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P - 35086i1:1X�d�;I'l.g �spections d��572�36U4 From: 7635742044 Page: 2/2 Date: 7/15/2011 10:44:07 AM T� * T�^r �CIiTiSt �b.;^�� � U �L�l.�l.]� �S�DEN''xl,t�.� .�.�'PI��C,A.'�'�Ul� R������a ����(� z�at� CI'�'�X ��' k'RT�?��'�' ---- q� -' l'$ ^ L( YOUR E•MAIL AAAJtESS , __-- -- rE nnn�ss ��� � c.�aR1' PQ- wE - -- i1S 14 PFLiCANT tS; 0 OL1filER I�pNTEtACTOR _._.. _.. �N,A,Ni' � ADDRE55: i�o�'7�. S�t_�„�¢- �3� — -- -G1TY PHQN�' "1(o�f�'"II d$�f$ _ �USM1T A �I'Y t3F IOtJR �TA'� �..tCE23S8 WI"i'ET APPLi�,A.TfON STATE W�&N5� ��Q�j,.,y!�bi'� FJ� DA7'B O"3 / 1 Z.. nzsz��:�ss�. :'.tp�, ,�.•.+� ly�g � crrY�ueu, t�a� __ �rn'r�.,� SS��'� ❑ "9A5Ei�N'!' Ffl�flSka �t dSCK ���.�� �a� $ `'�d SQt1,qRFS ,�,��,,, � ,, ci, .- �a,•s.� ► °r. 'a°saaa d � n ��,�r i i � .., '!an l�rievs► .�� :� :�e S�scfiiargc „�� Charge �ub Cut �scrow �i4�t Contro{ ro�rk P� ;a� Msin Charge � RaCSP � S[DIT1Q CS E{di15E 6G GAkAG� G ATTACHEIJ QARJ44E Ct 1)�'1'ACHki1? 6Nt�,A,Cr� I�Sot!'�t Gx Trim O Fa�x r3.15��� 81 ^ STORI � , bOWS � DRA�177LE C3 017iER N�TS 0�+4.Y 1 CdNo 1.Q�A'�'!pN 4F Wlf+ifl�OWS tiBB SC�E [►F 41 e� t, 2 o rr G�� ('LiSiNG "CH� �997 U.�.0 �E� SC�EDUI.�) I . Existi�g F�ot Plen �. Ptopased flbor �en $. �t df kdtttllitC0181EMlbN'810 b011pe� � �� FpR hTBW GONSiR11�17t�+1 AriG"LiJI%}NG L16C,'t'.S� r��CT1Ql�,T��_.PDRCt� SL�1�#1+ i. SiEe P1sniSu�+aY sho� it�R wti�tin$ st�res � p�� A�l� x. '�vo se� a[consau�ionpl�no 3. E:nmgyr C$tauleticros TER��LS: 6S% of �u�kii�g �'cxmit Fee A01 times t�€e total job valuation� ,Q005 x Par,tnit Vatua�ion Minita�w�n �.SO SS.00 (St�tc Liccnsed Residenti�l Gar�tractors) $1�75 }�er SAC Unit (Plaas t� M1��C ftrr dctcrtrtination) _�ft+6ft= �ix��l�� $A50 Conscrvati�n Plan ttevi�w Fee Deternaincd by �ngineering Agi��erncnt necess�ry { ) Ivon t�tecrs� { ? Makc checks oavab� ta: Cety af �'Mdl�y. _ A,tiac �. THi$ t� AN A2PLiGAT103V FOR A PERMfT-'f1CST VALtD UlJ'PL�. P�tE1G�S�E1? .7, ��� �PF�Y for a b�d� �it and 1 ac.�nowledga tbat the inf�rme�ia� abvva �a cornpleta and ar•curaEc; th�t dae vv�c wiIl be ir� a�a£oamance wit� dte ord'man� and cod�.s nf t�►c Cfty+ of �ridlcy and with thc Mic�neaota Constrticciop Codcs; th�t x undtrs�snd t�iR �s nat a sas�it but anly �rn apEslicatia� s pe�r►it and wark is nat to start withaut e pe�rnnit; th�nt the work wt11 be i� accordattce wtih the a�mvet! �» �n ttt� �a.se af all wot�t w�cb irms roviavw and approval cf ptans. ;e�aa� �► a�r r�aNr "�` PRtN'E' NAME �i+4 l�.�Z--r'� s� �,ar� �` i�' �� t !