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P - 48273MOV-21-2011 08:3@ �L�llktlll�' Insp�ctions 763-�'72-�604 7b3-�02-4977 FAX srrfi n��ss � THI3 A�f+I,1CANT I�; `I'ENANT StlglbhT A CdPY OF �rov�,srAT$ �c�s� AND �RTIPICAT� OP n�scRf�� woax �xo AM STANDARD WATER CONTROL �63 537 1882 P.02 131.11L�.iIN(;r Fermit No.;��1'�� �t'a� �Sil)�+ NTIAL .APP�ICA�I�N Rece.ived B�: C��.'Y OF F '�DLEY �ate Rec'd: , r�F�crrv� 1 t-zoi � ryr�m RI � � YOLTIt B-INAII. A�DRESS �•`•• .• _�—'� r �l�' � � �4Id73ZACTOR ADDRES3; - �.`_CiTY STATi_. Z1P PHOht�• . - S7'ATE LICF.N'S� &INGGE FAMII.Y/N�W CONSTRU 7 1'WO FAHqI.YlN13W CON5'1'ttiTCTION HAS�N"T FIId[3H � �(�pg �K 0 5YDIIVp 1�W HQME CClN3TRUCTION N�aF sQva�s �,,,` PR� SIZE: PROP0��3D F�I(i��T'T': ,�� �� J AlundlfiiRrl � O�t6er ...�„�_ Ci HOU'SB ONLY ❑ HOUSE & GqRAGE � ATTACF�1 Cr,qRA(3E � �3FTACHffi 4ARACrB A17Dri'IO�V �� ��IN TII.E OSpf�it EaDII1TG/Sd�T/jt�p O Trim �EMOVED? G YES p NO O FeociA uv �87TNQ OP�VINQS DYoa L7No LOCATtON OF'a'�1LX)WS OR FQi� iVI3W OP�Ml+TCt3•DESCWBE SYZE 4F �PFsNII!�Ci CFIANG$S Bt A� a�sEn oN vALUm I'1nn R�view Fire S�[YCharge S�� Licet� Surc,t�arge SAC CEimege C�b Ctit P.scrow Froaio� Control Psrk FI� Sewer IVEsin Chatge � 1997 U.B.0 FEE SCHEDUL�) 1, ExietingF[ootPlan 2. Propoecd Aoor plan 3, L11�t of str�ctureE membots to t�e nsed FOR 1�8W GONS'fRUCTION TNCLIJDiN'G DECI�B, 'A�I�ir S- � 1Pt7�r.�±�c rtr �a�•.•., 1. 3ite Ptq�Seuvey' ahe`�'a�8 tbe exi`ting shvctw+os aad pnaposed p,pjcct 2. Twa sets of c�U� py� FOR WINDOW�S — PR �VIDB U•VAY.L7� AND MMJ�►►Nt7FAGTUI2� STICKER (�1 WINDpW, � �e t�ec1� Psge for Fee Scheduie 6996 oFBuilding Pe�rnit Fee .001 timos the tot�l job valustion .OQOS x Penmit Velusiian Minimum 55,� �5.00 (State Licx�nsed Resideatial Cantractors) 52230 per SpC Unit (I�lans to 1VlWCC fbr deberminat;on) R+ 6 ft= __ it x S25= � 5450 Conservation plen g�r,iew � F'ea Determined by Engineeri�g Agreement nec��sary { ) Non Neces�sry ( ) �r_..._ . . 7iIIS LS AN APPLICAriON FOR A l��,M1T•1�'C)T VALID tJNfIL PR�C1CLiS� -----�_ --_.._ 1���` aRp�Y for a build�ng permit end I acknowledge t�at the info�� above is completa snd accurate� th�t tF,� work wilt be in conforltiance with the ordinanc�s and codes af the Clty of Fridlcy and r�virh the Minne�ota Canstruccion Cades; that I understand this ia not n permit but only an epplicatian for s permit and work 's not to st�rt without a perinit on six; ttrat the tv�rk will be in accor� e with the �PPm�A plan in the c;a�e af all r+y/�1S��h r�'� �iew �nd�iroval9f �:1.� / �► _ !/ _ . , / / 3I(iNA'1`ERtE 0'P APFLICANT `•�i/ i NO�-21-2011 08:51 AM STANLARD WATER CONTROL 7�3 53T 18$2 S�"�1NDA►Rt� V�'AT�R CQNT��L �1�5'F��AS, �N�. �33%' Leloelsnd Av�nw North e578 erra�on Blvd, A1 www.etandudwdK.corrl CI'yS�ll� MN 554�'8 Cllw, IA 60�i , Fax C789) 537-1882 %�� �� � � iwRNBV��e er.cROUC f10�:S1.IQ�Y Q161) �fb/�if (C� tli�Fi107 �9DJ 9�(l796 �y�m 7� 80 III�IYd R01' Af11010� � Nr►w CTf� 1� Ii6 �� �Op�R7E�� � _ i�) �lo �� �b �� � naon�� � �� �.,�, ,�r,�r� — � + ` � - r - ����� wrw��-,.�. � � � � Noin� lMwne ( �..� _��� ..,_ Hortw Pho�b ! �,�_} �.�,_� Walt Pl�n+e („'.L�} ,,•, Wbrk Phorr ( �'�f ) �, — � Z �A�fd Nhe� {?tlaMol ��r�, 61e. � 1YnY�h•MII Illbar a�d nMNMU� far ro� M �p�ollhd N ieebl�fil��a rMql q�hq YNp� � �I�b h� Y �prellhd:�n4a01MIM1U1tlin �wollop� n�r�,. . . . . , . 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