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P - 37238
Building 1t1SpeCtitlilS 763-57�-3644 �63T502-4977 FAY D:�TE _.7"�—�-U� s� .anrsRFSS .'�f� YI�I5 AF'PI,.ICAJvT IS: TENAI'�'J' S�7P MZ'f A, COPY QF YQUIi S'Frli'� LCGENSE aNr� cERriFrcaTe or tr�surtnrrcE TYPE Ok' Frorn: urtknown Page: 2!2 Date: 8/12l2011 2:18:20 RM BL7IL�TI�'� R�ESIDEI�TTIAL APPLICA��'�4�T t� Ow�v'ER NAME: _ �l�i � r1U17ti�S3:��� �n�.�7� �7t NAME: � ._4..� STA.TB LSC'ENSE �� ADDRES5:��C�+� p�or� 1(o.'S -2.�i 1- �'SL'VGLE FAI�IILF/Iv� � TWO F.4M;IJ.Y/�W ❑ AD�T1'CpTi ❑'sASTsA�N'f FIDIISH ❑ DECi€ CI IvFti%i�ON1E CONST DESCRi$L• Wpgj{$EINGDOh'E r �"L��2. OF SQU�tRES ,� C�� PRUpt7SED SIZE: � PROPOSET� HF.tCNT: � ��� ❑ Alui»;mixn C] 4thcr ��� �� ������ FFFECTt�!E i�I-20i1 Yt)t3R E-MAII..4DDRESS 0 ❑ HOtiSE f7?df.Y I�J'FdUSE � GARAG� 8�'t'T.4C1iFA GARAGE ❑ nEx�.C�iEV ��cE E9'5o'flit '�,.' �t �.•�' �'"F�sitn r� &�C+� C16�4+' ��' �acia �,G( (� i Q14C 7N ,F.t73'1'X�•GOP.�v71vGS �licx GNe LOCAliOT30FWiNDOWS nR FOR NF W �PF.NiNGS.nFar.R�F sr�. nF OPEv?NG CH.4TvGFS �. - i'�i�PE OF W�V790U+ TQ F}F. i}VS"�'ALLP:L1__ NL'T+fBEiL OF S �� F� Flfsn Rctiiew Fire Surchar�e .Surcharge Liccnse Surciaarg� SAC C}zarge Ctul� Cul �stavw Erosin,t� Control �?ac�: �ec Sew�r fiviain Cf�rge i��i L��A CERT C] I71�A�t I7L� L1 OTH�..3t ���.t No.: Reeeived By: Dat���l: � ���z � AASEMENT��x1ELIN(� SUSMIT• i. F.aiating Flnnr Plan 2. f�ropaecd floor pl.att 3. �.iatafstrucd�ralmemb�rato6e�sed 0 rux rvr,w c;c3NS�fKUC'IION INCLiTDJNG i�F.C,KS, A17Ll2TIQ1V5. & Pt7RC�3_SVB1Lt[T: 1 Site PlattlSurvay showittg the exisiing strutluY�es and proposed prajxt. 2. Two aete of coaatruetion pls�rs 3. Trtergy Caiwlatiass FOR WiN�QWS - P[LOVIiy� LT-VAI tJF, A,ND ty1Al�JCl7'ACTi�RT ^a'['[GT{ER ON WSNi7ipW. __� ee , ac 1ya,gc for Fee Scktedule ,! 65% of Builda,�g Permit Fee .QOi times the total job va�uar�on _ .O�OS x Far��it Vd]uatrUn Miniznurt� �S.Ol7 _ $S.Qt7 (5tatp Licensed Residentia! Goz�tre�tc�rs3 _$2�30 per SAC Unit (Pians to MWGC for determ:i,nationy ,y,,,_ ti + 6 ft= ft x$25� $ � ,_, $450 �onse�vation Plan Revzew � ...._ FeE Determ'tt�ed b!/ Engisieer�t�; Agieventcr►t neces.�ary ( ) I'�ion Necess&ry ( } Make rhecks psyable ro: Citv of Fridlev e*E�� r1r�s is hr1 n�Grcaztor FoR A rpx,tvurrroT v�r, trN'x1L rx�c:�:�shr� l I herehy �rpply for a buiidi�g pernYit and I aok�iawlodge that tha inforntatiom above is comp�ete arld &ccurate; t.�at the wo� wi11 be in, eonfcxmanee with the �rdin�ces arid eod� of tlae Ciry df Fridlev and with the �nesota Conssruction C�odes; that I understm�d ttais is ttat a paxmit b�xt oniy �an npplir,ntion for s pc,u�,t niul wvtk is n�t co s�tart witt�out a peanit on sit�; tEist ttsc wprk �*'ill b �n �oraancc w��, ihG approv ed plan in the case o� work 3� � quar$s rcview and app�oval of s. ]� SIGNATttRE �� ,4PPLIC:f4rT�� � PRTNTNAI�lE �i,:,tr'� �!i �� DATE � �4'! � � �1 IlV PE'CTt7R ST r A 1R�. •• •�• •— � :.: .. . . . , ,.;, . .::�:..7xL'F�iJlt�l�t'3:'f:`k�..:.�'tiT�'.P3dAX ."i'f',,:Tt�bA�1F`I+�:���s�:r�s�n�;'tr,Y:��ri.,�.:,,n.-r�wrY...��4..��.�,,.,:.....,.....,.•,� ,r..,..._.._�__..._��.._..��- _ �