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<br />~ <br /> <br />t1~ <br /> <br />SIGN PERMIT APPLICATION <br />CITY OF CENTERVILLE <br />/9f!LJ CfN~ S~E-r <br />OWNER'S NAME: "J;;t.A1 p./2DPE/lTf' l4#W.A7e~blr <br />CONTRACTOR: ,M?L:..- ~A1LD~JI!-~ TELEPHONE #: I/:JC; 1-4Se;-lZ/3 <br />CONTRACTOR'S NAME & ADDRESS: .~ m~~~t;f;!;. .. <br />~~.,./ ~~ HEidfl/6) MN ~7~ <br />/ <br />TYPE OF WORK: NEW~ ADDITION _ REPAIR _ OTHER, <br />DESCRIBE WORK: ~ ~.D/51J4L 7/1N . <br />ZONING CLASSIFICATION:~ ENERGY CODE CATEGORY: 1 <br /> <br />SITE ADDRESS: <br /> <br />2_ <br /> <br />APPROVED USE: <br /> <br />ESTIMATED VALUE: <br /> <br />TYPE OF CONST: <br /> <br />SIZE OF BLDG: (SQ. FT.): <br /> <br />................................................ <br /> <br />OFFICE USE ONLY: ZONING: <br /> <br />SOIL REPORT: <br /> <br />RICE CREEK WATERSHED: <br /> <br />FIREDEPT.: _ OTHER: <br /> <br />1HE UNDERSIGNED MAKES APPLICATION FORE A PERMIT TO UNDERTAKE CONSTRUCTION AS <br />SPECIFIED ABOVE AND AGREES TO COMPLY IN ALL RESPECTS WI11{ TIlE BUILDING CODE AND ALL <br />CITY OF CENTERVlLLE ORDINANCES AND TO ASSUME RESPONSIBIUTY FOR EMPLOYEES. AGENTS <br />AND SUB-CONTRACTORS AND CONSENT TO NECESSARY INSPECTIONS. <br /> <br />ENFORCEMENT AND ADMINISTRATION OF mE MINNESOTA STATE BUILDING CODE IS A PUBLIC <br />SERVICE AND IS OF NECESSITY. LIMITED IN NAnJRE, CONSEQUENTLY, nus BUILDING PERMIT AND <br />1HE SUBSEQUENT BUILDING INSPECllONS ARE NOT TO BE CONSTRUED TO BE REUED UPON AS <br />ANY TYPE OF WARRANTY, GUARANTEE, OR REPRESENTATION ON TIlE PART OF TIm CITY THAT <br />THE PLANS, CONSTRUCTION OR FINISHED PRODUCTS ARE NECESSARILY BY CONFORMANCE WITH <br />THE PROVISIONS OF nm MINNESOTA STATE BUILDING CODE OR OTHER APPLICABLE <br />CONSTRUCTION STANDARDS. FUR1lfER, 1HE CITY ASSUMES NO RESPONSIBn.JTY OR LIABILITY <br />FOR DAMAGES OF ANY NA1lJRE ALLEGEDLY ARISING OUT OF TIlE ISSUANCE OF TInS PERMIT OR <br />SUBSEQUENT INSPECTI NS. <br /> <br /> <br />D~Y~ <br /> <br />DATE PLANS APPROVEDe <br />s~~~. <br />V UATION <br /> <br />BUILDING INSPECTOR <br /> <br />BLDG. PERMIT # <br /> <br />L--_"_ ._ <br /> <br />51- <br />