EA187531 - Building - Single Fam - Issued Date 10/24/2023 PERMIT
City of EaganEAGAN Permit Type: Building
3830 Pilot Knob Rd �.�* 4,,.', Permit Number: EA187531
Eagan, MN 55122 ��-- •���
(651)675-5675 ,,,.
www.cityofeagan.com ,.w * E A 1 8 7 $ 3 1
Date Issued: 10/24/2023
Site Address: 1292 Balsam Tr E
Lot: 006 Block: 001 Addition: Wilderness Run 6th
PID:10-84355-01-060
Use: * 10 - 84355 - 0 1 - 0G
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
BL-Plan Review 65% $54.28 0720.4222
Valuation: 2,000.00 Surcharge-Based on Valuation $1.00 9001.2195
Total: $138.78
Contractor: - Applicant - Owner:
Great Lakes Home Renovations Duong Thai Pham
14690 Galaxie Ave,Suite 100 1292 Balsam Trl E
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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Permit Fee: ISO .—IS
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3830 PILOT KNOB ROAD i EAGAN, MN 55122-1810 �x
65'1 675-5675 FAX: 651 675-5694 I
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buildingins ections(o-ci ofeaaan.com I---------------------�
RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 10/17/23 site Address: 1292 Balsam Trl E Unit#:
Applicant is: ❑ Owner 0 Contractor R— i)
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Name: Duong & Gabrielle Pham
Address: 1292 Balsam TO E city. Eagan
� i, �. State: MN Zi : 55123 Phone: 612-205-98 Email:
s � Bathroom Remodel
W' Description of work:
20000
Construction Cost:
t _ Type of building: ILl Single Family ❑ Townhome, of units ❑ Twin Home
company. Great Lakes Window & Siding contact: Derek
14690 Galaxie Ave Apple Valley
��'k, Address: City:
MN 55124 952-891-34% derek.glwsco@gmail.com
�yState: Zip: Phone: Email.
, ,,� License#: BG060427 Expiration Date: 03/31/24
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+ r� � ��� Company: Contact.
Address: City:
Ma
State: Zip: Phone: Email:
' License#: Ex iration Date:
Q� I understand that Plumbing, Mechanical, and Fire Suppression work require separate applications.
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CALL BEFORE YOU OIG. Contact Gopher State One Call at(651)454-0002 or www aopherstateonecall.ora 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. __...m....
X Derek Brouillet X ° ...
Applicant's Printed Name Applicant's SigO ture