P - 36718Building
�nspectians
763-572-3604
763-SU2-4977 FA�
DATE
5TTE ADDRfi83 ,,,,�
T}iT5 APPLICANT 19:
TEI�ANT
sus�zrr A cvr� on
XOUR 3TATS LICGIV9E
ANb CfiRTTFICA'C�. bF
1NSURANCB
PiiOPERTY TYP�
PERMIT
From: 763 537 1882 Page: 1/2 Date: 4/15/2011 3:36:51 PM
BUILDl1�1(.� permit No,� j,�--0�" 4'7?7
RE�II)EN�'TAL AP�'LICAT"�(�N �tec�ived �y;
C�TY OF �`T�IDL�'+.,Y' Date �c�i'D A PR 8�
EFFECT9V'E 1-1•2011
YOUR �'-MAI.L ADDRESS
❑ b'V'JAlbR �CANTRACTQR
1vAM�I: �� � r� �x,. --
AbDR&SS� �[��s!L-0 — C1TY _ STATk�,�,,,,�Z1P
STA'�^E LICSNSE #.
� S1iVdLB FAMILY/NBW
G} TWp FAMrLY1NEW �C
C.� HAS�MENT FR116H ❑ ROO�
❑ n�cx o sinuva
T'Y"P� O� WORK: a�w Hox�s� crnvs�u�nox o,+��rrioN
O MAIIdTENANCE/R6PA1R pd�MODEI,ING
Y1�suCRIB& WQRK BE1TT0 DONE: � �
51Zfi OF II�ROV1?MENT -- _,,,,�� � LIIVGTH WiD'[1�C
Q HOUS� dNLY
NU� F 4QUAR�5 ❑!i0'USE 8t OARAGE
��
PROPOSEU B1ZH:
i'1tOPOSfiD HB�GHT:
.�itiyl
� Ahuninum
O Othor
iN�C3 OPENINCi3 qYp O1Vo
QS F0� NEW OFENfNG3-DESCTtTBE SIZB OF
OPHNfNG CHANQE3 .�
FEE5
'UTAL JOB VALU
Permit Fco
plen Review
Fire Surchsrge
SurclYerge
Licenae Surcharge
SAG Charge
Ctub Cttt Rscrow
�rosion Control
Park �ec
Sewer Main Chargc
�asEn oN
� AT7'ACHED GARAG�
❑ b�TACFIED C3.4RAGE
CRRT
1�DRATN TIL'�
C] QTF�EI
� :l fN L / r
���
1. Exas�ing Floor Plen
2. Proposed flaoz plan
3, Liet of sMtetufa! mombera ta be uecd
POR NEW CbN'STRUCTIQN 1NCii]DINO DECK3,
OSo�it ,�nl�ox5. & ro�r�s susMr�
O 1`rim 1, Site Plan/Sutvoy 8howing the exifting StCUCqtres
� ProPnaed Project.
� FBSCia 2. 'I�va 6ets of Ctmstivction pim6
s vc
3. �ncrgy Ceiculatioat
LOCATION OF R+INDO'9V9 FOR WINDO'1�V5 � PROVtDE U-VAL'fJE AND
MANU�'AC'TURE STIGKER ON WRVDOW,
rivr.��xx r�� �nows
SUATION, YNCLUDING 'I'rtYE CQ$T OF LAHdR AND MATERiAL$s
SING'TH� ]997 U.B.0 FE� 5CHEDULE)
Sec Back Page fpr Fca Sehodule
(�5% of Build'uig Permit Fes
.001 time� the total job valrzation
.00OS a Perm'tt Valuation Minimum $5.00
$5.00 (State iicensed Residtntial Gonuactors)
�2230 per SA.0 Unit (Plans w N9WCC for determination}
ft+6ft= Rx$25=$
$450 Conservarian Plan Review
Fee Determincd by �ngineering
Agreement neeesaary ( ) Non Neceseazy ( )
THIS IS AN APPLIC�TION FbR A PERMIT-NOT VAL1D UNT1L PR��ISSSD
I hereby appty for a building permit ar►d I aolrnn ledge tha�.-t � armation above is eamplete and accuratc; that the work will be in
conformancc �+vith the ordinances and eodes a ity o, nd wieh the Minnesota Canstruetion Codos; that 1 tuiderstand this is nat a
pormit but only an application for s �rk is � to s art withour a permit on site; that t4xe �+ork will be ,n aecord�ot with the
approved plan in tho css �re '� s. �����
9IGNATUTt� dF APPLI� ��/�M_� � � b<��i�ac�.'y�" ('�
11