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P - 48640From: 763389 5504 Page: 111 Date: 3/23l2012 2:'28:05 PM ��ilr�in� _ P�XTN.��3INIG Insp��ti4ns I�ES��DEI�T'lA� A�'F�YC,AT'�.�1'�T 763-572-36(}4 Cl't'Y OF �R�D�EY 763-502-4977 FAX F ��rr:x-►zvi:,-�-zarz I )ATfi,� •• � '�'� ...._ YUUlt 1:•MJ1u � At.li)ttC:titi _, __. .—. P�tlt1it Ft�c�ived F�3�: I ± Y"�_ F�atq�+#o�i:�.�. � �2 RL�• ._ _ _ _. , — .— ..:—. �—° — — 5r�'�� ni��a[_ti5 ,.�5"� ��.�.� --''�F .— �_ .—. .� �.._ .. —. . ___. —� �t'rt:l� �w���.ICnvC 1!�: O c�wNl:rt rj�:�c>N'rRnC'•PC)It awrrEr� TN.NANT 14tE3Mf'1' A (:t7k'Y f?t' YiyIJR ti'TA l'1? I.ICF:1''�151 1301VI) ANI) t:i•;RTli�iGA'i l�: []I= iNSUt�Ahf(:L� ��:RC47tT 'C"YE'F. TYP� t'?F V►+(l�Rll: NAMG __ AI)►)RF„Sti; , €:I'fY ._ S'CA't'li,_l.tl' ,_ ...._ PI lC?NI::.. ._._. �• — — .._— — . . _ _ R�,a� / � _�. ._ •- — -- NAn�� �n r �+�!.� . . w�.�1.:� • • — •—• -- �._ I",,+✓� ' ��rn'�•t. �it��:NS�i rt_. ����"- --- �. . � ...___ .—. -- i:xi> r�n r �. __.._ . _... •--., ...—.. �— S'TATI fitk1D11 1ilLI'�n17.._. , �.—... . -- --- •-- _ . . , . �� , ��� . c���rv ,�;r+rc��,c�:± . .� . ��'rr!'"�. r.irs s�. .tT]z>itl tiR: $i"3�.(p_ _!�.�.y"b'�!�� „ �,r�� i�f!{7N1._.��'r,����ji}�3� .. .. .._ ._ i�AX�(�.�_�. �.�'.+m'.3.. __ .____. --•— ��.�--- l��i{N(i1,Fi I�AMII,Y p Nt;W 13ET�ltLF� L7�St:tilPTlt)i*1 OF V4'ORFC ❑'t'Wn Tl�MIL.Y ��r:r�,n<�i;Mt;N'�' �i� . t� ❑ 'rc ��t'Nl �t atlri: N��#�!" ._— ---� —.. —. - r•r:I:S A��e�; 33h..�F:�� C)N 5��.�1f P[;K i�IXTl�lca,, t:Xt:1�P'C �wi n;tti3 �c�'flit>. ��I?Ci'UIt�:S: trr�ulC.A 1�r�.'I'CJTni. NUMHF�t Ut: �inCN lilslAW}, MI�IIMIiM Ff:ti S35.SC1. fiF 1()w l�.ii ._ WA l tiR P�7'f N£r 13/1'ff•i SINKPI./\1J ._l'I.t)()R I)RA[ti.ti — � Vvrt I lilt ,�tE)I�'INI:R tJ►�g) � tsA'I'li'1'U�3 _. tihti YIf�INCi (Ni;f>lS C:ITY l,lt:� _ tiW1MMtNt� M.XTt. WA'1 t;Ii t�l.f3wliT �_ HAL'ICt� I,(}VY Piti� V. (�t 3} .— C:LC}7'f II;S WASI•11:1i K I I'Ct ti'sN til MK �y�'I �.�� idi:ATl:I� (4�3i) l�i� II€KttiA't'iLN+I --l�lSIiW1�Si IE:Ft N. I.AUNtZKY TRhY � _ fj'1'! IEi[L . WA'17:R Nli: �'�?it Numbet' offtxtur�s (t� SlO.00 .�., x �ta.ao �- �.,^..� 1Vumber af fixtures �'u� $15A0 x $1S.Ott - $,..,, -- Number �f fxtttres (a3 �3S.ftU ,_„_ x �35.40 = S�� . �tate Surcharge 5�,2 M[I�i11MUM �40.Od Total =� $ � U'� 1'4115 i� AN ACI'I.IGA'i'tl)N FUtt A RLiEtMI'f•NC) I VAl.117 L1Nl7l. i'Ri)C l.Syf:iJ 1 l�crcl>y ar�lY for a plumbin� pc:cmtt anc� I acknow4cd�,e that thv inforrnation .►bovc, �s campletc sr,d accurfstc; that the wc►rk v++ill be in confarmanoc with the nrdio�u�u:s ttind cod� oitttie Ciry i,f Cridlcy anc� wi#h thc Mmncsotd Contitructic�n C,osics; thst 1 und�rstan� t#�is iy nac a�rrit but only an ap�1i t�n F'or •rmit and w�rk is nttit to �tart without � permit on :+ite: that thc wark: �vill h� in �ccardancc t,,,;tfr the approv,xl plan in the •� f I w r ich requirc� rcvic,-w and �pprt�v�o f�ians/} . rx�W1� Nn4i1;_ ��rs�.L_!�'i!x C � Dn �,;�� �'�'� ,� S1tiNh7'Ur�Idf?f A���t.IGA��P .,. —. .— '� .—. �DA1i: AY!'RCJVA1,iNtiPF:(,'{'t)1i.5:+1 . '1't:1tM, --- : __. �_�,......,� �.-.., n���� r�s�.it-: �� �CTRI['AL.ANCIMECHftiN��J�L W�RK City of Fridley �3uilt�in� ln��ections Dcp�wtm�ent C�431 i�}niv�rsity Av�nuc NF, Fridlcy, ivlN 5543? 763-s72-.3bv4 i,,4}�: 7fi�-502-4�77