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AF - 35551�, � City of Fridley, Minn. BUILDING PERMiT N° 3�� 9 ��... Date: . . � . .r�. /.�� . . . . . . . . . . . Owner ....................................... Builder ... .. . .. . ... . . . .. ... Addr�s ...................................... Address ............................................. ' % • . F BUILDING . � No. . . .. . .. .. . Street . .�-r� . . .. ��... Part o ......... . .... . � ........... Lot . ... � .. ... Biock ...... . .. .. .. ... Additlon or Sub-Dfvis`on��. . .. .. •�..... ... ;.. �. Corner Lot .1C. . . . . . . . . Inside Lot . . . . . . . . . .. . Setback .�� . . 8ideyard . .��. . � �. . � � '�`.� � DESCRIPTION OF' BUILDING To be Used : �� . . . . . . . �`PO:It . ��. P'° c�p�l ;?C, ,/, , � 4 $P.�g�lt .��.�:". `� ►�Q. �. �� . . Cil:. �'t. �� ........ ...... �021'� ........ D@pt}1 ..... P,� t........ SQ. Ft. ........ Cll. F't. ........ Type of Construction ................... �'t. �/.1��:�.. To be Completed ........... In consideration of tihe issuance to me af a permit to construct the building desribed above, I agree to do the proposed work in accordance with the descrlptlon above set forth and 3n c�mpliance with all provIsions of ord3nances of the dty of Fridley. , �, a �;,, �,,. ` �,�...- � �-, �,, � � , ;' _ n . .1�' . , : . . y ... : � ��: :'�. . : .`. .°. . �-�:°: : . . � . .'�.�-°._t� % � In consideration of the payment of a fee of $. /.� �. . ., permit is hereby �ranted to . . . . . . . .. . . . . . . . . . . ....... .......... ........ to construct the bwtlding or ad8ition as described above. This permit ia granted up�n the expres4 conditfon tha.t the gerson to wh�an it is �anted and his agents. employees and worlmzen, ia all work done in, around and upon said building, or any part thereoP, shall conform in a11 respects to the ordinances of Fridley, Minnesota regarding loca.tion, construction, alteration, maintenance, repa3r and moving of buildings with- in the dty limits and this permit may be revolced at an,v time upon vitola.tion of any of the provisions of sa3d ordinances. �� NOTICE: Thls parmlt does not cover the construotlon, Inataliatlon or alteration fo� wi�ing, ptumbing, gaa heating, sewer o� watar. Be su�e to see the Buliding Inapecto� fo� separate permlts fo� these itema _�" I• � ' i' �� ...- � APPY,ICATTOAT FOR BIIILDING PERMIT GITi OF FRIDLEY, MINNESOT� , . ; �°� ' - ' . . � • � �ers .Name 8uilder � 'Address �,�� - �`�� _ . Addrese .,,_. ` � . � LOC�.TION OF BIIIZDING • Nq��2�_. Street' �' �-�_-. �'t of Lot '� . . � . _ _�_.._r. / . �e Lot �„�.� &i:ock ��dddition or 5ub. D�v. G� L�� Corrier Lot . �� side Lot Set Hack �� • . _ ��% �c.�;��-�:�� gpplicant attach�to =�'building.loeation. this�form..Certificate of Survey of Lot and proposed. DESCRIPTION OF HUILDING To be us,ed3 as • r •r ' � � -� • � � `' �._..� � . F�ont � �pt�� : Iieight '� �. �t. : �� G�. Ft. �� F'ront ____._..._Depth NAight Sq. Ft. • Cu. F`t. � Type�`,of ` `Const,��ction ' �� °°` � To be completed ��-�Y°�`� � Estimated. Cost �p�:.: The underaigned hereby makes application.for. a permit for the:-work herein s�ecified,;agreeing ta do al.l work in strict accordance w3tli the C3t9'.�ihdinanaes and ruling�of the Department of Build3ngs� and tiereby , .. . . , de�].ares'that all the facte and representations stated in �his,_a.pplicat3on are true and� corr et.. � � -�� . °' �-' � ` � �,p � G '�n� � , � �.� Ua.te ' � � Sign8.tt7re�,. ��°'�''f�, � ,(& Schedu.7.e of�Fee Cost� can be found•on the Reverse Side) � � °� � � , -, , ,. ° • '�I �4 . ° � _ ,+� / P. BUILDIl�iG PE�MIT FEE SCHEDULE Section 2. The Inspector of Buildings shall, before issuing any permit for the erection of any building or structure� or for any additian to any existing building or structure, or for an�r alterations or repaira to an� exiating building or structure� upon applicat3.on therefor� require the.pa�*ment-by the applic�nt for such permit o£ feea to the amount herein below set forth a,nd in the manner herein provided to-wit: 2.1 For any such perruit for the erection of any fireproof building� other.than a gax°age, warehouse� factor� or grain elevatory or for the erection of any fireproof addition, for similas occupancy� to an� . existing b�zilding she.11 be at the rate of °v�l.l�0 for e�.ch one thousand cubic feet, or fra ction thereof, in such cubical contents. : 2.2 For any such.perm3.t for the erection of any firsproof garage, ware- hous$, �factory or grain elevator, or for the erection of any fireproof addition for s�.mi.lar oceupancy, to any exieting build3ng shmll be at the rate of �1.25 for each one thous�ind cubic feet, classified as "fis'eproof" by Section 502 of the Minneapolis Building Code. HOIISES 2e3 For a.ny such permit for the erection of any non-fireproof building other �han a garage, warehouse, factory or grain elevator�_or any � non-fiu°eproof addition� for similax oecupanc�, to any existing building. Permit �1,00 for each one thousand cubic feet. ,.. GARAGES � - 2.L� For any such permit for the ereotion of any non-fireproof garage� warehouse, factory or grain elevator, or for the erection of any non- f3reproof �.�.dition, for ai,milar occupa.ncy; to any exiat3n� building or for each•such building or addition. Ninety Cents for each one thousand cubic feet or fraction thereof; �in the cubical contents thereof with a minimun of �1,..00 � . For the purpose of computing fees for building permits-the cubical con'tenta of any,building .or• addition to a uniform hei ht throughout by mult�pl�ring the ground �.rea covered from a point six �6) �n�'hes �belrna the floor line o� the�basenen� or cellax to the average height of the upper surface or to the average height of the roof surface of the ma.in gable of a pitched roaf� � • . 2.5 For rapairs or alterations to an existing structure� the fee shall be ttt the rate of �3v00 for each Five Hundred Dollars_.(.�5C24.00), or frac-tion thereof in the cost of �1..1 proposed work. 2.6 In no case ahall the fee chr�.rged for any permit as set forth in Section 2 be leas than �4e00� � �i1 . - _ � i �_ a.� i � w � � g e y Ja � `, � �� .� �� 0 L.� `"s-�' .,.��., �?ix8`- �.} ,y� , &,� s �g :.-�`- z.:� -*+,�n�. .�e'- - `� qar ,� �� 3�� # '� ��- � 3� , . ., .. , � , , - «- , . , - ! _ � ' ��: - " .:. �- ,. . .. �0 GOM�tNtNCi. 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'_ -w-�+'*-^- �+ � �-- - . _ �; � � �� _ �� -. � �' ��z � '� .� ' r �.�^�p, t t - ' � � . .� �`'�-� `r.a� > -.'�+E � ,,.. ,� _ . . . . _ . - .,. _ - . . . �R. _ . .., _ �3'' . . Ir Ir O � � � �' � � � � � �� o M � � � � � � O �� ' � ''��i � � H � H � � � � 00 I � � Ki' � 0 � M w � � +o � �. 0 n � � a � � � 8 � � � � P O � � � � � �m� �� pf � � � M -p � � n � � o � y `� ce �, � � � � � � � �^ � @ � i`'°., o�� y tZ° R° � R�� R° R' �� ' oo�� '� �� ,�� °�°� � �"'�� m ° � r S� ST �y � O O O O �� 'd � � � � � � �0 ,�� O Ky � � v � � � 7y � � y � � � p �, o� �1�,� �' • �a' �'�.: " �. ��q �� : �s� �,�. �' �� o: �: �.. ��.y �Q: : 4 �Q. : f�D . . iT O g: . 0 p p. . lp . . . � O . . . : . UI . . . � � . . . M 0 . . . � : : : �' � . : : : 3 : : : : � : : : 2 � ' : : ' R � : � : . . . . . m � . . . . : . . . . : : � : : � : � : : : : : � : � � �, �O �� Q p O O G O O � � � � H � � /� W � � � � � � :d \ � R� � � � � b � � � � ►�i � � O x � O � � � � � �� z � � O I A � � � � � O �..� � � � �o.�+ [V f4 O W � � � �. � g ,\�. ��N� C7� p O C O G O O O O � � � � � � _� � .. m � � �.. .. � m � � N w � � � CT O O O O O O O fA &� O � � � � W � � � � �� 'b ��Q Y" pW� p��R+ -r+ �� ° � �� d ��o� ��¢� O y �p W �� p �`4 �°°�. . DG" �� p- `+- k��' w �tR.�p ��° H W �� y �*�� 0 � �' � '� � � �' D � � � m � 2 m C r m 0V K M � � � � � � a V O � 0 �, �% � � -�; � � � O '�e a� ,I' � � � �� i .i �� . � ��a �� ° '�' � `' �. � � � � �. � � � � , �. ��, jC ,� � � Ci.ty of Fridley, Mirm. BUILDING PERNI�T nate: duae 9, 1965 ��o�/ N° �816 ovener: S. J. 7�ixon su�der Inter C�.ty G�.a�e Hu�.lders' � 774 �esmett Drive N. E. aaa� 35 �t 1� Mpls.,- 33 . LOCATION OF BUILDING No. _� Street Bel�ett Driva Ri'..._F�— Part of Lot ��' — 81� � Addition or Sub-Div�aion Christi.e Add. ��' �t — In�tde Lot Setback Sideyard �R'� �� — Fo�mdation IIevation To be vsed as: DESCRIPTION OF BUILDING Front _____�.. Depth Height Sq. Ft C�u. Ft Front Depth fTeight Sq. Ft Cu. F� �►pe of Construction _ FrBme FF�t. Cost �1►.Q�.QO To be Completed Storm Dau«.ge repa3r In consideration of the issuancae to me of a�rznft to construct the building described above I agree to do the propoaed work ffi accor�iance with the d�scription abwe se� forth a�d� comPlience with a'll provlsions oP ordlnances oP the dty of FiirIIey. // Ea caa�iderat[ari of the payment oP a fee of •00 , perm�tt 3a hereby �rante� to Inter Cit�r Gar. B�t'.i3 �S�e?'� to construct the buflding or addition as d�crlbed above. Thisp�� t fs granted upon the egpress csondition that the person to whom it is granted aad hia agei►ta, ennPloYees anc� worl�nen, fn all arork. doae in, arouad and upon eaid huild�tng, ��Ypar� thereof, shall conform in all respects to the ordinancxa oF F'ridleY� Minaesota glxation, construct[on, alteration� maintenance, sePair and aiov3ag of bufldfr►gs wl�� dtY 73miffi��'this Permit may be revoked at any tinne upon violation of any of the provis�tons of said Al.a.ea densen �� NOTICEa 1W peemB doa eot wwr t6s wnshvcHon, Inatal�lton 1or vrGieg, pium6te8, �a 6aHne, sevra� or �ratar. Br sun io »� � �9 �* �* +�►+� P�rm6s fo� f6� hu�. . �, . � APP`LICATION FOR � ii� 1'�RMIT , CITY OF i?R�DL�7i� ; N14�pTA � m 0�'R � S �'+ �(/ � �1 �Ji?n � AIT77_11FR L _ i!s _ / i �ti e l/� - ' - e� � � ,f►DI3RESS � LOCA�`tON UF St�DIi� / . �.� j i � � i Lot % _B],ock � Ad.�iit.i�at or Su�d��i � of %C.�_ ... Corner Lot Inside �ot��et�k Side: Yaac� � SEWER E�,E`VATxpft FO�TiON EL��' ,T� � � ...,�.r..�,�.�.._.. ..._._.+...,._ Applicaiit atea�h to thi� faraq Two Certificates o�, Survey of La� and �oges�d'��: -�' iug location d��wn o� these �2�tificates, � � � '� ° ��` � DESGRIPT�pAT OF Bf1II,DIATG ��ti� r T�v be us ed �s ; d �`ront Dep� , H� �, 9q. Ft._ Cu. Ft. 6 ' Front Dmpth �Ieigh� . � �t�. Ft .,� . . Cu . Ft . Type af ConsCruction ._�f ' - . l��if� �z�'''-'� Estimated Cast ��..�...._,...._� ./ __e ,� . � j' The undersigned hereby mskes applie�tion for a pexmit for the worlc herein specified, agreeing �a �o aZ1 wo�k ac� etsict accordance w�tth the Citq of Frialey (?rd�iga��aces and. rulings �r�,��e Depar��z �of Buildiags, and hereby decl��es tliat aIl t�e f�ct�.�nd repres.eatations stated ia this application are true and correct. � � c — ,��S�dul�.af Fee Costs can be fauad on the Beverse Side). ^ � � :, . . >�.��"?.y •r'�'wk�. . .' • 1.'�� w} r�.:+ �&,r,'. • . . .: ' � t.',�K f ,� �� . � �' ±M. ��.•r 4 ,�t.�u'; ' a , e. - �-- � ., „ � BtJII.DING PEB�MIT FEE SC��ILE �. � Section 2. The Inapec.tor of Suildings •s��l�, be�ors ia�tt�,� anq pes�i.t for , th+� erection cf any buildiag or sCruG�,,u.,re.,. . sir � for aay add�ti.�,a es any e�ist- ing building or atrucbure, or for, aa� a�,terat�4xi,s*�o�:.r�epai�t� t� any existing . �. huildix�$ or sts�ctur�, upon applicat�� er,e�oa, �c:q�re the pa��t bq �he � ap�licant for such permit of feee -Cl� ttie amount �her�it��•below ��t 'forth.-a�ad � • � in the maane= herein provided to-t?�t:• ` �� ' _ ;. _ _ - :�--- --- �.1.. F�r .any� �uch permit for the Q��e�,tian�a�` an�► fire+�r�f bu�;ld�.ag� a�1�er ?� . ��.-�� a�,ar�ge� w��cehouae, faatar-y er� &�t�it, �evt}'p��';, :� £a►r. the et�t3�rri o� . ,' enY �fire-��of eddi�ioa;� f�� ain�$�;ar°�o�,��g�a�Y� �a a�q �xxia•t�i�g bu�..1d� '�•:_ •. w ahall be at the rate �f $1.4t1 for �as$,pt� tho��nd .�wbi,e feet� or��r�#,oa . , � r- .. . thereof, i� such cubical corit��t�s . • : .,� ,`,:.� � • `t `. �.;� • : n. � . � �'�� 2.2. �or any auch permit fo��..-t��e,.erectioa o£ any fire-pr�aa� 8+�r�..,w�°��- � �. �ory sr graia elev8tor, or �fq�•the �e�.tian e<f aay�.�,��oaL' . fer aimilar occ�ganGq, to any _sicist�#ng �a�ld%sg sha]:1� •be at .��ie : �: . . ...�.r fof '�aeh vne .theusand �vbic .feet;'., c��esi�ied . .a�s� •"firegroo�" b�y� .3� � . the-•Misaa�e+np��.3,a•-�Bu�,idln�. Cod�,."�F�.�+a=t�_.�, . , . . . .' � :� HQiJSES �- , .. , • , . y • . . . . . . . . . . . ��_ ' 2,r3',- Far any, such permi� fo� tbe er.�atioa af e.ny non-fir�p}�f b'uilding ��'--.t n e�ai�ge, warehouse, factory or. graia elevator, dr aay �►onr-ffar�pr+�sf�°�� additivn, for aimf��tr oc�upa'n�q� to an�r �istirtg �iiuildia.� - pe�i,t $�:� fc�r . J. each �eae thou�a� �c�bi�, fee�.. • � . � GARA�ES , . . ' ,� Z= For any such pern�it f�r the esection of any non-fireproof gaa�a�ey, � war.ehouss, factpry or graia ele.uator, o� for the_.erectioa of any gcm-f�aor�" edditi.on,r--f�>s�mila�� occupancq, tm an� exiating buiZd3ng dr for �scl� snch �' -_w�-�,lding or additioa - aiaety cenzs j$0.90j for each one thouaa�ad c•�bi� feet or fi�E,tioa thereof, in the cubical� coateats thereof with. a minitm�m �of $4.Oa..� - , • For Che purpo�e of caraput3ag fees for building permiCs, th�.cubicsl cr�t�te�C�-� of auy buildiag or addttion to a uaiform height- throug'hal�t �'ay t�ltipiying tti�-� '� ground area �oyered .fxam a�poiat siu (6) iache� bel�m the �Ioar liae tsf�he��.-,.- basement�br cellar to the:averag$ he�ight of the upper su�face•or to�the �� average height of the r�o£ s�=r€ace of the m�im gable of a,�itched ro�af. . ' 2.5.-. For repairs or alteratione to an exisziri� sCructut�.y �$� �ee sIi�11.��.�-°'�°°1' � a he rate of $3.00 per each Five t�uadred Doy,lar,,a .($s�b'sO��F or, irectic�a' . � ; � thexebf i� 6he co�� of,� �11 _ Proposed a�ork a , • :. : ,� . , , . , . .. . � �. . . . � ., . ^ �`. . . . ,.. . 2, .� In no �ase ahali �he _ P�r�i.�--� �et f��h in •' ., � . Sectiau r2 �be .las�i--,�lian-$�.�Ob: . . . . ' �' y5 y • �1 ; ,. J • ��" • -.l'��'�.. 0 I i � : w4 • • f ' tv,fr � .. � ' i � � � � � �, ,� � /i! r + �� . f! !- � � � � �j �%. F 3G-112 ' .- -�. -` .,. � • � f� � � City of Fridley, Mi.n.n.. BUILDING PERMIT Da�: June 9, 1967 pwner; _ Simon J. Dixon g�d� Adaress 774 Bennet Drive AddregB Sussel Co. 1850 Como Ave. �� N° 929'7 LOCATION OF BUILDING No. _ 7Z4 Stseet Bentiet Drive � ____ p� of Lot Christie Addn. Lot � 1 __ Block $ Addition or Sub-Division .____.._._.. Corner Lot ._ Inside Lot Sewer IIevation Setback ��_ Sideyard _.._ Foundation IIevation DESCRIPTION OF BUILDING To be Used as: D. Ga.rage Front 22 � De th 24 � Hei t P gh Sq. Ft Cu. Ft – �4h Front 8� Depth 24 � F�Teight —.. Sq. F�k Cu. Ft 7.�ype of Construction Frame �� $2200` _ To be Completed 90 Days s In consideration oP the issuance to me of a permit to construct ttie building described above I a�ree to do th� proposed work in accordance with the description above set forth and in compliance with a'll provisions oP ox�dinancea of the city of Frfdley. �— In conafderation, of the payment of a fee of $ 9. 00 ��,�t fs hereby granted to Sussel Co. to conatruct the building or additfon as descxibed above. Thispe rmit is granted upon the express condition that the person to whom it ia granted and his agents, employees and worl�nen, in all work doue in, around and upon said building, or anypart thereof, sYxall cbnform in all respecta to the ordinancee of Fridle3', Minnesota regardin� lacation, construction, alteration, maintenaace, repa3r aad moving of builc�n� withitt 'the dt3' ]im�its and th�a permft may be revoked at any time upon viola.tion of any of the provisiona of said ordinances. c;r.A7tFN ._ �ELZSLE Builc]in8 Inspector NOTICE: 'Ihis permM doa �rof eovse ths conslrueilae, instaWHon for wirin& P�+�9. 6� he=�8. ��' or water. B� sun to su the Bnildlere Inspfeto� fo� mparab parmtii fer �has i�nn. � OWNER'S NAME APFLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA �� a � � � � � � BUILDER c� � �' S� �!� 5 � ADDRESS �'� f ��a�>:�� .��s-� ADDRESS /�J'�� '�� I�c� ' LOCATION OF BUILDING �� \ N0. STREET PART OF LOT LOT BLOCK ADDITION OR SUBDIVISION CORNER LOT INSIDE LOT SETBACK SIDE-YARD SEiJ�R ELEVATION TOP OF FOOTING Applicant attach to this form two certificates of survey of lot and proposed building location drawn on these two certificates. DESCRIPTION OF BUILDING To be Us ed as : � � �� Oh� d��p-a�' �c�� : -- Front �-�, Depth �-� Height Type of Construction To B� Completed �q. F't ._ Front Sq. Ft ._ �� a .�� ° Cu. Ft. Depth $eight Cu. Ft. � . EstimaCed Cost � eL�.�r' The undersigned hereby makes application for_a permit for the work herein specified, agreeing �to do all work in strict accordance w�.th the City of Fridley Qrdinances and ruling of the Department of Buildings, and hereby declares that a11 the facts and representations stated in this application are true and correct. DATE_ �` U � --g- � � ia �� SIGNATURE � �'s � .�' �""� �-� " ,�e � , �'� �'--` � �"�r �"-� � (Schedule of Fee Costs can be found on the Reverse Side). .,� : _.___ �: _ __ � -, � � , � �� _ , �--�:,---_,r �_�._ � _ .._ _�`�__--� - - �� "�-� � --_ _ � � �jr;.� - -: � qq � {�__ f . A, -�-- -=� ;'l�.- ,� :.n. . � � . �-.�--, -_ � A�._..�� . � �1 a�—"� , , .I �� ' . � - �— , . �.,,, � . . — '-� - --- � �%o_ � � �� _ . o ,r�-�-�� , : � . o � _ � . . -�t � . � � � Y,�� N�`�� . , . � l BUILDING PERMIT FEE SCHEDULE SECTION.2. The Inspector af Buildings shall, before issuing permits for the erection of any building of structure, or for any addition to any existing buildi.ng:or structure, or for any alteration or repairs to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to-wit; • Ur..iform Building Codet Type 1,2, & 4- $1.75 for each one thousand cubic feet, or fraction thereof, in such cubical contents. Type 3& 5-$1.50 for each one thousand cubic feet. For the purpose of computing fees��for building permits, the cubical contents of any building or addition to a uniform height throughout by multipluing the ground area covered from a point six (6) inches below the floor line of the basement or cellar to the average height of the upper surface or to the average height of the roof surface of the main gable of a pitched roof. For repairs or alterations to an existing structure, the fee shall be at the rate of $3.00 per each Five Hundred Dollars ($500.00) or fract�on thereof in the cost of all proposed work. In no case shall the fee charged for any•permit as set forth in Section 2 be less than $5.00. • NSSSD �onnection Charges based on location- Area 1 or 2. � . . • � d�� ro _ e � �_�--'� i 0 �: 1 `� i � --- L �i �j�t�-_ ......., � � � � �' � � � ` � ; � � �' =�, �t� � ` b 4 t� � � '� � -��+,��+��ZSz��iC��p�,:�`r�,��,�� C c�, N Z � rn (� (� � R = � ' '� � � tE � z � � � � � '� �t '� � U► � � t� � - � t�, ��► � � � r � rti (� < �a �! L `� t7 �, -� a Y • -f � " � �� . �� j b � �� - o _ � Z'�� :2 z�`; r �c. �,� �GtU� � oD�, � #'�0:-� �, '�"C11.�'�� o ��a.�� o�'� �� , t� � � � � ` � � � �i = � �� c�. '� ��11t��a �� _� �i ='� � �t fl!� < � � z � � � �' f��t� D ln o � o �. �� f�� ot�i� � :��'rA �� , , �, � z. ; �, � z c ,� � .� � t� � �� g �� a ��r�o ��.�! .�� '��-�, � � � (� '� �^ � �" � r -,�s � � fl � Rp � � C'� p�" '� � � ` � ��: . �` �� ' �� (��b Z�� 'T� ��' o � � �fl �� . �� T m o � f�-� � � � � � C� -�� 0��' � � t� � � C� � � {� Z. �=ij � � ti �1 -1 �u r (n '� 'L ' . � � � � z D , � � + • � {� � `o � � N -� p � � ; �' � � � �� ^ �u v c � � ,�Z (� � , x � ` fl ,� U� (j ip � �, � _� H�_�t_ � ��"��'��-�`�� + t�tv ;�� _ t�t c3� c� p� � � .�t �e aNC�� '{�� -d L � Fa - .. �.t�°� - �¢� - � . � `° � -� � — � +�a • !. � � � � _ _ � t-is�� , ,. � , `�� . . � -� �� ; .___�_�m �' �. „� ��4�'s � � fl�al�'�ly �D" � � � � � ��a�s �� , � � ` � � ' 5�f'�O'� �° I �rvris��c� � V - �,�+i 3dA1 O p �Z.Zi an�vn � ' a � -�+7 x Z7.. : az�s � � � � �M�3W!' � r,�► � �~r�' ! �a a �c�� : r ' ' ` �±-��s�'�">1r. — > *�ir:,. -� %� _ .+ � i .r ,�,� y � �. � �07r tef` ' (� � , ,. s 0 I�� v�av 'L.j. ss3aaav v�rr� N ��r0a� ��1��?Ji7� 'N,�Otl � ' N D O'19 / 1 O `7 � '��7 � �. / � i 1 : � s r � s� � 0 < � a � x v� c � n � a � � �, � �� r � � � � � �� 0 � A � O �� O � �-�..�,., � i � � � �o � � � � @ a J� � ��,,. � � � � y � �� a�� ' w '�i � � � �� s � � �� o �� 25 �� . . � 3. •: � M � � � . $��y 8 « �. a � 0 r 00 I � x � 0 0 A � � �' � Q. � n w �. A � � � � � � � ��1 � � x � � b 0 r m � °< � �� w� o� W � � �� o� �o � G �t � � � E � � $ � � m � m �� a � A �C N � � � y os�� 3 � � y �� $ �� x � o � 8 � � � �:�oo 8 � 8 8 � � � � I � ' � Ii o y O m � g �' � I� � � I� � m � i . S � �� M �. '� J o I � I ( `�.. � � 1 � � �� a tt� R� � �r �a�� .� �'�s� ro � � � 8 � �� m � � a �► : +S' «5� � s 2S � � S � � ' Q W�,�wo 8 $ 8 � 8 ,. « �-1 � � � � .. � � � a � I I q� s � � �� y � � � e G C �' �� .. � � � � � mp, � . O. � � � . ,o° $ . . g : : i$88 r� ri � � � li pf fA A fl, � � � � " �� . �, � � � � m "�'' � ��.�. � d�� :b s� » � c. �' r8 .. o m 5D' `� � �o 0 y ~��r � �r•� � CW � ��G d �� m �O. p ? � �y A p� m V a�� m�� 5 ; � � � � � � s� � � '� � � --� T H _ T C � � M ! ,� � � � � � � �. �_ � N �� D w � O � SUBJECT City of Fridley � 9 5 9 31 AT THE TOP OF THE TWINS g U I L D I N G P E R 1�/ I I T � � � � � � RECEIP COMMUNITY DEVELOPMENT DIV. � � r j L � PRO�ECTIVE INSPEC710N SEC. � ; i � � �'��1 � CITY HALL FRIDLEY 55432 NlJMBER REV. DATE PAGE OF APPROVED BV �"""'� � �� 612-571-3450 910-F15 9115/80 / / JOB ADDRESS 774 Bennett Drive 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. � $ Christie Addition SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE Donald Delisi 774 Bennett Drive 571-4162 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Saiitros Roofiag � Siding, 11U5 - 50th Ave. N.E. 571-9569 4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION [� ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Re-roof with asphalt shingies 8 CHANGE QF USE FROM TO STIPULATIONS Roof can be second but not ihird must install galvanized roof valleys T PE FC ST. OCCUPANCY GROUP OCCUPANCYLOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, sp�a� VENTILATING OR AIR CONDITIONING. E- t'00 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 OR WORK IS SUSPENDED OR ABANDONEO 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 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SUFTAX WN H WHETHER SPECIFIED H REINIOR NP ToTHE GPANTING OF AO ERMIT �� SOO.00 • 75 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. 9•OO PLAN CHECK FEE TOTAL FEE � �- , � / D $9.75 SIGNATUiiEOFCONTR TORORAUTHORIZEDAGENT 1 ATEI WHEN PROPERLY A ATE THIS IS YOUR PERMIT . �, .3 � � � ��/S'�v SIGNATUREOPOWNERIIFOWNERBUILDERI IDATEI L G WSP pq7E CITY �� FRIDLEY - ��.: f�[?PLIC/ITIO,d �'OR RESIDE(dTI/lL C3UILDIitG PE�t�iTTS (fdew, Alter�tions, AC�CI1t7011S, or Re�airs) • Ot'ir•�ER: /,�O �.l � .�L �-�. �, .S • _ Aoa��ss: �7� .�e�-1�..��. TEL �t0: ,��j-� (� � 6llI LDER : -�..�g.�,��._.�o� �� -�- �ntS . - 11D(1RESS: i�.s��' � c°�.� ..�.s�o �, � 7EL t�JO: � ��' -� �`-� Construction Location STRI�T NO . �, SR.'REET: �� 4�� LOT: � BLOCK: �� ADDITION: C.�/7� �.I��/ � �� Corner Lotc Inside I,ot: SetbacY: Sideyards: Applicant at�ach to this form two Certificates of Survey of lot and proposed building �ocation dracan on certificates to scale. DESCRIPiIOI� OF COPISTRUCTION • � W � I'ron�: � Dapth: Height: Squa�e.Feets Cubic Feet: r'ront s Depth : H eight: Square• Feet: Cubi.c Feet: . ,�'��-�-- � Type of Construction: �� p�'� �'�/ �� Esi.imated Cost: $/��p �.,d a o 2b Be Cbmpleted: Propased Driveway Width If New Opening Is Desired: � Alt. A Alt. B $� $ SE� REVERSE SIDE OF SHEET Ti1e undersigned hereby makes ap�lic�tion for a p�rntit fcr the �,��ork� herein specified, agreeing to c� .al.]. work iri. s-L-r�.c't accordance witY� the City of Fridley Ordinances and rulii�gs of �the Department af Buildings, and hereby declares that all the facts and xepr�seni-.ations stated an this applicatian are true and correct. D�TE: ! �j SIGNATURE: � � � - ;. Stipulatians: ��,,.-.� �j,GU .T�° ,•?� , 9 �J v � , ' .�.. - L . _ ' __ ._,_,._ _ — - - - -. _ _ _ r�------- --�------ - - -. . • tiU)Lll11V(i 1'L-lit'1t i I L:1: :,i:i1f:1.)UL�' . �31�(:'�`ION 2. �'1'li� 7n!,>>ectar of l3tiilding ,.cha]J , bcfoxe �_�,suzrig pea�n.iL-a for the aracti_on af• <�ny 1�u5.1.cl:i.ncJ ar :.:i:�-uet.ure� or. fa�: any �zdc�i.t�i.�n L-o ac�y eri:,Li_n� Luildinc� or strucLizre, .. ci�- f:a1� -atey alt.rxation or re��air.s Lo •any c�:i.::Linc� }�ui.l_di.lic� or str.-ucturc, upon appli.c:ation _ 'L•her.�i'or_c, rcqua.re t}ie p�iyme�,L 1�y tlie aP��7.icant: fo�' sucli per.mi.L• of fee:, L-o tlie arnount I�c.z�in bcl.o��r sei: �or.t}i aiid 9.n tlie mannez herein ��:ovicicd L-o-�•�it: • I�T�:I�7 CONS�'I:UC`rIOt1: SingJ.e Fmni].y Ilomes ana Gar.aqes: ; 4.00/1,000 cubi.c tceti. . 3'Lnt� CIi;:Ci;: 2.5 ��crcer�L- ot I�u3.ldincJ }�ermiL ice. 'UR1VE4:A�' ll�Pl'.L•'S5I�I7: (Concret,c, Curb 5L-rects Only) " • Alternai:e l�: It�mova]. and replac�ment oi concrete euzb and gutL-er only; llriveway c�idtl� p7.us 6 ieet x Y�.,5.75 Alternate II: Removal and rep�acement of concrete curb and . ' guttcr and install a 3�oo�. wide approach <<�iL-h �' ' ,. 6 i.nch depth; Drive�ray width �plus G feet x$17.85 � •. . ADDI T I 0�/�.�,. I NFOR��lt1T I 0� ror. the purpose of compu�ing fees for_ bua.lding permits, L-he cubica� contents of any buildznq ar a.ddi�ion, is dctermined by rnultip].ying the ground area covered irom a p�int: six (6) inches below i:hc iloor l_ine of the basemen� or th� cellar to the average heights af the upper sw-face or L-o the av�rage height of the roof suriace oi the main gab].e o� a pa.tched roof . For. repai.rs or alterations L-o an existing stn�cture, the tee shall be at the rate of $3.00 xier eacli five hundred dollars �� ($500.00) �r fraction thereaf in the cost oi all proposed wor.Y.. • . . In •no case shal.l the fee clzarged for any pP..xmi.t as set foxth 3.n Sectian 2 be less � ttian $?.50 plus $.50 stai:e suxcharge. ' � � � � V�RIFICATIO�! OF 1=01.1��D11rI0t� ' NOTE: Permits �ar construction eaill b� issued a minimtun a� 24 hours £rom the ti.me oi applieation to a].locv for.proper review of ihe proposed stsucture and oi' the . constnaction site. A Certificate of Su�.vey of the l�t, sho�ti�ing the location of the foundation once S.t lias. l.�een cans�zlzcted �eill be reguired before pr.oceeding with the iraming. CtRTIFICgT� OF OCCUPA�GY Jlpplicatic�n for a Certificate of Occupancy sha17. be madn ten (1�} days prior io the use o� OCCIIp3I1Cj/ o� any si:nxcture for �ahich a builcling �ermit l�a� been �ssuec3; and s�aic� s�ructure shal]. uot ��e used a�- occu�ied unti.l a Cer�Li.�icate o� Occurancy has bc:en issu�ci. '°'- � .vz. � 0 • • °� ' � ' . 0 � 0 City of Fridle� , AT TME TOP OF TNE T1M�NS i� � � � ' y __��_ COMMUNITY DEVEIOPN�ENT OIV. r � � PROTECTIVE INSPECTION SEC � _ �"'1 � CITY HALI FRIOLE� S.i�32 �"-'� � ,�' 612-571-34b0 Bl11LD1NG PERMIT NUMBER � pEV DATfi PAGE OF 910-Ft5 1/24/02 / / ERMIT NO. � 32407 �� AnartpvEO er JOB AODRESS 774 Bennett Dr NE . t LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACMED oesca. 1 8 Christie Addition SNEET 2 PiiOPERTY OWNER MAIL AQOR�S$ Z�P PMONE Gregg & Donna Christopherson, 774 Bennett Dr, Fridley, MN 55432 763-572-2486 3 CONTRACTOR MAIL ADDRESS ZIP PHONE IICENSE NO Northwest E�cteriors, Inc, 6500 Walker ST, St. Louis Park, MN 55426 952-926-8663 4 ARCHITECT OR DESIGNER MAIL AOORESS 21P PNONE 2026�+650 � 5 ENGINEER RAAIL ADDFiE33 ZIP PHONE LICENSE NO 8 USE OF BUILDING Dwe�ling 7 CLASS OF WORK C� N EW B OESCRIBE WOHK 2 new windows 9 CHANGE Of USE FROM O ADDITION � ALTERATION ❑ REPAIR TO O MOVE O REMOVE STIPULATIONS Provide smoke detectors in all sleeping rooms and on all levels of the dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code. Caulking and flashing for all exterior openings. SEPARATE PEfiMITS ARE REOUIRED FOR ELECTRICA�, PLUMBING, HEATING, VENTILATING OR AIR CONOITIONING. THIS PERMIT BECOMES NULI ANO VOIO IF WORK OR COI�STRUCT�OM AUTHORIZED IS NOT COMMENCED V+!ITHIN 80 OAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR A9ANQONQO fOR A PEBIQO OF 12Q DAY$ AT ANV TIME AFTER WORK IS COMMENCED. ' I HEREBY CERTIFV THAT I HAVE READ ANO EXAMIN�O TNIS APPLICA71pN AND KNOW TME SAME TO BE TF]UE ANO CORRECT. ALL PAOVISIQNS OF LAW$ AND ORDINANC GOVEfiNING TMI VPE OF WpRK WI�I, Q� CpWpI,1ED WITH WNE7H SPE IFIED MEREI O NOT. THE GRANTING OF A PERMIT DOES NOT HESUM TO G�VE T ORITY TO VIOLATE OR CANCEL THE PRO ION OF A OTHER A OR LOCAL LAW REGULATING CON- TF,�U OF T E PERFOR E CONSTR TION S�GNAT CON'A4CTOpORAUTHOAiIEDeGENT iDATEi S�GN4TURE O� OWNEQ��t OWNEABURDEA� �OAfE� �. r NO OWLG. UNITS $3,500.00 'EiiM1T FEE $97.25, 5. OGGUPANGY GROUP OCCUPANCVLOAO SQ.FT CU FT OFFSTREET PARKtNG STALLS GARAGES SUR7AX $1.75 SAC CNARGE $3.50 Fire SC TOTALFEE : $107.50 RLV V LI TED 7HIS IS V UR P.E� MIT / Lc; �� -4Y qcrE J�1M-2�3-�002 �� 17 Ff�M C I TY OF FR I L�LE`f TO '�5'�926S��i F' . 4� 1%�3 NEW [ j GIiY QF FRIDLEI° Effectiv� 1/1i2Q02 ADDN [] 6�i3�1 Univqrsit�+Ave NE, Frid�y, MN 55432 (783) 57�-360�4 Bidg Insp AL'PER [] SBNGL.E FAMILY ANL� QUPLEXES R•7 AND R 2 �UILC}INC� PERIVIIT AP�LfGATlpid Construction Address: �%� ' l� G/7Yl L� %I � Q Legal Desaipti�n: t�runer N�m� & Address: �R�6� °' �� '�lS �D ��l �' �Sov� Te�. # ��31.�7�- o? �/�� coema�o�: �Ue2-r�lW�,s i�'x�s�a/�sf �� _ MN LIC�PIBE # a�0�/a�sc� �►cidre,as:6S3� ��/l1��Q S'� = ��. � 9�-9ab��lo6 �tt��, to t��s �PU�t�on, a Certiflcat� of St�vey oi the tot, �+vith the proposed cdnst�c�ior� dr2iwn �tn � to s�le. DE9CRI�T1pN t}F IMlPE�t�11EIVt�NT itVIN�3 �►REA: Length Width Height �q. Ft. C3ARA�E AREA: DECI�f �R�A: Lengtt� Width Height Sq. Fg. Lengt� � WidE� HgUGraund Sq, Ft OTHER: Construc#ian Type_ � � � IaJa ri �D�S � �-� E,�im�ted +Cost: � � �Z9� -- Drivew�y ��rb ��t Wideh hleec��d: Ft. +� Ft m Ft x� m�. �a�; � " � c� aPP��v . ` r�'. ��-9ad -8'6�,� Call {763) 572-3��4 fc�r R�rar►it Fe�s if nt�g ir� appli�ation oe F�xx to 763-57�-��$7 Yt eisi�r� crec�lt �c�,rci �nd wr� witl ca11 you for car�i nurttb�r. Permit Fee �ire S�rcharg� State Sur�i�arg� SAC Gh�rge Licen�e Surcharge Driveway �scruw CIT1( USE 4RILY - � � �S - � .�.5 � !. %S � $, �-�U $ Ero�ic�n Gor�trt�1 $ �50.40 �on�er�ration Plan C�eview P�rk Fee $ F� Dvtsnmined by �ngin�ering Sewer MaEn Charg� $ Agr�ement I�ec�ssary ( l Not N�r�;ssary [ Fee S�h�tlulc� r�r� R�v�rse Sid� .4+�1 s�f P�rmEt Valu�tion {1110th%j �.�Qt$1,000 ValuatBon $1200 per SAC Unit $S.�a �State Licensed 4��iderrtia4 �ontractor�j Alt. "A" oP Alt. "B" Abr�v� To�� D � s-riPUUarion�s: .. CITY OF FRIDLEY 6431 iTNIVERSITY AVENUE NE FRIDLEY, MN 55432 57"L-36U4 r'AX: (763) 571-1"Li37 � PERMIT O.: 2004-00707 / DATE ISSUED: OS/13/2004 ADDRESS � : 774 BENNETT DR NE PIN : 143024410031 LEGAL DESC : CHRISTIE ADDITION : LOT 1 BLOCK 8 PERNIIT TYPE : BUILDING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING VALUATION : $ 1,852.00 NOTE: UNDERLAYMENT AS PER STATE BUII,DING CODE. REROOF HOUSE (16 S� TEAR-OFF APPLICANT CHRISTOPHERSON GREG A& D L 774 BENNETT DR NE FRIDLEY, MN 55432 OWNER CHRISTOPHERSON GREG A& D L 774 BENNETT DR NE FRIDLEY, MN 55432 AGREEMENT AND SWORN 5TATEMENT This permit becomes null and void if work or construcrion 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 cerrify 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 violate or cancel the provisions of any other state or local law regulating c�nstruction gr th�erfQrmance of construction. Bldg Insp. BUII,DING PERNIIT FEE FIRE 5URCHARGE STATESURCHARGE,VALUE TOTAL � C�TT A 77 A TT TT7]1.fiT[� 7]T/ITTiTTT T!/1T R�/�TT) /1TiTT TTT � 1T TT[�l�TTTTT • T�1<n+ vui a u�[ a 1 ii 1 1�iu�u 1 � i�u� V 1lWY 1 Vl� ♦� VIUI V 111L1� 111[>1\ LLUV1�1LlIL AL V 1 L. 66.20 1.85 0.93 68.98 NEW [] CITY OF FRIDLEY Effective 4/1/2004 ADDN [] 6431 Universiiy Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION n � �j � �� 'l � Construction Address: � % �-( ��fv� � �T � ,� t d b ��! � �� Legal Description: s►.N G �� ,� y�., � �y t-p� rn� Owner Name 8� Address: ,pt� ,�9•v ��C �2.�6� C�E-i-�e-15� p�� sv� Tel. #_7�� 5� a-��4-� Contractor. MN LICENSE # Address: Tel. # LIVING AREA: GARAGE AREA: DECK AREA: OTHER: 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. Construction Type: Estimated Cost: $ Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x� _� DATE: � l3 0 � APPLICANT: �Bvr.u� (,�M ��O�,h�1 Tel. #� � � 5 7� ;� � � Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call you for card number. ' Permit Fee Plan Review Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge �' � � r�0 � P $ � $ $ $ $ $ $ $ CITY USE ONLY - Fee Schedule on Reverse Side 65% of Permit Fee .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1350 per SAC Un� $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Detetmined by Engineering Agreement Necessary [ ] Not Necessary [ ] TOTAL $ m � STIPULATIONS: BUII.DING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to-wit: TOTAL VALUE $1 to $500 $501 to $2,�0 $2,�1 to $25,000 $25,001 to $50,000 $50,001 to $100,000 $100,001 to $500,0� $500,001 to $1,0�,0� $1,000,�1 and up FEFS $23.50 $23.50 for first $5� plus $3.05 for each additional$100 or fraction thereof, to and including $2,OQ0 $69.25 for first $2,000 plus $14.� for each additional $1,(�0 or fraction thereof, to and including $25,�0 $391.25 for first $25,000 plus $10.10 for each additional$1,� or fraction thereof, to and including $50,000 $643.75 for first $50,�0 plus $7.00 for each additional $1,000 or fraction thereof, to and including $1(�,�0 $993.75 for first $100,000 plus $5.60 for each additional $1,�0 or fraction thereof, to and including $500,000 $3,233.75 for the first $500,0� plus $4.75 for each additional $1,0(� or fraction thereof, to and including $1,000,000 $5,608.75 for the first $1,(�0,(�0 plus $3.15 for each additional $1,000 or fraction thereof CURB CUT ESCROW (Concrete Curb Streets Only) Removal and replacement of curb and gutter only - driveway width plus 6 feet, times the annually determined rate Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. VERIFICATION OF FOUNDATION A Certificate of Survey of the lot, showing the location of the existing foundation will be required before procee,ding with the framing. New Houses Onlv , - �, PLUMBING RESIDENTIAL APPLICATION City of Fridley � �� d�s�°G'�l�l� NOTE: IF PROPERTY IS NOT OWNER/OCCUPIED- A LICENSED CONTRACTOR MUST OBTAIN THE PERMIT. DATE � � '� � YOUR E-MAIL ADDRESS SITE ADDRESS THE APPLICANT IS: (CIRCLE ONE) OWIdER NAME PROPERTY OWNER/ qpDRESS TENANT cinr,� PHONE # CONTRACTOR ' � l�[�7'I I-i� 17� NAME ADDRESS cinr PHONE # CONTRACTOR o i`� � . . u� TYPE OF WORK I ❑ NEW DETAILED FAMILY TWO FAMILY ❑ REPLACEMENT TOWNHOUSE �r� /Grc � u�� '� s/PSi � � �� i� FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED FIXTURES: (INDICATE TOTAL NUMBER OF EACH) BATH SINKlLAY FLOOR DRAINS BATHTUB GAS PIPING (Need City License) CLOTHES WASHER KITCHEN SINK DISHWASHER LAUNDRYTRAY � .,, Permit Fee $ !� �� Plan Review $ Surcharge $ .50 TOTAL DUE $ �� °� SHOWER SWIMMING POOL _yVATER CLOSET �� Nl�ATER HTR ($35) �WATER METER � � WATER PIPING WATER SOFTENER ($35) BACKFLOW PREV. ($15) FOR IRRIGATION OTHER MINIMUM: $15.00 or 5°/a of cost of the improvement whichever is greater on work less than $300 Make checks payable to: City of Fridley ...... ... ..,. .-.. ��.vr.. �v�� rvn e� rcnm� �� v � Y/1LW UIY I IL rRV VC�l�7CU 1 hereby apply for a plumbing permit and t acknowledge that the informatlon above is complete and accurate; that the work will be in conformance w+ith the ordinances and c�des of the City of Fridley and with the Minnesota Constructlon Codes; that I understand this is not a permit but only an applica�on for a parmit and work is not to start without a permi� that the work will be in accordance with the approved plan in the case of all work which requires review and approval of plans. NAME OF APPUCANT Cm/ � DATE �` �� , �lease type or print � . SIGNATURE OF APPLICANT OF FRIDLEY COMMUNITY DEVELOPMENT DEPARI 6431 UNNESITY AVENUE NE, FRIDLEY, MN 55432 {763)572-3604