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AF - 36105Village of Fridley, 1Vlinn. BUILDING P�RNdIT � � � - ..�',�°� Date: ..�. . .. ... .... .... +�%- Owner . � .�� . .�� �c�"�' ��° _ � �;�':'"�'' Address . . ;� !�° '� . . . .�G��� �:�: .�."�.`� � _=��—� ,i �i° 1655 Buiider............� ...........................:...... Address.............................. ............ � L .�C [O�,N pF BUILDING No. �. �. :�� . . Street . . . . . ��. . .�. �� . . . . . .�.�. :`. . . . . . . . Part of Lot . .�. . . . . . . . . . . . . . . . . . . . � . .`l�J�-�? .�9�rv�.r. . . . . . . Lot . .. . . .. .. .. .. . Block . .. .. ... . .. .. . Addition or Sub-Division . Corner Lot .... ..... Inside Lot .. �.... Setback ........... Sideyaxd ............................. DES,� R[P 10�1 OF �,UILDI�aiG "' To be Used ,�s: �"� �t' � +� : �9.r� .�rc #� ��z'.�,z'.�°' � ,,.;�'�� �'�'� � �� �� . . . . . . Front . . . . . . . . Depth . . . . . . . Height . . . . . . Sq. Ft. . . . . . . . . Cu. Ft. . . . . . . . . .............. . .... Front ........ Depth ........ Height .... . Sq. Ft. ........ Cu. Ft ........ Type of Construction .................. Est Cost ..................... To be Completed .................. ��.: �� �� r��. i� �.� te �= � ,� .4rraL6atr ,,r. 1 � ����:.ir- � ��� � e r ' %��'�k�� � ���.����� i�ei + G�+� � � �� • �� , � .�- s ��;�'� on de n. of the is�uance to me of a permit to construct the building described above, I agree to do th roposed work in accordance with the descriptian above set forth and in compliance with all provisions of ordinances of the village of Fridley. t�"' � � r � • + ..�...- � �, b � "'r � , K •' �' s �°�d!_�k� ��� ` � ,''�'���- • n �,�z . . . . . . . . . . . . . � � �d� Tn considerafaon of the payment of a fee of $. :� ......., permit is hereby granted to .'�°F:�� .. . �',,� ;� �' t .. �:' ����� . . . . . . . . . . .. . . . . . . to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, em.ployees and worl�nen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of bwllaings with- in the village limiis and this permit may be revokecl at any time upon violation of any of the provisions of said ordinances. � : .�.�. . . .� � . Building Inspector .. ����i .• .��..• NOiBGE: 7his permit does not cover the constructian, installation or aiteration for wiring, plumbing, gas heating, sewer or wafier. 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'� „ R �D � w 7 n _ � CIIYOF FR[DLE,Y FRIDLEY MUr1ICIPAL CENTER • 6431 UTIIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287 May 6, 2002 Donald Nelson 5971 Central Avenue NE Fridley MN 55432 Re: Paved Driveways Dear Mr. Nelson: In 1997, the City Council adopted an ordinance declaring gravel driveways a public nuisance. They were declared a public nuisance for a number of reasons, such as: they can cause erosion, contaminate soil with oil and other vehicles fluids, and deposit soil and gravel in the City's storm sewers and detention ponds. When gravel driveways were declared a public nuisance, the City Council gave property owners five years to have their gravel driveways paved. The five-year deadline is quickly approaching, which means all gravel driveways within the City of Fridley must be paved with approved concrete or asphalt by December 31, 2002. If on December 31, 2002, your driveway hasn't been paved a citation will be issued and filed at the Anoka County Cou�thouse. A misdemeanor citation is a criminal offense and is punishable by up to 90 days in jail and/or a$700 fine. If you've already paved your driveways, Thank you! Please call me at 763-572-3595, so I can update our files. For your convenience, a brochure on the City's loan program has been enclosed. You can use this loan program to acquire financing for your driveway improvement project. Please call Jim Hesnik at 612-335-2651, if you have any questions regarding this program. Thank you for your cooperation! As you successfully complete your driveway improvement project, please call me at 763-572-3595, so I can do an inspection of your property and update our files. If you have any other questions, please feel free to call me at the above number. Sincerely, Stacy St mberg Planner C-02-53 _ _ CITYOF FRiDLEY FRIDLEY MIINICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287 May 6, 2002 Beverly Nelson 37438 Dolphin Street NW Princeton MN 55371 Re: Paved Driveways — 5971 Central Avenue NE Dear Ms. Nelson: In 1997, the City Council adopted an ordinance declaring gravel driveways a pubiic nuisance. They were declared a public nuisance for a number of reasons, such as: they can cause erosion, contaminate soil with oil and other vehicles fluids, and deposit soil and gravel in the City's storm sewers and detention ponds. When gravel driveways were declared a public nuisance, the City Council gave property owners five years to have their gravel driveways paved. The five-year deadline is quickly approaching, which means all gravel driveways within the City of Fridley must be paved with approved concrete or asphalt by December 31, 2002. If on December 31, 2002, your driveway hasn't been paved a citation will be issued and filed at the Anoka County Courthouse. A misdemeanor citation is a criminal offense and is punishable by up to 90 days in jail and/or a$700 fine. If you've already paved your driveways, Thank you! Please call me at 763-572-3595, so I can update our files. For your convenience, a brochure on the City's loan program has been enclosed. You can use this loan program to acquire financing for your driveway improvement project. Please call Jim Hesnik at 612-335-2651, if you have any questions regarding this program. Thank you for your cooperation! As you successfully complete your driveway improvement project, please call me at 763-572-3595, so I can do an inspection of your property and update ourfiles. If you have any other questions, please feel free to call me at the above number. Sincerely, Stacy Stromberg Planner C-02-53 _ _ �.1� OF FR[DLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287 July 2, 2002 Donald Nelson 5971 Centrai Avenue NE Fridley MN 55432 . Subject: Paved Driveway Reminder Dear Mr. Nelson: This letter is a friendiy reminder that all driveways within the City of Fridley need to be paved by December 31, 2002*. As you are aware, the City Council adopted an ordinance declaring gravel driveways a public nuisance. They were declared a public nuisance for a number of reasons, such as: they can cause erosion, contaminate soil with oil and other vehicles fluids, and deposit soil and gravel in the City's storm sewers and detention ponds. When gravel driveways were declared a public nuisance, the City Council gave property owners five years to have their gravel driveways paved. The five-year deadline is quickly approaching, which means all gravel driveways within the City of Fridley must be paved with approved concrete or asphalt by December 31, 2002'`. If you've already paved your driveways, thank you! Please call me at 763-572-3595, so I can update our files. For your convenience, a brochure on the City's Ioan program has been enclosed. You can use this loan program to acquire financing for your driveway improvement project. Please call Jim Hesnik at 612-335-2651, if you have any questions regarding this program. Thank you for your cooperation! As you successfully complete your driveway improvement project, please call me at 763-572-3595, so I can do an inspection of your property and update our files. If you have any other questions, please feel free to call me at the above number. Sincerely, Stacy St mberg Planner *If on December 31, 2002, your driveway hasn't been paved a citation will be issued and filed at the Anoka County Courthouse. A misdemeanor citation is a criminal offense and is punishable by up to 90 days in jail and/or a$700 fine. C-02-83 _ _ CI"iYOF FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287 July 2, 2002 Beverly Nelson 37438 Dolphin Street NW Princeton MN 55371 Subject: Paved Driveway Reminder Dear Ms. Nelson: This letter is a friendly reminder that all driveways within the City of Fridley need to be paved by December 31, 2002*. As you are aware, the City Council adopted an ordinance declaring gravel driveways a public nuisance. They were declared a public nuisance for a number of reasons, such as: they can cause erosion, contaminate soil with oil and other vehicles fluids, and deposit soil and gravel in the City's storm sewers and detention ponds. When gravel driveways were declared a public nuisance, the City Council gave property owners five years to have their gravel driveways paved. The five-year deadline is quickly approaching, which means all gravel driveways within the City of Fridley must be paved with approved concrete or asphalt by December 31, 2002*. If you've already paved your driveways, thank you! Please call me at 763-572-3595, so I can update our files. , For your convenience, a brochure on the City's loan program has been enclosed. You can use this loan program to acquire financing for your driveway improvement project. Please call Jim Hesnik at 612-335-2651, if you have any questions regarding this program: Thank you for your cooperation! As you successfully complete your driveway improvement project, please call me at 763-572-3595, so I can do an inspection of your property and update our files. If you have any other questions, please feel free to call me at the above number. Sincerely, Stacy St mberg Planner "If on December 31, 2002, your driveway hasn't been paved a citation will be issued and filed at the Anoka County Courthouse. A misdemeanor citation is a criminal offense and is punishable by up to 90 days in jail and/or a$700 fine. C-02-83 � _ CITYOF FRIDLEY FRIDLEY NtUNICIPAL CENTER • 6�31 UNIVERSITY AVE. N.E. FRIDLEY, �IN 5�-�32 •(763) �71-3450 • FAX (763) 571-1287 December 13, 2002 Don Nelson 5971 Central Avenue NE Fridley, MN 55432 Subject: Last & Final Paved Driveway Reminder Dear Mr. Nelson: This letter is your last and final reminder; all driveways within the City of Fridley need to be paved by December 31, 2002. As you are aware, the City Council adopted an ordinance declaring gravel driveways a public nuisance. They were declared a public nuisance for a number of reasons, such as: they can cause erosion, contaminate soil with oil and other vehicles fluids, and deposit soil and gravel in the City's storm sewers and detention ponds. When gravel driveways were declared a public nuisance, the City Council gave property owners five years to have their gravel driveways paved. The five-year deadline is quickly approaching, which means all gravel driveways within the City of Fridley must be paved with approved concrete or asphalt by December 31, 2002. If you've already paved your driveways, Thank you! Please call me at 763-572-3595, so I can update our files. The City Council has agreed to allow an extension until June 15, 2003, to those of you who haven't paved your driveway and/or can't get a contractor to do the project until spring. In order to be eligible for this extension, proof of a signed contract from your concrete or asphalt contractor stating that they will pave your gravel driveway by June 15, 2003 must be filed at the City by December 31, 2002. You as the property owner will also be required to sign the statement on the next page, ensuring the driveway will be paved by June 15, 2003. Failure to do so will result in a criminal citation being issued on January 3, 2003 and filed at Anoka Countv. Thank you for your cooperation. If you have any other questions, please feel free to call me 763-572-3595. Sincerely, Stacy St mberg Planner C-02-150 SuB�ECT -- , City of Fridley 3 3 8 41 � AT THE TOP OF THE TWINS g U I L D I N G P E R M I T � ; � RECEIPT NO. � • COMMUNITY DEVELOPMENT DIV. � LV ����� � ���/ r � � PROTECTIVE INSPECTION SEC 1 ; � � � �"'1 � CITY HALL FRIDLE� SS1JY NUMBER REV DATE VAGE OF APGqOVEO B� �""-'� � ��� 763-571-3450 910-F15 8/29/03 / / 10B ADDRESS 5971 Central t�venue NE t LEGAL ��7 NO. BLOCK TRACT OR AODITION SEE ATTACMEO oesca. 9 1 Meloland Lakeview SHEET 2 PROPERTY OWNER MAIL AODFiESS 21P PHONE Patricia Kilian 5971 Central Avenue NE 763-572-9202 3 CONTRACTOR MAIL ADDRESS ZIP PMONE LICENSE NO Same 4 ARCHITECT OR DESIGNER MAIL ADORESS ZIP PMONE LICENSE NO S ENGINEER MAIL ADDHESS ZIP pHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK 0 NEW ❑ ADDITION D ALTERATION � REPAIR O MOVE O REMOYE 8 DESCRIBE WORK Reside gable ends of house; Reroof house & garage (18 Sq) tear-off; Replace all windows wit in existing openings 9 CHANCiE Of USE FROM TO STIPULATIONS Per Section 1402, 1997 Uniform Building Code, requires that a weather resistive barrier be placed over exterior sheathing to protect the interior wall covering. Exceptions for this provision would be if sheathing is an approved weatherproof panel or when the siding is an approved weather barrier. VinyZ siding is not a weatherproof covering unless the manufacturer states this in their appZication guidelines. Call for inspection of wrap before covering or take pictures. Caulk and flash all exterior openings. Underlayment must comply with State Bldg Code. Provide smoke detectors in alI sleeping rooms and on all levels of the dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code. Caulk and flash all exterior openings. SEPARATE PERMITS AFiE REOUIRED FOF ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GiiOUP OCCUPANCV LOAO VENTILATING OR AIR CONDITIONING TMIS PERMIT BECOMES NUIL ANO VOID IF WOFK OR CONSTRUCTION 20NING SO. F7 CU FT AUTHOR12ED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO DWLG. UNI7S OFFSTREET PARKING I MEREBY CEHTIFY THAT 1 HAVE READ AND EXAMINEO THIS APPLICA710N 1 STA�LS GAiiAGES AND KNOW THE SAME TO BE TiiUE AND CORFECT. ALL PROVISIONS OF LAWS yqLUATION SURTAX AND ORDINANCES GOVERNING THIS TVPE OF WORK WILL BE COMPLIED @ WITM WHETHER SPECIfIEO HEREIN OR NOT. THE GRANTING OF A PERMIT W1O�000 �S.00 DOES NOT PRESUME TO GIVE AUTMORITV TO VIOLATE OR CANCEL TME pERMIT FEE SAC CHARGE PROVISIONS OF ANV OTHER STATE Oii LOCAL LAW REGULATING CON- �181.25 Fire SC �LO.00 STRUCTION OR THE PERFORMANCE OF CONSTFUC710N PLAN CM CK FEE TOTAL FEE F�a. e SC $N/A $196.25 S N4T E OF CON'RACTOA O nu i2ED 4GENi �D�rEi NEN PROPERLV VALIDATED THIS IS Y R PER IT . � q �� � S�GN4tUqEO�OWNEQ��FO EABUiIDERi iDA E� BL G ihS� r���E � NEW ADDN ALTER [] CITY OF FRIDLEY Effedive 1/1/2003 [] 6431 Unive�sity Ave NE, Fridley, MN 55432 (763) 572-3604 Bidg Insp [] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION Construction Address: Legal Description: � � � l ���� %�'-YL /TY � /�" � Owner Name & Address: Y'�/�f:fl� 1�-� �/� Tel. #��3 ��v�'�c� Contractor. � CN� � MN LICENSE # Address: Tel. # LIVlNG AREA: GARAGE AREA: DECK AREA: OTHER: Attach to this application, a Certificate of Survey of the lot, vaith the proposed construction drawn on i# to. scale. DESCRIPTION OF IMPROVEMENT Length Width Height Length Width Height Hnt/Ground �� � �� � S . Ft. �' � 4 ��� . Sq. Ft Sa. Ft. ! Constnaction Type: �� Estimated Cost: $�l�i ��� Driveway Curb Cut Width Needed: Ft. + t= Ft x$ _$ DATE: �/� ��� APPLICANT: l f Tel. #7103 � 70� �/�� � Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will 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 ��lt� � ����5.� $ � � C�D $ , $ $ $ $ $ $ `, Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1275 per SAC Unit $5.00 (Stat� Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] $ l K � � _.. BUILDING PERMIT FEE SCHEDULE The Chief Building O�cial 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 structure, upon application therefore, require the payment by the applicant for such pernut 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 $500,000 $SOU,�1 to $1,0�,� $1,(}00,001 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 $1,000 or fraction thereof, to and including $25,000 $391.25 for first $25,000 plus $10.10 for each additional $1,Q00 or fraction thereof, to and including $50,000 $643.75 for first $50,000 plus $7.00 for each additional $1,000 or fraction thereof, to and including $100,000 $993.75 for first $100,000 plus $5.60 for each additional $1,000 or fraction thereof, to and including $500,000 $3,233.75 for the first $500,0� plus $4.75 for each adciitional $1,000 or fraction thereof, to and including $1,000,000 $5,608.75 for the first $1,000,�0 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 l� 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 � SuB�ECT �°{� - City of Fridley 387 � AT THE TOP OF THE TWINS g U I L D I N G P E R M I T � ; � CEIPT NO. � `y �����_ COMMUNITY OEVELOPMENT DIV. `^� r � � PiiOTECTIVE INSPECTION SEC. �6iI �� 1 ; i � � r'�'1 � CITY NALL FRIOLEV SS��Z NUMBER REV DATE PAGE Oi APPROVED BY �'""� � ��' 763-571-3450 910- F 15 9/ 12 / 03 / / J08 ADDRESS 5971 Central Avenue NE t LEGAL LOT NO. BLOCK TRACT OR ADOITION SEE ATTACMED DESCR. 9 1 Meloland Lakeview SNEET 2 PROPERTY OWNER MAIL AOORESS ZIP PHONE Pat Kilian 5971 Central Avenue NE 763-572-9202 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Donnelly Stucco 2500 E 25 St, Minnea olis, MN 55406 612-722-4200 202 68435 4 ARCHITECT OR DESIGNER MAIL AODRESS ZIP PMONE LICENSE NO. 5 ENGINEER MAIL AODRESS ZIP PHONE LICENSE NO 8 USE OF BUILOING Residential 7 CLASS OF WORK ❑ NEW O ADDITION 0 ALTERATION �7 REPAIR O MOVE ❑ FiEMOVE 8 DESCRIBE WORK Patch and redash house & garage 9 CHANOE OF USE FROM TO STIPULATIONS � �' �� �r�� e�to�n Cards ill � ip� 0 o eo ��r To P��� SEPARATE PERMITS ARE FE�UIRED FOR ELECTiiICAL, PLUMBING, MEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAO VENTILATING OR AIR CONOITIONING THIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONSTRUCTION 20NING SO. FT CU FT. AUTMOiiIZED IS NOT COMMENCEO WITHIN 60 OAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERI00 OF 120 DAYS AT ANY TIME AFTEii WORK IS COMMENCED. NO DWLG. UNITS OfFSTREET PARKING I HEREBY CERTIFY THAT I MAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SUR7Al( AND ORDINANCES GOVERNING THIS TYPE OF WOFK WIIL BE COMPLIEO @ WITH WHE7HEA SPECIFIED MEREIN OR NOT. TME GRANTING OF A PERMIT y�S�9OO ��F.�FS DOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE OR CANCEL THE pEqMIT f EE SAC CMARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR TME PERfORMANCE OF CONSTRUCTION �167.ZS Fir SC �H.9O PLAN CNECK FEE TO L FEE Lice SC $5. 0 185.60 S�GN4TU�7E OF CON"AACTOR OA AUTMOA�ZED 4GENT IOATEi HE PF� V VALI T D THIS IS R ERMIT S�GNniuqE O� OWNEAiii OWNEABUILDEAi iOATE� �� B G�h5� q`i SEP-09-2003 09�29 FROM CITY OF FRIDLEY TO 6127212091 P.0�i05 NEW (] C1iY OF Ff�lDLEY Effedive 111/2003 ADDN [ J 6431 UniversRy Ave NE, Fridtey, MN 55432 (763? 572-3604 Bidg Insp ALTER [] SINCLE FAMILY AND DUPLEXES a-9 AND R-2 (763) 5'�1-1287 F�x BUILDlNG PERMIT APPLECAT[ON Constructian Address_ Lega( Description: Owner Name 8� Address: Contr�ctor. �D �(?F Address: � `J (7 � � LIVING AREA: GARAGE AREA: C1�CK AREA: OiHER: �� � r� �� �� Te1. # � 7 — ZO� � MN LICENSE #� C Z� p?j� �.=f�,� � Tel. # � ��- 7�� �7Z� Attach fia t��is application, a Certificate af Survey of the lot, with th� praposed construction drawn on it to scale. DESCRIPi'ION �F IMpFtOVEMEIiiT Length _ Width Height Sq. Ft_ Length Width Heipht Sq. Ft. Length Width Hgt/Ground Sq. Ft. Constructian T e: �� � f"� `� yp L�r� !f �� � Estimated Gost: � ��l.t�s f3rivewa�y Curb Cut �dth Needed: Ft. + 6 Ft = Ft x$ =$ DATE: �J _ APP�.IGANT: t z7�-, Tel. #�l�' %� Y�� CaI! (T83) 572-36�p4`far Permit Fees if mailing in application. Fau to 763,579-7257 ii using credit card and w� will calt you far card r�umber. Permit Fee Fire Surcharge State Surcharge SAC Charge E.icen�e Surcharge Curb Cut Escraw Erosion Contral P�rk Fee Sewer Main Charge TdTAL CI`CY USE ONl.Y - � ��%�„ $ � • l� $ $ $ � �c� $ $ $ $ $ 1��: �6 . Fee Schedule on Reverse Side .001 af Permit Valuation (1 /10#h%} $.50/$1,000 Valuation $1275 per SAC Unit $5.00 {State Licensed � Alt. °'A" or Alt. "�,° Abov � ��� � $450.00 Cons�nration I F�e Determined by Enc tt•� �' �� , ,� � ��-�� c ° �-'-� Agreement Nece�sary j �. � �uv ���c�. . L►�Su�►�� �,, w� (I b l� �1 �.tiP� �-e-�� o� �-� t �fyau� o `%� � �°� ° ���,i� 7� �r� (� �a-���-Y�-� e ��CUJ``e !Y`�L� ( �v��,l ` � APR. 27. 2��5 � � � � � _1 n z (��' A v .1 T iL ` ,+ v, � x � � .�—. � � 1� \. � � r `A rn -� � O � D r '� m m m v � � n � � m G � ' O p �o G (J1 � �' � �� � Z �— � v � � � m � ,� 3 � C � ?� � �� � � N� d � � N A� r�r � � � O z� � c�'n w %� Q O o � rno � 9� 30AM � O � ��M� �R�� SONS, �, � � n o0 m � _' �m . � � � ' � Q� � � � C <�j ~ ��° "' � � m � " � s � �' � z O � � � � � �, � � ' � � N � � -1 � �. � Z � �� � � ' • r ,� � � C � m y� � � � ��, � . � � �� � m �' b ,�, ,l!7 �v � � r� � � � I I o I J I I I � o � � � . � � Z � m r $ � � � � � �^ L '� C � � � 0 � ��,�� O Q,Cwal �� p ��� 1/1 i!1 � v C.� S tg � d 4 G C► g O f � � C "� 1'� � v_ z o � �c� � � o m v � N �E . G,1 � , �. � 0 � � m � 3 1 z 0 � z m z � � � � � O � � .� y, • � iL' �• C `� � � °, � �' m �� � m �. °c° o m � o �' v � � ?: o � w �. � a � y � �; a �' a � � � � � o Q p� N � � � w N � � ,�„r � o -, �c�� � � � � p �C -� w � �' Vi � (D a� I � O D r O m � :� 1' � � N0. 705 1'• 2,�g _ v '� � '— °' a c� ��� c" =c C �` �" � NJ 7' �• � n cn r� T �. g � `� � � b N � � s t° m " 2 ,� '`r m �' 4 w � �. y ,�� v, �'' ` _.V► � N C` m � , � . z° < „ � C � �Z C � � m D _ �m � -c � O �.�., � � ' � D �C r -.1 .`� � 0� N .� � 1 0 0 m � z r�- G � �. � �� r Z v G� - O � Z � a v x � �� � N � O � � � � -� z � � " '� m �m m -i � � '�;� '�' �;, �� �, .�` ji� � � N � � O r^ O -� � 1 � A (i , � �p� I--: V1 vi� / �,z.' APR.27.2005 9�3aAM MCG�IRE& SONS N0.70S P.3/3 �� FILL IN COMPLE7ELY FOR REPLACEMENT FUEL BUF�NING APPLIANCE PERMITS COMMQN V�NT, VENT CQNNECTQR ANQ �QMQ41S'TIQN AIR 1/�RIFICATIQN When _r_e�lacinp_a�n �xisdng t��, the undersigned hereby verifies that the venting has heen examined and is free from rust, deterioration, obstructions, and is secu�ely supported end firestopped where required. Yes () No () 7he venting system is plasticJPVC and meets all current codes and m�nufactur�r speCifications including sizing, length, number of elbows and terminatibn. Y�s () No () The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacture�'s sp�acfficatians. This dbes include AGA GAMA Category I Central Fumace Venting Tables for fan assisted and natural draft appliancas. The existins� cnm6ustlon ai is sized and instelled to meet the cuRent codes and manufactur�er's specifications. ' Vlfhen required to i�tall � neKr comdustion at,ryit will be sized ar�d instaped to meet the current codes and manufacture�'s specifications. Yes ( ) No ( ) Yes ( ) Na ( ) Yes ( ) No ( ) When ir�s�.allin� a n�w ventinA svstem, the undersigned hereby verifles that it is a listed assembly and mests the current codes and manufacturer's; s�ecifications. This does include AGA-GAMA Category ( Central Fum�ce Venting Tables for fan assisted and natural draft appliances. � Yes () Is the common vent and vent connectors sized and installed cotrecfly �ftar an appliance has been �emoved from the oommon vent and vented separately as per current cades. (Vo ( ) Yes ( ) Na ( ) Appliance Tvae and Si�e/Common Vent and Vent Connector Information Appliance #1 Type ' 1„ bi �2✓ � BTU Input l0� � Fan Assisted o� Nat �,55i 5� Appliance #2 Type B7U Input � Fan �ssisted or Nat Appliance �13 Type ' BTU Input,� Fan Assisted or Nat � Total Appliances Total 8tu lnput Common Vent Type Vent Height Diameter � inches Appliance #1 Vent Connector Height ft Length �ft Diameter�in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (pescribe) ,,. , , HEATI NG CO: ( r`�(,'t,(,� I' � r'�1,1/l� c��?Yl S Signed By; ���� D .�'p � �}� Date . _�{-02�-� d .S'� JUL-28-2010 �ED Q9:01 AM E�a��eerin.g 763-572-3552 7�3-571-X287 fax �/ �v WA1�� .A�TII SEWER ��lIT APP�XC,A.'TION ��TY UF Fi?�3�.,�X �xx�c�vE �izrxo�o P• 00 � —c�f� s`-� Pe�t Received By; ( Date Rec'd: �� AFPLI�,A.'��OiV DATE�,a� t _'-� G" � �C� YQUR E-MAIL/FAX: THI3 ,APPLIC.�,iV'�' IS: Cf OWNER COANfRACfQ�t — JOB ADDRESS: �d � G� C'r1 '`°t .s� v xt ./�.�'� N&W CO'NS'�'RUCTION PERM!'1'fi� (IF t4PPLICABL�}: _ �'�tQpERTY OW��/ TENAN'�' � nnn�ss _S� q 7'/ � e v+.� -� f ..�'9� e. �ONE: � - - Q 0 G/ s�-� '�� C;UNTRACTOA NA�:�%`p a M f dc+•,�St 1�•ar� d�l'� ' Pr� ��i�J�.�7 i�'!�� �•, f: �.�ci SITBMl?'.� G+P�PX OF ADDRE3S: Y' — _ YOU�i'S�'it� " � �''Y'"�' CITY_. �j„+� f� � STAT��'�xp ��5'�// �,tc',�avs;� wl�t �torr� !,z :�'�} ,� ` S� q.� cs�.L.�aor�: �PP�(CAT'!ON STATE LIC # � ��v� � � ��. f S'1'ATB BONB: B33� z]AT'E: .�e� � X. �ia � tzvclwMttea desc�ni�tion: �' vv�t.f'_' r� ` � • e�� I " � � �• t''�l �'1'�'v �` t n. o r ' ..-� a � .�I'/�' �-r , • 2. PIeaae e e1� skede show�ing curb line, ntlIity � me, build' , et�e. witl� d�sta�nces on bac page. �. St��uistions• � � / ,--� �� -� _ � � � —� � 5 � ��C�� 1�iflTE: G��� ' '. �� � 7 � � 35� S � � j . ��..�,�: � �-L.�-�-$�r�. �1 5�u--���� .d �.-� `� �*E�itVQT TYPE ❑ SEWW��t CONN��TION �E�' Q WATER CO��'�(]N P�IZMIT ❑ W,A.'�R LINE kE�,q,� �SE�VER I��1VE RBPAYR �AbD ST�i'�,`� SUkkCHARGE S.A,C C�A,RGB @ $2�OQ = $�0 $50 �40 "" $40 � C�id �5.uo - o s� o �' ".` '�U'�A,L � �� � C�� � OTHE�t CHA.RGES (IF A�'L�CA.Bx.�) pAY Ta IJ',['�L�T�' H�LIlYG I�W W��'E�i 11+�TBR C05T – S�B U'��.ITY $YLLING _ SPEC�A.L A,SS�SSMEIV'I'S – SEE �,iN.A�rTCE WATER TAP , SE� �I�TGIIVEETtING 'A,�i, INSP OR SI�T1T C1k�' / EV�TrTINGS, WFB�1VpS 8c HOLIDAY9 � �� s runr rn�u rr r,�„ '�"�II55 IS AN APPLICp�'IQfi[ k'pR A PERMIT NOT VA,I.Ip i1A}TII. PROCE55EI3 � b�ereby a�ly for a wate;r vx sewer (new cohu�ection vr repair) pexmit aa�d I aclmowledge that ttae iu�fo�matioa above is contp�ete and accurate; tlaat t�z� w�ric will be �a caz�farmance witb� the �xdinances and cades c►�"the City of Pndley. Y understarAd this is not a pe�rxnit but only an a�rplication fox a permit and work is mot to st�rt wi�hvut a pez��t. S�GNA,'�URB l'�k' APPLIC '' "� ,�,� �.". PRINT NAMfi� � �/ /F C 9 r, �i�F+ pA'�:� ��•i�-- A.P�ROV�3b HY; �L ' �}AITE: � Z � `C� COPY ��N �� U'�' TY BII,LING (oaay if new meter) O�I1�C WOIi,KS ❑ E�TC�IT�ERAYG City o� �'x�dley �aa�i.neering De�aaxtment 6431 U�iversify Avenue NE, Fz�d�ey, MN' S5432 � 763-572-3352 FAX: 763�571-12$7 � � � � . � � � :.Sl � S � �. � P i�illa�e : g� : �i���e�, ��. ^ ' . #�I3�lC���6 $'!��� . ; �T�' S� 6 ���� af n����� �� su�n��s �; ��r �_��- O�vner �ir�+�,► ; Arc�itec't� �'rid'ey, Minn., �� ��� ; 1e,�� Suilder . LOC��.'IQI� ,OF �3 . TI�TG ; �,;.. `; . : No. Stree€ ��,�+`��� � � Part afi Lot �'" Lot.„ Biock Adclttion or S b-D3vision ° ' �a�„� �' �►q�"��T'�CY I��'���i G`E+' �LTIL�3�I'v`G ", . Fron�.� L)epth._,�,_ I3ei�ht� �toaies__� Manner of Cc�nstructicnc�, fifl �e u�ed as�� �o be completed � ;" Est�n$ted Cost _ . , > . . _ _ ✓ _ .vY, � ;; ;` ,�# Fermit i� 2xereby granted to `��i�etidiii'�;,.�� t(� �,`��p���._._ the buiici�a�� � dvseribed in the aba�re sta�mEnt. TM� .�ermit is grt�nted upon the .expr€sa Co�dition that the <person to who� it is ar�,nied, and liis agenta, e�tpioyees aaid vP'orkmen, in ai2 the work doAe in, aroun� and upon said building, or an� part thereof, �.shall conform in a.11 respects to i3�e qrdi- nances of Fridiey, �Iinn., regarding the constatzetiax�, aiter�.tion, maintena�s�; repa.ir a�d maving; of �u�I�gs within ttre city limzts, and this perrnit ma� �e revoked at any time upon; vio 'on oi any of the g�ravis4gas nf s�i� ordtaances. ` . . spector of �uiidin�`s; , , �� � � � � � � � . AGRE�iFI>IT Al�1D S'�VdRR� S�'`�T�Pk�NT , °: . I� .con�ideration mf: the assue a�d d�livery to LL;�e b�r the In<��ete� of ���i?.d�n�s of �id�� �f t�e ahove pe�nii, I herEby �rree to dc� th� prQ���e� �or�i in �ccc�rc��.�ce v�it.�i the des�ptzt�n' aboye set fo�h anc� acr;��di�ag to the �rc�visioz�s c�' t��e o�c�i�a ��c�w of 1�'rie�ley, a�.d; b�ing �� dul� swarn, � he�eby s�ate a.rid s�y'that the.��et� st�tcr� bq me an� �ts��ai�ec� ��.�he �.i�o�e perr�s�t a�e true as therein stated. ' . �, . ,. , ; ; _ . � �� � : � � � � � � �v.i��cribed and swarn to i�e�€��e nie at Fridl�y, �:�inn��ota, �his-�.< '�-�:.._.�' _ d�y' 4� s � -� � � ��' 3 �, �, . � � r ��