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.w+r� ♦'ii; i �Mrtr.I�V A i iON 1` 0R MIAMz S� OR VILL4G - .
Dete. ±. .,_ Job
Address GM 5
Legal Description _
CM* 44211 I*6111rt--
/ ' • 04404 •
Owner's Addrses____LIC# Contracting co. * POM SEPT 7ANk J G!!��• � pine
CLIANE% ANC,
?, N.E. Ind RVENUE•IAit9E
Qualifier 55 M 3313r46 — Phone 7
111, lsuaiolp tF .._,_ Competency (L1 J
a$.G. 1
A chitectr /Engineer,. +.� I •
Address_
Bonding any:
Address
Mortgagor �._ .._.
Address
Permit TYPe(cirele one): BUILDING ELECTRICAL pyE MECHANICAL
MORE DESCRIPTION
.. /f R _' " PAVING PENCE RIM
Square Ft .,,,,.—_-_
Estimated Cost(value)
4ARN I MG '1'Q OWNER: YoiT MET RECORD A NQT L CB CF FAILURE
So MAT RESULT IN YOUR PAYING TRICE FOR IMPROVEMENT�CY� r P RO P15R Or YOU Y DO TO
10 OBTAIN FINANCING, CONSULT tf wl� YOUR LENDER OR AN ATTORNEY MORE RECORDING YOUR
trOT I CE OF COMMENCEMENT).
&plisaatioe is hereby aide to obtain a permit to do work and insta1xation as indicated MECHANICAL above
the attached addendum (if applicable). x certify that all work will be a�t the
m add
standards of all laws regulating construction in this s rstan a o mepa the
permits are required for Bf EC RIC ., PLUMBING, SIGNS POOLS, OI�. I thaw separate AFFIDAVIT: I Qarti fy that all the � LS. ROOFQpING asrsd M a!$�ACljsy►;, ii(WORE .
M4
done in foregoing information is **curate and that all work will
ompliance with all applicable laws regulating construe
authorize the above - named contractor to do the work stated. toni i• /Furthermore, I
Q .Js.6..--.. ,
of �r and /o Condo Pres4ideu
rotary as to audAdgEtCdtalikrAtitgidarnt
b' CAVntfssi• .. � - fit INWARY PUBLIC - MINNESOTA
HENNEPIN COUNTY
MY COMMISSION EXPIRF-5 OCTOBAR 29, 1997
BEE: wiRm
C . C.F.
Meahaoiaes
Bate:
Tan Folio
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EV of Contract
WON
Permit F
o oso 9
•
Owner
tar, ea $o Contractor or Owner-- itaidsr
My CCmmisaion ix :
GLADYS y CO ,
NOT AMC rest tat coneri
MYVQMMe u J $) sto
NOTARY. TOTAL
v'
Piee Other
oaafirk.' ldin
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