AF - 36499sue�ecr PERMIT NO.
City of Fridley � 15 3 8 0
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
r
; � RECEIPT NOy
� • COMMUNITY DEVELOPMENT DIV. �L � � j
� � ti _����_,
r � � PROTECTIVE INSPECTION SEC. / ` �
1 i �� �8
i
� � �'�'1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BV
` �__'�•i �.J
612-571-3450 910-F15 g � 79 / /
JOB ADDRESS 1637 Brenner Pass N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. S 1 Innsbruck North Tawnhouse Plat rJ SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Darrel A. Farr Development Corp. 7286 - 72nd Lane N., Brooklyn Park, NII�i 55428
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Same 560-8110
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
X
8 DESCRIBE WORK
Construct an 18' x 28' Townhouse (C Unit)
9 CHANGE OF USE FROM TO
STIPULATIONS party wall must be two separate 1 hour walls from bottcen to roof.
Firestop soffits. Provide combustion air for furnace from outside.
`��`pE�tATE F'ERMITS REQUiREQ FOR iKfR1HG,
���EAfitNG. PLUMgING ANQ SIGNS. W�R��i�E�7r
&fon di�ging call locat uiilities
1f IFPNONE - �IECTRtC - C�IS Etc.
REQUIRED BY LAW
TYPEOFCONST. OCCUPANCYGROUP OCCUPANCYLOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
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 1363 12, 679
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. N0. 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 SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $24,360 $I2.�-H
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE
PROVISIONS F A OT R ATE OR LOCAL LAW REGULATING CON-
STRUCTI R T PE ANCE OF CONSTRUCTION. $SO. %2 $425.00
PLAN CHECKFEE TOTALfEE
�� - '-�` $12.68 $500.58
� SiGN.aTUaeOFCON'RnCiOa UTHORIZEDAGENT �D.47E� HEN PROP R�L71DA THIS IS VOUR PERMIT
� / �"�"�S
SIGNATUREOFOWNERiIFOWNERBUiLDERi iDATE� �� ' LDG iNSp �
.
Ci� I UI' I I(lUl_�T ..
. .� . .
� Itt'PI..ICl�TIO!! ('Oft {21�ST1)f:(•lTIAL �UILDII•!G �f'GItNfITS .
. (F��1�1, nLTER�T10(��, �1?llI?1Of15, OIt RL:I'nIIZS)
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Addr.css: 7 ,� .� %i• %�rii� ��r..�__ �Address .
1���1�.c- i�'� �-%h-��,'�r/� f'' Tc� . l�:o . : �.� ^ ' ,�/��` �
)do. / �3 % Strcet: �� T�� . � � .
r,o�: �5 Hr,ocy:: � • ADDX�r. zor� :���
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CO�tid1.R L01': xI�SXll� LO'P: ��� S; `xJ3J�CY.c � Sxl)1.X7112D�: `
?sp1�J.ica'r,t attach �o f:his foxm �1•�o Certi£i.catcs of Sui:vcy ot LoL- a»d �r.oposed �.:
bui.2ding locatian dra4�n on these Certificates. . �
- - � , � _ - - .
'_ DESCRI PTIOf•d OF BUI LD.I hG �i�-.. ��� ' �
To Rc Used Asz . - � _ .- '
_�7,�:�e.t.�2.,,.;�. - Fxonta /� " Uept.h : .�a � : . l�e�gh�t : �8 � .
. - . Sguare Feet: /3 � 3 Cubic teet: /a � 7 9 � . -
Y
- .. - •Fxont: .Depth:.. � Reight: ' . . -
. _ . Squa�-e I'eet: � CubS.c Feet: .
xype o.i Construction: L�/ �� ��-�-- Estixnated Cost: $���3,�`D
-, . : U . . . _ - . . -
�b IIe Comnleted: /�-�—v-- '7 g . ' - .A1L-. A A�.t. �3
' Proposed Drive;aay �•;�dt:h 7f I�ew Opening ]Cs llesired $ $
- � . . (SE% 1Z�vEF•SE SxDL' OF SliE�Tj
Tiie u�idersignrd he�'e}�y maZ:es applicat�on for a pexmit ior L-he ��orl: lierein �
specifi.cd� �r,r�e�ng to do all �.or}; in strici. acc��_dance �azL-1� tbe City o� _
Fxidley Ox'C�i111��11CC. and zuli�.sigs oi the Dci?atCmcnt o� }�uildii�gs, znd liczeby -
decJ.a�es ihat a1l tllc facts and represcnt:�itioi�s �tatcd i» this applicaL-ion
a�:e t�tie ��d co�:�ect. �See zevez_se side for c1CZC31L"1011��. �.ii�o�nai;.io:�.
• . .�7 /f . .
D7►�^�: �/� 1 � � �z�t������i:t.: �--� � � _----
StJIJ�U�.1L�.0I1S : , -
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ia �•i8 �cf%4-,eG �, �
• �as .—UO ��
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. •w , �
. ' ' �%i7/79
.3-�0•.5 �
0
HOUSE HEATING TEST RECORD
ADDRESS �� �? �� � APT. FLOOR CITY UBU B
OCCUPANT OWNER
HEAT LOSS,����` DATE H G. INST/�
SOLD BY �d.� 5.�� INSTALLED BY �m-p
Electrical Work1By — Gas Line By ���
TYPE OF HEAT GA FA _iG�-IW STEAM SPACE HTR. UNIT HTR. OTHER
GAS DESIGN CONVERSION
MAKE �.�-n Q� MAKE OF BURNER
Model __������ �`-Y' Model
Ssrial Max. BTU Rating
INPUT ���L-��� MAKE OF FURNACE
Model
CONTROLS
�' � �� Vsnt Size 1� '�
THERMOSTAT Heat Plug
Valve � KIND OF LINER �1—\ SIZE NONE
Limit �-' ���� Draft Hood �—��„1 RegulaTOr
Limit Setting {'�(}� � Fi Iters Size Numbe ,
Fan Setting 7� Chimnsy Loeation Inside�0utside
Pilot Type � Chimney Construction
Pilot Make •
Pilot Model $moke Bomb M�iring �
Pilot Timing ' i Draft �k— Test Tay t�
L.W. Cut Off Door Pressure Lightiny Inst. �
Pressure ,� • �`�—Pereent COZ Date Tsstsd
Input CFH �L�i=S Peresnt 02 Company Testing
Stack Temp. .3,��—Percent CO Name of Testsr
Form 235
CITY OF FRIDLEY
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION ANA
AIR CONDITIONING $YSTEMS AND DEVICES
PARTIAL �TE SCHED�LE
GR.iVITY is�R�i AIR:
Furnace Shell & Duct h'ork
* Re�2acer..ent of F�zr.ace
nepairs t alteratioas-up to SSQO.OQ
Re�airs b Altezations each add. $500.�0
1�SzC}iAtiIC�L itiAR�i AIR:
�rnace SY:ell E Duct Work to 100,000 BTt7
ea:a afld. 50,000 BTU
'P.:.�place�e :: of Furr.ace
t�.2:31�5 & Alterations-up to $500.00
�ep�irs � J,lter�tions each add. $500TOQ
s��t cQ tio� 1•:aTER SYSTE�t:
Boiler S Lines L� to 100,000 8�[J
each acca. SC,000 BiU
Boiler o^ly u� to 100,000 HTU
each ad�a. SO,OOO�BTU
OIL BUiL\ER- to 3 gal. per hour
� eac� az3. 3 qal. per ::our
R1lT�
�i2,00
7,00
7.0�
4.OQ
TOTAI,
6
�
�
$
$12. 00 $ � : . i; c
4.00 $
7.00 $
7.00 $
y,00 ¢
,
$12.00 $
4.00 S
7.AA S
�•AA ?
S�G�q�
• �R-Aq
G.as s!r�tar�- fro� ioo,000 ax-� ;.o i��,��� ��N s�R�RA
(over 199,999 BTU see Fee Sche ule
. �.�,..�
G:�S F:TTI:�G YEL'rJ:
lst 3 Fixtsres � X $ �•Qq
.?��itioaal :ixtures x 5 l.QQ
Gas �aaqe to 199�q00 ��LJ X �IQ;QQ
AI� CO\D?TIO\ING
Fa\' FE,�TI \G S�'STE�1S See Fee schedule
VE�TILaTI�G SYSTL';IS
ALTER4TIL`�;S f� REPAIAS
State Surcharge
. TOTAL FEE
P�liG'd INS?.
� Date
F�tu ztis�. ,� Z-� Z=� J
Date
AP?ROVAL FOR PER`fIT
REINSPECTION FEE
(.$10. 00)
S
S
$ � _,��.
S
$ -� c.� (.
�
�
$
$
S
$ .50
$-�; � `.�__;__L,
Y.T.SII:�:: FE: FOR AIQY HsATING PER'✓�IT SS $7. 50 PLUS '$. 50 STATE SUR(�iARGE
*:.ttacFC3 suc:c vezificar�on for� �
0
,7ob Address ���:, . .l �� � r � r� ���:� , �°(� `,�,
�
pepaxtment o£ B�}��c;}rigS
C�ty of Fridley
� Tel. #571-3450
The undersigned hereby ;na;ces application for a permit :or t�:e wor;c here�.
specified agreeing to do zll work in strict accor�aace with tze Citl Ccces
and rulings of the Departssient of Buildings, and 'nereby �ecla:es �zat a11 �'^.e
£dcts and Xepzesentations stated in this application are t��-�:e aad correct.
r^;idley� Minn. , 19_
o4�jNER � l: I,_l= �r IO�.'r;'i'i:f
�CINO PF BUILDI�jG "\ � ; _ '; ",-f
ps�p AS +�,�.,_: � j.,
� �� FOM�I.�T�R �$4U�
�5��?��A �P.s� � � ''! '- ` _
P�'A - ��FI ��1��R�FIG ���?�� NQ. P��.�I�T N0. //�, � � ,
�ES�R$P�'�ON QF FI]RDIACE/�UR�ER
#���ING A� �AP�#� ��!NTS� S��?-�!� #�QX Viat�rf Wa�.:n A}�- No.
Tx'dde Nanta ��(`(� t�, •, S�ze No.
Capdci.ty Sq. Ft. �PR STU `,s <: (,( i_: iiP
Total Connected Load Kind of Fuel
BUFNER - Trada Name Size No.
Capacity Sq. Ft. EDR BTU iiP
Company � F1� ,�. '
, � Signed By � . �
� Tel. ho. �� �< .�, -
0
97 8t,-l�16051 CITY OF FkIDLEY
� �i?PLICATION rOR QW��iBI�i� At�A uAS FITTI�JG PERMIT
� � >, v. �q U • Y rJ 4+at�-_r^
ro rn c u •-� .� -� �
�• c� c� N e•.+ ;r. a �+ w c tieater
cr +� �•-� � c, E•a � w v! ro�+ f.i�
-.y .: r,J C C! X:J U H .0 C C W /'r � il
y. ��� . ^ �-+ x - c c� 3 O u•-�I O.c U u
p u C -.+ i, � c� C u; •.. 7 O O +� u cr. v1 N �n .0
co r.�r 1a r r] -i 7 :.� O .0 .-i � tC '7 :f r ,tl ��j �tl +�
u � c c m 3 0:. v� w c� w�a �� �. c� o as 'lec
i
'1 I
I
1=�=1
} �� 1
=� i � I I
iti�.l I I I I
(�) _^.:tnre Co:uiectioa Oper.ir.g Connected with Sewer
(`i = t:ew Fixture, Old O�eainq Water
PAP,TIAL RATE SCNEDULE
?LJ43IXG FIXTURE R�TES: ATO. RATE TOTAL
:�:.�er ci�t..res
:i=�e c-x:,.re Coer.:r.g
::e�+ _ ixt,zre, Old C�eainq
�3LC : 33S1:1
t.at2: :eat�r - to 99,000 BTU
'_�J, •,')C� B^,T :0 199, 000 BTU
�:a:e= So_te: er
\ew Grou :d n^.:a Old Suildinq
iieCt�i= T�3ter Eeater
��S :=ITTI\G FE�S:
lst 3 fiaCnres
:,3ditioza: Fix tures
Gas ,�::.ye to 199,00� ETU
�.�a� �s � a�: ER.�TIO\S
Fizst $IOO.GO
ea�:: add. $I00.00 oz fraction
x S3.�0
x $2.00
x 52.00
x $5.00
x $5.00
x $10.00
x $7.00
x $5.00
X $5.00
S
S
S
S
S
S
S
S
$
x $3,00 $
x 51.00 $ �
X S«0.00 $
$S.OQ $
S2.00 $
State Surcharge $ .50
TOTAL Fi:L $ �'Q
REZ26SPECTIOV FEE
IS10.0(t)
Job Address 1637 Brenner Pass
Depertneat of Euildings
City ur I'riZley
Tel. i{�71-3450
The undersi.gned hereby nakes apolicatioa for a pe^it for the �+ork her�.Z
spee;.fied agreeing to do a11 work in str=ct accorda^ce w?th t':e C?�y Co�es
and rulings of the Depart:.ent of Build:r.qs, and hereby declar=s tr.at ai2
the facta and reprosentationa stated in t:�fs application are trse aad ccrzoct
12-23-80
Fridley, Mn. , 19
�„��R DA'�RELL FARR
XIND OF BUZL,�ZNG frame
USED AS res .
To aE cot�r,E:ED ABOUT 12-30-80 '
ESTIMATED COST �j�.��
OLD - NEW SUILDING PERvIT h0. ?ER:4ZT h0. ("7 y� �
Company �./ �jr. �'•
Siqned Sy �'��r`��:�;-::;
Tel. No. �
ROUGH ZNSP.
Date
FINrIL 2NS?. 1 - � � - � �
Date
APPROVAL FOR PER�IZT j� j�`�./l
MINIMUM FEE FOR ANY PLUN.BIIr'G P�R�dIT IS $7.50 pL'JS $.SO STS1i�� SU:M..Jf{�yE
MEMO TO:
� MEM4 FROM:
MEMO DATE:
REGARDING:
BUILDING INSPECTION DIVISION MEMO
Mr. Jeff Nienaber, Chief Residential Appraiser
Clyde Wiley, Building Official
March 29, 1993
1637 Brenner Pass NE
On March 26, 1993, I did an investigation of a complaint of settlement of the home
located at 163'1 Brenner Pass NE. The front entrance door did not ciose properly. This
was caused by loose tunges. The water closet didn't flush properly. This appEared to
be caused by water not entering ihe bowl fast enough. I sugg� haviug a plumber
out to check this.
There was some settlement at the front stoop where the ground had settled next to the
basemeitt. This could be remedied by eather concrete jacking or pouring a new front
stoop. Also some fill should be added at the house so that storm water is channeled
away from the house.
Please contact me if you have any further questions on this matter.
CEW/mh
���e �� �- � �. �
�
�
CITY OF
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(612) 571-3450 • FAX (612) 571-1287
November 30, 1995
Ms. Lois Anderson
1637 N. Brenner Pass
�idley MN 55432
Subject: Sump Pump Discharge Fee
Dear Ms. Anderson:
PW95-166
I received your letter of November 27, 1995 explaining your situation and your proposal to
disconnect your sump pump from the sanitary sewer system.
Be advised that we cannot cancel the sump pump fee as long as it is connected to the
sanitary system. The ordinance became effective in July 1995.
As a means of assisting you in reducing the cost for the illegal connection, recommend that
as soon as you have the sump pump disconnected that you contact our office at 572-3566 so
that an inspection can be made to verify the work. Once this is accomplished, we will be able
to terminate the monthly fee of $100.
You should also be aware that the City has agreed to contribute to the disconneet program
by paying one half of the cost up to a maximum of $450. If you are interested in this
program, when you have the system inspected, please provide the cost to the inspector so
that a review can be made and an appropriate refund provided to you.
I am sorry that we do not have the flexibility of negating the discharge fee. Anything we can
do to help facilitate your disconnection, please let us know. You can contact me at 572-3550.
Sincerely yours,
'"� ,- �
L �G�--�,f- C���-
.�-����
John G. Flora
Director of Public Works
e„�,���•�.�,,,�,
s�N«
Y�atcr
Parkc
SItCCIS
M1iamtenancc
TO: Ri� hard D. Pribyl, Finance Director . ��
FRC7M: John G. Flora; Public Works Director ;;
DATE: January 3, 1996
SUBJECT: Sump Pump Fees
�� � �-�.�
PW96-005
The resident at 1637 Brenner Pass has eliminated their sump pump in their building. An
inspection verified this action on December 29, 1995.
Based upon the removal of the sump pump, it would be appropriate to charge the property
for an illegal sump pump to the month of December 1995 and then eliminate any future
sump pump fees after December 1995.
JGF:cz
cc: Walter Cole
J
.,, ..
..�. ,
SUBJECT •
City of Fridley 3 0
AT THE TOP OF THE TWINS g U i L D i N G P E R M I T
; • RECEIPT NO.
� �' COMMUNITY DEVELOPMENT DIV. �D /_ Q
� � �.---•-- �
r � � pROTECTIVE INSPECTION SEC. ���
� . �
� � �"'1 � CITV MALL FRIDIE� SS�JZ NVMBER AEV OATE PAGE Of APOROVEO e�
�""'�'� �'' 612-571-3450 9t0-F15 6/27/00 � �
J08 ADORESS 1633,35,37,39,41,43 Brenner Pass
1 IEGAL �OT NO. BLOCK TRACT OR ADOITION SEE ATTACHEO
oesca. -6 � 7-12 1 Innsbruck North Townhouse Plat 5 SHEET
2 PROPERTY OWNER MAIL AODRESS ZIP PMONE
Innsbruck Townhome Association 651-224-5482
J CONTRACTOR MAIL AODRESS ZIP PMONE IICENSE NO
Garlock-French Roofing corp, 2301 E. 25th St., Mpls., MN 55406 612-722-7129 0000142
� ARCMITECT OR OESIGNER MAI� AOOFlESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADORESS Z�P PHONE LICENSE NO
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW O A�DITION O ALTERATION S1 REPAIR O MOVE O REMOVE
B DESCRIBE WORK
Reroof Townhouse Building (Tear off)
9 CHANGEOFUSEPROM TO
STIPUTATIONS
Underlayment must comply with the State Building Cade.
P�rmit Inspec#ion Cards
Wiil Be Mafisd
To Nomeowner Ti� Post
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV �OAD
SEPARATE PERMITS ARE REQUIRED FOR EIECTfiICAL, P�UMBING. MEATING.
VENTILATING Oii AIR CONDITIONING
THIS PEFiM1T BECOMES NULI AND VOID IF WORK OR CONS7RUCTION ZONING SO. fT CU FT
AUTHORIZED IS NOT COMMENCEO WITMIN 60 OAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENOED OR ABANOONEO fQR A PERIO� OF 120 DAYS A7
ANV TIME AfTEH WORK IS COMMENCED NO DWIG. UNITS OFfSTREET PARKING
1 MEAEBY CERTIFV THAT I HAVE pEAD AND E%AMINEO TMIS APP�ICATION 6 STALLS GARAGES
AND KNOW TME SAME TO BE TRUE ANO CORRECT ALl PROVISIONS OF LAWS yAIUATION SURTAX
ANO OROINANCES GOVERNING THIS TYPE Of WORK WI�L 8E COMPLIED �Z1,194. %S �IO. S9
WITH WHETHER SPECIFIEO HE:IEIN OR NOT. THE GRANTING OF A PERMIT
OOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE OR CANCEI THE pEiiMIT iEE SAG CHARGE
PROVISIONS OF ANV OTHER STATE OF LOCAI lAW REGUTATING coN- �349. ZS Fire SC .�21 . I9
$TRUCTION OR TME PERFORMANCE Of CONSTRUCTION
PLAN CMECK FEE TOtA� F
$38 . 3
S�GN�TUpE O� CON'AA�TOQ OA �UTHOQ�ZEO �GENT iO�rE� � EN iiOP ALIOAT 0 �5 IS V UR PERMIT �(
�r� �VV
$�GN�TUAE O� OWNfp��� Owr+EA Bu�iDER� � iO�tE� � � ��NS� - ��<<f r
sue�ecr P O. �
City of Fridley 33302 '
' , AT TFIE TOP OF THE TWINS g � i L D I N G P E R M I T NO.
� ♦
� COMMUNITV OEVEIOPMENT DIV.
r � y � PROTECTIVE INSPECTION SEC �+ C�`� '�
�
� 1 �"'1 � CITY MALI FRIOIE� SS�J2 NUMBER REV O�iE P�GE O� •vvnOVED Br
1 ' �' 1L/2O/O2
�'""�" ' 763-571-3450 9� 0-F � 5 � / /
�oe nooaESS 1637 Brenzer Pass NE
1 LEGAL LOT NO. BLOCK TiiACT OR ADOITION SEE ATTACNEO
DESCR. S—IO 1 Innsbruck North Townhouse Plat S SHEET
2 PROPEFTV OWNER MAII AODRESS ZIP PHONE
Patty Breightol �637 Brenaer Pass NE - 1- 0
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO
StaL�dard Water Control 5337 Lakeland Ave - -
� ARCMITECT OR DESIGNER MAIL ADDRESS ZIP PMONE UCENSE N0
5 ENGINEER MAIL ADDFESS ZIP PNONE IICENSE NO
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW O AODITION O ALTERATION ❑ REPAIR O MOVE ❑ REMOVE
X
8 DESCRIBE WORK
Install interior draint�le
9 CHANGEOFUSEFROM TO
STIPULATIONS
�ermit Inspection Card�
Will Be Mailed
To Homeowner To Pa�t
TYPEOFCONST OCCUPANCVGROUP OCCUPANCV�OAD
SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL. PLUMBING, HEATING.
VENTI�ATING OR AIR CONOITIONING
TNIS PERMIT BECOMES NULL ANO VOID If WORK OR CONSTRUCTION ZONING SO. FT CU �T
AUTHORIZED IS NOT COMMENCED WITMIN 60 DAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENOED OR ABANDONED FOfi A PER100 OF 120 DAYS AT
ANV TIME AFTER WORK IS COMMENCED NO OWLG. UNITS OFFSTREET PARKING
I HEFiEBY CEFTIFV THAT I HAVE READ AND EXAMINEO THI$ APPLICATION 1 STA�LS GARAGES
AND KNOW TME SAME TO BE TRUE AND CORFECT. ALL PiiOVISIONS OF LAWS VA�UATION SURTAX
AND ORDINANCES GOVERNING THIS TVPE OF WORK WI�L BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OA NOT THE GRANTtNG OF A PERMIT �1 �900 �.95
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OF CANCEL THE pEpMIT FEE SAC CMARGE
PROVISIONS OF ANV OTHER STATE OR LOCA� lAW REGUTATING CON-
STRUCTION OR TME PERFORMANCE OF CONSTRUCTION �G6.LO F�re SC �1.90
PLAN CHECK FEE TOTAL FEE
Licens C $5. �$74.05
S�GN�tUQEO�CON�AACTOQO%��UT�+OQ�ZED�GEtir �O�tE� ME PR "V VALIO ED TNIS IS VOUQ P MIi
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S�Gti•TUQE O� OwNEQ��� OWtiEp Bu��DEA� �D�iE� B G�ti ���
FROM �
FAX N0. : 7635371882 Dec. 12 2002 08:49AM P1
���;,�}�1 DEC-12-2002 08�06 FROM CITY OF FRIllLEY TO 537188� P.0�i02
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�, y� Dea 12 2002 @6: 0?i�'1 P3
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"�W � � CITY pF FRIDLEY
��0� E j 6�31 llniv2rsi�yAve N�, FrShce , MN �Sq32 E�i� �/7l2002
A{.TEf2 f J S�NCrLE FAM�LYqt�lp pup[��S R-� AlVII R.�, (�63y 5yz�6oa gidg Insp
� BUILOING PERMIT APP4ICAT]ON '
CanstruCtivr; RdQr'6ss: _,
Legai DLScription:
Owner Name � Address:
CCntractor. i�
Address; ��i. � �71n,1
Tei. :�a �.� � ��-�
MN 11C�N5E� �a7
� �
T�� � - �Py
Atfach to #h!s appiication� a Certlficx�te af Sun►ey of �he
lot, With tho proposed Cvnstfuctipn draum on it to sc2{�.
bESCWpTlOAI OF 11NPRpYE1VtEt�(T
uvtN� a�4: ��,y� � �
GaRAGE AR.Eq: ��� He�gizt . �i. i�t � -'
��� ,�.�_ VUfdttt ~'
Height $� � �`
, DECK ARE.4: L.9n�t?� �` y�,� y9��d Sq. Ft
OTHEi�:
Consiruction TYPe��LG�i�,ti EP Esiimated Cos� S��� .�.
,
Driveway Curb G1rt Width Needed; Ft t 6 pt = Ft X$ '= S
DA7E: ��' / APPLIG4NT: � . . , �L p.
TeL� �.� 7 �d ��
Calf {763) 572.3604 fcr �ermit Fees ;f maaj;�g i� applica#ioo or Fax to 763571�237 if �;�g C�� qb and vye wili
caU you for rard nurttber. �
Permit F��
F;re Surcharge
State S��charge
SaC, Ct�arge
Licer�se Surcharge .
Dr�veway Escrow
Erosion Cocitrol
Park Fee
Sewer iVtaln Charge
TOTAL
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S� D d
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s � D�
C1TY USB ONLY -
Fee ScheduJe on Reverse Side r
.001 af Perr�i# Valuatian {�thl?fh%) ' � �
�.10/$1,OOp Vai��ia� . �
$�200 �er SAC Unit
$5.Q0 .(State Lice�sod Resideritia[ Coniractors}
A�t "A" a�A�t. "6" Above
$4$0.00 Conservation Pian Review
Fee Determined hy Engineer:rtg -
Agreement NeceSSary j] Not �tec�essary j� �
STIPUlA?10NS:
TOTAL P.02