent steps (garage) ~
Permanent steps (main entry)
Permanent driveway
Permanent gas
Sod/Seeded grass i~
TraiUcurb damage i/
Porch ~
Basement finish ~
Deck ?
Plcase verify with the builder the removal of roof test caps from the plumbing system and the shut-off of water supply to
the outside lawn faucet before freeze potential exists.
Con[act engineering division at 681-4645 before working in righbof-way or installing underground sprinkler system. ~
White - City Copy Yellow • Resident Copy Pink - Contractor Copy
~ LI RESIDENTIAL ~ ~
BUILDING PERMIT APPLICATION 2q~
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-881-4675
Naw Constructbn Aeaulremenm pemoEeVNeoair AeauiremeMs
• 3 reglstered sKB surveys sfwwing sq. k. ol lot, sq. N. ot house; end II rooted areas • 2 copies oi plan
(20°/>meximumlotcoveragealWwed) . isetofEnergyCalculatbnsfarheatetlatldMons
. 2 copies at Dlan showing beam 8 wirMOw sizes; poured found deslgn, etc.) • t site survey for exlerior add'Abns & tlecks
• 1 set ot Energy Catulatbns • Indrcxte B home servetl 6y septk system for additions
• 3 copies of Tree Preservatbn Plan if bt platted alter 711193
. Ren Joist Detail Optbns selectbn sheet (blAgs wiU 3 or less units)
DATE VALUATION
SITE ADDRESS q_L9__-7 Wc446,~,'Fe~- Clr . MULTI-FAMILY BLDG _ Y XN
TYPE OF WORK °i 4_X-0 FIREPLACE(S) ~L 0_ 1_ 2
APPLICANTCa~-j„-u-c~~_ 'foY~ c~~ UC S
STREETADDRESS DQR9 P-Le, ~~~Ar_ -i-o CITY ~jIUk_ STATE)L~P SS~L_-2
TELEPHONE # 10Sl -_124'41 CELL PHONE # FAX #iUSVURB_b249
PROPERTY OWNER 1 V uti TELEPHONE # 19S1-L1~~'~~~~
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MIIVNFSOTA RULFS 7670 CATEGORY 1 MINNESOTA RULES 7672
(4 submission type) • Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculations Submitted
Plumbing Conhactor: _ Phone # _
Plumbing system includes: _ Water Softener _ Iawn Sprinkler Fee: $90.00
_ Water Heater No. of R.I. Baths
_ No. of Baths
Mechanical Conhacfor: Phone #
Mechanical system includes: _ Air Conditioning Fee: $70.00
Heat Recovery System ~
r~~r~adr~
Sewer/Woter Conhactor. Phone
ZUUZ
JUN 1 1
I hereby acknowledge that I have read this appllcation, state that the information B correct, and agree to comply
wiTh all applicable State of Minnesota Statutes and City of Eagan Ordinances. Y
`
Signafure of Appll
OFFICE USE ONLY
Certificates of Survey Received _ Tree Praservation Plan Received _ Not Required _
Updated 4/02
OFFICE USE ONLY
? 01 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 Ext. AN - Multi
? 03 01 of _ plex ? 09 07-plex 0 17 Garage 0 22 Porch/Addn. (4sea.) O 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex O 18 Deck ? 23 Porch (screened) ? 36 Multi
O 05 03plex O 11 10-plex ? 19 Lower Level ? 24 Storm Damage
O 06 04-plex O 12 12-plex Plbg_YOr_N ? 25 Miscellaneous
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition O 36 Move Bldg. ? 42 Demolish (FOUndation) O 45 Fire Repair
? 33 AHeration ? 37 Demolish (Bldg)` 0 43 Reroof ? 46 Windows/Doors
? 34 Replacement •Demolition (Entire Bldg only) - Give PCA handout to applicaM
Valuation Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) _ FinaUC.O.
_ Footings(deck) _ FinallNo C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ 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
City SAC
Water Suppy & Storage
S&W Permit & Surcharge .
Treatment Plant '
Plumbing Permit
Mechanical Permit
License Searoh
Copies
Other
Total
2005 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 d 1PD I ~
Site Street Address 4aya u~ E~;+r: itzsJ-6,;C Unit #
Property Owner /Yl h1 4kj Telephone # ( )
Contractor Telephone )
Address Z I I, l kFe:k"I. ~~1L City Jb,-(Jr'4.kA State2AA.L_ Zip ~
The Applicant is: _ Owner "AContractor _Other
Septic System _ New _ Refurbished Submit 2 sets of plans and MPC license Includes County fee
$ 100.00
Per as-built $ 10.00
Alteretions to existing dwelling $ 50.00
_ Add plumbing fixtures. This fee includes putting in a water softener and/or water
heater at the same time. !f vou are /nsta!lina onlv a water 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 Tumaround (add $125.00 if a 5l8" meter is required)
Other:
Water Softener Water Heater $ 15.00
_ new ~ replacement
Lawn Irrigation _RPZ _PVB _new _repair _rebuild $ 30.00
State Surcharge $ .50
Total $
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 'ty of Eagan and the plumbing codes; that I
understand this is not a permit, but only an application for a permi , work i not to startwithout a permit and work will be in
ed nd pproved.
.
acc 7 with th appro e d plan in the event a plan is require to b eview
r
Applicant's Printed Name ApplicanPs Sign re
PERMIT Control No. iq287
CITx OF EAGAN 3830 Pilot Knob Road PERMIT TYPE: a u r i_ 01 N c
Eagan, Minnesota 55123 Permit Number: @ 01 7 7 8
(612) 681-4675 Date Issued: 11 / 7. 2/ 9 2
SITE ADDRESS:
4292 WFSTCHESTER CIR
LUT: 12 BLOCK: 9
HAWTHORNE WOOD;
DESCRIPTION:
!Bu3l.din,g Permi.t Type SF DWG
' Build9.ng",Work Type NEW
UBC Occupanc.y R-3 M-1
Canstructian T.ype V-N
Zoning R-1.
Building Length , 66
Building Width 50
- . ,
n
' (\~~l /~A~ %
• REMARKS: C c7 a/(aa ~
PRV S& W CODITftACT'UR - F'GTNE PLt3G
FEE SUMMARY:
VflLUATION $180,000
Base Fee $919.50 MISCELLANEOUS $1,610.50
('lari-fteview $697.58 Tota]. Pee $3,917.68
Siarcharge $90.00
SAC $700.00
5AG % 1.00
SAC Units 1
SubCoCal $2,307.15
CONTRACTOR: - APPaicant - sT. L cOWNER:
OZMUN BI_URS INC 14315000 0001044 OZMUN BLDRS
15136 GALAX:[E AVE 15136 6ALAXIE AVE
APf'LE VALLEY MN 55124 APPLE VflLLEY MN 55124
(612) 431-5000 (612)431-5000
T hereby acknowledge that I have read Y.his application and state that the
inFormation is correct and agree to comply with all appli.cable State of Mn.
Statutes and City ofi Eagan Ordinances.
L -
'14GLICA~NTIF '~-~l 1 ~i~f~ ERMITE IGNATURE -'~SSUED : GNATUREV
PERMIT f CITY OF EAGAN ¢3, i I q.1,q
REACTIVAfE _ 1992 BUILDING PERMIT APPLICATION
, I I jj 681-4675
- r
SINGLE 6 MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
specifications, I copy of energy calcs.
Penalty applies when typing of permit is requested, but not picked up by last working day
of month in which re uest is made or lot chan e is re uested once ermit is issued.
Date Valuatio of work ~
Site Address: t2n4- AESTG~i~, GL°,
SiREET SUITE !
Tenant Name: (commercial only)
IAT BIACR SUBD. ~ P.I.D. k
Descri tion of work:
N_fti
The applicant is: 43[ Owner f~Contra 51tor ? Other (oe8«fbe)
Name 0_Z-Wtl - Phone -
Property lAST F,RS,
Owner Address V- ~ kw
REET STE 1
City Vdl~ State I 4N Zip. J~~
'
Company Q - 0 Phone
COt1tf8CtOf Address (U C~t License # (OI T Exp-~ ./1 17
City ~ V State Zip 551alM_
Company Phone
Architect/
Engineer Name Registration #
Address
City State Zip
Sewer 3 water licensed plumber Processing time for
sewer & water permits is two da s once a ea has en approve
I hereby acknowledge that I hav e is app cation and state that the information is
correct and agree to comp7,p allica e State of Minnesota Statutes and City of
Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY
BUILDING PERMIT TYPE " - '
O 01 Foundation ? 06 Duplex ? 11 Apt./Lodging 016 Basement Finish
E~02 SF Dwg. ? 07 4-Plex O 12 Multi. Misc. ? 17 Swim Pool
? 03 SF Addition ? 08 8-Plex ? 13 Garage/Accessory ? 18 Comm./Ind.
? 04 SF Porch ? 09 12-Plex ? 14 Fireplace O 19 Comm./Ind. Misc.
? 05 SF Misc. ? 10 Multi. Add'1. ? 15 Deck 0 20 Public Facility
? 21 Miscellaneous
WORK TYPE
31 New ? 33 Atterations O 35 Tenant Finish ? 37 Demolish
O 32 Addition O 34 Repair 0 36 Move
GENERAL INFORMATION
Const. (Actual) V- N Basement sq. ft. MWCC System R5
(Allowable) ~ lst F1. sq. ft. City Water
UBC tlccupancy R-3 M2nd F1. sq. ft. PRY Required
Zoning R_1 3q. Ft. Latal Booster PumP
# of Stories Footprint Sq. ft. F9re Sprinkler
Length On-site well Census Code ~
Depth ,5 p On-site sewage SAC tode o~
APPROVALS
Planning Building Assessments
Engineering Variance
REQUIRED INSPECTIONS
? Site ? Footing - O Framing O Insulation
? Wallboerd ? Final ? Draintile ? Fireplace
Permit Fee v.iusc;oo: g ~$O, OOc"7 ~
Surcharge
Plan Review G tAR ACu a'
a9 x.23 - 6~-7
License a x lo : ~~a~
MWCC SAC
City SAC `
yp~' ,
Mater Conn. ~-/0
Mater Meter '3aK36~ /O$o
Acct. Deposit- Z~a Ft-ooKl
SJW Permit e~ x 16= 4,..
S/W Surcharge l2X 13= f5 30x3g= /o~a
Treatment Pl. 13, 6-7K I4 :
Road Unit I1x ~~P /y 3 3Ki3_ 3
TrailDeDed. ~~53.69 Y3o
Capies ~~t~ooRS /~5'D}~(SE 21~So ,
Other
Total: 1'19' 018
sAC x ` I00 ~xz= r)9ur6
SAC Units
~ 2422 Enterpriae ISrtva
Mandota HeI¢hts, MN 55120
(Bi2) 681-5954•~ox 661--~488
Lp,Np $URYEYORS • CINL EN0111FFR5
~ lANO PLANN6R8 - IANOSCAPt AaCHthCTS 625 H3ghway 10 Northeost
* e3ng+neer n9 Blalna, MN 55434
* ~ * * (842) 703-1880•Fax 783--1883
Certificate of Survey for: OZY'f1U Buiiders, It`iC.
House Address; Westchester ircle Ea an MN
N 00427'05" W
104.52
- --------------i,
,
13
11 ~ ~
1 1 q~'~~
~ tl19~F~A ~ ~CP
W c~
x ll °
G4 Wy .
p
t0yo'.19"
1. zv --s-
~''s t ,,.19 1 Ak~ ~ .~"^J 'SO „ea,~ 1 N
P01,g£~
"M(V05Mi
fr~ ~ I ~ARAC~ ~ Nry Y k .
u
~ i9.e7
l 1
VO.fi~ ~ ` 52 VRIVEWA
p ~ ~[MMED
949.0 a~~- -
. ~ o rh ~
ae..
h8•~Q` . t,
_ 325,
4~
RING DEPT
H~ -
x eao.o penotes ExistnG Elevation W~S~G pRp&C-)SEq HaUSE EI.~VATION
.[doo. Denotes Proposed Elevatian L,owest Floor ~levption ?47>t5,4~p
Denotes Dralnage & Utility Easement Top af B1ack Elevation. 174'Z,87
Danotes Drainage Flow Direatlon Gorage Slob Elevation;9a'3,37
--c~- Denotes Mnnument
--ig- Denotes Offset Mub Bearinge shown pre ?ssumed LOT 12 , BLDCK 4 HAWTHORNE WOODS 1 ST ADD
DAKOTA COUN7Y, MINNES9TA
I hereby cer[ifY that this aurVey, plen or repvrt waa prBpared bY ma ar under my dlrect zu rviet0n and ihat 1 art1 dUiy R6pistered Lanq Surveyor
uodB~ the hwe ot tha Statk 04 MlnnasoYd. DOted Shis~, daY of ~p ~A.D. tP,~vwsp Is/a/9x k4C &4 F/fC~,JrirJc
cI+q4 CC'4 PnsP.1°d Re~h NSc.a.M• .
PC~t/, iL-tt-'C1Z~ 1~•v~st°.t7 1~AJ~E t~iM~5~o~5 ~i , 'n rt..
y~~~{I ~~Chn f~t . OBERT :Sf}~IC .REO.NO.14B33
! \.7~ .~:.~...-30..~
(M 9244a.07
FAS 010 P02
4
ozMUN suNMERS, iNt. ° . : . R .
paIGNERSANDBUIlDERS MN LIc.0001044
15136GALqXIEAVENUE,APpI.EVALIEY,MN55144 (612)431-5000
rage ""U",C~mp ~utation
Job Site A89raas ~ . 1~. ~ . Lq~
-
• Lagal Deeaription• I.L
. Lot,~~Black_~ABfliCi411_.'~~,'lT q~DeEe
AVS[tAGH LINBAL F8$T OF SRBQSBD WAY.L AREA AHOVB GRADE
Main Level ' '
Liaeal'Et of framed wall abpve gradejMx haiqht of wnll-41-~
8gcond leve2
Lineal ft'a#'#=iMed wall ebode grade-E-I-x hetght of wnll„&2 I
Vaulted Area f n
Lir~eal ft of £rema8 wall nbave~ grade :+,x height of wa11 I = dS
Riltl JOiet •At6a. • -
Linesl Et of rim glx heiqht eE rimJ____,a_!2_
' Lcvoes 1eve1 • ~
Liaoal tt oi iromed wa11 above graaexbeignt of wali ~io~
. Lineal ft of framed•vtall abova gra9a x heiqht oE wal ~0
Lineal Yt of.masonry wall above grade x h~j~•.abvire'+gr~de =
, TpYal Wall -ar.ea.above gxade including windows ead daors
' WYtanooq& e srAnfl ana mype ~
Axe ~ "t1" value
111 aq.Et. x "U"
• +?1t ~ 8q.ft.
X nUu a
1ll sq.ft, x "U" _
Illl sq.fLt. x °U" ~ ' s$.iat• x NVp M
1) SQ.Yt• IIUII Q
, Bq.Et. x °U° r
' 11N ~ sq.ft. x " 4
U"
sq.ft. x u0u a
Hq.PC• X "U" p
li 8q.ft. x "Up W
eq.ft. x "t1° ~
x "U" _
sq.ft. - ~ x °U° a
, S~O ~ • D00 L'Area-x "U"
• ~L f , sq.ft . x °U°
sq.ft x "U°
sq.tt. x "U"I I~ ~
~.i sq.ft. ~ X °U" e .
OpApUE WALL •CON6T&[1CTION c, Area x"U" vA u ~
Braming 1qBAtbe1^8 sq_ft r ~ x°U"
8ramed wall sq.ft x "~tu
Rim 3oist Area 8q.xt x"U°~ •
. Masonry wall . sq.ft x
Total wall area inoluding ' •
windowe and • Daors b031
Total(o) vALluea. b. Avg."u"
$LVi8ed bp totaY wa area a.~ud.1~
:.cOl l
A'11ERAf#13 °tl" •joinl.mWdl .11 ;qr lesa; for 1& 2 family dwellingo
R-96% 010 11-09-92 03:44PM P002 #19
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1. BL - /7/ CITY OF EAGAN CITY USE ONLY
PLUMBING PERMIT
SUB C 0 Z ~ 1~~
(612) 681-4675 RECEIPT
DATE
~
REBIDEDiTIAL
PLEASE COMPLETE UPYER PORTION ONLY FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND CONDOS
WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
WORK DESCRIPTIOI3 COMPLETE THE FOLIAWING:
N0. FIXTURES EA. TOTAL
NEW CONST _ REPAIR/ADD ON 15.00
ADD ON / SHOWER 3.00 7.
REPAIR WATER CIASET 3.00 T
/ BATH TUB 3.00
~ l IAVATORY 3.00 a-f
OWNER NAME: C~yYI ~tiGl~~~f~ / KITCHEN SINK 3.00
IAUNDRY TRAY 3.00 3.ar
SITE ADDRESS: ~ HOT TUB/SPA 3.00
WATER HEATER 3.00 ~•1~6
/ FLOOR DRAIN 3.00 4:c Z7
GAS PIPING OUT.
INSTALLER: ~ol ~ (MINIMIJM - 1) 3.00 I'C'a
? ROUGH OPENINGS 1.50 L1
ADDRESS: ~ G~--1' ~ ~/~-til/h~~C~,•~'~- OTHER ~
WATER SOFTENER 5.00
CITY:2IP: PRIVATE DISP. 15.00
PHONE U.G. SPRINKLER 3.00
_ W. TURNAROUND 15.00
[
STATE SURCHARGE .50
~
SIGNA'f(JRE OF PERMITTEE TOTAL:
COMMERCIAL
PLEASE COMPLETE THIS PORTION FOR ALL COI4IERCIAL/INDUSTRIAL BUILDINGS. ALSO FOR MULTI-FAMILY
BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT.
WORK DESCRIPTION:
OWNER NAME:
CONTRACT PRICE:
SITE ADDRESS: 1% OF CONTRACT FEE. .
STATE SURCHARGE - $.50 FOR
TENANT NAME: EACH $1,000 OF PERMIT FEE.
SUITE $25.00 MINIMUM FEE.
INSTALLER: CONTRACT PRICE x 1% $
ADDRESS: STATE SURCHARGE $
CITY: ZIP:
TOTAL: $
PHONE
gpR; (SIGNATURE)
CITY OF EAGAN
CITY OF EAGAN CITY USE ONLY
L B
rt~p MECHANICAL PERMIT RECEIPT # o Z I~l q8
SUBD. ~l~rca~~~vr~, (612) 681-4675 DATE1 g 9~
RESIDENTIAL
PLEASE COMPLEl'E UPPER PORTION ONLY FOR SINGLE FAMILY DWELIdNGS. AISO, COMPLETE FOR
TOWNHOMFS/CONDOS WHEN SEPARATE PERMITS ARE REQUIRED FOR EACH DR'ELLING UNIT.
OR'NER: ADD-ON A/C ADD-ON FURNACE ?
S11'E ADD S: , ADD ON/REMODEL (FJiIISTING $ 15.00
CONSTRUCI'ION ONM
INSTALLER: ~ HVAC: 0-100 M BTU 24.00
PHONE - q ^3 ADDTTIONAL SO M BTU 6.00
ADDRESS: GAS OUTLEfS • MNIMUM 1 Q $3 EA.
C1TY: ZIP:,~5WS SURCSARGE: $ SO
S~
SIGNATURE: TOTAL: $ ~
NO PERMIT REQUIRE? FOR DUCTWO?tK ONLY!
COMMERCIAI.
PLEASE COhiPLETE THIS PORTION FOR ALL COMhhfERCIAIJINDUSTRIAL BUII.DINGS. AISO COMPLETE FOR
APARTMENT BUILDINGS OR OTHER MULTI•FAMII,Y BUILDINGS WHEN SEPARATE PERMTfS ARE NOT REQUIRED FOR
EACH DWELLING UNTf.
WORK DESCRIPTION: CONTRACT PRICE: FEFS
196 OF CONTRAGT FEE.
STATE SURCHARGE LS $.50 FOR EACH
$1,000 OF PERMTf FEE $
PROCFSSED PIPING - $25.00
a
hmvn?zuM FEE - s25.oo
ORTTER: TOTAL: $
SI7'E ADDRFSS:
TENANT:
SUITE
INS1'AI.I.F.R:
ADDRFSS:
ill il~
CITP: 11 ZIP:
PHONE CTl'Y SIGNATURE:
SIGNATURE:
LOT J- BLOCK _Al SUBD. AJ"
RECEIPT N aFl3(~ & DATE 610wllW
1994 CITY OF EAGAN
IRRIGATION PERMIT (FOR BACKFLOWPREVENTEA)
COMMERCIAL INSTALLATIONS - FORM MUST BE COMPLETED BY LICENSED PLUMBER
Date: Commercial GPM
~ Residential (boulevards) GPM
Existing residential
Area/address to be ittigated: 109a (~JeS44eS4r- 6un.
Insta[ler: 16-0N bA4 b~9 ~f~LS .i~G Owner E) Plumber
Sueet address: '40~- ~ ~-L' '
Ciry, state & zip code: l CD n~, {R1l" , f~- ~ Y~ Phone `73~J ~~Sj 62
Owner Name:
Street address: ~'?Q~C~el~i~ CL~~',
City, state & zip code: ~'f} i~ ~ 2L3~v~r~~3 Phone N:
Irrigation contractor, if different than instailer: tinj `kf kz L``/i
Telephone
I hereby acknowledge that I have read this application, state that the information is correct, and agree to
comply with all applicable City of Eagan ordinances.
Signature Title
If construction activity occurs in public easement or City right-of-way, signature of property owner is reqoired.
The property owner agrees to hold harmless the Ciry of Eagan for any damages caused by the City during its
normal operational and maintenance activities to the facilities constructed under this permit within City
property/right-of-way/easement.
Property Owner Date
Approved by: Ql,%4 Date: T- N e 24
, l 99 ¢
PRV ? Yes 0 No
New service ? Yes 0 No Meter Size & Cost
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PERMIT
City of Eagan Permit Type:Building
Permit Number:EA159604
Date Issued:01/02/2020
Permit Category:ePermit
Site Address: 4292 Westchester Cir
Lot:12 Block: 4 Addition: Hawthorne Woods 1st
PID:10-32150-04-120
Use:
Description:
Sub Type:Fireplace
Work Type:Gas Insert
Description:
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home may require smoke detectors in all bedrooms. Chimney / flue must be inspected prior to
concealing.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 3,000.00
Fee Summary:BL - Base Fee $3K $88.50 0801.4085
Surcharge - Based on Valuation $3K $1.50 9001.2195
$90.00 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 -
Thomas E Mundy
4292 Westchester Cir
Eagan MN 55123
(651) 331-8558
The Fireplace Guys Llc
680 Hale Ave N #110
Oakdale MN 55128
(612) 326-1919
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA168383
Date Issued:04/20/2021
Permit Category:ePermit
Site Address: 4292 Westchester Cir
Lot:12 Block: 4 Addition: Hawthorne Woods 1st
PID:10-32150-04-120
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Includes Skylight
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site. We encourage you to retain an electronic copy of
photos until the project passes a final inspection.
*Roof permits issued between December and March will be inspected in the spring or when weather warms up.
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 -
Erica Erickson
4292 Westchester Cir
Eagan MN 55123
Property Claim Solutions Llc
2005 Pin Oak Dr
Eagan MN 55122
(651) 994-2028
Applicant/Permitee: Signature Issued By: Signature