P - 39909From: 7634752566 Page: 212 Date: 8/23/2011 2:42:06 PM
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F�FS ARF RARF,p �N 61A.00 pGR FTXT(JR.F., .F,XCEPT WEIETt� NtJ'i817. FTXTURr4; (f�11�1C�tt� T(3TAL NU�wBFTt OF T:AG7�[ IJCLOW). MINIMUM FEE
$35.50.
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^ EATHTI.113 � t7AS FfPING (NEEC► CPri' L.iC) 3WfMMING poOL WATIiR SOG'IN�R ($35)
_ CLOTFiF.9 W/t3HIiR ,,,,_, KrTC[-iF:N 3INK wATER CLOS�'C BACK�[,�W PREV. ($l5)
_, Ai5HWA$FT.T;R ,� i,nLJNURY TRAY WATT•.R I{�A"I'4•"R (�35) FOR IRRIC7�ITION
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THTS IS AN AFPLICATTON POR A l�ERMTT-NQT VAL1D Ii1VT[L PROCESSP.i]
I hercby appiy fcrr a plumbin� permit and ,i, ackn.owled�e th�t the informatiQn above is complete and accurate; that the work wiil be in
coniarmance with che ordin�noes and codes o�F City of �'ridloy and with the Minnesotfl Constructiort Codes; that I understand this i9
noti a permit but only an flppfiaatian for a permit nd wa is not to start without a�er�nit an sitc; that the work will be in accordanee
with the a}�proved plan in Chc �pf a11 work w,i � re . ires xeviow and Rpproval of pla.ns.
SIGNAT[�RrOFAAPLtCANT �G-� .�� _ „ P,RFNTNAMT-. �'x.t �1alir nnTr. �4'��3-//
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City a.f. F�rxd�ey
uiIding ln�pect�ans D�partmextt
6431 U'nive.�sity A,venue NE, Fritlley, .N�1 55432
. . . � �7G3�-�572-3G04 � �
1�.AX: 763-5.02-4977