EA180588 - Building - Drain Tile - Issued Date 12/12/2022City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675-5675
www.cityofeagan.com
PERMIT
Permit Type: Building
w ! , ®r. a �' Permit Number: EA180588
* E R 1 8 0 5 8 8*
Date Issued: 12/12/2022
Site Address: 1073 Tiffany Dr
Lot: 26 Block: 1 Addition: Canterbury Forest
PID: 10-16350-01-260 111111111 Mill 11111111111111111111 11M
Use: * 1 0— 1 6 3 5 0— 0 1— 2 6 0*
Description;
Sub Type:
Work Type:
Description:
Census Code:
Zoning:
Square Feet:
Comments:
Drain Tile
New
434 - Residential Additions, Alterations
PD
0
Construction Type: V -B
Occupancy: IRC -1
Fee Summary: BL - Plan Review - Fixed $40.00 0720.4222
Radon/Drain Tile $94.00 0801.4085
Surcharge -Fixed $1.00 9001.2195
Total: $135.00
Contractor: - Applicant - Owner:
Foundation Supportworks Solutions Adam C & Pui Yee Hornibrook
5116 Jean Duluth Rd 1073 Tiffany Dr
Duluth MN 55803 Saint Paul MN 55123--187
(218) 525-0720
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.
Applicant/Permitee: Signature
ssued B : Signature
______________
2-22 I For Office Use
1
Building Permit #: 180588 I
I
S&W Permit #:
EAGANII
Permit Fee:
Date Received: 12/8/22 j
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 I I
651 675-5675 FAX: 651 675-5694 1 I
� ) I � ) I Date Issued: I
buildin4insoectionsg)citvofeaaan.com I — — — — — — — — -- — — -- — — — -- — —
RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 12/8/2022 Site Address: 1073 Tiffany Dr unit #:
Applicant is: ❑ Owner 14 Contractor " s
Name: Adam Hornibrook
:`ll omoown_er Address: City:
1073 Tiffany Dr Eagan
State: MN zi : 55123 phone: 651-334-080C Email:
Description of work: Installing 19f of draintile and new sump
Type Of Construction Cost: 4000 P ! cari +C RX fORe 7�
Work
Type of building: 21 Single Family ❑ Townhome, of units ❑ Twin Home
Company: DBS Residential Solutions contact: Joe Harris
Budding Address: 5116 .Jean Duluth Rd city: Duluth
Contractor MN 55804218-525-072C Permits@dbsrepair.com
State: Zip: Phone: Email.
License #: CR692609 Expiration Date: 03/31/2023
Sarver" Company: Contact:
Water
Codtmctor
Address: City:
RegUlred for State: Zip: Phone: Email:
new construction
License #: Expiration Date:
1 understand that Plumbing, Mechanical, and Fire Suppression work require separate applications.
NOTE: Flak and uppor irtg: docufriaratt ttlat ypu sub�rnit are cpnsIdered to be public Jnfor�natian. Portion& of the
information may tie cigssified as ttan=public if you provide specif d i4asdns that would permit tttie Clty to conclude thst'they
are trade secrets.
CALL BEFORE YOU DIG. Contact Gopher State One Call at (651) 454-0002 or www.aooherstateonecall.ora for protection against underground utility
damage. Contact Gopher State One 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 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.
doe Harris X 4A P-2jm,Q�
Applicant's Printed Name Applicant's Signature
FOR OFFICE USE ONLY
Site Address: 1073 Tiffany Dr Permit #: 180588
SUB TYPES
i/ Single Family
_ Fireplace
01 of _ Plex
_ Foundation
Deck
_ Garage
WORK TYPES
New
_ Repair
Addition
_ Fire Repair
/Alteration
_ Water Damage
Replace
_ Egress Window
DESCRIPTION
Calculated Valuation V,00,0
Plan Review 1325%,0-I00%
Census Code
# of Units
# of Buildings
Type of Construction V(%
Lower Level
Porch
Pool
_ Siding
_ Reroof
Windows
_ Solar
Occupancy 3ac-t
Code Edition MAIlZC-QoaO
Zoning 1�1-)
Stories
Square Feet
REQUIRED INSPECTIONS
_ Footings: New Addition Deck
_ Foundation: Before Backfill Poured Wall
_ Framing: 1 Hour Residential Alteration
_ Braced Wall Framing/Blocking
_ Braced Wall Sheathing (prior to house wrap)
_ Interior Braced Wall Panel(s)
_ Firewalls
_ Insulation
_ Fireplace: _Rough In Air Test _Final
_ HVAC: Rough In Final
Radon Control
Retaining Wall
_ Move Building
_ Demolish Building*
*Demolition of entire building - give PCA
handout to applicant
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Suppression Required
Separate Stormwater Management Permit Required
Siding: _Stucco Lath _Stone Lath _Brick
Roof: Ice & Water _Final
Erosion Control
Pool: _Footings —Air/Gas Tests _Final
Retaining Wall: _Footings _Backfill _Final
Fire Suppression: _Rough In _Final
Windows
✓ Final/No C.O. Required
Final/C.O. Required
Reviewed By: /S6� , Building Inspector
FEES
Calculated Valuation �, po o �n� - 14'
Base Fee
Plan Review
State Surcharge
Met Council SAC
City SAC
Treatment Plant
Water Supply & Storage
S&W Permit & Surcharge
Meter
Radio Read
Other:
TOTAL $ 0.00