EA180282 - Building - Single Fam - Issued Date 12/12/2022City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675-5675
www.cityofeagan.com
PERMIT
Permit Type: Building
Ki Permit Number: EA180282
9= A rum A 1 1001.10 11011 10.1 11001 10111 §0110 1IMNI 10110 1101 WE
*EA 180282*
Date Issued: 12/12/2022
Site Address: 4070 Mica Tr
Lot: 6 Block: 12 Addition: Cedar Grove 5th
PID: 10-16704-12-060 111111111111111111111 11111M
Use: *10-16704-12-060*
Description:
Sub Type: Single Fam Construction Type: V -B
Work Type: Egress Window
Description:
Census Code: 434 - Residential Additions, Alterations Occupancy: IRC -1
Zoning: R-1
Square Feet: 0
Comments: Improvements to the home may require smoke detectors in all bedrooms.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota
State Building Code).
Fee Summary:
BL - Base Fee
$88.50
0801.4085
4707 Hwy 61 N, # 146
Plan Review
$57.53
0720.4222
Valuation: 2,300.00
Surcharge - Based on Valuation
$1.50
9001.2195
Total: $147.53
Contractor: - Applicant -
Owner:
Egress Window Company
Gillen Living Trust Dated 8/23/2013
4707 Hwy 61 N, # 146
4070 Mica Trl
White Bear Lake MN 55110
Eagan MN 55122
(612)913-0013
This permit shall be null and void if work does not start within 180 days of issuance, or if work is suspended for 180 days or more after
started.
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Applicant/Permitee: Signature
sued B : Signature
i ,m 01 P -►
----------------
For Office Use
Permit* 180282
'jEAGA
I
E C E' V E I Permit Fee. + 1
I
Date Received: 11/16/22 1
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 NOV 16 2022 1 Staff: 1
(651) 675-5675 1 FAX: (651) 675-5684
buildinginsoectionsO-)citvofeaaan.com BY: I ------------------J
2022 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 11/15/2022 Site Address: 4070 MICA TR Unit
Name: GILLEN LIVING TRUST - BOB GILLENPhone: 952-240-4178
i e$ident/
Owner Address / City / Zip: SAME AS SITE
Applicant is: Owner _K Contractor Owner Email:
REPLACE EXISTING WINDOW 32"Wx16"H W/ EGRESS CASEMENT 28' 42"H. NO HEADER CHANGE.
T ,pe of
Work Description of work: LOCATION: SOUTH - SIDE YARD NEAR BACK, EAST CORNER. SETBACK 25 FT.
Construction Cost: $2300 Multi -Family Building: (Yes / No
REVAMP REMODELING & DESIGN DBA MARY M. DEVENS
Company: THE EGRESS WINDOW COMPANY Contact:
Contractor Address: 4707 HWY 61 N #146 City: WHITE BEAR LAKE
State: MN zip: 55110 Phone: 612-231-0010 Email: revampdesign@comcast.net
License #: BC634654 EXP 3/31/2023 Lead Certificate #: F114840-2 EXP 7/23/2023
If the project is exempt from lead certification, please explain why: R-1, Cedar Grove
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan Issued a permit 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:
Fire Suppression Contractor: Phone:
NOTE. Plans and supporting documents that you submit are considered to be public Information. Portions of the Information may be
c/assitled as non- ublic if Lou grovide s eciRc reasons that would permit the 2LtX to conclude that they are trade secrets.
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at
www.cityofeagan.com/subsedbe. .
CALL BEFORE YOU DIG. Contact Gopher State One Call at (651) 454-0002 or www.aor)herstateonecall.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.
X Mary M. Devens x ' ()- --
Applicant's Printed Name Applicant's Signature
FOR `OFFICE USE ONLY
Site Address: 40-7 6 M I C01, -TO I I Permit #: � M,0Z
SUB TYPES
_ Foundation
_ Fireplace
_ Porch (3 -Season)
_ Miscellaneous
K Single Family
_ Garage
_ Porch (4 -Season)
_ Accessory Building
Multi
_ Deck -
_ Porch (Screen/Gazebo/Pergola)
01 of _ Plex
_ Lower Level
_ Pool
WORK TYPES
_ New
_ Repair
_ Siding
— Retaining Wall
Addition
_ Fire Repair
_ Reroof
_ Move Building
Alteration
Water Damage
_ Windows
Demolish Building*
_
Replace
Egress Window
_ Solar
_
*Demolition of entire building — give PCA
handout to applicant
DESCRIPTION
Calculated Valuation 9, 3DC7.
Plan Review
(25%_ 100% A)
Census Code
# of Units
# of Buildings
Type of Construction
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation Foundation Before Backfill
Roof: _Ice & Water _Final
cx Framing A 30 Minutes 1 Hour
Fireplace: _Rough In Air Test _Final
Insulation
Sheathing
Sheetrock
Fire Walls
Braced Walls
Shower Pan
Occupancy I V -G- 3 -
Code Edition MIS U-zo-z-o
Zoning 12,-1
Stories
Square Feet
Length
Width
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Suppression Required
_ Meter Size:
_ Final / C.O. Required
be Final / No C.O. Required
HVAC _ Service Test Gas Line Air Test _ Hood
Pool: _Footings Air/Gas Tests _Final
_ Drain Tile
Siding: _Stucco Lath _Stone Lath _Brick _ EFIS
_ Windows
Retaining Wall: _ Footings _ Backfill _ Final
_ Radon Control
Fire Suppression: _Rough In _Final
E i C
0
ros on ontrol Stormwater Management
Other: Permit Required:
Reviewed By: 2�� S hro" , Building Inspector
RESIDENTIAL FEES
Calculated Valuation `d13CID
Base Fee e6 81- So
Plan Review Cil - yp
State Surcharge 1-60
MCES SAC
City SAC
Treatment Plant
Water Supply & Storage
S&W Permit & Surcharge
Radio Read
Other:
Copies:
TOTAL $ 0.00 1q7* 55