EA187674 - Building - Single Fam - Issued Date 11/01/2023City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675-5675
www.cityofeagan.com
Site Address: 4106
Lot: 3 Block: 2
PID:10-16700-02-030
Use:
PERMIT
Permit Type: Building
Permit Number: EA187674
EAGAN
E R 1 8 7 6 7 4
Nicols Rd
Addition: Cedar Grove 1 st
Description:
Sub Type: Single Fam
Work Type: Alteration
Description: New Shower System
Census Code: 434 - Residential Additions, Alterations
Zoning: R-1
Square Feet: 0
Date Issued: 11/1/2023
I IIIIIIIIIIIIIIII III'IIIIIIII IIIIIIIIIIIIII II IIIIIIIII IIII I)
r r r r r
Construction Type: V -B
Occupancy: IRC -1
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:
Minnesota Rusco Sandra K Carroll
5010 Hwy 169N 4106 Nicols Rd
Brooklyn Park MN 55428 Eagan MN 55122
(952) 935-9669
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.
1 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
I y, 1 o 12:b
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1E
(651) 675-5675 1 FAX: (651) 675-5694
buildinginspectionsna.cityofea4an.com
PqEIVED
OCT 2 42023
______________
j_ For Office Use
I Building Permit #:
187674
I I
j S&W Permit #: ¢ Q
Permit Feer
Date Received: 10/24/2023
I I
I I
I Date Issued: I
I_____________________J
RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 10/24/23 site Address: 4106 Nlcols Rd Eagan, MN 55122 Unit#:
Applicant is: ❑ Owner 14 Contractor
Name: James and Sandra Mishler
Homeowner 4106 Nicols Rd Eagan
Address: City:
State: MN zi : 55122 phone: 651-454-802 Email:
Demo essl ng, Install new shower system and wall sunound. M'nnesola Rus. to nsulale, 'nslall vapor barter, tape antl seal. Installsmpke antl G.O. alarms to code. Glumbmg permit to be pulled separately.
Description of work:
T e of R-1, Cedar Grove
Wo11599.00
Work,
construction cost:
Type of building: 0 Single Family ❑ Townhome, of units ❑ Twin Home
Company: MN Rusco contact: Kelli Gugisberg
5010 Hwy 169 N City:New Hope
E�Ulldln€j ! Address:
Contractor MN 55428 952-935-966 kelli@minnesotarusco.com
State: Zip: Phone: Email.
License #: CR805613 Expiration Date: 3/31/25
Sewer 8c Company: Contact:
Water
ContractQC Address: City:
Required for` " State: Zip: Phone: Email:
newonsuconc"`'
License #: Expiration Date:
1 understand that Plumbing, Mechanical, and Fire Suppression work require separate applications.
NQTE; Plens"antl supparting 4lo uments that you,subMtt are donsidered to be "public informatlon, P
ortibn of #he'
informatlon rp ba classf#t6 4s %non-public if you -provide specific reasons hat WouId permItAho City' o'onclude,that theyt
are"trado secrets r'A
CALL BEFORE YOU DIG. Contact Gopher State One Call at (651) 454-0002 or www.cloaherstateonecall.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 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.
X Kelli Gugisberg X
Applicant's Printed Name Applicant's #fgn6fure
EAG
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1E
(651) 675-5675 1 FAX: (651) 675-5694
buildinginspectionsna.cityofea4an.com
PqEIVED
OCT 2 42023
______________
j_ For Office Use
I Building Permit #:
187674
I I
j S&W Permit #: ¢ Q
Permit Feer
Date Received: 10/24/2023
I I
I I
I Date Issued: I
I_____________________J
RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 10/24/23 site Address: 4106 Nlcols Rd Eagan, MN 55122 Unit#:
Applicant is: ❑ Owner 14 Contractor
Name: James and Sandra Mishler
Homeowner 4106 Nicols Rd Eagan
Address: City:
State: MN zi : 55122 phone: 651-454-802 Email:
Demo essl ng, Install new shower system and wall sunound. M'nnesola Rus. to nsulale, 'nslall vapor barter, tape antl seal. Installsmpke antl G.O. alarms to code. Glumbmg permit to be pulled separately.
Description of work:
T e of R-1, Cedar Grove
Wo11599.00
Work,
construction cost:
Type of building: 0 Single Family ❑ Townhome, of units ❑ Twin Home
Company: MN Rusco contact: Kelli Gugisberg
5010 Hwy 169 N City:New Hope
E�Ulldln€j ! Address:
Contractor MN 55428 952-935-966 kelli@minnesotarusco.com
State: Zip: Phone: Email.
License #: CR805613 Expiration Date: 3/31/25
Sewer 8c Company: Contact:
Water
ContractQC Address: City:
Required for` " State: Zip: Phone: Email:
newonsuconc"`'
License #: Expiration Date:
1 understand that Plumbing, Mechanical, and Fire Suppression work require separate applications.
NQTE; Plens"antl supparting 4lo uments that you,subMtt are donsidered to be "public informatlon, P
ortibn of #he'
informatlon rp ba classf#t6 4s %non-public if you -provide specific reasons hat WouId permItAho City' o'onclude,that theyt
are"trado secrets r'A
CALL BEFORE YOU DIG. Contact Gopher State One Call at (651) 454-0002 or www.cloaherstateonecall.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 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.
X Kelli Gugisberg X
Applicant's Printed Name Applicant's #fgn6fure