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3614 Denmark Ave 11/29/2016 1 : 18PM FAX 9529858836 Bulldog 110001/0003 Use BLUE or BLACK Ink For Office Use * City Of —tan Permit Fee: 9-7 ` 0 0 3830 Pilot Knob Road Eagan MN 55122 Date Received: Phone:(651)675-5675 Fax:(651)675-5694 Staff: J 2016 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 11/29/16 Site Address: 3610, 3612, 3614, 3616 Denmark Ave unit#: Crossroads Partnership 651-454-3352 • Name: Phone: ResiientJ, 1500 McAndrews Rd W. Ste. 100, Burnsville, MN 55337 • er is Address/City/Zip: • Applicant is: Owner X Contractor Remove & replaced asphalt shingles Description of work: p p 9 Type;'or'work Construction Cost: $15,000.00 Multi-Family Building:(Yes /No ) ° Bulldog Contractors, LLC Peter Retka • • Company: Contact: ;`..;• ,•. `;.`4,.r 21663 Cedar Ave Lakeville Address: :contractor+ ;< City: - State MN Zip: 55044 Phone 651-253-8211 Email: pretka©bulldogroofs.com BC639635 NAT-F162654-1 ' ' License#. Lead Certificate#: 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: Ucensed Plumber: Phone: Mechanical Contractor. Phone: Sewer&Water Contractor: Phone: Fire Suppression Contractor: Phone: 'NOTE:Plans and supporting documents:that you;submit;are considered to•be public,information: Pgrtions.of•' the Information may he 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.aoohorstaleonecall.orq I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with the ordinances end 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 x . Applicant's Printed Name Applica s Signature Page 1 of 3