EA190230 - Building - Siding - Issued Date 04/15/2024 PERMIT
City of Eagan A ® , a Permit Type: Building
3830 Pilot Knob Rd ®'A ° ®�p®`� E A A N Permit Number: EA190230
Eagan, MN 55122
(651)675-5675
www.cityofeagan.com * E A 1 9 0 2 3 0
Date Issued: 4/15/2024
Site Address: 4060 Pennsylvania Ave
Lot: 12 Block: 5 Addition: Stafford Place
PID:10-72500-05-120 111111111111111111111111 119MINIM
Use: * 10 - 72 $ (00 - 05 — 120 *
Description:
Sub Type: Siding Construction Type:
Work Type: Replace
Description:
Census Code: 434- Residential Additions,Alterations Occupancy:
Zoning:
Square Feet: 0
Comments:
Fee Summary: BL-Base Fee $133.15 0801.4085
Valuation: 5,000.00 Surcharge- Based on Valuation $2.50 9001.2195
Total: $135.65
Contractor: - Applicant _ Owner:
USA Builders Damian Paul Moran
8019 Cleadis Ave 4060 Pennsylvania Ave
IGH MN 55076 Eagan MN 55123
(612)867-2220
This permit shall be null and void if work does not start within 180 days of issuance, or if work is suspended for 180 days or more after
started.
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Applicant/Permitee: Signature Issued By: Signature
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i For Office Use
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` e f I Building Permit#: I l
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0s,® j S&W Permit#:
EAGAN I I
Permit Fee: 122I
Date Received: I
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 I
651 675-5675 1 FAX: 651 675-5694
Date Issued:
buildinginspections cbcitvofeagan.com I---------------------
RESIDENTIAL BUILDING PERMIT APPLICATION
Date: `�« Site Address: _ &�o �y��`�-7--,'� � Unit M.
Applicant is: ❑ Owner gContractor de
Name:
Homr x eowneo g� dam,
Address: �O6 / P�' �/'�!i/ i'I� /TvG City: ze!2�!/�/V
State Zi .._I Phone: Email:
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Description of work: .01f�
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r Construction Cost:
Type of building: nSingleFamily ❑ Townhome, of units ❑ Twin Home
Company: 4 .f09 ,rl ot Contact:
BUtitdi>c Address: �G/c �1c9 `/ /��C
city: Csl`�.
Stater Zip. Phone: mail:
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.Sovt+ r& Company: Contact:
Gbntrd"a r-, Address: City:
fequire ,for "! State: Zip: Phone: Email:
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License#: Ex iration Date:
❑ i understand that Plumbing, Mechanical, and Fire Suppression work require separate applications.
NOTE^Pian$acid uppc,rtin{ dt�curttentsr that you submit ark considered to,be public Information Port#ons of the
informatic `may i; c[�aeJjieds. ra�pubh i youiorde tspsc�fia�keaaans`th�t wauid permit thy;City tc donclude that they
are trade sss re° �., 1,G
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.
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Applicant's Printed Name Applicant's Signature