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P - 35971AUG-0�-2011 09:55 AM STANDARD WATER COMTROL 763 537 1882 �+ v�aatiFillG ■ - ■ ' ������ �I1S�7BCt1011S � U Fennit No.: � 763-572-3�04 �"-�'���T�� �PLICATI�N Received By: ��3-so2-���� FAx CITY �F 1�RIDLEX ��� R���d. DA'f�„�,� SI'T� ADbYtESS � rxts.+►r�ac�,tv�r rs: 7'E�'ANT CONTRACTOR str,eMrr A cot� oF YOUit STATE LICENg$ AND CERTIFICATE O�' nvsr.�.,�vc� M��l ,i�' i ��'� YOUR E-MA1L ADb12�88 ' r. � r STATE i1CbNSE e snvGr.e Fnr�m,�rnv�w cotvs�xuc�r � O TWO FAMILY/NEW CUN3TR�7CT10N O BASEM�NT FINISH q ROOP x � �E� a s�naG TaIPE �F WOIiK; _❑ NSW FIOA�tB CQN877tYJC170N _ r y.�. � D 1►4AAVt'$AIw1V Arn b$BCAiBE'W'bRK BiSiN'G AONE: � � 37ZE OF iMPROVB LENG'i'�i � F S UARY.9 ��OUSE ONLY Q �.. ❑ �OUSE � GAR��OE � � ATI'A►CHED �ARA(3E �Q�� 3�� ❑ bBTACHE� GqR,+,pE PROP08BD H6I(3}l"1'c -,�,.�. � � Alµ�j�� O Other „�� 1N�0 OP�N{}S pypg ppv QR FOR NBq► OPBMNaB•bE9CRIgfi � pF oF�rrara cxaxcss a� Ai.i. V Plan Review Fare 5urch�ge Surcharge Liconse Suretiarge SAC Charge Curb t�ut Bacrow $ro�icm Control �ark Fee Sewer Mein Charge _� ❑Seffit G Ttitn ❑ Fasoir LOCAT!(7N OF'V4'�iDQWS 7'E� 1997 U,B.0 FEE $CHEDLTL�} CERT '�iiAIN TlI.� q 4'I�R P. 03 1. Exiatiag Floor PI� 2. Pt+upoeed fi.oc� plan 3. �,isl of atructtua� mem6ea op be �■od 1?OR NE�V CONSTRUC?'IQN UICI.UDiNG bHCKg, 1. Sita Plan/StltvGy shpprj� � ��g �Cturea 2. 'I`wo �eon�etruction pl�,s 3. Et�ergy G�lc�ilttiams FOR V1�ND0'OVS - PR�VtI]� U-VAL'l.ig AND �+xuFacrcr�� sncx�x ox wuanow. Soe Back page for I�ea Scheduk 65% of Huilding Perrnit Fx .001 times the tatal jab veluation .0005 x Permit Valuation Minimum $S.Ob �5.00 (State Lic�ensed Reeidenti�l Contractora) S2Z30 pet SAC tlnit (Plano to 1�tWCC for doberrn,ination) ft + b ;ft = �� ft �c $25= $_ �450 Cane�rvation Pian Re�,ie�v Fee D�tnrmined by+ Engineering Agreement nocesea*Y i) Nan Nxesea�Y i) �$ IS AN AFPT,.YCATIOIV i�OR A PERMYT.NOT VrWD UNY'lI, ppOeEggE� --- —�-- I hereby� apply for a building perallt and I aclrnowlcdge that thc infarmatian above is campleW and accurate; that che wark will be in confarmance with tha ordinsnees �1 � of the City of Fri�ey and with th� Minneaota Canstruction Codes; that I undcrstand thi� is nat a pecmit but only ati appliestion g p�� '�t ��� ��aut a ermit on sits• that We work wi11 be in c sppa+aved plan in r�he case of al p��,,� p,�r �ce with the t�oval ��s�'.�' .� i � � � / . 31CiNA7'URE OF APPT.ICANT ___ e� ..,�• �,.. a , ir w__ r7� . i AUG-04-2011 11:27 AM STAWDARD WATER CONTROL �' ��1�'�l1�* �i� ����.r� ��'����� 53;'37 I�k�land Ay�nue IVort� g�7a 3,��n E}Ivd, At Crystal, MN 584�9 Cllv� IA 90,9�8 MINNEf1P0U6 �T. PAUL C�1 ���ae� �ea�y rn�se�� ���� s'i= o�0un �,,,� (�} 894�41b7 _ (�p1 P,H��67tl9 ��}e) 7p7�1A@6 �63 537 1882 �R�������1� ����i vVWw•StElnd�rdweter.uom Fax (783j 537-1882 Rt7CFI�BTEq 041i8TAT£ {'.�� Z06,0548 fBtlOf 876789i QES MeQINlB _ (615) 90B•7�6b w���on� sy�a� ro� �e ��ued � ��a�r� �r �..W f _,..�... �on � � �9�1 „� . '�- -��, astd � Name ,� 1 ""'� " Cny �f i� �� � � �+p a � �Addrrl�r � �� P� � � � ��.�.�:�..� � �' Z�p Wbtic Wrrene ((, j� f'�, b 1�."�l�:�� � wone Pnoe. ���) 8�end�rd. M�br Contrdl �—'" "� �i � � �.�.. Inslail�uon ��+c, wlll h+rrdllh. all hYa Nnd n�lsr�als tor �rark as �nnnM►ed ro i� r1r apsoNiw'and,;arnplwd ln �►+ra�'wrenlllc�. � In �aooi'd�nq wEth dmrin@ FiNow. In tM �wM u �nner, �Noneee� bbr�dlt1011� s�quiw t�lw eo �ror� Mt Job iil's 4i11r tAu� ae�IMhd, ownsr must itlow worfc +q�w !� eontlnF�a +�orking wNh no �nMnupNax�s 4nNt �ob ts li�l�d�'� atharWro �p�aiftW. �Y �wqu�nt,arrrk� orllt 10 ►asNl�n! 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Th� � n�ay �sY lhet you da erot w�ont !h� ooadd or .e�v�o.r snd bust tra ma�ad brro�s. m�dnigMt ot !hr thlyd budr� day etttr �ra+ ai8n tbta epn�m�nt, 'r1k notlea mu�t b� md1�d to: St�ndsMd WaN'r Controf � Inn., �37 Lakatand Awnuir Noreh, Crymtaf. Mlnn�eoM b64Q9. I have raro AcCEPtRMC� OF PRAP!C9AL �Y t'sad 6Wtr1 q1� 1rorn• and th9 k�Ck ot t614 aqql'oYment, ihp Job PrePd'lnbn Ltttw, �ob Prbpeuatlan Choclvi�t� and edl �1' � P�ee ep�Ifl�Ior�e ar�d nae�dlG4sr0. t'Pw.a�tma Att bWh �deB of thl�;4proamer�t end ths Job Pnpsradon L�lt�' aro a�I�tory ahd•di�l! IleN�bY �P�. Ahy � 1tQn11110 �rrlr� Arld/0Y 9pbalflpp�tq� W� CB�uft In an QXl�i e�QU 41'� 8u�forizpd t4' tlo !hs work fs speCiHed. l apres •ao makte psyms�lf as outllnsd �� . d�� �...._..,_..� Ownar ..,�„-�'".'�_....._--...._.._.,.. D �/ �t+� �, 3a1v9 R�p• �;; �� �' °% i'S�vrt�r ' � --�--�,...._ WwroraetCmi��e! 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