P - 39346From: 7637555390 Page: 2/2 Date: 9/7/2011 8:47:41 AM
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Building
Inspections
?63-572-360�4
?63-50 -4977 FAX
DATB
sTt'� ADD 39
T'F1IS APPLICANT IS:
PRt1p�RTY QWNERJ
',l'�NA1�TT
GONTRACTOR
SUSMiT A C,OPY QF
YOUR STATH LIC�riT3B
ANb CBRTIFICA'i'� OF
II�sUt�n.t�c$
DESC�Ha wOxK BEII+7p
BLTIL�II��
RE�IDEN�"IAL AF�I.ICAT�(�1wT
CITY �3�'+ �'RIDL��Y
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❑ dWNER �CON7RACTOR
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SINaLE FAMILYlNEW C�1�TSTRUCTIQN
� TVYO FAMILY?�W fONSTRUCTI4N
❑ BA9EM�:NT FAiISH
0 DECK
CI NRW HOME CON3'��UC'
G1 MA�ITENANCF./!!�1'AIIt
� OP 6QUARES„�_
S�ABt�F�
PROPOS�1] 51Z6:
PTiD��BD HEIUHT:
O Vinyl
�! piwni[nm�
a act�
wtnrnnwa
IIV EJC1�'illhid OPBNIN(iS ClYes �io
C1R FOR NSW OPENlN(i5•DE9CRIDS BIZE 4F
OpEN¢�p cHax�bS d�
TOTAL
Plan Re�view
Fire Surchmu'ga
s,�G�B�
Liccnsa $woheuge
$AC Char�t
G"�rb Cut Eeerow
Eroaion. Control
Park Fee
$ewer Main C�ar�e
I hettiby apply far s
canfolmanca witih tha
parrnit but oniy an e�
approved �aa�s in !he c
BzCrNAT[J4i,E OP APPLIC,
9lDI1VG
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I.�AD CERT NL:
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WINDOWS
❑ a�►nv x�.a
❑ OTHER
0 ADD£f14'N
❑ R�MUpBLIN4 "!
E,HOU�$ o1+LY �,�t�t�►1�[!
�iPU9B & aARAdE"�
o arrac.xen Qnx�afi
O DBTACFIED dARK4�
❑SOtilt
❑ '�'r!m
❑ Paecia
LOCATfON OF WIIVDOW9
�s� vN vA�.vr��ton�� nv�cLUnnvc �� casT o�
(UBII�G THE 1997 U.B.0 FEE SCHEDUL�)
f
Permit N',
�����a
�
�
0
8A3BM�ir �MOE7B��1a SUBM(T:
l. Eni �ticQ P1oor Plm
2. Propoeed fleor plan
3, Liet of atructu�sl membere bv be uamt
F�7R NEW CON9TAUCClON INCLL►b1N6 DECH9,
BnnrTTON P�RC�4 rwMIT•
i, SiM Plmn/Sutvey showing the exl�tin�, atructsuee
and pt+oyoaod Frojeot,
2. Two eete of caw,tn,etloe piano
3, F-nerg�+C.sicwlet{onr
FOa wm1�C�W3—PRUVin$ U•VA1,UE AND
MJWUPACTURE 67IC7tER ON WiNDC7W.
$ �?, �: > See Back Palge for Pee S chedule
$ 65S/o of Building Permit Fee
$ '? ' .OQ1 tima� th� =ate1 job v81u&tion
�_
- .000s x P�►t vs�uac�� ��mu� ss.oa
$ S�C: � �5.00 (State I�iaartsod Reaidvnrisl Contraotor�)
� $2z30 �er SAC Unit {P[ans to MWCC for determination)
$ �f! -� 6 fl ¢ ft x $�5= $ _�_
$ $450 Conservation Plan Review
$ Fee Docerminad by Engineeting
� Agrerment n�ooasary ( ) Non 1�ecos�ary ( )
THI9 I APPLICATID�T x4R h PBRMjT-TTOi` VAI.ID VNTIL PROCE9198b
a�nit snd clmaw that the informaticra above ie completa az�d a�eurate; that the wark wlll be in
and ade he Fzidley and with the Mintiesota Gandtrtictian Codce; that I understand thi� ia nat a
r a. '�ty w r s not to �tark wlthaut� arm�itQp� "; that the woq`�v��be 'n ao denco with th�
p�l� ich r q and a oval of pl�� •� j� )_�—�� A r�
�Yt F�ild� 1�,. '" ATE