1777 Serpentine Dr**
City of Eagan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
Permit #:
Permit Fee:
Date Received:
Staff:
2010 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 1/ /'r /0. Site Address:
Tenant: £ . 11C)F-F/1
/ 77 7 dv 1( e( v
J
Suite #:
RESIDENT / OWNER
Name: 0 kAO ^ rt1 1A -r) Phone: 451 - 2{S l -- .3D
Address / City / Zip: kn l r1)2_ f1/ T( �ti t��, �l� �i ild� 0414J3 77).
Applicant is: Owner Contractor
TYPE OF WORK
Description of work: 'G/ //M./4r( i7Lgf1b `C '� Cc, .51+71
Construction Cyst: ��r/O Multi -Family Building: (Yes / No,c)
CONTRACTOR
Name:
Address:
State:
PROTECTIVE I4O777: COVERIt O !VC
67€33 C , CT E
PRIOR LA6,.2, , 63372 $R .
Contact: jtLUt 1-11A-2 Email:
License #: id06 30 gro
City:
7d -J0-4. Q/7oO
� Ptc$/0 C0 �
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 an.. ddress of master plan:
Licensed Plumber:
Mechanical Co actor:
Sewer & ater Contractor:
Phone:
Phone:
Phone:
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 that they are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org
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.
Applicant's Printed Name
BUILDING PERMIT
CITY OF E.AGAN
3795 Pilot Knob Road Eagan, MN 551n
PHONES 454-8100
nc". Est. Value
7,34 2
Receipt #
Date 19
Site Address
Lot Block Sec/Sub.
Parcel #
sc Name `t
W
Address
p Name
Address
Name
Address
1 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.
Signature of Permittee
A Building Permit is issued to:
all work shall be done in accordance with all opl
Building Official
Erect Q Occupancy
Alter ? Zoning
Repair ? Fire Zone
Enlarge ? Type of Const.
Move ? # Stories
Demolish ? Length
Grade ? Depth Sq. Ft.
Approvals Fees
Assessment _
Water & Sew.
Police
Fire
Eng.
Planner _
Council
Bldg. Off. -
APC
Permit
Surcharge
Plan check
SAC
Water Conn.
Water Meter
Road Unit
Total
on the express condition that
ble State of Minnesota Statutes and City of Eagan Ordinances.
Permit No. Permit Holder Misc. Permit No. Holder
Plumbing
H.V.A.C.
Water well
Disp.
Sewer
'ctrie p?
T -7 1 g j D
r l&c
2S .
Inspection Date Insp. Other
Found
f
Insulation
Final Plbg.
Final HVAC
Final 44
Water Describe Location:
Well
Sewer
Pr. Disp.
CITY OF EAGAN Remarks Sew ¢ wtr permits and wtr & sew conn. pd- cm )1-1)1-69
Addition Cedar Grove #6 Lot 9 elk 5 Parcel lo 16705 090 05
Owner > > " Street 1777 Serpentine Dr. State_Eagan,MN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK
* SEWER LATERAL 1970 7 .00 20 paid
WATERMAIN
* WATER LATERAL 20
WATER AREA
* STORM SEW TRK 1970 20
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 900
on 1323 -1
BUILDING PER. .
SAC 200.00 1323 -1 - 9
PARK
This request void ?(r27
18 months from I
T 79918
L5, 13 5, CL r GroJE (o -307 /'(
yi
Request Rule Fire No. Rough-idn Inspection
Require?
Ready Nqw E] Will NutilY.lnspec-
?
co
GID1 / I g ? Yes ? No for When ReatlY
Licensed Electrical Contractor I hereby request inspection of above
Owner electrical work installed at:
Street Address. BosR le No. ?
F1 `, {l( Ci
ecu pn No. Township Name r No. Range No. County
O c p tit IPflINT1
? Phune Nn.
PZr `ii uppl r
tX_ Add ss
Ele trical Cn actor ICom n Nam Con }Exr rtgi's Li cegl No.
Mailing Address ICq actor or Owner Making in'tailation)
Authorized Signature (Contractor/Owner Making Installations Phpne Number
yqa-gyy r
MINNESOTA STATE BOARD OF ELECTRICITY THIS ICNSPECTION REQUEST WILL NOT
Griggs-Midway Bldg. - Room N-191 BE ACEPTED BY THE STATE BOARD
1821 University Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS
nr.....e frstlt 9B7_2111 ENCLOSED.
7 G G REQUEST FOR ELECTRICAL INSPECTION EB-00001-03
18 ' See instructions for completing this form on back of velloW copy.
?°ae4 J
"X'" " 8,1, Weak Covered by This Request 307
Neal Add Rep. Type of Building Appliances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Lighting Fixtures
Apt. Building Dryer Electric Heating
Commercial Bldg. Furnace Silo Unloader
Industrial Bldg. Air Conditioner il k Milk ank
Farm Other Speafy lyl r ? c l
1 er G Othor Othor
Compute Inspection Fee Below
n Fee Service Entrance Size a Fee FBader$rSebfeadera # Fee Circuits
'O rD 0 to 100 Amps 0 to 30 Amps 0 to 30 Am s
101 to 200 Amps 31 to 100 Amps 31 to 100 Amps
Above 200 Amps Above 100-Amps Above 100-Am s
Transtormers Remote Control Circ. i I Partial,'Other Fen
Signs Special Inspection $ . Q
T
Remarks OTAL F E ?f?
Rough-in t
,
D t/tj? I, the Electrical
•? . • ? Ins aector, hereby
ce
tif
th
t th
b
Final
!
Kl?
Dane
/?• r
y
a
e a
ove
spec lion has been
"
n t
This request void
18 months hom
EAGAN TOWNSHIP
BUILDING PERMIT
Owder...??-K ?.
Address (present) "°
Builder ------------------------------------ --------------------------------------------- ..........
....
Address
DESCRIPTION
N° 1983
Eagan Township
Town Hall
Date.:
Stories To Be Used For Front Depth Height Est. Costs Permit Fee Remarks
LOCATION
<>. .TrGd ?csr -6„ 7 - L, G/ d=Wj G
Addition or Tract
This permit does not authorise the use of streets, roads, alleys or sidewalks nor does it give the owner or his agent
the right to create any situation which is a nuisance or which presents a hazard to the health, safety, convenience and
general welfare to anyone in the community.
THIS PERMIT MUST BE KEPT ON THE PREMISE WHILE THE WORK IS IN PROGRESS. ,
This is to certify. that ....?i?...r.. .:.............has permission to erect a-.':' . .................... -, Pon
the above described premise subject to the provisions of the Building Ordinance for Eagan Township adopted April 11,
1955 ??i / ...- ? _•__??? -------------- Per .-.-?..._. ... -yr1? ?ic:...
.??]?...'......?...... .........._ ...............? ............_...........tidi... Inspector ..... -<e...........
. ..
Chairman of Tnwn Boar Building
CITY OF EAGAN N9 7 3 4 2
n .. 3795 Pilot Knob Rood Eagan, MH 55113 -
PHONE: 454-8700
BUILDING PERMIT Recelpt ??OS /?
To be used far51Gi POOL & RENCE Fn.Vahx. $9.000 rk,ta Jute 16 to 82
Site Address 1777 Serpentine Drive
Lot 9 Black 5 Sec/Sub. Cedar Grove 6th
parcel # 10 16705 090 05
f Name Ray Cink
Address 1777 Serpentine Drive
C; Eagan 551¢2 Phan 454-3091 Erect ft
Alter ?
Repair ?
Enlarge ?
Move ?
Demolish ?
Grade ? Occupancy R-3
Zon;ng R-1
Fire Zone NA
Type of Const. -
# Stories °
Length 35
Depth 17 Sq. Ft.-
Name Custom Pools Approvals Fees
Address 601 E. Excelsior Ave.
E Assessment Permit 74.50
? city Phone 933-2255
Ho2kins Water & Sew. Surcharge 4.50
t)w. Noma Notes 10s clearance Prom -
l
Ce Pion
check
Fi
e SAC
y: Address any source of electricity Eng. Water Conn.
<W City Phone Planner Water Meter
Council Road Unit
I hereby acknowledge that I have read this application and state that Bldg. Off.
the information is correct and agree to Comply with all applicable
State of Minnesota Statutes and City of Eagan Ordinances. APC Total $79.00
Signature of Perrnittee
A Building Permit is issued to: Custm I the express condition that
all work shall be done in accordance with all oppli I tote of s urea of Eagan Ordinances.
Building Official ?.?i?Q
? 9 ?f/ !i y2 , CITY OF EAGAN Include 2 sets of plans,
/??-y"/ ( 1 site plan w/elevations &
BUILDING PERMIT APPLICATION 1 set of energy calculations.
14- T-P AC P-
To Be Used For &00t'Aincl 00 lon Date
?- /i //8
Site Address 1 ?? Y ??? ?L UT OV OFFICE USE ONLY
Lot Block 'Sec. /Sub. CE c y- 6 V Occupancy T 3
Ere t
Parcel #: 20 110705 O 5 _
Alter Zoning
Repair Fire Zone Ilia
Owner: AL R Enlarge - Type of Const.
Address:
SEQ Pr: LINE
?-6 ' Move # Stories
Demolish Front 5` ft.
City/Zip Code: ?-
Phone #: qrtj-
Contractor:
Address: CDO
City/Zip Code:
Phone #: C,
Arch./Eng.
Address: _
City/Zip Code:
Grade Depth / t•
APPROVAIS FEES
Assessments Permit s
Water/Sewer Surcharge .0" X/---j
Police Plan Check
Fire SAC
Eng. Water Conn.,
Planner Water Meter
Council R Unit
Bldg. Off. r
APC
Phone #: ? TOTAL
r ° ?D P top 'roof r? IPG?IQ?d?00 90 hz
an y ?SodRce o f F/Ac-Ixie,/ry.
MEMO
TO: 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, Lots 1-12 12
Block 8, Lots 1-18 18
Block 9, Lots 1-11 11
TOTAL 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. City Eng.
EK/je
I
1
r '
EACtli TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR WATER SERVICE CONNECTION
Date:dzy/ 9 Number: 262
Billing Name: /yJ/ //??
Owner-A& ,?llln.. &4t .? ,
Plumber: A-WLJ f4it .
Site Address:'7:S'/0 177
Billing Address
NO Total Chg.
Building is a:
Residence1,_
Multiple No.
Commercial
Industrial
Other
Meter
Permit Fee 7.50
Meter Reading Meter Dep
Meter Sealed: Yes_ 'Add'1 Chg.
Inspected by
Date
Remarks:
By:
Chief Inspector
In consideration 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 Township, Dakota County Minnesota.
By:
Please notify the above office when ready for inspection and connection.
EAGAN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR S34ER SERVICE CONNECTION
DATE: NUMBER 384
OWNER 1. Address °jvr-(o 777
PLUMBER TYPE OF PIPE
DESCRIPTION OF BUILDING
Industriall Commercial Residential I Multiple Dwelling I No. of units
Location of Connections:
Permit Fee 7.50
Street Repairs
Total
Inspected by:
Date
Remarks:
Connection Charge 200.00
By
Chief Inspector
In consideration 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 Township, Dakota County, Minnesota
BY, C sGGfsYt/ of??,•
Please notify when ready for inspection and connection and before any portion
of the work is covered.
City of Eagan
PERMIT
City of Eaan
Permit Type: Building
Permit Number: EA115237
Date Issued: 09/24/2013
Permit Category: ePermit
Site Address: 1777 Serpentine Dr
Lot: 9 Block: 5 Addition: Cedar Grove 6th
PID: 10-16705-05-090
Use:
Description:
Sub Type: Reroof
Work Type: Replace
Description:
Census Code: 434 -
Zoning:
Square Feet: 0
Construction Type:
Occupancy:
Comments:
If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar.
Pictures are not acceptable in lieu of inspections.
Carbon monoxide detectors are required by law in ALL single family homes.
Tammy Donner
Fee Summary:
Valuation: 4,000.00
BL - Base Fee $4K
$103.25
Surcharge - Based on Valuation $4K $2.00
0801.4085
9001.2195
Total: $105.25
Contractor:
Ashco Exteriors Inc
11164 Zealand Ave N
Champlin MN 55316
(763) 225-8333
- Applicant -
Owner:
Daniel J Hoffman
1777 Serpentine Dr
Eagan MN 55122
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
City of Eagan
PERMIT
City of Eaan
Permit Type: Building
Permit Number: EA119276
Date Issued: 11/21/2013
Permit Category: ePermit
Site Address: 1777 Serpentine Dr
Lot: 9 Block: 5 Addition: Cedar Grove 6th
PID: 10-16705-05-090
Use:
Description:
Sub Type: Siding
Work Type: Replace
Description:
Census Code: 434 -
Zoning:
Square Feet: 0
Construction Type:
Occupancy:
Comments:
Please leave printed pictures of house wrap on site for the final inspection.
When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to
ensure maximum ventilation to attic. Call for final inspection after installation.
Fee Summary:
Valuation: 4,000.00
BL - Base Fee $4K
$103.25
Surcharge - Based on Valuation $4K $2.00
0801.4085
9001.2195
Total: $105.25
Contractor:
Ashco Exteriors Inc
11164 Zealand Ave N
Champlin MN 55316
(763) 225-8333
- Applicant -
Owner:
Daniel J Hoffman
1777 Serpentine Dr
Eagan MN 55122
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
*C!tyofEaaaii
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
�04 11 A0M
Use BLUE or BLACK Ink
For Office Use L�
Permit #:
Permit Fee: 664 1-37:31e
Date Received:
Staff:
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit #:
Name: Pc14 4Ofl1L4'\ Phone: 651 7. --,?h3 77'
Address / City / Zip: / 777 Se -fp 1 t
Applicant is: Owner / ' Contractor
i
Description of work: �I bi''r
Construction Cost:UX• Q0
Company: 0(2612/7-6_10i
t DI
Multi -Family Building: (Yes / No )
Address: , foa3 U S Li 10 V f
State: /UI/ V Zip: 5S3555 Phone:
ntact: c i p Par—tentri(,6/
City: 6/%� . I _ k�/l�[
-593 -ogaq
License #: BV it -14& q Lead Certificate #: NAT A T ` nb6 c 7
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
\9(1C)
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:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
Phone:
'TE: Plans and supporting docurrrenls that you submit are considered to -be publlc nfo
re information may be classed as noir publ'lc rf you provide spec c
• conclude that they are trade: seci -_
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.gooherstateonecail.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 perr►it, 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.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
x DEoiSE dM(?13EY2e
Applicants Printed Name
Applicants Signature J
rzcir-(lec-44.
Page 1 of 3
1
DO NOT WRITE BELOW THIS LINE
SUB TYPES
_ Foundation Fireplace _ Porch (3 -Season) T Storm Damage
jt Single Family Garage Porch (4 -Season)_ Exterior Alteration (Single Family)
Multi Deck Porch (Screen/Gazebo/Pergola) _ Exterior Alteration (Multi)
01 of Plex Lower Level Pool Miscellaneous
Accessory Building
WORK TYPES
New_ Interior Improvement _ Siding _ Demolish Building*
Addition Move Building Reroof_ Demolish Interior
44 Alteration_ Fire Repair _ Windows _ Demolish Foundation
Replace Repair Egress Window Water Damage
Retaining Wall *Demolition of entire building — give PCA handout to applicant
DESCRIPTION
Valuation 44%D Occupancy rik , MCES System
Plan Review Code Edition ,Za7 SAC Units
(25% 100%t!1Zoning £ -1 City Water
Census Code H3t'l Stories Booster Pump
# of Units 1 Square Feet "� PRV
# of Buildings 1 Length Fire Sprinklers
Type of Construction ,I Width.
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) Final / C.O. Required
Footings (Addition) ;it, Final / No C.O. Required
Foundation HVAC _ Gas Service Test Gas Line Air Test
Drain Tile Other:
Roof: Ice & Water Final Pool: Footings Air/Gas Tests _Final
Framing Siding: _Stucco Lath Stone Lath _Brick
Fireplace: _Rough In Air Test Final Windows
Insulation Retaining Wall: Footings _ Backfill _ Final
Sheathing Radon Control
Sheetrock Erosion Control
Reviewed By: , Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
G7-=
Page 2 of 3
4°1°
City of Eagan
Date:
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit #: •\ a O -(4 O
Permit Fee:
poi
Date Received:
Staff:
2014 RESIDENTIAL PLUMBING PERMIT APPLICATION
2 / % Site Address: 1 7 7 7 S2I2- �'� %%�>� OP—
Tenant
P-
Tenant t'J 1 `L_ _ ®F& ,14 kv
)
Suite #:
Resident/Owner
Contractor
Type of Work
Permit Type
Name: Dik01 . L !'-IAF`` %v A phones --1 " 95`/---3272
Address / City / Zip: / 777 5d17 p 6
Name: License #:
Address: City:
State:
Contact:
Zip: Phone:
Email:
_ New _ Replacement Repair _ Rebuild _ Modify Space _ Work in R.O.W.
Description of work: + -rev---f - 5/N /c
RESIDENTIAL
Water Heater
Lawn Irrigation ( RPZ / PVB)
Septic System
New
Abandonment
Water Softener
Add Plumbing Fixtures ( Main / Lower Level)
Water Turnaround
RESIDENTIAL FEES:
$60.00 Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)
$60.00 Lawn Irrigation (includes $5.00 minimum State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge)
*Water Turnaround (add $200.00 if a 5/8" meter is required)
$115.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge)
TOTAL FEES $
CALL BEFORE YOU DIG. Call Gopher State One CaII at (651) 454-0002 for protection against underground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org
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 1 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
ac • - e wit the approved pl- n 'n t of work which quires a review and approv. - s.
711
Applicant's Printed Name
x
Applicant's Signa ure
FOR OFFICE USE Reviewed By: Date:
Required Inspections: Under Ground Rough -In Air Test Gas Test _ Final
Meter Related Items: Meter Size Radio Read Staff:
4°6
C!ty of Eaall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit#: 1Zo1
(.?()(j.
Permit Fee:
Date Received:
Staff:
12014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 1�_ / Y Site Address: 777 ��R_PE rI E Dvz-- Unit#:
Resident/
Owner
Contractor
Name: h.AA) %L l-`lv,P,Phone5/--- "VS* 2 7
Address / City / Zip: /777 S fa OEEite *Ai
-
Applicant is: Owner Contractor
Description of work,
Paravr t t' 4
lVt.. D IttM ltv tI 5
Construction Cost: b� • Multi -Family Building: (Yes / No )
Company: -641"1-1--- 6 ic�/V
Address: ! 77?j`L� Pg-Al77AIL_
Contact:
State: /41N 'Zip: "5(22-- Phone:
0
City: cit ‘4"/(/
5t— q – 7 Z_
License #: Lead Certificate #:
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
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:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may classified as non-public if you provide specific reasons that would permit the City to
conclude that the are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.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 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
days of permit issuance. /�
` F A�
Applicant's Printed Name
Applicant's Signature
Page 1 of 3
1-77
DO NOT WRITE BELOW THIS LINE
SUB TYPES
Foundation Fireplace
Single Family Garage
Multi Deck
01 of Plex Lower Level
WORK TYPES
New Interior Improvement
Addition Move Building
Alteration Fire Repair
/Replace Repair
Retaining Wall
DESCRIPTION
Valuation
Plan Review
(25% 100%
Census Code
#of Units
# of Buildings
Type of Construction V • g
s_15- 00. a --t,
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation
Roof: _Ice & Water _Final
✓ Framing
/Fireplace: _Rough In
// Insulation
Sheathing
Sheetrock
Fire Walls
Braced Walls
Reviewed By: CIP-414(.9
Porch (3 -Season)
Porch (4 -Season)
Porch (Screen/Gazebo/Pergola)
Pool
Siding
Reroof
Windows
iz&51 *
Exterior Alteration (Single Family)
Exterior Alteration (Multi)
Miscellaneous
Accessory Building
Demolish Building*
Demolish Interior
Demolish Foundation
Egress Window Water Damage
*Demolition of entire building - give PCA handout to applicant
Occupancy
Code Edition ZOO MSPC
Zoning ^ 1
Stories
Square Feet
Length
Width
Air Test Final
Meter Size:
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Sprinklers
/Final / C.O. Required
Final / No C.O. Required
HVAC _ Gas Service Test Gas Line Air Test
Pool: _Footings _Air/Gas Tests _Final
Drain Tile
Siding: _Stucco Lath Stone Lath _Brick
Windows
Retaining Wall: _ Footings _ Backfill _ Final
Radon Control
Erosion Control
Other:
, Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3
City of Eagan
PERMIT
City of Eaan
Permit Type: Mechanical
Permit Number: EA138847
Date Issued: 09/22/2016
Permit Category: ePermit
Site Address: 1777 Serpentine Dr
Lot: 9 Block: 5 Addition: Cedar Grove 6th
PID: 10-16705-05-090
Use:
Description:
Sub Type: Residential
Work Type: Replace
Description: Furnace
Comments: Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Fee Summary:
ME - Permit Fee (Replacements) $59.00
Surcharge -Fixed $1.00
0801.4088
9001.2195
Total: $60.00
Contractor:
Wenzel Heating & Air Conditioning
4145 Old Sibley Memorial Hwy
Eagan MN 55122
(651) 894-9898
- Applicant -
Owner:
Daniel J Hoffman
1777 Serpentine Dr
Eagan MN 55122
(651) 454-3272
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