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AF - 35570� SUBJECT P E City of Fridley _ 16 3 2 8 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T � r ; � RECEIPT NO. � ; y__�_ COMMUNITY DEVELOPMENT DIV. 2(� y� r � PROTECTIVE INSPECTION SEC. � � � .3 % � � i � ��1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BV �----� • •�� 612-571-3450 910-F15 8/6/81 / / JOB ADDRESS 7650 Brigadoon Place 1V,E. LOT NO. BLOCK TRACT OR ADDITION 1 ESCR. �-2 2 Blomberg Estates SHEETTACHED 2 PROPERTYOWNER MAILADDRESS ZIP PHONE Garjac Ince 481 - 206th Avenue NaEo, Cedar, NR�T 434-7096 3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSENO. Same 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 Cons.truct a 44' x 24' Dwrelling and a 24' x 22' Ga.rage 9 CHANGE OF USE FROM � �lNI911Y� AN� �fCl��, STIPULATIONS Provide combusti�n aix for fireplace or existing furnaceo P.rovide a hard surface drive�nray, Pronic�e sod in the front and side yaxdsa Provide City with copy of verifying surveyo SF�'niER AND WATER SERVICES OUT OF EAST SIDE OF LOTo SENTER "Yp: 70' South. of M.Ha "Y" Elevations 895.02 MINo ELEVATI�T FOR TOP OF FOOTI1�iG: 898, 02 WATER StAp Bax at Centerline & 60' South of MaH. (M.H. INV. 895.30) � CiTY pF FRiD1.EY DOES NOl GllARANTE� TIt� •� A�� CC{�RR+1Cfi Or UTt11TY IOCJ►i1QNS AND Ei.EVATlG�aS. 8�� diagint ceii lac�1 utilities ��t�► �c �t �a�now Pu�POSes pN�Y N,,a iEE.EPH�NE - ElEC�'RIC -�A5 Et�, wie� �ea1a � wcvt� �t t►� w�ow�s,�t� SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LO VENTILATING OR AIF CONDITIONWG. �OOd Fid�e THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN BO DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT 23,976+5280 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 SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $61, 550 �S`3Oe %8 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. �1.�.%. 02 $425e OO PLAN CHECK FEE TOTAL FEE � � � 29e26 $602,06 SIGNATUfiE� IZEDAGENT 1 ATEI WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT & � � , � 4��c� ar�� ;- SiGNATUREOFOWNERtIFOWNERBUILDER� IDATEI BLOG �NSP I] TE ' \� CITY OF FRIQLEY APPLICi1TIa'�1 FOf; RESIDL"t�TIRi. BUILDIilG PC�tt�iTTS (tJe►�r, A1ter.�tians, Additions, or Repairs) Ot1iJER: ��+�-�� %%�� [3UILRER: ��-�'�� ADDRESS: �/� f - �`�� 1�1c� _ 110DRESS: TEL N0: �/.�', �J - �)�9'� TEL IdO: Construction Location STRI•�T NO :�� STREET: � t� I�� L� C�� 6�a �'"��` , L07.': /� BLOCK: � ADDITION : � ,� �iY1��e� �� o �'7�-S Corner Lot: �� Inside Lot: SetbacY.: .3� Sideyards: /% Ap�licant attach to this form twa Certificates of Survey of lot and proposed building location drawn on certificates to scale. DESCRIP7IOi� OF COi�STP.UCTIOPd '/�/ s ' ��1�_� Front: . "-�`� � Depth: �`� � Height: �Q Squane. �'eets t�ibic Feet: �� ; � _ �� '-�-�� Front: �� " Depth: y �� Height: �(� e. � '� Square• Feet: Clabic I'eet: '� � : � Type of Construc�ion : ��p �� Estimated Cost: $ G G, �� :�� Zb $e Oor.�pleted: � Alt. A Alt. B Proposed Drive�vay Width If New Opening Is Desired: �� $� $ ' , SE� R�VERSE SIDE OF SHEET , Tlie undersigned hereby ma}:e� application for a permit for the tork� hexein specified, agre�ing to c�a ,all work in stra.ct accordance erith the City of I'ridley Ordinances zuid ruling� of �tl1e Delkzrtmen� of Buildings, and hereby declares that all the facts and represent�zti.ons stated in this applicatio�are true and correct. n.-��: � � 7 �! SIGNATUF�: SL•ipulatio . � � � � � �� "^� � � I � � e � � � �0 , � � �� f ,R `% � '� �,� � �.-'+�� q - ' ��:�� e • � �. PQ tiveD�° u•'� h F�� F', n��n r� ��1 �/t �U R N �L . IIUILAIIJG t'Cft��IT FE� sc�tr_nu�� 4 . -; 5)iC'PIOl•7 2. � Th� 7n a��cci:ar of 13ui1din�J : t:h:i7.�., bcfor:c �.r�sui�ig Z�cnnit;; tox the crr.ct•i.on of .xny }�ui1.cl:i.ncJ ar :�iruct:urc:, �r. ior ana► adQi.i:a��n L•o auy cr.i�ta.ng Lui2dincl ni stn.ic�ur_e, c�x !'ar. ui,y a�.L-cxation or_ xc��air.s L•n •any exi. .L•ii�c� bui.l.di,»=� oz sL-r.ucturc, u��n ar�p].i_c:ation ihcl:�i'or.c, zcquire U�� Paymer►L 1�y tl�e api�].i.cant: foi- such per.mi.t o1.� fees to tlse �n�unt hez�in bcl.ati•r sci: �'or.th and i�i thc m�nnez hcrein providect t�-t:iL•: • W3.1•J COHSTI:UCTI02�: Sing].e kamil.y ]lomes anci Garages: Y4.00/7.,0�0 cu}�ic fear. PLT�?� C:lil:�t:: 25 rercei�t oi buf.lcling }��ex-miL- fee. . Ui�SVEtd11Y DEI'P1:5SIOI•:: (CpncrcL-c, G�rU Strcets Only) � • Altcrnat:e n: ltc�moval at�d rej�lacement oi concrete curb and guL-ter only; Driveway �ridth plus 6 feet• x$13. �0 Alternate II: Removal and replacem�•nt of cancrete curb and . ' gutter and inst�ll a 3 foot wide approach �.�i�h �' ' _ 6 inch depth; DriveV�ay ��i�th �plus G teet x S1S� 7� . . g,T�.DI i 10N�L I NFORf�1/�T I OJj_ For the purrose vf coatputing fees for building permits, the cubica3. contents of any builcli.ng or addition, is deL-exmined by multip�yir�g ihe ground area covered iro:a a point sir. (6) inches below thc iloor ].ine of tlie basement or tha cellar to the averag� heights of the •upper surface or to the average heigtit of the roof. suriace oi the raain gable of a pa.tched roof. � For repai.rs or alterations to an exista.ng stnicture, the fee shall be at the rate of $3.00 Pex each five hundred dollars -� ($500.00� or fraction tlzereaf in tiie cost of all proposed wor.k. . . � In •no aase �ha�.l the fee cliarged fcsr any pp_nnit as set forth i.n Sectiun 2 be less � than $7.50 plus $.50 state surcharge. ' � VERI F I C,�TI ON OF Ft1Ui�tn117I0f� NOTEz Permits �or construci:ion �vill be issued a minim�n oi 24 hours f'rom tlie time nf apPlication to a7.lo�v for proper review of the proposed structure and oi' ih� construction site. J� Certificate � of Survey of the lot, shoc,*ing the location of tiie foundation once it has been cons�ructed ti*ill be requir�d before procecdi�lg Y�ith the iraming. �FRTTFICAT , OF OCr,� PAJ t�Cti. '?►pplication tor a Certificate of Oceu,��ancy shall be made ten (10) c3ays prior to the use oz oecugancy oi any stzvcture for ��iiieh a builcli�ig permit l:as been issued; and said structure shal]. uot be used or. occupied ��til a Certificate oT OccuP�ncy has been xssued. ❑ 0 r • ' �r • � . ❑ � �— i;� ��_ ,� I, � � �� ,� �� ,� ��, � �G �°I� � � .� �� ,� � i °� � 2� � I � � ��' � �� .�� I � � � �� I � � �� i � �� i` - ,4 -,; � . . — � a-� � t�►�c�� ,� � �� , � , � � � �� '� � � s � ��e �� ; �S_6_CC� o- ��A� e4� '�I li! '�II ,� � �q,�� 3e � a `� G�� s �`�r� %G�'�s ��'° ��i��.�� I �c 3� . �� ; ��►(� �� .-�:� - ; ;- � i• r/ — � � Surveyors Certific�te � � COMSTOCK & DAVIS, INC. Consultiag Engineers and Iand Surveyora 1446 County Road J, Minneapolis, MN 55432, (612) 784-9346 '�uFZVE`C FoR Gc�rjac Const�uc'h �on 48 1- Z06 � h �ve. . NE . C¢c�ar, Mn. 5�0 11 g� N N ---i 8�` o� '' 3 /.•� a N �' e� 0 N � ; , ; � I ( DESCTLIPTIOIJ � --i � BRIGApooR! PL,ACE ni. N 88° 59� 53'W //7.59' _� b • zasa•' •�s.as•• • L�Q249°,4S.51` v s.�;• . -.,• � � � � L° 3�.10' �. f;----.____r--�_j __._.,�—...�—� R'aZ0.00� � -1. . � - ' J h i �' I � ` �'!''! � i I � . r� � ( � � ( � �� t r;17� • � I ( j,� ' �>.� ^ 11 N V �.. � �.q� a-�• � ti� '" i N� I �. �4 �3 j 1 s�' ^ � N � •; .L I O' ( � �O 'f' ,� - � _ � � . �„� 1Z � o � I lo' co 2 14.68 a1' � � 0 I d SFaunJay`:sy � �i Y� ( 'd N N � �' O Q � o` zo.�' '� zi .o d I/� Q Lh � $' � � � �� 5 83° 59' S3"E /3� z5' � � � Z=. n� ; ;� �+ �- � !Lot I2, Block 2, Blor�berg Estates, City of_ Fridley, Anoka Cvunty, Tiinnesota. SCALE: 1�� = t,� ! • QE�\O�'-�S • �F�o�+• Mon�JMr.NT �o u ti t� m 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 �he State of Minnesota. ,�, ��, ��83z C,�! /, r�s r 4�?8 Reg. No. Date Job No. Book No. 0 p ��'��'S �� C�?l�i�'l'�CK 8c lDA'J�S, I1�TCo Consuitnng JEngiraeers ��I I.aead Surveymrs i44G Coax�nty Rmad �i,1Vlintieapalis,l'�dI',T 55432, (6i2) i8$93� SUR�IEY FOR : B & G Investments 961 Hiil�rind Road �ridley, 1�Iinnesota 55432 �r m7 "w N � o� ��t � t� a'i� F�Cf� l�J � � FFt.rt.'d %� 60 il�- f i�. �� .�/V C) �"L.�L.1°° BRl GAD'OOA1 PL,ACE 'N N 88° 59" 53" W. l�7.59' " -� � . L1=89°dsSl° y, r`------------------- L= 3�.10' I.,. --�� iz�ZO.«� i � _ i Z5. � ' •i � - , � :tn iv I�, a 1 N V ,�- Iy �' i. N � � %-- 3 �o-;; DT /,2 =`, `' � � N r� � I �o� � � - � I � .w 1 tt� O ' ° � � �� o p � ,.. +�n i° 1, ` di o. o � i �c $�� Z — . � � 1� � � 5 ge° 59' S3"E /�7 z5 � � � ,� � Z=� � ,; ;� . DESCRIPTION Lot 12, Block 2, Bloaberg Estates, City of Fridley, Anoka County, Minnesota. SCALE: 1" = 40 p Denotes 1/2" diameter iron pipe monument set and ca�ged No. 10332. I hereby certify that this survey, plan or report was prepared by me or under my ciirect supervision and that I am a duty Registered Land Surnyor under tite Iaws oi the �tate of 1blinnesota. ��o�� 10832 Nov. 17, 19a0 4278 � 9 � Reg. Na �' ' Iiate Jdb I+Io. Booic No�. � ° ,,.5' �' r� � � /� U, _ ,� � c� � �� r —�- � -�- , � � ,� � , � �, > � - r , — � �� y � a_ "� � • � !_ �'✓" �= �.� �` `� � �s � � r-r- �� ,� ,�' - �9� / �� 1 \ / ��. - y ` �l �• � ��' ' ��— , �� 9�1 �, ,� ' f �� i, � � � � ' �� ^ �; � ,� - � �� e�� , ��' � � vtll � �= r` � -� o, �= �� ,, i � �' �= ,'� ' � � e� �1 /Y� 1 a-- � u �.n.; . ��7� .3C� . „ . .� � S � , �,/= /��-� , �{ , h� • �z � u �. � ti �s•' � �. .- �I , <,� �� w-�� i �^s � � �k&�9". *F � � 1 ��r yt�Y � Y;, .� � #� = .:. 5 ��_ � � �_" � ' �.,; � ,t � °* � '' '` 4� , �u. October �-; x �� `��2�,,,;, x;., ;�.-:t>,, CIiY O� FRI�ILEY 8431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432 29, 1981 Mr. Gary D'Aigle Garjac, Inc. 481 - 206th Avenue N.E. Cedar, t�Il�T 55011 Re: Final Inspection at 7650 Brigadoon Place N.E. Dear Mr. D'Aigle: TELEPHONE ( 612)571-3450 A final inspection was �de on October 28, 1981 of the above address and the only item that needs to be completed before the structure can be finaled out is; Provide sod in the front and side yards by June 15, 1982. We will expect the above item to be completed by the scheduled date when a reinspection will be conducted to determine compliance. If you have any questions on this item, please contact me at 571-3450. S' _. lY. DARREL G. CLARK Chief Building Official DGC/mh CC: Homeowner 7650 Brigadoon Place N.E. / � NEW A[�DN � r ALTER [] CITY OF FRIDLEY Effectnre 4/1/2004 ( J 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg ins [] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-7287 Fax �C BUILDING PERMIT APPLICATION ��►� � ��-C�l�>9 � Construction Address: Legal Description: � Owner Name & Address: �r��(ne,� ��.1 L�cia �;�' Tel. # �� %/7—/01 ye% Contractor. MN UCENSE # Address: Tel. # LMNG AREA: GARAGE AREA: DECK AREA: OTHER: Attach to this application, a Cert�cate of Sunrey of the bt, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Sq. F� Length Width Height Sq. Ft Length Width Hgt/Ground Sq. Ft Construetion Type: Estimated Cost: $ � � Driveway Curb Cut Width Needed: �F� + 6 Ft =�Ft x$ Z� _$ DATE: APPLICANT: Tel. # Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-5T1-1287 if using credit card and we will call you for card number. Permit Fee Pian Review Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge $ $ $ $ $ .$ $ � $ $ 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 Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ J Not Necessary [] TOTAL $ STIPULATIONS: ,, BUILDING PERMIT FEE SCHEDULE The Cluef Building Official shall, before issuing pe rnuts � for the erection of any building or structure, or for any' addition to any existing building or structure, or for any alteradon or repair to any existing building or structure, ugon 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 $2,000 $2,001 to $25,000 $25,001 to $50,000 $50,001 to $100,000 $100,001 to $500,0� $500,001 to $1,00O,OOU $1,Q00,001 and up FEES $23.50 $23.50 for�first $500 plus $3.05 for each additional $100 or fraction thereof, to and including $2,000 $69.25 for first $2,000 plus $14.00 for each additional $1,(m0 or fraction thereof, to and including $25,� $391.25 for first $25,000 plus $10.10 for each additional $1,000 or fraction thereof, to and including $50,�0 $643.75 for first $50,000 plus $7.� for each additional $1,000 or fraction thereof, to and including $100,0(� $993.75 for first $100,0� plus $5.60 for each additional $1,000 or fraction thereof, to and including $5�,�0 $3,233.75 for the first $500,000 plus $4.75 for each additional $1,� or fraction thereof, to and including $1,0(�,� $5,608.75 for the first $1,(�0,000 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 proceeding with the framing. New Houses Onlv ADDRESS PIN LEGAL DESC PERNIIT TYPE PROPERTY TYPE CONSTRUCTION TYPE VALUATION I LINEAR FOOT CITY OF FRIDLEY 6431 UNIVERSII'Y AVENUE NE FRIDLEY, MN 55432 s�i-36u4 r�ax: : 7650 BRIGADOON PL NE : 123024110117 : BLOMBERG ESTATES : LOT 12 BLOCK 2 : DRIVEWAY CURB CUT : RESIDENTIAL : DRIVEWAY CURB CUT e APPLICANT JAMIESON ROBERT R& SANDRA M 7650 BRIGADOON PL NE FRIDLEY, MN 55432 OWNER JAIVIIESON ROBERT R& SANDRA M 7650 BRIGADOON PL NE FRIDLEY, MN 55432 12 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction 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 certify that I have read and examined this application and know the same to be true and conect. 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 construction or the performance of construction. Applicant Date Bldg Insp Date s�l-iz�� DRIVEWAY CURB CUT PERMIT NO.: 2004-01419 DATE ISSTJED: 08/26/2004 TOTAL PAID WIT'H CHECK # 5190 ��raxa i� r�iuvli i � x�� u ix�li r ux w uxK u i ti �x i tiaiv li��c;tc��li atiu v�. 240.00 240.00 CITY OF FRIDLEY DEPARTMENT OF BUILDING INSPECTIONS Upon request of e an � C � /Property Owners %�s(� ,�r�q �.dooh l��ae /1✓ /Address ��l ss 3 I hereby grant permission to the above property owner to extend the width of their � driveway up to the adjoining property line. This would be an exception to the three foot setback ordinance in effect now. �� ' �� --�—v 11�1.�.�.a �°4'�,�.�� . (,� 2 (� 4-ca.�i� wQr1� � ��.l� ff� �. � � � ' -1 `c:� � �1 P �.� tp � I�1 S 9�t� -�;��-P� Property Owners Names (PRINT) � ° � .� �. � Property Owners Signatur � �-� `7(� ��' ��l'��oon �L ��°��l��o� �`s �32�- Address �� Date Building I�spections 763-572-3604 763-502-4977 FAX DATE � STfE ADD S ]�i ' TI-IIS APPIICANT IS: PROPERTY OWNER! TENANT CONTRACTOR SUBMTf A COPY OF YOtIR STATE LICENSE AND CERTIFICATE OF WSUKANCE P�iO�ERTY TYPE �y �UILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY &MAIL ADDRESS ■ • '- �' . ....--.��_-- ��.c� �� . Permit No.: R��v� By: D d�( STATE LICENSE �1 EXP DATE ann�ss: crrx srArE zrn ❑ BASEMINT FINISH ❑ DECK CONSTRUC'f10Ai TYPE OF WORK: ❑ NEW HOME CONSTRUC7TUN 0 ADDTl'ION MAIlVTENANCE/REPAIIt ❑ ELl DFSCRiBEWORKBEINGDONE:�S� ..t`i�e ,,,d'cCl�4CP�hest�fi' SIZE OF IMPP�OVEMENT LENGTH WII ROOFIIKG C] H�t1SE ONLY N(JMAER OF SQUARES C] HOUSE & GARAGE PR� SIZE: PROi'C1SED HIIGHT: SIAING ❑ v�yt ❑ Alumin I �ott��r o�tv d WIIVDOWS IN EXISTING OPEMNGS �Y� ONo OR FOR NEW OPENINGS-DESCRIBE SIZE OF OPENING CHANGES & F� � � v Pl� Rewiew Fire Surchazge Surcharge License Surcharge SAC Chazge Gtiirb Cut Escrow Erosion Control Park Fee Sev�+� Main Charge O ATTACHEI) GARAGE ❑ DSTACI�ID CrARACiE OSoti"tt ❑ Trim ❑ Fascia LOCATI�N OF WINDOWS O DRAIN TILE ❑ OTHER VALUATION, INCLUDING THE COST ttiF r�USIIVG THE 1997 U.B.0 �EE SCHEDULE) � M/`ftTT f�� 7' REMOAF,LINCi SilliMff: 1. Existing Floor l�an 2. Proposed floot ptan 3. Li� of s4vctural membera w be used FOR NEW CONSTRUt;TiON INCLUDING DECKS, N?�.JTfIONS. & PORCHF.S SUBM[�': 1. Site Plan/Survey showing tt� existing atrucwre,s � �a� �i� 2. Two sefis of construcri� planc 3. Fmergy Caiwlaiians FOR WINDOWS — PROVIDE U-VALUE AND MANUFACTURE SITCKER OAT WINDOW. �� See Back Page for Fee Schedule 65% of Building Permit F� .� 1 times the total job valuation .0005 x Permit Valuation M'uumum $.50 $5.(Kl (5tate Licensed Resideutial Contractors) $2100 pe� SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$24=$ $450 Co�s�+ation Plan Review Fe�e Determined by Engineering Agreement necessary ( ) Non N�essary ( ) THIS I5 AN APPLICATION FOR A PERA�IIT-NOT VALID UNTII. PR�ESSED I hereby appty for a building permit aad I aclmowledge that the infom�ation above is complete and accw�te; that the work will be in conformance with the ordic��es and c�es of ffie City of Fridley and vvIth the Minnesot� Construction Codes; that I understand this is not a permit but only � applicai�ion �or.�q�nnit and work is not to start witfiout a�it on site; that the work will be ia acc�rd�ce with the apgroved plaa in ffie case of r'� LG�<..,l�inh revi �d approval of plans. SIGNATURE OF APPLiCA1VT ___�`�-t�ir�N //f �PRINT NAME �. u�A� q,/ t/, % C4Il, l� DATE /�5 ��' ��