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P - 44993„,�, ,,,, From: unknown Page: 1l4 Date: 5/12/2011 11:45:26 AM ,,,�,, � � ”, � � ,.�, , , � � - --- .. ... . BU��ding $UX�.,��� Pertnit No.:Zb �(jQ(�� lnspections �+ ��ENTIA�,.L APPLICAT�.(�N' Received �i •. r��` 763-572-3�04 ��T}� ��' FRIDLEY pate ��� �� 763-502-4977 FAX EFFEC'!"IV�; 1-1-p$ --- . . __;. :... . __, _,..:.r.- narE .� 1�� I i_ _. .__ Yc�uKU-n�i�nLsDRESS�i r.t.e.�x:t.�i� � Se.%�rerbrCS. Law� q� � SITF ADDltLSS _��. (_� I e+^^ po .. . 1. e�� r ca..e..a_ THIS APPLICANTTS; ❑ UWNL'K (�OCC.)1`iTRACTUR PROPERTY OWN�R/ NAt„t�' TENANT . _.�.. ... __...... �e. v� rc�- ��. �J i 1� $T/ITF. T�I'IJl 7.iP ,��� Z, rH�NF: 71n3 � 7 �?,��.�97 NAMG: ..�.. _.. ._ CQNTRACTUR nUDRESS;_, ,. /15 '� J XO2� �i p�/ (� f v C� CirY f� '��_STnTCi�±�ZIP�� SUBMIT A COPY QF PIInNF. _... ���-'-' .� 7 7—,[(o Ch �._... FAfi �. f�� �� 7 7�- �% [� Q ' YpUR STA'1'k LICLNSE � STATF L1Ck;NSL �1���',,�j.� � .. . F.XP DA'1'L' ..� � / �.. ._ _ . .. . PERMIT TYP� Tx�� oF wo�: �si�c� rnMn.Y/NF.W CONS'!'KUC['10N ❑'IiNO PAMTT.YlNFW CY)N57RUCTlON O AT�nTT7i7N d CARAGEJSHEU � ❑ RASF.MEN't P1NlSli Cl R(K)F � AEC[t ❑ SID[N� fl SWlMM1NG YUUL ❑ NGW [IOMR CONSTKUC'1'ION ❑ AnAiT10N ❑ MAIrJTF.NANC'FJREPAtK ❑ RF.1vE �Ll DESCRtsE wOtuc Dr1NG �OxF� �;L1� 4.0 i v��'i w; �n.a4c..s5 `� (� ltOpFING NUMYiER OF S(�UAItliS G �c. s TROPOSED 51'Lii: AROP{)ti�U lIG1GIIT: _,. M RTDiNG Q Vmyl O Aluminum ❑ Othtr _, . _, TN F��.STI��NC'r OYLDIINGS �Yes ❑Na (1R FqR NLW OTENiNC*R-DFSCRIgk, 5!'L[i Or c1PENtNG CIIANGF.S � � , , ALI, FBFS ARE TOTAL dOB VAX.XJATTON ❑ HOUS� ON�Y � H0�1SE Rc GARA[iF. S{Zti S'1'G1t2LS � � WiNDQWS � n nx.a�r� ri�.�, ❑ arHr�x O ATTACHF.D CiARAG� ❑ nF.TAC'HED CiAKA(il: ❑Sa£fit a �r� ❑ 1�u�Cia � L' � � :r.�7 sc�o w'� LOCATtON (7F WINDUWS ��1� ��� � �Gxi. �4 W + ��(4V�Q..^NLIMI:uu nr. w�rn,nwc 'Y . . �� �...,^...�x,c_'4�� ��K�y�r �71-t [I�1GIi'� SU h"1' AR SEME�!1'E; KL'MC7UCLkN�e.�3I� n�LT' 1. t:xuung I�I�wr !'1�► • 2. Yroposed Aoor plan 3. List oI slntc2vrnl �mhcrs t» bo u.sc� PORIV�W CONSTR[JCT[ON INCLUlllNGUL;CKS. nTini'Ti(7NR � Pt)RCH�S SUgMIl': 1. Site PtatJSurvay shuwing (he eXisllo� sp1lCUsrCs and TnoPo� ProJtx:t. 2. 'fwo scu of wnscruetion plans 3. 13n�,gy Galcutations Of LABUit AN11 MATF,RTAI.S: Pcimit fee $ L q5 �Lr.� ��e H�k Payc for F�� Schcciule Plan Revicw $ GS% ol'Suilding Permit Fee Fire Sptctlar�e $^�� .fi01 times thc total jvb vAlUation Swchatgc $ . .4005 x Perttlit Valuatian Minimum $.50 License Surcharge $ __ ,�$5.00 (�tate Licenscd Residentifsl C:o�tractor.,) SAG Chargc: $ . $ t$25 per SAC' llt�it. (Plans to MWCC for dtl�rmitiatioa) Curb Cul �SCrow $ .._ ft + (i ft = Ii x $21= $,_ Fmsicrn C.onlrol $ $454 Conxervatic�n Plan Review Park Fee $ .� Pee Deterrnined by Engineering Sewer Main Charge $ Agrecmcnt nec;essary () Non Neccssary () Total Due --- $ -- ��� •3� MBke checks 1�Y�ble to: City af Ft'idlty Attach Stipulation� _... 7'H1S 1S AN n1`1'i.TCATI()Pf PUR A YEi1tM[T•NOT VAI.ID UNTlL PKU[:L'SSlill t herehy appJY for A bvilding permit snd !�uJcnuwledge t�t tlic inf'nnnauon abuve is cumqletc a�xt accurate; thnt the wo�1c. will bd tn Conf�mienx with tha �diaanrxg aiul wde5 af thc Gity uf Ftidlcy and with thc Mi�mnsula Const�'uct+�n Cc�dcs; Nnt 1 iaxtcrst7nd t}lis �s not a permit but cmly an ap}di�9tion for a pcmut ond wrn�k is not W atatt wilhuut a �cmtit tm sit�. UL1t the work wi�� 1x in accnrJunc.� widt thC apPmvcd pinn m thc c�r uf ap wpck which rcquires rovirw :+ncl �,ova1 of plans. , S1C;NA't'URE OF A�'P�AN1' 1�.�7�r,.. , � � PRINT NAMG '{ �tbN.r► G��l 1)A�'I:��/� E, ,�.,...a �.ia • . ., :... ,� l�1