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<br />I CITY ARDEN fxHlf>IT B 0 <br /> OF HILLS <br /> 1450 WEST HIGHWAY 96 <br />~ ARDEN HILLS, MN 55112-5794 <br /> PHONE: 16121 633.567S . FAX 16121 633-7839 <br /> 5s-' DO NOT WRITE IN THIS SPACE <br /> Permit Fee........ .................$ 28- .00 <br /> a: <br /> w <br /> Z State Surcharge ................. .S <br /> ?; - <br />I 0 City Plan Check Fee... . .................$ J <br /> a: SAC Chafge (UnIU) ............ .S <br /> ,0 <br /> z>- Other........ ..... ... ..............$ 5. 00 <br /> OU <br />I u< ~~J <br /> 0:: City <br /> >- , $ <br /> >-0:: Name 11-/;1-13 $ <br /> Uw <br /> Ww <br />I !:z Address Penalty. . . . . . . . . . . . . . . , , . . . . . . . . . . ,$ <br /> x- <br /> u'" City Tel No. TOTAL FEE PAID..............$ <br /> o::Z <br /> <w Receipt No. 03/LP":)O <br /> Registration Number Dale <br />I Slructur DEMOLISH BUILD ADD ALTER RE~ MOVE <br /> Used As , Zone 0 0 0 0 0 <br />I BLOCK ADDITION DR TRACT <br />I <br /> WIDTH DEPTH SIDE YARD SETBACK SIDE YARD SETBACK FRONT YARD SETBACK <br /> OT <br /> SIZE <br />I WIDTH LENGTH HEIGHT TYPE OF CONSTRUCTION ESTIMA TED VALUE <br /> STRUCTURE - <br /> DETAILS t},OOO - <br />I VAL FOR PERMIT <br /> DETAILS OR REMARKS: <br />I 00 NOT WAITE IN THIS SPACE <br /> NOTICE Tyee of Ot.eueancy Oil/ilion <br />I SEPARATE PERM ITS ARE REOUIRED FOR ELECTRICAL. Conll. Groue <br /> PLUMBING, HEATING, VENTILATING DR AIR CONDITIONING. <br /> THIS PERMIT BECOMES NULL AND VOID IF WORK OR Sizeol Bldg. No.ot MaI. <br /> CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN fTOlallSq. Fl. Storie3 Qee. Load <br />I 120 DAYS,OR IF CONSTRUCTION OR WORK IS SUSPENDED DR <br /> ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME Energy U.. FlrllSprinklen <br /> AFTER WORK IS COMMENCED. Audit Zone Required eyes DNa <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINEO THIS No.of OFF STREE~ PARKING SP1CES: <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />I CORRECT. ALL PROVISION OF LAWS AND ORDINANCES Dwelling Uniu <br /> GOVERNING T IS TYPE OF WORK WILL BE COMPLIED WITH Covered U~ed <br /> WHETHER SP CIFIED HEREIN OR NOT. THE GRANTING OF A Spec:j~1 ApllrOI/;lI, Required Receil/ed Not Requir..:l <br /> PERMIT DO NOT PRESUME TO GIVE AUTHORITY TO <br /> VIOLATE 0 CAN L THE PROVISIONS OF ANY OTHER BOARD OF APPEAL <br /> STATE L CAL L REGULATING CONSTRUCTION DR THE PLANNING COMM. <br /> PERFO CE ONSTRUCTION. <br /> 1/1LlAGe COUNCIL <br /> R OR AUTHORIZED AGENT SPECIAL USE <br /> FIRE OEPT. <br /> SIGNATURE OF OWNER (IF OWNER BUIl.DEA) IDATE) SOIL REPORT <br /> DUED OTHER <br />I /p/S/'13 <br /> ~.,J , <br /> BUILDING OFFICIAL , (DATE) <br />