EA186123 - Building - Reroof - Issued Date 08/16/2023 PERMIT
City of Eagan b , , g Permit Type: Building
3830 Pilot Knob Rd N %!�.', Permit Number: EA186123
Eagan, MN 55122 EAGAN
(651)675-5675
www.cityofeagan.com * E R 1 8 6 1 2 3
Date Issued: 8/16/2023
Site Address: 4526 Birchcrest Cir
Lot: 1 Block: 2 Addition: Ches Mar East 1st
PID:10-17150-02-010
Use: * 1 Q — 17 1 S0 02 - 0 10
Description:
Sub Type: Reroof Construction Type:
Work Type: Replace
Description:
Census Code: - 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:
Haven Builders Barbara L Tste Korman
3515 48th Ave N 4526 Birchcrest Cir
Brooklyn Center MN 55429 Eagan MN 55123
(651)300-9711
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 Issued By: Signature
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For Office Use
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% i 0 0 1 Building Permit#:
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as �0 �"r 1 S&W Permit#:
EAGAN Permit Fee:
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3830 PILOT KNOB ROAD I EAGAN, MDate Received:
N 55122-1810 I
(651)675-5675( FAX: (651)675-5694 I
I Date Issued:
buildinginspections(a)citvofeagan com
RESIDENTIAL BUILDING PERMIT APPLICATION
Date:
8/16/2023 Site Address: 4526 Birchcrest Circle Eagan, MN 55 Unit
it#:
Applicant is: ❑ Owner 14 Contractor
i
Name:
Terence Korman
Homeowner Address: 4526 Birchcrest Circle City: Eagan
State: MN Zip: 55123 Phone: 651-452-82 Email: I
Description of work:
Re-Roof
Type of 17 735.13
Work Construction Cost: '
I
Type of building: 0 Single Family ❑ Townhome, of units ❑ Twin Home
Company: Haven Builders, LLC contact: Derek Kuefler
Building Address: 10140 W 76th Street City. Eden Prairie
Contractor
State: MN Zip: 55344 Phone: 612-468-77 Email: derek.kuefler@haven build
License#: BC7587296 Expiration Date: 3/31/25
Sewer & Company: Contact:
Water
Contractor Address: City:
N
Required for State: Zip: Phone: Email:
new construction
License#: Ex iration Date:
❑ I understand that Plumbing, Mechanical, and Fire Suppression work require separate applications.
NOTE; Plans and supportlrig docurnents that you s11 ub11 mit 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 tradesecrets
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.
Digitally signed by Derek Kuefler
X Derek Kuefler Derek KueflerDate:2023.08.1611:45:14
X -05'00'
Applicant's Printed Name Applicant's Signature