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AF - 43471sue�ecr PER . City of Fridley � 17 311 AT THE TOP OF THE TWINS B U I L D I N G P E R M I T . i� , � RE . • COMMUNITY DEVELOPMENT DIV. //� `3 � LV �����', r � � PROTECTIVE INSPECTION SEC. � �G 1 � i � � /'��1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY � ""'�� ,�� 612-571-3450 g� 0-F15 10/31/83 � � JOB ADDRESS �580 Brigadoon Place N. E. 1 LEGAL �OT NO. BIOCK TRACT OR ADDITION SEE ATTACHED DESCR. % 2 Blatnberg Estates SHEET 2 PROPERTY OWNER MAII ADDRESS ZIP PHONE Garjac Inc. .�' 481 - 206th Avenue N.E., Cedar, MN SSU/1 434-7096 3 CON7RAC70R MA1L ADDRESS 21P PHONE UCENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PNONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Resiaential 7 CIASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE X 8 DESCRIBE WORK Construct a 48' x 26' Dwelli and a 24' x 26' Gara e 9 CHANGE QF USE FROM TO STIPULATIONS provide a h�rd surface driveway. Provide sod in the front and side yards: Pxovide the City with copy of verifying survey before capping. SEWER LOCATION: (Approx. 6' Deep In Street) BB�X 110' S. of M.H. (Inv. 893.94) WYE ELEV: 894.38 TOP OF FOOTING: �cpose service prior tA establishing footing elevation. WATER LOCATION: 10' S. of Sewer Service � DRIVEWAY DEPRESSION ESCROfni: 16' + 6' = 22' x$13.50 =$297.00 TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. WOOC� FY�CL@ THIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANV TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION �- STAILS 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 S7O�9O0 $35.45 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE PROVISI NS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- TRUCTI OR THE PERFORMANCE OF CONSTRUCTION. $346.00 ��ZS.00 PLAN CHECK FEE TOTAL FEE � $86.50 $892.95 NATUREOFC NTRACTORORA HORIZEDAGENT IDATEI WHEN PROPER VALIDATED THIS IS YOUR PERMIT • '�/�he,Q l 1!�h� �b � SiGNA7UREOFOWNERiIFOWNERBUILDERi �DATEI BLDG iNSP � DAT ��rv����s �'Qrt�ifa�c��e COMSTOCK & DAVIS, INC. Consulting Engineers and Land Surveyors 144b County Road J, MiYSneapoiis, MN 55432, {612j y84934b SU :VEY FOR: B & � Investments 961 Hillcoind Boad Fridle_y, :Zinnesota 55��32 ;t.: ClCY OF F3�tDlEY DOES htOT Gtl>>t;aN7�c ,., �C��iRAC� O¢ UiILETY IOCATIONS AhD ELEV�,Tlt;� ;;��s� OAI�: t5 FOR MNfORrV+AT10N PURPOSES ONLY Ati:: '::R�i:tv: USING 1' SNOUlD VERIfY THE �NFORMATIO' .�,� r;�,: ��� � �R���� , ItIB` I?efiore digg+ng cal� �oca1 �t�l i �t_EI'HON�. - E�-tCTRIG - GAS Ct�., ;�:.���::zLl���'� �� Q�A''�!``', I _� I N 88° 59' S3"W ` ' J 37. i5 � z s' � . �... .-t-, ;..` � p� ` '1y p W /�: � i - � h � - � I=. � r 3 � , i /O' � � lo,; . L�T � i W � � -��� � � , : o r : v� i ��" p p O A �,. � a Q +11 ''_�-- ----- — —�Q-------.1� O � � � 'p``- pro.:nq � $- Lt . i_ � ` . ,. . . °i }i�1�� �.Q.94�h6h�' ��'� : � . . . � �_ p . 5 88° 59"5 3 E /37. /3' � � . I ZS � - �� � DESC�IPTIO?V . Lot 7, Slocic 2, Blomberg Estates, City of Fridley, Anoka County, ^sinnesota. SCALE: l,r � �� O Denotes 1/2" dia�eter iron nine monur.ient set and canPed No. 10332. I hereby certify that this survey, plan or report was prepared by me or under my direct supervision and that I am a duly Registered Land Surveyor under the laws of the State of Minnesota. p... Y��v . . . . . .• 10�32 Nov.' 17, 1930 4278 Reg. Na ►� • Date Job No. � g � Eaok Ida c, �_� � � ( ,,� ��n , � ��� �� -S'T.��E j �G � � ���� �' /� �� ' S. � �� ;-�� � t�,� � ��3. ��yJ L��-'� �� � �, - 8y y, .��� —� � �� D ,� �UO % /�%�r - �� �Sc� .S��v.c e � � � . f� l �' � �G E'S %.�f f3 �/.S'f{/,�6� l�'%/,�� ��- �c% 7�a �v �, , ; '' �' � �Z� � v'� 1� 1 ,_ , �v S� � � ���-c���' �N�l/l C �. ��n y ______ --- , ( `l` � �� � y � ��� 3 � ��` � /� %SS'�G.CJ �����- � G� �C� � , � s—� _ � v .�/� �, �T ,� -� � x / � �9�� � i �- � �, � � � ���� �� �'� �>�v� �� �a,-� �,�_- �� f �/ l/��it� / T pa•��--� �� . s yc°4 %� � . . . i + . � CITY QF fttIDLCY ti�PLIGATI�1 FOf� RCSIDL'i�TII'�� QUILD]�.G P��'��ITS (I�c�•i, Alterations, Additions, or Rc�airs) 0�lNER: no�r,FSS: TEL K0: STRI�T A10 : r �� C> STREF.T: Effective Aug. 1, 1981 , �QUI LDER : �i�� �� C � �`'� nnnrt[ss: �� g 1 av�z.�. c� �1 � TEL 110: y3 Y� ���� Construction Location IA7': � BIACX : -� ADDITIOii : ��. o C� M� r.' 2�' F_ S?•�tT-Q Corner Lot: Inside Lot: � SetbacY.: .s�� Sideyards: /s � fG Ap.�licant attach to tl�is form ta+ro Certificates of Stirvey of lot and pzop�sed building locstion drawn on certiiicates to scale. DESCRIPTIO�� OF CO��STF:!)CT10N ,/ ,��? ( ��_(S� Front: '7' A Depth: �.���s�'(' Heiqht: g Square Feet: j2 S� (]ibic Feet: ��/�f�Cc Front: r�� � Depth: ��o � Height: ip � Square Fents Clibic Teet: _ %�,�jo a a 'I��pe of Co:,struction : f� f�fl�l�- Estimated Cost: S ! Zb Be Cbr.�pleted: /� C C �� � `'L 7�►lt. A Al t. B Proposed Drivc���ay tiidth If New Opening Is Desired: ~ $ %,W S . , S�� PiVF.R;L' SIDi OF SF1E�T 1S�e undersioned hereb.� T�l;c� t+�plic�lticn for a penzit fcr the �:vrk herein specified, agreein� to ao .all �ork i:, strict accozdance �ith the Ci�y of Fridle}• Ordi»ances z�id tuliu3� of tlte Dc:partmel�t. of Bui:dinc,s, and hereby declares that all the fact� and represc��itiens stated in this applic�tion,�aze true and/+�orrect. D�T�: / � — �� slcxn�tv � : Stii�ulations : P.s� -3 �16 , o�o P•e gG . so �x 3�, 4 � ��c �l z.r . a� p��, a��.� � � � *�� V . . . � oo�, ' OG ���'b�QG W��/"� � �� 04 '� �� � X 1'Z, .. .� fl� ' c,�, 0 05 ' C�G "Z.�'�)�'� = ��•�� �c �2� � �2 0� r� ��e�� °� on•��.#rs PZ 02' E�1i' �h � >> x �r ; �c�' b� x dr Z � ��`i��8'Zt� A) •c� -z � �'� at �.,7�1� � L �.S 3r 4 i �Z� �l � � s3 �C 9 -r 8�� 7 Z '� ��a� l�h 'I z� � L' '��Z x ti� �5'�Gn � � '9Z a�$I Gv��r � � �r n , � � vr �s� �j ' f�°°c��' ' '� �8s � . sue�ecT PER . City of Fridley 17 8 41 AT THE 70P OF THE TWINS gU I L D I N G P E R M i T r � . � � . i • COMMUNITY DEVELOPMENT DIV. ' j lr ----- � r � � PROTECTIVE INSPECTION SEC. / c�/a J i � J 7 / i ' � �"'1 � CITY HAL� FRIDLEV 55432 NUMBER REV. DATE PAGE OF APPROVEO BV `..��� / �.J 612-571-3450 g10-F15 ]. 22 85 � � JOB ADDRESS �580 Brigadoon Place N. E. t LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. % 2 Blomberg Estates SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PNONE Gary Van Slyke 7580 Brigadoon Place N.E. 780-9841 3 CONTRACTOR MAIL ADDRESS Z�P PHONE LIGENSE NO. Same 4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO. 5 ENGINEER MAIL ADDRESS ZIP pHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION C� ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Basement alteration 9 CHANGE OF USE FROM TO STIPULATIONS Provide power vent in bathroom.� Provide fire ala�zn in hall by bedrooms. Use treated bottom plates. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PIUMBING, HEATING, VENTILATING OR AIR CONDITIONING. WOOd Frd�e 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 ABANDONED FOR A PERIOD OF 120 DAYS AT R-1 ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS yqLUATION SUfiTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WIIL BE COMPLIED WITH WHET R SPECIFIED HEREIN OR NOT. THE GRANT�NG OF A PERMIT $2►OOO $�..00 DOES NOT P ESUME TO GIVE AUTHORIT O VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIO S OF ANY OTH TATE OR O l L REGULATING CON- STR I OR THE PE RM NCE OF C R TION. $32. SO �t �/ PLAN CHECKFEE TOTALFEE ''��,� $33 . 50 IGNAT E OF O � RACTOA OFl AUTHOAIZ GENT - IDAT� , N PROPERLV VALI�HIS IS VOU�E�O J � � � SiGNATUREOFOWNER�IFOWNEROU�LDEA1 IDATEI BLDG �NSP f)4TE NEW [ ] ADDN. � pLTER. � City of Fridley �R-1 AND R-2 Building Permit Application Construction Address: /�[� � v�� G,� ,l� v r''�/ �� Effective 4/1/8� Legal Description: Owner Name & Address: �i¢,/�C� / /l� L 5���� Tel�#r � �i� Contractor :�� L� Tel .#��`?a 6 j g7 Address• ��"'� � LIVING AREA: GARAGE AREA: DECH AREA: OTHER: Attach to this application, a Certificate of Survey of the lot, with the proposed construetion drawn on it to seale. Length Length Leng,th _ _ DESCRIPTIOp OF IMPROVEMENT Width Height Sq. Ft. Width Height Sq. Ft. Width Hgt/Ground Sq. Ft. Corner Lot [] Inside Lot [] Ft. Yd. Setback Side Yard Setbaek Type of Construction: Estimated Cost: $�d � � Approx. Completion Date: Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: S gack Page for Explanation . DATE: � � � ��APPLICANT• �— Tel. # �$� �gY� � � � � 7$� Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Maia Charge TOTAL CITY IISE ON1.Y � � .� Fee Sehedule on Reverse Side � "'� 25� of Building Permit Fee $ � •V V $.50/$1,000 Valuation� � '� ��25 per SAC Unit $ '�" Fee Determined by Engineering , Agreement Necessary [] Not Necessary [ J $ • � � r ��, • . . , 1� ' � �/ / � � .� i,�� / :� *� ���_ , �_ � ,/� . - . . � ��� 9 X � // b `�' °� ,9 7't � �o� � . ., . . . . .-.-- .� .I � - ,,�� , Q/ � . p � , �- �Z��� � ti �� . �— , � �� � �r � � � �� 1� �h,� ��� , � ______— „ C � o! � x $ �� � , ,, �, / ,� , � � �a� n o�t� �� � �� ��� ° _ � :�a��ov� ��� �J . � �� �� r5 ' — , ��' o�� �� aa�9t� y� 1� -� ±���1 � ' oQ ZI , . � C.� c � n� s �y,��, /hR ,��Sc3L �vrv�t /�' �'�'��'>>���` � �G � �31�C 7� N�/1 �� y�? � . . 5171�!'� �O !�N1 Gh' � � �r; y��J �'V o ar�o/�3�j%� �� s � ���r �o ��s � » a /yo 1 �� � FJ 9.�E -�Ci'�1.���� ���?�1���s �,,'o� ,, �,l% �I�c;.n oY-V�� U���' ��N.� �/t - �l S � y �� � �i� .- ��� �v�� , s � ����► �-� /�-, ^� S ; X � _ � �� �'S' � �� /� � � � � __.�L , I / � s � sue�EC� PERMIT NO. City of Fridley 2 8 4 35 �`�7������ THE Tw'"S gU ILD1N� PERMIT RECEIPT NO. COMMUNITY DEVELOPMENT OIV. r � v � PROTECTIVE INSPECTION SEC. �3� (� 1 � ����� � CITY MA�L FRIOLE� SS13Z NUMBER REV OATE PAGE Of APPROVED BY �""�'� ,'� 612-571-3450 910-Ft5 � � 10/27/98 J08 AODRESS 7580 Bri adoon Place NE t IEGA� �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 7 2 SHEET 2 PROPERTY OWNEfi MAIL AODR�SS 2�P PMONE Bob Brucke�° - 3 CONTRACTOR MAIL ADORESS Z�P PHONE UCENSE NO Ri ht Wa Roofin - e ARCNITECT OR DESIGNER MAI� ADORESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS Z�P PHONE UCENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK O NEW ❑ AD�ITION O ALTERATION � REPAIR ❑ MOVE O fiEMOVE 8 DESCRIBE WORK Reroof house and gara e(28 S) Tear-off 9 CHANGEOFUSEfROM TO STIPULATIONS Underlayment must comply with the State Building Code. ?YPEOFCONST. OCCUPANCVGROUP OCCUPANCVLOAO SEPARATE PEfiMITS ARE REOUIREO FOR ELECTFICAL. PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING TMIS PERMIT BECOMES NUII ANO VOID IF WOfiK OR CONS7RUCTION ZONING SO. fT CU FT. AUTHORIZED IS NOT COMMENCEO V�ITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONEO FOR A PERIO� OF 120 DAYS A7 ANV TIME AFTER WORK IS COMMENCED. NO DWIG. UN17S OffSTREET PARKING I HEREBY CERTIfV TMAT I HAVE READ AND EXAMIN�D TMIS APP�ICATION STALLS GARAGES ANO KNOW THE SAME TO BE TRUE AND CORRECT. ALl PROVISIONS OF LAWS VALUATION SURTAX ANO ORDINANCES GOVERNING THIS TVPE OF WpRK WILL BE COMPUED WITH WMETHEA SPECIFIED HEREIN Oii NOT. THE GRANTING OF A PERMIT $2399 $1.ZO DOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE Ofi CANCEL THE pEqMIT FEE SAC CHARGE ?i:OVtSI S Of T ATE OR LOCAL LAW REGULATING CON- STR p P RMAN TRUCTION �]�F.]5 FlrO SC �Z..�FO PLAN CHECK fEE TOTA� FEE �" License SC $5.0 $83.35 G aE F C QA . OA AU NOQiZED �GEtit i��iE� WMEN PROPEQ VALI ATED THIS IS VOUF PERMIT � �✓ � � S�GN4TUQE Of OwNEA��� OwHEQBU4DEAi �OATEi � Bl G��+So � � ���TE NEVG ' [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY / ALTER [] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 �`) BUILDING PERMIT APPLICATION 2 �, �� � 3p� ConstructionAddress: ����;�;! j�j���j��,(j� �(,,- � Legal Description: Owner Name & Address: iJ�1� �'�f (,1C�C� �'1 Tel. #3�Sq � IZ�S Contractor: j�i LV �, "" j���C:SE�,''a MN LICENSE #���'�Cj Address: I��t:l'' E;. �(�,i�� Sfi S-s'U� 5" Tel. # 4;5.3t�'�c( Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVING AREA: GARAGE AREA: DECK AREA: Length Length Length DESCRIPTION OF IMPROVEMENT Width Height Width Height Width Hgt/Ground Sq. Ft. Sq. Ft. Sq. Ft. OTHER: .� ✓- Construction Type: �j��(�-� � Estimated Cost: ,��i.�.�� � v� (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: l C � Z l� l C1.4 APPLICANT: K,k C-t,'�`��''`C� � 3�,��1� � Tel. #�S3 C��t-t �d Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ % r 7.�" $ r,�. $ f �.�U $ .�� $ �� $ $ $ $ � 83 3S CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1 / l Oth %) $.50/$1,000 Valuation $1000 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 [ ] . . � SuBJECT � . . � ,�'N'a'_.__ c;ty of Fridley 313 6 AT TME TOP OF THE TWINS g � I L D I N G P E R M I T ' ' RECEIPT NO. � . � • COMMUNITY OEVEIOPMENT DIV. ' j V ����� � ��!✓�L./ r � � PROTECTIVE INSPECTION SEC. � . � 1 � /"�1 � CITV HALL fR10lE� SS�3� NUMBfR REV OATE PAGE Of AI�PROVED 8Y �""�"� �'' 612-571-3450 9i0-Fi5 9/5/00 / / 10B AD�RESS 7580 Brigadoon Place NE 1 LEGAI ��T NO. BIOCK TRACT OR AODITION SEE ATTACHED oesca. 7 2 Blomberg Estates SHEET 2 PFOPEiiTY OWNEFi MAIL ApORESS ZIP PHONE Bob Brucken 7580 Brigadoon Place NE 763-784-9128 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Right Way Roofing 7810 12 Ave S, Bloomin ton MN 55425 853-0049 3999 4 ARCMITECT Oii �ESIGNER MAIL A�ORESS ZIP PHONE LtCENSE NO. 5 ENGINEER MAIL ADDfiESS ZIP PHONE LICENSE NO 6 USE OF BUILOING Residential 7 CLASS OF WOFK O NEW O ADDITION ❑ ALTERATION ❑ REPAIR O MOVE O REMOVE X 8 DESCRIBE WORK Reroof House & Garage (28 Sq) Tear-off 9 CHANGEOFUSEFROM TO STIPULATIONS Underlayment must comply with the State Building Code. TVPEOFCONST. OCCUPANCVGROUP OCCUPANCV�OAp SEPARATE PERMITS ARE REOUIFED FOR ELECTRICAI. PLUM8ING. MEATING, VENTI�ATING OR Alii CONDITIONING THIS PERMIT BECOMES NULL AND VOID if WORK OR CONSTRUCTION ZONING SO. fT CU FT. AUTHORIZED IS NOT COMMENCED WITMIN 60 OAYS. OA If CONSTRUCTION OR WORK IS SUSPENOED OR ABANOONED fOR A PER100 OF 120 OAYS AT AlJY TIME AFTEA WORK IS COMMENCED. NO OWIG. UNITS OfFSTREET PARKING I HEREBY CERT�fV THAT I HAVE REAO ANO EXAMINEO THIS APPLICATION 1 STAIIS GARAGES AND KNOW THE SAME TO BE TRUE AND CORi:ECT. ALL PROVISIONS OF LAWS yqLUAT10N SUFiTAX AND ORDINANCES GOVERNING THIS TVPE Of WORK WILL BE COMP�IED @ WITM WMETNER SPECIFIED HEREIN OF N07. THE GFIANTING Of A PERMIT y�2,447 �� $1 .ZZ DOES NOT PiiESUME TO GIVE AUTMORITY TO VIOLATE OA CANCEL THE pEqMIT FEE SAC CNAFGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR TME PERFORMANCE Of CONSTRUCTION �53. ZS F1 2 SC �2. �FS PLAN CMECK fEE TO AL FEE Licen $5. 0 $91.92 -- S�GNAiUpEOFCON'AACTQROQAUTMOR�2EOeGENT �D�iE� HE PR P � VA�IOAT THIS I$�UR � Jj� li� i�� / L�� S�GNATUAE O� OWNEQi�F OWNEABUI�OEAi iOATE� Bl �NS� ' ���TF ir � F�L�`,-31-���f 11 � 5� FROM �' I T'Y OF FR I DLE`r TO N�VW [ j AD��v t 1 A�r�� � �s�nstrtac�tion Adcir�ss: L.egal Descrip�iar�; � C7w�r Name & Addre Co�rrtracto�: --1��k es3eal�? �,��.�3 EfF�ctive 1;1l2000 C17Y QF �'Rit3l.�Y (7�3) 57��6i�d 6�1g (n5p SINt3L� FAl4�1LY AND pl�P6�)CE� R-7 ANQ R-� 8U1L[91NG PERNili �PLlt;ATtpN �_. 7�1. # MN LfC�NS� � °`` ' T�I. # �� as Attach to this applic�tion, a Cer�ifrcete of Surv�y of the iot, with the proposed t�nstruction drewr� ot1 it ta �ca(�. D�SCR(Pl°ION QF Ii�IPROVEAIEN"i LlVIN� AREA: L�ngttt _,___�_ Width � Height _ Sq, �t. _ GARAC3E AREA: Length � Width Height _�„___„___,� Sq. �i. DECK AFtIE�4: Len�#� 'Ndth HgrlC�raund ��q. Ft, � dTHEI�: I / Construction Typ�� Est�rnated Cas�: g� �- A �r. , ____� Driv�way �urb Cut Width Nee�(ed: Ft �+ 8 Ft � Ft X$,�„�_,_� r$ DAT�c ��3I—L�6 APPLICANT: _�� Tei, # °OC7�/ ,� �l�� OiVLY - Cat1(763j Si�-3�oq fia�r Fertmit Fees i� maNiinq in app�icati�n �'�rr�r�it Fe� �jJ `� � �' �e� ucheduf� on R�v�rs� �ide Fir� �ur��rarge � ,���� .00� of Permit Valuation (1J1dth%) �`'�te �urch�rg� �_....,..��2� $.50/$1;000 Valuatiori S,�►G Cha��� ��--- —$11�� p�r SAC Unit Lice�� S�re�°»rge $.� -�°�� �5.00 ($tate Licer�sed l�esidential �ontr�c4�r�� Drs���vay ��crcaw �_. Alt, ��A" or Alt. "B,� Ab�ve �rc�ian �c�ntrt�! $` $4�f?.QQ Cons�roatian Pla� Review Pa!rk F�e $ Fe� Detemiir�d by Eng�neerlrtg Sew�r 6��1� �harge $ Agreemet�rott N�cess�r9+ � j Not Neces�at'Y [] / �� a��r°r� $ ��d'IP�i.ATIOi�S: � � ' � �� SUBJECT � .. � � � � � `P NO. c�cy of F��a�ey 3, g�2 \ AT TME TOP OF THE 7WINS g � I L D I� J � P E R M I T � � RfiCEIPT NO. COMMUNITY qEVELOP�ENT pIV. % �/Q� r `� V � PROTECTIVE INSPECTION SEC. 5/���0� � 1 /"'1 � CITY MALL FRIOIE� SS�32 NUMBEp � REV O�TE OAGE Of AiPROVED BY �""�'� �'' 612-571-3450 9�0-F15 5/24/O1 � � JOB AODRESS 7580 Brigadoon Place NE . t IEGAL ��T NO. BLOCK TRACT Op ADDITION SEE ATTACHED oescA. 7 2 Blomberg Estates SNEET 2 PROPERTY OWNER MAIL AOOpESS Z�P PNONE Bob Brucker 7580 Bxigadoon Place NE 3 CON7RACTOR MAIL ADORESS ZIP PHONE IICENSE NO Northern Exposure Exteriors 8944 181 Ave, Forest Lake, MN 55025 651-982-9190 � AiiCHITECT OR DESIGNEF MAIL ADORESS ZIP PHONE LICENSE NO. 20173814 5 ENGINEER MAII ADOfiESS ZIP PHONE UCENSE NO 6 USE Of BUILDING Residential 7 CIASS OF WORK �1 NEW O ADDITION O ALTERATION O REPAIR O MOVE O REMOVE 8 �ESCRIBE WORK Construct a 12' x 16' Deck 9 CHANGEOFUSEfROM TO STIPULATIONS See notations on plan. ° TYPEdFCONST. OCCUPANCVGROUP OCCUPANCVLOAD SEPARATE PERMITS ARE REOUIREO FOF ELECTRICAL, PLUMBING. HEATING. VENTILATING OR AIR CONDITIONtNG TMIS PERMIT BECOMES NUII ANO VOIO IF WORK Ofi CONS7RUCTION ZpNING SO. fT CU fT. AUTHOqIZED IS NOT COMMENCED WITHIN 60 DAYS, OF IF CONSTRUCTION � OR WORK IS SUSPENDED OR ABANDONEO FOA A PEA100 OF 120 DAYS AT ANY TIME AfTER WORK IS COMMENCED. ' NO DWIG. UNITS OFFSTREET PARKING I MEREBV CERTIFV TMAT I HAVE AEAD AND EXAMIN�D THIS APPLICA710N 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIQNS Of LAWS VALUATION SURTAX ANO ORDINANCES GOVEANING THIS TVPE OF WORK WILI �E CpMPllEO WIThi WMETMER SPECIFIED MEREIN OFi NOT. THE GRANTING Of A PERMIT �2� i1Z �1.0.5 DOES NOT PRESUME TO G�VE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CMARGE PROVISIONS OF ANY OTHER STATE OR LOCAI LAW REGUTATING CON• @83.25 Fire SC �2.11 STRUCTIO TM EFFORMANCE OF CONSTRUCTION W PI,AN CHECK FEE TO L FEE Lice SC $5 0 $91.41 s 5� T AE FCON"AACT AOp�uiHOQiZED�GEtit iDATEi ME PRO V VALI A TMIS I$ VOUR PERMIT ' �,�"=.Z.s =6 l S�GN47�JqEO�OWNEAi�FO�NNEQBU�LDERi IOATE� � � B G �ti ����E NEW [ j ADDN [ ] ALTER [ ] Construction Address Legal Description: _ CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION �• �� 'L, Effective � �, �� _ �l,!� �� / Owner Name & Address: �D% %J�;��ZGfC���'C � _ _ � Contractor: /�D/�j e�/ ��01U�� � 0/� MN LICENSE # r,?0/ %3�'/� Address: c���� � 8/��`- ��T�" /'G�iY. aS6L-� Tel.# �S`/ 1'�2''%/94 Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRtPT10N OF IMPROVEMENT LIVING AREA: Length Wdth Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length �� Width �� HgUGround S � Sq. Ft. JC�.,Z OTHER: J�o! /f� X /l� DP..� �� � � ��� Construction Type: ��',c�� L�c,����� Estimated Cost: $ Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ �si� DATE: �o UO APPLtCANT: Tel. # ��Z- ���� CtTY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in apptication Permit Fee $ �3 �3-��- Fee Schedule on Reverse Side Fire Surcharge $ �� �� .001 of Permit Valuation (1I10th%) State Surcharge $ �. ���'� $.50/$1,000 Valuation SAC Charge $ $1100 per SAC Unit License Surcharge $ �: �C� $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Erosion Control $ Park Fee Sewer Main Charge TOTAL STIPULATIONS: Alt. "A" or A(t. "B" Above $450.00 Conservation Plan Review $ Fee Determined by Engineering $ Agreement Necessary [ ] Not Necessary [ ] $ `�'i' /�� V v w r r �.�-�.-� -.� � � .� ! �� . 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