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P - 35783Building IIISp�C$�O�S ?63-572-3bQ4 7�3-502-4977 F,A� SI'�'� .AbDRESS From: 7635712746 Page: 3/3 Date: 7i26l2011 1:26:19 PM �' °� �- - , ._ �Q � . BUILI�ING C UMMERCIAL/INDUSTRIAL # �IT� a� r�nL�� E-MAIL �'c,rmat No.�" � � �` � Received $y: �eJ�� ` � i , `.' �,til � 1► COY'Y�} TE,N;A�1T_ � - _ .!'� 5uxce No. • Nc�n�; crnr LICENSE R'E{��iJER�h E h Cti'�RCIAi,, �?U91'RiAL AND ADDRESS: r� L�II�l11�J/ �i.'�1:�� A � d� . • � . NA,ME: .AJJMDR��S: C�'X'X STA'T�2iP — - - - _a«_..., ;..�►.� �� : ,� �r • l/ / " _ t > r �► � : � LI REMODEL !7 ROD� C) SW;�ti�I+1G ��• PT�ASE SIlBMIT: 1. 4 SE'T SETS t?F DRAWit+1GS 5. CONTRAGTaRS OR LICk�1S� 8. � S�T-�3IGTTAL C1R ELE+C 0�1TC 2. 3URVBYlSI'T8 PLAN LIGENSE APPLiCATION FLA�i �. L.QNDSCAPE PI�ANS 6. SP�GJAG IF�TSPECTION 3�HE17ULE __ _ 4. ENERGY GALCS 7_ PERFORMANCE B�TiD AMd'[JNT � BiJiLDING TO BE USEU AS: 't'�'I"A�.i. SI�s: � , c A�'��D D�SGR#�T[4N QF 'IV�S sF U�R � CECTiON (Y/I�T) A►C(YfiT�� THI$ TS AN AP!'[.i�ATtQNFOR A P'Ett0.diT-NOT VAW'p UNTtL pttQC�$$�[7 I h;exeby appiy for a building psrnut and I acimowiedge ttiat the iafomiatson abave is comp�ete and accurate; that tf�e wark witl be in conformance with tha ordinances ancl cades af the City oiFriciiey and with the M'snnesota Constructian Cvdes; c�fat � und�rstsnd this is t►ot s pel�lt �1it OA;�y An A��11GRtiikOA �Cx S�fEJ[%�,L SAIa VI+OX�C AS A.U�t td 8�t WI�UtIt a�}e�,lj;t (J�► Sf,tc� k�]lAt �71C W�f�f W'!11 � Iil ACCOiijBxllC� WAt�1l �'IlC approved pl�.a � the ca�se q�a�l wor�C w�tich t�ui;res review azed appr4val of plan�s. _ " i ti e � � � �.►. �. , %�' _��/�7� ,�� F„ -, . �. - �-� — ! _ _ ' — �I�� A,�'� �.t1."s�7 �I+T V�AI.Ij�1,'�'�d�i � �J. �. 7[ � L'031/St�, ft. a v8�9SttOII � 5q, ft. z$ Cost/sc�, ft. = Valuatacin; $ S+q. ft._ �ost/s,q. ti. - Valuatiou S '��O'�'AL JCt� VA�UA'�'�QN: S �' �' - -U�uE OCCUPANCY. _ _ .__ TYPE Piar� R�vicw �ire Surclt8rga S�cttarge sa� Cha��e �rosic� Gontrol P� ��C Special A�sess�rteut5 See Bsek P'age for Fce Schedule 65% o� $uilding Permit Fee .001 ti�ones the total j$b �aluation .U005 x �"ez�z�it Va}uatton �►'��,inanm �.3� �?Z30`per SAC Unit (Flar�s ta MWGG foe decerminaEicmj �4�v c�►s��e� �r� �� ee petez+r�maa' by Er►gzr�e�riz�g AgTeement neGCSSSty ( ) Not� IrTecCSSaiy ( )