EA187512 - Building - Reroof - Issued Date 10/16/2023 PERMIT
City of Eagan , R a Permit Type: Building
3830 Pilot Knob Rd Permit Number: EA187512
Eagan,MN 55122 •-•- ---• EAGAN
(651)675-5675 �,.-.r
111111111111
www.cityofeagan.com * E R 1 8 7 5 1 2
Date Issued: 10/16/2023
Site Address: 4205 Pilot Knob Rd
Lot: 4 Block: 0 Addition: Carlson Acres
PID:10-16400-00-040
Use: * 10 164Q10 — f710 040
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: Owner:
- Applicant -
Craig A&Krista K Nelson
4205 Pilot Knob Rd
Eagan MN 55122--182
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.
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Applicant/Permitee: Signature Issued By: Signature
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jFor Office Use
I Building Permit#:
S&W Permit#:
EAGAN
Permit Fee:
I I
I Date Received:
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 l I
I I
(651)675-5675 1 FAX: (651)675-5694 I Date Issued: I
buildinginspections ancityofeagan.com I---------------------J
RESIDENTIAL BUILDING PERMIT APPLICATION
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Date: 1� � Site Address: 4016 , l d , ' d Unit#:
Applicant is: 0Owner ❑ Contractor
Name: kA -t ,_ S
Homeowner Address: Z Q 7 < <c! �- V City: ,
Stat Zip: 5�I ZZ Phone: -j��a �q ril:
Description of work: �t? `�-J 6
Type of yq cj ,
Work Construction Cost:
Type of building: �ingle Fam' Townhome, of units ❑ Twin Home
Company: Contact:
Building Address: City:
Contractor r
State Zip: Phone: Email:
License#: Expiration Date:
Sewer & Company: Contact:
Water
Contractor Address: City:
Required for te: Zip: Phone: Email:
new constructio
License#: Expiration Date:
❑ 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 specific reasons 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 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 o 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 pl
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Applicant's Printed Name Applicant's Signa