EA187179 - Building - Single Fam - Issued Date 10/06/2023 PERMIT
City of Eagan , ® , , Permit Type: Building
3830 Pilot Knob Rd EAGAN Permit Number: EA187179
Eagan,MN 55122 ,.__ •_,,
(651)675-5675
www.cityofeagan.com * E A 1 8 7 1 7 9
Date Issued: 10/6/2023
Site Address: 4096 Pennsylvania Ave
Lot: 32 Block: 1 Addition: Stafford Place
PID:10-72500-01-320
Use: * 10 72500 0 1 - 320
Description:
Sub Type: Single Fam Construction Type: V-B
Work Type: Alteration
Description: Bathroom
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:
Great Lakes Home Renovations Daniel R&Erin E Brandt
14690 Galaxie Ave,Suite 100 4096 Pennsylvania Ave
Apple Valley MN 55124 Eagan MN 55123
(952)891-3400
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 55122-1810 t I
(651)675-56751 FAX: (651)675-5694 I I
I Date Issued:
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RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 09/29/23 site Address: 4096 Pennsylvania Ave Unit#:
Applicant is: ❑ Owner 14 Contractor -- f V 19�'�O p l a
Name: Erin & Dan Brandt
-` Address: 4096 Pennsylvania Ave City: Eagan
" State: MN Zi : 66123 Phone: 952-891-34 Email: derek.glwsco@gmail.com
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Description of work: Bathroom Remodel
Construction Cost: 12000
Type of building: hu Single Family ❑ Townhome, of units ❑ Twin Home
Company: Great Lakes Window& Siding Contact: Derek
14690 Galaxie Ave Apple Valle
Address: City: pp y
State: Zip: Phone: Email. g �g
MN 55124 952-891-34� derek.glwsco@gmail.com
mail.com
' BC060427 03/31/24
License#: Ex iration Date:
Company: Contact:
Address: City:
State: Zip: Phone: Email:
License#: Expiration Date:
Q� I understand that Plumbing, Mechanical, and Fire Suppression work require separate applications.
SIR N
CALL BEFORE YOU DIG. Contact Gopher State One Call at(851)454-0002 or www oopherstateonecall.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.
' 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 t#o& t a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval Ola s.
X Derek Brouillet X
Applicant's Printed Name ApplicanVilignature