EA185135 - Building - Single Fam - Issued Date 07/25/2023 PERMIT
City of Eagan , ° e ® Permit Type: Building
3830 Pilot Knob Rd Permit Number: EA185135
° +
Eagan, MN 55122
(651)675-5675 EAGAIN
www.cityofeagan.com * E R I B S 1 3 S
Date Issued: 7/25/2023
Site Address: 4072 Nicols Rd
Lot: 1 Block: 1 Addition: Cedar Grove 1st
PID:10-16700-01-010
Use: * 10 - 167QPJ — r01 - 01fD *
Description:
Sub Type: Single Fam Construction Type: V-B
Work Type: Alteration
Description: Bath Remodel
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 $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:
Clear Choice Bath Harvey A Tam
PO Box 386 4072 Nicols Rd
Carlisle IA 50047 Eagan MN 55122
(800)484-2833
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
rFor Office Use "_ w —I
f [ 7 r
i Building Permit#:
S&W Permit#:
A G A NI I
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Permit Fee: 13 7 I
diI Date Received:
3830 PILOT KNOB ROAD i EAGAN, MN 55122-1810 viive I
(651)675-56751 FAX: (651)675-5694 I i
buildinoinspectionsCcDcityofeaaan com Date Issued:
JUL 10 lues —__ '
RESIDENTIAL BUILDING PERMIT APPLICATION
Date: July 7, 2023 Site Address: 4072 Nicols Road, Eagan, Mn 55122 Unit#:
od
Applicant is: 13 Owner ® a isContractor R_I � I
Name: Shawn &Jackie Tam
Homeowner Address:4505 Scott Trailcity: Eagan
an
State: MN Z;p5122 Phonef 51-890-7963 Email: shawntam2380 ahoo.com
Description of work: Bath Remodel &replace window in bathroom
Type of 16,000
Work Construction Cost:
Type of building: ® Single Family ❑ Townhome, of units
❑ Twin Home
Company: Clear Choice Bath Contact: Sid Tyler
Building Address:PO BOX 386 City: Carlisle
Contractor
State: *' -Zip: 50047 Phone: 515-989-9115Email: sid@clearchoicebath.com
License#: CR712412 Expiration Date: 3-31-2024
Sewer& Company: Contact:
Water
Contractor Address: City:
Required for State: Zip: Phone: Email:
new construction
License#: Ex iration Date:
® 1 understand that Plumbing, Mechanical, and Fire Suppression work require separate applications
E
TE:Pians and supporting documents that you submit are considered to be public information. Portions of the
ormation may be classified as non-public if you provide specific reasonsthat would permit the City to conclude that they
trade secrets.
CALL BEFORE YOU DIG. Contact Gopher State One Call at(651)454-0002 or www.gopherstateonecall.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.
off) f,
X.Sid Tyler with Clear Choice Bath , ;
Applicant's Printed Name ApplicantX Signatuur