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'�'HIS APNLICAN7 IS:
�'RO�'I�RTY UWNEIt/
T�PJAIYT
CONTRACTQR
SUBMIT A COPY OF
YOUR STATE LICENSE
WITH Al'PLICAT1dN
W PRbPERTY TYPE
F�',RMiT TY�?�
OF WO1tIL.:
�UI.L�]IN�
Permit No.
R�SIDENTIAL �,��'���.ATI�N ��G����a �y�
CIT� UF FRII�LEY Uat�%'�a:�
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ADDRESStw._...._.. ....�� _�iI�N� DI�L . C.i"1'Y ••� � _... .. STAT�'IY 55�4'JZ
PH�NE:�'LY _�.�_y��'.'..�'79 !
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NAMG:_•..T.I.I� VU ��I�i� ���Q�,I.....,!'C''� �..........
ST�1TC LICCNSE # �?CP DATE
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ADDRESS'--yy �......�,�I.I�r..�.i1 cST. CI1'Y I�(�lo L,FkKCi.S,aTAT�lP_SSQ�i-I�
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STZE UF iMPR(7VEMENT LENV7'H W1DTH_._. ._ HFIGHT Sa. Ft.
NUMBGR OT SQUAIt�S _
C8
i'EtUP�J3BD SIZB:
PROPl�9CU FIGi(7F�17': ._ ,__
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1� A'1"I'ftC:H �I.) tiAltA.tiE
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DASCMENT Rr.MC)DELlNC; SUHM['I:
1. Existing floar Plan
2. 1'n►put�ci fk�or plan
3. List oistructural metnbers lo br ��;�xi
� POR NLW CONSTR[iCTIQN iNCLUDINKi �yc:'K$,
� v�x� �ISof�t
�'.�?�.'�,S�i'J�t..+�..�R�BE� 5-UBI�ItT:
C7 Alumimxn ❑ Trim I. Site PInn/Survay showing ti�c cxisting atr►�ctures
❑ Other [7 hwsaix arul �ropustd prcyjeu�
�,g 2, '1'wo scts otconstruotion plans
IPI�SXi$TIN(3(�YNNIN(iS 17Yes QNo LOCATIONOFWINDDWS 3. Ener�;yCnleutatians
OR FOR I+IEW OPCN3tVQ3-D�SCRiBE SiZC3 [)P
c7YFiNINCi ('HANC�I3S Rt
TYPE pF W1NUt�W TQ BFs iNSTAId,,£sC) NUM6t3R OF WIIVDOW5
AG�. F�FS A,R� BASE� UN VALUATION, INCLUDING �'�� t"O'�T d� LABUR A►tYp MAT�RIAI,..S:
(U51NG THE 199T U,H.0 F�E SCHEUULE)
TOTA,I� �TO� VAf.�LtA�'I`�OY'i � aSr'Ob. �__ C7�C:UPAIYGY TYPF.
Permit Pee
Pl�t1 Rc�vi�w
F'it� Surcharge
Surchutge
L.icense Surcharge
SAC ChArge
Curb Cut Escrow
Etp$IV11 G(1ntt�qs
Park Fee
Sewer Main Ct��rge
Totul Dus
� �3 ��� 5ee 8ack Pa�e for Fee Scl�edule
� ,_.. . 65"t� of Duildin� permit 1 ee
$�� �� _.001 times the tot�l jab vAluAtion
� .OQOS x Pei�nit Valuati�n Minin;um $.SO
� $S.QO {St�tte Licensed ltesidentiaF �ontr�utors)
� $1550 per SAC Unit (Ftans to MVVCC for det�ennination)
�.._.....
� R+G9�= ftx�2l=$
� $450 Conservatio�� Plan Review
$� I�ee Determin�d by �ngineering
� -�;�- �+�reement necessary { ) Nan Necessaty { } �
$ "� V�-�- ~ Mxke checkx a�v�hle tn: Citv of Fridlev Attne
7'HIS IS Alti APPLICATIOM AOR A PERMIT•TJOT VALID UNT1L PR(�F5SFp
1 h�rt�by �pply tor $ building permit and I acknowladge that the information alx7ve i3 COIT►pll•7tC �ilt� �CGUTBtC; that t�ie work wili be in
conform�►ncc� with the ordinenqps �nd 4tyde4 ut t�►e City of Fr�dley and with the Miz�nesota Con�truocian Coda�; 4h�.t 1 understand this is not a
perrnit but only an application for A permit and wprk is n�yt tp stftct without a perniit; that the work w9ll be in �ceordflnce wiCh thd �rp�►rc�ved
Plan in the case ofali work hi h reqaiies re iew and approva! ofplans.
SIQNATI,TR� Q� APPLICAIJT „�,��'�!����'�-„ `�- - .. PRINT NAMC � �DAT� rl'Z9'
_ �
Since 1965
BASEMENTS
DRIED UP
.�� PERMANENTLV
to
Address € t':�'
i
City, State, and Zip
Home
Work
�� � �� � r � �: � a��
WATERPROOFING �°� ��� .:��:��'���� � � �' �
� ��•�,� ���:� '.,r
MN Contractor Lic. #20638376 BC www.rite-waywaterproofing.com
448 Lilac Street • Lino Lakes, Minnesota 55014 •(651) 786-0550 • Fax (651) 786-0555
Job Name ,__ „ K �,. _ R L„ -�• _
Fax
Address
Cityb�State, a
HomelWork
Email Address
Cell
��
This proposal (Contract) entails the following activities to be performed by Rite-Way Waterproofing:
To install an underground drain system below the basement floor level as indicated on the detailed drawing. A pertorated four inch plastic pipe shall be installed
in a trench and will be encased by a minimum of iwo inches of crushed rock. Block wall construction shall have each cavity and seam drilled as near the foundation
level as feasible on the lower course of blocks. A one half inch plastic drain pipe or 1/2" drain board shali be installed on�n each of the drilled cavities and seams
so that any water will be drafned into theplastic pipe line. The plastic line shall terminate in a sump and a pump will be installed to remove the accumulated water.
< The trench shall be cemented to the level `of the basement floor. We will be leaving.a vapor gap between the floor and the wall to catch any moisture and
' condensation from the walls. ""
The owner is responsible for the removal of appliances, fumiture, carpeting and clearing the excavation area before we arrive to start the job. If they are nof
removed and it becomes necessary for Rite-Way personnel to remove them, we will not be responsible for any resulting damagea Rite-Way Waterproofing will
not be responsible for job dust orthe restoration of tile; paint, orcarpet along the area of excavation. Upon final payment, Rite-Way Waterproofing will issue a.
iifetime guatantee where our drain tile'has been installed.The guarantee does not cover condensation or dampness on walis or floors. The pump and exit line
are-covered by a separate 1 year manufacturePs warraMy.
.�.,,
NOR7H WALL �� FL POURED WALLS .� SUMP:�E = DEE�P PUMP 1/3 HP y/2 HP
S�UTH'WALL � FT. ` CERAMIC TIL UNOLIUM/WOOD/ ARPE NONE CEILING HEIGHT �S
EASTWALL _�"�*_�FL fRAMIN FUR STR ;�, 2X4/NONE H20 PROOF: EGRESS/WW"'#�
.....
INEST WALL � FT. HEETROC ANELING � VAPOR GAP '4.1`.�$`
TBUNK UNE �' FT. BLOCK LL�C� E�3 CORE) '� POLY DRAIN �
TOTAL : __��___�, 0 FIREPLACE: ❑ GUARANTEED ❑ NOT GUARANTEED
v IF HEARTH REMOVED
NORTH
A�di#ions R:ite-WayDoes Not Cover ,
,�'$ Homeowner to:supply 110 electric�l outlet for pump (10 amp) �,
���Paneling and/or sheet rock walls may have tobe cut �
,» .� ....� � �,,, �„, � ��» .�., , ;
off at the battom including fr8ming ;;,,�,
,, .
•�NBiI heatls may pop or coiner.seams may separate on 2x4 ���'"
sheeticocked walls. ' a , ` �
�Painted walls rrtay become ni�ked or sta+ned �
,�Ti1e in excavation area wili be`lost
, �Floar'r�ay have to be beveletl
' �Carpeting to be removed/replaced by hAmeawne� _ . _ . ° "�'
�Baseboards to be removed/replaced by homeowner
r��r Bathroom fixtures (toilet, shower, vanity, etc) to be removed/
replaced by homeowner t ;
Oth� �s to be oved by homeowner �€� �i �$��
. � �. �
Tunnefed areas.hlOTguarant,eed
Remarks � ' �---
�aellef�' Hipti��W�ter Level'.Alarm Add: $ ;� , Qty: -
�. Zoeiter�` Ba�ery Back,-up SYstem �` Add: $ ��` "� , � � � ' ;Qty: � _ , , � � � ���
CD'�OSE hereby to furnish material and labor
.. -t� 1 y �^� . . t 1 _ [
NT TO:VOUR PqOPERTY MAY F
0
..y;�
electi�ical conduit,
e been fumished :"
ay after'the dete of
id, tweifty-flva (25%)
.IEN AGIIINST YOUR
OVEMENT
L 720DAYS AFTER
)R OR MATERIAL
nplete, rn accordan� wdh the above specrfications for4k� „ um of:
Dollars {$)
��Zb Dollars ($) ��::�
.,rt ,,._. ---� �.__ . , � ,. , a.� _
[ nNq. GIa0YV01 NGWVO � � �^- �
upon strik9s a'cciderts or tlelays beybnzl�6ar` O'O
re, tomado, and,other necegsary insurance. (�°10� C�V�%i1 P"8��1 t�$) "iiD` ` —
,_�� �>,.,��,� ;��"��� OD
dts and excessNe sand/soil infiRtatlon due to (� - +
.� ..�Balance $
id in guarantee. +^
ionsib�e torthe presence ot or damaye caused PAYMENT TO BE UPON JOB COMI�LETION.
mgi, bacteria, yeast, or thefr spores, scent or OWNER/AGENT TO'PAY FOREMAN UPON JOB
in shall apply w removing, cleaning up, treating, CpMPLETION UNLESS OTHERWISE NOTED.
g, remediating, ar disposing of any such
ib ther th9 substarsce was present prior. to 1•5%Per month IMereat cMrged on' ue eCCOUMa
rk�f rmed by Rite-Way, ,
ered by Workmen's compensation Ir�"!'�nee:� ,� Re�resen tives Signature �
, ' .! �+is propose/ may be wlthd ' r tivit " n 30 dayf.
�—�le abOVe� ; Ices specifi�;ation s�htl conditions are satis�f�ry and are hereby
�C§rproofing is author�ted to p�r��vork as�Y s�ecified. Payrrient �s outlined abo�
� � .� � �� ��t� ���. ��r �»�
. .
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Dete
�ne�'s signature_
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