1261 Forest Ridge Tr CITY OF EAGAN WATER SERVICE PERMIT
3830 Pilot Knob Road
P. O. eox 21199 PERMIT NO.:
Eagan, MN 55121 DATE:
Zoning: _ No. of Units:
Owner: - — —
Address:
Site Address:
Plumber:
Meter No.: Connection Charge:
Size: Account Deposit:
Reader No.• Permit Fee:
I agree to comply with the City of Eagan Surcharge:
Ordinances. Misc. Charges:
Total:
By , i l A d°" Date Paid:
Date of Insp.: `'°■- 1 01 — ` 6 t o Insp.:
CITY OF EAGAN SEWER SERVICE PERMIT
3830 Pilpt Knob Road
P. O. Box 21199 PERMIT NO.:
Eagan, MN 55121 DATE:
Zoning: No. of Units:
Owner: —
Address:
Site Address:
Plumber:
1 agree to comply with the City of Eagan Connection Charge:
Ordinances. Account Deposit:
Permit Fee:
Surcharge:
By Misc. Charges:
Date of Insp.• Total:
Insp.• Date Paid:
12/02/2016 11:11 7207336427 FEDEX OFFICE 1752 PAGE 04/13
Use BLUE or BLACK Ink
For Office Use4011/P
City Ol Ea � :::: e;
.
3830 Pilot Knob Road
Eagan MN 55122 Date Received: . .
Phone:(651)675-5675
Fax:(651)675-5694 Staff:
W
2016 R - L BUILDING PERMIT APPLICATION
Date: 12/02/16
Site Address: 1257, 1261 Forest Ridge Trail unit#:
Name Forest Ri.ge Partnership Phone 651-454-3352
Reside /;;;flwner Address/City 1 Zip: 500 McAndrews Rd W. Ste. 100, Burnsville, MN 55337
; ���•
Applicant is: owner Contractor
'`'' '` Description of work: "emove & replaced asphalt shingles _
,Type;.ofi�Work`: p
` $ 2000.00
' Construction Cost. Multi-Family Building:(Yes X i No
Company Bulldo" Contractors, LLC contact: Peter Retka
' ''° 21663 I edar Ave Lakeville
:v;::.,„$;. Address; City:
; oil 'tr for; MN 5-044
State. Zip: Phone 651-253-8211 pretka@bulldogroofs.com
Email:
License#: BC63' 635 Lead Certificate#: NAT-F162654-1
If the project is exempt from lead certif cation, please explain why:
COMPLETE THI- AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months,has the City of Ea.an Issued a permit for a similar plan based on a master plan?
_Yes No If yes,date and addre,s of master plan:
Licensed Plumber: Phone:
Mechanical Contractor; r Phone:
Sewer&Water Contractor: Phone:
Fire Suppression Contractor: Phone:
:NOTE:P4a s,•and'sgpporting docu ants that you`submit are considered to be public infor tion.:'Portions>of:
theinfor�iatior►,may,•be classified s non-public if you provide`specifie reasons that h the City to':
. •,: ., >.... .,” ,.,..::. hsacra
;,.:.• . e
•.., ;.,. . �. . :; • ,: • , „'� :cooeiud that they are trade..• is •.. ..,. �. ..
CALL BEFORE YOU DIG. Call Gopher ate One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of und-rground utilities. www.00ahersttateonecall.oro
I hereby acknowledge that this Information is co pieta and accurate;that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is riot a permit, b t 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 4,rk which requires a review and approval of plans.
Exterior work authorized by a building permit ssued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
x
Peter Retka x (7,,gE:) 06vr5 .
Applicant's Printed Name Applicant s Signature
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