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, . . . � . . _' '_ ' '' _� v •��i w •����w� <br /> � � Tooal F�: � � _ . Dabe Recetved: 7-�C> � G`�. <br /> 8o�esOd By: __� � . ' Par�ott�: _ '�(.��1C1 • . <br /> . . <br /> . err� oF oRorro - Bvn.DZNG ��r APP�.icA�roN . <br /> . � . - w. - <br /> Alt iAformxti�n must be�bmt�bt�1 fn lull�.b�'ore plan review will be stsrted. . . <br /> �, � (�tea8e prlru at!lrybrnia�ion)� . � . <br /> • �...�..... ..........�.....,.._.. .._...._��_.�.�.,_. . <br /> THE APP'I:ICANT IS: . (circle one) OWNER p CONTRACTUR <br /> � � . ' � . . , <br /> � . �os s��AnD�: 3�S� �c��S1,M��c. zi�: 55�91 ::�. <br /> ... . <br /> . �: N�oF owr�: • � �ox�: ci�)����Oo 13 <br /> �. t� � <br /> NUA.:n�tc�nn�ss: 3�15`r3 (v��� �e.�c. crcY: rt�c�n,� a:�ae: j . <br /> _..,_._._o._._.,.: _.,_._ . <br /> . L . - <br /> � RFNEWAL BY ANDERSEN � ' <br /> C����R: --�-------- 350-13R0 AYE. NE - -- --- . <br /> ��.CO1VTaCT�'�ON-� FRIDLEY, MP! 55432 � ` � <br /> . . A�AI�•nYG�U�3:� (612) 502-4777 ZIPi ' <br /> ' '�A��,j��; � LICENSE �20130983 � <br /> ' � ' . <br /> � • ABC�T�(.'T/F•NGIl1�R: � PHONE: .� <br /> MAILIN�ADDxFS3: C�'1'y � Z�• - ' � � <br /> . . <br /> NAM�: � BEG�.STRATION� � <br /> . ,' , , � � . . , . <br /> TYP� 0�+''i�VORH: New_�,�__, Addition r____ Acce�o�y S�e <br /> . , . . Move� Remodel/Alt�erativn,�_ Land Al�raHo4� - � <br /> 1RtOP4SRD�ORK(descrtbc iri de�ailj: � �'S y . <br /> • , ,. . .. <br /> _ <br /> b"1'C��S: _�,.__.____� . SQ.�'BBT O�F�AC81�t.008: � . . . <br /> 1�Q0. OF BED�OOMS: �, GARAGE STA1.Ia5: ATT. �„ DE'T:�,,,,. � , <br /> � �STIMAT.ED C4NSTRVCTI4N VAL'rJATION �� , . . <br /> (�61��= �_.., � <br /> I he�eby appiy for z lyuilding�petmit aad I acknowle�ge tbst tbe�nforn�a�ion abovo�c,ompleoe and <br /> accur�tc; tb�t t}�e w�r1c wUl be in conFoi�maaoe'with t�e ordinas�s�nd �odes of the Ci4►aod with <br /> � .' d1e S[ata Buliding Code; �at I underat�d thia u c�vt a permit and work ig not to scai�wltdc�ut• � �� <br /> . 'pc,rmlt; sad tbac tbe worlc will be �n�cccorciatbeG wlih .app�oved plsn: � � . � �� . <br /> hPp1.tCANT'S SIGINATURE: 1�: ,�Q� I • . <br /> � � 1VOTE� PQr�dg�o,�s evs�naqufne separnt�e pen�t yPpu�o�'ql by Pol�lca�pari0a�ei�t m�d � �. . <br /> l�► Cawicll Qe da'�pr�or ro the ever� xan-perAdet�d ev�rfi w�ll no!be a�lowsd. � . <br /> . . � <br /> E/l 'dP�p, 1986 'aNm� c�h �� ���3S lIW�3d 9Nfalf�8 S3N0�-�3413� ��Wd9b� L DOOOZ ' L ' I �f <br />