EA187909 - Building - Single Fam - Issued Date 11/07/2023 PERMIT
City of Eagan EAGAN Permit Type: Building
3830 Pilot Knob Rd ,•q,• �•,� � Permit Number: EA187909
Eagan,MN 55122 ••
(651)675-5675
www.cityofeagan.com * E A 1 8 7 9 0 9
Date Issued: 11/7/2023
Site Address: 941 Jefferson Lane
Lot: 7 Block: 2 Addition: Lexington Pointe 3rd ® ❑
PID:10-45072-02-070 ll
Use: * 1 J - 45072 - 02 - 070
Description:
Sub Type: Single Fam Construction Type: V-13
Work Type: Alteration
Description: Bathroom Remodel
Census Code: 434-Residential Additions,Alterations Occupancy: IRC-1
Zoning: PD
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:
Minnesota Rusco Scott J&Kathryn A Kluegel
5010 Hwy 169N 941 Jefferson Ln
Brooklyn Park MN 55428 Saint Paul MN 55123--260
(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.
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
--------------
For Office Use
I Building Permit#:
187909
I I
I S&W Permit#:
'�� I Permit Fee: ` 11
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rctn
Date Received: 11/6/2023
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 NOV 0 6 2023
(651)675-56751 FAX: (651)675-5694 I Date Issued: j
buildinginspections@cityofeagan.com BY, I---------------------J
RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 11/6/23 site Address: 941 Jefferson Ln Eagan, MN 55123 —Unit#:
Applicant is: ❑ Owner 14 Contractor
Scott KI u eg el
Name:
Homeowner- Address: 941 Jefferson Ln city: Eagan
MN 55123 651-783-621 kluegel6@gmail.com
State: Zip.. Phone: Email:
Demo x t ig.rsl.l naw sho ,d seal Install smoke and C O.alarms to code.Plumbing permit to be pulled separately.
Description of work:
Type of
Work Construction Cost: $7711 .00
o
Type of building: 0 Single Family ❑ Townhome, of units ❑ Twin Home
Company: MN RuscoContact: Kalli Gugisberg�
5010 Hwy 169 N cit New Hope
Budding � Address: y: i
Contractor I State: MN Zip: 55428 Phone: 952-935-966 Email. kelli@minnesotarusco.com
CR805613 3/31/25
License#: Expiration ,Date
I Sewer & ; Company: Contact:
Water
Contractor_ Address: City:
(
Required for State. Zip. Phone: Email:
new construction)
_` License#: Expiration Date:
1 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 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 /"U,6-. �
Applicant's Printed Name Applicant's Si6fiatWre