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AF - 34923� �.�T _ _ . ���s� City of Fridl:ey, Mi.nn. � � 1 � ' ' � � ii ..: _ - � - , i j' .�' rr/� � / / ,; ,_ , � . • �„ , i � �� � :.; y� � %� :.. ��._:� - d _� �rJtL :=�'��r:_ — v i.., � ��; . _ _ I,. . ti_ �; ca oF gu� �iw� Nar. a�$�� 8treet Part Lot Lot ---�� Slock �� Adai � or Sub-Div�isia� — Coraer Lot Inside Lot Setbaek _���.r.... Sideyard �.� �`'� � - � SeWeT ElevBtton ��� • �% ,Z �-�'� Elev8t3on —�T a f"�PoF ��,�'ilVb DESCRIPTIOPI OP BUILDING j� , , � ,r.' %!" � ,,, ,� . _ , / _ � - �' '' -.,, f j 1�%///� ' .., � �°�,J' w �� � � �. .�.... ,,, ..- , _� _ ��ir., �, , > � � t% J � - - ,<� - ' ���; � ��� �I...,:.�i� _ - _ �� - In camsideration oP the i�uancae to me of a permit to canstruct above I to do th� propo�d work in acoordance with the desentp#� abrn►e set f with a�l +�ns of or8iasnces of the dLy of FricIIey. In ca�deration of the payment of a fee of ���.!`� ,�t is herebY granLed to to conatruct the builciing or additio� as d�cribed above. This �ermit ia �rant,ed nP�n f1�te eupre� conditian that thep�rsa� to whom it is granted aad his agenl�, emPloye� and worlmnen� in aIl vvork. do�e �n, ara�md aad upan said huildia� or au�►�rt thereo� shall ecnform ia all nape� to the o�tttance� t�R FridleY. Mina�ota re1�s p��ai�t may be revoised�at ea,Y 19nae nPo�no�n �� o�f � �8���� Wi� dty ]imiffi aad ^ Ol�% � �B � � Nonc� 11d. p� aee. ae! �w ths �ee, � hr �Iea n�9. 6� �• •a�e er wafu. 6. w.. io ... da e�d� I�r i� ap� P� Ior t�a hw. >'-°— �.. � � a *� �+t �. _ ,._..� . . _ � ._ . "�`�. _ . � . , •.� , .. � . . , A�Fi.T�ATZON FOx: �U�ING.. PER1�T� _ ����° _ . ._. . , , • . , f C�, Q�'. ���� � Mi1�3QTA; , � . � : : �: z , . .: . . . • . _ .. .. : ,�• .. ,. -. .�;, , . _ ._ _ . , _. . - �.� .. . , . . _ . . - � � ',:' . ..._ ...`.. ora��s � ��� ��� ��``��,��� suir�� . �`_'�� ..�����".�`�.���- ,�., ,. . :,! c �j:��' �.. �°'�r�... - • . , . r _ r. :i . . � �A�7.rw�L�'.�.'�+r'.:.r ti ��-',^0���,°�.�''�-.t!<� �_o°� , ,.. , ' .� _ ,. . . , . . . , , . _ . .. ' , . � .. 0:;`:: _ .. ., ,-. _ .. ., � . . . ' . . , ,,.. LYVea��i� '�� Bv,w��ihs . � . � . .. . . ` �.. . t,� Nb. �r��' �/ _ . . "t e�t 15��-�� �/��,. .�ast.., 4f Lot . �:�� -, . . �'� ___. � . . . .. r � : , . ` A �^�'� Lot���,�81ock � � � : � Ac��i��ot►, or ¢µbd�ivis,ion ` : ��1� �i � . . . � .,��� �,. , < �'�,� Conier �ot�'_In's3.de �Loti etiiack � ` � S9.de-Yard . �� _ SBWER EZ.EVATION FOUI�IDATION ELE'VATION Applieaaz at�ach tQ �hi,s form Twa �Cp�rt�,��aat�s. of. ,Surv��►. pf . Lo� aad gragosed: buiid- � in� . loca��,:qn.,.dxawa,,ou �he�e . Ce�rt��ic�te�s.�. � , . . . , � . . . ' .. �r'r., .�L� , a'', ;� . , ., ,.. , , , . . .; . . .. . ` . . DESCRII�TONi � fSF BUit.DI�G To be used as: ' . s . _� , . ... P.� . , __ � � . ;F � . , �. a >_ - . , ;. .������ �- i.t�� �' ` . � , Fr�pqC ' ,� .Deiptb�-_-H�igh� � _ . f 4 ■ s+•�l��wy r irl��� �rqi l.i++w�R )�. '� ' k . . ., . . _ . .� _ . ,� �. .. �' . . . , . . i :- � . .5�� �� •:. er... ,y� �9r�Q S� ;��.�.��� t ,�. � -' � ,,���/��a/� ,. . . Fi'�ont �`... � `�pth � ' . Height . . r . P ` a , � � , / • ,, / . . . .. � . t e.. . . � . ...' . �_. .i-. +t_ .-d:. .:`.���'i ���A������• f.�'.s�.�Y.�.r�' i�`" __ Type' �of �Co�tructioa /'°`-�°'�-�s�,�' : E�-tiq►�,Ced C�ost .�.1�� C�,�ae� ., . . . . . - . _ .�.:,r!�1�i` � 1. Y, �., � I ; r. er . . _ . To be Coampl�ted � . . .. . , . . . � . . ; � ° . . . _ ; � _ . . ' . . . • � . . _ �� _- . . . . • • � , . . .. � . . .a. - �• • . � . . _ � ' , .,ID ,_ . < , �,.;... ., . .. f : .� .� e t _�'. The undersigned`'hes�eby mak'es app'licat3,og. ^for �,: pes�ni�, �o�z t�i�, wcrk; he�rei,a spec�iied, agreeir�g to do all work ia strict accordsace wit1� th� Citq of Fridley Ordfnances aad ruliuga ef the .De art�at.. of Buildings,;, amd, hereby de�cl�#re.e-, tlsa , 1,t#�e fa�te aad represeritat�ians' e�ate�° ia'�this application are tru�s- and co,�e ,�....; ,. ,� �. � DATE ��i � � � SIGNATUR� " ' _ � �3cbedule of Fee Costs caa be fo»nd oa the Bsverse Side). � � � ,,�4 _ - � -.. , � _ �. � -. . �. ,�. �, * a BUII.DII� PE�MIT FEB SCBEDULE � �ectioa 2. The Ins'pector of Buildia�e shall, before issuiug aay pes�it for the erection of any buildin� or structure, or for any addition to aay �xxist- ing building or structu��a, or fo� any alterations +�r repai=-e Co any egistiag bu�,�ding or striicture, upo�t �p¢li�aation therefo�, require the gayment by the applicant for auch permit of fees tv the amwnt heraia below set forth and ia the maaner herein prov�ided to-wiC: _ 2.1. �or any such permit for the erectioa oE any fire-proof building, other than_a garage! wareh�use,.factory or �raia el+evator, ar for_Ehe erection of anq fire-proof addition, for similar occupancy, to any enistiag buildiag shall be at the rate of $1.40,for each one.,thoueand cubic feet. or fraction thereof, in such cubical coat�ente. � 2.2.' For anq-auah..geirmit for the erection o� anq fire-proof garage, werehouse.,_ factory or graia elevator,,or for the erectioa of any fire-proof �dditicn, for simila� occupancy,`to s�q eni�ting'building shal! be at the rate of $1.25 for each one thovsand cubic �eet, claesified as "fireproof" by Sectfon 502 of the A2Lnne�golie Buildf�g. Cvde, � 80USES . _ 2.3: For �iy s�ch permit for 'the 'erection of eny aon-t3reproof buildiag cthe= than a garage, warehouse, factary or grain elevaCor, or anq noa-firepzooi addition, for similar occupancy, to aay eaistiag buildiag - permit $1.00 for each ane thousand cubic.feet: GARA ,S 2_ .4._ For any such permit for the erect3a�t of_any noa-fireproof ga�e, . warehouse, factor��o,r.grain e'l�vator, or for tbe erection af=suy non-fire�r�oof additioa, -€os`s3milar_occupancp, t� any esistiag bwtlding or for each auch � _�., .-buildiag or additioa - ain�aty�-sents '($0.90) for each oae ehousand cubic feet or fra�tiou thereof, in the cubical coateats thereof with � minimtm� of $4.00.- For the purpose of camaputia� fees £or buildiag permite, the cubical cactte�ts of any buildiug or edditfoa to a uuifarm tieiglit throughout by �LtiP�ying the ground area covered fr� a point ei� (6) iache8 below the flaor line of_the b�s_�nen�-or;callar to the average height c€ tha upger surface or to the average height of the rQof aurface of the mai$ �able of a p�tched roof.. 2.5. For repair� or alterations to an euiatiag structu�e, the fee shall be at the rate of $3.00 per each Five Huadred Dollars ($500.00) or fractioa therebf in the'cost o�'all,progoeed work. ' ' 2.b . In no ca�e s�ia11 the feet .char�ed..for -.a�r_ perm;�„ a� aet forth in Sectian 2 be lesc�. than �$4,�.00. ' � p � �,� e f: o ♦ "i'S � .7� � � � ' � l +w�: � T'!'. 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FLOOR DRAINS �� ��� � WASHER � nva�. c�s RAkGE � OPEN�Nt3S e • z • � � � � � � �a ���,� �° � a o � �' , � ���. ��.o � � � � � � � � � � � � � � � � �� r'« � �� � � �y � O �i e� p � � h ���� �� ' ����.. ���� `,���� � o � � ►- � � m � � 3 � �. � � F��b � ;a � M � � � � � a� � � �� M � � �p � �• � � , : ` �, m � � =. � d 0. m � � M � �b � o � m 1 A � \ O � ��� \' � ��.� H E A L T H C 0 M P L A I N T CITY OF FRIDLFY, MINNESOTA �. Beported by: 2. Address: 3. �on� No. �% n " 4. N of Vio ators S. Addresa: 6. Phone No. �. � ' 7. Nature of Complaints �%,�., .�2,�r.o,� z� .-Q�..�� � �ea'.� �� � � U,.�.�� � .� �� c�� , . � � ' (A�,,�-c�-� � c�-e�a..�. � � m�.� S e /�YI.7- �A.N'� • •V r � . ..�,� �F''�A' c�-`°`h.�-�.m.J `''O-� �� � � a � Z��:c� - � �„ , � , S'S'�/o � S. Complaint received bq: 9. Complaint R�ferred to: � �c�-�c,e��.. 11. Beport of Actioa Takea; (Specify date of action) Clean up order issued. Regular 14 day notice. 12. Report Made by: . R. H. Ross #3 � � d � y � . Date ��a 3�7a � .. ' 6-z�dt�io �uiiain��, �IlS�7���Ci0i1S /�J-� /?-��i1�. 76�-�0?-=��77 F_a�i SIT� ADDRESS T'fiIS:1PPLIC.�Y1' IS: PROP�'R�'Y t3tNly'ERt! 1'1;1Y1�.'YT SUBMIT �. COPY OF YOUR STATE LICENSE, BOND AND CERT.�TCr1TE OF IN5URA3�tCL �;�:�+�4� � �e��� f] t7VYNEP� ADDR�SS: ����:�� � ��������, _`�i:.�� � .:��1=�± ���� ��� �� ������ _ �rF'E � t T-� �� YOURL-+VIAiL �DDRESS Perna.ir Rec�ived Bt�w' `� �ate R�i�iJ � C T ATE�ZIPS STATE LICENSE � " �' DATE . _�,,,,� STATEBOND� ADDRFSS:�v� PHONE � QSSIIVCLE FAM$.Y TYF� OF'9VO�K: ( ❑NEw FAX ❑ TWO FAMILY 0 TOWNHOUSE ,- . x. . «�� �:� �Q' DATE �. � � 1 �ir � il• 1• • • r •• , "uvl �' I�li[���J([.�ia ��il ��'►'l:�GJ�'L2�1I � FJ� PER MS 168.665 the permi�t fee is a m�nac of �7.5.D0 or 5a/o of the totaI eost � to S5flQ.00, whiche�er is �eat�r, far the impravem�t,. iastatlation or r�placemeat of a residenizal fixuir�, excluding the fix�rev. �('This should re�ect oniq the cost of labor ) Labar cnst mid� �300 =$15,00. Labor cost between �00 to �500 = cos# of labor x AS = ' pins .50 surcharge FOR PROJE�TS �4F�RE LABORE7iCEED3 $500, FEES ARE BASED ON $10.00RPERFD�TtJRE, EXCEYT �Vl�RE NOTED. FL`CT[JRES: (IlVDICATE TO� NU14�IIt ffF EACH BELOW}. Iv�IIlV1UM FEE S15.S0. . _BATH SII�iK'/L?.V ' �ZOORDRAIIVS SHOWER WATERPIPII�TG A _ BAT.fiTUB _ GAS PIPINC} (NEED QTY LIG7 SVVID�IlYlII1G POOL WATERSOFTNER (S35j _ CLOTHE3 WA9H�t _ KITCI�EN SINK WATER CLOSET ,_BACI{FLOW PREV. ($1S� _ DI9HWAST�R _ LAUNDRY TRAY + �WATER.HI�r4TER (5357 FOR IItAIGATiON . _ WATER MEtER _ OTE�R Permit Fee 9urcha�e TOTAL DCTE IMIJIVI $I5.50� Numbar of �es (c� $10.00 x $1Q.00 = $ Number of fixt�es (c� $15.00 x $15.00 = � QR PJumber of fixtures �$35.00 � x�35.00 =$� . Stata Stuch�arg� _ $ 50 � � � (Mfi�(IMUM �15.50) Tatai = � � THIS I5 �,N A.PPLICATION FOA A PERMlT-NOT VALID UNTII. PAOCES5ID [ herebv apply for a plumbin� parmit and I acicaowledge that the information above is coraplete and accurate; that the worit will be in '• aonformance wirh the ordinflnces and codes ofthe City ofFridley and tivith the Niinnesata Consttuction Cod�s: that I understartd this is - not a permit but oniy an au,plication for a permit and work is not ta start without a permit on site: thaz the tivork tivill be in accordattce �'= �� the anproved plan in the c:ase of atl �vorlc �vhich reauires review and approva! of plans. � SIGi�iATTJP.E nF ;LPPLIC.'1NT �/��w�" t,G�'d'W`� °A.ITlT; lAME�`I � ��'� DA'iL 1�/�iv9 I r -� 9 f � .tPPP.dVLD 131' �A77s `, i �i:L-::���i�dF;T�: 'iE:?:��:R':_T�:i?�i�tI7�",�R�'�'E�UlREL �+?R'3.1.[TL"i�I1�lr:..�i�'"�'f?1C:�L.?;��`D'�.•iE'�'-ifi"idTC.1L..:�ii�Rly �:i3r �)A.t�'":��'•r �e$1RCFLp1� �'19Y3k3"��:UIIL9 ��"�3.`i�'.':�1-(.."' L ,u_ i :�live:si�� .,.ti�eaue ..�L-. :idle�� :�•:�ii�•[ :.:-__ -h�-.-_ ;o(i1 . ..._. ;i=-.ii_—��^