EA182020 - Building - Single Fam - Issued Date 04/10/2023 PERMIT
City of Eagan ® ® , ® Permit Type: Building
3830 Pilot Knob Rd Permit Number: EA182020
®®®® ®®®®
Eagan,MN 55122 ®®®® ®®®®
(651)675-5675 E A
www.cityofeagan.com * E R 1 8 2 0 2 0
Date Issued: 4/10/2023
Site Address: 4178 Countryside Dr
Lot: 6 Block: 1 Addition: Country Hollow
PID:10-18275-01-060
Use: * 10 - 18275 - 0 1 - 060 *
Description:
Sub Type: Single Fain Construction Type: V-B
Work Type: Alteration
Description: remove soffits in kitchen-window opening between
kitchen and diing room Occupancy: IRC-1
Census Code: 434 Residential Additions,Alterations
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 $149.70 0801.4085
BL-Plan Review 65% $97.31 0720.4222
Valuation: 5,040.00 Surcharge-Based on Valuation $3.00 9001.2195
Total: $250.01
Contractor: - Applicant - Owner:
John W Schlee Remodeling LLC Sally Gene Cortez Ngo
1048 Winslow Ave 4178 Countryside Dr
West St Paul MN 55118 Eagan MN 55123
(651)554-9970
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
ECEIVE
For Office Use
BY: I Building Permit M
S&WPermit M
EAGAN\\_• •si• I r I
Permit Fee: "J o.01
� 1
I Date Received: +/,+/I, I
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
651 675-5675 FAX: 651 675-5694 1 I
� � � � � I Date Issued: 1
buildinainspections(&citvofeaaan.com I-----------------------
RESIDENTIAL BUILDING PERMIT APPLICATION
Date: `1�3 Site Address: Unit#:
Applicant is: ❑ Owner C&Contractor
Name: {/l lid l/ is
Homeowner Address: �/ Ind 44yV4_^N �P' City: F"&-A U
Statej�l Phone:6/;L ���-EnYail: no danN I L�"� _
Zi : 6
Descriptionofwork: � ,15 6 f-ACL-I... 1,1di�c- 5Lie 0,J) 6�
Type ofdb h#_ ki &L' . +
Work Construction Cost: ®� R-1 COUNhollow
y w
Type of building: Rpingle Family ❑To_wnhome, of units 11 Twin Home S
Company:J Q r` CA.) �J� 1 g� 4s 0 Ci#1 L"4 ContactV
:
Building Address: 10y 7 4`�yrk-- — Aut- City: a Silo- PA44 1
Contractor ,/ / s�P��
Stat�N Zip: 5-5 115' Phone:LP�� Email: �9t 10//M4C0`-- 0
License#: -79 Ex iration Date:
Sewer& Company: Contact:
Water
Contractor Address: City:
Required for State: Zip: Phone: Email:
new construction
License#: Expiration Date:
XI understand that Plumbing,Mechanical,and Fire Suppression work require separate applications.
NOTE:Plans and supporting documents that you submit are considered to be public Information. Portions of the
Information may be 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. Contact Gopher State One Call at(651)454-0002 or www.gopherstateonecall.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
accordancei.Cvith the approved plan in the case of work which requires a review and approval-of plans.
i
Applican'siPrinted Name Applia04 Signature
FOR
,0,FFIC/IE USE_ONLY
— 9 1 n
Site Address: �� / 1, l IA- 1 ®� �t(~ Permit#: 1
SUB TYPES.
Single Family _ Fireplace _ Lower Level
_ 01 of_Plex _ Foundation _ Porch
Deck _ Garage _ 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 ValuationSQ Occupancy IAC-"'- MCES System
Plan Review 025% 1od% Code Edition --,6W IZC--20 y0 SAC Units
Census Code Zoning City Water
#of Units Stories Booster Pump
#of Buildings Square Feet PRV
Type of Construction \j Ig Fire Suppression Required
Separate Stormwater Management Permit Required
REQUIRED INSPECTIONS
Footings: New Addition Deck Meter Size:
Foundation: Before Backfill Poured Wall Siding:_Stucco Lath _Stone Lath _Brick
Framing: 1 Hour Residential Alteration Roof:_Ice&Water _Final
Braced Wall Framing/Blocking Erosion Control
Braced Wall Sheathing(prior to house wrap) Pool:_Footings —Air/Gas Tests _Final
Interior Braced Wall Panel(s) Retaining Wall:_Footings_Backfill_Final
Firewalls Fire Suppression:_Rough In_Final
Insulation Windows
Radon Control Other:
Drain Tile
Grading I)L Final/No C.O.Required
Final/C.O.Required
Reviewed By: Building Inspector
FEES
Calculated Valuation �C 1� )! a'� 1 s o�5� , X 2Z
Base Fee
Plan Review cj7, 3t
State Surcharge 3,
Met Council SAC
City SAC
Treatment Plant
Water Supply&Storage
S&W Permit&Surcharge
Meter
Radio Read
Other:
TOTAL $ 0.00 J9D.0 1