EA184671 - Building - Reroof - Issued Date 06/16/2023 PERMIT
City of Eagan , , Permit Type: Building
3830 Pilot Knob Rd Permit Number: EA184671
Eagan,MN 55122 EAGAN
(651)675-5675
www.cityofeagan.com * E R 1 8 4 6 7 1
Date Issued: 6/16/2023
Site Address: 4672 Fairway Hills Dr
Lot: 10 Block: 1 Addition: Fairway Hills
PID:10-25600-01-100
Use: * 1 0 — 2 5 6 0 0 — 0 1 — 1 0 0
Description:
Sub Type: Reroof Construction Type:
Work Type: Replace
Description:
Census Code: 434-Residential Additions,Alterations Occupancy:
Zoning:
Square Feet: 0
Comments: Please print pictures of ice and water protection and leave on site.
If water damage is encountered,please call(651)675-5675 to schedule a site visit to verify the extent of the damage.Any
repairs must be inspected prior to covering. The inspector will determine if an additional permit will be required to repair t
water damage.
Fee Summary: BL-Base Fee $133.15 0801.4085
Valuation: 5,000.00 Surcharge-Based on Valuation $2.50 9001.2195
Total: $135.65
Contractor: - Applicant - Owner:
Poundstone Consulting Joshua&Quinn Check
16472 Duluth Tr 4672 Fairway Hills Dr
Lakeville MN 55044 Eagan MN 55123
(952)913-6546
This permit shall be null and void if work does not start within 180 days of issuance,or if work is suspended for 180 days or more after
started.
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Applicant/Permitee: Signature sued B : Signature
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I Building Permit#: I
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Permit Fee: i J (0 5 1
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Date Received: (o 120 2-4 1
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 /_ 1
(651)675-5675 1 FAX: (651)675-5694 1 Date Issued: k l l� 1.20�3
buildin4insi3ectionsD-citvofeagan.com 1__________-_^__________
RESIDENTIAL BUILDING PERMIT APPLICATION
Date: <%3 Site Address: /� 7 Unit#:
Applicant is: ❑ Owner Contractor
Name:
Homeowner Address:
l City:
State: Zi Phone: Email cJ -
Description of work: 02-)
1. �'
Type of
Work Construction Cost:
Type of building: �ingle Family ❑ Townhome, of units ❑ Twin Home
Company: Contact: `s
Building Address: �l / � T f City: 44 f' / A(-Y
Contractor ��11
State:✓Ju/,/Zip: J`rSt� Phone: �jr — Email:
&Ag
License#: Xr Ex irt Date:
Sewer$ Company: Contact:
Water
Contractor Address: City:
Required for State: Zip: Phone: Email:
new construction
License#: Expiration Date:
❑ 1 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.aopherstateonecall.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 w hich requires a review and approval of plans.
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Applicant's Pfiffiffid Applicant's Signature