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2010-07-29 Monument Sign
Date Received ml / CV BUILDING PERMIT APPLICATION Date Notified ', C Nbertville 5959 Main Avenue to Paid Albertville, MN 55301 C Cash, CC Small Town living. Big City life. Phone: 763 - 497 -3384 Fax 763- 497 -3210 ermit # 6010 . 16Y Site Address: cell/it cs (? yr� f 01, 37 , BUILDING PERMIT FEES I Business Name: ,tc / /f/s // E'^ e-t s% I i' � ,� 1 The Applicant is: Owner A Contractor Tenant I Permit 1 • 1 Legal Description: � Surcharge Z i 00 Addition Lot Block 1 1 Plan Check 76./70 1 Owner: I I rrt 1 Engineering site 1 Name ohiff/ S' ri ra/ Address ctit/11V 6 �i .Y. • t,; ri 1 g g ( ) 1 37 I Mechanical I City Auticul //t St /PM/ zip S 1 Phone H �7 1 Fireplace (s) 1 ( ) ( ) (C) Contractor: I Plumbing C ompany N ame /ACGat& 5 A �fjr 7A Licens # to 3t>/ 87 � s & W Address X7 J`�i', 37 C. /. /i $' City ,, St �x Zip.5'..1,.S � Water Meter 1 Contact Person -kin /1'1c G©cja,e City WAC Phone: (W) p1',2 - 3 S 3 (C) 7S .- i. -i f 6 C i JP WAC 1 I -- Y " (Fax) yS�2 °� 7c:1 I Architect: 1 SAC I Name /I/7i� Address I • 1 I Storm Water � • City St Zip 1 1 License Check Phone (W) (C) (Fax) I 1 Other 1 T pe of Work: - - _ 1 TOTAL ril` ❑ New Construction Residential ❑ Addition ❑ Alteration ❑ Finish Bsmt 1 ❑ New Construction Commercial ❑ Garage /Shed 0 Reside/Reroof ❑ Fireplace 1 ❑ Tenant Finish ❑ Plbg ❑ Htg ❑ Deck � Type of Const. I I of Work: C G - c7 . p /t✓//u�it ` 1 Description Use of Bldg v r A, .'e b , , • - ` E e3 4 1 ',. ic 1 I Occupancy Group I Size of Structure: j �� Total Square Footage: I Occupancy Load Length ia7 -O First Floor I " Width ,-,7 `i` Second Floor I Zoning I Height - -e>' Basement I i - Garage I Code Used Estimated Valuation of Work: I Sow I 1 1 I hereby apply, for the above consideration and declare that the information and materials submitted with this application are in 1 Are Fire Sprinklers Required? I compliance with City Ordinance and Policy Requirements and are complete and accurate to the best of my knowledge. 1 ❑ Yes ❑ No I 1 understand that all City incurred professional fees and expenses associated with the rocessin o this re P g f request are the 9 1 of property pp promptly p f y f Date Approved responsibility o the owner and %r applicant and should be aid. I a ment is not received from the 1 pp 1 applicant, the property owner acknowledges and agrees to be responsible for the unpaid fee balance either by direct payment 1 Fire Dept. or a special assessment against the property. If the property fee owner is not the applicant, the applicant must provide written authorization the owner 10 make application. /P - . 'w. -Ian P AleGocc+1c . 7 -a 1 /0 1 City Engineer I App icants Signa e Applicants Printed Name Date 1 City Planner L- - - - 1 - - 1 (Ellie Works 7 /?i 2 ( ,"o Ailliii alP Ap�•d y B, "ding Officiat Value A oved Dat Special Conditions or Comments: _ I mo) 1 1 `� Received Stamp RECEIVD City of A b'crtvi11e 5959 Main 9 JUL i 1 2010 Albertville, MN 55301 -0009 smell Town Living. Big City Lift. 763- 497 -3384, ext 103 Fax: 763- 497 -3210 Building Inspections PERMANENT SIGN PERMIT APPLICATION Please print or type all information. Complete all applicable items on both pages. A Building Permit Application must accompany each Permanent Sign Permit Application. Property Owners/Landlords Approval is required for Permanent Signs by signature below or letter of approval submitted with application. N,fA✓ Property Address: fCi j/ 0'74 Ernri , C OY`n et C/ do fir? fap ; c 9 r = c" 3 7 Applicant Name: Gccabt Doi / viter44;y Address: '1737 Nezy /c/ Sc'rY i. 1 40 Applicants Phone: FS.2 2 /2 - /pF 6 Applicant is (please check one) L'. Owner $Contractor I Other X `D7�vae C.5Arf s Property Owner's Name Owners Signature * Required P Y Street Address Phone Number /9/6C/414.14.// /WA $S3• ( fir, ,r3:30 City State Zip Code ,r .4911 % 46k k keel 75 2 /2 — /% %c Sign Contractor's Name Telephone Number 73 svi' Street Address /ytri9/TF7 r3 cr / M ,041,4" 5-53y„S City State Zip Code Class of Work: KNew I Addition Alteration 11 Repair 11 Demolition MUST INCLUDE A PICTURE OF SIGNAGE ON BUILDING WITH DIMENSIONS OR SURVEY WITH SIGN DRAWN ON IT TO SCALE FOR MONUMENT OR FREESTANDING SIGNAGE Please Complete Page Two: FIELD MEET SHEET Locate Request # t t 4, - Meet D &T Meet P lace ime: : USIC INFO EXCAVATOR INFO Name: Excavator's Co.: Emp #: District: , Met with: J , Phone #: -- 'Sup. Group: Phone #: PROJECT PHOTOS TAKEN Yes' Nol 'i Yesj °� Nor ,t> , WRITTEN DESCRIPTION OF SPECIFIC INSTRUCTIONS AGREED UPON High Profile Conflict: Conflict Location: MAPPED DESCRIPTION OF SPECIFIC INSTRUCTIONS AGREED UPON Indicate North with arrow (Diagram Not To Scale: Footage Must Be Noted) 0 - i Will this visit complete the ticket? If "NO" please list the next proposed meet schedule Yes ;:_ 1 Nol 1 USIC Employee Signature Excavator Signature Reviewed By * * * ** *NOTICE TO EXCAVATORS Sup. It is your responsibility to pot hole, expose, and properly DM: support the underground utilities when excavating within the tolerance zone mandated by state law on either side of location markings or when crossing a utility. Additionally, it is your responsibility to call in a new ticket if marks are destroyed. 3 Part Carbonless Copies CC - White Locator - Yellow Excavator - Pink Revised: 10/30/2009 . Ko<l in ike — -.. - 1 k,it ., #‘,./ ,,.4,..je a, f -0. • I ,... ,;,__ 1 iev ....,,,,.., d • N7 - t • V, • • a e .46 ..„,„ / 1 • • y ___," .„„ ____ ta .s • • ed , r 1 • P. " * ":1, .1 4 0 •. -� 0. .,„ v „p.,w- %-.- :a ? if•AP 1 W d3 • e •• w Al 2% . i .1 . ,.......) w . • . •� . .ey-, •P _ _,,,, . ,- vt, ‘ . 7 „ . ,... . , ,..1 1)- 4. - , 0 . • •• ' o gie ‘t 144 gb - 1' -% c p • 1 7,11 ■• A S SIP • , P . N • '4? vi 4. * - `• • * • % # • , i• ,10.71-- 1 • CA !. • • * - 1 .1 • i . • ) -- 4t , � . r AO air4. r.r_ ._. ..___ , , ‘1•6 1 4 • ..b \ 4?\S\ , ce_ c-c. ..t, —5 I 7 p , . mar • .40. • Ji 2 s . , 00 , rb 434,,,,zr :1 k nr ) ‘ 0,* ' • Al n Ay !...4.:, ...l c,-20 •• . [ . t ,. ©� _ 1J� '_" �..� . ■ : a Ci 4 ral &TNI s sts .0 c) se k i ;711 ---t I I 1•61 TO 1 a .-• h---' Mb ' ---4--- - - - -- I - 7 sr. -----: 1 1 11: , .. till ''t ,H 4 1 , - • , , ‘), !,'I l v 0 / L, , .... • ..,,,.. . . . ,aii....... ......--...• . -.._ . I i t i t ---. 7 / I Li:1 • ' ,'N \ 1, k ,--7,--. 1 • ' 4 i — — ------ - , N 11 ''.. 4 l'4 7 ,_n ■-' : - . J ' ' 1 1 . -• . 1 ,''' i i ,r • - s-k) 1, 7 i l i . ' • ..z, ‘ ,... 3,_ i ■ 1 I r ' " - ' (s1 • .-- \>---; k i •■■ 1 'Z. ti r. ' i ...„. „ i '3 Z._ • I . 4 ).) Q 'I. ■ — ,,,, _.... _ _ i_,..._ (\. _ . .--. -■ i I I -4) .1 .4: .; • -...... p • ____ ___ = es a oi.0 0. 4 111••• GO C•TI4 a era ... Cid ot M a ig -3 .;?: , t IIIIII „... •,... .-.0 ..... N 7.4... I i ‘,..„ -.71 •-) \ -..,4 O.._ .... . L., _ , CITY OF ALBERTVILLE INSPECTION ICE M T W TH F PERMIT NO. SCHEDULED 1 11‘PI 1.— ADDRESS CA 37 ANN /� 4 Time OWNER 1C P J HO ' N J E CONTRACTOR PHONE °6 ❑ FOOTINGS ❑ FIREPLACE AT THROAT ❑ DEMO • ❑ FOUNDATION ❑ INSULATION ❑ SITE INSPECTION ❑ DRAIN TILE ❑ PLUMBING FINAL ❑ GRADING /EXCAV. _ ❑ PLUMBING RI ❑ MECHANICAL FINAL ❑ COMPLAINT ❑ MECHANICAL RI ❑ FIREPLACE FINAL ❑ FOLLOW -UP ❑ FRAMING "FINAL ❑ • COMMENTS ON Utile:N 51&AI cc w j J/'J Z Gt e ►� (M c t o Amt PoV-Ic I toil w cc U WORK SATISFACTORY: PROCEED. ❑ PHOTO TAKEN W CORRECT WORK & PROCEED. W ❑ CORRECT WORK & CALL FOR RE- INSPECTION BEFORE COVERING. UNSAFE I • ❑ CORRECT U SA E COND T I ON IMMEDIATELY o ❑ STOP ORDER POSTED. CALL INSPECTOR. U ❑ INSPECTION REQUIRED. CALL TO ARRANGE ACCESS. Call Bldg. Dept. at 763- 497 -3384 x 3 at least 24 hours in advance for an appointment. Owner /Contrac or on Inspector City of Albertville, 5959 Main Avenue NE, Albertville, MN 55301 Phone: 763 - 497 -3384 x 3 Fax: 763 - 497 -3210 White Copy/ Inspector's Files Yell CITY OF ALBERTVILLE INSPECTION NOTICE M T W (91 F PERMIT NO. SCHEDULED 1 Iz I it ADDRESS KtJC V I/Vl, 51.1PSSUI Date Time OWNER PHONE CONTRACTOR PHONE ' FOOTINGS 51 ❑ FIREPLACE AT THROAT ❑ DEMO I— FOUNDATION ❑ INSULATION ❑ SITE INSPECTION 0 DRAIN TILE ❑ PLUMBING FINAL ❑ GRADING /EXCAV. _ ❑ PLUMBING RI ❑ MECHANICAL FINAL ❑ COMPLAINT ❑ MECHANICAL RI ❑ FIREPLACE FINAL ❑ FOLLOW -UP Z ❑ F RAMING ❑ FINAL ❑ COMMENTS L K. -1.2 j 7 (,4 Er w CoK� 0 cc 0 w (0 ( OP )\ .. w w s- U W ' WORK SATISFACTORY: PROCEED. ❑ PHOTO TAKEN ORRECT WORK & PROCEED. W ❑ CORRECT WORK & CALL FOR RE- INSPECTION BEFORE COVERING. p ❑ CORRECT UNSAFE CONDITION IMMEDIATELY O ❑ STOP ORDER POSTED. CALL INSPECTOR. U ❑ INSPECTION REQUIRED CALL TO ARRANGE ACCESS. Call Bldg. Dept. at 763 -497 :384 x 3 at least 24 hours in advance for an appointment. Owner /Contracto on /.. - Inspector `► City of Albertville, 5959 Main Avenue NE, Albertville, MN 55301 Phone: 763 - 497 -3384 x 3 Fax: 763 - 497 -3210 White Copy/ Inspector's Files Yellow Copy/ Site Notice