P - 42131Building
Inspections
?63-572-3604
763-502-4977 F.A�
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From: 763 757 1357 Page: 1/3 Date: 9130/2011 2;44:44 PM
BUILllING
RESLDEI�TTIAL APP�ICATION
CI'�'i� OF FI�.II�LEY
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See Back E'age for Fee Sc6eiiule
65°!0 of �3uild�ng Pe�mit �ce
.001 times the total job vatuation
.ODgS x Pernrit Valusiion Mi�+imtxn �5,pp
S5.00 {State Liacnsed Resid�e�ial CoaMactcxs)
52230 per S,�;C Unit (P�ans W MWCC far d�Ecrrnination)
fi + 6 ft= ft x 5�5= $
$450 Conservatioo Plan Review
Fee De�ine� by EpginaainB
Agrt�memnocessary ( j Non 1*ia�y ( )
7�IS LS AN APPLICAII(riYJ'OR A PERMtT-1�t)T VA1.ID UNT1L PiiOCESSEp
��Y $PP�Y for a iwl�tg peim�t artd I mdcnvwledgs tltat the Eaf'orm�tion above is eoe�plebe aad a�xur.�me; that ffie wark wi� be ea
conf�rmance wi�t tbc ondinance.s mxd aades of the City of F�ley and wxth t'he Minc�esol�a Consi�tivn C,ades; ti�e# E snciexstarui fhis is rxrt a
pernnit but only an �piicatiau for a it atzd is n4t to start witlro� a petmit t�n sit� t�at f3ra work wil� be ut avcor+dancc � t6e
a�zover� p(atw in ihe case af all w ic ' review and approval of pl�ns,
SiCiNA1l1RE 8F APPI.IC!#NT pgQ�7� NA� Jtephen Kanaff p,q;� 04-30 241 i
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