3607 Crossroad Ct 11/29/2016 1 : 12PM FAX 9529858836 Bulldog Z0001/0007
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For Office Use
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Cityof Eataft Permit#: /10
3830 Pilot Knob Road
Permit Fee:
Eagan MN 55122 Date Received:
• Phone:(651)675-5675
Fax:(651)675-5694 Staff:
2016 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 11/29/16 Site Address: 1264, 1268 Duckwood Dr. 60C.' -z6°7
C� os� CS
• Unit#:
C-71;
•
Crossroads Partnership
Phone. 651454-3352
:':•ResidohV•.,;.;�:,•:
address,city/zip: 1500 McAndrews Rd W. Ste. 100, Burnsville, MN :55337
Applicant is: Owner X Contractor
', Description of work: Remove & replaced asphalt shingles
:;Type•of Work-;
_' ;'.•` Construction Cost 0 Multi-Family Building:(Yes X /No . )
Company: Bulldog Contractors, LLC Contact: Peter Retka
21663 Cedar Ave
C,oritracto r'' Address: City, Lakeville
..'; State: MN zp: 55044 Phone: 651-253-8211 Email: pretka@bulldogroofs.com
Lead Certificate ii NAT-F162654-1
License#: BC639635
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'documentsi that•you sub'niltWre.considered to be public information Portionsof
the Informationmay be classified as•non public if yojr provide specific reasons•that would permit*City;to.
conclude that they are trade secrets: ' • '
CALL BEFORE YOU DIG. Call Gopher State One Call at(651)4544002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locales of underground utilities. www.noaherstsjteonecall.oro
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.
x Peter Retka
Applicant's Printed Name Applicant's Signature
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