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AF - 43759
�a City of Fridley AT THE TOP OF THE TWINS f 1 1 � � � • COMMUNiTY DEVEIOPMENT DIV. � �_ .-__-� r � L � PROTECTIVE INSPECTION SEC. i � � � �4 � �'^"1 � CITY HALL FRIDLE� 55432 ""'�' ,`� 672-560-3450 SUBJECT BU ILDING PERMIT` NUMBER REV. DATE PAGE OF 910-F15 9/2$/76 � � fRMIT NO. ° 13'78 ECEIPT NO. ApPROVED BV JOB ADORESS 16:�1 Camelot Lane N.E. 1 LEGA� �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2�. 2 Harris Lake Estates sHeer 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Brickner Builders, Inc. 6245 Ben More Drive N.E., Fridley 574-9871 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. 5ame 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 O REMOVE 8 DESCRIBE WORK W���� Construct a 52' x 26' Dwelling and a 22' x 24' Ga.rage « S�pERATE pERMITS REQUIREO '"F(�'t WERING, YEIEpHONE' �� t0Ca1 u�i�t,eS 9 CHANGE QF USE FROM ��� p��MBtNG A ,REQUfREp g S G� W STIPULATIONS provide truss design. 5oi1 borings and compaction tests will be required. Provide a hard surface driveway. Provide a verifying survey before capping. Provide sod in the front and side yaxds. SEWER LOCATION (Approx. 9' Deep) 38' West of Manhole (Inv. 879.00) WYE ELEV: 878.85 TOP OF FOOTING: 882.35 Minimum WATER LOCATION: 11` East of Sewer Service � t;�r ot ramudr oo�s +� au�� n� AC�'1'MAN( OP UT1111Y LOCAtiONS MtD EIEYATtG'. t;il5 DAiA IS FOR INFORNUTtON PUf:POSES O�LY .,'r•. • �ER3QNS tJSiNG � R SHOULD VERIFY i!# 1t�ORMATION ON IN� 'S1'1!. TYPE OF CONST. OI SEPARATE PEFiMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. WOOC� FY'aIlle --IMPOF�T'ANT— NOTt�'Y THE FR{DLEY ENGI OIVl310N REGARDING CURI REMdVAL AND REPLACEMEI AT DRIVGWAY OPQWINGZ, �YGROUP OCCUPANCYLOAO THIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONSTRUCTION ZpNING SQ. 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 1352 �' SZ8 ANY TIME AFTER WORK lS COMMENCED. NO. DWLG. UNITS OFF: I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION �. STALLS AND Kt�10W 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 GRANTING OF A PERMIT SS4 � 3'rJS DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE PROVISVONS OF ANY OTHER STATE OCAL LAW REGULATING CON- STRUCTION O ERFORMANC OF ONSTRUCTION. � +�1�-8•9�- PLAN CHECK FEE ��i � "2,�` y' $29.73 GNATURE OF CON i RACTOR OR AUTHORIZED AGENT IDATEI WHEN PR � PERLY _ 6� 1C SiGNATURE OF OWNER IIF OWNER BUILDERI IDATEI BLDG. WSP 0 CU. FT. 29.728 Tota1 ET PARKING IGARAGES �`i%.ie $350.00 TAl FEE $525. 82 IS YOUR PERMIT / � ",�� .r^ APPLiCATIOr! F�R RESZDENTTAL ALTERATION, ADQTTIOfd, Oi�: Ftk't'AIR f3l1ILUIPIG PEP.MI�f �N_ ��� o���r. � s �� ; _ _ �u��n�R :��? � c x ►v�, ,2, �L � 2s rl��' . ADDP�ES S : �__ �� �i'T/!�9E `� L D � '�'�� ADDRES S : � S' � J +/•i�' � �� /� `C ,�� ��� " ���� N0: . �(!�'YI ST12.�ET: }� �< Lr���c� /�/� ��.. LOT:_�.��BLOCK: � ADDITION:���.R,�� �'""'°�+�"� CORA'ER LOT : INS IDE LOT : y SETBACK :�� SIDBYA1tT1: ����� Applicant attach to this f.a�.'m ��o Certificates of Sua.-�� of Lot and proposec� building location drawn on these Ceri:ificates. vESCRIPTION OF BUILDII�G T e ITsed As : � / _Frant;_� �� Depth: � � Height:_ _ � � / Square �set : ��SL. Cubic Feet : � �; y�8 Fror�.t : ''? '�" Depfih : �- � Height : � v Square Feet ;�_�Z � Cu�ic r eet : � �- � � .� � '.�ype of_ Constru.cti�n: ��0 d�Estimated Cost: $ ��_f�,`� 2o Be. Completed: � ��i The undersigned he}eby makes applica_ti�n for a pei-mit for the �aork h�rein specified, agreeing to do al.l �oork in stxict accordance �aitli the Ci�y of Fxidley Ordinances and i-ulings of tlxe De}iartmeni: of �uilciings, and hexeby declares that all the facts and repxeser:tat.ions stat=ed in this appli�ation axe txue and correct. Q' ► „L 4 . �..-� � 1 DAT� : '� / � � S IGNATIJRE : `. 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I � . _ _ . . ; ._. _. .t _ , r . , -' � _ . , ' I ; 1 7 ; . . :_ , _., _; , ,___ ._ _. . � ; i : ; , , - _ . . _ . _ , __� . _ � . : -' _ , -_ '_ . . ,_ -i- _ � r '. � � _, � . , ! : , i i . _ � __. _ - , . _ . , . . _. .. _.. . - - . . . . �- . . ,- _ . .._ _ . : _ . __, . :._ - _- ..-:. . ._ . : - -- -- - �- - .._._ _ _ � y . . .� _ �. ;_�. i .. , t � � , ; � _ ._ , :_ __, _ __� � _ _ . , t ` ; ' ' , , + � - - ,-- : � --_ ;_ __ _ _ � _ _ -- , . __ . f 1- - -t. . . . , ___ , , , ,_ � _ _ _� . _ � EXTERIOR EtdVELOPE AVERAGE "U" COMPUTATION OWNER: SITE ADDRESS : /� t ! `��v{�2'C vC�CtirLtt,.,.. v CONTRACTOR: . Page 1 of 4 DATE / � y� � 1 PHONE : s 7� �� j ' / Determine working square footage of each � _ 1. Total exposed wall area...... �� 2� sq. ft. x .17 = .7 /�' ?L 2. Toal roof/ceiling area ...... 7� sq. ft. x .OS = � �'' G Total exposed wall area above floor = a. Total wall window area .............................. b. To�al door area .................................... c. Tota2 sliding glass door area ...................... d. Total fireplace wall area ............ ............ e. Total wall framing area (average 10�) ............... f. Total rim joist area ............................... g. wall area above floor ....................... h. wall area above floor .......................... i. wall area above floor .......................... j. wall area above floor .......................... ' �� Total exposed foundation area = � � k. Total foundation window area .......................... l. Total net foundation area above grade ................. Determine "J" value of each wall segment (e.g. window, door, each separate wall section) a. 1�1.. 3 ti X��u„ '. f�' _ �3 . 11/ b. 3 ? • � X „U„ � . s� g = '� f . �� � `� • �' _ ,�/ • "L � C. 3, v X„U�,� a' a. �o X „U„ � • 1-'1� _ � ` � e. �7�•:�"%!X ��U„ , � 3 = �3,(�3 f , �-3 `� X „�„ . t� � _ � � � 1 -- ' g. ��`' -�' b X,� U,� B 7 = , g 1/ h . X "'�7" _ i. X "U" _ �� X nUo — , S'" k. � X 'U" � _ 1 ,� X �� , • �� _ 3 . ............................. tal = 1 �.'V 39��8' ��'. �'3 � t / � 5 � � If item #3 is the same as. or less than item #1, you have met the intent of SBC 6006 (c) 2. • 0 � 0 � �.5cterior Envelope Average "U" Comgutation Page 2 of 4� Total exposed roof/ceiling area = / � `/ � m. Zbtal skylight area ............................ n. Total roof/ceiling framing area (average 10$)... o. Total net insulated roof/ceiling area........... Determine "U" value for each roof/ceiling segment m. X "U" _ n. X ��U�� - . a � L — • g_ _----� o. I �I � X „U„ , 4 ........................... Total = � 9 ,� . � If total of #4 is the same as, or less than #2, y�i..hav et the intent of SBC 6006 (c) 1. Alternate Building Envelope Design Zb utilize the total envelope slstem method, the values established by the sum of i,tems #3 and #� shall not be Greater tha:� the svia o� items #1 arid ?�2. � . � %y�� � + 2 . � Z� �, = ��� 7- � � " � ,, ,/ 6 � . 3 '% + 4 . � ' � �. _ �L � �� • �/� WALL SECTIONS NOTE: Use 10$ af opaque wall area for ` frame construction � ., ,, ; � r � . , ,, � �. �, � . �G. #3 FRAP3E taAT•T• � ��d,� �.._ ,' � ' cy _ . � ` � [.L ' � • t . . • � �., ` : . , � . � ' � - Page 3 of 4 Construction R-Value 1. Interior air film 0.68 2. ' L �, 3. � �';� s T✓b . 3S' a . �'` _ _ �,�t� f� S-�.. _ l - ! 5 . �/, � w�� �t �' � 0• � �6. Exter�r air film 0.17 Tota1 ,,, � � � • � 3 l. Interior air film 0.68 2.' l,'' S 2, 0' .�' 3. � '��j = _�i N Sv_L' /% 4. `^,y �. ���`L��S'�., � �. 1 5. ����,r �,�son►� r�- o. c, 6. Exterior air f ilm 0.17 Total / 1�, �� �, b i I 1, Interior air film 0.68 2. ��ti.�' �%%5�1.�, IJ 3 . ► ti� � %Z/ �In �' � I � . '�L �° N 1� -�. , / �I s . '+/ �-o �y } �, a. C 6. Exterior air f ilm f1.17 . b� Total 'S- _ `� 1. Interior air film 0.68 ''6 . - 2 . . . /� - - - _ 3 . i� � �'R f � � �J � ��- �` .'L � 4. 5. 6. Exterior air film 0.17 .�A S Total j, . � 'S - � � : \ . . .� , � � 6 . � � • � � a . • � �' ( � ` l..i � � • .��: � �?�T X ' ,, � ` . �,�. . • . '�—� !! ( � � , . ' . ' /<( � , ' . ' , b ' � 111 ^. , _ , r- (t '� ' ' ' -- / � � FIG,. #4 NOT1: : t : • -- ` ' /(/ � . = - - � �� ` � / !!( �s ' �. o �- � - 'iir - -- • .:. ..- x— � �( �c� � � /�� _ lrr = ��, _ � Indicate tyne, "?t" value, depth and placet�ent of insutation. ' . . ' • .--='""� �� . v-���r Vented ROOF/CEILING 3 ) r--{ t: � �iil�,.ii«�.��tt i��i����,i��! � � ----r %i, � 1 2 •• . _��� fleat flow up . . FIG. �5 � � .. , 9A��t;!•.�..N..J���_�i��1.,.:i_ti,,A'S+° C.��C---.l�'^-�-L: ATaI - . �. _. ._._.. � .___.. . . � r"�„"tr' . \J `:.� ���� ��1 . � Heat f los�� up . � , ; •ven�ed• • � � � � . ,FIr,. #kb - . .. . . . �' " . � . _ _ _ 1 �`'" ----f �' . � , v ' li ' irU�C"YL'Pilr.1J . , � . . �� � . ' . Hent � , , ,� � � £law up _ . • , . .; . . .. • F.:�G. N7 � � . • . . Page 4 of 4 Construction R-Vaiue ` l. Interior air film 0.61 2; '/„ s_ rL.. .y� 3. ���" 1 N S V �- 1'3G-o,,,� .��v 4. Exterior air film (still) 0.61 ' Tota1 d�� ,.�N' '�L 1: Interior air film 0.61 2. 3. 4. Exterior air film (still) 0.61 Total 1. Inside air film 0.61 3. 4. 5. Outside air film 0.17 Total Note: Use additional sheets if more space is needed for details and calculations . °� _ �. usuRSAN ��� ` j�� NQIN�ERIN� � �J _ _ _ _ �Nt. _. � Ciuil, Municipal & Environmental Engineering � Land Surveying • Land Planning • Soil Testing � l�uberl Minder. /ieg. Eng. Wm. E. d�rnsen. Reg. Eng. Mr. Dave Harris 6279 University Avenue NE Fridley, Minnesota 55432 Re: Lot 21 Block 2 Harris Lake Estates Dear Dave: �/ � 0 .� �1 � �� ,v Main Office 571•6066 6875 Highway No. 65 N. E. Minneapolis, Minnesota 55432 South Office 890-6510 1101 Cliff Road Burnsville, Minnesota 55337 October 15, 1976 �,�1 ..� . � �� ��' At the request of Jerry Belair, on October 5, 1976, we examined the excavation on the above subject lot. Several hand auger probes, to a depth of 3 feet, indicated all peat and muck had been removed and the lot could be backfilled. After backfilling on October 11, 1976, we ran two density tests.at footing grade. The tes.ts,.passed at 1.04.%. and 106� of modified Proctor density with 90� being the minimum acceptable. Based on the above, it is our opinion that the foundation material is satisfactory to support a typical single family framed dwelling. If you should have any questions, please call at your convenience. PJM/jp cc: City of Fridley (Darrel Clark) ,lerry Belair E. A. [{athbun, Reg. Suru. Wm. K. Meyer, Reg. Eng. Sincerely, SUBURBAN ENGINEERING, INC. "c� i�� ��.r- Peter J. M linaro Project Engineer Wm. E. Price, Reg. Eng. N. William Rogera, Reg. 3uru. Gary R. Harris, Reg. 3wu. 0 � ri1�Y OF FRIDLEI' APPLICATION FOR PUI,f�ING AtiD �AS FITTIh� aEr^u`^�IT � � .. j T� �,� �r � �� �. ; � .:3��� �r �^� �, ,.� � :� �� � d ;. t / � c � ,I ( f:�•:.;.or :J +� 1 "'� �"' � L^ I' � l ? .a •. � ^ .. Y � ,i � � ? i. � � r' I - .. � �, �t` ' � ,- I .. � X i J G '� . � G U i j �� t �� � f ^ � ;� � L.� � p � o -� I �'� I c� i�^ a �I ,.+ � ey J ,.y r r; I �� � , I t� C.! ( � ' .=, f tn .- O... � c: V G I 2.— I C� I �— O ;�1_: i i E :�,i I Ir! � I/{ ,i IW/- 1 I I �l- 1/ i �1i/I ` �....�� ��� � 4 ( 3_���i���� ��:i !i�ii (F.i = . ���_ _ .....� ec _:o^ G:�aiag (�i = ..C'.! '�1....�E. �:'� .ri_ =..11i� � Con:.�c:_.. �.rit:1 PARTIAL RAiE SCHEJULE � PL:::lri\G iiXTU�E ?L�.TES: \0. R�TE ..,�..,�� ?i�::t:: es �� x 53.00 c^a_.._e r.......ze C�e^i^a x 52.00 ::c:. ?i:c:s_c, Q�d Coc^'_ng x 52.00 w'..=:1 �:._.::1 X $=.Ci� ��___ .:catcr - to 9Q.c�o a:J _� . sS.00 '_CO,��� .._„ to :99,000 3TC r. 510.00 �;atez cC_`t_re: x 57.00 Z;c•.+ Gro:::: ?_r. 01Z Build.ing _ x 55.00 E:ettric �.�_�_ �:cater x 55.00 G.�.S :IT�:::G .��S: Ist 3 ..ir.L::res _� x `,3.00 :.��:tio :al r�ccnr^_s r. $1. UO Gss R:.-Se =o :99, 000 B.0 x 510. 00 R=?:;:RS $ :;':.Tc� 4TI0\S ___st J:C�.JJ S�•OO ea_h a�3. S_00.00 or °=act:on a2•CO 5`ate Surcharge mCi�iw Ff..-� . a�..�..Ji:.���v.� F�._. • �S.'Q•C�� �� $n4:..� 1'it�t�i TOT:�L S ,�� S S $ s 5. vU S S S S S 3_vv S S S S - $ .50 S _��_,�. _S� �,,;, �>�� � �/ ` � ��` .:05 �+�a_��SS ,� � .Ji:i�:l � t.'lt: O� .rillllC:l:l�`3 C;��f O� :��:.CGic`j/ . Tcl. ,-.,71-3.:i0 1hc u7dc:siqncc: hcreby �akes apalicatio� °or a per�it for the �.vzk herein snccified aqrecing to do a11 .:ork in �.._:c= accorZ�ir.=e �.+:th t'r.e Ci:y C�.�'.es and rul.ing� of the Depa� � cr.t O� �L'11��:1CS� �nd ::ereby deciar�s t4s;. ai. tne facts and reo:e�c.^.tatio^s st��ec _.. ....:s a�oL•catio.^. �._� Cn:e ar.d eorre.^.t °ridlcy. �1. _ � '�I , =°� ow.s� ;��,�'�f' -Yi--3�=� F.,. � KI.ID OF i:UILDZ\G 1JvA:�i �J �� TO Bc CO:•:?i.ETED I�?CUT ESTI.`�'�TLD COST ' �� �'` �- OLD - hEW 3liIi.DI\G P�R.VIT �O. PER.u�T \O. /� � � , Co^;�ar.y i- � Si,^ed 2y ��z'Z�"r'�-� . TC�•. :.U. � / � _ �� ,.T -��?_,�. ,� <,. tw ROUG:-I INSP. Date Fzr;,'u, ivsr. �j ' ,s'—r % % Datc APPROVAL :OR P�f':ZT _1%�'//_1� MZ:vIN.Ut^. FEE FOR A.�Y PL'JMBItiG P�RV�T ZS S7.50 CITY OF FRIDLEY APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRI6ERATION AND .AIR CONDITIONING SYSTEMS AND DEVICES PARTIAL FATE SCHEDULE GRAVITY WARM AIR: RP.TE TOTAL Job Address ���� (%�Z��,�("�2•� F'urnace Shell & Duct Work $1?..00 $ 1�,; , Replacement of Flxrnace 7.00 $ Repairs & Alterations-up to $500.00 7.00 $ Department of Buildings Repairs & Alterations each add. $500.00 4.00 $ City of Fridley Tel. #571-3450 MECHANICAL WARIN AIR: Furnace Shell & Duct Work to 100,000 BTU each add. 50,000 BTU Replacement of Furnace Repairs & Alterations-up to $500.00 Repairs & Alterations each add. $500.00 STFAM OR I-IOT WATER SYSTEh9: Boiler & Lines up to 100,000 BTU each addn. SO,U00 BTU Boiler only up to 100,000 BTU each addn. 50,000 BTU OIL B URNER- to 3 ga1. per hour each add. 3 gal. per hour GAS BURNER- £rom 100,00Q STU to 199,999 BTU {over 199,999 BTU see Fee Schedule) slz.00 �.00 7. 00 7.00 4.00 $ �Z. G'G S S $ $ $1'1..00 $ 4.00 $ '1.00 $ 6.00 $ $1().00 $ 10.00 $ Siu. oo S iv dU $ GAS FITTING FE1;S: lst 3 Fixtures x$ 3.00 Additional Fix tures x $ ]..00 Gas Range to 199,000 BTU x$10.00 AIR CONAITIONING FAN HEATING SYSTEMS 5ee Fee Schedule VENTILATING SYSTEMS ALTERr1TI0NS � REPAIRS � � 7�� ��,�� State Surcharge t K r T �iY y r TOTAL FEE ROUGH INSP. Date FINAL INSP. �-��/^ %(� Date APPROVAL FOR PERMIT i� REINSPECTION FEE (.$10.00) S 3�Z. $ S S� S $ .50 S ' . � MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50 PLUS $.50 STATE SURCY�IRGE The undersigned hereby makes application for a permit for the work herein specified agreeing to do all wark in strict accordance with the City Codes •- and rulings of the Department o£ Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Fridley, Minn. � i� �/ � 19 % 7 OWNER c%-�iC /i� ���y /L / )L �GrL $~ KIND OF BDILDING Gti .`G ��' /J %l� ��1� � USED AS ��2 ��r �L � �-'�� C9- TO BE COMPLETED ABOUT C� ��S' 7� -7 U�- ESTIMATED COST �J L��� �,�; ( � OLD - NEW BUILDING PERMIT NO. PERMIT NO, C'�Ir .1 DESCRIPTI9N OF FURNACE/BURNER HEATING or POWER PLANTS, Steam,,Hot Water, Warm Air- No. �/ > � � � Trade Name t�./j�y�-F� ✓� Size No. ��iy/S� /�/li Capacity /OT (yj,� Sq. Ft. EDR BT[7 HP ,,/,r� �- . Total Connected Load Kind of Fuel ,�/ N� BURNER - Trade Name� Size No. Capacity Sq. Ft. EDR BTU HP Cnmpany , ,r,w� ����� � ' Siqned By vG� Tel. No. �� � `� � Y,� SUBJECT � City of Fridley � � � �9 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T � � � RECEIPT NO. � � COMMUNITY DEVELOPMENT OIV. ��y� � � �V-'-'.' , � r � � PROTECTIVE INSPECT�ON SEC. � � � � � � �'��1 � CITY H ALL FRIDLEV 55432 NUMBER AEV OATE PAGE OF APPROVED B� �-"'�'� �'' 612-571-3450 910-F15 6/10/97 / / JOB ADDRESS 1641 Camelot Lane NE � LEGAI LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 21 2 Harris Lake Estates SHEET 2 PROPERTV OWNER MAIL ADDRESS ZIP PHONE Nancy Boynton 1641 Camelot Lane NE 571-5351 3 CONTRACTOR MAIL ADDRESS Z�P PHONE UCENSE NO. D& D Home Improvement Inc 11773 Magnolia St NW, Coon Rapids MN 55448 757-7780 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 4840 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ AODITION O ALTERATION C7X REPAIR ❑ MOVE O REMOVE B DESCRIBE WORK Reroof House & Garage (26 Sq) Tear-off 9 CHANGEOFUSEFROM TO STIPULATIONS Underlayment must comply with the State Building Code. TYPEOFCONST. OCCUPANCVGROUP OCCUPANCVIOAD SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK Oii CONSTRUCTION ZON�NG S�. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENOED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTFEET PARKING I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF IAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED �2�145 �L.O7 WITH WHETHER SPECIFIED HEAEIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR GANCEL THE pERMIT FEE SAC CHARGE PROVISI F ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUC ION O THE PEiiFOR CE OF CONSTRUCTION. �74.75 Fire SC, �2.14 if PLAN CHECK FEE TOTA� FEE �J License SC $5.00 $82.96 S�GNATUREOFCON'AACT0�70RAUTHORI DAGENT IDA EI WHEN PfiOPERLY V O.T€D THIS IS Y UR PERMIT W / _ SiGNATUREOFOWNERUFOWNER6U�LDER1 IDATEi i"' �BIDG NSP 06TE NEW ADDN ALTER [l [l �� C�TY OF FRIDLEY SINGLE FAMILY AND DUPI..EXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: /C� Legal Description: Owner Name & Address: Effective 1/1/97 � � � � � Tel. #��--��% - � Contractor: �� � H�p TmrrnVem�n,t� �nc MN LICENSE#� 4840 _ c+-,-oet nira nnn Rani d� SSddR Tel. # 757-7780 Address: 1� �73 Maqnoli a � � Attach to this application, a Certificate of Survey of the �ot, with the proposed construction drawn on 'tt to scale. LIVING AREA: GARAGE AREA: DECK AREA: UTHER: DE5CRIP'TION OF IMPROVEMENT Length Width Height Length Width Height J�ng� Width Hgt/Ground Sq. Ft. Sq. Ft. Sq. Ft. Construction Type: � l-�� � Estimated Cost: $ �l `1 � ��c�uy�E� (Fee Schedule on Back1 �." (J Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x� _� DATE: f� A.PPLICANT: Tel. #� Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STiPULATIONS: $ �� � `�� � �. � �� $ 1 r, `7 $ $ � C�'C�' $ $ $ $ � c; � < <' CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation {1/10th%) $.50/$1,000 Valuation $9S0 per SAC Unit $5.00 (State Licensed Residential Contractors) Ait. "A" or AZt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary ( J Not Necessary [] ,. , NEW ADDN ALTER �oos�- �7r� � � CITY OF FRIDLEY �� 6431 University Ave NE, Fridley, MN 55432 (] StNGLE FAMlLY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: Legal Description: ,_ Effective 1/1/2003 (763) 572-3604 Bidg Insp �763) 5T1-t287 Fax Owner Name & Address: Contractor: � \ C�s� Address: 'J��J�7 :�.vl,iT Tel. #�.3" J`��%l-Jr35� � MN LICENSE # o�a�o�� � � IV Te�. #� 5 I- a�3 -o� �9 � ss/a� Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: �ength Width Height _ Sq. Ft. GARAGE AREA: Length __ W�dth Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Constn.iction Type: ` ` Estimated Cost: $ �3 �� Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: ��P APPLICANT: � Tel. #�pSl"�3'��� �! Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-128T if using credit card and we wi!! call you for card number. CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge $�a,3. 0'�.5 Fee Schedu(e on Reverse Side $ /3, DO .001 of Permit Valuation (1/10th%) $ � SD $.50/$1,000 Valuation $ $1275 per SAC Unit $ 5, DD $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 [ J _ ..TOTAL _ . ._ .:.. _... $ .�. � 7 . _ �TIPI 11 ATIQNS� .. ... , ._. .. ... . ,. ,.. ._._ . . .._.._ ,...