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P - 47265cUi i-t i-io I�:�+a Built�ing Insp�ct2oris ?63-572-3604 763-SU2-49?7 FAX From: HomeSure Page: 4/5 Date: i1/t8/2011 1:27:00 PM nuiiicaui�C tc� +� lroa! aUC-�+yru r�+1a �U��.,��(ir Permit No.:�-(�� (�� RESI��N'Y'I,�� A.�'PLICATY+DN DATG��,�J_J J 51TE AFD(tESS rI �� I �.I�LS �' TFtlS ArPLtCANT IS; O qWN€R PEtOPER'TY �WNER/ NAivt�: (� T�NANT . ��.,.,,,,,_ �, � SUBMIT A COPY OF gTATE ir c�rrs� ir: YflUR $TAT'E LiC�N$� ` AND C�I�T1F"lCATE OC ADDRESS;,�. iNSIJRANCE p,:�,,,�rr�� . �. �Y7'�' ��' FRI�]�� crtiuE i,i.�n� � �MA1L ADDRCSS P� �► ��c�.� �AMi�,Yn��w ca�asTRUCrION stz O TtVp FAMI4Y�Ew CONSTRUCTION ST( E CI ADD1TiCiN � GARf�GEJSEIED 013ASEM6NTFINISFI G3t00f O dGCK 0 SILiING � SWlMMING POOL K: � NEW 4tOME CCINSTRUCTION 0 ADDITICIN 0 MAINT�NANCE�REPAIR 0 REMODELING D�SCRIDL� WI]RI� �E1NG rtooFi►vr NUMDGR OF SQUAItGS � pttOPQ;;�D $IE�; PRQ('OSED I•IEtGHT: SlffiNC 17 Vinyl'. � Aluntinum 'I� Other WIN.OdW� /" INL•"?CIST[NG4P�NINGS 47'�ow pNo OR FOR NEW �PEi�31NC��.DE$CRIDC S1ZE OF OPENING CFTANGES Rc ,� r:�+�+� 'C'OTAL JCIg VANrUrl7'ION 1'lan Rcvicw Fi�c Surcharse Surchar�c I,iccnsc Surchargc SAC Char�c �urb Cul E,kCrow f7N ❑ liOU56 ONLY C] 1 [OUSG & GAEtACE Q ATTACI•1�p GARAG� O f�ETACkiED GARAGE osotr� 0 7rim ct r��„ 1.(�CATlp1r' OF WtNAOWS CER7' NU rl•1� X�97 U,13.� f'�C SC1�I�DULE) Cl Di�CA1N TILE D' qTFt�it ��v�a BY: � t�AtiEM -N7 R�MOD : 1N S J�M[T: I. Exiating Flaor n1c�n 2 �na�ro�ecl floor �lun 3. Liht nl'KtructuCUl meml�nt ta b� utiCr1 F�R N�W G�NS'fEtUCfION INCLUDING'DECICS, A.D,DLTLqNS��Pd:RCHES 5U�MIT: l, Sile Plt�t�Sutvcy nitnwing thc c�inting xtnicturcx ;itid' pro�sased riroj¢�t, 2, Twa �elx oFoanxtruction hluns 3, Escr�tyCtitculmiunx FOR WjNDOWS — PROVIDG U•VALUG ANd MANUFACTURE ST[f:KL'•R UN W1NI]�W.. MA OCCUPANCY TYE'E Scc B�ck Pa�c for Fec Schcdulc 65% of Builc�ing P�rtn�t �ec .001 tim�s thc tat�{ job vt�Iu��tion .Op05 x Pcrmit Vnlua�ion Minim��m �5.00 �S,pO (St�tc Licenscd Rc�identinl Catitraetors} �2230 per Sr�1C Unit (Plans to MWCC for dc�crmim�tion) i't + G Ct = ft x�25= S Erasion Contral $ �450 Conrcrvation �'lan Rcvicw Park FcC S Fcc Dctcrn�incd by Enginccring Scwcr M:�in Chnr�c S AgrCtntcMl n�cciti3ty () Nvn Nccesa;ary {) Total Duc $(��,�^ Mukc ch��ckx � Ablc to; Citv of �ridl��v Att�cl� �ti ulat�ons TFIIS 1S AN APPLiCATiON FOR A PEttM1T•NU'1' VALID UN7[L �RCIC�s��D [ hcrcby lpply for a bui[ding pcnnit and I acki�owled�c that tlic iEtfortnutian Abavc is co�nplctc tincl acouralc; lhat �hc work wi11 bc in �Qn1Qrm�nce wit� tl�c ardinanccs a»d codc� of thc Gity of i�ridlcy nnd with the Minnesut�� Cc�nStruct;Un Code�; th�t I undcr�u�nd this is not a �crmit but only an a�plicatiat� t'or � per�nit and work is not to stnrt withoui n permit on si�c; th�� thc w�rk will bc in accord�ncc with tho upnrovcd plun in thc cu�e of atl rk w'ch re uires review nnd approvnl uf p�►ns. SIGNATUR� pF APALICANT _,,l�� f�RINT NAME��j _„ DA7E_U,�,�.�' � I ennnn�fer n.�anrnmnn e�nwr,�m�ir�