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P - 48440�.�a� �di�� $�J�I.�����G ����,a� ��.: °e:V ,� � � � Inspections � RESIDENTIAL APPLICATION Received By: 763-572-36t34 r��� c��� c�F �i�I�I��Y >��-�t��-=���� ��� : �� EF3�'EC"i 5��: 3-i-2D31 DAiE_ � i„_{,� "f.�� _ _ �,� �--��� 1_____ _ � ()1_;R E-%tAiL ALiL)RESi J� � �l�sh J-- c�_'" - _ -- -g-�-�- ��?�1r?-C?1_L�_ �-e_�-r�r� _- _ -- -- StTEADDRESS ���q_���`__�(�_ {� � Tiai;� .�.rr�i.}L'ri��'T IS: �r(3b`v'��ac �Ci'�ati7`��°ii�� PROPERTY OWKER/ �anrtF: 1, �Gti.YI �_ k.X� r� ___ _ C`Y��i- �,? y�c.�,�'c>v1 __ �--- OGL v„ TENANT n���r:ss:�cU ��`�`l (p�j`�_j�c.��2 � —cr� �����.�t �s-�AT��zQP 55_���. ������ - CONTRACTOR NAMG: Slinil�ifT r1 COPY OF _ _ __ _ __ _ Y�Uit S I�AT�. LQCEiV1.�'iE S"1'.17'E LIC�;i'dSF i! LE.�iD {'�gi7' NU",►9l3N.12 l#'�;T?{"�:�:Tl���'�1�,3;(3F ,�I�1�R�SS: C9'9°Y S�'.��'� Zi�' _ _ _ __ _ __ _ ___ _ _ __ _ -- — ,_ 1NSUKANCE pHONE FAX PR�PERTY TYPF. �Sf'``f'jI.F. FA'vIII.YINF.�'V CONSTRUCTTON Si7.F•. J�(jQ JrC/ �'f. C7 TW� �A7b9l�Y./4�dE�N ('ONS�'RtJC'd'ION S7'O�I�S � PERM�'�' "1'XPE ❑ A��e��or� ❑ Gr��n���sgl�n ur►�aus u I3�.5�.a��;�w i �'�����i � ����r �i v�i� �iL� � � � DECK ❑ S[DING ❑ OTHER n c�rrMMI?�IG PG�L TYPE �F WORK: ❑�F.w r�oni� co�rsT�[�i'r�or� ��.��rT�orr o n�nnvaExn�c��nra �€zi.�c�D�Lrrrc DESCRIBE WORK B�ING DONG: (,. f.'� r� . •� W �� Y�-�,�) r�U.i `� I�; S�; E i�� i'viPRO�'E[�iF.;vT LENGTt� ,a J f• �.`�: y }tE[Gf3T �: ��t'-�' . S F1' ROOFING ❑1--1 HOr�USE OoNLYr� BASEMENT REIvIODELIAIG SUBMIT: ; T�7T 171���g (�F ��i i��s .. L3 iixJ�.d�� ii' {3!�iti��i�� �. �i1�9�1'�' 'Tix9lY1� �i31i �UARAUF.S ❑ ATTACHED GARAGE 2. Proposed Floor plan � PRnPOSF.n S17.F. ❑ DF.TACHF.D C'iAiZAC'rE 3 I,ist of structural members To he used IPR(1POSED HEIGHT: ������ FOR NEW CONSTRUCTION [NCL[IDING BECKS, r'aia �3Tn'a✓�� a �i�n�_nr�i :5�.'�niv3ii: 1 ����y� �����; 1 Site P1anlSurve showin Che existin structures ❑ Aluminum ❑ Trim � � � g n i?t!:er n F�,c;a and proposed project. 2. (�iw scG ot �Ui�siiuciioii plans I WiNDOWS 3. EnergyCalculations IdVF.X1ST�1VC:d7�PFN1Ni:S �IYYC �7�In I,[�(('ATI()3�T�FS�V�Nd)i�04;S � ` � �f)92W�MTN)WC—�PR(i1VA�F'!I-VAA.IIF.ANI� �L)R F()R *.I'W OPENINGS-DFSCKPBE SIZE i"�F __ �.�`�" � i G_�Y'r� L1JW�c� �i � ia3Ai�3L�1 r�,C'"i'L3RE S3'�� �� �C9i*! iV4ND0�1. � OPF,NINU CHANGES & i F'i �. i,t' nt;yvv?ti i�i iJC r�yjif�i�i.Lii i'yi'ivlLSGtc ili' vrllSViit'Fj � � ALL FEES ARE BASEll Oti 1�ALUA'�"10N, iiVC1,i1D1iVG TH� COST fl� LA�ti1Z A�iD MAiER1ALS: Atc4�,Ir,' �'�,r� aoo� ['.�3 � ��3� S�'�!�l3L"!L,�, TflTAL JOB VALUATION $� �(��(^' � C� (� OCCUPANCY TYPE i nP.^.::i: F� IPlan Review Fir� Sur�!±arn� Surcharge T.i�PncP CLS�h?rae � SAC Cha1'ge � C'»r� Ct'i Fzcrnw Erosion Controi Park Fee Sewer Main Charge Totai Due e �� �'> !C } �:�_., � a1 � R -$ — — $ c�P rzac!: Pu P f � FyP c��.��u�� 65°io of Building Perrrait Fee .(ld'11 4qaqaac f4�� ��?fi.�9.in'��le, ���9�a�4arpro .Ofl05 x Permit Valuation Minimum $S.Ot� S:S,Q(1 (.CtatP i.icgncP�i RgciriPntial Cnntractprcl $223fl per SAC �nit �Piar�s to 91�`�J�C for deterrninatior�� f3�-�?$= t}x?��5=$ - ._ ____ $4�0 Conservatian Plan i2eview Fee Determined bv F.neineerin� A;r�ar��nt necessary {v ) d�lor� iv�ecessa�y ( ) Ma�C�e c�ecl� �ay��bte t�. �its �1' Fr�d�ey A1�xch THIS IS AN APPLICATION FOR A PER[vilT-NOT VAL[D UNTIL PR(X;ESSED T F�P�elv�i .�.�?l�r f�r � 1.?:!'.�U�:!7�* �P:7I?!t 2►'.i� �.3C�:!1^:yl�rinP that th� �rf�rrr�af!^!? 23'.^..'� !S C.^,mnlPtP ^u.^.f� .�,C�.,r34s.� fl�wt t�li Zi�rJf�: ,:':�� �.S° in .y.v�v conformance with the or ' �ces and cades of the C;�ty af Fridley and with the �vl9n�►eso�a Cons�ructson Codes, that 1 urederst�asi this is not a n�rmit haat [troly an a,- lr�at c�a� ��r � a�e �. _nri w�a�k as n�t daa et�!? wifiht�9si �'sY c�rt� si�e; tMa4 Y_,he w���C wil9 he a�t a����t�aa��e wdfih the approved pian in the cas ai woric e�h C uires review and ap�rova! of p lti`� `I . SIGNA"►"[JRE OF APPI.iCt1I�L,T ,�-e-.% P�tINT NAM �d t'Ji'I ��X7w DA.d.E 7�% �( Hrf�I�lj'V HL iiYJCL\. f t n� JfiyYYH I�VYIli , PLEASE NOTE: SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, ELECTRICAL AND MECHAMCAL WORK ;, - " 1 __..__-,, w __ y � ° . ; -i 4' i I _ 'f if _ _ __ __„� � . ,__�...m._._- - _ -__ 1� �� � -=I1 � � f { V _ � +�'�,�'�" /� .. .... �-�„ ._..._.. . ._. _.._. �- � ,� \ ....__.._ _ .. . _. .. �.,_. __ .- �, 1 N�� ,. �.. � � 1 L; ' �'--����� �, � � � � � _9 �- �: \ � : �> � " - �-' , � �' ` _ ' � . -� /� 1 '..� --.. 6" � i I _ �_� I i i -s� � � '��� _ ;". __. 1 � N I � `}�\ � ! � \ . _. � _� �_. � . .e O� �`J N � 9 � `_ �