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�tr. eet . Part of Lat
�?aek Addit^on or wz�i�-Lia?aio� �� s �' �f �
Per�!it is hereby granted to :.�'�"�`_ to ������'��
t
the buii�ing �` desc.ri�ed in t�e above statement. This permit is granted
��ou the exnress co:�ditron that e person to u�hom it is �r�!:itec?, �,nd �is a,�ent,7, exn.plo�yees and �orY.men, in a.Il
th� wo�k da�e in, around»�and�tzpon s�,id bi?�lding, cr a�;� t�,:t�t ther�o�, s}?ali conform in �,il respects to the ordi-
na,nces of £'ric�ley, Misn., regarding the censt�uctimn, al��r��-san, znainien�,nce, repair wzad moving of buiidings
within the city li:nats, aud this permit may be rev�l,ed a,� e_?.agr tir_�e tzperm viol.ation of a,ny of the provisions of said
ordina.nces.
� �
� ��+++�'� Insg�ctor of Buildings.
' 1`iC��'dP�I�i�'T�'�' ��'��3 N J�l�?'�.T�T ��il^.-.'.��;1"��T�7'�.' .
�Fl COXAST��Y'�,t?O5Z Qi t�ae i�su� aa�c� dnfl:c�eT`�7 �O Y4�'/�' ���� C 1,T� cc,'.�CaT y� ��a'�'�x.i1S.�"�ri' �+i j`.!Gi1�iT O�
th� alaove pev�rnit, � herebS� a�x�ee �to �'�o t�e pbox��:��� 'S�Y�9r.T.. i�� ..c�c, r�E.F�.c� ��.�?a �.he c�e�e�iptio��
�.3aove aEt �i3%'j;Y�Y d,I1CI elCCQ:r"�1?7� to th.e �S�ov:sio�s c�' F�R.e c?;�i:_�,�•��,��� r�� �'�:c??.�v, �nd, iaezng fia°;,t dtt��
�vvo�°n, I herebJ� s��,*e and say ��at the f�c�s sta4;e� �;� :�.:� �z��. coa?��?.�?�d 9�� t�i� abov� �e��t are
true as �h�r�in ��ated.
� ��/' r. �
� . � ---����{—�{�—��` � �� � — �
Suhscribed ar�c� svvo�n to before m� at Fric�.e3T, ?',ai ����•�z�,, t���� ,�
y � �
day of ,� A.D: 19� :� �`� �
�. ,
f
. . . . . . . . ' . �. � �.,:'.� .
( ��
. � . � . - .. � ��
. � . . . . . . . . . �
�illage of FY idley, 1VIinn.
.�
BUILDING PERMIT �� � 2 � �
Date: ��.'� f . . . . .'� � ."� { .`'f�,J
Owner �'�.� �j... �t'� �'3'"� /.. Builder .. .. .. �.?.'�".`'.'°r."�'."' :.. .. .. ... .... .......
` Address . ..''.���. �� ,�,�,�"?.G'�+i� .�t.�t.�t �" Address ..... . ............................. .......
LOCA1'ION OF BU[LDING
No. ..�.�c,�.�. Street ...� �d:Y.l,l..�;ti�.......... Part of ot .. . . ... .
� � � �L�i ..1�4 ,�. .�.
Lot . . . . Block . . . . . . . . . . . . . . . . Addition or Sub-Division . . . . . . . . . . . . . . . . . ! . . . . . �.'�'. .
... ��� ���.
Corner I�t . .. . Inside Lot . ... . Setback :t�.` � � Sidey
: r.,���` . . � . . . . . . . . . . . . . . . . . . . . . .
—_ i�'A� �/^'erhr ..✓"I@+uJt�,.
To be tised as:
�j a�'.� fa �,
.........4�...........
D��CRIPTfOI�t Qr= f3L�lLDEI�lG
�� .
Front . �. �. . Depth ..�'�`.' �'1'•.. Height . ..!}. .. . Sq. Ft. ... .. .. . Cu. Ft. . .. .....
..................... Front ........ Depth ........ Height ........ Sq. Ft. ........ Cu. Ft. ........
Type of Construction . %�!'.�.!'�. :�". . , , , Est. Cost . . . . . . . .. . . . . . . . . . . . . To be Completed . . . . . . . . . . . . . . ....
�' �° .� � `•���
�
Tn con�ideration 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 s.et forth and in compliance with all provisions of
ordinances`of the village of Fridley.
.�,: :� . . :�,�-?�:"''"�`�..,�': . . . . . . . . . . ,
, . ,� . ,
Yn consideration of the payment of a fee of $:!`.":......., pexmit is hereby granted to ..' ...................:..
••..:..•• .:....:......... to canstruct the bui�ding or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employe�es and worl�nen, in all work
done in, around and upon said building,;, or any gart thereof, shall conform in all respects to the ordinances of
F'ridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings with-
in the village limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinanc2s.
. . . . . �rr.���. . .� . . ..�. . . � `�` .
,+''��� . . . Bu�ldu►g Inspector
NOTIGE:
7his;permit d0es not Cover the construction, installa.tion or alteration for wiring, plumbing, gas heating,
� sewer or water: "Be sure to see the Building Inspector for separate permits,for thP�e items:
53 -8� -5-9? 5 .51
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r �,t°� ��r+�rr ���sf.'n� � ' , _��� >�
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�a��TIA� R�►T� S�h������
>6.: �ig��; :.�"• � ...':'�'�S: l'�� AJ!'� �):.:�
TYu�:�tt �� 3' �er:; , � _, � . . . n . , e . a � e r ....._.r..�.. �e =200 ��
:��4�a� �i.:�'���U - ,:_e•e�t�g . .� _ c � � , _ �, x �1.3� S� _.
1�T�� Fix��;r� �?E;; C�ning .< w.�. �,. ,..� x i1.50 f
€�at�� �����., � � » _ . . . . . . . . , . . e . . . � x �3•Zb i
�°mt�e �d��4er ':�� to 99.000 BTU►. ... x i3.00 t
I���> (;rota�d iiun Old Bl�g. . . . . . . . . x f3.25 S
FJ��Ie W�t�r Iie�br . . . . . . . . . . . . . . s M.00 =
G/l� FITTINQ FEEB: NO. RJ1'rL' TOTAL
lst 9 Fixtures . . . . • . . . • � • • . . . . • • : M.00 :
Add�tlonal lristu.�a . . . . . . . . . . . . . . : i .76 i
�iat Ran�e to 19l►.00o BTU . . ... . . . . ... 1 x =6.00 { 5. 00
• State Surcharge $ •SQ:
ItEtllilt3 i 11LTElt�?IOI(b--lt�br 1s CoA� --
i%�.CrlpaOtl . . . . . . . . . . .. . . . . ... . ... . . . .... . . .. . . a . ... . .!
To►r,u, rr.� � 5. 5�
�� n�K .�U1C►�ar88 �.50
�. � E -� � . .... �
:. ..,.,. .: .� 3-15-?3 _
,����, �,oger Seure
��sec� at �ui���ee� ____ Frame _ _. _.e.�__._._ . _ . .. ... .,..�..m�._._... _...�s__._.._.
U.xd � ,�_.�...� ���.�'__� ..�..�.� n..� a_T <�.�,.�.�.,�,.<�.�.,�._
'Tv �t CORl�Fltld 2t��►9?� „�.,...� .�--�._%� �._..n.,.,.:,.n.._�....._.�_.��.a..�...,<,o.�_..,.
�
.�"�.•fk��te� ��,�a ` .� �.�,�Q.. - �__ _..w._.za-.w�.
�Nevr. �3uildar.� �a-rnif AI�s PwrsetAi�. `5 ����
� Sianed
•
sy
Business Rwne No
ROUGH
FINAL 3 '' l0 ' % �1
a
0
„_ . . . .�.,,-- t=.. .`�-rs-^. --.-.,—„._.-.-��_ . . .. _ . . .., . . . . . - .. . . .: . . ..: . ” -
�� _�°�� g�� � qj� � ` � Minnesota V�taU and Boritu�: . ,
WE�L OR 86RING LOCA N " 70ANNESIC)TA DEPAFfi1'1uFENT OF HEACTH __ _ Sealing Nts. � �.- �
� : 2"6=' �� ��
c�,�nt�� � �MELL AND $ORING SEALING RECtORD �i���e�tat�n� t�. -
Minr�esata Statutes, Chapter 1031 or W-series No:
� �. � . . Qeavg biank A not knowN . . �
ownship Name Township No.- Ran No. Section No. Frection (sm. Ig. DateSealed Approximafe Dete Well :
w Bonng Constructed
l�rlJ'��,�i 3�i . �3: _ ?1 3fr< �,4.�,4 #�—!3 `: � :
Num r al St�eet Address or Fire Nu�myb,er and C�1y of WeU or Bonng Location +�
�� ��� +7i �� ������ Depth Before Seating ��� ft. Onginal Depth �+ fl. ..
i :
Show exact tocation of well or boring .. . . - ' Sketch map o� well or bormg . .. �: � .. � .. � . Static Wate[ Level . - � �AS�urete � -.�� :. } �� . . <:
. � in section grid with'•X.. - � � .location. showpag�property Rnes. � � � . . ' .� . . - - - . ,
oximate : � '
� roads, and buildings. � �DIN
-i- - i- -i - -�
, � SingleAquifer � Muitiaquifer ��� tl � "bAiow abOVeiandswface �r
� i �� i � � . . � . .. � � . . ... -� . . . � ._ .:y �.....� . . .r.�
< _i_ _ � _ _ �. _ _i_ CASING TYPE ,
W ' ' ' . ' E � -
� � � � �
-r -�- -r- -r - � . -
� � � � . � Steel ❑ Plaspc ❑ Tde _ � Olher ,
:F mile . . ,: � ., _ ; .
� J_ '!_ _L_ _i_. .� . � . . ' .�� -....� �# .Q� ��� " f. : . �T • =. m �
i � . i � " - � ��� .. �
S Screen from to fl. Hole fran IR_ !►.
�,+"�
N--�- r mue ----� OBSTRUCTtON/DE8RIS/FILL 'r
'� � ��� � � � � � � � ��fKrStruction� ❑ DeMis� � Fi11-. � ,� ,-� ' -' ` ` "-'
. PROPERTY OWNER'S NAME. . - - . � . . . .. _ . , - �:. . . .`=.r .�
�� ��� Typemf debns/obstmction ��, ��� � � �� ' , ;
Mailing Address if diHerent than propetty address indicated above. ' � ' ` ' "
ObstrudionlDebris/Fill removed? �'es ❑ No �.
, � _.
�� PUMP . ' , ;
.� � Removesl ❑ Not Preseni - ❑ Other h -- � ,
CASING . - ' ", , .;t
HARDNESS OF '
GEOLOGICAL MATERIAL , CQLOR �MA� : FROM TO •' -
Diameter Depth Set in oversize hole?;� < Amular�ate �r 9tv�Nt�;
If not knowrr, indicate estimated forma[ron bg from neartiy well or ba�ing. -� :
_:. ,,
� . . . - .� . . . � � � . . �� � in. from . . � W ���� i4 �,. �' � Yes �� �o . ' ❑�Y6s�� � NO ..0 Unknoayfi _...
_ in. frort+ to ft. ❑ Yes ❑ No ` �'Ies � Mo�i [] UPktie�wh ...-�
, ,_ : , , S
� ;.�
�
m.�hbm ro tt.~ . ❑ Yes �.No � Yes :❑ N� .' 0 fbUcnRt�l
.- ME'CHOD U$ED TO SEAL ANNULAR SP�CE BE�N 3 CASM48Ss UR C/kSlli3 �� 116tE:- ' -�
� . � . � �.No�AnnularSpaceExists � . .. . . °. . " .. " . ._ . ,_�����
❑ Mrtular space grouted with Nemie piPe � = '; ,?
` 0 CaSing PerforatioNRemoval � j
. _
�
` , � �
' ._ _
� _ ,
,� ; i ��
in. from to ft: : ❑ Peiior�d � R9moved �
in. fran to k. � Pwforated "`� E�e�d '_
� � � � � � � � . ��
_ ,. ,
Type of perforator . ; _ "°
❑ O[her " � ;
GROUTING MATERIAL , . . ; � . ,;
Groutirg mate�iaf �i � from � W- �� }I. �._,._..r�� yartls ' 1 A° tlags
ai�r
. - �� >t
f�� ro ft: ynros n�s `::
flEMARKS. SOURCE OF DATA, DIFFIpULT1ESJN SF.�lltlii(i Y `'
B
. �,_ < ,
� �iL #t� I�H MIi11 df�l�[ I!!Ot 1� ,,;,,, —� � n � ��.: _ �, �.,
' ps��'stiag Y � � T
trom to n. �� � :;_
UNSElkLED WELLS AND BORINGS ,� •
{ � `
� � � � � � . � . Ot�ter unsealed weli or boring on. property? � � ❑ Yes �o � : � �_ �" � '� f
, � . . . _ � �. �. . .. . .. . . . . . ... ... � . :.., ..:_ �
C LICENSED OR REGISTERED CONTRACTOR CERTIFICA710N
� Ttus�vetl or boring was sealed m accor0ance with�nneaQt6rRUles, Ct�apter4725. T4�e�iqk)nr�ortGor#�datilhie rapofl �'
� . . . � true to the best of my knowledge. . � - � � � - � - ... - � . �::
. . . . - � . . : _ . . . .. ,�z<t
{ i�sr'k t�et t Co., I fll� �:
Contract siness C/ w 1 License or Reglstralion Mo.
. �� �'�� �^ ���w
Aufhonzed Representative Signature UQte
tocni coPY H � R�dy ��lisM " _. ;
�� ��� Name of Person Seal�ng We1l or Bonng
_: ' .' �
: � HE-01434-Ot � � � � - � . . . . � � - . . .
. . � . � . � . . . . . . _ . . . . � . . . . . _ . � . � . . . _ . .. . . . . - _ ._� .> s..... . ...
sus�ecr MIT NO.
City of Fridley 2 2 7 21
AT THE TOP OF THE TW INS g U I L D I N G P E R M I T --�----�
i � RECEIPT NO.
� �` COMMUNITY DEVELOPMENT DIV.
r � L � PROTEC7IVE INSPECTION SEC. ���I g
� �
� � �"�1 � CITV HALL FRIDLE� 55432 NUMBEP REV. DATE PAGE Of APPROVED BV
�""'�' �'� 612-571-3450 9t0-F15 7/15/94 � �
J08 ADDRESS 5995 Ben'amin Street NE
1 LEGAI ��T NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 1 1 Worrel's Addit'on SHEET
2 PROPERTY OWNER MAIL ADDRESS 21P PHONE
Greg Hanson 5995 Ben'amin Stree 572-8304
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAI� ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW C� ADDITION t] ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct an 11' x 6' Addition and a 16' x 11' Deck
9 CHANGEOFUSEPROM TO
STIPULATIONS
See notations on plan. Provide smoke detectors adjacent to all sleeping
areas and in basement.
WARHING �
Before digging c�ti for
''SEPA�ATE PERMfTS REQUIRED FO�t all utility locations
WIRING, HEATING, PLUMBINC AND SIGNS. 454-0002
REQUlRED BY LAW
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PIUMBING, HEATING,
VENTILATING OR AIR CONOITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZpNING SO. FT. CU. FT.
AUTHORI2ED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANOONEO FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTEfi WORK IS COMMENCED. NO. OWLG. UNITS OFFSTREET PARKING
{ HEREBY CEflTIFY THAT I HAVE READ AND EXAMINED THIS APPIICAT40N 1 STAI.LS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
ANO ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED �S OOO �Z.SO
WITH WHETHER SPECIFIED MEREIN OR NOT. THE GRANTING OF A PERMIT �
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PRQVISIONS OF ANY OTHER STATE OR LOGAL LAW REGULATWG CON- $72�00 Fire SC �S.00
STRUCTION OR THE PEF;FORMANCE OF CONSTRUCTION.
PLAN CHECKFEE TOTAIFEE
$79.50
S�G ATURE OF CO � ACTOA OA AUTMOA4ED AGENi IDA�E1 s�� � �/�I p� PRO RLY V ID D THIS IS YOUR PERM17
.— �_ �S .q ' � � �e���'�� `�—�5-�
� SiGNaTUREO WNERiifOWNEPBUiLDER� iDATE� B�DG �NSo r�aiE
NEW 1 I. . . Effective 1/1/94
ADDN � j I � CITY OF FRID�LEY � .: �
ALTER (� S[NGLE FAMILY AND DUPLEXES R-1 AND R-2 .�����
� Building Permit A�plicdtibn
Cc>nstruc;ti<mAdciress: �� � S '-.�+'I G:�+-�.t rl �� �� �'�(� C�� 1�'L1� �� �{ � -Z.-------- ----- --
. . � .
t,egal Description: ---------,------ ---- -- ---
Owner Name 8c Address: G���p,� Tet. #�72'� �� __
C�ntractor: � • � � MN L[CENSE #
Adciress:
LIVIIVG AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Tel. #
Attach to this appl�cation, a Certificate of Survey of the
Iot, w.ith the proposed const�vction drawn on it to scale.
. `: 'DF�.4CRIPTION::OF.I1VfPRO�EMENT . . � • . . .
Length � � . � Width� �_ � Height . . . . � Sq: Ft: . (p(o .
Length � Width � � � Height . Sq. Ft. � �
Length '� Width ���� Hgt/Groutid �;,: . Sq• �t•. 1^l . .
Comer Lot [ j Inside Lot � Ft. Yd Seiback ��ilZr Side Yard Setbacks 2�I � .
,
Type of Construction: � o ac� �o�, Estimated Cost: $�, 0 0(' ��1 � a���
r� ....
Approx. Compledon Date: g �Q � ��.��
- .,--�'
(Cost on Back)
Driveway Curb Cut Width Needed: Ft. + b Ft = Ft x$ _$
DATE: �-�j �( APPLICANT: Q,,� Tel. #�2 -83U�( �
�ITY USE ONLY
Permit Fee�
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
$ 7� •� Fee Schedule on Reverse Side
$ �' � � .001 of Permit Vaivadon (1 / l Oth %)
$�=� $.50/$1,000 Valuation
$ $800 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 j)
$ � `�!�
STIPULATIONS: , • � � �
�,�.�'�c-�.� ��.r.�.� �.�� �;'.;?�� .� �,�"� �'•�'��:> �.�, ,,�
��� ���
�
CIIY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE �
Fridley, MN 55432 APPLICATtON FOR POWER PLANTS AND HEATING, COOLING, VENTILATI(�N,
572-3604 REFFiIGERATION AND AIR CONDiTIONiNG SYSTEMS AND DEVtCES
RATE SCHEDULE
Residentiai Rate
Furnace She11 and Duct Work; Bumer -
Also Replacement Furnace $ 20.00
(Side Vent - Fil( Out Back)
Gas Piping (Needed with new furnace) $ 10.00
Gas Range � $ 10.00
Gas Dryer
*Air Conditioning - All Sizes
$ 10.00
$ 10.00
All Others/Repairs & Alterations (LIST ON BACtq
1% of Value of pliance or Work �
I�cLc� �C`� W C� l' �,c.. �b � c�c� t`�1 O✓1
Com me rcial/I nd u striai
1% of Value�of Appliance or Work
State Su�charge
TOTAL FEE
TOTAL
$
$
$
$
$
Effective On January 1, 1993
� �� � �
JOB ADDRESS ��`J�( S 4,vi �M�
��.1 �y � M� �5�1'32
The undersigned hereby malfes application for a permit for the work herein
specified agreeing to do ali work in s#rict accordance wfth the City Codes ar�d
rulings of the Building Division, and hereby declares that all the facts and
representatians stated in this application are true an corre�
----�_L ��� .. ] �_
OWNER l`� 'rt G. ✓�
BUILDlNG USED AS �QS 1�S-�
ESTIMATED COST PERMIT NO. �:�����
DESCRlPTIC3N OF FURNACE �ND,QR 6URN�R
$(�,� No. of Heating Units Circle One (Steam) (Hot Wate arm '
Trade Name (���✓�� Size No.
BTU HP EDR
$ Fuel Tota! Connected Load
.50
�.$ � ���
MINIMUM FEE. FOR ANY HEATINGJCOOLINGNENTILATION
REFRiGEAATtON[AIR CONDITtONiNG PERMtT t5 $15.00
PLUS THE .50 STATE SUFiCHARGE
REfNSPEC7I0N FEE $30.00
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
/
�
.� r�
� ' v1
�' �� �`
��
Burner 7rade Name
B7U
HEATING COMPANY
Signed By,
���
Size No,
EDR
Tel ido. �� Z �� _
a .?
Approved B Aaugh-!n Date� Z-�-1 IFina! Dat� !�'c,�/
FILL QUT BACK SIDE FOR STACK VER{FICATION ON
REPLACEMENT FURNACE
NOTE: #1 through /�8 required when using a side venr furnace.
�HIMNEY AND STAGK VERIFICATION
The und�rsigned }�ereby verifies that the existing chimney or stack:
1. Has t�een carefully examined Yes �x) No ()
2. Is free from rust or deterioration
3. Has no foreign ohjects lodged within
4. Is secweiy supported
5. Meets all current Code requirements for size
and total BTU's connected
0
7.
$.
Has total heating BTU's of
All other BTU's
TOTAL BTU's
Has a liner been provided for water heater
Has combustion air been provided for water heater
Rernarks:
�ist A,LTER�TION Being Dong;
HEATING CO:
Signed By:
Daie:
�
Yes {�y No ( )
Yes (�Q Na ( )
Yes (� No ( )
Yes (�) No ( }
Yes(}NoO
YesONoO
0
sue�ecr P itRiTN17`�_ _.
City of Fridley � �. � � 5
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T �
r
; � RECEIPT NO.
� `y_______ COMMUNITY DEVELOPMENT OIV. ,
r � � PROTECTIVE INSPECTION SEG }r
� U
' ' �'��1 � CITY HALL FRIDIEV 55432 NUMBER AEV DATE PAGE OF APPROVEO B�
�----�•� �•' 612-571-3450 sio-Fis 7/29/96 / /
JOB ADDRESS 5995 Benjamin Street NE
t LEGA� LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 1 1 Worrel's Addition SHEET
2 PFiOPERTY OWNER MAIL AODRESS Z�P PHONE
Greg Hanson, 5995 Benjamin Street NE, Fridley, NIN 55432 572-8304
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO
Greg Hanson(same address)
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS Z�P PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK �.-
CI NEW � ADDITION p ALTERATION O REPAIR ❑:, QVE O REMOVE
8 DESCRIBE WORK
Remove garage / add garden shed 10' x 12'
Garage & house addition % remodel existing house
9 CHANGE OF USE FROM TO
STIPULATIONS
See notations on plans.
� .�� .
.. . .... ��� ''.
,�
,.. �-t� "�
� - � ��
. ��,�M�� �'
� ' G; ��'A�ING,
�
TYPE OF CONST. OCCUPANCV GROUP OCCUPANCV LOAD
SEPARATE PERMITS ARE REOUIRED FOfi ELECTf;�CAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZpNING SQ. FT. CU FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED Ofi ABANDONED FOfI A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWIG. UNITS OFFSTREET PARKING
I HEREBY CEf1TIFV THAT I HAVE REAO AND EXAMINED THIS APPLICATION STALLS GAFAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROV�SIONS OF LAWS VALUATION ' SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMiT �40�000.00 ��FO.00 Fire SC
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGEStgte SC
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- �VV
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. �S�ann ��FH�F. %S �X� �ZO.00
PLAN CHECK fEE TOTA� FEE
$544.75
SIGNATUR OFCON'RACT0�70�7P.UTHORIZEDAGENT � IDATEI � yyHEN PfiOPERLY UD TED THIS IS �OUR PERMIT _
^ -�'i � u
S��GNATURE FpyyµEA��FOWNERBU�LDERf � ATE� BLD �NSP ��4�E
NEW
ADDN
ALTER
�]
c�
L]
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Effective 3/ 1 /96
ConstructionAddress: �� � � �� � �✓h � r. �-�—� Jl� G Fr, -�.� �
Legal Description: � i , �S t % ( � �� rr�1 S � � � ��t c� �
Owner Name & Address: - �Q ;,� �'v� Tel. # ��12�� � �j�(
Contractor: �, �Q � ,�5 !3 � MN LICENSE #
Address:
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Attach to this application, a Certificate of 5urvey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length � `' _ Width �Z Height
Length 2(� Width � Height
Length Width Hgt/Ground
0
Tel. #
�C¢ �n;,,g !�r►.,�.
3 �(�, %� o,u� 14-� .
Sq. Ft. —I � �'� 2.�� �y
Sq. Ft. �
Sq. Ft.
. _�
1 , G�� �e. �' �
Comer Lot (] Inside Lot [] Ft. Yd Setback �'( � Side Yard Setbacks � w.� 1��( �� IC�
Tyge of Construction: �,�} ���-�,n� Estunated Cost: $� 0 0 0('�
Approx. Completi4n Date: � ��c� ��
(Cost on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: % � �I APPLICANT: _� � Tel. # � % Z � � U�
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ �/
$ ya� `�
$ �. �
$
$
$
$
$
$
� �/ { 7
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (lildth%)
$.50/$1,000 Valuation
$900 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Detemnined by Engineering
Agreement Necessary [ ) Not Necessary [ ]
. •
„ :
, ,
Larson Engineering of Minnesota Transmittal Date: � p— ��—�j (o
3524 Labore Road
Whtte Bear Lake, MMnesota 55110 Re: Z�� f=t�c�R /4t�h� � Comm. Na �7Co (oZ 8
612 481 •9120 Fax: 612 481-8201
�■ �
■\ '
��
To: ` f
!� f2 � G I—t IA L�l S Oh.l
5 9 9 S t3 ���.s J' e� t—t �« ��1' �
��►���� M�
Attn:
We are sending you
❑ attached ❑ under separate cover via ❑ mail ❑ UPS (next day, 2nd day, reg) ❑ messenger ❑ pick up
❑ plans ❑ calculations ❑ copy of letter ❑ change order ❑ prints ❑ shop drawings ❑ other
Copies Date ' No. Description
� �vs� s��-r►c�t�
These are transmitted as checked below:
O For approval ❑ For your use � requested O For review and comment
❑ Resubmit for approval ❑ Retum conected prints ❑ Prints retumed after loan to us
Remarks:
Copies to:
Signed:
��_� � .� � .1
.
09l16/1996 09:35 507-645-6315
PRAIRIE CREEK ARCH
. �
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4 =
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T �
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PAGE 02
W
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CITY QF FRIDLEY INSP�CTION DIV.
6431 University Ave NE
Fridley, MN 55432 �4PPUCATIOfV FOR POWER PLd�NTS AND HEATI�JG, COOLIhIG, VENTILA�'ION,
572-3604 . REFRIGERATION AND AIR CONDITIONING SYSTEMS AY�ID DEVICES
RAT„� SCH��ULE
Residential
Furnace Shell and Duct Work, Burner -
Also Replacement Furnace .
(Side Vent - Fill Out Back)
Gas Piping�Needed with new furnace}
z ,�� y��-
Gas Range
Gas Dryer
*Air Conditioning - All Sizes
Rate TOTAf.
$ 30.00
$ 10.00
$ 10.00
$ 10.00
$ 25.00
Ali Others/Repairs & Alterations (LIST ON BACK)
1% of \Value of Appliance or 14�ork �
�)(.� C/ GL�G-�Z(( �y-�`rc f���� /�s�
Commercial/Industrial ����� � � � -� SZ? �
125% of Value of Appliance or Work ' ��"
State Surcharge
TOTAL FEE
� y. ,f�i
��
$ %� C'C;
� I ���'�� �
$����
$
Effective On March 1, 1996
Y� � o� 1
J�B r4DDF1ES:i �J UI � 7 �� �� c1 � �;�-� �-}" ��{ �.( t c� I.t�/�
.�
The undersignod hereby makes �pplication for a pErmit for the work herein
sp�ecified agr�eing to c4o all work in strict �ccordance with the City Codes and
rulings of the �uiiding Division, ancl hereby declares that all the facts and
represee�tation� s�at�d in this application are true and correct.
.� _ -
_}�ItIV��� � ,...� 1996
� (� �-
BUlLDING UaED Av �`(�ir�-toc: C-k� ��vt � �� c l� 'Iz�v
�z: �- � ►� ,� " ( �
ESTI�viATED C�JST PERMIT N0, ; ���
�FSCRIFTION �OF FURNA���ANa �OR BURNER
$ �. ��'� No. af Heating Units Circle One (Steam) (Hot Water) (Warm Air}
Trad� Name Size Na
BTU HP EDR
$ Fuel Total Connected load
,50
:� ' �'d)
Burner 7rade Name Size No,
BTU HP EDR
NEA7lNG COMPANY
MINIMUM FEE FOR ANY HEATING�COdLIWG�NTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 Signed '�y
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $42.00/Hr
*Air Conditioners can not be placed in a sid� yard without
written permission from adjoining property owner.
Tei No. S� � �3V y
Approved �y/C \/.j Rough-In Date Final
FILL OUT BACK SID� F�R STACK VERIFICATION ON
REPLACEMENT FURNACE
CITY OF FRIDLEY INSPECTION DIV.
� �
6431 University Ave NE
Fridley, MN 55432
572-3604
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
�
Effective On March 1, 1996
/'� ��
��� �.
PLUMBING FIXTURE RATES
New Fixtures
Old Opening, New Fixture
Beer Dispenser
Blow Off Basin
Catch Basin
Rain Water Leader
Sump/Receiving Tank
Water Treating Appliance
Water Heater –Electric
Water Heater – Gas**
NO. RATE TOTAL
�
Gas Range** �
Gas Dryer** �
Back Flow Preventer Required ()Yes () No
Type _ _
�
$ 7.00 � . (}�?
$ 4,00
$ 5,00
$ 7.00
$ 7.00
$ 7,00
$ 7.00
�� �.��
$ 7.00
$10.00
$10.0�
$10.00
$15,00
Reihspection Fee $42.00/Hr
ALL OTHERS AND/OR RERAIRS AND ALTERATIONS
1.5°k of Value of Fixture or Appiiance
State Surcharge
TOTAI. FEE
$ .50
JOB ADDRESS �`��� Gt%rt, c�.rv��f1 �'�' lv�, �.( t��ti�
The undersigned hereby makes application for a permit forthe work herein
specified agreeing to do all work in strfct accordance with the city codes
and rulings of the Building Division, and hereby declares that all the facts
, and representations stated in this application are true and correct.
Owner
a
NLiV��'Lt�ar1 � G--_ , 1996
V C
Building Used As. ✓,ln�-� �-'�- '���\ �j� �'�,
Estimated Cost �; Oj:�`� `— pERMIT NO,_ /� ��,��
PLUMBINGCOMPANY Nv���'�K�'V1�-�_� DC�;�'�� ��-,�� W^��
1
SIGNED BY TEL N0. 5��� �� X�� L��
. �n ��� - ;�����.�{�a
Approved By U�' Rough–In Date Final Date
$ a%S� PLUS THE $.50 S7ATE SURCHARGE
**COMBUS710N AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6–A. MINIMUM SIZE 9 SGl INCHES.
� DEC 09 '97 10�42 BIOMEDICAL FRONTIERS P.1
.. .
THE INFOAMATION CONTAINED IN THIS FACSIMILE MESSAGE IS LEGALLY PRIVII.EGED AND
CQNFIOENTfAL INFORMA710N IN7ENDED SOLELY FOR 7HE USE OF 7HE PERSON OR ENT'17Y NAMED
BELOW. lF YOU ARE NOT SUCH PERSON OR ENTITY, YOU ARE H�REBY NOTIFIED TWAT ANY
DfSTR16UTION, piSSEMiNATION OR REPRODUCTION OF THIS FACSIMILE MESSAC3E fS STRfCTI.Y
PROHIBITED. IF YOU HAVE RECEIVED 7HIS MESSAGE 1N ERROR, PLEASE CAIL US AT (612) 378-0228.
FACSIMILE COVER SHE�T
70: �j�t�' yf,�
y
FROM: � �q �-v�S� �'
Jr
DATE: �Z�r`( /�{ �
TOTAL NUMBER OF PAGES INCLUDING THIS COVER SHEET: �
IF THERE ARE ANY PROBLEMS 1N RECEIVING THIS
TRANSIVIISS�ON, PL�AS� CALL (612) 378-0228.
ADDIYtONAL C4MMENTS:
a.:� rry
/�
-�.
'e ) S��SS 5�2, c. � Q� v�.�re
,
�
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109510th Avenue S.E., Minncapolis, Minnesota 55414 LISA. • Telcphonc (001) 612-378-0228 Pax (001) 612-378-3601
,� D �� �09 �' 9��10 � 3��8 �OMEDI C� �u?�ON���ER M� 1 715 876 55b5 TO 16123?83601
NEI,.S�N
STRtlCTl1RAL
ENGINEERIN�
83A8 JIl,! AVE.
EAU CU11RE, Wl 54701
(71b) 838-8794
/�r4-,v sa �J
�,P/�y �.� Y� n� N
C�E•�m �
G flan � N �� r 2 s�%r -�s� '�/F,. = 4/ 3/�r
SPf►-^i � Z�.6��
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.
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v�d.11ow) = Z. �S35S� = LGf 7!° > v �' o:�l
. �
S�2Z9'9 �i:.� ?.�.�� ¢ .!?5��� .Q' • ,'. OSC
° � s?� (a� aw, °%C 8 a a) ""' ,3os-' �..—
B�AM /►7:JST BE Fi4S'7�B�u�sp Ta Z I�LY G/RQER Ti2t/St �N O�OR+�
Tb �iEAnr���6R $S� �/r -
7",.� �/�'�x�"«� @ ����
�%,. _/ re 1a) = d4a °�/<T > 8,s/ �9`/�r '� x
� f Z r, �
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� hereby ceeti�y that thi� plan, speci-
fiC�kion��r rr'.It::rt k'a� urtsy:.tr�d by m.e
or und�r��;,; .��r.:�c au,�vrv�=inn �nd ehat
4 �cti � �iuty l���is6�r�•�1 1'ro1'N.,.viun.�i.
i�ngin�e.t' lli::lari tii� leY�v� Of LhC �IaLE
aY IMiin . 2/J /
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�ate 7:�0-9 ���b ibtratioxi N� �90�7
�x* TOTAL PAGE.01 �k*
� aU� 15 '96 9:32 F��M MID�EST T�J55 TO FRID PAGE.O@1/009
, e ... , . . � �,.r �v'
�
' ' MIDWEST M.aNUFA�TURING � �' �
� TRUSS SPECIALS �
5231 KANE RD.
EAU CLAIRE, WISC4NSIN 54703-9624 p
Phone: 715-876-3343 �
Fa1c: 715-876-5565 ._ ' , . w
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To: �i]►NSON Jobs P0806!'XI ' � � �
C; �c�.a'1Sv�'� 60i� LOADING '� �
FRIDLHY �� , , 1' O.C. ;r�. <� f2i1
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Phoae : ,�,;,
FaX: �
Salarp�r�ous sANDEN qlork ord�r �k: P0930PRI
Contsct: JID� Quota Date: 8-7-96
Tlxms= Expirwtion Dat�s
st�www*www�lrtttirtt+►**+►wwwesw*wtr�rtartfittt*�*w:w�ewww**+►w*iwww*srrA,►#*rirl►�Rt+ra*tt
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9 30- 0- O T8 SPBC 4/ 2.44 2- 6- 0 0'- 0- 0
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6 30- 0- 0 T3 SP�C 8/ a.00 0- 0- 0 0- 0- 0
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FABBICATIO►�t NOTES
/IIU �O /i/inda. MC hhkf10c1W K�k+1
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2-PLY TROBSI fastan r/lOd rails !ui
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Distribuia lards puslly to sach plp.
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sAis 2-PLY truss Aa�i¢ad to c�rry
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. TC...PORL�...CSI BC...DUR[�...CBI
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AN Maeiy a�/ ewniy uecMw�ewl+das �re
ta te k0Iw�1 u aen.eum .�1 •A.ww+�e
MrMiK k �ese4!'. M9�lL Tw�a re w
:a �� a+;� �ro i� �
6*+e�• 'hwpa�rr a.s r�.�a,dr. MaeM�
kr Mri.� Yrfrst M� w�itM nl plm�9 �►+v
ro. ■r w� �� ar� rw«a,e.r a
ew=,.a,awa�ey� c��►.�a
1� u a�swr ra s.a.»� w,ay it.?+qs
�rin0. ra�yl MactMlwnrr ac�oo 1w
wte, w�Me+ wel� �w�cr �'�IC e�t
�Ma�Vo� Oetwsa rrncs a naU w�
,a�r�. n.�nt.�a�d
«w,a ��Il k ti.a� Me �..rn�.r pe+ww�
��r s�i.'�r.e m�r e�i. �r y.�o+ea.
c..x..sra. aoa�rcra a�It Q.�e.
do �s b6t� bA vsN �ee k a�Md a
r.a.:a�s 'r... ,bNNsa�e.wr�e
wet/NM4aenw��YMW ,�+WdM
b�� sUM��dM�
�SPLICFS
t.�w�e id::K r yyra.. �as d
rncl r►o� apxr joir a fM� a
ws. Ms.;�.
Y�DP Cl�S c 2�c8 SY� Y250i+-1. 9C
2x8 9PP Nl/�2 (N1 1,�
80T Q�ONDSS 2x10 8P ]250l-1.9�
�OR
Ni88s 2x�! 8PP 81W (N3
*�• t� ding D�lg�er ehsll psorids adequat�
b�aring sre► acd aachorage.
...........SS71RIIit7 71[t�71 RmQVIII�...........
ID �rg Size +R I[in Sise -or- llin ]lrsa
1 0- 1- 8 0- 3- 0 �.�7 si
+• ise apecified by custc�sr
1Q�Z � LAI1D L�L�C.TI"aHi r
W9l1 at JOD1T Ml�
La-0.37" Da-0.19�' '1�-0.56•
1L�4-Il
1-0-0
_._!___
�
' �. �;�:
E:3
Trus� desigisd with 40.0 ps! Li� Load in �........�Joint Locvtims�.���a..s.�
Aoo� asy. 1) 0- 0- 0 6) 17- 9- 7 li) 4�• i- 1
DlQi/P�ZS LQ71D8 -- Thi.s deaigw io tbs 2) S- 5-15 7) 72- 1-12 12) 22- 1•12
000poafts rwult ot ailtfplo loads. 3) 7-10- 4 8) 2�• 6- 1 13) 7-SO- �
All OOIF'7tES6IQ1 Gbords as� asstard to be 1) 12- 2- 9 9) 30- 0- 0 li) 5- 5-IS
oontiauausly bracd ml.ese oot�d othssxi�s. 5) 15- 0- 0 10) 30- 0- 0 IS? 0- 0- 0
..TC...POft�CR...(�T ..HC...lDR($...(:SI -_--_'.._.._ 'PO?I►L �BIQIt G0�1LLS •""•"'_"
1- 2-�667 0.21 15-1� 291Z 0.19 VniEoa PLI lYca PLf So
7- 3-]814 0.91 14-13 29J0 0.39 TC Vsrt -100 0- 0= 0 -I00 32- 6- 0
3- �-T475 0.90 13-12 2502 O.ti HC Vert -20 0- 0- 0 -20 7-10- 4
4- 0 309 0.70 12-i1 28�5 0.�1 HC Vizt -100 7-10- � -100 12- 1-12
5- i 303 0.71 11-10 �819 0.20 HC V�rt -20 12• 1-12 -20 l0- 0- 0
6- 7-?rt81 0.88 Ooacemtratod LnS Looatioa
7- t-3781 0.89 DC Vatt -170 7-10- �
8- 9-3569 0.31 DC Vert -1T0 Z2- 1-11
.11�. . . P01lL'B. . .CSI .1�. . .!'ORC�. . . CSI
2-li -i49 0.36 t-11 -949 O.il
2-13 -1088 0.57 6-lf -2998 0.89
a-u n�o 0.99 4-li -Z9la O.es
�,�7-12 2074 0.l6 5-li 7!0 0.
i � � a
ri.N �s
�
1-Y-�
1
I
11�-0
r, 3.-.-. �1,
�S 14 13 12 lI 1
2527/ 3.�0• 28K�/ S.S�"
3►�H �
(R34-1
E%CEPi' A6 SHO�VN �'I.ATE3 ARE Ti.20 GA 17N P8R A(VSNTPI 1-f9�S � 17tN sc�ie s�.iHS
READ ALL NOTBS 0,�1 TFIIS SHEET.
A COtY OFTI�IS DRARRNG TO SE GIVEN TO ERSCTIIYG Dw�:
COiV7�RAC3�oR. flspr: nP c�:
DRACWG WARNWG TC Li��e �N.� p�t
1vac+.� �naw. o. a++ aa»iq i� �a+ natlanlneM�, MMI oaeiH, paari lrseiai a tYMIr MacL� TC Desi l �.� ptf
wfiicM k a F/� d Qe Wt4i4i dettp sN wMd �n1 Ec oowdn�d b Ibe brli0l� Iefipu�. Ma:l>� BC l.ire O.Y
a�. i� rx wnu1�R d.vu ne.ier,. aar w rt�CC 1rctWC �f+ h.,nsia,..w,R ►e Pd
.u,s r„u� ws�f�Or.c� u ars,d ,�SafiN ace�«n aaenawr ►y r� rir�JM� �cr+�rs.. BC Dea� U,0
MEMa.d ee,e+M at de •acw iwr.'t+�r rnr ee �eqri-a. (a.e MIe9l a YrQ. tb. yre++ac Pd
rs�."�i o� »� ua`�`�,a,.• �an�� .(rnh, vwe �w•w�e. �ni. u�.w .c TOTAI, f0.0 vd
i�l'ILlB ID: �
Date: a-15•9f
DurFac - Lbr: 1.15
D�rFsc - Pit: 1.IS
O.C. S�ci�: ?A.O"
D�i�o Critecia: UBC
COdC 3it�C:
JICt OA.l3_Af
DFSLGN IrtFOR..biATION
ia+..ew,. r ru�,.:.�.�w.i e.a�
cw�ar W Mn Otaw W�d w Mfa�wiwaR
Se�aM/ �Y Ar dkat. 7M �ics[/�a dhcL'ats
Mry wp�wlYxy � dwr� a s rek d'
tady �r kuwaxc i�'��uw�, �a.lAcxN�
+�.yer dniw iwr:Ma1 w ae a+w b1Pn
►y �FS �nw �wd iAe crnnsrss M rocwry
ut wls d6.r�wia� a� K ua� Rire � a ya
cMSc�ro)saa�l �acyu�s�ef�rmi6iAhv
��neMn wscwWN riree�ri» OMIa�
w�. Ma01M�. ahip¢s�t sd ioWNrtmol
Wfta. '04 tn�a bs ksw �nilrt a wi
lNt+f�rNbrWt� �I 1�uerMroe
rdA'T�1�9S' tN 'N06�M�' aee i+oaACae�i
a��wt a� ue r.N�e�c�+M�M � �r
uc,iY�e� (xtatcKt sKr:acc� ar fwtwk�al
nslpet�, 7RYe� rs�ic�d Nt ;ttovd IY MK
Mw�l�sie q'�ec Yw dt4r NrIM�f d�.a�
�aq Yc cloclntd N be wu M�Y Mc dp Y�wR
lilt M/r[KM171 �S* At ICqI � lOSN.
4rsl dSr�oe �eoars Nr wW « woi� IaM,
�ab �wu�i�nia Y�x���uip¢1��
wn�s a �rc+pw.y la�a 'ILe f Wp nnwn
<a.MuwocwN� Ny «w.,q urc �Ma
wiq snad y A�rlr� rol�u oMnwiac
t�aeilEel. tYMsCao�w cArdt M e�d�w rs
�a Mh Mioct UtrMr b � /uR�b �7
��pOaslWi. � rAwN �s M�cwi r a
�IiaiAM10 �OII� � p'-0� OC.
FAdRICATION NOTES
►INf b INa[Min. Mr 1lMkn0! iAaM Rrkr'
t1:a ba+i� w wib rw W�.(K h M
erAen�s�et r�itA Me OMfcalorY rN 4
eeaKte a mMiwiK as�wirility �ati� .a�
Msltat �JWeqaaclarroLeplf�
rKiN�be4+ecrcM� �ricyNM. Cwaatw
� wr� k CfMMAC SIN11 � �li�
...;�a,►Ki �xcw� �srw �ss�. �`M,
MK�DOed Wra��aNwNeff Mer�Us Ao+a
Plwn flr� iwt be icailcl o.sr t�pdNtn.
k�w �r Nreif W t2* atueMn �1d1 h w
Ae aait wi� �tlk I�Mr �r.lciinl Md �Md M
��+. ararl w. Jet�t Mkss al�nwifc we«.. �e
f�iL+ritJ'wlMt�'I�, Airl�b�tb�'
wMs.i'NK. Slm(Mk�w+�pwlMe
Mia dMekK7M N�ci/ai. DabQ cNs r�w�e!
wesM�t Oull wwrt x ilw aiwni/ d dr �c�u
�M�tYCL�OM1f fA0W1. COMOCIO[/fLlflW
i!t q�R� IFiCf ��� M WC �(IOti �I)M111
a.a n.r.ew w w IMan.e� ta unw �,d.
.ry�� WIM aa�kn Nrwu. TM� tw U oct
u& dis3cae/ vriTh Aee reunb�tasa►vl
AwW ..Iw o�LecvrsM �4cw�. Far ae6da�N
id0lr�KIMtMQwW�C�tttNlreN �QrWp�
sw�.d r.r x.e�l n.e c.w«t� waa
iwus. Q67i6 ri 7Pt Ikc�.s/o0 Cbre
M Stnls�i hac[ke'.
lRB�CAVTIONARY NOTES
Ar asei�y „� a�woe r�oo.w.ed.a�n,K
N lc iNlwd �w mm�Jrce wM'Na�Ntc�
Yf� �r� ��Yea
r1lm�Wf. �eN+en W GWxN� M w�i!
�e. tn�uara�ipardKMriy
iw la1dM� �neea M a a►�I�t rt i1� la►
(dr� ad far 1eYitfqt blep( IEratt iAd10e
�w�s�fe+yal�eo, oeel.�Iir�L
Es�i� aa�L1 rM aectlN MnMt b ahrqu
�rkRL pen�il MtewMM+n' �e11M (a
raw �qrw� w� �a.ry MeM� �wiiy
w�w/,i+oi.ww«w «oc� a a..N prlt�
wr..d.aw Tk.io�nHw.d.ncn...c
a�� flr� M mitr b oWrd Krnw�f
aR�lc�cel N d�e hwtWM� �f Yvee4
n.k,r«.r �v1a iN �r.aqk imx�N.
eawanne. a aa.welk�. NW► pa�r
M� Mr � baN �InN � �e �Ikd u
Wftesrs�ewr. tioMWadc��Ye
wti�ht d M acewn �WI �e �pWi M
�� r aR HNrw�e Wlcs3r�I
SlLICE.S
wi. �»�neP �►Yas.s�,M.nc u�.r
i s.Ma�*Mpwvn�sarjN�n�Mwwm
�cov oa�was tiu apP sssor-i.x
!OT (7�ti�8t 2x10 8P 22507'-1.98
1�.5� 2x,4 9PP STpD {Di)
1lnw drig�d with 40.0 pa£ Liw Loa4 tn
RO� tiA1. . .
MuLTIPLS LOl1DS -- This dalgn ia tM
eo�pa�ite teeult o! �ultipls loads.
Huildinq Dssigner �hali ps+o�vide adecpiat�
bfilloQ iL'N t�d iOChO=�Ql..
...........DiB#R�7O 1►RRA ASQtJIII�D...........
ID Bsg Si:e �• Yia eiz� -os- Min ]►rsa
i o- i- e o- 3- 3 �.ao .s
*• sise epeailiad by eusta�sz
291�: LiVB LC1i1D D�I.IDCTI�T :
L/906 at JO� !13
L.-0.36" D.-O.li• �-0.54•
]2-�-11
i-ae
�
�
`�-�.• .
/ c�rrr: %�-�
�..._�--�. "" �
SXCEPT AS SEiOWN
�l=4 eantinious latssal bracisg att�cLed �dt6
]- lOd nail� wch arb�r �h� pi�4MU.8raci.Og
1AST bo poeitionad to proviQs aqwl uaDraced
to�ts Glt 4x4 "T� bcaas
a ot vab vith 12d aa�L �ae�iid1Ba o ct
Bzace a�et �xtand st lw�t 901� oC Meb 1�mgCh
Zx6 Hrsca r�.irsd an aoy w�b aoccaadirg 14' .
M
]111 QOt�Rffi9ION C�oatla ara a�wasd to b�
continuously bcaced u�l�se mted otlkrriso.
. iC...!'ONCS...CSI .BC...FORCR...CSI
1- 2 -�41 0.07 16-18 189 0.14
2- 3-�108 0.54 15-L! 1891 0.20
3- !-1909 0.65 14-13 1806 O,s!
4- 0 �G� 0.64 13-12 2143 0.50
5- 6 969 0.51 12-]1 Z578 0.19
i- 7-2150 0.92 11-1C 3566 0.1'
�- e -as� o.ea
t- 9 -7170 0.13
.1�. . . FOftLB.. . C8I .NSa . . .lOR�. . . CSI
„�-u -scai o.e� � e-�s -io39 o.s�
3 2-13 !Z� 0.38 3 6-176 -2l86 0.67
�-�-13 1*26 0.6� 4-17 -14i6 O.iZ-�
8.eo�-i� isa o.es s-i� cs� o.as.M
7X6
aas�.e...aann.JOint Lxatlons.e...a..�...:
1) 0- O- 0 7) 22- 1-17 13) 7-30- 4
2? 5- 5-15 9) TA- 6- 1 1�) 5- 5-15
3) 7-10- i 9) 30- 0- 0 15) 2- 0-12
4) 11- 2- 9 101 30- 0- 0 16) 0- 0- 0
5} 15- 0- 0 I1) 2�- 6- 1
6? 17- !- 7 12) 97- 1-17
�------•-��� '1'OrIAL U6SIQi [Ly1D8 --------����
clni ro:a M.T pfcu� pL/ �lb
TC V�rt -100 0- C- 0 -100 32- 6- 0
8C Vert -1U 0- G- 0 -20 T-10- �
HC V�rt -100 7-10- ! -100 22- 1-12
BC Yert -20 ZZ- 1-17 -20 3Q- 0- 0
Uo�icawtrated LHS [oeatioo
eC V�rt -170 7-10• 4
BC Vett -170 17- 1-12
�
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��s is t4 i3 u u - i
271�A� 3.19" 2�7A/ S.S�"
r �-0 2.f
� (R3�-1
PLATE3 A=B 'I7� GA 17�M PER AlK4f/TPI 1-1!!S I7�+K
2 AEAD ALi. NOTES OiY THIS SHEET'. �[. Ieti:
� A CO�'Y OF 'I`�S DiIAWIlVG Z'O dE G1VBN TO ERECT'IIV �`
COlYT1lACI`OR. I1sp�ra 7BP CWc:
'PC Lre
/ .+o�e.ki.�, 'PC De�d
,M`�. BC I.irc
I.
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SP6CIAI.S) wtt boeMt �w:�ew�e�e. c��tt bNCMt a�e.tiiyer�a�`set
5-5565 sa oro.or,a o�... �,... wiwM: u»�. TOTAL f0.� osf
BRACING WARNIIVG
�Mei�t �n a� iMls dnwl� b ea eueYUnb�.'iK.
wMd� 4 a pwt d Om bailNK �eJp Md wMiO wra
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wadr M w�clw 4wa11raeMK r ed� s.d �ecNied load�r
A�6�iu�l o[ be v.sAl titrcre w!e K
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ao.�an.d �r r. �.�w-.� a�tM- R,x�
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Date: 8-15-96 m
D�Fac - Lbc: 1.15 m
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O.C. SpiCi�=: 21.�" �
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JUN 04 '98 08�33 BIOMEDICAL FRONTIERS
� P. 1
FACSIMILE C4VER SHEET
T O : Barry Reischland
F R � M: Greg Hanson
DATE : 6/4/9�8
PAGES TO FOLLOW INCLUDING THlS COVER SHEET: 1
IF THERE IS ANY PROBLEM IN RECEIVING THIS TRANSMISSION,
PLEASE CALL (612) 378-0228. '
ADDITIONAL COMMENTS:
Barry,
As per our conversatian this morning, I am writing to request an extension of my building
permit and all other related permits issued to me in July of 1396. I am expecting to
concentrate my efforts on finishing the exterior of the house, i.e. three windows which need
replacing, trim, siding, seeding of the lawit, etc. this summer. Optimistically, the exterior
should be done by Sept. 98. The inierior rnrili require another �,rinter before completion so I
wfll estimate final inspection to be spring bf 1999. Thanks for the understanding.
Sincerely,
/ 1 �u.
Gregory J. i�anson
5995 Benjamin St. NE
Fridley, MN 55432
37&0228 (D)
572-8304 (E)
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G�
'� ��
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109510th Avenue S.E., Minneapolis, Minnesota 55414 USA •?elephone (001) 612-378-0228 Fax (0p1) 612-378-3601
sue�ecr P�RMIF Nfd�„,,,
c;ty of Fr�a�ey � 3 0655�
A7 THE TOP OF THE TWINS g � I L D I N G P E R M I T
r
� � NO.
� �
� • COMMUNITY DEVELOPMENT DIV. / �7
r � y � PROTEC7IVE INSPECTION SEC. (/� �5 ��
_'
� � .�.i �l
� .
' � /"'1 � CITY NALI FRIOIE� SSIJZ NUMBER REV DATE PAGE Of AVPROVED BY
�""�"� �'' 612-571-3450 910-F15 2/9/00 / �
108 ADDRESS 5995 Benjamin Street NE
1 LEGAL LOT NO. BIOCK TRACT OR ADOITION SEE ATTACMED
oesca. 1 1 Worrel's Addition SHEET
2 PROPERTY OWNER MAIL AODRESS ZIP PHONE
Greg Hanson 5995 Benjamin Street NE 572-8304
3 CONTiiACTOR MAII ADORESS ZIP PHONE UCENSE NO
Same
4 AFCHITECT OR DESIGNER MAI� AODRESS ZtP PNONE LICENSE NO.
5 ENGINEER MAII ADDRESS 21P PMONE LICENSE NO
6 USE OF BUILDING
Residential
7 CIASS Of WORK
❑ NEW O AODITION C� ALTERATION O REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WORK
Renew building permit ��24395; finish interior sheetrock & flooring for addition
9 CHANGE OF USE FROM TO
STIPULATIONS
See notations on original permit. Detached garage must be � removed
from site by July 1, 2000. Renew plumbing, heating & electrical permits to receive
final inspections on that work. Provide smoke detectors in all sleeping rooms and
on all levels of the dwelling per Section 310.9.1.2 of the Uniform Building Code.
TVPEOFCONST. OCCUPANCVGROUP OCCUPANCVLOAO
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING. MEATING.
VENTILATING OR AIR CONOITIONING
TMIS PERMIT BECOMES NULI ANO VOIO IF WORK OF CONS7RUCTION ZONING SO. fT CU FT.
AUTHORIZED IS NOT COMMENCEO WITMIN 60 DAYS. OR IF CONSTRUCTION .
OA WORK IS SUSPENDED OR ABANDONEO fOR A PER100 OF 120 OAYS AT
ANV TIME AFTEi; WORK IS COMMENCEO. NO DWLG. UNITS OffSTREE? PARKING
I HEREBY CERTIFV THAT I MAVE READ AND EXAMINED TMI$ APPLICATION 1 $TALLS GARAGES
ANO KNOW THE SAME TO BE TRUE AND COR9ECi. ALL PROVISIONS OF LAWS VALUATION SURTAI(
ANO OFiDINANCES GOVERNING THIS TVPE Of WORK WILI 9E COMP�IED @
WITH WHETMER SPECIFIED HEpEIN OR NOT TNE GRANTING OF A PERMIT �2�SOO �p1.2S
DOES NOT PRESUME TO GIVE AUTMORITY TO VIOIATE OR CANCEL TME pEqMIT FEE SAC CHARGE
PROVISIONS OF ANV OTHER STATE OR IOCAI LAW REGULATING CON•
TRUCTION OR TME PERFOfiMANCE OF CONSTRUCTION �5�.25 Fire SC �2.SO
2`� ��� PLAN CNECK fEE TOT FEE
� s�.00
S�GNStupE CON�QACtO�7OQ �UTMOA�ZED AGENT �O�rE� EN OP VALIDATE TMIS I$ y�}�R PERMI�
v� ''��' ,
`S�GNn7UAEO�OWtiEF��vOWMEt+BW�OEQ� iD�tEi 8�D �h5� � r�crE
N EV1/ [ ]
ADDN []
ALTER [ ]
Construction Address: �y
ClTY OF FRIDlEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMITAPPLICATION
Effective 1 /1 /2000
(763) 572-3604 Bldg Insp
l �')
,.t�W" �-.�
Legal Description: �..cr�- I (� ��c � l,�rrea S��� e'i��
Owner Name & Address: �rc c, r�t�.,n So,.� �ps �')``�`'`'^ S} � Tel. #I� �2) S�2 $�ULI
Contractor: __ �r�u r�-�Sc�•, MN LICENSE #
Address Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height
DECK AREA: Length Width Hgt/Ground
OTHER: =n-�r�c�- S I^e�bc.�,t�, Floor�+�a � a�+ �'+� n�r,
Sq. Ft.
Sq. Ft.
�, � en r.,;-f�- �- 243 q 5
Construction Type: �r,���� Estimated Cost: $ 2�Sa�
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: L/ R��� APPLICANT: �r'ec� ►"'�r�.,Scn� Tel. �,,� i2�� 2- ��C3�
CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application
Permit Fee $ �, o?S Fee Schedule on Reverse Side
Fire Surcharge $ �-SZ� .001 of Permit Valuation (1/10th%)
State Surcharge $ / �ST $.50/$1,000 Valuation
SAC Charge $ $1100 per SAC Unit
License Surcharge $ $5.00 (State Licensed Residential Contractors)
Driveway Escrow $ Alt. "A" or Alt. "B" Above
Erosion Control $ $450.00 Conservation Plan Review
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ Fee Determined by Engineering
$ Agreement Necessary [ ] Not Necessary [ ]
$ °'�_ C�D
� � � SuB�EGT �.. . � . - ➢ .
City of Fridley 31 1 19
AT THE TOP Of THE TWINS g � I L D 1 N� P E R M i T
r
; � RECEIPT NO.
� • COMMUNITV DEVELOPMENT DIV.
� � V � PROTECTIVE INSPECTION SEC. /�q
e .
i•__-�; �"' �'� CITY HALL FRIDLE� 55�32 NUMBER pEV D�TE n�GE Or APiROVEO r
L 612-571-3450 91Q-F15 6�/2�9/00 � �
J08 ADDRESS 5995 Benj amin Street NE
1 LEGAL �OT NO. BIOCK TRACT OR Ab01TION SEE ATTACMED
DESCR. 1 1 Worrel's Addition SHEET
2 PROPERTV OWNER MAIL AODRES$ ZIP PMONE
Greg Hanson 5995 Benjamin St. NE, Fridley, NII�1 55432 572-8304
3 CONTqACTOR MAIL ADDRESS ZIP PNONE LICENSE NO
Greg Hanson
� ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PMONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE UCENSE NO
6 USE Of BUILDING
Residential
7 CLASS OF WOfiK
O NEW ❑ AODITION ❑ ALTERATION p REPAIR p MOVE [� REMOVE
8 DESCRIBE WORK
Demolish 20 x 15 garage
9 CHANGEOFUSEFROM TO
S71PUl.ATIONS
All debris shall be removed from site within 2 days of demolition.
TYPE OF CONST. OCCUPANCV GROUP OCCUPANCV LOAO
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICA�, PLUMBING. HEATING.
VENTIIATING OR AIR CONDITIONING
TMIS PERMIT BECOMES NULL ANO VOID If WORK OR CONS7RUCTION zONING SO. FT CU FT.
AUTMORIZED IS NOT COMMENCED VR!ITHIN 60 DAYS. OF IF CONSTRUCTION
OR WORK IS SUSPENDEO OR ABANDONEO FOR A PER100 OF 12Q OAYS AT
ANY TIME AFTER WORK IS COMMENCED. N0 DWLG. UNITS OfFSTREET PARKING
I HEREBV CERT�FV THAT I HAVE READ ANO El(AMINED TMIS APP�ICATION 1 STALLS GARAGES
ANO KNOW TME SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF �AWS VALUATION SURTAX
AND ORDINANCES GOVEFNING THIS TVPE Of WOfiK WILL BE COMPLIED
WiTH WMETHER SPECIFIED MEREIN OF NOT. TME GRANTING OF A PERMIT
DOES NOT PRESUME Tp GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT fEE SAC CNARGE
PROVISIONS OF ANY OTMER STATE OR LOCAL LAW REGUTATING CON-
STRUCTION OR TME PERfORMANCE OF CONSTRUCTION ZO. SO
PLAN CMECK fEE TOTAL FEE
$20.50
S�GNATU�7E O� CON'AA(;TOQOR �UTH0�7i2ED sGENT iDATEi HE PROP l A OAT TNIS IS � P MIT
_�►�--___ � cZR �� —�"���
S�GNiTU�7E � OWNEA��F Owr+Ea8ui�0Ep� �OATE� OG..�N � �1�.1E
Effective 1 / 1 /00
CITY OF FRIDLEY MOVING [] WRECKING � PERMIT APPLICATION
6431 University Ave NE
Fridley MN 55432
(763) 572-3604
Job Address: �qq'S ��,.,�r�,�, S"� � �rtio�
Legal Description: �o-�- � ���,�, � We�re�S 1�-�� c�
Owner & Address : Gr-e � Sq�1� (;en�c.�..;v� 5-1- IV�
Contractor: ���
Address: State License #
DESCRIP'rION OF BUII,DING
HOUSE: Length Width Height Sq. Ft.
GARA E•Length � Width �� Height �� Sq. Ft.
OTHER: Length Width Height Sq. Ft.
Estimated Cost $ Approx. Completion Date
T e 1. # ((012) S7'L--�3U`'(
Tel. #
Cu. Ft.
Cu. Ft.
Cu. Ft.
UTILITIES City Water/Sewer Minnegasco N S P U S West
NOTIFTED: 572-3529 [] 372-4720 [] 330-5500( ] Business-603-6000
Home-244-1111 [ ]
Water Bill Paid: Yes [] or Collect [$ ] Signature
Moving Route:
The undersigned hereby makes application for a pemut to wreck/move the building described above, agreeing to
do all work in strict accordance with the City Ordinances and rulings of the Building Division, and the State
Code which requires any water well on the property to be sealed by a State licensed water well driller, and
hereby declares that all facts and representations stated in this application are true and correct. ALL
DEMOLITON DEBRIS, INCLUDING FOUNDATION & SLAB. SHALL BE REMOVED FROM SITE.
�O/2-�I fa0
Date Sisna re
Moving: Principle Building into Fridley .... $300.00
Accessory Building into Fridley .... $ 42.00
Through or within the City ...... $ 20.00
Move a building out of City ...... $ 20.00
Wrecking: For each 1,000 cubic feet or fraction .. $ 1.25
For structures which would be impractical
to cube the fee shall be based on the
total cost of wrecking at the rate of
$6.00 for each $500.00 or fraction.
Minimum Fee: $20.00
Minimum Fee: $20.00
PERMIT FEE: �6� J t-�' STIPULATIONS: �G `% %,�/���" �''�ji��G
v�� �r�� %�'�✓ y� �'i� �!� l�vir,t�...i o2 � � �.c
.��-,�o. . , _ . y
CITY OF FRfDL�Y iNS�'C� fIUtV Ui�i.
6431 University Ave NE
Fridley, MN 55432
(763)572-3604
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
Effect�ve Ui� ,lan 1, LUU"t
PLUMBING FIXTURE RATES:
New Fixtures
Old Opening, New Fixture
Beer Dispenser
Blow Off Basin
Catch Basin
Rain Water Leader
Sump/Receiving Tank
Water Treating Appliance
Water Heater -Electric
Water Heater - Gas*'`
Gas Range**
Gas Dryer"'
Back Flow Preventer Required ()Yes () Nc
Type
NO. RATE TOTAL
�
$ 7.00
$ 4.00
$ 5.00
$ 7.00
$ 7.00
$ 7.00
$ 7.00
$10.00
$ 7.00
$10.00 �G . �?�
$10.00
$10.00
$15.00
Reinspection Fee $47.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance
State Surcharge
TOTALFEE
`� 0�
��
.50
�0 � �'�
JOB ADDRESS 5 CICI S�Z����v�-,,.� S"� � t.'l—r� �
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the city codes
and rulings of the Building Division, and hereby declares that all the facts
and representations stated in this application are true and correct.
D-ec., ( (� , 2oo'z._
Owner
Building Used As J�eS 1 C�,YI C�
Estimated Cos� �� PERMIT NO. I ��?�' �`��
PLUMBING COMPANY �`% �
SIGNED BY TEL NO ��3/ Z G
FAX # n
Approved By .�� Rough-In Date Final Date _(��C��
COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE