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06/11/O1 11:08 FAX 6124933689 MINNESOTA EXTERI �001/001 <br /> � F •• �./��� ��-�� <br /> ���i cl <br /> � Total Fee: $/'.5��0 ��� DateReceived: �__ �� �� / <br /> � � /'� DateApprovedT— <br /> Entered By: � 6��>�7'� Permit#: rC �'� %3Lf <br /> ; —�� / <br /> Q^ ',� �>�� � CITY OF %��� PERMIT APPLICATION <br /> J�' �-�� " <br /> II �� <br /> �,�'�'� ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WII.L <br /> �� BE STARTED <br /> �`' ___r___--_�___ ___"____��"----��-----'--__r___�'___�_________________ _ -�-�-�---- r--��____ <br /> �� THE APrLICANI' IS: (circle onc) OWNER OR O^TRACTOR <br /> � �1_ 30B SITE ADDRESS: ������,�! • ZIP: 3� <br /> � <br /> �� �. <br /> , <br /> �,�� NAME OF OWNER: PHONE,: (home) � — � <br /> -�' ,,/� ,`,, � � (work) 3 — o <br /> �"J MAII.ING ADDRESS: �'U� �'/ �/ll �I CITY: ZIP: <br /> ,� ;��.3 ,� <br /> CONTR.ACTOR: ��� PHONE: ��'���.���f <br /> MOBILE PFIONE/PAGER: <br /> MAILINGADDRESS: ,r�n� s�lu/u �CITY: �SS�O ZIP: S,3E5 <br /> STATE LICENSE: # /-������_ <br /> ARCHITECTlENGINEER: PHONE: <br /> MAILINGADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION #f <br /> TYPE OF W ORK: New Addi ' Accessory Structure <br /> Move od lteration Land Alteration <br /> PROPOSEDWORK(describeindetail � � - <br /> STORIES: __� SQ. FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GAR.AGE STALLS: ATT. DET. <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ �0 �01 _ � `� <br /> I hereby a�p'ly for a bvilding permit and I acknowledge that the information above is complete <br /> and accurate; that the work will be in confozmance with the ordinances and codes of the City <br /> and with the SCate Building Code; that I understand this is not a permit and work,is not to start <br /> without a permit; and that the work will be ' ccordance with the approved plan <br /> APPLICANT'� SIGNATURE: DATE: �r, <br /> NOTE! Parade of Homes events require separate permit approval by Police Deparlment and <br /> City Council 60 days prior to the event. Non perniitted events will not be allowed. <br />