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 .
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, � RE .
• COMMUNITY DEVELOPMENT DIV. //� `3
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r � � PROTECTIVE INSPECTION SEC. � �G
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� � /'��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'
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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.
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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 :
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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
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COMMUNITY DEVELOPMENT DIV.
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r � � PROTECTIVE INSPECTION SEC. / c�/a J
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' � �"'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
$ •
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�
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 $83.35
G aE F C QA . OA AU NOQiZED �GEtit i��iE� WMEN PROPEQ VALI ATED THIS IS VOUF PERMIT
�
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S�GN4TUQE Of OwNEA��� OwHEQBU4DEAi �OATEi � Bl G��+So � � ���TE
NEVG ' [ ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY /
ALTER [] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 �`)
BUILDING PERMIT APPLICATION 2 �, ��
� 3p�
ConstructionAddress: ����;�;! j�j���j��,(j� �(,,- �
Legal Description:
Owner Name & Address: iJ�1� �'�f (,1C�C� �'1 Tel. #3�Sq � IZ�S
Contractor: j�i LV �, "" j���C:SE�,''a MN LICENSE #���'�Cj
Address: I��t:l'' E;. �(�,i�� Sfi S-s'U� 5" Tel. # 4;5.3t�'�c(
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA:
GARAGE AREA:
DECK AREA:
Length
Length
Length
DESCRIPTION OF IMPROVEMENT
Width Height
Width Height
Width Hgt/Ground
Sq. Ft.
Sq. Ft.
Sq. Ft.
OTHER:
.� ✓-
Construction Type: �j��(�-� � Estimated Cost: ,��i.�.�� � v�
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
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' /��
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