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P - 48031From: 6127551554 Page: 2/2 Date: 12/5/2011 1:01:30 PM FROM : MASTER MiQBILE H�OME SERVICE PHONE ND. : 6127551554 Dec, 03 2011 10:58PM P2 B�tildin� l��spectaans ��-s�2-3�a� 7C3-S�2-4�77 FAX �� /�'' { nATL_,I,�, �.�.f, r �; ITF. A IJi>R 8S5 !.. j�� THIy ArPWC:ANT 15c 1VYEC'�HAI'��C�i�� RE��DENT'IAL APPL:�IC.�4TY�1�( CiT� OF ��DLEY GFFF.G1'tYl'. P-1-2UlF ��. ��5� tllt ?-{, MAILAL)f.>RF.SS_.. ... ._ t�� ❑ nWIY'L'R �(;'C}NTRr1C.T(iit 'HVt'L+1CA Y I NAML' � 1:�, UWNE.�/ AL�L7RFSS:__._ '�`ENA1�i'T f'c.rn�i:f Nc�.: � I 1/Ca�..1��`d Rc:ccived 13y: ��..� ��►,�� -�---� 1� L.-.-' .. ... ... _. ... . . _ .. ,: - c��Y� ... „ . �s'raTr_�,�'�tr� 4VtYlKA�.. [v�c ��[�MnANY NAML'; av tn J_}_�f ��'� t�._ 'L} ► ' 5.��:!-K.�•`..� _tL=.� •,,,,.� ... ... .. _ SU$MfT A COPY U� CUN't a.�:T f�[.�r��N: ��,,,�). �... ��"��__. _ _. - - --.. .. .-.� YUr1R STArE S'1'ATE UrF.NS� N_ ,__7 1 f.�`,d,�„ _ ._ LXI' DATl; __ , �. ,. LIG�iN5� wE'YI�1 �� _ . ... f:ITY _ _$TA'1'L'_..7.1P ADC�1ti,5S:___ .. ... A#'Y[.,I�A'1'InN , �y . _.. 1 HnNL _.1 �'� :� � FAX _� � "' _ ,.. ._`�� .... PE.RMIT'T�'PE i�S�NU'.t' FAM�'.v o rwc� �`AM��,v ❑ Z�owNHC>usE� TYX'E O� "WOR�: 'i��'W � �E��,n�%t=MEN'C ❑ ALTLI2AT3C1N/KI.;MClDE4 �.. , r DETAILL� 1�ESC;ILIPTIQN OF' WORK -.. _ . .-.. �, ..� �..� " .. } r � � � . , � FEES A�E IiASf�D Utv Si0.0U F�:�t �'lX'1'UI2E, El��'r1'': WFfh;�tF NU1'�ru. l�IJtiTU1zF.S: (IIYi31C;A�E °r<}•i�nL NUM�irft UF' LAf,.'ri gCLUW) RROYIDE Nf�AT LOSS CAA,C"S PLIt-MANUAf,J 2p'U6 �SHRAL IdA�{D1S0�7K• I?quiprrten� fnstalicd Mi�c:;: , . __ Mt'>17F.Li �. �,., SI'./,r/itTi� ..__.._. , ..... _ ,�-. .. . ..: ... _ .. . .. ' � . . _ ..:. ••- - • . .. _. _ . ..,._ _.... . .; . '' : Tv1Fl3:._.. '-:. _ .. 1NODEL: _. . _..... SI;LC:7l3Tl1' ..._,.,; '.— . . MFCi; MUDi:L; ,. SE7.RJS7'U AlC.. $2g,pQ . _ FIR�PS.ACE (C�S) �15.U0 .. •-- GAS IiANGEfUVTiTf �t0.U0 AIR'i0 AIR iiXCHANG�F.,R pIS _i�lC(FP[.AC:L (WC.1QU) 535.6U _NFW CiA5 GIZTl.L $1U.00 BUIiER;$35.00 • PURNAC:L $3$,O0 _t;�AS UNI'i JiTR S}U.00 � C.k!'IMNEY LlNFR $10,00 �G�S DItY�R$1(>•()U _1'C'l�7L Hi;i1TF..R $35.00 —'n��r^rwri�i(�bntltl VtrASf'[PW�$tRUU _ VfiiVTILA'1'C7Tt$1S.qU m offzxtures�cr��,`$1a.00_x$'1�.0U=� ,_ ; � Numbei'tif fixtwres (u), $1S.q0.,,_,_ x �+15.�0 = $ — Number of fixtures �ii� $25_OU � x $25.Q(} _ �S Number of Cxhuc� �) $35.00'_ x $35.00 = $ „� State SutChar�z =' $ S.UU MiNl.MUM N�L�' �4Va)u) 1 �Trai =� � 4, v , .r � . : _ . , .. : , , • : . . '' �'�'Nl5'IS'itN APP,Git /c3'1AN FOR A PERl�lti AfC)TV'ALXn UN Ftl.,.T'.�E)CE53liCl • . . : , � I hZ�by'apply for � t�uiTdin� 4�Ernait and I Fi.cknowled�e that I.tLe informatip�i ab.tiv� is c�r�npl�te and �x�curatc; lh�it €tic'work wiR bc in co�aformanco with th� urdinanc:�s �n cc7cies nf t.tie City uf E7is�lcy and with the Minr�esota CUnstt2ictinn C:�des; th�it I undc�•st�nd t3�is i� ncrt a permit but unly an ��i ' PcrmiE tii�d ork is not to sGirt witltuu� a��cnri4; tliat tl�c worl. wiil ne in �ccordancc with the approved pipn in the casa of a k l � view anci a�proval c�f plan5, . S[CiNATURG t�F APPL.�c'.AN -- _ t�ltlNT 3�J�MF. ,�� --�`� %��• ' DA!'L_,� � �':�'!— � City of Fridley S dYn� �n��aerti�ns D�partment , 64;3 � U'��iversily AvencEe N�,, �t�dley, M'N 5,5432 7fi3-572-3GU4 �A}C: '1b3-502-4977