EA184856 - Building - Deck - Issued Date 07/10/2023City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675-5675
www.cityofeagan.com
Site Address: 4140
Lot: 9 Block: 3
PID:10-18276-03-090
Use:
PERMIT
° e
Permit Type: Building
®® Permit Number: EA184856
EAGAN
® * E R 1 8 4 8 S 6
Countryview Dr
Addition: Country Hollow 2nd
Description:
Sub Type: Deck
Work Type: New
Description:
Census Code: 434 - Residential Additions, Alterations
Zoning: R-1
Square Feet: 0
Comments:
Date Issued: 7/10/2023
III 1111111 I IIII I I IIII II II II I I II II I I
Construction Type: V -B
Occupancy: IRC- I
Fee Summary: (BL) Plan Review $97.31 0720.4222
Valuation: 5,520.00 BL- Base Fee $149.70 0801.4085
Surcharge - Based on Valuation $3.00 9001.2195
Total: $250.01
Contractor: - Applicant - Owner:
Artisian Decks MN Donald J & Theresa L Gaylord
7737 Grinnell Way 4140 Country View Dr
Lakeville MN 55044 Saint Paul MN 55123-394
(612) 710-3071
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{�-
JUN 2 6 2023 ---------------------I
For GHica use ,
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3830 PILOT KNOB ROAD I EAGAN, MN 55122-1610 I
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(651) 675-5675 1 FAX: (651) 675-5694 I Date Issued I
buildinoinsoectionsP-citvofeanan com I — — — — — — — — — — — — — — — — — -- — —
RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 06/22/2023 site Address: 4140 Countryview Dr. unit #:
Applicant Is ❑ Owner ® Contractor �' I K
Name: Don Gaylord -1 IVROW
Homeowner Address: 4140 Countryview Dr. city: Eagan
State: MN Zi 55123 Phone: 6512497799 Email: DonGaylord@gmail.com
Description of work: Build deck
Type of
Work Construction Cosy 261544
Type of building: ® Single Family ❑ Townhome, of units ❑ Twin Home
Company. Artisan Decks MN cone: Shane
Building Address: 7737 Grinnell Way Cary; Lakeville
Contractor State: Zip: Phone: Email: MN 55044 6127103071 Shane@artisandecksmn.com
License #: CR806896 Expiration Date: 03/31/2025
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: Pians 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 al (651)454-0002 or wAw goohmstateronecall ona tot footesiton agamct uniierground utilitp,
damage Contact Gopher State One Call 48 hours before you intend to dig to receive tocatc5 of undargivund utilities
hereby acknowledge that Ihis Information is complete and accurale, that thn i%ork will he in conformance wth the oitimances ann rade, of thee City of
Eagan, that 1 understand this is mist a permit, bol only an application for a permit and v-ork is not to shad without o "rmtt, that the wom *iii be in
accordance with the approved plan in the case of work which requires a revieiv and approval of plans
XShane Knolls x
Applicant's Printed Name Applicant's Signature
FOR OFFICE USE ONLY
Site Address: 1-140
C otam�-yl c� DIA-
Permit #:
SUB TYPES
Foundation _ Fireplace
_ Porch (3 -Season)
_ Miscellaneous
Single Family _ Garage
_ Porch (4 -Season)
_ Accessory Building
_ Multi'X 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
�50
Calculated Valuation 0-1,0
Occupancy JILG-1
MCES System
Plan Review
Code Edition AOV(LC' zoZ.Q
SAC Units
(25%_ 100°!0 04)
Zoning R.:L
City Water
Census Code
Stories
Booster Pump
# of Units
Square Feet
PRV
# of Buildings
Length Fire Suppression Required
Type of Construction ifQj
Width
REQUIRED INSPECTIONS
Footings (New Building)
Meter Size:
Footings (Deck)
Final / C.O. Required
Footings (Addition)
Final / No C.O. Required
Foundation Foundation Before Backfill
HVAC _ Service Test
Gas Line Air Test _ Hood
Roof: _Ice & Water _Final
Pool: _Footings Air/Gas Tests _Final
Framing 'X 30 Minutes 1 Hour
Drain Tile
Fireplace: _Rough In _Air Test _Final
Siding: _Stucco Lath _Stone
Lath _Brick _ EFIS
Insulation
Windows
Sheathing
Retaining Wall: _ Footings _ Backfill _ Final
Sheetrock
Radon Control
Fire Walls
Fire Suppression: _Rough In _Final
Braced Walls
Erosion Control
Shower Pan � / _ , Other.
Reviewed By: Building Inspector
RESIDENTIAL FEES �➢��
Calculated Valuation Z, S� X 5' S�
Base Fee
Plan Review
State Surcharge 3 ,
MCES SAC
City SAC
Utility Connection Charge
S$W Permit & Surcharge
Treatment Plant
Radio Read
Other:
Copies:
TOTAL $'VO