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P - 46801c�ii-ii-i► i�+:�y �uil,ding .�nspections 7d3-572-3604 763-502-4977 �,A,�C SITG ADDRGS$ � TFF15 Ai'PLICANT 15, TEN,4hIT SUDMIT A COPY 4r YOUR STATE LICEIVSE AND CE[tTIFICATC QC 1NSURANCE From: HomeSure Page: 2/5 Date: 11/1712011 2:22:41 PM n�ui��ui�� ic� r� tro�� UC-�+yru r c�� i�JY��IY�� Permit Na.:�-b��'0 �- i�.E��►�N7'Y.AL A��T��C.A��'TiON RcccivedBy. � -- -- �IT"Y UF F'��' ��t��: �,r� � � q � � � � 6FP�CTIVE 1•!•:f)I 1' YOUR E•MA1L ADD'RESS ❑ OWNEFt STr1TC LZCCNSL' Il �iNG4� FAMILYMEU' TW4 FAMfLYl�EW GC t7 iiASEMENT f%1h11Si1 o r�o�r• CI DECK ❑ SID�NG CITY 'r1'P� Ci� WbR;[�: �p N�W I•10M� GONSTRUCTfc7N 0 ADD1Ti0� 0 MAINTENANC@JEtCPA1R d RGMODCLINC DESCRTDE WQRK DE1NG DONE: 11��4�1f�d13.�+.� SIZC �P IMR[tOVEMCNT LENGTFI WIDTFI �� I-1(7US� O�LY HUM$�R 0� SQUAl��y 0 FIC1U�� 8t GARAGE , .ARA . .S ❑ ATTACI�tED GARAGC PROPOSED 51ZE: 0 DETACI [GD GARAGG t�ftOI�OSED I�IG1GI�iTt �L4J�� ❑ Vinyl � AIUmi�turtf Ci (7thCr WfNfftiWS lAi EXiSTING DPEhI[1NGS CIYc�, QNa OEt FOR N�W OPCNINGS•DESCRIBE S1ZG OF (]PENtNG C19ANGES E� ALL "1'OTA�.,10#3 VA��JA1'ION Plan Rcvicw �irc Surcharhe Surch�rgc Liccnsc Surchar�c SAC Ch�r�c Curb Cut Escrow Erosion Control i'nrk Fcc ^�ewcr Muin �hurgc o5otrt � Trim 4 F+ixcin LCyCAT101V OF WINDOWS crRT 0 DRAfN TILE p {,3T1•IEf2 �I fStNG THE 1'997 U.�.0 FFF, SCH`F,�Li1�C) RecFMENT REMODEtiNC SUIIMIT• I . Exi4tinb Cl�+�r Plim 1, f'Yn�uxecl' fioor pinn 3. Liat af Htruclurrl mCmhe�v tn bC u+�d F4R NEW CQNSTftUCTl4h fNC4UDiNG DECkS, p�'}DITIS�1�"a� �t.Pi}i3(.Jrl�:� �� i, SitePln��!$urvcyvhowingtheCxi�tiltRat+uCtu€�� +ndpro�osu�;� hrojeM, : Two :kts of caa�trucliun hltra� 3, En�rgyf:c�ivK�lutianh F'{7'K W1N130W5 — PRbVIDE U•VALUE ANO MAIJUfACTURE tiTIC1C�R (�N WiNDpW, LABQIt ATVD MATERIAL,S: Soc Back I'ttgc for Fec Sclicdule CS% vf Buitdinb i�crinit Fcc ,QUI titncs �hc tvt�I jab valuation ,dOQS x Pcr�t�it Valu�tian Minimum SS.00 SS.4Q (St�tc Lie:cnticci Rc�icicntial Gonlr�ctorti) �223Q per SAC Unit (Plars tu MWCC lur cictermination} ft�h6l1- Rx$25=5 �450 Conscrvation Plan Rcview Fcc Dctermined �y En�inecring A�rccmcnl nccG:�:;sry ( ) Nvn N�ccti:vary ( } TIt15 15 AN APPLICA7'lON I�OIt A P�RM17-NOT VALID UNT1L PRCICESSED I hereby npply for a buildins per�nit nnd 1 neknawledge �hat �he in£ormution abc�vc iti eamplctc �nd a�ccuraie: th�t tho wark wi1l bc in conformAttce with thc ordinanccs anc� codc� uf thc City of Fridley anci with thc M;nncsvta Can,tructian Codos; tlia� f undcr�laRd this is not a permit bwt onty an app{icatio� for a permit and wvrk i� not t4 start witltoul � ncrmit on sitc; that tktic work will bc in aecordt�nce wFth the apprpv�d nlan in thc c�,4� vf a:ork whi i quirc� rcvicw and apnrovul of �lans., , Dn'rE� SICNA7'UtzG Or aPWLIC'A��.�s�� G.r� e��'�_r�.�tr^r NAME��G�l�iP..:�--