3773 Grey Dove Lane
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Use BLUE or BLACK Ink
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Permit#: VO 3b2
City of Ea I Permit Fee: I
1
3830 Pilot Knob Road I t
Eagan MN 55122 i Date Received: 'D 2p I
Phone: (651) 675-5675 I
Fax: (651) 675-5694 ! Staff
# 9 L - - - - - - - - - -
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
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Date: w '1- l3 Site Address: 37i~7 3 71 , 3>73y 3777 7 21 Unit
Name: Phone:
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s Resident/
( Owner Address f City / Zip'
Applicant is: Owner Contractor
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Description of work
Type of Work
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Construction Cost! J oLU+O p Multi-Family Building: (Yes f No
.,.....~..w... _ Company: Conte
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{Address: e-cL, r , City:
Contractor
State: (y),AJ Zip: _-)'5343 Phone: 1 52 3-/ ~2 - 220-0
License # 4~ ; ~y `1 Lead Certificate ~OooC
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 pen-nit 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 maybe classified as non-public if you provide specific reasons that would permit the City to
- conclude that they 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.
I hereby acknowledge that this information is complete and accurate that the worse 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 be completed within 180
days of permit issuance.
Applicant's Printed Name Applicant's Signature
Page 1r of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA168889
Date Issued:05/06/2021
Permit Category:ePermit
Site Address: 3773 Grey Dove Lane
Lot:3 Block: 19 Addition: Town View 1st
PID:10-77100-19-030
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 -
Valerie J Tinker
3773 Grey Dove Ln
Saint Paul MN 55122--112
Renewal Andersen
1920 County Road C West
Roseville MN 55113
(641) 264-4088
Applicant/Permitee: Signature Issued By: Signature