EA187167 - Building - Pool - Issued Date 09/29/2023City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675-5675
www.cityofeagan.com
Site Address: 1760
Lot: 1 Block: 6
PID:10-16705-06-010
Use:
PERMIT
Permit Type: Building
4 Q P
\ Permit Number: EA187167
�+� �9®�
EAGAN
® w1 aM
*ER 187 167*
Date Issued: 9/29/2023
Serpentine Dr
Addition: Cedar Grove 6th
III Iii111111111111111111111111111111111111111111111111111111111I111111IIII
G 0 G G 1 0
Description:
Sub Type: Pool Construction Type:
Work Type: Demolish Pool
Description: Inground
Census Code: 434 - Residential Additions, Alterations Occupancy:
Zoning:
Square Feet: 0
Comments:
Fee Summary: BL - Demolition $94.00 0801.4085
Surcharge -Fixed $1.00 9001.2195
Total: $95.00
Contractor: - Applicant -
Owner:
All State Companies
Ray Christensen
28494 149th St NW
1760 Serpentine Dr
Zimmerman MN 55398
Eagan MN 55122
(612) 810-2372
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
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
(651) 675-5675 1 FAX: (651) 675-5694
Plan Submittal: buildin inspectioULSncityofeagan com
-----------------------
For Office Use
I Building Permit #: g?qi I
I I
I I
Building Permit Fee 95.00 1
I I
I Date Issued:
I I
I 1
Staff. I
-----------------------�
DEMOLITION PERMIT APPLICATION
Date: Lk. 23 Site Address:
Description of Demolition: _ 9I "\i
Anticipated Start Date:
ZS , Anticipated Completion Date. ler i - 2,�
Name: (��1� i'S ``�% Phone: U Q, 203, 4 357
i
Address/City/Zip: 5&VOL Ck S
Contact:
Email:
Name: \ 6y(hrLicense #:
Address: City:
Stater Zip: Phone: SLI &10, 21 / Z
Contact: ®� T'` Email: �" �?� Lti'!�eVA
STORMWATER MANAGEMENT REQUIREMENTS
All building demolitions require a separate Stormwater Management Permit.
❑ Please attach a Stormwater Management Permit application (pages 3 & 4) and Land Disturbance Plan.
SEWER & WATER
Will you be disconnecting from City sewer or water? ❑ Yes No
If you answer "no," please proceed to the next section.
If you answer "yes," a separate Sewer & Water permit is required.
❑ Please attach a Sewer & Water permit application to this permit submittal.
❑ Water meters must be returned to Utilities prior to Demolition Permit issuance. Please call
(651) 675-5200 to coordinate water meter removal.
SEPTIC ABANDONMENT
Will you be disconnecting from a septic system? ❑ Yes ANo
If you answer "no," please proceed to the next section.
If you answer "yes," a separate Plumbing Permit is required.
11 Please attach a Plumbing permit application to this permit submittal.
or
EAGAN
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
(651) 675-5675 1 FAX: (651) 675-5694
Plan Submittal: buildin inspectioULSncityofeagan com
-----------------------
For Office Use
I Building Permit #: g?qi I
I I
I I
Building Permit Fee 95.00 1
I I
I Date Issued:
I I
I 1
Staff. I
-----------------------�
DEMOLITION PERMIT APPLICATION
Date: Lk. 23 Site Address:
Description of Demolition: _ 9I "\i
Anticipated Start Date:
ZS , Anticipated Completion Date. ler i - 2,�
Name: (��1� i'S ``�% Phone: U Q, 203, 4 357
i
Address/City/Zip: 5&VOL Ck S
Contact:
Email:
Name: \ 6y(hrLicense #:
Address: City:
Stater Zip: Phone: SLI &10, 21 / Z
Contact: ®� T'` Email: �" �?� Lti'!�eVA
STORMWATER MANAGEMENT REQUIREMENTS
All building demolitions require a separate Stormwater Management Permit.
❑ Please attach a Stormwater Management Permit application (pages 3 & 4) and Land Disturbance Plan.
SEWER & WATER
Will you be disconnecting from City sewer or water? ❑ Yes No
If you answer "no," please proceed to the next section.
If you answer "yes," a separate Sewer & Water permit is required.
❑ Please attach a Sewer & Water permit application to this permit submittal.
❑ Water meters must be returned to Utilities prior to Demolition Permit issuance. Please call
(651) 675-5200 to coordinate water meter removal.
SEPTIC ABANDONMENT
Will you be disconnecting from a septic system? ❑ Yes ANo
If you answer "no," please proceed to the next section.
If you answer "yes," a separate Plumbing Permit is required.
11 Please attach a Plumbing permit application to this permit submittal.