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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 Page 1 of 3