EA190280 - Building - Reroof - Issued Date 04/16/2024 PERMIT
City of Eagan , , , , Permit Type: Building
3830 Pilot Knob Rd \ � R e R EAGAN
Permit Number: EA190280
R R 0 0
Eagan, MN 55122 "�" "'�'
(651)675-5675
www.cityofeagan.com * E A 1 9 0 2 9 0
Date Issued: 4/16/2024
Site Address: 4052 Rahn Rd
Lot: 12 Block: 4 Addition: Cedar Grove 5th
PID:10-16704-04-120
Use: * 1 0 — 1 6 7 0 4 — 0 4 — 1 2 0 *
Description:
Sub Type: Reroof Construction Type:
Work Type: Replace
Description:
Census Code: 434- Residential Additions,Alterations Occupancy:
Zoning:
Square Feet: 0
Comments: Please print pictures of ice and water protection and leave on site.
If water damage is encountered, please call(65 1)675-5675 to schedule a site visit to verify the extent of the damage.Any
repairs must be inspected prior to covering. The inspector will determine if an additional permit will be required to repair t
water damage.
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: Owner: - Applicant -
Omar Reyes Pineda
4052 Rahn Rd
Eagan MN 55122
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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1 For Office Use
1 10 0
I
1 Building Permit#: 1
�0 1 S&WPermit
#: 1
EAGAN
Permit Fee:
1 Date Received: I
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 1 I
651 675-5675 1 FAX: 651 675-5694 I1
Date Issued:
buildinginspections(ccDcitvofeagan.com I_____________________ I
RESIDENTIAL BUILDING PERMIT APPLICATION
Date: ' 6 Site Address: ""l �a2 KcAk(\ P� Unit#:
Applicant is: Powner ❑ Contractor
Name:
Homeowner Address:H o 5D- "k�vn AZA City: �ao V1
State: Zip: L Phone:(212, Email: CdM
Description of work,
Type of
Work Construction Cost:
Type of building: Single Family ❑ Townhome, of units ❑ Twin Home
Company: / Contact:
Building Address: City:
Contractor.
State: Zip: Phone: Email:
License#: Expiration Date:
Sewer& 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.
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 thatthey
are trade secrets.
CALL BEFORE YOU DIG. Contact Gopher State One Call at(651)454-0002 or www.-qoi)herstateonecall.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.
x x
A icant's Printed Name Applicant's tignature