Laserfiche WebLink
<br />~Sf3VHmE <br /> <br />COMMUNITY DEVELOPMENT DEPARTMENT. PHONE: 651-490-2238. FAX: 651-490-2931 <br />RESIDENTIAL BUILDING PERMIT APPLICATION <br /> <br />PERMIT NUMBER: <br /> <br />New <br /> <br />Alteration <br /> <br />~ <br />Grading (see supplement) <br />Other: <br /> <br />Garage <br />Demolition <br /> <br />WORK PROPOSED: <br /> <br />Deck <br /> <br />Roof/Siding <br />Draintile <br /> <br />Window <br /> <br /> <br />INDICATE <br />SQUARE <br />FOOTAGE OF: <br /> <br />Basement: <br />Garage: <br />Deck: <br /> <br />Porch: I (') 0 <br />#of Stories: <br /> <br /> <br />Acknowledgement and Signature: <br />The undersigned hereby makes application to the City of Roseville to perform the work as herein described. The undersigned further states, under penalty of <br />law, that the work will be performed in accordance with the Minnesota State Building Code, this plication, and any approved plans and/or specifications. <br /> <br />Signature: rC~~~ <br />Phone: lo~) "V} -9/1 'J- Date: 7-1,\" a \ <br /> <br /> <br />Print Name: <br /> <br />SEPARATE PERMITS REQUIRED: Electrical <br /> <br />FEES: <br />Permit $ <br />State Surcharge $ <br />Plan Check $ <br />Cert. of Occup. $ <br />Metro SAC $ <br /> <br />Mechanical <br /> <br />Plumbing <br /> <br />Water <br /> <br />Sewer <br /> <br />Water Meter (# <br />Construction Deposit <br />Contractor's License <br />Assessments <br />Park Dedication <br />Other: <br /> <br />) $ <br />$ <br />$ <br />$ <br />$ <br />$ <br />Total Fees: $ <br />Receipt #: <br />Receipt Date: <br /> <br />WARNING: Be sure to contact public utilities for location of underground cables, <br />conduits, pipes, etc, before digging. <br />Call Gopher State One: 651-454-0002 <br />