AF - 44520�
� ,
City of Fridley, Minn.
BUILDING PERMIT
Date: ___._ S e.,,pt emb er,_ 14,__19 7 0.._.__.._.�. �_.�_�
s'337
h�
1082
Oamer: _...Benedict Novak____..._..__-.:��'`�---.�q� Builder _.__ Same�-
Address...._11.�.-.7..1st,..Wa.3.'.._..N...x.E t._...---....--•--...._....._..------......._.._ Address _._...Same _..._ .............�.._ __.__._..__........_...._.._._..___._
i,y,5- _� ��� ,,�9�� LOCATION OF BUILDING
No. -----...,�..._... Street ._.._......._.... lst. Way__NTE._--____._.. .... Part of Lot __._.__..__....._..______...._.._._.________
� Lot ....._........��:......_..._ Block _._.___._._......_........_..._.__.._.._. Addition or Sub-Division ....Auditor's Subdivision No. 77
Corner Lcrt ....._......_..._.._.._ Inside Lot .-----•--------......_-----.---... Setback ..__._-----•-----------•.---•-----. Sideyard
Sewer Elevatian :----...._._.__--•------_....__....--••-•-------...._._..----•-------•-•---•-•-- Founda.tion Elevation .---•---.._._.
To be Used as:
Livin� Room F•�nt
DESCRIPTION OF BUILDIN
�y, 9/����I(�
16 �..._ Depth .._�.�....._. Height •_1 �-�---_ Sq. F't _�� _ Cu. FL �
._._._.._....___..__...._._........._...._ Front __.___..._.__ Depth _..._._-•-•-----. Height ._.._......._....__ Sq. Ft. _..___._...._ Cu. F� _.__._._._
Type of Constructiott -.----.--- Frame .---.._....-.-•-.---.. Est. Cost ..........._...._�2:500.._00.-- To be Completed ....._June �1,� 1971
��R.:�Q.-eQ.,i,�.�.�.2+z..�J ��s. v � /2JL-t �,�� � ,S" � h�.S�
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordance with the description above set forth and in compliance with all ''ons of
ordinances of the dty of Fridley. �—^ - �
��_.
) � . c c^.�
In ca�siideration of the payment of a fee of �._.��-�'�.._.._.., permit is hereby grauted to_.._..Mr. Novak �
....__,...._.._.._..._.._....___..__.___......_ 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 said building, or any part thereof, shall conform in all respects to the ordinances o�
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and movinS of buildings
within the city limits and this permit may be revoked at any time upon violation of any of the proviaions of said
ordinances.
NOTICE:
Yhis psrmh dws nof eow� fh� eonstruafion, installNion fo� wieing. Plumbtng. 0as h�afi�. aw�r er wat�r. 8� sun to sN
1h� BuiWieg Insp�eror for s�parat� p�rmifs for 1h� fNms.
• •
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APLICATION FOR RESIDENTIAL, ALTERATION,
OR AllllITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER' S NAME :�1G� �(°Q� C�' � I%�/� �BUILDER : /" Z� r� L° L�
c'--� �--'� � —�—t
ADDRESS : %/ � �-%/ � j� � � �� ADDRESS :
NO:. - S1'�ET:
�
LOT: BLOCK: ADDITION:_�� �� � � �� _
CORNER LOT: INSIDE LOT:�l�SETBACK: SIDEYARD:
Applicant attach to this form Ztao Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
�ESCRIPTION OF BUILDING
To Be Used As:
/� � Front:
(.o Depth : `�p Height : f �_
Square Feet: Cubic Feet: C/ �o O
Front: Depth: Height•
Square Feet; Cubic Feet:
r--
Type of Construction: � q m�e Estimated Cost: $ ,� �, O-�
To Be Completed : � ��_ J Q���_
,.�..._
The undersigned hereby makes applicativn for a permit for the work herein
specified, agreeing to do all work in stiict accordance with the City of
Fridley Ordinances and rulings of the Department of Buildings, and hereby
declares that all the facts and representations stated in this application
are true and correct.
UATE : „T ' �C��_ S IGNAT[JRE : '
(See Revexse Side For Additional Infonnation.)
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sue�ecr PERMIT N
City of Fridley
AT THE TOP OF THE TWINS B U I L D I N G P E R M I T
r
; � RECEIPTNO.
� • COMMUNITY OEVELOPMENT DIV.
� ; 4 �����_� .
� � � PROTECTlVE INSPECTION SEC. / _
� U!
i
� � �'�'1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPFOVEO BY
�-°�� � �'� si2-5so-3a5o g10-F15 10/9/73 � �
JOB ADDRESS
1 LEGAL LOT NO. BLO TRACT OR ADDITION SEE ATTACHED
DESCR. SHEET
2 PR�PERTY OWNER MAIL ADDRESS ZIP PHONE
3 ONTRACTOR MAfL ADDRESS Z�P PHONE LICENSE NO.
4 ARCHITECT OR DESIGNER MAIL ADDRESS 2iP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE UCENSE N0.
6 USE OF BUILDING
7 CLASS OF WORK
C� NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WORK
Cor.struct 3 ZL � x 32' det�cchE:d g«rare. Present gar.age will be:
used a� ar. t of_ thE: hor-�e .
9 CHANGE O� USE FROM TO
STIPULATIONS
1. Fx°ost foati.ngs waived as ov�-ner. agr_ee:: ne�•er to atte�� this
garagF to the e:xisting structur.e.
2. Provide z hard si:rfG.ce drive wY!en �tre:et is improvec'�.
SEPERAT�' PERMITS RE�UiR£D FOR WiRtNG,
HEATiwG, PtUM81N� AND SIGNS.
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAO
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUM8ING, HEATING,
VENTILATING OR AIR CONDITIONING, WC�Od
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION 'lO4 %� O�iO
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKlNG
i HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED �` 3� 1 H 9. 12 ],- . 6 C
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTNORITY TO VIOLATE OR CANCEL T1-IE pERM1T FEE SAC CHARGE
PROVIS�ONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- 13.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PIAN CHECK FEE TOTAL FEE
, $14.60
NA7UREOfCO RACTO ORAUTHORI2EDAGENT IDATEI F{�ERL IDA THIS IS Y�ER�71T ..
/
SiGNATUREOFOWNERUFOWN B ILDERI IDATEI � BLDG.INSP DA7E
�PPI,ICATION FOR RLSID�:NTI�L, ALTI�Rt��l'I�)V,
OR f1i)ll1"I'ION Bt1II,DING PEIZMIT
(�1'!'Y C�F F1:1llLf.:'�', `.�t1:�ti�Nf�:SiJ'I'1�
� /
QWN�R � �a NA,'KE : `J �/1/ � CD % C �<, j • �J i�A//1�U ILDER : �'j ��, /V� C %�
�
i
,�A�xESS :_/ y S - 7 � � �,v � y eD�x�s s :
NQ. - STREET:
T.Q :�� [�LOCK: ADDITION:_ L�=.f.�-�'- c�c:!�.z�i�#'!1
GQ�NER LOT: IiVSIAE I.OT: SETBACK: SIDEYAFD; �; �
,A,p�1.�.can� attach to this Lorm �ao Certificates of Survey af Lo� and proposed
bu.ildalxig location drawn on these Certificates, Y
U�SGRIPTI�N OF BUILDING 9
To $e Used As: �
� , � ,/ � /
.,r'�'��A � Front : Z 2_ Depth : �� Height : ,�.
4Rl ��
Square Feet: Cubic Feet; �, jJ��
Front: llepth: Height:
Square Feet; Cubic Feet:
Typ� a£ Constzuction: Estimated Cost: ,�r
'�o Be �ompletE:d. � ��a �� /�`%. /�Z.�
Tt2e tzndexsigned hezeby ma.kes applicativn fox a permit for the work herei.n�
spec�.fied, agreeing to do a11 work in stiic� accoXdance with the City af
�'x'idley Ordinances and rulings of thc� Uepartment of Buildings, and hereby
d�claxes that �11 th� facts and xepresentations stated in this application
axe true and �.,rrt c t.
� ., • _
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BAT E : , . C; �A'iiJRE :
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(See Reverse Side For Additional Tnformation.)
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560-3450
C�c�t o �`��i��Ce
� �
ANOKA COUNTY
6431 UNIVERSITY AVENUE NE December 14, 1976 - FRIDLEY, MINNfSOTA 55421
Mr. & Mrs. Benedict J: Novak
145 - 71� Way N.E.
Fridley, Mn. 55432
Re: Change of House Numbers
Effective January 1, 1977
Dear 1�' • & Mrs . Novak : .
it has been necessary for this office to change the address
of your house
FROPf 145 - 71� Way N.E. TO 125 Alden Circle N.E.
LEGAL DESCRIPTION Part of Lot 34, Revised Aud. Sub. #77
We have notified the Post Office Department, Minneapolis Gas
. Company, Northern States Power Company, Northwestern Bell Telephone
Company and various departments in City hall of this change. �
Sincerely,
• ' `� ` .
D �L G. CLARK
Co.;ununity Development Adm.
DGC/mh
sau•3�50
�r¢ti � r[��e
J �
�
ANOKA COUNTY
6431 UNIVERSITY AVENUE NE December 14, 1976 FRIDLEY, MINN[SOTa :i5432
0
Minneapolis Post Offi.ce D2paxtment
Superintendent of Delivery
lst & Marquette Avenue
Minneapolis, Minneso�a 55402
Gentlemen;
Re: Change of Address-Effective Jan. l, 1977
Citiy oi Fxidley
We are listing the following change of address in the City of Fridley;
jQ�; Mr. & Mrs. Benedict J. Novak
FROM: 145 - 71� Way N.E., Fridley, Mn. 55432
T0: 125 Alden Circle N.E., Frid2ey, Mn. 55432
LEGAL A�SCRxPTIQN: Part of Lot 34, Revised Aud. Sub. #77
We have notified the occupant ot this change and we would appreciate
it very much if you would change your records accoxdingly.
Sincexely,
E � � �
G . CLA,RK
Community Develop�nent Adm.
DGC/mh
CC : City [�ater Bill.ing bept .
City Assessing DGpartment
kii.nneapolis Gas Company - Bxoolclyn Park Otfice
Noxtliern Sta�es Powex Company
Noxth�acst�exn Bcll Te].eplione
� City Voters Ragistration
i3omeowner
- SUBJECT PER .
c�ty of Fridley , i4i96
' ` AT THE TOP OF THE TWINS g U I L D I N G P E R M I T ,PT No.
�
r; y_._.._ COMMUNITY DEVELOPMENT DIV. �� ��
' �, ; PAOTECTIVE INSPECTION SEC. �
, � /"�1 % CITY HALL fRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVEO BY
�'°'� � ,'� 612-560-3450
910-F15 rf-S--r/7 � �
JOB ADDRESS
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. �(� Au(1].tOTtS Subdivision ��%% SHEET
2 PAOPERTY OWNER MAIL ADDRESS ZIP PHONE
Benedict J. Novak 125-Alden Circle Fridley, MN 55432
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LlCENSE NO.
6 USE OF BUILDING
Patio slab and footin for future fire lace
7 CLASS OF WORK
O NEW C� ADDITfON ❑ ALTERATION ❑ REPAtR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Same
9 CHANGE QF USE FROM TO
STIPULATIONS
TYPEOFCONST. OCCUPANCYGROUP OCCUPANCYIOAD
SEPARATE PERMITS ARE REDUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID !F WORK OR CONSTRUCTION ZpNING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 OAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. OWLG. UNtTS OFFSTREE7 PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GAi7AGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND OROINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED . SO
WITH WHETHER SPEClFIED HEREIN OR NOT. THE GRANTING OF A PERMIT �I,I.Z.00
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY O7HER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. %. SO
PLA CHECKFEE TOTALFEE
' + $.0�
IGNATUfiEOFCO iRACTO OR UTHORIZEDAGENT IDATEI ♦'� �r\I N PRO E Y V ID ED HIS IS YOUR, �PERMIT
�\ /
C.,l
iG A U OF WNERUF W BUIL� HI ' (DA7EI �DG.INSP DATE
CITY OC F«IllLEY
APPLIC/1TIOPd FOR RCSIDEf�TI�L BUILDING PERt�1ITS
�NE'vJ, ALTERATIONS, ADDITIONS, OR �EPAIRS)
OWI7L•'R: ���/L� ��"", �,i � �� � BUILllLR:
�ddress : � J- �� dJ(.° �i�� f"(�� Address :
Tel. No.:
No.: Street:
LOT: 3� BIACY.: ADDITIQIJ: `��
,
CORNEF LOT: INSID� T,OT: S,^;TBACK: SID�YIIRDS:
Applicant attach to this form �ao Certificates of Survey of Lot and proposed
building 2ocation drawn on these Certificates.
DESCRIPTION OF BUILDING
To Be Us ed As :��� /,��✓ 'ay�_1��y�� ,L�IE-t ����'�V r
{ r- ° `
Front: �epth: Height:
Square Feet: Cubic Feet:
Front: Depth: • Height:
Square Feet: Cubic Feet:
Type of Construction:
To Be Completed:
Estimated Cost: $ �� Z� D�—
Alt. A Alt. $
Proposed Driveway Width If New Opening Is Desired $ $
(SEE REVERSE SIDE OF SHEET)
The unc3ersigned hereby makes application for a permit for the work herein
specified, agreeing to do a11 work in strict accordance with the City of
Fridley Ordinances aiid rulings of the Department of Buildings, and hereby
declares that all the facts and representatioiis stated in ttlis application
are true and correct. See reverse side for additianal i�iformation. �
DATE: S � � SIGNATUP.E: ` �'
L�����
Stipulations:
r---d
�w�1� �.�
� �a
��
� c� �
�
d
m
SUBJEC7 ER
City of Fridley ° 14265
AT THE TOP OF 7HE TWINS g U I L D I N G P E R M I T
r
; ',, RECEIP .
� ; L _ COMMUNITY DEVELOPMENT DIV. ^
r � � PROTECTIVE INSPECTION SEC. Q� 9O
� � �/'�"; � CITY HALL FRIDLEV 55432 NUMBER REV. DATE PAGE Of APPflOVED BY
` ---'�' '� 612-56o-3a50
910-F15 8/3/77 � �
JOB ADDRESS 125 Alden Circle N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. Pt. 34 Pll1C�. SllU. #77 Revised SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHOME
Benedict Novak 125 A1denCircle N.E.
3 CONTRACTOR MAIL ADORESS ZIP PHONE LICENSE NO.
John Myrdal
4 ARCHITECT OR DESlGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
6 USE OF BUI�DING
7 CLASS OF WORK
❑ NEW ❑ ADDITION �l ALTERATION ❑ REPAIR O MOVE � REMOVE
S DESCRIBE WORK
Construct a fireplace
9 CHANGE QF USE FROM TO
STIPUTATIONS provide 1" air space between combustibles and masonry chiznney. Builder
must apply for contractors license in Fridley within 5 days.
SEPERA�'E PERMITS R�C�t�Q �� ��Rt��''
MEA�ING. PLUt�3lNG AN4 S�NS.
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING. CAIICY'0te
THlS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, 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 CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES
AND KNOW-THE SAME TO BE TFUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED.
W(TH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT Sle 18O yS`.59
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF AtJY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUC710N OR THE PERFORMANCE OF CONSTRUCTION. $g .00
PLAN CHECKFEE TOTAIfEE
$9.59
SIGNATUREOFCONTRA ORORAUTHOR12EOAGE tonrEi HEN PROP LY VALIDATED THIS �S YOUR PERMIT
+ . _� �
iG ATUR OFOWNE I�F WN LD RI IDA7E1 BLDG. WSP �DATE
l,i I Y UI I((IJJLLY
APP(_JCf�TIOid FOfz RESIl1C=�•fTI/1L PUII_DIt��G Pf_R(�lITS
'u�t�J, �LT[=i�tl'tiT l O�J�, �i�DI T I Ciil�, 0f7 REPAI RS )
OZ•7IJF:it: C � G � �7 (f /� E;U7LDI;IZ: ,1 � h%� �`/%" %�r � _
Address. %G �- �}'G��J,, .�/.�'�,� 1lddress:
Te 1 , tdo . .
No.: �2 Cj Street: /�-��� �(/ �lr�,C t�
LOT: ----��-�-- BIACY.: T�DDITIOPJ: ,�� �.7
CORNEIZ LOT: TI�SIDL•' LOT: SiTBACY.: SIUEYTiIZDS:
Ap�l_icant attach to this form ZWo Certificates of Survey of Lot and propos�d
buildirig location dravan on these Certi£icates.
DESCRI PTI OPJ OF BUI LDI NG
To Be Used As:
�%`F ���C '� Front:
Depth :
Square Feet: Cubic Feet:
Fron t :
Depth:
Square Feet: Cubic Feet:
iieight :
He ight :
�� ����� .
Type of Construction: " � Estimated Cost: $/�J g"Q, 4�
,, . �
fio Be Completed:
Alt. A Alt. B
Proposed Driveway tdidth Ii New Opening Is Desired $ $
(SE� REVERSE SIDE OF SFiEET)
The undersigned hereby makes application for a per.mifi. for the work herein
specified, agreeing to do all work in strict accordance with �he City of
Fridley Ordinances and ruli.nqs of the Depar�ment of Buildings, and hereby
declares that all the facts and representations stated in this applicatioti
are true and correct. See reverse side �or adciitional informatioi.
DATE: ��` SIGNATUF.E:
,7.
Stipulations:
l�i,,�-�-�:.�C.z l '° a.cft �-.� �G��e.�-�..
G.�r,,�i�.� .2��10 o'y`-r� ..,Y1���-
C��rn� �
��. ,���C<-, .�n�rrr,c�-�
,
� i
/�
� � r
; �: ,,,, � •
i ���
�°,
��e
� � � 4�
%�"�'� . �y
�J��-� �.,�._
� �
SUBJECT
City of Fridley
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
r
� �
� .
� • COMMUNI7Y DEVELOPMENT DIV.
� ; V ����' �
r � 1� PROTECTIVE INSPECTION SEC.
� �
� � /'�'1 � CITY HAIL PRIDLE� SS43Z NUMBER REV. DATE
�'""�'� ��� 612-571-3450 910-F15 7/3/91
JOB ADDRESS 125 Alden Circle
t LEGAL ��T NO. BLOCK TRACT OR ADDITION
DESCR. 34 Revised Aud. Sub. #77
2 PROPEpTYOWNER MAILADDRESS Z�P
Tom Kindom 125 Alden Circle NE
3 CONTRACTOR MAIL ADDRESS Z�P
Stock Roofing znc. 289 Liberty Street, Fridley, MN 55432
4 ARCHITECT OR DESIGNER MAIL ADDF;ESS Z�P
5 ENGINEER MAII ADORESS
PAGE OF
� �
� 20918
EIPT �
�U ��SJ
APPROVEO BV
SEE ATTACHED
SHEET
PHONE lICENSE NO.
780-3561
PHONE LICENSE NO.
PHONE LICENSE NO.
6 USE Of BUILDING
Residential
7 CLASS OF WORK
❑ NEW C� ADDITION G� ALTERATION O AEPAtR ❑ MOVE O REMOVE
8 DESCRIBE WORK
Construct a 12� x 24° Addition,• Reroof S:tructure (30 Squares) A1ter Qverhang
9 CHANGE QF USE FROM
TO
STIPULATIONS Smoke cletectors to be proyided on both levels of existing house.
See notations on plan.
SEPARATE PERMITS ARE REDUIRED FOR ELECTRICAL, PLUMBING, HEA7ING,
VENTILATING OR Alii CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING
AU7HORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONEO FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNIT
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINEO THIS APPLICATION
AND KNOW THE SAME TO BE TRUE AND CORFECT. ALL PROVISIONS OF LAWS VAlUAT10N
AND ORDINANCES GOVERNING THIS TVPE OF WORK WILI BE COMPUED $4,050
WITH WHETHER SPECIFtED HEREIN OF NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO YIOtATE OR CANCEL THE pERM1T FEE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- �'72, OO
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
S�GN URE OF CON' �ZED AGENT �DATE�
.-`��-� \'
:;r.unruoc nc nwuFa �iF nwNER BUILDER� �DATE�
_ �
GROUP
CU
OFFSTREET PARKING
STALIS GARAGES
SURTAX
$2.Q3
SAC CHARGE
Fire SC $4.0.5
TOTAIFEE
%8,�8
RLY T IS IS YOUR PERMI
LOAD
� � � Effectiv+e l,/1/91
I�DL't�T [ ] R-1 At�ID I�-2
piI,TII2 [ ] Building P+�xmit Applicatial
Ooa�stx'�ctian Address: �'� .5 f /b�� �'�%z �
_. . � � .� . .
OWi'�ez' AT3me & Ad�drpS.s: �b� ,��.ucd�„g�- 're1. �
aoa�tract:c�: ,� �� � /L�, f%� .��,� - — Te1. � ?��-356 /'
Aaares.S: � 8� � �,�tLf,r �S�" f'���/�, - -- --
Attach to this applicaticri, a Qertificate of S�uvey of the
lot, with the praposed oazstructian drawn ac�► it to �le.
� r_��'�� � •i� � i• -.� � s i:�
LIVII�IG AREA: Iength / a� Width �`/ �•
C� !�: Iergth Width
D�CR ARF�: Ierigtil Width
o►�: 3� '� �e �,e oo F�'���,� o%��
�3�� S"z- � t S��
Corner Iat [] Inside I�t [� Ft. Yd Setback Side
I
�I�E.' Of Ca0I1S�Y11G'tlOal: �],II1clt� 006t I
Appz'oX. �letiaa'2 17ate: 7`wb Lz,ee��
Heic�t ___,�__
Helc�lt
Hgt/Grau�d
sq. Ft. y�
SQ. Ft.
Sq. Ft.
�/� � D '�aa�r��
rl SetbacJcs
�a �'o o , '
. �
i�J '�' ' �C��
Pro�sed Driveway Width If New Openir�q Is Desired: Ft. $ S
Width + 6' See Back Page
DATE: �ti ( X Z AP'P'LSC�,Nir: /�i�_� Tel .# 7� Y- 76 S�
Pezmit Fee $ `�p��C�C�
Fire Sur�d�arge $ C�
State St�rharge $_� . C'�
SAC C'S�arge $
Driveuray Escrow $
Park Fee $
sew�er Main Chazge S
� �� ��'
QTY � Q�Y
F�e�e Sciyec�ule an Revexse Side
.001 x Piermit Valuation (1/lOth �)
$.50/$1,000 Valuatia�'i
$650 per SAC U1tit
Alt. "A" or Alt. "B" AboVe
Fee Detera�ined by E�gineerirg
�t �-�xY [ l � N�Y L l
���:
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a ►�-- �� ��--' � �� uS �,
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--- --___.__._----_ _.____ .__ ______ __ ___ _.__--. _ _. _ _--___ _ ____ _ _ ____ ____-- ------- -
_.--- --_ __-_.
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. _ - - -- -- . _ _ _ . _ _ . _ _ _ _ - _ _� - --_ _-------- ---
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� - -- -- ----- — -- ----.. _ .__ _--�__— -- --------
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---.�izUUC c✓i4// �° irta�{�r`% _eX�Sf,e�
---- ----- ___ __0�'�'S� . /� ri � .__ _ _ __ _
�._- - _ _.: _- _ _ _.__ . -------
_ __ � _ _ L _ -�G 11 ��� __11��c.—n.��c �_____ --
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---�----- -- - ____ _-- ------- ----- -,, - - -------- -- -------_ --- - - - _--__ _ __ __---- __— ___—
----- ---. _ _ _ --- . _ _ _ _ _ _ _ _ - _ _ _ _ __ - _ _ . _ __ . --__ _ -- --______----_�.
___�___ _____________---_____ __ ___---
- _-- -- ___- - _ _----------_-- - ----
--.-------- -- __ _ --- -- - _ __ _ - .
_ __ _ _ _ _ --_ -__ _ --- _ _.- _ _ -------------
_ __ -�-__- - -- ------
___ __ ---- - --- -
_ _ ___ __ _ _ - --- ----- ---
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---__ _-_- - -_--- ---- - --
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-------__
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--- - - - - _ _ _ - - - __ _ _ _ _ _ _ __ _ _ _ -- -- --- . _ : . _ _ -- - --------_ _ —__ _---------
Building
Inspections
763-572-350�
763-5Q2-4977 FAX
STfE ADDRES5 l'
THIS APPLICANT IS:
OWNERI
TENANT
SUBMTT A COFY OF
YOURSTATE
T.tCEN3E WiTH
APPLICATION
PERMIT TYAE
From: 2
Page: 6/7 Date: 7/23l2009 3:32:45 PM
MECHA�iCAL
�iESIDENTIAL AFPLiCATION
CITY UF FRIDLEY
XOUR 8-MAIL ADDRESS
❑ bWN$R
Permit lYo.;
�,
NAME: L1iv�v.�.,.� ,� �..,..v.•;. — -rj5L.1 �.
ADDRPS3: �2FJ �i"LQ �`G1�1 G\�Rt...L'E ClTY �'R) i7L �' Y _3TATE i�1 ZIP
rxorr�: �t� • 1�'t 4�$ _. ,
COMPAAiY NAME: ►� r� • ' -
CONTACf PERSON: ,�__�� o c� D a�
STA'FE LICENSE # � �ATf'
nnnn�ss: 13511 %3P��� .�_i1_� nP�v-rrtit�, s�ra�.z���.3 '7
rxoxe�j0�-�{�t- $5�1� F,ax `ltn3-�-4�-1-0���-.._ _
FAMiI.Y ❑ TWO FAMILY
TYt'E OF WURK: I[t xEw �REpI.AC��vt
❑ TOWNHOUSE
[] ALTERATtOriilREMODEL
DETAILED DESCRIP'!'lON OF WORK ,�P--1�„��,
FEFS A�RE BASLD OTi 510.00 PER FI1i 1'URE. EXC£ NO'1'EA. YQtTURES: (IPiDICATE TOTAL NUIVIBZ�t ��� BE1��
Fquipcnant Installed MEG: ����� lv10DE[.:
MFG: MUDEL: SIZEBTU
MFCi: MODEi.: SIZF�STt7
A!C i2i.40 FTREPLACE (tiAS) Sl 3.00 dAS RANC�B/OYEN S10.OD
Allt TO AIR EXCHANCiEER S15 FIRF.PLACE {WOOD} t35.00 AiEVi' GAS GRILi. Si O.DO
BOILER S35.flU �FfTRNACE $35.00 �GA3 UNTf HTR S10.OU
9 ARYER 510.00 POOL HEATER 535.00
CHiMNEY L1NER 510.00 ----- •- -- v�t aTnR e15.OD
Number of �ixiures (u� $10:40 ____ x $ IO.dO = $
Number of lixWt�zs (a� SIS:�O �,,,,, �� 15.�)U =�i
Numbe� of ��ures (t� �25.00 � x �25.00 = $ _ _
Numbct of flx�uss ��35.Od x 533.00 =$.
St�te Sw�ch�rge = S � � .50
{MINiMUM FEE S3s,5v) �1'0� _ � 7 J • .�v ,
TH7S iS At3 APPLICATION FOR A P? :RMIT-NOT VALID 1JNTIL PROCESSED
I hereby apply for a building permit and I acknowledge that the inFornaatian above is complete and accurate; that the work will be in
conforn�a�►ce with the ordinences and oodes of the City of Fridiey and with the Minnesota Consuvction Codes; that I �ndersta�td t�s is
not a Qennit twt onLy a�► apPlicetion it and work is not to stast withaut a pcnnit; thst the wortc wilt be �n accorda�ce with the
approved ptan in the cese 1 w whi uires review and a��Prov AMEpC,�a°s• �e��-' �('r� �23
�}DTATURE OF APPLiCANT ..—. � •.� -_ --- - - --_ . . «.,.....�
� City of Friidley
Building In�pec�ions Department
643 ] University Avemue NE, Pridley, MN 55432
7b3-572-3604 F.AX: 7�3-502-4477