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,:35 FAX 651 223 5646 _ ROLD ARCHITECTS 1a002/002 <br /> '1 <br /> INITIAL APPLICATION FOR PLAN RE <br /> VIE <br /> 4H but this application and return it to the Building Codes and Standards Division,approximatcl four(4) <br /> weeks prior to.your expected plan review submittal. Failure to submit this form may result in up to a three(3) <br /> week <br /> delay-in the processing of the plan review appiication. This initial application will help us expeclite your <br /> rev�e�x►. <br /> ?. l+*gjectTitie �,��.j .�r A t;ort7erdotionVn2uation <br /> 1' SIxAd'disss � 0110 `.�``�VV� I'D Townslrio <br /> E CirYl Stade,Zip �+rlirl is j rCowry <br /> i <br /> Owner's Contact Per..an <br /> 1 Owner Address <br /> �►t+� - • o,;�Ptro,x (�tSZ:) y"19r . ��•� <br /> City.5taee,Zip State Agency(WAppliaable) <br /> 1 i I <br /> 'Owls"Firm <br /> Firm Conine!Person <br /> � '_ i Firm Address �,r�� �l <br /> � fir -. I Phone <br /> . j i City,Ststw Zip F t'j � <br /> a. �''�M• to2. c Gyp <br /> T ZZ3lt;� <br /> 10 Public(state)building paid for by the state or other state agency as a: D.State Cotlege D Zoo i ❑T .O.T. M D-N.R <br /> .� O Statq Uaiversity O National Guard U State Hospital• O Stale Home. O Capita]Complex <br /> Q Atb=specify <br /> .$1 PubUc achooi distrigt building of$100,009 or more In construction cost. <br /> Vt r O State Licensed Facijity licensed as a: Gl Hospital Q Nursing Home O Correctional Facility <br /> . = O Supervisgd Living Facility 0 Free-standing Outpatienr$apgical Center <br /> �Pe? : Q 00:ipr;specify <br /> i ;fl New Building Construction C1 Addition �emodelirlg � O Otllei:Specify. i <br /> USC Oempaocy Ciassificatiou(s): UBC Type of Construction: <br /> =ka� :Project Dqscriptioa: 1641o� y''1G�D <br /> C5l 10• 1St• [Cp .. <br /> Total Projeeftd Construction Valuation' <br /> Upo1 <br /> n recei�+' the completed initial application we will confirm that we are <br /> the propor jurisdiction fo=the <br /> Pro�je�t,i assign it a projecenumber for tracking and determine if the city./mu nicipnlity will do the plias raview, <br /> thc(irispections,both or neither. we will notify you of the pro3ect number,where to submit your documents for <br /> review aad.lioiv the inspections will be handled. if delegated to the city/mvmicipality,you will only Abed to <br /> follow their piocedures and fee schedule. If your submittal is to the•BCSD, our standard npplieation process <br /> wild Reed to�c followed. � <br /> ;I Hereby ac ow hat t 1 a is tion is not a Building Permit,nor does itautho)*e the start ofconsr,•rrcdon. <br /> Apli t S se ; Pate <br /> B 1 g Codes spd 5taridards Division,408 Metro Square Isuildbig, 121 7"Place East,St.Paul,MN 55101-2131 <br /> Voice:651.296.4639: F=6$1297.1973; TTY: 1.800.627.3529 and ask for 296.9929 <br /> I ' <br /> J <br />