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P - 603501HML151715 Builtiing �T1S��C�I'E}i1S 7C3-5'T2-360!4 76�-Sti2-�97'7 �'A� � M � � . . � N . � ! ' / ►„ Ad/ .. -. : DATE OA10912012 YC'>UR: E-M,0.TL ADDR�SS � ��ppg�r� 6391 DELLWOODDR. FRIDLEY,MN,55432 THIS APi'LICANT iS; Ct OWNEIt x iGON"fRACTOR ��"��x NAME: DARRELREDEPENNING 4�� p,}�p�s; 6391 DELLWOOD DR. ��y FRIDLEY STATE MN LTP 'CENAIYi" 55432 p�p��: 763-571-8623 � ��ay � �`�^ � �� NAI�: LINNSTAR TRANSFER SLJBMTT A C{)PY C7F 'Y(3iJ12 STA'l'E STA7"� LtCENS� t# 063901-PM �p �� LiCENSE, $i�ND ANT3 STA"CE Hf3NU' # � E�tP T?A'CE CER`iI�iCAfiE f}F ADI7RESS� 9995 W 69TH ST ��y VINTON STATE IA ZtP 1NSC;►RAN�� 55432 p�q� 651-6337621 �A� PERMIT TYPE "1'Yi'E OF WQRK: X 1 StNG1:E FAMTLY` ■ C! TWC} F�IMILY El Tt}'W�TFIOt15� X REl�LACEM�N1' DETAIL�D �ESCRIPTtC7N CtF WC)RK REPLACE DISHWASHER ��FS ,a� �ns�n crx � to.r,o rs� ��.r��, �xc�wr �� rrc��n. ��s.so: �n�t s�,.�v ��z.�o�t nrtar�vs ' �an�rtrruH � �ns rrnnasc {r�� cx�r �.�c� cz��s w�s� �z�rc� szrt�c 1 D1SEiWASITEER � LAUNDKY 1'EtAY �tt�cruurc�s. ttr�nr�nz`� �ca-r�. rru�� c�� nc�t a�t,ow�. �tn��n� � s�ow�rt — s^�rtt+ans�� rcux� � WATEIt CLOSE? �WA'T'EFL F{EA'fER ($3Sj � WA'['�R M�1'ER' `tiTIS [S AN AFPL€CATlQ23' FdR A P�R14fi1'-f70T VAi..iti t1NR'IL PTCC'yC�SS�D I hcreby apply for a plumbing p�rmit a canformance with the ardinances -a�� nc�t a permft bnt only an �pplicatian foi with the approve� ptan in the case of al! , _ w,�� t�rtr�c war�rt sa�nv�� {sas� , �ACKFL(?W i'RF.Y; (StSj FOtt tRRIG�"['tON O'TITER. ,e th�# the i�fortnsiit�rt abov� is cnmplete and aceuraie; that the work witl be in Qf Fridl�p and wzth the M�nnesata Gor�struction �odes, thai I und�rstarad tbis is �ar3� is r�ot ta start witfiQUt a permiYan site, that the work will be in accordan�e t� v��d appr�rval crf:plans. ' P�'INT NAivb��CHARLES GABRELCIK pp� 4-09-12 � �ATE -� = _ — — �City af Fri�dley �uilding Inspecti�n� De�artmeat ��31 Univecsity Avenu� NE, Fridley, MN SS�i32 763-572-36U4 FAX: 763-542-4977 40.00