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THI$ iS AN APPi„ICATlpN �C►R A P'F.RMl7.NOT VALII) UNR1L PRQC�3SP,1] �
f heroby apply for a buiEding p�mit and 1' acknowlodgc thnt thc inforntndon abo�e Is complete �d accurotp; that the w+ork wili be in
+�nfarmano° �+'ith did w�di�anc�s snd cadas oFtho City of Rridloy and with t�o Minnosota C�nstit�ctivn Codos; q�at T undqt'stand thia i�
nat u ponnIt but only sn applit�tion fqr � ppTriit qnd work i� npt ro squt withauC a permit; that the work will bo in pocoMance with the
opproved plan in tt�e ca�o of�l] work which ropu�ros roview and approvel oPpians.
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" City of �rfdl�y
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f'431 LTnivcrsity Avenu� NE� �'ridtey� MN SS4�2
76�-572-36�4 FAX:76�-502�977
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