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EA188341 - Building - Single Fam - Issued Date 12/07/2023City of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675-5675 www.cityofeagan.com Site Address: 4040 Lot: 18 Block: 10 PID: 10-16704-10-180 Use: PERMIT Permit Type: Building Permit Number: EA188341 EAGAN * E R 1 8 8 3 4 1 Amethyst Lane Addition: Cedar Grove 5th Description: Sub Type: Single Fam Work Type: Alteration Description: Bathroom Remodel Census Code: 434 - Residential Additions, Alterations Zoning: R-1 Square Feet: 0 Date Issued: 12/7/2023 IIII IIUIIII11111IIIIIIII11111111III11111II1111II1111III111111II11111III111I 111 0 G B G Construction Type: V -B Occupancy: IRC -1 ComlTlents: 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: Mad City Windows & Baths David & Brenda Efteland 5020 Voges Road 4040 Amethyst Ln Madison WI 53718 Saint Paul MN 55122--290 (651) 500-0514 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 --------------I For Office Use 188341 I Building Permit #: I �0 I S&W Permit o•__ •.+e EAGAN14 3 O I � Permit Fee: � Date Received: I 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 I I I (651) 675-56751 FAX: (651) 675-5694 I Date Issued: buildinginspectionspcityofeagan.com I---------------------� RESIDENTIAL BUILDING PERMIT APPLICATION _ t Date: 12/5/23 site Address: 4040 AMETHYST LNUnit #: �mm Applicant is: ❑ Owner 14 Contractor Name: DAVID & BRENDA EFTELAND Homeowner Address: SAME AS SITE ADDRESS City: State: Zip:9524579632 Phone. Email: 8 Description of work. REPLACING TUB. EXPOSING PART OF EXTERIOR WALL WILL REINSULATE TO CODE Te of Work Construction Cost: 4,255 R-1, Cedar Grove Type of building: 0 Single Family ❑ Townhome, of units ❑ Twin Home Company MAD CITY WINDOWS & BATHS Contact: Building Address: 2621 FAIRVIEW AVE City: ROSEVILLE r Contractor State: Zip: Phone: Email: MN 55113 651-867-438E PERMITS@MADCITYWINDOWS.COM BC775012 3/31/23 License #: Expiration Date: Sewer & 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 nformation may be classified as non-public if you provide specific reasons that would permit the City to conclude that theyre 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. xGUADALUPE VEGA x Applicant's Printed Name Applicant's Signature