EA185973 - Building - 01 of __-plex - - Issued Date 09/29/2023PERMIT
City of Eagan®,
01 of _-plex
Permit Type:
Building
3830 Pilot Knob Rd
Eagan, MN 55122
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EGAN
Permit Number:
1111111111111 IN 111111111111111111111111111111
EA185973
(651) 675-5675
R-4
Square Feet:
0
www.cityofeagan.com
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Date Issued:
9/29/2023
Site Address: 3566
Blue Jay Way 104
Lot: 105 Block: 04
Addition: Lexington Place 2nd
PID:10-45051-04-105
Use:
* 10
4 S 0 S 1-04-10S*
Description:
Sub Type:
01 of _-plex
Work Type:
Alteration
Description:
Bathroom
Census Code:
434 - Residential Additions, Alterations
Zoning:
R-4
Square Feet:
0
Construction Type: V -B
Occupancy: IRC -3
Comments: Improvements to the home may require smoke detectors in all bedrooms. Carbon monoxide detectors are required within 1(
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 Jesse L Nowicki
PO Box 386 3566 Blue Jay Way Unit 104
Carlisle IA 50047 Eagan MN 55123
(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
Issued By: Signature
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3830 PILOT KNOB ROAD I EAGAN, MN 55122-181 ECEI�/E
(651) 675-56751 FAX: (651) 675-5694 `t �`
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Date Received: . I
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APPLICATION
Date: 8-9-2023 site Address: 1566 Blue Jai/ Way, Eagan, MN 55123 Unit #-104
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Applicant is: 0 Owner q Contractor R — 4 1 P la uc,
Name: Jesse Nowicki
Homeowner Address3 A566 Blue Jay Wayaty: Eagan
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State: MN Zi : 55123 Phone: 262-490-7831 EmaidessenoWlckl@gmail.com
Description of work: Bath remodel
Type of $11,000.00
Work Construction Cost:
Type of building: ❑ Singie Family ® Townhome, of units ❑ Twin Home
Company: Clear Choice Bath contact: Sid Tyler
Building Address: PO Box 386 city. Carlisle
Contractor State: Zip: Phone: la 50047 515-989-911 Email: sid@clearchoicebath.com
CR712412 3-31-2024
License #: Expiration Date:
Sewer & Company: Contact:
Water
Contractor Address: City:
Required for State: Zip: Phone: Email:
new construction
License #: Expiration Date:
If I 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 specificreasons 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 w wv.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.
Sid Tyler with Clear Choice Bath-
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Applicant's Printed Name Applicant's ignature