3626 Denmark Ave 11/29/2016 1 :20PM FAX 9529858836 Bulldog lj0001/0003
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3830 Pilot Knob Road
Eagan MN 65122 Date Received:
Phone:(651)676-5675
Fax:(651)675-5694 Staff:
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2016 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 11/29/16 Site Address: 3620, 3622, 3624, 3626 Denmark Ave Unit#:
Name: Phone.Crossroads Partnership . 651-454-3352
,: �'�..i '•:,i-;:`..;:;;;^:`r.:c•,
esiden ..,.•'•• 1500 McAndrews Rd W. Ste. 100, Burnsville, MN .55337
OWnei ';• Address/City i Zip:
Applicant is: Owner X Contractor
description of work Remove & replaced asphalt shingles
.•,Type'�of�Work'''
Construction Cost $15,000.00 Multi-Family Building:(Yes X /No )
company: Bulldog Contractors, LLC Peter Retka
Contact:
Address' 21663 Cedar Ave city:
' Lakeville
C,ontractor:',';
State: MN Zip; 55044 Phone 651-253-8211 Email: pretka@bulidogroofs.corn
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:subniit are considered to be:public information: •P.ortions of.,•;
the information may,be classed 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,00pherstateonecall.orq
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 Appli ants Signatu
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