AF-COS - 44063SUBJECT PER 12633 �
City of Fridley
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T •
�
; � IPT NO.
� ; L __���_ COMMUiJITY DEVELOPMENT DIV.
1 � PROTECTIVE INSPECTION SEC. � r) 3�-D
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� � /'�'1 � CITY HALL FRIOLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY -
� ���'�: �•J �
612-560-3450 g10-F15 7-16-��F � �
�os nooRess 5170 Buchanan Street N. E.
t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 3O 1 Ma.rian Hills Addition SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Charles M. Nara 5170 Buchanan St. N.E. Fridle 55421 788-8789
3 CONTRACTOR MAILADDRESS Z�P PHONE LICENSEN0.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Addition to house
7 CLASS OF WORK
❑ NEW C� ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRtBE WORK
Standard wood frame addition
9 CHANGE QF USE FROM TO
STIPULATIONS
SEPERATE PERMITS REQU�E
NE�tTING, PIUMQ��G q� � FQR WIR�N�,
��
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING. 00C1 fi3IIle
THIS PERMIT BECOMES NULL ANO VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCEO WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANOONEO FOR A PERIOD OF 120 DAYS AT RE3S . �FZS H SOO
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT 1 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 . LO
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OF CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. ��-G.00
PLAN CHECK FEE TOTAL FEE
7-16-74
tGffn uaEOPCO RnCi0a0 U7H nGENi IDATEI WHEN PROPERLY VA ATED TH IS UR PERMIT
7-16-74 -
SIGNATUREOFOWNERIIFOWNEA UILDERI �DATEI BLDG �NSP �ATE
APPLICATION POR RESID�NTIAL, ALTERATION,
' c OR AllDITION BUILDING PERMIT
� � ��� � CITY OF FRIDLEY MINNESOTA
��� �
OWNER' S NAME : C F�R RL E S I�I . N R�� BUILDER :
ADDRE S S: �I �% � A IAC �'10,+'�Ow1 S'�'• N��• ADDRES S:
Y'1 � 1 ► ►'f►� . 'Jr" S�{.? / w
.
N0: .,�/70 STREET: ��c:,n0.Y10��'1 Sr. /�.� •� I r/a �eh ���l 1/�1� • J�'T��
LOT: .3'� BZOCK: % ADDITTON: Mt►rian H�I�S
CORNFR LOT: � INSIDE LOT: SETBACK: SIDEYARD:
Applicant attach to this form Two Cer.tificates of Survey of Lot and proposed
building location drawn on tl:ese Certificates. �
- • DESCRIPTION OF BUILDING
' To Be Used As : ��S ! �'�„ � �
,� �, / /�Q
,� " Front : .� �ji / Depth : �6 Height : �
Square Feet: ��J� Cubic Feet: �/ o( ,�'`, ' �-`
Front: Depth: Height:
Square Feet; Cubic Feet:
�`ype of Construction: S'f b�hd0�l�p1 lii�DOQ ��d Cost: $ 6, 0�
To Be Completed: ���-3�� %�
The undersigned hereby makes applicatinn for a permit for �he work herein
specified, agreeing to do all woxk in stzict accordance with the City of
Fridley Ordinances and xulings of the Department of Buildings, and hereby
declares that all the facts and representations stated in this application
are true and correct.
DAT�: / /� �S �%y SIGNA7°[T . •
(See Revexse Side For Additional Information.) � `
�-�. 7-
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City of Fridley, Minn.
BUII�DING PERMIT N•° 3 8'7 3
�tl': . . . Y. . . `. l. . K. . .,.- . � � . . . . . . . . .
Owner ..................................... . Builder .... . . � . ... ...... ...�/t'„�., �
. �
Address...................................... Address .............................................
L�CATION OF BU[LDING
No. �l. . ,/. .�. Street . . . . . . . . . . . i,,��!�: . . �: l. .'�! Part of t . . . . . . . .
Lot . . . �.Q. . . Biock . . . . . . � . . . . . . . . . Addition or Sub-Division i!� L .� . . .,r!Ni�lv�. . ���'4:�(. .
Corner Lot ............ Inside Lot ..?i........ Setback :��.: a�. Sideyard ...........................
DESCRIPTION OF BUILDING
TO USC(� ` � ` a q > e w �/ x
,�CcG . . . Froxrt �.t . (: .� Depth �. � . � Height !. . �: 5�! Sq. Ft.��,/. .� Cu. Ft. q�.J�}o
. . . . . . . . . . . . . .. . . . . . Front . . . . . . . . Depth . . . . . Height . . Sq. Ft. . . . . . . . . G�. F't. . . � . . . .
Type of Construction . . . . . . . . . . . . . . . . . . . Est. Cost. / la .Q St � . . . . . . . . . . . . . . . . . . . . .
.�. To be Completed
In consideration of t'he issuance to me of a permit to construct the buiiding desribed above, I agree to do
the prop�ed work in accordance with the description above set forth and in campliance with all provisions of
ordinances of the city of Fridley. � ., �.
.!?...... ........ `. � ..
...,��Z�� ... ����`............
/�o
In consideration of the payment of a fee of $. f,l�. .et . . . . ., permit is hereby granted to . . . . . . . . . . . .. . . .. . .
. .. .. . . .. .. . . . .. . . . . .. .. . to construct the building or addition as described above. This permit is granted upon
the express condition that the person to wharn it is granted and his agents, employees and worl�nen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinaneea of
Fridley, Minnesota regarding location, construction, alteration, maintenanee, repair and moving of buiidings wfth-
in the city limits and this permit may be revuked at any time upon violatiqfi of any of the provisions of said
ordinances. . � / _,
i� i ar;�ii�l � r ll,�- �� . < . • �
NOTICE:
This permit does not cover the constructton, instaliation or aiteration for wiring, plumbinq, yas heattn�,
sewer or water. Be sure to see the Bulldinp Inspector for separate permits for these itema
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