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P - 48271� � ,�" � � c� -� :S" � � M �A O � v i � � � '� � � � � � � 4 W ' � � � t� � `� � T 1.L. From: 7634349348 � � � •a -.,t' �+�J c� � � � � � � c�* :,? 4 � .C�.. � S � y �' -!/, � � 9 y , .,_.._...__._ _ .. ._: � � Yy ^ 6 - ,`� r .._ � —: J � 9 � `i � i.' t *�7 E : -. - - - � i � .. :.:'� `� ; F �_�� i.a � ,� . r_`' i.a.! � � G-t z� ;c- _s .- : t-- 6 c'�r � ; =.� ". ��..' I � _. ..- I �sJ � ' �-i � i..._........._ .. .. . . _ Page: 2!3 � � ��g� �.e �-. `'f` �� �� ��� s Date: 10/19l2011 2:01:06 PM � �'�_ C ( 3� a1 v� Z 'tt �L �. 8 �p .�� !"� � � � _� a ca., O � � � � �� G� �� � �� ___a..._______ � � 1 ,.-��;�c�.�x � �s� �i � " i�4L � �~ � � ,� a� �-j tl� CL�-'7=� C_> � 3-" � C.� �� FJ s�._' d� ...d�ta. '' .... �y i ch :'~° r-- � � � � �:Qt/>,� �" �_._ __.__ __�....•.-� � � � � V �l C� X s� ..,... �� '�'' � � From:7634349348 Page:3/3 �Q ��F��+ � ---.— r � Date: 10l19l2011 2:01:06 PM �� �: � � � 7 � � � � / � � � � � � � "� � � A � � � E� L: Building Inspections 763-572-3604 763-502-4�77 FA� DATE �G"- � `t "� 1 F si� a��nr�ss �� Tli1S 9PPL}CANT 1S: T�NANT SUBME�' A E4PY ()F YQUR STATE I�ICENSE AAiDi CERTIFiCA't'� OF 1NSUI2Ai�CE TYPE D�E5!GEtiBE WCC�LK BEINC, BUILDING RESIDENTIAL APPLICATICIN CITY UF FRIDLEY EFFECTIVE 1•]-2011 Y(�UR E-MlUL ADDRFSS =r'1aQ � ❑ owrt� �S[cc r���: ��n_�,. Pc�' �aeESS:��2 pxc�.-�; "7F�3 - ���► �. Nr�J+�s: ' S7'A'CE LfCENSE �� ' Ai'1DRFS.i� �7�^ ��A FAM[L' D BASEIvIENT FCNISH iP D6�ClC HOME N[3�C F 34UARES �� ��� PROPOSED S1ZE: FROPQSBD i�iEl�FfF: SmL1►iC �vinyl ❑ Aiuminum ❑� O RV� EX�IS'T�N(3OPEl�EE[MG5 ❑Yes Wtita OR Fd[2 NEW �PF.,t�l1NGS-U�SCRL�3E SIZE 17F OP�f'.+IG C}iANGES dt P'lan R.e�iew Fire Sw�h�ge Sur�'ge License S�urchafge. SAC Charge Cl;il� CIII '�9G�U1iiV �il'OSI011 t:OUf[fll F� Fee Sew�r Main: Cl�ge CdNSTRUGTIC}N ❑ ADDITIOItf ❑ [tEMU�itNG , ,. r., r�_ C] HUf3SE fJ;*iLY '� H16�f/IMt�"sAR�GE CJ A'i`TA�CHED Gf�R`A{iE 0 DETA�HBD C3ARAC�"i �C D�lt ❑ Tr'sm � Fasc�a LOCATI03*i't3F W1N1?C71�5 ❑' ORAtN 1"ILE ❑ f7t'Hdt VAI.UATION,INCLUDIIVG TH� Lt��l' U#�' �(U3Sll�{C THE 1997 U.B.0 FEE SCHEDULE� r � nrrrrm Permit No. � � Received By: n���� ` ������T ��nn���r n�rr c•t tn�,crT• I. E�cist�g F�c�Cr }*lan � �opasbil 9oor pl�u 3, List c*f s�naau� mvasbers ta be �ed FOR tJEW GO�TS'i'ttUGTIUN tNGI.UDII� i�GKS, �,�ITIOTF^ 8e AQRCHES 4I�B�irIIT: i, Sita Pl�alSurvey Siwcving, t4e acistie� �s �nd PrW�snd pt�►.i� 2. Tw�_ssts s!f co�cru� pk�ms 3, Sne►�g� CaIcul� FOi� WIN�7ti�Y5—PROYIT}E U-�ALUBANI)1 MAiVLi�ACTtiRES11C1C�RC?N WINAUW. See Back Fage for F� Scheduie b�%o Qf Buildi�g Parmft F'e�e .4Q1 titrtes th� tot�ti jub vaivatien .00QS x Perm�t Valtrdkion Minimum $S.4iT $S.W 4State Licensed Residential Ccui�aetors) �223(i per SAC Unit (Atans to MWCCf far deGermination) t{ � {�' � 3.. � .�F �J��� W $�%$Q �OBSCt'Y8�10T! P18I1 �iCVICW �C� �EE8Y1111CIPXi �3y �.tt1�Yl:1$ Agreement �tecessar}+ { } Aian l�ie.cessary ( ) T�#I5 i5 AN APPLICAT7QN �flR ,A PEIfMt7'-A�Qf i�,4i.�D UN1'iL PR4CESSfiD I hereby a}>ply for a L�uildus�permit and I acknawledge that ihe information ab�ave is comptete and a�cc�rate; that the work will be � copfc►rrtiance with the ardinances d c of the City o� F'ridley and with the Minnesc�ta Canstruction Codu�, tl�at i understand this is nat a p�mit �at only an appiicati or a . it d work is not to start withflut a g�rmit on $ite; that the wQrk wfll be in aecardance w€th ttie �pproved plan i� the case of 1 Qr uires review arul approval of plans. ` SIGTiATURE4FAAPL4CAN'C , PRLV'TI:AME�g� �:'�i� DATE I�3'" 1�"� � I 90:LO�Z 660Zl61./OL :aie0 £/4 :a6ed 8b£6b£�£9L :uio��