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Site Address: <br />' 7550 Sunwood Drive NW. <br />/lam <br />Ramsey, MN 55303 <br />763-433-9850 - phone <br />763-433-9848 - fax <br />1 G oa Osmi utm S Nit <br />Legal Description: Lot 3 Block Subdivision C�IQ l !',k) der- soV\ <br />or PID # NteS <br />Chad and Mel i-ed <br />Owner Name: St-or ba k ke, h <br />Address: Il,Oa, I OSMIUM St. ti W. <br />City /State: R Q YYi 5e y, NIA Zip: 55303 <br />Phone: 76 3 7/at- 51-4y <br />G(nad 614,- a � <br />Contact:brbd k►<eY1 Phone. . Fax: <br />Description of Work: A c c e 5 5 O r9 B u i (d I h g d ' X 4 ( ) / <br />variav\c -e r,e50( - t t- oS -09 - -J G7 <br />V ki ion (including labor): * 7 6 3 0 <br />Does this plan qualify for SS1300.0160 yes X no. If yes, the master plan number is <br />The undersigned acknowledges that he /she has read this application and the above information is correct and accurate. <br />pplicant also understands by signing this application that he /she could be held responsible as representative of this <br />t or y violation of c s , iance w' h all ap.licable laws and ordinances of the Ci of Ramsey. <br />Signature of Applicant or Authorized Agent <br />Engineering Approval Vita <br />Planning Approval <br />* * * * * * * * * * * * * * * * * * * * * * * * * * * * ** FOR OFFICE USE ONLY * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** <br />NOTICE: This is an application only. Permit will be issued after City approval and payment of fees. <br />Fire Marshal Approval <br />Septic Approval <br />Building Approval <br />Date <br />Date <br />RECEIVED <br />AUG 2 1 2009 <br />BY:. <br />Contractor: <br />Address: <br />City /State: Zip: <br />State License No. <br />° $ <br />Date <br />Type of Const <br />Occupancy Classification <br />Special Conditions <br />Total $ °al ■ .53 <br />Permit Application <br />Building V <br />Plumbing <br />Heating <br />Sewer <br />Permit # a()10-1?--- <br />