EA187914 - Building - Foundation - Issued Date 12/06/2023City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675-5675
www.cityofeagan.com
Site Address: 3678
Lot: 4 Block: 2
PID:10-14381-02-040
Use:
PERMIT
Birchpond P1
Addition: Blackhawk Hills 2nd
Description:
Sub Type: Foundation
Work Type: Repair
Description:
Census Code: 434 - Residential Additions, Alterations
Zoning: R-1
Square Feet: 0
Comments:
Permit Type: Building
Permit Number: EA187914
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Date Issued: 12/6/2023
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Construction Type: V-13
Occupancy: IRC -1
Fee Summary: BL - Base Fee $215.90 0801.4085
BL - Plan Review 65% $140.34 0720.4222
Valuation: 10,000.00 Surcharge - Based on Valuation $5.00 9001.2195
Total: $361.24
Contractor: - Applicant - Owner:
Safe Basements of Minnesota Inc Evgueni V Tsiper
60335 US Highway 12 3678 Birchpond PI
Litchfield MN 55355 Eagan MN 55122-420
(320) 593-8729
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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EAG
3830 PILOT KNOB ROAD 1 EAGAN, MN 55122-1810
(651) 675-56751 FAX: (651) 675-5694
buildinginspections(W ityofeacian.com
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For Office Use
I 187914 i
I Building Permit #: I
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S&W Permit #: (^
Permit Feer
11/6/2023 I
Date Received: I
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I Date Issued: I
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RESIDENTIAL BUILDING PERMIT APPLICATION
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Date: 11/6/23 site Address: 3678 Birchpond PI Unit#:
Applicant is: ❑ Owner 14 Contractor
Name: Evgueni Tsiper
Homeowner Address: City:
State: Zi 703966-5256 Phone: Email: R 1, Blackhawk Hills
Description of work: 162 scl ft of 90 mil wall encapsulation, sump pump, sump basket, 18 ft
Type of 26,068 of interior drain tile, excavation of failed wall/temporary
Work Construction Cost: support of floor joint, 2" insulation foam, remove and
replace 175 cinder blocks to rebuild wall.
t Type of building: 0 Single Family ❑ Townhome, ofunits ❑ Twin Home
SafeBasements of Minnesota, Inc. Stephanie
Company: Contact:
Building Address:
60335 US Hwy City: 12 Litchfield
Contractor tate: Zip: Phone: Email: MN 55355 320-5938729 info@safebasements.com
a S
BC446489 03/31/2024
License #: iratiDate:
, .. . Ex on �
Sewer & J Company: Contact:
Water
Contractor Address: City:
Required for State: Zip: Phone: Email:
new construction
License #: Ex iration 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 hey
are trade secrets a
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.
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 Stephanie Hanson X i��� -_
Applicant's Printed Name App icant's Signature