EA186556 - Building - Reroof - Issued Date 09/06/2023PERMIT
City of Eagan
Site Address: 4179 Countryside Dr
Lot:5 Block: 2 Addition: Country Hollow
PID:10-18275-02-050
Use:
Eagan,
Permit Type:Building
Permit Number:EA186556
EA186556*
Date Issued:9/6/2023
Permit Category:ePermit
10-18275-02-050*
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
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 the
water damage.
Please describe the work, including any skylights that will be repaired or replaced:RE ROOFING HOUSE
Applicant: Ibrahim Ibrahim
12252 Nicollet Ave
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $133.15 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
135.65Total:
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.
Contractor:Owner:- Applicant -
Richard & Karen Collins
4179 Countryside Dr
Eagan MN 55123
480) 231-4060
Minnesota Restoration Contractors Inc
12252 Nicollet Ave
Burnsville MN 55337
952) 479-7131
Applicant/Permitee: Signature Issued By: Signature