3888 Serpentine CirCity of Eaau
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
Date Received:
Staff.
INFLOW & INFILTRATION PERMIT APPLICATION
Plumbing / Sewer & Water
Date: 3-1-1- ) I Site Address: 3 V e J€ ,e PE /" r,
J
Tenant: Suite #:
RESIDENT /OWNER
Name- OC 11'°-'1-1/ 1 Phone: 5-/q5 Li- l
2- c%
Address/City/zip: 3 Yg0 SEfPENrWE- L' ►12e -t- E./46f f410 5;j 1 L_Name:
CONTRACTOR
License #:
Address: City:
State: Zip: Phone:
Contact: Email:
TYPE OF WORK
PLUMBING (Within the building envelope) SEWER & WATER (Outside the
Sump Pump Repair Repair
building envelope)
Other L9A4-2 ( #2d feee/714 v€) other
DESCRIPTION
-,r cl 4 i
$
Description of work: it3E R l agd /eE Alt YC e
FILL-cr.) e 4
FEES
$55.00 / Each (includes
$5.00 State Surcharge) (Rev. 6-30-10) TOTAL FEE $
*
*Permit fees will NOT be reimbursed by the City of Eagan. If you plan to submit Ill repair costs for
reimbursement, two quotes from qualified contractors must accompany this application. A list of contractors
can be found by visiting www.citvofeauan.com/inflow, or City Hall at 3830 Pilot Knob Rd.
CALL BEFORE YOU DIG. Call Gopher State One Call at (661) 454-0002 for protection against underground utility damage. Call
48 hours before you intend to dig to receive locates of underground utilities. www.gooherstateonecall.orq
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 revi = and approval of plans.
L A. m E Ar -
Applicant's Printed Name
x
Applicants Signature
FOR OFFICE USE Reviewed By: Date:
Required Inspections: Under Ground Rough -In „Final
CITY OF EAGAN Remarks Sew & wtr ermits 1-24-69
Additionr Ced3I' GI'OVe #6 Lot 8 81k b Parcel lo 1 705 080006
Owner ~~'L sr~.+ Street 3888 Serpentine C~~ r~~ EState £''agan.,MN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK
-JE SEWER LATERAL 197 O T472.00 ZO P81Cj.
WATERMAIN
# WATER LATERAL 1970 20
WATER AREA
# STORM SEW TRK 1970 ZO
S70RM SEW LAT
CURB & GUTTER
510EWALK
STREET LIGHT
WATER CONN. 200.00 ~ igo 1-27-69
RUILDING PER.
SAC 200.00 iigo - _
PARK
INSPECTION RECORv
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
SITE ADDRESS: APPLICANT:
„ . , ~ . ~i . r,:~ ~ . , :ei; , ~ ~ ,
G r d J -e -,1:6
PEPM1T S49TYPE: TYPE OF WORK: w
. ~ . , .
INSPECTION . DA
~ ~
Pertnit Holder Date Telephone #
PLUMBfNG
HVAC
Inspection Date Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLEiG
FINAL HTG
ORSAT
TEST
BLDG FINAL
DOMESTIC
METER
IRRIGATION
METER
FLUSH
MAINS
CONpUCTIViTV
TEST
HYDROSTATIC
TEST
BSMT R.I.
BSMT FINAL
OECK FTG .
DECK F1NAL
EAGAN TOWNSHIP
BUILDING PERMIT N° 1938
.
Ownex '---'dlz:7. ~ `Eagan Towasbip
Address (presenf) ....:.3~:f `.....::g: yr...:..... ~...'.14- Town Hall
Builder
° Date -----..~_'2.7.-.~.9.........'-'_--.
Addsess
DESCRIPTION
SSOriesl To Be Used Foz Froni Dep2h Heighi Esi. Cost ~Permit Fee Aemazks
LOCATION
Slree2, Road or ofher Descriplion of LoeaSion I Lo! Block Addifion or Trae!
This permit doas not au3horise the use of sireels, roada, elleys or sidewalks nor does it give the owner ox his agenY
the righf !o creafe anp siluaYion which is a nuisanee or which presenis a hazard to the healih, safefy, convenience and
general welfare !o anyone in the communilp.
THIS PEAMST MUST BE KEPpT- ON THE PREMISE WHILE THE WORK IS SN PAOGRESS.
.O~
This is !o eerfifp. 2hai r%r-..s.T--~~Y!................. ..haspermission fo ereet a. ?~..4_.. ....:""f."""'__" _
. upoe
~
the abova described premise eubjeei !o the provisions of the Svilding Ordinance for Eag4n Townshi adopYed April 11,
1955.
Per .&<,......(/.~.__r"'^~_._..............._""'------------------
Chai an of Tnwn Soard Suilding Inspector
0 le
a< -tm
;
~
of Ea~a~ ; ;
3830 pitot Kno6 Road , t
. i Date Aemvred: i
Eagan !1N 55122
Phona: (651) 675-5675 i Smtt: ~
~ I
Fax: (651) 675-5696 - -
20D8 RESIDENTlAL BUILDING PERMIT APPLICATION
oM: ~ t' D$ srtenaa?ess: 3M`d SE
s~dte
TenaM: ,r q
RESIDEM' I OWNER Name: U~ ~~%V N 12Vti'~ ~Crl'Cfl Phone:
Address / Ciay / ZP:
qppkaM is: _ Owner Cantractor
TYPEOFWORK oe=~n orvvork: T~~ CEE ` a1.33x2
c«,sUucc«, cog: 383q . 40 Va,m•Fammr suikfirg: (rca_/NoV
',~~RaN9W
CONTRACTOR Name= ~m t.
!
Address: ~
.W T.m: 5
s~~: L
Phone: p' f
"I ~ 1 • `1 &IJ Contact Person: ~!1 f`P?~~
CPLETE 7HlS AREA ONLY IF CONSTRUCTING A NW BUILDING
7672
Minnesots Rules 7670 Cateaorv 1 Mmnesoffi Rules
. p,aeide+~l veraTetion Cmgorr 1 wor~eet code wodalwe~
. En~~gy Ernebpa Cafailaao~ SudniGed
Uhs, has the CitY of Ee90n iesued 9 p@nnM tor a Shnilar pWf besed on a nm9ter p6an?
In the Ie5[ lZ mor
_Yes _No If yes, date and address o( master plan:
Lidnsed Plumber: phoreMechanical Conusctor: Phoria•
Sewar & Wa[er CoMraMOr: Phone:
i nercpy aclawwtedge ttmt ttds informmfon is wmpletead amumta; tlo ft worK w19 ba in anMfinenes vdth tha ordfnenees aM ootles of Ue Ctly ai
Eagan: mffi I undgMYanW ws le m a peffmn, an onlv an appOcagon 1or a vwmb, ara wa'Ic is na m:start wWwKrt a ter^il; no me walc wM ne in
aaorEance wIm are approvad vW m o+e eaae of wark whkn rpwes a review and appmw of vwm
x M~ Ikl~1 Mv~C~ x~ `C~.~rV?~~til,~co~~
APPlIcanYs Prmted Name ApplicaWs 9a9noWre Pepe 1 M 3
r a, .
, MEMO
~city of eagan
T0: DIANE DOWNS, UTILITY BILLING CLERK
FROM: ED KiRSCHT, SR. ENGINEERING TECH
DATE: AUGUST 25, 1993
SUBJECT: STREETLIGHT ENERGY COSTS
CEDAR GROVE NO. 6(141 LOTS)
This memo is to inform your department to begin to invoice the energy costs at the single
family rate effective August 1, 1993 to the property owners in Cedar Grove No. 6 Addition
as listed below:
Block 1, Lots 1 1
Block 2, Lots 1-8 8
Block 3, Lots 1-18 18
Block 4, Lots 1-11 11
Block 5, Lots 1-9 9
Block 6, Lots 1-53 53
(Lots 54 through 61, Block 6, should not
be billed at this time)
Block 7, tots 1-1 2 12
Block 8, LDts 1-18 18
Block 9, Lots 1-11 11
TQTAL 141
The City is currently being billed by Dakota Electric for streetlighting in the above listed
subdivision.
,
Ed Kirscht '
Sr. Engineering Tech
cc: Mike Foertsch, Asst. Ciry Eng.
EK/je
~
EAGfS3 TOWNSHIP
3795 Pi.lot Knob.Road
Se. Paul, Minnesota 55111
Telephone 454-5242
PER141T FOR WATER SEAVICE CDPINECTION
Date• (`~L~.'--- Number• 211
Billing Name: 3ite Address:~~~(0
Owner: exd'~j- Billing Address
Plumbe'r;
Location of Connection Meter Size Coanection Chg. ;>oo_nn
Meter No, Permit Pee 7•50
Meter Reading Meter Dep.
Meter Sealed: Yea Add'1 Chg.
NO Total Chg.
Inspected by
DaCe
Bu3.lding is a; Eemarks:
Residence-j-
Multiple No. Units
Commercial
Industrial gy;
Other Chief Inspector
Ia coneideration of the iaeue arnl delivery to me of the above permit, I
hereby agree to do tte proposed work in accordance with Che rules and
regulations of 8agan Township, Dakota County, MinnesoCa.
~
By: r~ •
Please notify the above oftice when ready for iaspection and comection.
EAG6N TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454-5242
PERMIT I'OR SBWER SERVICE CONNECTiON
DATE: ~ NUMBER 329
OWNEF. Address 3&P
ILZ PLUMBER~ TYPE OF PIPE
DESCRIPTION 08 BUIIAING
Industrial Commercial Residential Multiple Dwelling No. of units
l
Location of Connections: Connection Charge 200.00
Permit Fee 7.50
Street Repairs
Total
Inspected by:
Date
Remarks:
By.
Chief Inspector
In consideratioa of the issue and delivery to me of the above permit, I
hereby agree to do the proposed work in accordance with the rules and
regulations of Eagan Tormship, Dakota Count , Minnesota~
By ~ •
Please notify when ready for inspection aad connection and before any porCioa
of the work is cwered.
FERMIT CY.OF EAGAN aurLnrNG
38' Pil6[Rnob Road PERMIT TYPE:
Permit Number: 033 413
Eagan, Minnesota 55122-1897 09/ 2 3/ 9 a
(612) 681-4675 Date Issued:
SITEADDRESS: 388$ SERPEN7INE CIR
LQT: ~ BLQCK: r
'.~.u DJQE,9--r• GRE S `P
P.I.N.: 10-16705-080-06 G f0 v-Q-~ ~
DESCRIPTION:
T.O. & REROOF
permit Type STORM pAMAGE
Bpildiflq, ~'ao,rk Type REPAZR
,,q.en* tt5 CctdB434 AIT. RESIDENTIAL
Fs s ?Pi.
!u~
W
bp &RT
S
YA eti g
~
s ¢ " a
m
h
'r
{ ' 4 m ~ i ~z
~ $n - ¢ L^f5
ar y.
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. `?°vvar c i~~.~ ..VLW
REMARKS:
FEE SUMMARY:
M0}7"~UTNSTRUCTION INCPP 118887942 2337 ` PWNER FReo
10740 LYNCtALE AVENUE S 3888 SERPENTINE CIR
BLOOMINGTON MN 55420 EAGRN MN 55123
(612) 888-7042 (651)454-1440
1 h
` e,raby- acknaa+ledge that z havq read tttis a0pl1c0.t4°dn' A red it~te .thaf'°the ;
1 6f aC'rttatian is ctirreet and -jagree 'tca cortply With, s12`"dpp_ifeable SC;ate .41'', Mrti.
Catut~s,4frtf,
01ty of Eagan_Qrdinan,ces>°. "
, .
,
APPLICANT/PERMITEE SIGNATURE 't&SUED BY: SIGNA UR~-
1998 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
f I~ 3830 PILOT KNOB RD - 55122
-i e81-4e75
QI .
New Construdion Requirements RemodeVReoair Raquirements
• 3 registered sde surveys • 2 copies of plan
• 2 copies oi plans (inUude beam 3 windaw sizes; paureA fnd. design; etc.) ? 2 sita surveys (erzterior addkions & tlecks)
? 1 energy calculations ? t energy nlculationsfor heated additions
• 3 copies of tree preservation plan H lot platted after 7/7l93
requi:01 o
DATE: CONSTRUCTION COST;
DESCRIPTION OF WORK:
STREET ADDRESS: Scw I ~~l/C
LOT: (53 BLOCK: SUBD./P.I.D. C-Q-4 Q" C, YO V
4
Name: //u Phone
PROPERTY Last First
OWNER ~
Street Address:
Ciry State: Zip:
Company: Alc4c C.~/~,fiel!( l Phoae e- Xl 9
CONTRACTOR
Street Address:~~IU License # 1)3? 7
City State: ~j / Zip:
ARCHITECT/
ENGINEER Compan Phone
p( Registration i~:
treet ddress:
~C(ty State: Zip:
Sewer 8 water licensed plumber (new constructlon only): . Penatty applies when address chanc
and lot change is requested once permit is issued.
I herehy acknowledge that I have read this application and state that the infortnation is correct and agree to comply with all applicat
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant IIIAU
OFFICE USE ONLY M
Certificates of Survey Received _ Yes _ No ~ -
I
Tree Preservation Plan Received _ Yes _ No _ Not Required
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish
? 02 SF Dwelling ? 07 4-plex ? 12 Multi Repair/Rem. ? 17 Swim Pool
? 03 SF Addition ? OS 8-plex D 13 Garage/Accessory ? 20 Public Facility
? 04 SF Porch ? 09 12-plex ? 14 Fireplace ? 21 Miscellaneous
? 05 SF Misc. ? 10 = plex ? 15 Deck
WORK TYPE
? 31 New ? 33 Alterations ? 36 Move
? 32 Addition ? 34 Repair O 37 Demolition
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. MC/WS System
(Allowable) Main level sq. ft. City Water
UBC Occupancy sq. ft. Fire Sprinklered
Zoning sq. ft. PRV
# of Stories sq. ft. Booster Pump
Length sq. ft. Census Code.
Depth Footprint sq. ft. SAC Code
Census Bldg
Census Unit
APPROVALS
Planning Building Engineering Variance
Permit Fee Valuation: $
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
SNV Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
% SAC
SAC Units
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Use BLUE or BLACK Ink
W
I For OfficAUse I
l I
/(1/ I
Permit 1
City of Eap ' 1 Permit Fee:
3830 Pilot Knob Road 1
~ Date Received: I
Eagan MN 55122 i
Phone: (651) 676-6675 1 staff:
Fax: (661) 675-6694 1 1
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
ZISLeL Unit#:
Date: Site Address: Cic-
Name: ~aG +2V f'w....~-o. Phone: Z
Quvn~ Address /City / Zip: ? ~'c ; yt416e C't'rl-c"T---~-~ ZZ
ii
x Contractor
Applicant i3: Owner
'.:;.',,.;,'.:":';':,,,.;1;~~,;;,,,:;,,,) l laver brlL~ "r.+nber►t~►e
cbzs~ Z3 ww4~n
Description ofwork!'~ r_ 04 + r~in
ii .
Construction Cost: 97Zg'_ 97- Multi-Family Building: (Yes of No
Company: Contact:
Address: l zJ~ .S ~Po>?7'" G /P~ City.
7Vi O~sc't~ir i. b ~ 7
Phone:
' State: Zip: ~SJD .3
9T d/ 7/f/
License Lead Certificate
if the project is exempt from lead certification, please explain why: (see Page 3 for additional, information)
1C5
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan Issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
I,~~I F";:!?! ~::3'. ~ r n ~~.;i .l. , • 1 . ,110,,,:, 1
: :.'r+ :1 r"i' i•• l i l r.~ J ,1,. ya r I r . i , ~rTi•wtrl~~lb. "1~ r~ n,1.
CALL BEFORE YOU DIG. Call Gopher State One Call at (851) 464-0002 for protection against underground utility damage. Call a8 hours
before you intend to dig to receive locates of underground utilities. www. h rsteteo Il.o
I hereby acknowledge that this information is complete and agate; 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 rase of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
daye of pemtit Iseusnea.
X rG'~`lC/ ~~/aC dr x
Ap,plicants Printed Name Applicant's Signature
Page 1 of 3
L0/50 39vd 31X3 WO1Sf10 S-1-13NNOD T06Z8EbT59 80:ZT ETOZ/50/60
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA170635
Date Issued:07/13/2021
Permit Category:ePermit
Site Address: 3888 Serpentine Cir
Lot:8 Block: 6 Addition: Cedar Grove 6th
PID:10-16705-06-080
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
If water damage is encountered, please call (651) 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 the
water damage.
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 Total:
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.
Contractor:Owner:- Applicant -
Beverly K Armenta
3888 Serpentine Cir
Eagan MN 55122
(612) 562-3635
Twin Cities Contracting Services
140 W 98th St, Suite 202
Bloomington MN 55420
(952) 405-6201
Applicant/Permitee: Signature Issued By: Signature