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1607 Johnny Cake Ridge LaSiIRNSrVILLE Heating & Air Conditioning, L.L.C. 12481 Rhode /sland Ave S, 5avnge, MN i5.378 • 952•890-0005 Orstet Test Report for Job# .riYiA/Jti1? l ,-7? City ?'?`i Date of Install Type of HT. F/A ? HW Space HT Unit HT Otlter Make 1. t ?»c,y Model Serial ?a°?=5=}+?U7 input ??,, c;??o ?7c< N Pilot Type HOT SURFACE /GNITOR . Pressure ? :5 }+0' C02 C. I _ Input CFH 02 Stack Temp =-3-I CO 10 Date Tested ?? tn - V 2 Company_ Technician BURNSVILLE HEATING & A/R CONDITIONlIVG Address '(0o-7 J-i9?)Ylnu CAe. RlJrn I /jY1e--- Zip 5512Z?_ L.ot D I_ Blk _I Sub 00?c2 (o+I'' TFIESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION. Date: /Q')? / C), Qa Yes No Inspector: Final grade (6" from siding) .? Permanent steps (garage) .`/ Permanent steps (main entry) ? ? Permanent driveway ? Permanent gas ? Sod/Seeded grass ? TraiUcurb damage Porch Basement $nish Deck ? Please verify with the builder the removal of roof test caps from the plumbing system and the shutoff of water suppty [o the outside lawn feucet before freeze potential exists. Conqct engineering divisioa at 6814645 before working in rightof-way or instalGng underground sprinkler system. ? White - City Copy Yellow - Resident Copy Pink - Contractor Copy PERMIT # S?? 3 I RECEIPT DATE: 1 8008 RESIDENTIAL PLUM$INfi PEiiMIT APPLICATION crrY oF EAsm 3830 f'ILOT KAOB RD EA6AN, MN 551EE 651-6$1-4675 Please complete for: SITE ADDRESS: OWNER NAME: : INSTALLER NAME: STREET ADDRESS: CITY: single family dwellings, townhomes and condos when permits are required for each unit, backflow preventer for irrigation system 7 Q3lcnn TELEPHONE #: (A EA CO?E) TELEPHONE #: (AREA CODE) STATE: I?Iv( ZIP: ,SS _ SEPTIC SYSTEM, new/refurbished (requires two sets of plans and MPC license) $ 100 00 includes $40.00 County fee . Note: Additional consulTant fees may apply • MODIFICATION/ALTERATION TO EXISTING DWELLING UNIT, INCLUDING: _ Adding fiMures to lower levels or room additions, excluding water softeners and water heaters. $ 50.00 _ Abandonment of septic system. _ Water tumaround - existing dwelling unit (+ 5/8" meter if needed -$118) Other: _ RPZ: new installation/repair/rebuild $ 30.00 _ lawn irrigation system ReplacemenUadditionaL• (/water softener water heater $ 15.00 State Surcharge $ 50 Total ; $ I hereby acknowledge that I have read this application, state thal the informatlon is correct, and agree to complywith all applicable City of Eagan ordinances. It is the applicanPs responsi6ility to notify the property owner that the City of Eagan assumes no liability for any damages caused by Ihe City during its normal operational and maintenance activities to the facilities constructed under this P 1 l ermit within C' ro . /ri t a se e ?. .PArh' .? ?:Y? Y?F 7tSIGNATURE OF PERMITTEE 1/02 ? Site address, Lot ? Block¢? Subd.??`? vo Isg On Aprii 15, 2000 the Minnesota Energy Code, Category i Building Requirements for insulation protection, air tightness, and ventilation, was adopted. As a result, the City of Eagan is requiring that the following information be submitted prior to issuance of a Certificate of Occupancy. This structure: is constructed to meet minimum requirements of the Mn Energy Code, Chapter 7670 / OR This structure: will e constructed to meet more reshictive requirements of Chapters 7672 or 7674 APPLIANCE GAS ELEC MANUFACTURER MODEL BTU'S VENTINGTYPE WaterHeater M ?a SI Furnace ?..a Ca Dryer EXHAUST SY5TEM LOCATION TYPE MODEL CFM's VENTED Yes r+o Kitchen kitchen Bathroom 1 G`h GNK OM.? F?- S Vo Bathroom 2 _a siP p 'So ? Bathroom 3 Bathroom 4 Other FIREPLACE S LOCATION GAS WOOD MANUFACTURER MODEL BTU'S VENTING DIRECT AiMOs ( c,I {U 6-/0 f, 7 ?oa MAKE-UP AIR MODEL TYPE CFM's that the above informa6on is correct and agree to comply with ine Minnesoza cneryy ?wd aiiu vity ul wayul, Date This form is the responsibility of the General Contractor, La 1- a ? 3l o J_- ! _?f-?'?A? (? RESIDENTIAK BUILDING PERMIT APPLICATION CITY OF EAGAN 1rii1 `P 3830 PILOT KNOB RD, EAGAN MN 55122 651•681-4675 P P New Canstruction Reauirements RemodeVReoair Reauirements • 7:egisrerea ;ite surveys showirg sq. ft. of !ot, sq. fl. of house; and all roofed areas . 2 copies of plan (20°% maximum lot coverage allowetl) . i set of Eneryy Calculations for heated additions C ScSZS'(e, ?( • 2 cocies of plan showing 6eam & window saes; poured found desyn, etc) . 1 site survey for extedor additions 8 decks • 1 set of Energy Calculations y? . InOicale if hame serve0 5y septic system for additions • 3 copies of Tree Preservation Plan i( lot platted after 717193 /(Y? ?? . Rim Joist OeWil Options selection sheet (bldqs with 3 or less units) ?DATE oIl9Iaz- ? VALUA710N"? SITE ADDRESS 107 MULTI-FAMILY BLDG _Y?N TYPE OF WORK NG,, FIREPLACE(S) _ 041_ 2 APPLICANT $TREETADDRESS 5;I5- Nar?kWCSAr- ?PA(tvaZe2CITY"kt?STATE 11N('4Ip SSIZL TELEPHONE # &51`W--Z57`( CELL PHONE #6I:Z-3(;1-R&A? FAX # PROPERTYOWNER??I'1? ? TELEPHONE# -------------------------------------------•--------------------------------------------------- COMPLETE THIS SECTION fOR KNEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MIV'VE:SO"C:112UI.E5 7670CA"CE(;0RY l NIINNl:SO'l'.A RT'LL':S 7672 (v submissioa type) . Residential Ventilation Category 1 Worksheet Submitted • New Energy CoCe Worksheet Submitted • Energy Envelope Calculations Submitted Plumbing Contractor. ?_? ??cJ?^ Sp?t Phone !t =??2 -°?- rt ZI f? ',. Plumbing system includes _ 4Vater So4fener :;La{Y[i(Sprihkl'cig2 Fee $90•00 ? Water Heater 'No. of R.I s No. of Baths LLi? Mechanicai Conhactor: Phone # ?a - ?R NIcch;ulic.d scs[cm include,: .1ir Condition ? Pcc: 570.00 - Hcal RccovcSystcm '?;; Phone fk 7G3-%a9 -a9°3f' Sewer/Water Contractor: lkdlt Gt.,?,44!Z,._ S19171tZ,C, ------------------------°----------°--------°---°----------°-------•----------------- I hereby acknowledge that I have read this application, state that the information is with all applicable State oi Minnesota Statutes and City of Eagan Ordinances. Slgnature of Applicant ....................... and agree to comply OFFICE USE OvLY Certificates oF Survey Received ? Tree Preservation Plan Received _ Not Required ? Updated 4l02 OFFICE USE ONLY , . , ? 01 Foundation O 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg 3,( 02 SF Dweliing ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4sea.) ? 33 Ext Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi ? OS 03•plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 44-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous )( 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)• ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement 'Demolition (Entire Bldg only) - Give PCA handout to applicant Valuation q dL90 Occupancy aa?. L& MC/ES System Census Code Zoning tp 00_ Ciry Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. ? PRV ? Nbr. of Bldgs Length 3K , Fire Sprinklered Type of Const _VL%_) Width , REQUIRED INSPECTIONS ? Footings (new bldg) ?C Finab'C.O. _ Footings (deck) _ FinaUNo C.O. Foorings (addition) _ Plumbing Foundation _ HVAC Drain Tite 0[her Roof Ice & 68arer Final Pool _ Ftgs _ Air;Gas Tests _ Final _ _ Framing _ _ Siding Stucco Scone Fireplace ?' R.I. 4.4it Test ?,Final Windows (nzw/replace ment) Y Insulation Y Rztaining Wall Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Ptant Plumbing Permit Mechanical Permit License Search Copies Other Total Approved By T Z- , Building inspector -------- ----------------- --------------- ?w'SPL r''l rr.aA-' l? 36 x sL1 b*nan-& 1-/ 67? ?! ??O = () t-6-k- 7? ?f Z ;i 0"° ? O?? 71F,! n^..2900 13:53 "777c1-r.?,.;•k CUMPLIANC$ S2EPORT •.q!„?e?.,-?r,a Enezgy Code j•P.i.jr?i..?,r?: SOft,'WeLLf! VEYBf.(711 3.0 P. E12.'03 Pexm t Chec a y Date r":'•, ?,., , DakotA Minnesota 2 C'•.'A !?IITtvliCTION TYPS: 3ingle Family G+n'Tr?, 6-7-2000 nh7r' ,^F PLAI7$: 3/28/00 ' T rr•"• 11MBv-R WALICOUT ELFVAT20N 41 PA99E3 F?ar?, i•?d fJA m 393 ???„- unrze = 294 ?i°•:?'- raetter Thgn Code Area or Cavity Cont. Clazing/boor Perimbter R-Value R-value U-value _.-------------------^----------•------------------------------- S 1228 4410 0.0 ----.. :'t?' `? ? rk+od Fxame, 16" O.C, 2039 1910 2.0 1 j•7A7::.!;: 57i.od Frame. Z6° o.?.`. 1.99 10.C 2.0 R?'`1 9.0' ht/8.3' bg/9.41 insul 47 11.0 0.0 P:?11' ' r'o''ic. 3.51 ht/3.1 1 bg/3.5 1 insul 20 10.0 0.0 C-rWicdows or Dnors, Above OYada 334 0.350 1 pC„ P?z 39 0.350 HVn?' F,QI;IpMENT: Furnaae, 92.0 AFVE .. _ _._.."-^--^'--"`-""--_""----"_`---'-'-^----_....-"_---^'----"_ ,rn-'a?'3.,i1±prCE &TATE1MfiNT: TF.e propheed building deeign deeorlbed here is co-?-is•-en.t with thA building pLana, apecificatfons, and other calculakione evbmzk*_ed with the permit applicatloii. The prnpoeed builriing has been de-75yr-d ta meet the requirement? of the Minnesota saergy Code. I 6v1AP?? lejA- lhvv? ,..nArr 0 { LOT SURVEY CHECKLIST FOR RESIDENTIAL BUII.DING PERMIT APPLICATION ? ? c m s U Y ¢ a O z ¢ cv / ? ? iG? ? _. n ? L-J ?Y r ? ? ?. ? ? ? n p r_ d G ? /rn : - ? '_: ? ? ?/- r y = DATE OF SURVEY: F'f"O? PROPERTY LEGAL: LATEST REVISION: DOCUMENTSTANDARDS • Registered Land Surveyor signature and company • Building Permit Applicant • Legal description • Address • North arrow and scale • House type (rambler, walkout, split w/o, split entry, lookout, etc.) • Directional drainage arrows with slopelgradient % • Proposed/existing sewer and water services & invert elevation • Street name • Driveway • Lot Square Footage • Lot Coverage ELEVATIONS Existina • Sewer service (or Praposed) • Property comers • Top of curb at the driveway and property line extensions • Elevations of any existing adjacent homes • Adequate footing depth of structures due to adjacent utility trenches • Waterways (pond, stream, etc.) / Prooosed ?J ? ;- • Garage floor ?? ? • Basementfloor • Lowest exposed elevation (walkouUwindow) ?/? - . Propertycorners . L? ?? . Front and rear of home at the toundation PONDING AREA (if aoolicable) ? ? ^ . Easement line ? ?/ ? • NWL ? p,?L • HWL ? 6' /7 • Pond # designation ? '? • Emergency Overflow Elevation i? ? Reviewed: DIMENSIONS • Lot lines/Bearings & dimensions • Right-of-way and street width (to back of curb) • Proposed home dimensions including any proposed decks, overhangs greater than 2', porches, etc. (i.e. all structures requiring permanent footings) • Show all easements of record and any City utilities within those easements • Setbacks of proposed structure and sideyard setback of adjacent existlng structures • Retaining wall requirements, f OK • - Surveyor's Certificate SURVEY FOR :PULTE HOMES DESCRIBED AS :Lot 21, Block 1, OAKBROOKE 6TH ADDITION, City of Eagan, Minnesota and reserving easements of record. AU G 19 REC`D :E k. }; . ? 0 x .A o 'a??-^ . ? .:i-_.?•_. . .?... - . d T P ?LU !kk? ? ?,u LOT SQ. FOOTAGE = 3,960 HSE. SQ. FOOTAGE = 1,821 LOT COVERAGE = 461'o # ,794, PROPOSED ELEVATIONS Top of Foundation = q27.5 Garage Floor -1? 27 1 Basement Floor = qi8.5 Aprox. Sewer Service =9i5.5*_ Proposed Elev. _ (:::?D Existing Elev. - Drainage Directions = Oenotes Offset Stake = . SCALE: 1 inch = 30 feet HEDLUND I HEREBY CER7IFY THAT THIS IS A OF THE BOUNOARIES OF THE ABO\ BY ME OR UNDER MY DIRECT SUPI PLANN7NG BNGlNB6R1NG SURV6YIN0 SHOWIIAPROVEMENTS OR ENCROAC 2005 Pin Oak Drive ? Eagan, MN 55722 DATE J.2 ,(12 Phone: (657) 405-6600 Fax: (657) 405-6606 14376 I Oakbrooke 5 BENCHMARK, TNN @ Qy66lQ Eleo= q27,5) MIN. SETBACK REQUIREMENTS Front - House Side - Rear - Garage Side- JOB N0: noN 02R-520 =YED TO BOOK: PAGE: :? :M. \ PERMIT City of Eagan Permit Type: Building Permit Number: EA104822 • Date Issued: 06/12/2012 of ERin Permit Category: ePermit Site Address: 1607 Johnny Cake Ridge La Lot: 21 Block: 1 Addition: Oakbrooke 6th PID: 10-53765-01-210 Use: Description: Sub Type: e-Reroof Construction Type: Work Type: Replace Description: House & Garage Census Code: 434- Occupancy: Zoning: Square Feet: 0 Comments: If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar. Pictures are not acceptable in lieu of inspections. Carbon monoxide detectors are required by law in ALL single family homes. Fee Summary: BL - Base Fee $4K $103.25 0801.4085 Valuation: 4,000.00 Surcharge - Based on Valuation $4K $2.00 9001.2195 Total: $105.25 Contractor: - Applicant - Owner: Krech Exteriors Inc Charles A Blixt 5866 Blackshire Path 1607 Johnny Cake Ridge La Inver Grove Heights MN 55076 Eagan MN 55122 (651) 688-6368 I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA127568 Date Issued:10/07/2014 Permit Category:ePermit Site Address: 1607 Johnny Cake Ridge La Lot:21 Block: 1 Addition: Oakbrooke 6th PID:10-53765-01-210 Use: Description: Sub Type:Siding Work Type:Replace Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please leave printed pictures of house wrap on site for the final inspection. When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to ensure maximum ventilation to attic. Call for final inspection after installation. Valuation: 4,000.00 Fee Summary:BL - Base Fee $4K $103.25 0801.4085 Surcharge - Based on Valuation $4K $2.00 9001.2195 $105.25 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Charles A Blixt 1607 Johnny Cake Ridge La Eagan MN 55122 Property Claim Solutions Llc 2005 Pin Oak Dr Eagan MN 55122 (651) 994-2028 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA128117 Date Issued:10/27/2014 Permit Category:ePermit Site Address: 1607 Johnny Cake Ridge La Lot:21 Block: 1 Addition: Oakbrooke 6th PID:10-53765-01-210 Use: Description: Sub Type:Reroof Work Type:Replace Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please print pictures of ice and water protection and leave on site. Carbon monoxide detectors are required by law in ALL single family homes . Lisa Nyberg Valuation: 4,000.00 Fee Summary:BL - Base Fee $4K $103.25 0801.4085 Surcharge - Based on Valuation $4K $2.00 9001.2195 $105.25 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Charles A Blixt 1607 Johnny Cake Ridge La Eagan MN 55122 Property Claim Solutions Llc 2005 Pin Oak Dr Eagan MN 55122 (651) 994-2028 Applicant/Permitee: Signature Issued By: Signature For Office Use % % 1 1 ..;,, EAGAN % % . �0 * :::e: (o.� 3830 PILOT KNOB ROAD EAGAN, MN 55122-1810 Date Received: 5-(:). -/87 (651)675-5675 I TDD:(651)454-8535 FAX: (651)675-569 ,. Email: buildinginspections a(�citvofeagan.com Staff: Commercial Plan Submittal:eplans(a�cityofeagan.com L ________________7_- MAY 292018 2018 RESIDENTIAL MECHANICAL PERMIT APPLICATION Date: 05/24/18 Site Address: 1607 Johnny Cake Ridge Lane Tenant: Suite#: Name: Nancy Blixt Phone: 6516883581 -tier Address/city/Zip: 1607 Johnny Cake Ridge Lane Eagan MN 55122 Name: Burnsville Heating &Air Conditioning License#: 003114 3451 W. Burnsville Pkwy#120 Burnsville Address: City: MN 55337 952-894-0005 - 19 State: Zip: Phone: r' contact: Stephanie Email: smessenger@burnsvilleheating.com Ary RESIDENTIAL Furnace �' ic ✓ Air Conditioner 7 1IIPer it Type Air Exchanger Heat Pump ' 'A14 „ Other New ✓ Replacement Additional Alteration Demolition 1 '� 'Dk Replacement residential AC Axa Description of work: = fi RESIDENTIAL FEES $60.00 Minimum Add or alteration to an existing unit,includes State Surcharge _ 60.00 $100.00 Residential New, includes State Surcharge =$ TOTAL FEE You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeagan.com/subscribe. I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and workAis not to start without aa permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Applicant's Messenger J' uJvA . � Applicant's Printed Name Ap scant Signature -17 -,.,.6,0_004:0,„,-t � e,___,,,.„. .,::__,,,014:-..,t4,,,,,,,, _ , �„ _ Vi ,, ,� -' 4 i��� _ �� ��r ® E Ut d gr u • 7*-,, t _ '" Ser e `G,r l t I t �'I�1' � �` • • • 71 e e • .N l _ o • � For Ofilce.Use ,..0i s.i I Permit#:. q''--` .� • x... .. ;� _ � " Permit Fee; YZ� . D 3830 PILOT KNOB ROAD.I EAGAN,MN-55122-1810DEC 11 7018 Date Received: �°��Il'� (651)675-5675 I TOD:(651)454-8535 I FAX: (651)'675-5694 .bulldinginspecllons{a,cltyofeagan.com Staff: L J .2018 ` E.SIDENTIAL PLUMBING PERMIT APPLICATION Date: P04111 0 l9`-�T ih� Ceikcti _c �_.. , V Site Address: Tenant: 1 �t„t ,b t�(g„ 5 . 4 � � 1 Suite#: Y ` /041 I 'J t` arae; /.I, ►.L/ �> 5�c� J �ri 0r G' ts !•C$ :t' "' � � t , Phone: •• x:1' 4,,I,i?S.09 }�Ux .;.d: Address/City/Zip: ,, _ til, Name; MILBERT COMPANY dba CULLIGAN WA ER 4 NI WC641376 rh.:404 4141 License#:p �� Y`�"U"'y+ 'f'° 3r;Fit Address; 1801 50TH STREET EAST k(z�cgr1'}rCity: INVER GROVE HEIGHTS zi r e ,� i ,4 )'n State: MN . Zip: 55077 .',„ y 'tW6Y >a;. Phone: 651-451-2241 �4�rl�k�s��: ` a FY;tpstt 4,,.:gik 4,.!i.i k'� Contact: BILL MILBERT Email: •loria.abas@culligan4water,com • acv to Jt f 4 ;;,1s �` ''pff�'.q.r �,.F -.___New _Replacement Repair __Rebuild _-__Modify Space _Work In R.O.W. 'tb,,t14;f'A.gt ;,{4„1,4 Description of work: r .>5«r p• r< !i RESIDENTIAL -- t e,L,r- ,`rL'l ,, .5 ti,,}., `,,,,r _Water Heater rP ttt, M,V;6 ,.41'1.*n ; ___Lawn Irrigation(_ PVB) X Water Softener n r F.., RPZ/ c1`ij�}Jt;�:t��1�i};�PrtitS�tlsv�f'St�,���: - i n '1'•tisl f�;40 r`04i Septic System Add Plumbing Fixtures (�Main./ Lower •,_,•-,r,i ti 'f,. Level) � ,� eAli,q., f. r b` t�att � �S�¢rjr; New WaterTurnaround Abandonment r _---__ $60.00 Water Heater,Water Softener, or Water Heater and Softener(Includes State-Surcharge) —� ��_�—~ RESIDENTIAL FEES: $60.00 Lawn Irrigation (Includes State Surcharge) $60.00 Add Plumbing Fixtures, Septic System Abandonment,Water Turnaround*(includes State Surcharge) 'Water Turnaround(add $280.00 If a 3/4"meter Is required) $115.00 Septic System New(Includes County fee and Stale Surcharge) 60 00 CALL BEFORE YOU DIG. Call G.ept Srato One Call al(651)454-eon for protection against underground uAlllit L Fdama e, intend to dig to receive locales-of underground utilities. www.oouherstateonecall orn ' You may subscribe to receive an electronic notification from the City of proposed ordinances VST~-Call 4'8 hours before you webslta at www, recei comisubscribe. by signing up for an email update on the City's I hereby acknowledge'that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this Is not a permit,/but only an application for a permit, and work Is not to start without a permit; that the work will be In accordancewltp h?approved plan In e cas 6f work !oh requires a review and approval of plans. ik x .�. Applicant's Printed Name x • ,//666 . rl t Applicant's Signature (0`S 1 f(� Za T�<�!{r;;F`�1r'd,�(v�;%;4!f,( )r'�S`�i111°5~fAV�"Y}�fis IR"OO F:IGE USE?'y`; 'ilf tG 4,40,g1Milt;�I(P v�'> ;y l rti PRO ?1 .(i�'i t.i4VY"u,' 4i' it ! �% ••��� �i�v�'�y ,�y, vp,, a.lt >r, �w � i.,•l:i? ' 'i 1 t.�.� £.,(r,<:. Sii G.1.. t ;'r. -r ,,Y1 'ii:::-;.d•, ,,�'t�r '}:r .v 7[}. :,r.(,, ..c..;;jiAi I-A 'k: m .,ao k 't qq�,}t.�,,,., ,oy , ,! .r,r _ E.4,, .p,,;i., :,.. ({ vi'eWadti, ,?.,E;_:; -{i-;i`:. •i• - ti"` :c!*VIA- ,>:• A,:,rz.:W 1,:C,,,:; } ^t,`�.,I`�. X�"%:�'t# rl. 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