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AF - 46076C� � r 1 U Date: Owner � • � �. ! City of Fr dley, . BUILDING PERMIT No s 6 2 7 � � ��� _._....��-�����...�_ ....._._.�. . _. .__.. : _.__��E�-=`--�d�_�-�rr- ' _. -� ._.. ._..._ ._ Bwlder ... • .._. =�.'�. .�.� .:..............•----......------......._..._____..__. Address_..._......._...._..._.._.._...__.._..._._...._.._.....__ ................_...._...._..._......_.._ Address CA OF B ItDING No. ���Jn � � - d •� .. Street ._.. _ .. . . .. ..:._ ._. ....--�'••-� �-�....------.._. P of t ......_.--___.. ....._.. ...._._...._....... . _ ..... Lot ....._. ... Block .----.._..._..� ...•---------• •-------. Addition or Sub-Divisio� ....._. .. : : -----. . .._ . . .. ... ........ ._ ...__...._. _.. .. �j 1 �y Corner Lot ...__......._..._.._._ Inside Lot •---•--. �.......... Setback ..v?--�._....--•--.--- Sideyard ..._.....� �r._:._._'_�.._.:.__.._..._.._..__..._ Sewer Elevatiari _._......_.__..__._...._...__..._.._.._.._..___._ ............._......_ Foundation Elevation DESCRIPTION OF BUILDING o v : / , _ _. Front _.. �� DePth ��..._.�.._. Height .,r.��.. Sq. F� �,���--Cu. Ft.O'�..!....�i=•- __.._.._....___.__......_........__..._._ __._.._...._...__ Depth .....__..� Height � .A�Sq. Ft. ._..__._._..._ Cu. Ft _._._..._._ •----_...._..... __ Type of Construction .. ....._.._ ._. . Es� Cost�y�.'""-����.. TTo�be Completed _..._......._..__........_._...__.._._. In consideration of the issuance to me of a permit to construct the building des bed above, agree to do th� proposed work in accordance with the description above set fox�h anc�� com ' ce with al�provisions of ordinanoes of the city of Fridley. . /(i / // a� -__ Ea camsfderation of the payment of a fee of $.�� �...-.., permit is hereby grauted to.___...._..T . to construct the building or addition as described above. This permit is granted upon ...__,........_..__......._......._.:......... ._.____. the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon safd building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked a t ax�y time upon violation of a.ny of the provisions of said OPdiri&i10E8. /") /9 A �l Bll11�IIg iI18pCCtOT NOTICE: '�his p�rmit do�s not wwr th� eonmueNon, installNion for wieiny, phnnbing. 0as h��, aw�r o� wabr. 8� sun to sN fh� Bvildiep lasp�efor for s�parNe pamhs for fh� itNns. � .. .. �. i APP'LICATION FOR BUILDING PERMIT CIT1f Ol� FRIDLEY, MINNES4TA ' QSJNET�' S NAME BUILDER ADDRESS AbDRESS � LOCATxON OF BiJILDII� No. �J �� Street_������ Part of Lot Lot � Block Addition or Subdivieion Corner Lot Inside Lot Setback Side Yard SEWER ELEVATION FOUNDATION BLEVATION ApplicanC attach to this form ltao Certificates of Survey of Lot and proposed build- ing location drawn or► these Certificatea. To be used as; DESCRIPTION OF BUILDING Front Depth HeighC Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction: Estimated Cost To be Completed � The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Departmeat of Buildings, and hereby declares that all the facts and representations stated ia this application are true and correcC. DATE � � � GNA ���'���1� �� � SI TURE s`��-�-- `?%/ � � �� � � (Schedule of Fee Costs can be found an the Reverse Side). ^ ,, - � 4 . ~ � Application �or Power Plants and Haerting. Cooling. Yentilation� Refrigeration and Air Conditioning Systems ond Deviees PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work . . . . . . . . . . . . . . . .. . . . . . . Z.. �r 8.00 $ �(- ` Replacement of Eurnace . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.00 � Repairs & Alteratians—up to $500.00 . . . . . . . . . . . . . . . . . . 5.00 $ Repairs & Alterations each add. �50Q.00 . . . . . . . . . . . . . . . 2.50 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,Q00 BTU . . . . . . . . . . . . each add. 60,000 BTLT ....................... Replacement of E�rnace ............................. Repairs & Alterations—up to $50U.00 . . . . . . . . . . . . . . . . . Repairs & Alterations each add. $500.00 . . . . . . . . . . . . . . 8.00 $ 2.OQ � 5.00 $ 5.00 $ 2.50 $ STEAM or HOT WATER $Y3TEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam .... . 8.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $ Each add. 2U0 sq. ft. EDR, Steam . . . . . . . . . . . . . . . . . . . . . . 2.50 $ Each add. 32U sq. ft. EDR Hot Water . . . . . . . . . . . . . . . . . . 2.50 $ OIL BURNER—to 3 gal. per hour . . . . . . . . . . . . . . . . . . . . . . . . 5.00 $ over 3 gal. per hour—See Fee Schedule GA5 BURNER (up to 400,000 BTU) . . . . . . . . . . . . . . . . . . . . . . 5.00 $ GAS FITTING FEES: NO RATE TOTAL lst 3 Fixtures ...................... x $1.56 $ Additional Fixtures . ............... x .50 $ - Gas Range to 200,000 BTU . . . . . . . . . . . x 2.OQ $ AIA CONDITIONI1�iG � FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ ALTERATIQNS 8c REPAIRS TOTAL FEE � �—� ROUGH FINAL Depi. of Bldgs. Phone SU i-7470 Location � �� � � 1 � � l C c��• %1�,1 � � i � � � City of Fridley: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. _ ^ Fridley, Minn. �,�,�c, „ �--G . , 19 �� Owner � -X � Kind of Building _ Used as � To be completed about ��" u��% [i',etimafnA f!nef � •� � U Old—New. Building Permit No. G�''z . Permit No. "� � � OF WORK HEATING or POWEft PLANTS—Steam, Hot Water, Warm Air—No. Trade Name�,�l Size No. Capacity Sq. F� E.D.R._�f 6 aG BT[J H.P. Total Connected Load�a., .� a�-7� 3°` Kind of Fuel �. , y BURNER — Trade Name Size No. Capacity Sq, Ft. E.D.R. BTLT H.P. (REMARKS—OVER) ��<z sM Signe � B3'---�,�-r L-� - Business Phone No.�� ��' � S� S CIiY OF FRIDLEY aP?LICATION FQR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITION?NG SYSTEMS AND DEVICES P�RTI�L �TE SCHEDULE GR�IVITY WAR��[ AIR: Furnace Snell & Duct Work Rep2acement of Furnace Renairs & Alterations-up to SS00.00 Repairs & Alterations each add. $500.00 �SECHAN I CAL �VAR�I :� 1 R: FUrnace S'r.ell & Di:ct Work to 100,000 BTU each add. 50,000 BTU Replacenent of Furnace Reoairs & Alterations-uo to $500.00 Repairs & Alterations each add. $500.00 STFr'1h! OR HOT WATER SYSTEAI: Boi2er & Lines up to 100,000 BTU each addn. Sii, 000 BTli Boiler only up La 100,000 BTU each addn. 50,000 BTL` OIL BURNER- to 3 yal. per hour each a3d. 3 gal. per hour GA� BURNER- from 100,000 BTU to 1>9,999 BTU (over 199,999 RTU see Fee Schedule) RATE TOTAL $12.00 $ 7.00 $ 7.00 $ 4.00 $ $12.00 4.00 7.00 7.00 4.00 $i2.00 4.00 �.eo 6.00 $10.00 10.00 slo.00 Job Address ��~� Department of Buildings City of Fridley Tel. #571-3450 The undersigned hereby makes application for a pernit for th2 work hereiXi $ Ypecified agreeing to do a:i wo'rk in strict accordance with the City Codes $ and rulinqs of the Department oE Buil.dings, and hereby declares that all the $"� UO facts and representations stated in this application are true and correct. $ % 4 � a Fri�lep, Minn. / � "� �� . 19� � . OWNER ���1 ( � �( � %7 $ KIND Or^ BUILDING '-7 A�/� �^� y ; � � USED AS ��,�__ $ 'i'O BE COMPLETED ABOUT r v _� a^ ��. $ �j�/ G9C� ,r, ESTIMATED COST `%� �%b °� OLD t7EW BUILDING PERMIT NO. PERMIT NO. _�� `�-� $ GAS FITTING FFL'-S: lst 3 Pixtures � a� 3•�� $�'� U Additional Fixtures x $ 1.00 $� Gas Range to 199,000 BTU x$10.00 $ _ �IR CONDITIONING �� S FAN HEATIVG SYSTE�IS r See Fee scnedule $ VENTILATING SYSTEMS S ALTEF2�;TI0;�'S $ REPAIRS ,) S_ - State Surcharge $ .50 TOTAL F'EE � e�O . S,2i RUUGH INSP Date FINAL INSP.�-/ - Date APPROVAL FOR PERMIT < FD REINSPECTION FEE (_$10. 00) MINIMUM FEE r^OR ANY HEATZNG PE.T2MIT IS $7.50 DESCRIPTIO?�7 OF FURIJAC°/BURNER HEATING or POWER PLANTS, Steam, Hot Water Warm Air- No.� Trade Name Size No.�� , Capacity Sq. E' . EDR _ BTU xP Total Connected Load Rfnd of Fue1 �� C! BURNER - Trade Name Size No. _������ CapaCity Sq. Ft. EDR BTU _ HP Company . �L�/ �� �.LC.t� �' � 'I��' l•r�w� Siqned By ��4 -�- ` ��.r �. Tel. No. �,��� � � 7 � SUBJECT City of Fridley 2 5 31 0 AT THE TOP OF THE TWINS g � I L D I N G P E R M i T i � R . � � ` COMMUNITY DEVELOPMENT DIV. ��� �� V PROTECTIVE INSPECTION SEC. � _ , ; "" , r , '; i.---�; /'��;'� CITY HALL FRIDLE� 55432 NUMBER REV OATE GAGE OF APPROVEO 8V � 612-571-3450 9�0-F15 7/24/97 � � JOB ADDRESS 752�_29 Able Street NE t LEGAL LOT NO. BIOCK TRACT OFi ADOITION SEE ATTACNED DESCR. ( 2 Nagel's Woodlands SHEET 2 PFOPERTY OWNER MAIL ADOfiESS ZIP PHONE ABLE PROPERTY MANAGEMENT 9920 Zilla St NW, Coon Ra ids Mn 55433 754-0743 3 CONTRACTOR MAIL ADORESS ZIP PHONE LICENSE NO Kozitza Construction 9175 Isanti St Blaine MN 55449 786-3625 2650 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE UCENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PMONE LICENSE NO. 6 USE OF BUILDING Du lex 7 CLASS OF WORK ❑ NEW O ADDITION O ALTERATION O REPAIR ❑ MOVE O REMOVE X 8 DESCRIBE WORK Construct a 22' x 22' Detached Gara e 9 CHANGE OF USE FROM TO STIPUTATIONS See notations on plan. Provide a hard surface driveway. Variance on rear yard setback approved by Appeals Commission on 8/14/96. � ������ eefore digg►�B �a�� for $EPARATE PERMITS REQUtRED FOR all util�ty localions WIRING, HEA7ING, PLUMBING AND SIGNS, �� �2 R�QUIRED BY LAV1� TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NUIL AND VOIO IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAVS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFV THAT I HAVE READ AND EXAMINEO THIS APPLICATION Z STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SUHTAX AND ORDINANCES GOVERNING THIS TVPE OF WORK WILL BE COMPLIEO WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT �8,949 ��F.�FJ DOES NOT PRESUME TO GIVE AUTHORITV TO VIOIATE OR CANCEL THE pERMITFEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGUTATING cor,- �149.75 Fire SC �H.95 STRUCTION OR THE PERfORMANCE OF CONSTRUCTION. C� � PLAN CHECK FEE TOTA� FEE License SC $5.00 $168.17 5iG ATUAEOFCON'RACTOFlORAUTHOA�ZEDA ENT �DarEi WHEN PROPERI ALID ED THIS IS VOUR PERMIT � , y SiGNATUFlE OF QWNEA i�F OWNER BU�LOEAI IDATE� Bl �NS� �1�TE i\� E�V�� AllDN ALTI�IZ ll [ l � ) ConstcuctionAddress: � Legal Description: L, Owner Name & Address: Contractor: Address: �� : i LIVING AREA: GARAGE AREA: DECK AREA: OTHER: CI'I'Y OF E RIDLCY SINGL� FAMILY ANU DL�PLEXES R-1 AhTD R-2 BUILDING PEIZNfIT APPLICATION �a�z -- a �i �, � � �� �� ����� .Q ' y �,,v�p.:7� � / % Z.f°� ���iS �� l�-�% ! � C� ii'� rrr������ liti�� .L��'����/a �� Tel_ # 75'y- �7�l3 �= MN LICENSE # ����� Tel. # ��Y�G'2�t 3 Attach to this application, a Certificate of Survey �f � lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT �n� Width Height Sq. Ft. Length �2 `�. Width a a Height Sq. Ft. Y�� �ng� Width Hgt/Ground Sq. Ft. Construction Type: �l� �,�zQ � fY,�,,,,.� Estimated Cost: $ �(�Dc� <<��� ,.s�e�_ , I (Fee Schedule on Back� Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft �x $ —$ DATE: 7 - � � Permit Fee Fi.re Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Se�ver Main Cllar-ge "1'( )' I'n I , ti f�il'( I(.;�'l�i( �Nti: A.PPLICANT: � �' ';�,� Tel. #�7 ;� Y� c5 ? Y 3 � CITY USE ONLY $ f �/�� % Fee Schedule on Reverse Side � . � .001 of Permit Valuation (1/lOth%) � � �% $.50/$1,000 Valuation $ $950 per SAC Unit $ L � $5.00 (State Licensed Residential Contractors) � Alt. "A" or Alt. "B" Above � $450.00 Conservation Plan Review � Fee Deterinined by rngineering � Agreemenl Necessary [ ] Not Necessary [ ] �_ �!� �L— : , . ..... , . . . .. : . .. . _ : :. _ , . _ : . . . _ _ ,. • � - ,: ,:. . . , . . ,� :. ,.. _ . . . ... _ ;. , r _ � .. . . . . :; 5. . . .:; ,, ,. .. . _ , , , . , ..,: . .-, . - ,_.. , . :.. _ . . . _ , . . _ .-: . . .:.: . , ;. ;: , _ : _ _ ,� , _ . . . .,: _ �. . , _ :_. -�. .. .:.. ., , ,.. .. _, . . : _ ..: . : ,. . - , ..,. � . - .0 _,. . ><., �x�- _<. . ._:.. . _. _ _:. : . .,_, .� � . 1 � `t� 4 :� ..... , . . , _ _ _. . d . , . . .: ,, _ ,, . . , .. . . _; , _ . . ,. . . .., . -. . � . /. �� y .���.. � .. � �-.._ �.... �� .. . . . � .`. � .. . . :.�.v . .�,..-: ... .... _ .. H1�:... . .. �.. ....� �... :. . ... .. .- .:- . - �. ...sfn � ♦ ,... _ . . �. �.. .. ,. . ��. " - �,. <..... . .: '_ ... ... �:. :�.:. . �: � .. .. � . . : �:.-� .: . "� '-...�.. �:..:..-. 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City of Fridley 2 6 79 6 AT THE TOP OF THE TWINS g � i L D I N G P E R M I T r � ` RECEIPT NO. � • COMMUNITY DEVELOPMENT OIV. ,� / e� . r � L � PROTECTIVE INSPECTION SEC. `� � J � . � � � �"'1 � CITY HAIL FRIDLE� 55432 NUMBER REV OATE PAGE OF AGVROVED BY �.---� • •'' 612-571-3450 9t0-Ft5 7/23/98 � � JOB ADDRESS 7527-29 Able St NE 1 LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACMED DESCR. 6 2 Na el� SHEET 2 PROPEiiTY OWNER MAIL ADDRESS ZIP PHONE Able Pro M mt 754-0743 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Owner 4 ARCHITECT OF DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAII ADDRESS ZIP PHONE IICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW O ADDITION ❑ ALTERATION �7 REPAIR O MOVE ❑ REMOVE 6 DESCRIBE WORK Reroof 22 S Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must complywith State Building Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV lOAO SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING. VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID If WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCEO WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERI00 OF 120 OAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFV TNAT I HAVE READ AND EXAMINED THIS APPlICA710N 2 STALLS GARAGES AND KNOW THE SAME TO BE TRUE ANO CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND OROINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GiiANTING OF A PEFMIT $1834. HO �. 92 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE PROVISIONS OF ANV OT STATE OR LOCAL LAW REGULATING CON- S7RU ON OR THE ORM CE OF , ONSTRUCTION �59. SO Fire SC � 1. H3 �` PLAN CHECKFEE TOTALFEE License SC $5.00 $67.25 StGNATURE OF CONTRACTOR OR AUTHORIZED AGENT iDArE� WHEN PROPERLY V DATED THIS IS YOUR PERMIT . W � C` _ / •_- SiGNATURE Of OWNEA UF OWNEA BU4DEAi iOATE� BIOG �NSP p�TE NEW ADDN ALTER �) Il �) CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: ��� `� �-- v� j� �Q � L �S � /��� • L,egal Description: Effective 1/1/98 �v a� ��� Owner Name & Address: d�,�!3�, C r��-G�� ���i1.1�, Tel. # Contractor: ��/t'� MN LICENSE # Address: Q � ? O `Z % �- �7� i �C�� ������._S' � Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. � LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Construction Type: Length Length Length Driveway Cu.rb Cut Width Needed DATE: Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: , DESCRIP'TION OF Il�IPROVEMENT APPLICANT: $ ,�� $ `�F3 $ . �� $ $ � $ $ $ $ � Z� � . Width Width Width Height Sq. Ft. Height 5q. Ft. Hgt/Ground Sq. Ft. ` �- ��- Estunated Cost: $ iC,S 13�� (Fee Schedule on Back) Ft. + 6 Ft = Ft x$ _$ Tel. # CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1 / l Oth %) $.50/$1,000 Valuation $1000 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] , , . y. CITY OF FRIDLEY PERMIT o.: 2004-012� 6431 UNIVERSITY AVENUE NE ___-� FRIDLEY, MN 55432 DATE ISSUED: 08/06/2004 �631572-3604 FAX: (7631571-1287 ADDRESS : 7529 ABLE ST NE PIN : 123024220023 LEGAL DESC : NAGELS WOODLANDS : LOT 6 BLOCK 2 PERMIT TYPE : BUILDING PROPERTY TYPE : DUPLEXES CONSTRUCTION TYPE : WINDOW/DOOR REPL VALUATION : $ 1,500.00 NOTE: PROVIDE SMOKE DETECTORS IN ALL SLEEPING ROOMS AND ON ALL LEVELS OF THE DUPLEX PER R317 OF THE 2000 INTERNATIONAL RESIDENTIAL CODE. CAULK AND FLASH ALL EXTERIOR OPENINGS. INSTALL AN EGRESS WINDOW. PERMITS REQUIRED FOR BASEMENTBEDROOM FINISH. STATE LICENSED CONTRACTOR 1 APPLICANT TRENDY ROOFING SONS INC (20027543) 210 ZACHARY LANE PLYMOUTH, MN 55441- OWNER ASHRAF LLC 2947 BENT TREE HILL RD NEW BRIGHTON, MN 55112 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of wor� will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to vioIate or canc t�e provisions of any other state or local law regulat' erformance of cons cti n. Ap ca Date Bldg Insp � Date � BUILDING PERMIT FEE FIRE SURCHARGE STATE SURCHARGE, VALUE LICENSE SURCHARGE TOTAL SEPARATE PERMITS REQUIRED FG�: WORK OTHER THAN DESCRIBED ABOVE. 54.00 1.50 0.75 5.00 61.25 N� � � CITY OF FRIDLEY ADDN [) 6431 University Ave NE, Fridiey, MN 55432 ALTER [] SINGLE FAMILY AND DUPLEXES R•1 AND R-2 BUILDING PERMIT APPLICATION � Construction Address: � Legal Description: Owner Name & Address: Contractor. � � �'`n�' LIVING AREA: GARAGE AREA: DECK AREA: ,. �7 S �� Effective 4/1/2004 (763) 5T2-3604 Bidg insp (763) 571-1287 Fax �,.��C;�� K (`�1�% � ��_-� �!' Q �,,. � Tel. �C 1 MN LICENSE # �``j�Tel. #�l-�3 5�,1 �q�-'13�3 Attach to this application, a Certificate of Survey of the bt, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length _ Width Height Sq. Ft. Length Width " Height _ Sq. Ft. Length Width HgUGround Sq. F� ATHER: .5�.� ,��. Construction Type: � � "' ��'� Estimated Cost: $ Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE:� ^ ^ L� APPLICANT: � T�'��= ��_l� Call (763) 572-3604 for Pertnit Fees if mailing in application. Fax to 763-571-128 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee Plan Review Fire Surcharge State Surcharge , SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge TOTAL �,� $ ,�y C.� $ `—.-' $ � S C? $ �S� $ $ S -C�C� $ $ $ $ Fee Schedule on Reverse Side 65% of Permit Fee .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1350 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] ., $ - �- �?S cn STIPULATIONS: � _ _ ____ _ � ��� ay �o� �'� U�,� �� r� C� � 3) s��. � �� ���� � s� �►,�� �a � � � Q '� � o�l j�; S 1, �y`►�; � — � � � 11 �� � � � -� a�� w: a� x���� T�, �� �' A � � a �► '> ) o� `� � loc /< � `�1� --� ���cSS ��nciu� --c���kUVI � �` Se �''�RV�� � �� � � �i _� �$„ � - � � � ` C� f .���n �1 oC � g� X � Z- „ H:y� �..,:�� � -> a�,�k ���,,� a X I a g��n o+1 a'N �S;as� �� -r_ n s�'u �� a E-� a x�� s��� �R�,ae� � S �`� � � � ��-�� � /'� S� � � �� 1 � � . � , �a� .n _� f` �� �� LJ�' Ov � S�'� o� Q loclC �clo� �c �o a{� e. S� � d 13 ��%(„c, �. o�C � f�, : �a ov.� � 1 a,�- � �� a � 12 .,.> : �� S ; '� � .� REVI --� RQ�,�. o�a w,,na�� � �ak� ��4 � �� � �Qe�Q.� �� �,;,:�a�