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AF - 35584� � � o �� Caty of Fridley, Minn_ ,� BiJILDING PERMIT �o. 7 o i s nate: r�_��.'��.� � Ovener: Builder Address Address --- � � �� LO�►�� BUILDING lvo. st�eet �." .�� r Part of t � Lot��81ock Addition or Sub-Division d Corner Lot � Inaide Lot _,�.._.... Setbe,c �.___... Sideyard S� � �� eVa�� Founda.tion IIevation DESCRIPTION OF BUILDING T U : p Front Depth � Height �� Sq. F't. C�. F�t�S�� Fr t Depth fTeight � Sq. F� Cu, Ft, Type of Construct4oa F�� Cd��! ` To be Completed ._._.. In consideration of the 3sauance to me of a permft to constru ding descrilxd above, I agree to do th� proposed work fn accordance with the d�scription above set rth in com ce with all proviaions of oidinances of the dty oP Fridley �� / Ea consfderation of the paymeat of a fee of $ � , permit fs hereby granted to •� to construct the building or addition as described above. Thia permit is granted upon fihe eupress condition that the person to whom ft is granted aad his agents, employees and worl�en, itt all work 8oae in, around and upon sald building, or anypa� thereo� stxall oonform in all respects to the ordinance� of Fridley, Minnesota lacation, construct�on, aitera.tion, maintenance, repe3r and moving of bufldinga o�� dtY ]imits�� permit may be revoked at any time upon �tion of any of the Provisions of said Bvildiag Inspector Nonc�: T�s pqm�tf doa not cerer ths conatwcHee, IestaUalfoe tee rr�rle6. P��+b+& e� 6�9. �wer er walsr. Bs ans to sa t6a Buildiue Insp�eto� hr aparaN pormih for fhas h�ms. � � � •a � APPLICATION FOR BUILUING PERMIT G'ITY OF I�RIDLEY, MINATE30TA ��5 � �6��-� � ��6�� B�� a6�� r ��- ADD�ESS �% � 5� �7��6: � o� ��" m ,AbDRES$ ��?'� �'�a� �?�� -a � LOCC1�iiT�OPi OF B�DI1�1G Na. Street ,��0�7� �-�-� Part of Lot LoC ��'a� "�°! B1ock �� Addit3on or Subcilvision �v�ec�r�f�t,se N�lg��• � Coraer Lot Inaide Lot � Setback �� r Side Yard, d� �/T/�Si�. ai�� Sos¢� SEWER ELEOATIOAI FOUNDATiON ELEVATION S6'�� Applicant attach to thia �form Two Certif3cates of Surveq of Lot and proposed build- ing location drawn on these Certificates. DESCRIPTION OF BUTLDING To be used as: 7� � f✓� � Front �� Depth �� He3ght � ��'��" Typ� of ConsCruction To be Completed �Y� Sq, Ft. Cu. Ft.• FroaC Depth Aaight 3q. Ft. Cu. Ft. ,� � '�d °� . Eetlnnated Cost ��' �' � � � � � �� The undersigaed hereby makes �pplicat3on for a permit for the work herein apecifipd, � agreeing to do a11 work in strict accordanca with the Cftq ot Fridley Ordinances an� rulin,gs of the Departnent of Buildings, and hereby,declare�s,that.all the facts a�d representa.tions atated in thia application are�ue and correct. DA� �� (schedule of Fee Costs can be fouad oa the Reverse Side). � �..� _�� _ � �, . � R 1 s � ' � � 4 • � e i C $UILDSNG PEItMIT FEE SQiEDUd,E Section 2. The Inapector of Buildings sha11, before iesuiag any pex�i.t far �he erecCion of any buildiag or structure, or for any addition to aay exise- ing builfling or etructure, or for aay alteratioas or repai�a to any exiating bu3ldin� or at�ructure, upon application therefor, require the paymeat by the applican� for such permit of feea to the amount herein below aet iEorth Pnd in the mannes herein provided to-wit: Z.1. For aay such permit for the esection o.# any fire-proof building, other than a garage� warehouse, factory or grain elevatos, or fos tha erection of any Fire-proof additioa, for similax accupancy, to an� ex3ating building sha11 be at the rate of $1.40 for each one thousand cubic feet, or fraction �hereof, in such cubic�zl coatenCa. 2.2. For any such permit,,�or the erectioa� o£ anq fire-proof gara�e, warehouse, facrory or graia elevator, or for the erection o� aay fire-proof additioa, for aimiler occupancy, to any exiat3ng building shall be at the rate of $1.25 fo� each on� thousand cubic fe�C, classified as 01fireprooi" bq SecCion 502 of the Minneapolis Building Code. � �C3T7SES 2.3. For any sucb permit for the erection of any non-firepsoof building other thaa a garage, warehouae, factorq or grain elevator, or any non-fireproof additioa, for similar occupancy, to any esi�ting build3ng - permit $1.00 fos each one thousand cubic feat. , GARAGES 2.4. For any such permit for the erecCion of any non-fireproof garage, warehouse, factory os grain elevator, or for ehe arection of anq non-fisepr� addit��a, for s3milar xcupancy, to any ex3eting buildiag or for esch auch � bn�lding or addition - ninaty cent� ($0.9A) for each one �housaad cubic feet ox fraction thereof, in the cubical canteats thereof wLth � minim�am of $4.00. For the purpose of canpu�ing fees for building permits, the cubical canteats of aay buildiag or additfoa to a unifarm height throughout by muitiplying the ground area covered fr� a poiaC siu (6) inchea below the floor liae o£ tbe basemeat or cellar to the average he3ght of the upper surface or to the average hei�ht of the roof surface of the main gable of a p�.tched roof. 2.5. For repa3rs or alterations to an eaciating seructure, the fee sba].1 be at the rate of $3.00 per each F'ive flundxed Dollars {$500.00) or fraction ther�of in the cost of a11 progused work. 2.6. In no casa shall the fQe chacgAd fc�r enp pera�it �s set forth 3n Section 2 be less than $4.00. ,� . . .. ,�.� /� � �� - , ��- ..e . V �, _ _ -� _ � �. _� ,, _ . - ____ _ _ � - � . � �, ? � � r Lvnd Plat��i�t9 �'S-Hr�hn� �CS �tl.E. ' �►Srrrve�ini� ` ArJ'ur�eo�/rs32, .�"s�s��9 ENG I NEERI hiC, 11'�tG. �°fa Civif fr;�iun'xi�! 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FOUNT. sHwRS. .� RWR DRAINS �� 8/�SINS nuro e✓/�'i� GAS APPL GAS RANGE GAS OPENINGS � i Z ! � '°� Pn > A m � p �� , � � � �� y p �v@i 04 � �� °a• °� �e w � O � ��o� � � � � � � � �a � �°��.� �� o�� ' p � �' o � ¢ � p �'�,o tD y ��w � �� f`�p H 'y �N i-i: � t-r _e} (D � �C � �Oy �'��' .' � � � �� d OC � �ro w0 �x &°� p � M � � � M � � � � � � � � - _ � �. �� T � �. ; � � � �� M !" � �. � pror� �Q ?� � A aQ � '" � A \o �� '. � �Ji.J�.. - �� Caty of Fridley, Minn. No 9 2'7 0 BUILDING P�RMIT Date: � M�Y 24, 1967 p��.c�bert Kretlow B��, Inter City Builders Addres,4 � 8%oa d AvP .�. E' . Address 35 H3ghWay 10 7855 LOCATION OF BUILDING No. ....._ � 8�§ Street � Broad Ave . � �_ Part of Lot � 25-26-27_ glock � Addition or Sub-Division . Riverview Heights Coraer Lot — Inside Lot _.._—. � Setback —� Sideyard Sewer IIevatian Foundation IIevation DESCRIPTION OP BUILDING To be Used as: Gara�e ,_ Front ?2 � Depth 22 � Height $� Sq. Ft 484 -�'� � 3872 Front Depth _..._ I%ight ._._ Sq. F'� Cu. F't. Type of Constsuction �r�e $16 00 June 15 , 186 7 F�� C�t _..._._._.._.._.___.—..__ To be Completed _._.. In consideration of the issuance to me of a permft to construct the ding descrlbed above, I agt�ee to do the proposed work in acc�rdance with the description above sgt forth ��n compliance with all provlsiona of orclinances oE the dty of F'ridley. �1 /� //' In consfderation oP the payment of a fee of $ �•�� , permit 3s hereby granted to I�'�er City Builders to construct the buflding or addition as descrlbed a'bove. Thispe rrmtt ia graated upon the express condition that thepe�on to whom ft is granted and his agents, employees and worlunen, in all work. done in, around and upon said baflding, or aay part thereof, shall conform in all reapecta to the orc�tnances of FridleY� Minnesota regarding lacation, construction, alteration, maintenance, repair and moving of bufldings withitt the dty ]imits and this permit may be revoked at any time u�n violation of any of the provisiona of said ordina,ac�. CLARENCE BELISLE B��,��r NOTICE: Thh perrni� d� not eover fhs aonstrneHoe, instaOaMee fo� wtrine, plambing, en heatins. sswa� o� wNsr. B� sun to � tlre B�ildhtg Inspeetor for ssparah psrmiti Por f6e�s liena. � � APPLiCAT`�ON F0� BUILDIAIG PERMtT 3 CITY OF � FRI•DLEY, MIIJNESOTA . owrr�R � s � �� a r� � � ��' �_ ,�.�,.�.��,� BunnEx ,��'r�-� �'„- � `� ��1 �. �� - - - � � ADD88SS—_ ��D�� ' ; ADDRESS_ � � ��a ,�� ;��-�� . � �� . . � , � L�AZ'IQN OF BUILDING ' .- ,� No., � �,��,� �A� c�� r;�i� °rf';;�� Street Part �of Lot��; -� Lar �� A .�� sL�x � �nni�o� oR suBnrnzsaop �s�� 7'.� . � ��-=- Corner Lot`_Inside L0� �"�' � Setback Side Ya�d SEWFR ELEVATIdN ' FOUNDATION ELEVATIOIY ApplicanC aCtac& to this form Two Cereificates of Survey of LoC and proposed building location drawn oa these Certificates. , . DESCRIPTION OF $UILD7NG Ta be used as : ' � , _ ' � `r ��_ ^ Front �- � Depth � � Height _ �`�� • 3q. Ft. "`� �"� Cu. Ft._�� Front Depth�_Height _ Sq.' Ft�. ' � Cu. Ft, � Tqpe of .Cottstruct3.on��/i�� _�! EBtimated Cost ,d,�, � � �_ To bE completed � �✓,^ �� ,��'" ,� � Th� undersigned hereby n►akes appli�ation for a permit for the work herein apecified, agreeiag to do a11 work in strict accordance �aith the City of Fridleq Ordiaances and rulings af the DeparCment of Buildiaga, and hereby declare� that all�the facta and repreaentatfo�s stated in thia app�li�ation'are true and correct. DATE � �� ' � � f ;� ; � � ,�,�� / - SIGNATIIRE ,: �� , 3chedule of Fee Costs can be faund on t,e Reti�erse Side). � � __ �� _ f � � � �� f �= ° '=4 v ,� �` `' ., � � - � �� ..-' ,� �, -�' �' �� '� � - �-; _ ` z �, �-� � �� . ` . � P � �� . - - ,�,; . . � � 4 � T�,� c �- � .�;� � F� ��r�� ;� ..-_=� �_ BUILDING PERMIT I�EE SCHEDULE SECT_ IOft 2. The Inspector of Buildings shall, before issuing any germit for the erection of any building or strucCure, ot for any additioa to anq ezisting build- ing or structure, or for aay alterations or repairs to aflq existing building or structnre, upon application therefore, require the payment by the applicant for auch pesmit of fe�s to the amount herein below set forth and in Che maaner herein provided to�wit; 2.1. For any such permit for the erection of any fire-proaf buildin�, other than a garage, warehouse, factos�q or grain elevator, or for the erection of any fire-proof addition, for aimilar occupancy, to any existing building, shall be at the rate o£ $1.40 for each one t'housand cubic feet, or tract�.ou thereof, in su�h +�ubical contents. 2� For aay such permit for the erection of aay fire-praof garage, tdarehouae, factory or graia elevator, or for the erection of any ffre-proof addit3on, for similar occupancy, to any existing building sha1.1 be at the rate of $1.25 for each oae ehausand cubic feet, class3fied as "fireproof" by Section 502 of the Minneapoli� Building Code. flOIISES 2.3. For any such permiC far the erection of any non•fireproof building, other than a garage, warehouee, factory or grain eZevator, or any non-fireproof addition, for similar occupancy, to any eatisting building - psrmit $1.D0 for each one thousaud cubic feet. G�ARAGES 2.4. For any such permit for the erection of any non-firepr,00f garage, `aarehouse, factory or grain elevator, ar for the erection of any non-fireproof addition, for similar occupancq, to aay existing building or far each such buildiag or addition - ninety cents ($0,90) for each one thousand cubic feet os fraction the�ceof, in the cubical, contents t�ereof with the minimum of $4.00. For the puspose of camputing fees for building permits, the cubical contenCa of anq build3ng or addiCion to a uniform height throughout by multiplying the _-- �raund area covered from a point six (6) inches beiow the floor liae of the basemeat or cellar to the average height of the upper surface or to the average height o£ the xoof surface of the main gable of a pitched roof. . 2�.5. For repairs or alterations to an existing structure, the fee ehail be at �he xate of $3.00 per each Five Hundred Dollars ($500.00? or fraction thereof in the cast of all proposed work. 2.6. In ao case shall the fee charged for aay percnit as set forth in Section 2 be.Zess than $4.00. i �� SUBJECT P c�ty of Fridley AT THE TOP OF THE TWINS g U I L D I N G P E R M I T � i � � `L ____� COMMUNITY DEVELOPMENT DIV. �° r � � PROTECTIVE INSPECTION SEC. l' i ' --_-� ��"" �`� CITY HALL FRIDLEY 55432 NUMBER REV. DATE L 612-571-3450 910-F15 7/9/8 5 JOB ADDRESS �gg5 Broad Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION DESCR. Z�J-2% AA Riverview Heights 2 PROPERTY OWNER MAIL ADDRESS Alden J. Gerszewski '7885 Broa.d Street N.E. 3 CONTRACTOR MAILADDRESS Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS 5 ENGINEER MAILADDRESS 6 USE OF BUILDING Residen t%al 7 CLASS OF WORK ❑ NEW 8 DESCRIBE WORK Reroo�` Dwelling 9 CHANGE OF USE FROM 21P ZIP PAGE OF � � PER �° 1810 RECEIP . /��Zi APPROVED BY SEE ATTACHED SHEET PHONE 571-8638 PHONE LICENSE NO. PHONE LICENSE NO. PHONE LICENSE NO. ❑ ADDITION �] ALTERATION ❑ REPAIR p MOVE � REMOVE TO STIPULATIONS R,00�ing can be the 2nd layer but not the 3rd. Install ridged galvanized valleys. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IP CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. • NO. DWLG. UNITS I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1. AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GFiANTING OF A PERMIT S8OO DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. S�.S. �O SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT 10ATEI WHEN PF � � � �,Q� a _,,�,i�,� _ �S .. ��iGNATUREOFOWNERiIFOWNE ILDERi iDATE� BLDG iNSP PANCY SQ OCCUPANCYLOAD CU. FT. OFFSTREET PARKING STALLS GARAGES SURTAX $.50 SAC CHARGE TOTALFEE $15.50 F�( VALIDATED THIS IS YOUR PERp NEW [ ] ADDN. [ ] ALTER. [ ] Construction Addi•ess: City of Fridley Effective �t/1/8�1 R-1 AND R-2 Building Permit Application � Legal Deseription: � � " 01� l�"- d� / �;5 L� r''� /� � 1� � U'2r��/t ''�� 7� �(� TS' Owner Name & Address : J� ��e ►� U � �� S 2 2-c.� � `� i" Tel . � � 7 �" � � �8 Contraetor: Tel. � Address• LI9ING AREA: GARAGE AREA: DECK AREA: OTHER: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to seale. DESCRIPTIOA OF IMPROYEMENT Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length Width Hgt/Ground Sq. Ft. Corner Lot [] Inside Lot [] Ft. Yd. Setback Type of Construction: �� U�� l�.�c' Approx. Completion Date: Proposed Driveway Width If New Opening Is Desired: Side Yard Setbaek Estimated Cost: $ �d � Alt. A Alt B $ $ See Back Page for Explanation DATE: l '� ` �� APPLICANT : �� o. �a.�; Tel . ��7 r� � � � R Permit Fee Plan Check State Surchar�e SAC Charge Park Fee SeWer Main Charge TOTAI. STIPULATIONS: CITY IISE ONLY $ j� . c�C� $ � � � � � $ s . s� Fee Schedule on Reverse Side 25� of Building Permit Fee �.50/$1�000 Valuation $425 per SAC Unit Fee Determined by Engineering Agreement Necessary [ ] Aiot Necessary [ ] BIIII.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 strueture, upon applicatio n therefore, require the payment by the applicant for such permit of fees to the amount herein bel'ow set forth and in the manner herein provided to-Wit: Total Valuation $1.00 to �500.00 Fees $10.00 (Minimum Fee is �15.00) $501.00 to $2,000.00 $10.00 for the first $500 plus $1.50 for each additional $100 or fraction thereof, to and ineluding $2,OOa. $2,001.00 to $25,000.00 �32•50 for the first $2,000 plus $6.00 for eaeh additional $1,000 or fraction thereof, to and ineluding $25,000. $25,001.00 to $50,000.00 $50,001.00 to $100,000.00 $100,001.00 and up $170.50 for the first additional $1,000 or including $50,000. $283.00 for the first additional $1�000 or including $100,000. $25,000 plus $4.50 for each fraction thereof, to and $50,000 plus $3.00 for each fraction thereof, to and $433•00 for the first $100,000 plus $2.50 for each additional $1,000 or fraction thereof. DRIVEWAY DEPRESSION ESCRO�i (Conerete Curb Streets Only) Alternate "A": Removal and replacement of curb and gutter only - DriveWay width plus 6 feet times $13•50 Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approaeh With 6 inch depth - DriveWay width plus 6 feet times $15•?5 VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper revieW of the proposed structure and of the construetion site. A Certificate of Survey of the lot, showing the location of the foundation once it has been oonstructed will be required before proceeding with the framing. _.> � E�pineerinq Sewer WaICr Parks Streets Maintc�ance 0 'Y TO: John G. `�Mark A. MEIIIIORANDUM Flora, Public Works Director PW91-404 Winson, Ass't Public Works Director . FROM: Jon Thompson, Estimator & Construction Inspection DATE: December�24, 1991 SUBJECT: . Potential Problems with the 1992 Spring Thaw When the snow melts this spring, several potential drainage problems could occur. Additional late snowfalls and the rate of snow melt will be the deciding factors. , At 573 Rice Creek Terrace the floor elevation of 831.27 is 2.73 feet lower than the 500 year storm line elevation of 834.0 and approximately one foot higher than the 100 year line. � At 567 Rice Creek Terrace the floor �elevation of 830.47 is approximately 17 hundredths above the 100 year storm elevation line. At 6801 Channel Road the floor slab is 100 year flood line. --� In addition, the homes at 7899 a d B Mississippi River dike, but will e tc sandbagged and pumped in order to keep � the Mississippi River and flooding them. 0.2 feet higher than the � ��O ,oad Street are behind the have the culvert on 79th �ter from backing up from � � / � fRl�Y SUBJECT City of Fridley MOVING `�� " AT THE TOP OF THE TWINS �� p E R M I T 214 6 4 i � ' �• COMMUNITY DEVELOPMENT DIV. RECEIPT NO. r � L � PROTECTIVE INSPECTION SEC. �G% ° � _ � � ��1 � CITY HALL FRIOLEv 55432 NUMBER REV. DATE PAGE OP APPROVED BY �.---� • •'� 612-571-3450 910-F15 7/27/92 / / JOB ADDRESS �gg5 Broad Avenue NE t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 25�26�2% AA Riverviecs Heights SHEET 2 PHOPERTY OWNER MAIL AODRES$ ZIP PHONE City of F'ridley 6431 Uni:versity Avenue NE 571--3450 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Ernst House Movers �400 85th Ave N, Mpls., MN 55445 425-2822 d ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW O ADDITION ❑ ALTERATION � REPAIR � MOVE O REMOVE 8 DESCRIBE WORK Move House & Ga,ra,ge Qut o� City 9 CHANGE QF USE FROM TO STIPULATIONS ROUTE; S�qad Ave to 79th TeTay to East River Road to 85#:h Ave to University North.qut a� City Water & Sewer �atill be disconnected after house is moved but before basem,ent is filled in � Contractor to call City when house removed. TYPE OF CONST. OCCUPANCY (iROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REOUIREO FOR ELECTRICAL. PLUMBING, HEATING, VENTIIATING OR AIR CONDITIONING. TH1S PERMIT BECOMES NULL AND VOID IF WORK OR CONSTFiUCTION 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 ANO CORREGT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEHEIN OR NOT. THE GRANTING OF A PERMIT $S �OOO N�A DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pEFMIT PEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- �� Fee STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. _ C� � PLAN CHECK FEE TOTAL FEE �JK _�� ^0— SIGNATURE OF CON7RACTOF OR AUTHORI2ED AGENT 10ATEi _ � y�,r EN P O RLY VALI'0 . TED THIS IS YOUR PERMIT SiGNATURE OF OWNER iIF OWNER BUILDEiii IDATEI OG �NSP �_�� [ ] �i-n9 [ ] k��J « ., • • .. • � � •!• "I'I:rM �� V� �' Job A�adress : `7�' � S � G2 Q�. ..� � f�.s Legal Description: Owriex & p,ddress; Gs Tel. # Co7ltxaCtor:_ ��N� i � ' ,�i��zvs c.� ��Q �/C.S2 �, # �z� -z ��z Address : 7 S`c� J �'5��.' �i�-' %/ �Jl /� � /12�v S"��/s State Lioense # � �.� �+- �: ��- :�� Living Area: Les-igt.h _�o Width _� Heic�t � Sq. Ft. C'ti. Ft. Gazage Area: Tp*.�h 7 Z Width � G� Heic,�t Sq. Ft. Cu. Ft. Other: Iength Width Heic�t Sq. Ft. Qi. Ft. Estimated Cost of Wrecking/Mo�in9 5� �� c.� Appr+ox. Cxntpletion Date �/�- S�. � .� . :, . .�.�+. City Water/Sewer Mpls. Gas Coa�any Northern States P+ower Northwest-:ern Bell �el Co. 571-3450 [ ] 372-4720 [ ] 566-9120 [ ] 293-0665/293-1319 [ ] Water Bill Paid: Yes [] Amount To Be Collecte,d [$ ] Initials Maving Route: _l,�R��t ,p - 7g � ,�%� f. - C 6L�v�r-rc � � - c�°S'� - (��vsC/�,er'irc' �N6� ri.� �'�S Movirx�: Principle Building into Fridley . A+ooes.sory BuiTding irito Fridley . 'Ihroix�z, within or out of City . ... . . . .. $ so.00 $ 20.00 M�*+��*++ Fee: $15.00 S 15.00 i�1r'ecking: For each 1,000 cubic feet or fraction .$ 1.25 For struc�ture.s which would be impmctical to cube, the fee shall be ba��ed on the tatal oQSt of wrecJt;� at the rate of $6.00 for each $500.00 or fraction. The undersic��ed hereby makes application for a peYmit to wreck/mave the bu.ilding described ai�we, agreeing to do all work in strict acoo�noe with the City 0�linances arxi rulinqs of the Buildir�g Depart�nt, arxl the State Uode which reguires anY water well on the P�rtY to be sealed by a State li�en.sed water well dri�ler, ar�d herpby declares that all facts and representations stated in this application ar+e true ar�d oorrect. a �� P�+IIT F�: � �� l�-� � Signature S'I'IPULATI�LS :