EA171915 - Building - Commercial/IndustrialPERMIT
City of Eagan
Site Address: 4130 Blackhawk Rd
Lot:1 Block: 1 Addition: Blackhawk Plaza
PID:10-14388-01-010
Use:My Medical Clinic
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675-5675
www.cityofeagan.com
Permit Type:Building
Permit Number:EA171915
*10-14388-01-010*
Date Issued:10/19/2021
*EA171915*
Description:
Sub Type:Commercial/Industrial
Work Type:Int Impr
Description:
Census Code: -
Zoning:
Square Feet:0
Occupancy:B
Construction Type:II-B
Comments:
Valuation: 48,500.00
Fee Summary:BL - Base Fee $671.00 0801.4085
Plan Review $436.15 0720.4222
Surcharge - Based on Valuation $24.50 9001.2195
$1,131.65 Total:
This permit shall be null and void if work does not start within 180 days of issuance, or if work is suspended for 180 days or more after
started.
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 C Kite
% Suntide Commercial Realty Inc
2550 University Ave W Ste 416-S
Saint Paul MN 55114
Design 2 Build, Inc
4892 Twins Ct
Eagan MN 55123
(612) 396-4556
Applicant/Permitee: Signature Issued By: Signature