AF-W - 43737City of Fridley
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Effective Aug. 1, 1981
WRECKING PER�IT APPLICATIO�d
Pemit lio.
Receipt To.
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Job lddress
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Legal' Lot No. Block No. Tract or Addition -
Desc. `l� � !S r'� �si �Y��S � �J �OOC
Property Ow�� Iz' ��� 1 �% �,�sS �' f�(/iLD 1 L-�9✓r/� h n`�1 `f
Contractor Address Phone
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Description Front Depth Height Sq. Ft. Cu. Ft.
of ldg.
S� To, of Dwelling Units Taxes Paid Tax Receipt ro.
Estimated Cost of Wrecking �� To Be Completed
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C� �-�� �2 `�v s2 rv �D �� � ti a7-,�2.� ��- = c��-`r� 2 i3 ! 1--1- �i4 �D
Utilities to be t7otiiied and date Sezvices Diaconnected
!lpls. G�s Cb. N.S.P. Nozthwestern Sell Tel. Co.
Enqr. Dept. Cust. Bus. Qfc. ffi�s. Ofc.
372-4850 � � � � � 330-5540 � - 5 � �% 332-4112 � �" S'� �,
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Dnte Date Date
Nzecking Pees: S1.25 foz each 1000 cubic� feet �or iractiAn
For stzvctures which vould be i.mpractical to cube, the fee
ahall be based on the total oost of wreckinq such stzvcture
at the rate of $6.00 foz each S500.00� or fraction.
IMiII'1 PFE: S15.00 No State surcharge on Wrecking Permits.
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Approved By Water � Sewer Department:
All Bills Are Paid Services Are Disconnected
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The undersigned hereby makes application for a permit to wreck the building
described above, agreeing to do all work in strict accordance with the City
Ordinances and rulings of the Department of Buildings, and hereby declares that
all fa ts and r rese tations stated in this applicati�n are tnie and correct.
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Date