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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 1111111111111 IN 11111111111111111111111111111 IN * E R 1 8 7 9 1 4* Date Issued: 12/6/2023 III IIIIIIIIIIIIIIIIIIIIIIII IIIIIIIIIIIIIIIIIIIIII'IIII�IIIIIIIII��IIIIII II'lllllll • p r • r 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 \\ \ e 0d EAG 3830 PILOT KNOB ROAD 1 EAGAN, MN 55122-1810 (651) 675-56751 FAX: (651) 675-5694 buildinginspections(W ityofeacian.com -------------- For Office Use I 187914 i I Building Permit #: I I I S&W Permit #: (^ Permit Feer 11/6/2023 I Date Received: I I I I I I Date Issued: I I ---------------------J RESIDENTIAL BUILDING PERMIT APPLICATION t 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