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DATE 1122 _& -()/ <br />City o{ <br />Ell P,iver <br />13065 Orono Parkway <br />Elk River, Miq 55330 <br />PER3iV1IT # 7 -3 <br />-BUILDING <br />PERMIT APPLICATION <br />JOB .ADDRESS 9-7 S L. _LK Ptv p.1- <br />NE <br />THE APPLICANT IS: OtiVR COiTR4CTORlOxHER (DESCRIBE) <br />LEGAL DESCRIPTION <br />SUBDIVISION LOT BLOCK PID rt <br />,S��ran M B III -,, 3 <br />CONTRACTOR LICEN <br />NAME ADDRESS � � <br />mks V,y V� ) A vk s<) <br />NAME <br />DESC:RIB11, wwff--V- <br />_ <br />3-;.J� Y1 <br />CoMpLETION DATE <br />• (`Q <br />ENERGY CODE OPTIONS. [] CATEGORY 1 <br />?NONE # <br />1-- C)463-8112, <br />PHONE # <br />El <br />,TT IL CONSTRUCTiu! <br />2000 ENERGY CODE <br />V NTILAT1XG OR AIR CONDITIONING. <br />TI1IS PERMIT BECOMES NULL AND VOLO I � WORK Uc 0a� R Wad S SUSPENDED <br />Z'IS <br />NOT COMMENCED WITHIN 180 DAYS, OR <br />OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORKIS <br />COtIfM,ENCED. <br />OFFICE tTSE ONLY <br />I HEREBY CERTIFY THAT I IIAVE READ AND EXAMINED THIS APPLICATIONA-7VD K'Vd W <br />THE SAME TO BE TB UE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDI7VAN-ES <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br />HEREIN OR NOT, THE GRA?VTLVG OF A PERMIT DOES NOT PRESUME TO GIVE <br />A UTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OFANY OTHER STATE OR <br />LOCAL LAW RESULATIN ONS UCTION OR THE PERFORMANCE OF CONSTR UCTION <br />DATE <br />SIGNATURE QF OYYNER <br />ENGLNEER FEE <br />PERIMIT <br />SURCILARGE <br />SEVER <br />ATTORNEY FEE <br />LICENSE CHECK <br />-MM� <br />TOTAL <br />API' RECD BY <br />APPROVED FOR <br />ISSUANCE BY <br />TYPE OF <br />CONSTRUCTION <br />OCCUPANCY <br />GROUP <br />DI'VISIO?V <br />SIZE OF BLDG <br />(TOTAL SQ FT) <br /># OF STORIES <br />NIAX OCC LOAD <br />USE ZONE <br />FIRE <br />SPRINKLERS <br />REQUIRED <br />[] YES <br />NO <br />BUILDING & ZONING DEPARTMENT • PHONE (763) 441-4900 ■ FAX (763) 441-7425 <br />