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AF - 37360� �'�1 City of Fridley, Minn. BUILDING PERMIT No 41'� s nate: .....__��et_31,_l9?9 __T owner: Address Builder •----Z'��e . B11ildATB._.._..__... Address ..._�1�.. L3�d�-e .�venue....5outh...��..`_w Minneapol38, Minaesote. LOCATION OF BUILDING rro. --�--5�......._........ Street ....._��-._�1@.--••---........_ ..............._................----...._.-•---------. Part oE Lot :...--�--•---...............__.._......_....�..._......_..___..._.._ Lot ....-----_�L....---....._........ Block ----------..1--�----�---..._......._........ Addition or Sub-Division _---I'��14�._.�,�,.��'.�.�.....�'��,_.�.t.T.. .�. Corner Lot .................................... Inside Lot ..........._g.............--�-�---� Setback ......�s�.�-�---..........._........ Sideyard ..---�'-�•�----............_........._.............__....... Sewer IIevation -.----••-------.._..--_--------••---------.•---.-.•------.---�°--_---•---- ............... Foundation Elevation DESCRIPTION OP BUILDING To be Used as: DW811�II.g--------------�-•-•-•--. Front ....�..��..t...._.. Depth ....._...��.. Height 19t......._.. Sq. F� ....._..._7� Cu. Ft. _1_4.s.5g2 ...._ .............._....... --..._....................... Front ........................ Depth .........;.........._.. Height ........................ Sq. Ft. ....._............._.. Cu. F� Type of Construction ........._Ft'sII1Q .................�� -� .. Es� Cost......�g��+�............................. To be Completed --�--••--.•--•••---..... When applying fbr fliture building permits on this part3cular -type oF dwelling� please refer to the Number of this Building Permi.t. In consideration of the issuance to me of a permit to construct the building described above, I agree to do the proposed work in accordance with the description above t forth and in compHance with all provisiona of ordinances of the city of Fridley. ��/ -••� ��--� In consideration of the payment of a fee of $...15..CtQ ............. permit is hereby granted to...._............._............._............._.......--- _�_._.-------.....____._...._..------•----.... ta construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is gran.ted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minaesota regarding locataon, construction, aiteration, maintenance, repa.ir and moving of buildings within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. , �-,� � � Building Inapector NOTICE: This permit ,does not cover fhe aonstruetion, installation for wiring, plumbing, gaa heatine, aewer or waler. Bs surs fo ses the Building Inspeetor for separale permits for these Aems. 4 ;� __ , . . APPLICATION FOR BI�TLDI1dG PER�TT . .. . -. , CIT� OF F13�LEY, MINNESOTA �.. . ,; : � , . . � a�-- Owners Name Builder Addreas Address l G •� 9' .:�,:' � . . , �- . LOCATION 4F BUILDTNG No. �� Street '� R' Faxt of Lot . Lot �ia Block i Addition or Su.b.Div. G► I��w •�� E Corner Lot -��'__ Inside Lot,�,;�,_,Set Baak �►d t Sid�-Yaxd�'�� SEWER, EL�l�TION FOUNDATION ELEVATION � • �pplican� attach to this form Certifica.te of Survey of Lot and proposed buildin� loca.tion. ,iI �:_. . .. . �. � DESCRIPTIO�i OF BUILDING , To be used as: . .� r ,� ' i� ��va�� Front :� "L' Depth ZY Height y a. ,, ..., ,. .. � . :... � , ,. . . . Sq. Ft. �� Eu�:. �t. f �. �:..y �-'. . � :� -. : , Front � - Depth . Heigh�. __; Sq. Ft. _ Cu. Ft. , '.. Type of Construct�ton� � � Estimated Cost �. ,,,,,. _ . ... � • . . •,. To � co�i��ea. . . v' •'�►�• rp . : � �," 1�- . : � . The undersign�ed hereby maises applica.tion for� a� permit for the work herein speai�ied� agreeing to do all work in strict accordance with the City ardinances and rulirig of the Depertment of Bu.i.ldings, and hereby declares tha.t all the facts and representa- tions stated �.3.n : this. � app�.icat�on are tr�e and correct. � �.� . . . .: . ' .' W �A� f� 1,� . _ SIGNATURE� � (A Schedule o€�'Fee coste can be found on the Reverse 5ide.) , .. . , ,..�: d ., , � � . J - -a . BUILDING PERMIT FEE SCHEDULE Section 2. The Inspector of Buildings shaTl, before issuing an�r permit for the erection of any building or structure, or for any addition to any existing building or structure, or for any alterations or repairs to any existing building�� of�''�structizre, upon a,ppli.catian therefor, require the payment by the app�..��¢i�:int:��£or� ��R�h� :�ermit of�; fees to the amount herein below set forth and in the manner hereiri�provided to-wit: ��'°'2':1: �`�or-��.n�-•�u�h Tp�t for _th�,; ere��tion of any fireproof building, other than a garage, warehouse, factoTy or �gx°airr �.*�ev�'a'�ox'r.or__..fQr the:,«.i,:; •;;��,: -;;,�; '�'�"e�`d'Ctiorr-o€�-��y •£irep�og�__addi#��arr�:, for similar occupancy, to any existing building sha.11 be at the rate of��d�Z�:40-for��cY�-one_.tl?2usend _:�;;;,::�,�:;t cubic feet, or fra etion thereq�.,.in,such cubical contents. � ._._._.�. 2__For�any such pe�mi�, for the erection of any fireproof garage, ware- house, fac`tory`or grain ele�a�ar,-�.c�r..f.o�'_.the erection of a,ny.,f�seproof . ___,..�.ddition for similar occupa,ncy, to any existing �builctirig sh�i.ill�-fie- a�-�•t�e-•-•�-•. .••� •= rate of�1:�5� �'oT ��:�h' �one� thousa'ricl` e�xti3:E ,feeti classifiedy.�s;,"fireproof" - - .. . ..._. _�;��.,Section 50�-,af :�Y�e- Minneapolis Building Code. � �'�•� � � - •------- •-•.�--- •' � ._..... _ HOIISES �---• ._-._-_ _. --.. _.._._ ....._ , . .._._.. _. t , . _ �_._.........� _� r,. .. .. �- �. . ........ � � : . . _ ;`, ; i -: ..1,.,: --._..___.__._ . 2.3 �'or any su`c�'i permit for tfie �erectiar�. �f._any_.non-fireproof buil�.ing , ,„,_. y��3ther. t1�an a,garage�. waxehousey factory or grain eleva�or; br any �� ''''t' non-fi.reproof addition,� for si�ilb[r `bceupan�g� to ar�y�. existing building.. . , Permit �1.00 for each one thousand cubic feet. ` � '��='�" GARACrFS � - ' �ti:�:1 . .. . .. , ; �.... 2.1� For any such permit for the erection •f ang non-fireproof garage� warehouse, factory or grain elevator, or for the erection of any n�- :.. .-� "`�-'�trep�ne#' `�i:dd�:tion,._..�.or simi.l�.,r• rpccupancy, to any existing building or for each such building or addition: "' �I�l:n�ty ��Cents fo� -.each o�e _.. ,. _ thousand cubic feet or fraction thereof, in the cubical contents thereo�+��-"``" with a minimun of • �4.00. �' ..__ .---�-_._._. _.._ � . . �: ._,_�____ ....._._�_.._ . .,3 � �=; -__..__..._. _..._.._.�_- � • ...._.__..___-._ i ,�' •-. ._�.. _ . �,.. _._ .._. For the purpose of computing fees�fo �v.z�d�ng permits the..cubical _ contenta of any building or addition to a uniform height throughout by �� T` multi 1 in the � � -�� p y' g ground are�, covered� fr��-a .po��t six -. b in�lies, below ,� ,„�:: '" �°- -t�re •€l�o�- .1ine of �the� :b��e�nt or cellax to the average height of the � upper surface or to the average �'he'igh't of -°�i�e -�oo�-.-surface of� •the� ffiin �_. ::�. "��"-`-`� � g�b�.e--of a..pit.ched roof. � ..._ . . _..__..___.. � �-:;.t.� . i •. ._ • • .... . .. � ..;,�::�. :;_ .. . . 2:.� ��'or repairs or �.lter,�tions to �.n existi,ng structure, the fee sha.11 :...,�, � - •. . " be a�t�'�he��ra�te of �3.Qa �a� e�,G� Five Hundrec�.`13ollars� �(�500..00), . o�*;; :<:.Y;F� ...:. ; .. , . . � fr'act�i'o�r"'tl�ef�eof ��:n the• ca�;t o;�..all proposed �urdrk. � °�; .'-:.. , ,. _ : : � - �, � -. ,:_ :.> �.i� ; � � :; �-. ��-=-:::r.r�:.� . 2.6 In no case shall the ,fee chrjxged for any 'perm�:t `a.s �'se� � `.�'or�h::�i,�.,.,; ;, ~ �, - �•� .._.___... ._ Sec�-i,a�-2._ b.e._.�.�ss._than��4.00. . . - ....._....._..._ � t.. • �}' `� _ . . ... �s; . . �� . . ..___...._.__,t.,. . � �. � r� �. ,, - f. _- � - - �..�.., . _ .,, _ �....>.�...n._,..„.�,w.� .: �:.;... ...,,.,, .. ..�� .�.� .:..�,_ �.;.,,. .,. .,..� ,. -� .�: - ' `�� `-" . � �'d 9 �.� ��- HARVEY A. CARTINRIGHT ANOKA COUNTY SURYEYS MENNEPIN COUN7Y SURVEYB MINNEAPOLI9 SURVElrB 64f0 PALM STREET N.W. 9UN8ET - 4-7858 OWNER � �� O�ON J�EB�HILL, CIYILEENIi1NEER - ¢BTABLISMQD �saa LA ND S UR V E YORS c. F. SANDNOFF CIVIL ENGINEER R6GilTiRiO UNDiR LAWS OF lTATE OF MiNNff80TA 66TABL18MED taoe LIGENS[O SY ORDIMANCt OF CITI/ OF MINNEAPOLIS 328 PLYMOUTH .BUILDING FEDfiRAL B-B721 �AMES NELSOfV SURVEYOR INDU6TRIAL — JUDICIAL HENNEPIIV AT SIXTH • MINNEAPOLtS 3. MINNESOTA BBTABLIBN6D ioaa BuBiNESS — TOPOORAPMICAL ��(r�jC„ OT'g �ertitttatc METROPOLITAN L,AND CITY L0T8 — PLATTING L SURVEYORS, E67ABLIBNED �set Lyndal� Buj.].� e �� —_ __,_-.�. 0 � ► N 6 � ��iG.. 7s.o' %.e _ � , I - � 1 �?� � I ��-,, �� . �i W� .•� , .` �, � �.� : . �.. � '� , .1 . � � J1 � 1 o � r; : o ` : •-, � � �; �,,- , � 4 '� �� o, t� 01 5, �,' � _ _ -- ; .�„ �� , "��" 42.0' n srn �. ^� ,. I� �; ti Invoic�e #�0854 � �� t � I hereby c6rtifg that tk�i� i� a true and correct ropresen— t�.iion of a�urvey of t}1� b�und�ric s of : Lot 6, Biock 1, LJ�aale Builder� 4th �ddition� Anoks. Covnty, t�in.nes�ta. As sur�eyed b� me t hia 20th day of August,::.1959. i_%.�-' ,—�- _ `�"_ ' �?'3` s� �:�-- ;,� �, � �.; .'''_ �y _ �,t _;� � � _ sioNEa� °�' ` '-� ` . �E�3YNRIGHT wND O1.90N�;.:�' r �' � �• � 0 � � � � � � b 0 � � �� o 1�1 ��j7 �� Q Q 11�1 �, � � � O � � � � � � � � � �—,� � � 0 � � � m � � � � � � � �. � �' I i� � � � � o � _'� � � �' V b � , � � M � � � � �o b � � � �w� 0 � ° 0 °c � � • � � : : O r � c° w � F W �. � R 0 � g � y t� � � � �' : � � � � � � o °o ',� ',� �� • � � � � �� M � � � � � � � � � � � � � � � R� 8 � � ° �. R� � re � � �� o g� 0 � � o� � � �' � : � �' o � w b� : � o Q' v�i : r+ �o ; ' s� �$ g : : o � v , ; : � � � : ' : : : .• o� en N N ao 00 0 0 °o 0 0$ c° � ! � ! �� o w � � � b �. �� z � � o �' o �' � � b ��O \ � � � � � �b � � � � � � �� o � �� e '�,� b � ��NO� c�, o 0 o c 0 0 0 o v Q � 0 O y I, � c z � � � � e � � � n � � � � � � g ro � � � O � � � � � �, � � � x _I � � e � "1 ,� O � ► I I I� � � � � � � �' n R° R° � v�, � � � � � � o � 0 0 � �� . � o : R, tsa . . cn . . e�i� Q � : 0 0 : . c . . o • • • o : ; ; ��,�� er o 0 0 0 0 0 0 cn fa O t" � a� �" � �� €��'� � �. �° �� a. � � � o�� a � d� ��o� �� o� � �� o M b �� as�, K: �'� �� oN�� p�y�EL �a�p p�p'�,o ►! y � � � � �d � �� " �� o �� m � � �' -�� A� �../� 0 �� D � r � � m N _ m C r m d � �, t.,o `� � � a � V V 0 � �� i 5 � � � �O � .,' � A rt d � _f� � Q t0 ;. �N� N � � Q � o. =� A � �• �'. � � � � � � �. � 0. ,-,� �`� � I � `` ' �.�-� �°a�'.�� .�°'�' �� '' �� • � �� A a NEAT LOSS CALCU[.A�TIONS�'�� DEPARTMENT OF BU(LDINGS Village of �1 � Weatherstrips A.S.H.V.E. Coastruction No. Insulatioa Guide ��indows�. Doors Reference Out. Wall Int. Wall Ceiling Roof F7oor Kind How Appliec � �'��'� (�'" e—� 19_ ,� � P ,•� � Fl�,, �',s,� Room � Length �' �� Width 1� = Height " FI.J� f��, Room Length �° Width '�° E Windows a Doors—Crackage and Area Windows and Doors—Crackage and Area �Vidth Hefght No. o[ Lineal tL Aree Wldth Helght No. ot Llneal tt. Aeea No. ot pane,. ot Dane llghta ot crack eq. tt. No. ot pane � o[ pane Ifghte ot crack ea. it. /�, �l q , � 4� / Ed' "i' �� - � F�i � �� l� �� c� �',� ��` _� � �,' �.,� . � �,�. ��•� � �,� Coef. Btu Coef. lnfiltration ��°� -°�'�� J� � Infiltration f' �`� �� Glass �°� ��'r�� Glasa �� F.xp. wall `� � Eap. wall Net exp. waU �'�� 'r� ° �� Net esp. wall � �'� �� Int,_wall Int. wall - – Ceiling ` ,f'% �"F� � /'G' -C� Ceiling � - r:�� (� Floor �, �o `� �'`f `�','-� Floor ve �, /' Total Btu. /s� `� � %� Total Bcu. ' Required sq. ft. E.D.R. or aq. ias. W.A. Leader area � Requned sq, ft. E.D.R. or aq. ins. W.A. Leader area F7. � � �oom ( Leagth J� � Width� � � Height �' �.I ' '° R�om I 1.en8d►��`�' � Width% � ° E .�9 —s° Windows and Doors—Crackage and Area Windows and D�rs—Crackage and Area Wldtb Helght No. o! Lineal it. Area Width He16ht No. o! Lineal tt. Area No. of pan ot pane IlBbte ot crack aq. tt. No. ot pane/' of Dane I16hta ot crack eQ. it. � � � � �'' � ,�'� � �� - � . �-� � / m �,� �-� � �I�'� �' �a� � ,�1 � � �,�,� ��; , ,� � `� � Ia6ltration � Cdaaa �;�� ' Eap. wall �' �� Net eap. wall �' �� lnt. wall Ceiling �'' . `%` � Floor ��'`� Total Btu. Required sq. ft. E.D.R. or aq. ins. W.A. Leader area / . ;� a� �. �-�Room �Length �'� Width � Windows and Doors—Crackage and Area Wldth Helght No. o[ Lineal tt. Aree Ro. ot Dane ot pane Ilghte ot crack _. eq, it. � � �� Btu ��" �� Infiltration �'�!��A Glasa Fap. wall �� 1Vet eap. wall Int. wall ' �—�_� � Ceiling "� C`-�_ � loor �,� iE�� Total Btu. Coef. Btu �: Infiltration � " _� !" � Glaaa � �� '�� Ep. W81� ,r s'= ? .^ .E „ � � � Nec eap. wall `��_, : ° �^�� < Int. wall Ceiling �� , � 1� loor ,,�`'� � Total Btu. �� Required aq. k. E.D.R. or sq. ias. W.A. l.eader area B.D. 218 �� Btn I �._� � I quired aq. ft. ED.R. or aq. ins. WA. Leader area �.� ; . � ��:,: �oom I Length ,/� m Width � `� Hei� Windowa and oora—Crackage and Area Wldth HefBbt No. ot Lineal 1t. Ares ot esne ot vane Ilshts ot cracB sa. ft � Infiltration Glass F7Ip. W8U 1Vet eap. wall Int. wall Cei�ing Floor Total Btu. Coef.� Btu h. E.D.R. or sq. ins. WA. L�ead�[ �a=.. � � � � � o�p : � : 7i . � ' M • M : o . � . m � . � : � • � � � N � � i �A � r !'� � .•, � �' n �� • o � o � : o . o . o . . G : : � aa �a x � r � O O O � � . H H �� C" � � � � � � z � 8 fD �„ ��{ �"' � � � ~ "� � � � x �° � �;�.�� : o � � �� ,�� : � �- : � � W y°oo : �' : 0�'�9 � . . . . o . . . . : � : : : : � O �a �a x �a �a �a � � ca � w ►� r� ►� e�n °o c�"i� °o o c y �� f» sn ts3 r» �» � °�o e 'JN�- t\ H � � � � � O � x v m c� en C� V, � m � �� D � 1"' � � m � n _ m C r m � • ►��' R. p a-� 'n R. m � 8 M� 3 � �� p �� I � � �� b 8 g� � ��r o � � w `° � o 8 a � bd � o � �' � � � � �' � �, � � � I a n � �� . WATER CJ.OSETS URINALS enrti �� BA51WS SINKS WASH rennrs DRINK. FOUNT. sHwss. FLOOR DRAINS �� 9ASIN5 nvro wns►�a GAS APPL GAS � RANGE GAS OPENINGS a • z a � � � A m � m � a,a� � �� H ,F' �D � y � � �oq�� o � U' �• ;e � �o � �ps� � � �B. �j � M � ^ « � � � � � �a �ro� �, �� b�� p�p�a � � � p � �. o ro lD � y 6' f{y'� A� ��ro � ��'� ¢ � �� y ��W� �� o �� `''� � � � G � ti d � H A �ro a� �x C� �°n i� _. �� i � � .. � • � � .�w �� W �� _ A � O, � �, � r� City of Fridley, Minn. BUILDING PERMIT Da�; Sept. 27, 1967 p��; Framcis Mager g,�� Address 548 Cheri Lane Add�s Sussel Go. 185 0 Como Ave . �o � ; �s� 9�69 LOCATION OF BUILDING . No. 54$ Street Cheri Lane part of Lot Lot 6 _ Bl�k 1 Additton or Sub-Divfaion L3mdale Blders, 4th Addn. Coraer Lot — Inaide Lot Sewer IIevation Setback __._ Sideyard Foundation IIevation DESCRIPTION OP BUILDING To be Used as: Gar age �t 24' �p� 24' g��t „ 10' gq, �-t, 5 76 �, �, 5 76 0 Front Depth I�eight &1. I+'t Cu. F't. 1j��e og Construct�on Frame �, �_ 2190.00 To be Completed In cansideration of the issuance to me of a permit to construct the building des�lbed above I a�ree to do the PraPosed work 9n accordance with the descrlption above forth and ffi compliance wlth af l proviaionB of ordinances oP the dty oP Frldley. �� In cona4deration oP the payment of a fee of $ 9.00 ��t ��, �� Sussel Co. to construct the building or addition as described above. Thi� t 9a granted upon the express condition that the person to whom it ia granted and his agents, employees � worl�nen, fn all work doae fn, arotmd and u�n said buildiag, or anypart thereof, shall canforia 9n all reapects to the ordinancee of Fridley, Minnesota reg la:ation� construction, alteratilon, maiatenaac�� repair and mcving of builclia� within the dty Ifm�its and� permit tnay be revoked at any tiiae upaai violation of aay of the provl�tons oi eatd ord9nances. CLARENCE BELISLE �� NOTICG Tld� psemh dees no1 covse ths conslrodiee, 6u�all�toe �er wirteo, plambiee, 0a huNno, s�w�r ee wd�r. 8� wn te a� N+s Buildin8 lusp�etor for aparai� �rmhs for th�a N�a. � � A°?`Y��C:�`t:i.f�:a � i;:t :3?J�i,D �iiG °��s��.T CbSS. oi l'iC.7.1�:.r�n''..�'� r1!tYal.r'1.5�[i OWidER' S NAi�1E � � d�-�c.s ,�`�: e__�„�._ fi`��:i �i�LP. ��s S � � � / �' S'u �� :: ADDfiESS �,� ' �, ��, i „�,n� � A�1�i,ESS �+- � d l.�-� _ � � LOCA7'�:C}�]' Q1� BtJILAI:IG . �— ' �� NQ o____-�-,-`�_ ,._.e. sxtuF�x� {�� ,��C�.� PART o� LOT `�Gr� e'� ,� �� --��Q.�.. 9 ��°"" �, LOT� BLOCK � ____ ADJT��iON OR StTi�D:.VISION �C, /U�O �, �� , , . CORNEP� LOT INS�DE LOi SET1iACK SIDEaYARD � SEWER Ei,EVA'�iON FOUN�}AT�O;� Ei,EV�`�'70N Applican� attach to this fo�n T�,�o Certificates of Survey of Lot and prQposed bu3.l.ding lacation dra��m an these Certificates. , . _ . DESCRIPTI0:1 OF BUI�DTIvG . - - To Se Used As : . - • , . -. - - � �i �.:-�•-� � � „� Front �- � Depth � � Height_,,,�,�, � Sq. Ft . ,�� Cu. Ft. c�� Front • Depth Heighe . • _ Sq. Ft. � Cu. Ft . Type of Construction �� Estimated Cost �� o Be Completed �`'�O � � . - - The undersigned hereby makes appiication for a germit for the work herein specified, agreeing to do a11 taork in strict accordance a�ith the City of FridLey Ordinances and rulings of the Department af Bui�dings, an3 hexeby declares th�t all the facts and representations sC2ted in this apgiication are true and correct. - DATE_ •�e� -�7� � % °- •/ %� � STGrIATURE �v sS � � �- I�:3°c C'a�� - �t i�� {Schedule of Fee Costs can be faund on the Rzverse Side}� jl � - , i �� . . � _ _. �1 _ . _ � n � . � . BUILT)ING YF'F.i�1IT FEE SCHI�DULF SECTION 2. The Inspector of Buildings shall, before i.ssuin; germits for tkie erection of any buildind of structure, or for any addition to zny ehistino building:or structure, or f�r any alteration or repairs to any existing building or structure, upon application there£ore, require the payment by the applicant iox such permit of fees Eo the amount herein bel�ca�set forth and in the manner herein provided �to-wit: , , , . Uniform Euildin; Cocle: Type 1;2, &��- $1.75 for each one thousand cubic feet, or fraction ,thereaf, in such cubic�.l contents., Type 3'& 5-$1.50 ior each o'ne thousan� cubic feet, - ° � For the purpose of computing fees ��'or buildin� permits, the cubical contents of any building or addition to a uniforni height throu�hout by multipluing the ground area covered from a point six (6) inches beloti�� the floor line of the basement or cel.lar to the average height of the upper surface or to the average heioht of the roof surface of the main gable of a pitched roof. _ For repairs or alterations to an existing structure, the fee shall be at the , rate of $3.00 per each Fi:ve Hundred Dollars ($500.00) oz fractior� thereof in the cost of aI1 propased work. ° --� �• ._ 0 In no case shall the fee charged for any�permit as set forth in Section 2 be Iess than $5.00. - NSSSD Connection Charges based on location- Area 1 or 2. 0 � _ ,. � -. . , . e . . .. .. .... .., �� . .. . . ( 1 ;� � � � ^ ' . . . . " . ' ' m , - � _ ' . a �� a /� '� �� LO BLOCK ADD'N. NAME Fr2.�a ivcis r� ADDRESS S �/ E3 G HElZ / AREA F/� /1.� LG Y � �. AG.L _ OW N �2 _ . � - •� /�1 Y 5 .�E FO/Z E' Z y, .. �Tq�Tia� ?�. sQVAl�E �//TN siU� ��o,�c'�Ty G��ve •A5 s�aw�V. � 5�t�� o� C,.� i�..�� ro sT.n �z r S' S�� "' 4 / SIZE �� VALUE F/2OM S�C3 �_ /�/ao NE ✓2 T � G/NL. �� ra N �� SffG�IniN. � /=/�AwT O/= G�►/2AGL TO 3TA/2T `J /�" �.�GK Fl2o�l GV/2liE O� �- ort�`��t � S/Q G�/2C> f'G �Z T y .L�N.cz .4 s S tJOWM � �[v' TVPE � g U °-°- �� \ , `� � � �� 1 \�` t �/�! C S t/ g GOM U(� �T �� ' r, , � �°�'�� ; �' .T/+✓ �TA[.G NE W G o.�c : O i2 ✓ uL: � � . � �+"%��.�Sfi T�' �T 2E�T � 5 5N�M1M 1 ,� � �' �.�C�..o,Nra/G�N ....I!TS. i4 5 /�✓EGG SSs4 tZ� p" � �lN��v JC� C3 �� Ga�n iOL.� T,E'. "�A�c,�As,�,,, �r�o�i�J-E �x�.a.vsiv.v /�=�'" ( � JT_ A T F2U•v 7' � TlZ�G T D Y,rC`O,�G 2 T y eG��v� .+4 ``'--�' Sf�IdaPJ. �`��? ♦ ��''..�` 1PEG/A aL" � G O P� C 1J�L /� C TO - oCj��A �.G N TE2 lzo�2 A�O�DC/z ,��• �'�G � 2.n ��v.��c .� s_ s.vo W w. � 5�' � o w �v�r� �ou �� . _ r,� E M�s'w cc�n�rc• I � 1� lZ I V,� �i W� r+�SK I 3 � � 2 J�"IZQN T ST,� _E T�2A �'� ,i��'Y Ic-1 iVIE �-- � ,r�,�'7'"!Z€�L"� , - ' /�1 . � � � � _ � � �� 3 t i� �. � � . b^ � —.� ,' �7( � G �l ��-� i HARVEY A. CARTWRIGH7 ANOKA COUNTY 6URVHYS 11CNNEPIN COUNTY SURVEYS MINNEAPOLI& SURV6YB 8410 PALM STREET N.W, SUHS[7 4•7656 ' OWNEN � ,•' - . q ` � .� ��+� � �i.990iJ�� J�EB�HILL. CIVI�,EENGIN6 R; aetneueHac �eoe L� ND S�IR �'EYORS c. F. SANDHOFF REG18T6AiD UNDBR (.AWB OF BTAT6 OR MINNESOTA CIVIL ENGINEER C9TABL19/180 1�08 � LICGNGEO OY ORDINANCG OF CITY OF MINNHAPOI.IB 328 PLYMOUTH •BUILDING FEo�aq� A-8721 �AMES NELSON SURVLTYOR INDUBTRIAL � JUDICIAI. HENNEPIN AT SIXTH .• MINNEAPOLIS 3. MINNESOTA E6TABLiBM6D ioan BUSINE85 —� TOPOORAPMICAL � ME7ROPOLITAN LAND CITY 10T8 — PLATTINa �urbepor � �ertiftcatc $URV6YOR8 Lyndale Buildera C��! ----._.._ _,�_ , C6TA6LIBMlO tASI Invoico �20854 . - � �� ; 5 , �5. 0 ' �?'-o , 9 1 I � `"„ 1 � , I v �I ,V � �1 �I � � .. W� . � , .� , �5 ; g .'� - a. � � ' � 1. ,�� . � ,• `i� �.. ,, � � � y1 ,� � ir �1 � ;� � o , : �� ► . � � � , �1 � `� . e1 ' � ��' , Q� �1,� �, L� �` +i .�� . � � . � • ui � "°�' 42.0' n lrr /'� �� o� �i ti 5 I hereby certify that thia is s true and correct ropresen— t�tion of a survey of the ; bouudarie s uf : Lot b, Bloak 1, L;rndal� Builders 4'�h Acidition, Anoka County, A"�innesota. nn As survoyed by a� t his 20th' dAy of Augu'st,':.1959. • �� .,�+'�+r" .a":�.,:•� � �*�' ' t•'�Y.� � .. . �. eF� �• a ./Y./ , ' r �..r: �`] SIONEQ . + f �,� . �i.,'...... , ' } , ., -"� • �RIGNT AND OL90N':,. ' � 0 . � � � • � � r � � � �� j � � d x '�9 x 7G �� w '�~' � � 7, � ~ � � � r ~ � �, � h7 � � A � � ',� ~ 6d � �N s � � � � " � � � � � � • O � • O `� � • � o ,o � �' O y y, . � � Q . : � p .» � '� � ; a � r5 ° � � p, ro � � �. • � o� m . . � � . � � . . .. ►Y � : . . Q, O . oa : � r~--'� . : : : °•° 8 . . . : . o,� . . . . . � . . . . � � . . . � � . . � . i • • • • • • • • � : . . . . . . . . . i, . . � . . . . . . • N • O O � M i1 N M k x k x �e �C � �p a �p �i� � �p � � � �p • C � O u,� � � O � � � O � M M � M tA !N b! &► tN tA �7 o O I I O `-' , �! I �I � J r I �y C G' O W � c � � A � � m �-� � � C7 � � < � I� � � i� � � ,_� i !, � i O � fD E Q. � b �. � ° a 0 � 0 � D '� r � � � � i m C r m ..■.' � : .■.■1 � 1 ...■, � � ��, • • �■■■, � .■.■, �� r � � o � ��a�� Oi p1 Q �1 � O v� r� a � W Q � � y � � � w . g F � � g � � � - r � � N m � wA�u a�os�n ua�w�►s MTM n� ews�►a 5�� wwSN iqAK DRINK. fOUM. �. �ooa DMINS GTU+ eASIMS �0 w� CiA$ �� cws a�ce G� O�ENINGS � • _ • N � a � � � ��° ao. a ; �� jpy, A p a R O � � � � ��o�'� � oR 5�� w b � �� ti � � �� o �' D, O „� �� 0, m � � � �� . .. � � �f�p M �� A 7 .. n 3 �d � B �d � � � � �� ^ � � p M � � � � � � � �t � � 0' P • '� � �C ��ie � , � x � � � �)'l W 1 � � � N � � � SUBJECT City of Fridley T __ 16 6 3 2 AT THE TOP OF THE TWINS g U I L D I N G P E R M I � ECEIPT NO � � i �` COMMUNITY DEVELOPMENT DIV. n� � 1 L �"��'i � r � � PROTECTIVE INSPECTION SEC. � j � REV. DATE PAGE OF APPROVED BY � � �---1 � CITY HALL FRIDLEY 55432 NUMBER �----� • •'� 612-571-3450 910-F15 6/llf 82 � � JOB ADDRESS 548 Cheri Lane N.E. LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED 1 LEGAL SHEET DESCR. 6 1 Lyndale Builders 4th 1�ddition 2 PROPERTYOWNER MAILADDRESS ZIP PHONE Francis L. Ma er 548 Cheri Lane N.E. 572-9244. 3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO. S1IIt� Z�p PHONE LICENSE NO. 4 ARCHITECT OR DESIGNER MAIL ADDRESS 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING 7 CLASSOF WORK � NEW p ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE � REMOVE 8 DESCRIBE WORK 9 CHANGEQFUSEFROM TO STIPULATIONS TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING. HEATING, VENTILATING OR AIR CONDITIONING. Nj3SOT1].'�@ THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZpNING S�. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS STALLS GARAGES I HEREBY CERTIFY THAT I HAVE READ AND_,EXAMINED THIS APPLICATION SURTAX AND KNOW THE SAME TO BE TRUE AND COpRECT. 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 �. 5OO SAC HAR E DOES NOT PRESUME TO GIVE AUTHORITY TO VIOIATE OR CANCEL THE pERM1T FEE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- 2rJ.00 STRUCTION OFi THE PERFOflMANCE OF CONSTRUCTION. pLAN C�ECK FEE TOTAL FEE __ _ $25.75 Si TUREOFCONTRACTORORAUTHORIZEDAGENT IDnTE� WHEN PROP L VALIDATED THIS IS YOUR PERMIT � $ a�. � 7vlr � L �P lI d SIGNATURE OF OWNER �IF OWNER BUILDERI l0ATE1 BLDG �NSP � TE CITY OF FRIpLCY Effective Auq. 1, 1981 APPLICATI�� FO�� RCSIDCi�TI/li_ IiUILD1t1G PCiti�ITS (��c��. A1 terations, Addi Lions, or Repa i rs ) 01�lNER: /�2 i9 /�.e � S L. �,1� C, r/2 ADDRESS : _ .S�'7� � C /-� /� � j �.g �C TEL N0: s � � —9 �. � Y c� I3UI LDER : -�.A,;�'1- � ADDRCSS: TEL fi0: Construction Location - STJi1�T NO: .S�d STItF.ET: � �T:. � 8��: l 2 � ��n/r �� AnniTioH : L �N OAL k � �� T� � ,.� Corner Lot: Insiiie Lota Setback: Sideyards: Ap�licant attach to tliis fora two Certificates ef Survey of lot and proposed building �.ocatioa� drawn on certificates to scale. -� DESCRIPTIOid OF COPJSTP,UCTION �. S.c �_ Front: Depth: Height: Square Feet: Wbic Feet: . Front: Depth: Height: � Squar.e- Fept: Gvbic Teet: Zype of Cor.structien : �A'S O� i�J Estimated Cost: $ I�� _ U?� Rb Be Obr.�pleted: Alt. A Alt. B Proposed Drive�iay width If New Openinq Zs Desired; $� $ , SE� Re^.VER�E SIDE OF SHEET � �iie undersioned hereby maZ:es application for a permit for the �:vrk� herein specified, agreeing to do ,all werk i.n strict accordar,ce r�ith the City of 1'ridle}� Ordinances �i�d ruling� of tl�e �lkzrtm�n� of Buildings, and hereby declares that all the facts and represr�taticns stated in this application are true and correct. w Da�: /� T�i �' l� v sicxnzvr,�: � � f O��`� Stipulations: 5 � �� . v� �� ..� ��" n� � .� BUILDING PERMIT FEE SCHEDULE The Inspector of buildinqs sha'll, before issuing permits for the erection of any building or structure, or f or any addition to any bxistinq building or strsicture, or for any alteration or`repairs to any existinq buildinq or structure, upon application therefore, sequire the payment by the applicant for such permit of fees to the amount herein below set forth and in the m annex herein pron3ded to-wit: TOTAL VALUATI�T $1.00 to $500.00 $501 to $2,000 $2,001 to $25,000 525,001 to $50,000 FEES $10.00 Minimum Fee $15.00 plus surcharge �10.00 for the first $500 plus $1.50 for each additional 5100 or fraction thereof, tc arid including S2,000 $32.50 for the first $2,000 plus S6.00 for each additional $�,000 or fraction th ereof, to and including $25,000 $170.50 for the first $25,000 plus $4.50 for each aaditional $1,000 or fraction thereof, to and includinq $50,000 - S50,001 to $100,000 $283.00 for the fizst $50,000 plus 53.00 for each additional $1,000 or fraction thereof, to and including $100,000 5100,001 and up $443.00 for the first 5100,000 plus 52.50 for each additional $1,000 or fraction thereof PLAN GHECK: 25 percent of building permit fee DRIV�Tn1AY DEPRESSION ESCROW: Concrete Gtirb Streets Only Alteraate "A"s Removeal and replacem�nt of curb and gutter only Driveway width plus 6 feet x$13.50 Alternate "B": Renoval and replacement of curb ar�d gutter and install a 3 foot wide approach with 6 inch depth Driveway width plus 6 feet x$15.75 VERIFICATION OF FOUNDATION Permits for const:v ction will be issued a minimwa of 24 hours from the time of appiication to allow for proper review of the proposed structure and of the construction s3te. A Certificate of Survey of the lot, showing the location of the founc7ation once it has been constzvcted will be required befor� proceeding with the framing. �._ CITY OF FRIDLEY 6431 iJNIVERSITY AVENLTE NE FRIDLEY, NIN 55432 57Z-36U4 l+'AX: (763) 571-1287 _..�---� � ---� — PERNIIT N�.: 2004-01727 � '°°.»----_-- DATE ISSUED: 10/06/2004 ADDRE5S : 548 CHERI LN NE PIN : 233024430008 LEGAL DESC : LYNDALE BUII.DERS 4TH ADD : LOT 6 BLOCK 1 PERNIIT TYPE : BUII,DING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING VALUATION : $ 2,385.00 NOTE: UNDERLAYMENT AS PER STATE BUII.,DING CODE. REROOF HOUSE & GARAGE (20 SQ) TEAR OFF. STATE LICENSED CONTRACTOR 1 APPLICANT AJS CONSTRUCTION (20177567) 9747 3 ST NE BLAINE, NIN 55434 OWNER MAGER FRANCIS L& VERA P 548 CHERI LN NE FRIDLEY, NIN 55421 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or consiruction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and lmow the same to be true and correct. All provisions of laws and ordinances governing this type of wor� will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating cons t�on or the performance of construction. Appli� Date 1 Bldg Date BUII.,DING PERNIIT FEE FIRE SURCHARGE STATE SURCHARGE, VALUE LICENSE SURCHARGE TOTAL � 83.25 2.38 1.19 5.00 91.82 OCT-04-2�04 14 � 41 C I TY �F FR i DL.EY `I ( Y Uf fhllULtY �� n�� "►�i'I � � N� [ l 8a31 Unive Ave NE, Fridley, MN 66432 (763► 6?2-36�4 Bidg Ms � � �� (� SINOI.E FAMILY AND OUPLEXES R-1 AND R 2 (763) 571-1�7 Fax � SUtLDIPfG PERMtT APPLICATION ` . 1 I P�� L��. Constn�c�ion Addcess: ,-�� / �_ � _c�, � �: S5i �� er � Tel. # 7/ ;3�'7� la � �rnar Name 8 Address: ' �--- " � ��Qr ` LIC�NSE t�� D / �7 7 � Addr�ss: -- �3 P ` Te1. # � -?�' � 7�'..� Attac#� to this appQcation. a Certiticate of S�rvey of th� b!. wfth tl� Dropossd construction drawwn ort d to �ca{e. pESCRiP710AI OF }dAPROVEARENi WlNG �ARU1: let�fi l.,._ Wid� Height � Sq. Ft. QARA� /�EA: Leng� .� �1► �,..-.-- Helght �— Sq' Ft D�CK AF�A: l.�r��► � Wid� _._.�_ H9tK3round _� Sq. Ft on{�: a Cortst�ut�on Typ�: F.sGmated Cost: S � (�l�y CINb C�2 Width Ne�ded: �,FL + 6 Ft � Ft x$_,,,_,,,,,,,_,.,..,,,., =$, c� �y ��.. DATE: � ' 0 �,,. APPI�CANT: ��.� ��"c��`J CeU r163j 672-3604 �or Petm� Fees if � in appli�ation. Fax to 763-871-1287 � using ctedit eatd and �te will c�fl you for card nwnber. CfTY USE OWI„Y - P�RnR �ge Piem Rovi�vv Firo 5urcharge State Surdtarge SAC Charge License Surcharge Curb Cut Fscro� Eroslon Control Park Fee Sewer Main Charge TOTAL �� $ o��?� $ _-�° $ �.,� �' �_+ 1.� $ � ��L'�� S S �''/ � � � � � � �-'` Fee scl�ea�� cn rZeverse side 65% oi PemUt F� .009 pf Pemni# Valuat�on (1/10th°k) $.50/$1,000 Valuation $1350 per SAC Unn $5.00 (State t.it�ensed Resrclent�al Cor�tr�dors) Alt. "Au.or A�. "B" Above $450.00 Conservatfon plan Revtewr Fee �termined by Eng�ring Agreement Necessary j] Not Necessary (] � STIPUTAiiQNS: � CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE . FRIDLEY, MN 55432 (763) 572-3604 FAX: (763) 571-1287 ADDRESS PIN LEGAL DESC PERMIT TYPE PROPERTY TYPE CONSTRUCTION TYPE : 548 CHERI LN NE : 233024430008 : LYNDALE BUILDERS 4TH ADD : LOT 6 BLOCK 1 : BUILDING : RESIDENTIAL : RESIDING PERMIT NO.: 2004-02024 DATE ISSUED: 11/02/2004 VALUATION : $ 10,000.00 NOTE: PER R703, 2000 INTERNATIONAL RESIDENTIAL 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 VINYL SIDING IS NOT A WEATHERPROOF COVERING UNLESS THE MANUFACTURER STATES THIS IN THEIR APPLICATION GUIDELINES. CALL FOR INSPECTION OF WRAP BEFORE COVERING OR TAKE PICTURES. RESIDE HOUSE AND REPLACE WINDOWS WITHIN EXISTING OPENINGS. STATE LICENSED CONTRACTOR I APPLICANT MR BUILDER 17527 XENA ST NW ANDOVER, MN 55304 OWNER MAGER FRANCIS L& VERA P 548 CHERI LN NE FRIDLEY, MN 55421 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of wor� will be complied with whether specified herein or not. The granting of a permit does not presutne to give authority to violate or cancel the provisions of any other state or local law regulating�cons� ction or the performance of construction. App11Can� 11 Date � I Bldg Insp "_�{�U/�,��/►/\ Date BUILDING PERMIT FEE FIRE SURCHARGE STATESURCHARGE,VALUE LICENSE SURCHARGE TOTAL SEPARATE PERMITS REQUIR�D FOR WORK OTHER THAN DESCRIBED ABOVE. 181.25 10.00 5.00 5.00 201.25 NEVV [) CITY OF FRIDLEY Effective 4/1/2004 ADDN [] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax � BUILDING PERMITAPPLICATION �(0'�73 �� . y�7� � Construction Address: �� Vl- � l� t � i� Legal Description: � Owner Name 8 Address: ��NC 1� 1�1,�C°r �� Te�. #�� 7� �- � l% e% Contractor. �a � r��-�� MN LICENSE #_ ,� � �7 � Address: i��' a'7 e�° =i�' �- S` T' 1`l' t-(� �� Tel. #`�6��"�� 7"� .� LMNG AREA: GARAGE AREA: DECK AREA: Attach to this application, a Certificate of Survey of the bt, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft. Length Width Height Sq. Ft Length Width HgUGround Sq. Ft OTHER: �, �s ` �� -��u� d �, �� Construction Type: timated Cost: $ 1 � Driveway Curb Cut wdth Needed: Ft + 6 Ft = Ft x$ _$ � DATE: � l 1� APPLICANT: Tel. #� p�� Call (763) 572-3604 for Pennit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call you for card number. Permit Fee Plan Review Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge $ /�� $_ � f�— � -1�� $ � .$ �'r�i $ $ � $ $ CITY USE ONLY - Fee Schedule on Reverse Side 65% of Permit Fee .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1350 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ TOTAL $ �� o�,s'� STIPULATIONS: �� / � ��c/�-��2��,,�� BUII.DING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or �r anY addition to any existing building or structure, or for any alteration or repair to any existing building c� structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to-wit: TOTAL VALUE FEES � $1 to $SQO $501 to $2,000 $2,001 to $25,000 $25,001 to $50,000 $50,001 to $100,000 $100,001 to $500,0� $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,�0 plus $14.00 for each additional $1,000 or fraction thereof, to and including $25,0� $391.25 for first $25,000 plus $10.10 for each additional $1,000 or fraction thereof, to and including $50,000 $643.75 for first $50,000 plus $7.00 for each additional $1,�0 or fraction thereof, to and including $100,0U0 $993.75 for first $100,000 plus $5.60 for each additional $1,000 or fraction thereof, to and including $500,�0 $500,001 to $1,000,000 $3,233.75 for the first $500,000 plus $4.75 for each additional $1,000 or fraction thereof, to and including $1,000,000 $1,000,001 and up $5,608.75 for the first $1,000,000 plus $3.15 for each additional $1,Q00 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 be issued a minunum of 24 hours from the time of applicadon 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 ADDRESS PIN LEGAL DESC PERMIT TYPE PROPERTY TYPE CONSTRUCTION TYPE CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 ►63) 572-3604 FAX: (763) 571-1287 : 548 CHERI LN NE : 233024430008 : LYNDALE BUILDERS 4TH ADD : LOT 6 BLOCK 1 : ELECTRICAL : RESIDENTIAL : ADDITION/ALTERATION PERMIT NO.: 2005-00004 DATE ISSUED: O1/04/2005 VALUATION . NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. 763-753-5731 1;1 APPLICANT KOVAR ELECTRIC LLC 23049 ARROWHEAD ST NW ST FRANCIS, MN 55070 (763)753-5731 OWNER MAGER FRANCIS L& VERA P 548 CHERI LN NE FRIDLEY, MN 55421 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of wor6 will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. Applicant Date STATE SURCHARGE, ELEC FLAT ELEC AMP SERVICE FEE ELECTRIC FORM FEE TOTAL PAID WITH CHECK # 7181 Bldg Insp Date I SEPARATE PERMITS REQU[RED FOR WORK OTHER THAN DESCRIBED ABOVE. 0.50 30.00 l .00 31.50