EA188713 - Building - Single Fam - Issued Date 02/21/2024 PERMIT
City of Eagan s , Permit Type: Building
3830 Pilot Knob Rd %;,A°� Permit Number: EA188713
Eagan, MN 55122 EAGAN
(651)675-5675 1111111111111 IN 11111111111111111111111111111111
www.cityofeagan.com * E R 1 8 8 7 1 3 *
Date Issued: 2/21/2024
Site Address: 647 Atlantic Hill Dr
Lot: 4 Block: 1 Addition: Lakeside Estates
PID:10-44300-01-040
Use: * 10 - 44300 0 1 - 040 *
Description:
Sub Type: Single Fam Construction Type: V-B
Work Type: Alteration
Description: Bathroom
Census Code: 434-Residential Additions, Alterations Occupancy: IRC-I
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
BL-Plan Review 65% $54.28 0720.4222
Valuation: 2,000.00 Surcharge-Based on Valuation $1.00 9001.2195
Total: $138.78
Contractor: - Applicant - Owner:
TLC Remodeling Stuart B&Kathleen Samsky
4439 Nason Parkway NE 647 Atlantic Hill Dr
St.Michael MN 55376 Saint Paul MN 55123-200
(952)261-8079
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
LM /I2
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I For Office Use i (�
Building Permit
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9
EAGAN
SB�W Permit#:Permit Feer
1 i
EC E 1 V E i Date Received:
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3830 PILOT KNOB ROAD I EAGAN,MN 55122-1810 ,
(651)675-5675 1 FAX:(651)675-5694 9 JAN 0 8 2024 Date Issued: I
buildinginsoectionsnacityofeagan.com I —'---------- —
RESIDENTIAL BUIING �^ WAPPLICATION
Date: 1/8/24 Site Address: 647 Atlantic Drive Unit#:
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Nai�s P l Lct'k&s'ta�
Applicant Is: ❑ Owner 0 Contractor -
Name:
.� .,.�.. �Stu Samsky
s
Homeowner 647 Atlantic Drive city_ Eagan
Address:
State: Z�� Phone:- Email,
Email:
t �� R
Description of work: Remodel primary bath
Type of 17523.00
Work Construction Cost:
Type of building: ® Single Family ❑ Townhome, of units ❑ Twin Home
Company:
TLC Remodeling contact: Leslie Sale
Building Address:
4439 Nason Parkway NE city, St. Michael
g Contractor MN 55376 9523564303 LMSALETLC@gmaii.com
i State: Zip: Phone: Email:
BC629141Ex iration Date,- 3/31125
License#: w
Sewer 8� Company: _ Contact:
Water
Contractor Address: city:
Required for State: Zip: Phone: Email:
new construction
( License#: Expiration Date:
I understand that Plumbing, Mechanical, and Fire Suppression work require separate applications.
�NpTE:Plans,and supporting documents�that you submit are.cons'►dered to be public informattor►.�Portions,of the �
tnformation may be classified as non-public if you provide specific reasans thatwould permit the City to conclude that they
� .�.-
CALL BEFORE YOU DIG. Contact Gopher State One Call at(651 454-0002 or www gooherstateonacali cr 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.
XLeslie Sale X .i
Applicant's Printed Name Appl�ic s Sigma iie