EA189235 - Building - Single Fam - Issued Date 02/20/2024 PERMIT
City of Eagan EAGAN Permit Type: Building
3830 Pilot Knob Rd `�' + % '�° Permit Number: EA189235
Eagan, MN 55122 •-��
(651)675-5675 1111111111111111111111111111111111111111111111111
www.cityofeagan.com * E R 1 8 9 Z 3 S *
Date Issued: 2/20/2024
Site Address: 3963 Thames Ave
Lot: 18 Block: 1 Addition: Perron Acres
PID:10-56975-01-180
Use: * 10 - 56975 - 0 1 — 180 *
Description:
Sub Type: Single Fam Construction Type: V-B
Work Type: Alteration
Description: Bathroom
Census Code: 434-Residential Additions,Alterations Occupancy: IRC-1
Zoning: R-1
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:
Status Contracting Inc Adam&Jodi L Husemann
1910 Stoughton Ave 3963 Thames Ave
Chaska MN 55318 Eagan MN 55123-470
(952)941-8896
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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For Office Use
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Building Permit
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EAGANI Permit Fee: I
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I Date Received:
3830 PILOT KNOB ROAD I EAGAN, MECEIVE
N 55122-1810 I I
(651)675-5675 1 FAX: (651)675-5694Date Issued: I
build inginspectionsocityofeagan.com FEB 14 2024 `---------------------'
RESIDENTIAL BUILD APPLICATION
Date: 2-13-2024 site Address: 3963 Thames Avenue unit#:
t
Applicant is: ❑ Owner Contractor
Name: Adam & Jodi Husemann
Homeowner "" Address: 3963 Thames Avenue City: Eagan
State:
MN Zip: 55123 Phone: 651-263-782E Email: adamjodi5@msn.com
Description of work: Bathroom Remodel
Type of
Work Construction Cost: 12,000'00
Type of building: 0 Single Family ❑ Townhome, of units ❑ Twin Home
Company: Status Contracting Inc. Contact: Dale Schultz
Building Address: 1910 Stoughton Ave City: Chaska
Contractor State: Zip: Phone:MN 55318 612-554-211 Email: dale@statuscontractinginc.com
License#: 649726 Expiration Date: 3-31-2024
Sewer& Company: Contact:
Water
Contractor Address: City:
Required for State: Zip: Phone: Email:
new construction
License#: Expiration Date:
0 1 understand that Plumbing, Mechanical, and Fire Suppression work require separate applications.
f
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. 3
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 a d 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 With o't a ermit, hat the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
XDale Schultz X
Applicant's Printed Name Applicant's Signa ur
FOR OFFICE USE ONLY
Site Address: 3963 Thames Avenue Permit#: /f923S
SUB TYPES
X Single Family _ Fireplace _ Lower Level
_ 01 of_Plex _ Foundation _ Porch
Deck _ Garage _ Pool
WORK TYPES
New _ Repair _ Siding _ Retaining Wall
_ Addition _ Fire Repair _ Reroof _ Move Building
Alteration _ Water Damage _ Windows _ Demolish Building*
Replace Egress Window _ Solar 'Demolition of entire building—give PCA
handout to applicant
DESCRIPTION
Calculated Valuation Z ow Occupancy T/lC MCES System
Plan Review 1325% 121100% Code Edition /YIN/1CZOLo SAC Units
Census Code Zoning /l-/ City Water
#of Units Stories Booster Pump
#of Buildings Square Feet PRV
Type of Construction VB Fire Suppression Required
Separate Stormwater Management Permit Required
REQUIRED INSPECTIONS
Footings: New Addition Deck Meter Size:
Foundation: Before Backfill Poured Wall Siding:_Stucco Lath Stone Lath _Brick
Framing: 1 Hour X Residential Alteration Roof:_Ice&Water _Final
Braced Wall Framing/Blocking Erosion Control
Braced Wall Sheathing (prior to house wrap) Pool:_Footings _Air/Gas Tests _Final
Interior Braced Wall Panel(s) Retaining Wall:_Footings_Backfill_Final
Firewalls Fire Suppression:_Rough In_Final
Insulation Windows
Radon Control Other:
Drain Tile
Grading Final/No C.O. Required
Final/C.O. Required
Reviewed By: ����� t�� , Building Inspector
FEES
Calculated Valuation Zovo
Base Fee
Plan Review
State Surcharge
Met Council SAC
City SAC
Treatment Plant
Water Supply S Storage
SSW Permit&Surcharge
Meter
Radio Read
Other:
TOTAL $ 0.00