3614 Crossroad Ct 11/29/2016 1 :05PM FAX 9529858836 Bulldog lJ0001/0004
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Cit of Ealan Permit*. /V /1/ D---
3830 Pilot Knob Road
Permit Fee: c9---7 . 0
Eagan MN 65122 Date Received;
Phone:(651)675-5675
Fax:(651)675-6694 Staff:
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2016 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 11/29/16
Site Address: 3608, 3610, 3612, 3614 Crossroads Ct.
Unit ii:
Crossroads Partnership
Phone: 651-454-352
• ;;''Residentl.,; ''; 1500 McAndrews Rd W. Ste. 100, Burnsville, MN 55337
Owheir}; r;:.':•; Address/City/Zip;
. • Applicant is: Owner Contractor
,,, •,,..,,.,;.;o:o, Description of work; Remove & replaced asphalt shingles
Type of..�:Wo'Ifk;:r
' Construction Cost: $15,000.00 Multi-Family Building:(Yes X /No ii
;:; ,' Contact
'''`•• Company: Bulldog Contractors; LLC Peter Retka
••• '::,' ,;; "`• Address: 21663 Cedar Ave • Citi_ Lakeville
MN 55044 Phone: retka
•`'• State: Zip:
651-253-8211 Email: p @bulldogroofs.com
License# BC639635 Lead Certificate#: NAT-F162654-1
If the project is exempt from lead certification, please explain why:
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:
Fire Suppression Contractor: Phone:
•':`NOTE:;Plans and supporting'documents,'that'you?submitare.considered to be public information Po'rtions'of .
the informationinay be classifiedas non.-public 1f yoL provide specific reasons.that,would,permit.the City.to
• :conclude thaf•they are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at(851)454.0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. wwN.aaoherstateonecall.Ara
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 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 vithIn 180
days of permit issuance.
x Peter Retka "
Applicant's Printed Name Applicant's Signature
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