EA183183 - Building - Single Fam - Issued Date 06/01/2023 PERMIT
City of Eagan ® ® ® ® Permit Type: Building
3830 Pilot Knob Rd ®m®; ® 0®®®® A AgElb Permit Number: EA183183
Eagan,MN 55122 ®m®® ®®®® EAUAN
(651)675-5675 IRFINIM
www.cityofeagan.com * E R 1 8 3 1 8 3 *
Date Issued: 6/1/2023
Site Address: 4676 Cambridge Dr
Lot: 8 Block: 5 Addition: Beacon Hill
PID:10-13500-05-080
Use: * 1 0 — 1 3 5 0 0 — 0 S — 0 8 0
Description:
Sub Type: Single Fam Construction Type: V-B
Work Type: Alteration
Description: new shower system and wall surround
Census Code: 434-Residential Additions,Alterations Occupancy: IRC-1
Zoning: PD
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 $83.50 0801.4085
Valuation: 2,000.00 • BL-Plan Review 65% $54.28 0720.4222
Surcharge-Based on Valuation $1.00 9001.2195
Total: $138.78
Contractor: - Applicant - Owner:
Minnesota Rusco Mark&Karen Taverna
5010 Hwy 169N 4676 Cambridge Dr
Brooklyn Park MN 55428 Saint Paul MN 55122--278
(952)935-9669
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
Ca r—
For Office Use
BY. I 183183 I
® ® ® I Building Permit#:
I
®®e 0 j S&WPermit#:
EAGANI Q G U I
Permit Fee: I J a b
Date Received: 5/26/23
3830 PILOT KNOB ROAD i EAGAN,MN 55122-1810
I
I I
(651)675-5675 1 FAX: (651)675-5694 1 Date Issued:
buildinginspections@_citvofeaQan.com I-----------------------
RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 5/26/23 Site Address: 4676 Cambridge Dr Eagan, MN 55122 unit#:
Applicant is: ❑ Owner 14 Contractor
Name: Karen Taverna
Hotnediwner Address: City:4676 Cambridge Dr Eagan
li state: MN Zi : 55122 Phone: 651-452-323( Email: tavbball@comcast.net
Demo existing.Install new shaver system and wall surround.Minnesota Rusco to insulate,Install vapor barrier,tape and seal.Install smoke and C.O.alarms to code.
Description of work:
Type of $10,154.00 PD, Beacon Hill
work Construction Cost:
Type of building: 21 Single Family ❑ Townhome, of units ❑ Twin Home
Company: MN RuSCo Contact: Kelli Gugisberg
P Y�
Bullding Address: 5010 Hwy 169 N City: New Hope
contractor MN 55428 952-935-966( kelli@minnesotarusco.com
State: Zip: Phone: Email.
License#: CR805613 Expiration Date: 3/31/25
Sewer$, Company: Contact:
Water
Contractor Address: City:
Required for State: Zip: Phone: Email:
new construction.
License#: Expiration Date:
I 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 provlda 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.aopherstateonecall.org 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 Kelli Gugisberg x
Applicant's Printed Name Applicant's Srdnaf4re
FOR OFFICE USE,ONLY
Site Address: 4676 Cambridge Dr Eagan, MN 55122 permit#: 183183
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 Valuation Occupancy -T?-c-I MCES System
Plan Review 025% 21100% Code Edition MNVC-dodo SAC Units
Census Code Zoning Pt) City Water
#of Units Stories Booster Pump
#of Buildings Square Feet PRV
Type of Construction VS 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 ✓ Final/No C.O. Required
Final/C.O. Required
Reviewed By: Building Inspector
FEES ��gwcr �J�oct.we..s�
Calculated Valuation
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