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AF - 43317' ' . 0 � I�►�III�TDER ��l'GINEF.�.IN1� Ctl►. �,�N�. EIVGI NEERS �ND SURrI'�Y�RS L.AND evav�.v�Nq 901L8 TESTiWO � 61VIL d. M1JNIGIOAI. flNO1NEBRINQ I.AIVO PLANRIiNO 6418�56T" AVENVE N. NtINNEAPOl.15 2T, M�NN. KE T- 3637 �lr�;�M���'i�� 4� ���T1l�► �A R L BE/VNE T T CO�VST. C0. � � .S°� G �� s � ,� �ao � i� ��r . Y \.!r' .°�'� . ,?`' 2D:i4 � '', �' f � , �w. � �� .ifs` � � �3 ���• .� ���✓� . ��i,�:� .;':. FM f``;; '`,�,�J° �; � �� . ti V ``-. � �� '� � !�� � � '7�'�.. - � � `°��,. r �� . � ✓ �# �, � r ♦- y � � �� . \ \ ��` �, /� � .�i'4� �1 � 5i.-%� C+ � � ff= +� �v, °'�.�° �c.'° � � I` � � ��p e V !i °�.. �\ � l..a"� �� � � � � :� �;�-����� � �;��-���enr�'�� ���"AT �� � ��`���' ,A o �'�J . � YVE HEREt'llf GlRT1FY T�iAT T►ti�S 1� IA TRUE M1D CORRECT I��PRES£NTl�T►OW 0� A SURYEY 0� THE Bt3tJN�AR►�� OF THE I.pND A�tSVE OESCRIB'ED ANO 4F 7�11E IOCATiON OF AI.L BU��L��NGS � IF .�1Y, TuEREBN , Rt�1� At1 v'IStBt�E Et�tRoA,CMMfNTS, i� a,NY, Faor� aaa� swo u�NO. td11N�EC� �.NGtN1EERING CO., INC. ont�D �r►us..._..,.e r,�Y � - �'EPTE("1B£.� �,�.ti��g ENG�wtE ct� aN� S�}JRv a5G=, .,. - c."' �r�` . C .`�"� b • , � ,F�"r �`'����' riL.J�1e..�r.,, . V ¢�/ .� � P � �„ i� . . .. . . . � . L t - . City of Fridley, Minn. BUILDING PERMIT N° 6023 nate: � '+ �"'°° Owner: � der _ / � Address Address _.._ +LO TION O UILDING No. �� Street P Lot Lot ..y�_�'�_____ Block �� Addition or Su visio � ... � . Corner Lot — Inaide Lot �. • Setback Sfdeyard _ -��--- . —�_ Sewer IIevation — — Foundation IIevation DESCRIPTION OF BUILDING T Used � P'ront � Depth _.���Hefght � Sq• F`k �!��Cu. Ft,��S.����� _ Front Depth FTe�ht �Sq. F't. ___—�_ Gw. F�k y Zj►pe oP Construction _�� `�.,,.��� Es� Cos� ��....�-'�_"To `�e Completed ���"� In consideration of the 3ssuance to me oP a permit to construct the building descrlbed above, I agree to do the proposed work in accordance with the description above aet forth and in compliance with all provisiona of ordinancea of the dty of Fridley. �.. In conafde�tion. of the paqment of a fee of $.� , permit is hereby granted to to construct the building or addition as described above. This permit is granted upon the express conditlon that 7he person to whom it is granted and hia agents, employees and worl�en, in all work daae in, around and upon said buildittg, or any part thereof, shall conform in all respects to the ordinauces of F'n1d1eY, M3nnesuta regardfng lacation, construction, altera.tion, maintenance, repair and moving of bufldiuga within the dty ]imits and thia permft may be revoked at any tune up� violataon of any of the provia�tona of said ordinancea. �,, __ Bwtldin8 Inapector NOTICE: Thb psrmh d�s not cowr �hs coe�trneNen, te�}all�loe fee rriein�, ph�mblee, oa 6eMtee, a�w� o� wahr. B� sun fo ss� tln Bn(IdinB lesp�etor far aparal� psrmhs h� t6a� ti�m, � =� ` -'- � � l � 4 E .� APPLICATI0�1T �OR BUI�D�NG PEi�ST C�TY O�' FItZDLEX� MTNNESOTA �mer's Name Bu3lder ���± � C //�� '� : 6���- .�� , Adclress- ------- - - Address . ���'i' e LOCATIDI�T OF BUI.i�DING � , Noa e��� �street ��� � �'���� Past of Lot � �� ��G���� Lo� �� �81ock � Ad i�� r S i�aion� � Corner Z,ot Ins i�e Lot � Setback�S iale-Yard � 1� f� sEWE� ELEVATION FOUNDATION ELEVATTOL�T Applicant attach to �this �o�m Certi�icate of survey of Lot and proposea building location. DE�CRIPTYON OF' BTJILDING To be used as o `�j�+�Y+.� �'ront�Depth � He3ght � �7�s r 1.• �r�L• rt• Front_____,___Dep•ch �ie ight Sq. Ft. Cue F�. lype o� Construcition � � Eatimated Cos� lo be Completed �� i The unders3.gned here�y makea application �or a perm3t �or �he work herein specified, agree�.ng to do all work in �strict accordance with the City of Fridley Ordinances and ruling o� the Deparf�aent of euild- ings, and hereby declases that all the facts and represeni:a�ions s�cated in this application are true and corr�ct. DATE d� U ��� SIGNATtTT�E � �� � .. .. � _ . c des� m � (Schedule o� Fee Costs c�n be raund o� the Re rae Sid . .. . =_w �", n a �t� �vYLnaN� P��m=� r� scr�nv� Sec�:ion 2. The Tnspector ofc Buildin�s -shall, befor pex�ai•� �or the e�ec��.on oi any �uilding oac struc�ure acidi�tion to any ox�.s�in� building or atruc�twce, ar f or �epa�.rs �o any oxist�.ng build�.ng or struc�ure� up ��re�or, require the pay�nent by the a�plicant for s rees �o the amount horein below set �Eorth and �.n the px�ov�ded to-v�ito �.ssuing atiy or �or any �r any alterat�lons n application ch permit of manner herein 2.1. For- any..such p�rmit for the erect�.on of any fire-proo� building, ot�er than a gaTCaga, warehouse, factory or grain elevato�c, o�c �Eor the erec�ioa of any i3ra-p�oo� acldition, �or similar occupancy, to any exis��ing building shall be at the rate o� $1.�0 for each ono thousand cu'�ic �eet, or �rac�tioa thereo�, in such cubical con�tents. 2.2. For any such porcn�t �or the erec�ion o� any fire-proo� garage, wa�ehouse, �Eactolcy or gra3,n elevato�c, or �or the erection or arly sire- proo� addition, 10� sir��i.lalc occupancy, �o any existing bui].ding shall �e at the ra�a or $1.25 ior each one thousand cubic fe��, classiriec7 as "�ireprooi" by Sec�ion S02 of tYae �i�.nneapo7:is Huilding Cac�e. FiOUSES 2.3. For any auch perm3.�c for the erection o£ any non-fireproof build- �.ng o�her than a garage, warehouse, factory or grain elevator, or any non-�ixe��coo�E addition, for s3milar occupancy, to any exis�t3.ng building Persmit $1.00 for each one.thousa�d cubic feet. C1�2P1GES 2e�. For ariy such �e�cm�.� fcor �he �recfiion o� any non-fireproof garage, warehouse, �actory or gra3n eleva�or, or ior the erection of any non-�ireproo�c addi�ion, for sint3.lar occu�aricy, to any existing bui].d�.ng or for each such bui].ding or additione l�inoty Cen�ts gor each one fihousand cub ic �eet or fcraction �hereof, in the cubical contentB thereof. wi�h a min�nvun o� $9,,00. �'or �he pu�pose o� computing� fees for build�.ng perm�.te the cubical coa- tert�s o� any building or addition to a unifo�n h�ight throughou� by multiplying �he grownd area covered :�xom a point eix (6) inches I�elaw �the �loor 13ne oy the Taasement or ce11a� to the average height og the upper sur�ace or �a 'che average heigh� oS the roo� surface of the main ga�le of a pitched �roof. � 2.5. For repairs or.alte�ations to an exi�ting structure, the �ee shalZ be at the ra�te of $3.00 per each Five F3undred Dollars ($500.00) or �ractior� �hereor in �he cos� o� a],l propos�d �vork. 2� 3n no case ehall the see charg�d �or any pesn�it a� set fo�th in Sectioa 2 be less th� $4.00. � ��-� -� � S ,� � � 1 �� � � V ' A �, V\ ` � . � oG � �� . C �1 � � C d • � � ' y� � •� _ . "ey' � � � � � � ` �a � - � • �. � r� _ �� 0 � � a � .� a � � d � A � 0 W _ H W � J I-- � a 1 �(�, ` 1 � q��j} C�j C�J Q7 � .� � �M � . ��� wd�s �A W � � �� � u d��� a�, �,� eo� y � F id R+ � q°�.�q a��� 0 �� q , c`�uv;�° a�:�� ���� �ti °q °O� .���p � .� �� y .� � � � � y ���� d A m � ��o� � °� ���� o � c. Y �'d �a U mc�m � � � w �r � °o °o °o ° � � a � � 0 I W N � � 1 � J ` �� � � � � � � �` � k1 � � w� � o � '� a�i O � 5 � va tg t�a rta °o °o °o °o, �°n 00 N WO u9 N � � � �. U A N � O U � � W Q 0 � a � � z � a � w O 0 a � Q W ti e � o � z � z � ' � � � o � ,g p4 � 0 � a � � W 0 � O � �, �� 0 �J �y � �Q � � a° �� � i� v ,- z � � � � �, '� � �� � E�-� � U Ey csr .tsr �s vs vr °o °o u°� �° o° 00 OC N N �t7 : . . . : . . . . �. : : : : � : : `l. : � : : :g � � : �� � . . e o ' . o : : $ o �o i . d . . o � • : °o"�s �' : : � ,� � • : �,d �, � � � � o . . � � o : � b � � � • a' ', � � � � � °g � �.� � � � a A � � � � O o � � , � ��� �.���� �' � 4 � o � � �ay'� � � O �,��y1 ���y1 3 � ; � `�'� y � ^ 41 � "1 �I d � d C � � � � � � � o � I �a `� °� ' w � � � .� .� �' , � .� .� � � � �J ,� ca 'm � � 'id � ��aaa� �� r�ar� 4�� � • � . � , : �3 �.� � � � � � O O N C+� � � w w : � :� :� : y : W . �, -� � � � o ti .� � � � a � � � a° M '� 1-i .Fa a o � � Oq a 0 z .`� � b � � � � a � o �'� E+ y v� '�'� �sr esr c�a ars °o � � �°n. p � � .� N � ��� m � x � � � � N N � 0 0 0 0 0 w ° � cG z � i4 4 � � � w � � ,��. : : � : � o � : � ° � 0 o � � ii N +�' � (A N W �r'Y'� p �aq �i � � � W O cq o� V1 fA � � a x E *'v, � � `" N �„Z~„ O E. .� d C7 E" � � w 0 U v� p� � z F v 4 w � 4 L� % � Z � � a � � �1 ca � � P.� � �. � �: ��� ��� �� �� �q � c° y `�.� av � O �a N n N ��� � � w � 0 N Y � a � �I�C��153`'ROMS HTG. & AIR COND.� INC. 1ob NamP �sb� 4410 Exeeleior �nlevard, Minneapolis 16, Minn. �, �Z6 H6AT LOSS CALCYLATIONS Job Address � Weatherstrips A.S.H.V.E. Construction�No. I Insulation — Guide Windows I Doors Referenee Out. Wall Int. Wall Ceiling Roof F1oor I ICind How Applied Yes—No Yes—No 19_ � Fl•��=�� ��: ,., Room � Length -� =� Width -� Height ;r- Fl.� �. �, Room Lengt6 � Width �� Heigh�' Windows and Doors—Crackage and Area _ Windows and Doors—Crackage and Area �Vidth Helght No. ol Llneal ft. Area- Wldth HalBht No. o[ Llneal it Ares No. o[ pane o[ pane IlBhte o[ crack eq. ft. No. ot pane ot pane lighte of crack eQ. tt. � l - _ �� � � . �, L�, � �� �T �i �a t g�P � � �� � � � €� _ -- - ; �, � °. � ��' �' � � p � � 6� __ i � ; Coef. Btu . Coef. Btu Infiltration � �' �=,^,a � �` '"�' �� Infiltretion � � �;,� � � � °� � Glass � � �� �� _�* �" ;� c� Glaaa � �.a �,`�� 9 �2 �� Eap. wall _ '�' - Ea�i. wall � _ �' "�' 4; Net ex wall � � � P• � F- ��, � �� '' �` _ '� Net eap. wall �? �i � �' �, i" � ,P E� ?. � Int. wall In� wall Ceiling �, `�' �' � Ceilin8 � �' ,� `�= �.� . � .�' Floor Floor Total Btu. �'�� �'' �' � Total Btu. _<�' �`� h Required sq. k. E.D.R. or aq. ins. W.A. Leader area � Required sq. k. E.D.R. or aq. ins. WA. Leader area F7.� -_-,.._ Room ( Length Width Height = F7.1 � ra �r, Room I Length �� Width �/' Heig� Windows and Doora--Crackage and Area Windows and Doors—Crackage and Area Width Helght No. oL Lineal ft. Area Wldth Hetght No. oL Llneal tt. Area No. of pane ot pene Ilghte ot crack eQ. tt No. ot yane of pane 1lghte o! crack eq. it. - � � �' ',� ci c-✓ �I � � f � /� c� � r�r � /� : � f� �' ... COOf. _ 8�11 Infiltration � � �=� �, � �? �-» Glaaa �' �' �; r_, r ,� � Eap. wall �,� � � �' ,�' Net exp. wall ,�° ; a � ,� �» � � r� Iat. wall Ceiling f''° _ �,f' %� �' ,,,a ,� � � � Floor Total Bm. � �� ��` � Required sq. ft. E.D.R. or aq. ias. W.A. L.eader area � FI. d�, ,� � ,�, Room � Lengt6 � ��' Width � �� Height �' Windows aad Doors—Crackage and Area Wldth Helght No. ot Llaeal tt. Area No. ot pane ot pene Ifghte ot crack sq. tL n �, .r'r�`�, �/' � � . 4 .� .� . : . -. /� COef. Btu Infiltration �f ^° �=,`��a � ' ,� , - nn - Glaaa ;' F <_r ;. Exp. wall �?� �` � -- �„ �� ' ,P Net exp. wall 1 i =� `+ � � , � � � ,::» �_ [nt. wall Ceiling A , ' "�'`� ! � S �!`� � Floor Tbtal Btu. Required sq. ft. E.D.R. or sq. ins. W.A. l.eader area � � � � � � � In6ltratioa Glasa Eap. wall � 1,�, � -- c¢ Net esp. wall �� Int. wall Ceiling ,�� � �� Floor �fotal Btu. ��r;� ra �` � Nt°a! �' � H=' 1�: ,,,r_ a ;t' ,�t; r.a " r'.h`� � �C �° ��� Nued aq. k. E.D.R. or aq. ins. WA. I.eader area __ �.� � �..a o Room I Windowa and Doora—C WtdtA Helght N oI pane ot pane II � �, � � �: �� � � � �! Inhltration Glass �. Wa1� �r`a' � ° R-j �� Nec eup. wau 4l / Int, wall Ceiling �' �� , s �? � Floor Total Btu. � Width and Area neallt. Area , crack eQ. tQ � � � � Height Coef. Btu � c-;a , P �� �,-�5`� k ' m —� �� k. E.D.R. or sq. ins. WA. L.eader area � r� �� � C�ppR� (��IS�ROMS HTG. & AIR COND.� INC. �1ob Name �S6' 4410 Fxselsior Boulevard, Minneapolis 16, Minn. �,_ z6 HeA'� L08S CALCYLATIONS Job Address '� A.S.H.V.E, Weatherstrips Construction No. I Iasulation Guide Windows Doors Reference Out. Wall Int. Wall Ceiling Roof F1oor Kind How Applied Yes—No I Yes—No 19_ I F7.� ��� �, �� Room � Length �`� ,� Width ;" 1' Height �; ,(�Fl.) ,�-;".� � � Room Length �.� Width � Height Windows and Doors—Crackage and Area Windows and Doors—Crackage and Area �Vldth Helght No. ot Llneal t. Area Wldth Helght No. ot Lineal ft. Area No. of Dane of pane Ifghte oL cracB eq. ft. No. ot pane ot pane ligbte o[ crack aQ. tt _�y- �,^ �. —s �° _ r�`, � � � �° �� �i"�, � c� / `�' � � � -_ � Coef. Btu Coef. Btu Infiltratioa � c�� ":' a �' ��_ �:�' �'? ��r8tI0I1 /' � '� ' �� � ,� �� WBSS �j �ill ��.,, �i Q'P �� ��, ,F:1 WBSS // �' '=�c � t �' �� ;�'r Exp. wall �'' � � � � �`' Eap. wall �'�- `°_� : � � �- � ;� , <, � Net exp. wap �v° � �' s' ��" �;� ^ ,= ��� <� ^ Net eap. wall Z . f' � �' �' � °3 c� � / � Int. wall Ip� �,`,a�� Ceiling � i �.. � `.� �` cl,' � � � �`� � Ceiling Floor Floor ;�+ � � � ,�� ,�4`'� Total Btu. ^ f � � �' Total Btu. � � � �' � �� Required sq. ft. E.D.R. or aq. ins. W.A. Leader area ` Required sq. k. E.D.R. or aq. ins. W.A. Leader area �F1.� ��. Room ( Lengt6 �,c� Width ,� � Height �� �,� Room I l.ength Width Height Windows and Doors—Crackage and Area Windows and Doors—Crackage and Area Wldth Hetght No. o[ Llneal !t. Area Wldth Helght No. o! Lineal [t. Area No. ot yane o[ pane llghte ot cracB eq. ft. No. o! Daoe of Dane IIBb� ot crack eq. [t. � �� �� � [� � � i� �; � Infiltration � �; � Glasa Exp. wall ,� r,i��, `� � _ �� r� � Net eap. waq � � Int. wall Ceiling Floor ��' �;,. " Total Btu. Coef. Btu bf � � "r � � In6ltratioa �4 � � - � ° Glasa �p. v,►�u �=' E� P�? �� r�' Net eap. wall Int. wall Ceiling % '� � a' � � Floor - f�''' , r`' �� 7'otal Btu. Required sq. ft. E.D.R. or aq: ins. W.A. Leader area B�'�FI.� i�� � a G�* Room Windows aad Doors—� Wldth HelBbt No. ot oane ot vaae Inhltration Glaaa ' �p. Wau � G r�. � � � Net exp. wall Int. wall Ceiling Floor " `� Tbtal Btu. �j Width and A� rea ieal ft. Aree crack ea. it. ft. E.D.R. or sq. ias. W.A. L.eader area Gf. B�II „ i -, �' � ,��'„ c- , - i� �, . j' aq. k. E.D.R. or aq. ins. WA. L.eader area � Fl.) VUindowa and Wiflth 1 No. o[ ysne � Infiltration Glass Esp. wall Net eap. wall Int. wall Ceiling Floor Total Btu. Room I LenSth _ Width Height aad Area neal tt. / crack ei IRequired aq. k. E.D.R. or sq. ins. WA. L.eader area Btu i �� 0 � � . � m � � = a . 1L � 0 .: �` a � C A � v o+ 0 � U � � � �� � :r$.° . 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Q Q o° vi � ro � � � a � � � � � � � q � � C� '° � `g � � � � �, � � � � � 4 a � �y � � � v ti � � � � • . 4� G � a w x � � � . a \ � , `� \\ / _ , , .. '._: \� ; ri o. � o �g. � O �G � ►o � naz .�J � � O� � W � � � fr � � � � � � � • v C • � °OJ 0 � • � � � � � � � � v � � �i �� � � � � � �' � ���� � � o � a ����a� � � � � q q a a � ��� $ � � U � � W 1 � � .� � i � . o z , � � co � 00 � fn �i er� w R � � � o a � � M ai �� �� � � � � � � • � � - � M `� a AW w � : J $ °� «�'� o �s��x � i ° � A „ d w w �� � � � w �^ �� �, d� SM N � N Vi u tyi � � O � � ���w� � � � � � � � � � � 0 � � � � N � i 4 � �1 v 4 � � ,, A � � o ►. L � � �0 � � � �� 3 M �a� O � i� D � a O � � N a� b � � � � � � � � � � � � i I� o I . � � . � • � � � � � � � � � � �:� �sa ea c�i � �o � i4 9t N � w � I � o � h ! e I I ��^, � �� � W � � � � . � . � ��� � � � � � �� � �� �� � � �.. � � � �� �, � � � � ; � � � �, �� � � � "� ic � � �, sa � �'1 �f � � � t§�7j � � o r}r' �.1 S7 � � Pq �,q � p4 F- r,� � � � �� � ro f: �p � � d U e � p� � �� a� � v ��» �?. � ' � � � � E: �: : • _< ao '� ' � 1� � � .� � � � � � � � � Q � 9 -�,r --- — sue�ecT � PERM13123 City of Fridley AT THE TOP OF THE TWINS g U I L D i N G P E R M I T r — � � RECEIPT NO. � ; L____�_ COMMUNITY DEVELOPMENT DIV. ��� a r � � PROTECTIVE INSPECTION SEC. � 1 ; � 1� � /""1 � CITY HALL FRIDLEY 554$Z NUMBER REV. DATE PAGE OF APPROVED BY ----� ' '•' s, 2-sso-saso 910-F15 $ � 75 � � JOB ADDRESS 255 Craigbrook Way N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. � 9 6 CraigWay Estates 2nd SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE John West 255 Craigbrook Way N.E. 3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO. Leo Sanders 7813 Jackson Street N.E. 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. 6 USE OF BUILDING � 7 CLASS OF WOFK ❑ NEW ❑ ADDITION ❑ ALTERATION OX REPAIR ❑ MOVE ❑ REMOVE e oESCR�BE ��s`�a 11 drai n ti 1 e . 9 CHANGE OF USE FROM TO STIPULATIONS TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Y�Z�iI ���@ THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 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. UNITS OFFSTREET PARKING i HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GAiiAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF �AWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED �� �600 .�O WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE PROVISION� OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $9 � 6O STRUCTIO OR THE PERP MANCE OF C STRUCTION. � PLAN CHECK FEE TOTAL FEE � $10. 40 SIGNA RE OF CONTRACTOR OR AUTHORIZED AGENT (DATEI W EN PRO E V ATE THIS IS YOUR PERM IT SIGNATUREOFOWNERIIFOWNERBUILDERI IDATEI BLDG INSP ATE�'��� ' - r - +_� _ _ ! � ' '. • •A�PLICATION rOR RL•SI'DL'NTIAL., ALTL'RATION, � � � • OR AllllITION.IIUILDING �'LRI�iIT ' CITY OF FRIDLEY, hIINNESOTA • . � �� � � BuYLV�x • , � c ��.��� � � . OWNER S NAl�i� • . ADDRESS : ` � ` � ADDRESS • ' '� , � , �/ �-- '. � . . NO:. � STREET: � . , . . � � IAT : BLOCl: • � C� � ADDITI01� :�,� �� � _-�� . CORI�TER LOT:, INSIDE I.OT: _ SETBACK: SID�Y�D: pppli�cant attacr. �o this for� Zt�o Certificates. �f Surve .of L�ot and.proposed . . • building location dzAwn on these Certificates. � . Ta Be Used As : HESCRIPTION�OF BUILDING - Fron� : Depth • � ' Height • : � et: .Cubic.Eeet: . � . -I . . . Square Fe , � ' . ' � Front:� _Degtii: • Height• _ . �_ . � � Square Feet; Cubic Feet: " �� ' . Zjtpe of �Construction: �,��� �'� Estimated Cost:��,/� � ��� � . To� Be Completed: �'�, • � �"' 7 S • • '. " .. • �• The undersigned hereby makes applicativ��for a permit for the work herein specitied, agreeing to do all worlc in strict accordance �oith the Cit}• of ' Fridley Ordinances and rulings oi the Department of Buildings, and her�by declares �thne all the facts and representations stated in this application 8re true and corrcct. •• � ' � . . . �. . . � • • , ' �� ' SIGNATUItE : ' �� �' � • pATE: � _ , . �(See I�everse Side For Addition�l Info�ation.)' . . . ;�� � �, � . . ' . . . , � � . ' ' : - r ��, .��� ' .. . . . . . � � � �� ° . �� • � • . . ^ ��� � . ., . . � • .. s � - �� • � � �. 13U1Lll1N� t'.L•JN�Il! r1�L• ���icLUr.� l • i S�CTION 2. Tlie Inspector oi Buildinfis shall, before issuing permits for the eXection ot any building or sCructure, or for any addition to any existin� building or structure, or ior any alteration or xepairs to any existing bui.lding or structurc, upon app�ication thereforc, requixe the payment by the applicant ioir such _pennit of fees to thc air.ount hcrein below set �orth and f�l the manner lierein provided to-wit: . , • UP�FOr.M BUILDIrG COD�: �►pe 1, 2& 4-$2.15 for each one thousand cubic feet, or fraction thereof, i.n such cubical �ontents. Type 3& S-$1.85 for eacl� one thousand cubic feet. • �• �IDDTTIONAL INFORI�IATION .For the purpose of ;:omputing fees fox building permi.ts, the cubical contents of any builcling or addition, is determined by multiplying�the ground area • covexed from a point six (6) inches below the floor line oi the basement � ox the cellax ta the average heiohts of the upper surface or to the average� height of the•xoof surface of the ma.in gable of a pitched roof. • For repairs.or alterati�ns to�an existing structure, the fee shall be at the ° rate of $3.00 per each five hundred�dollars ($500.00) or fraction thereof in the cost of all proposed work. • �� � in no case shall the fee charged for any, permit as set forth in Section 2 be � less than $5.00. . � • � � VERIFICATION OF'FOUNDATION 0 e NOT�: Permits for construction coill be issued.a minimum of 24 hours fxom the time of application, to allow for proper retriew, of the proposed strucfure and. • of the construction site. . • A Certified Survey of the lot, sho�aing the location of the foundation, once it has been constructed, will be requixed before proceedin� with the fraina.ng. . . CERTIrICATE OF�OCCUPANCY • Application for a Certiiiczte of Occupancy shall be made ten (10) days pxior , to the use or occupancy of any structure for whi.ch a buildin� permit has been issucd; and said structure shall not be used ox occupied until a Certificate �'•� of Occupancy h�s been issued.. , _ •• . � , e � . . . e . .. � . • _ I � . , . � ° �� �. . I . ' I . • � e•� ' • � � • . � . • �� � �`� ' � . �1 ipi � � RM � ,�r. �! O � 5 � N �� � � �u.+o ooe�. ' s�'1+�1 ►�° �• o y u 4 . ;� M ='m0 C � � y.o'�� u� ��uu `% ' a''i�: � � - w��o� � o4�d M � �� . O .�i b+ a'�+ e �' � s~+ �.�i C � ' • O m 'O +� '� . .'�i.�i�m � . l ��x�� R � O O m k a� 3 ( a � i� t"� �� aa m � w � . � ,.�j�j m�am .�1 � O� Sm M . � � m�i� m � � .-�t N +�/ f�ali O 'd , L1... f0 J� FI M �- 10 � m ' °1 a w � a d..°a ,� . � � � o� � w a ro z . � � m,a ww � o a�.�im �wcm �� ti auc+ � ro�i N A Q . . •. .-. t� � A . Z . � Q . O t7 � m � Z � � � � E �x ro V � �l �a�p ' 4.' . t�i, abu� sp�J z ' � ��F3 'as�L+t H � V ' jCTCi{� SE�J w J� 3aqsapl d ���eruo�n� Q su sE � H t�J�E, , �U �oaT3 sxaMOqs . suzr;ano3 buTKursa sdYSy yseM S�UFS su�srg $QAL �I3p8 sTrvFsq s�asoT� svT3o�S ' I �� . � ° �1 � � d �/ � z '_' ' f �) � � � � � � a tJ , }!` �, � • C � � °z �g' o+ .i ,E, C� m H 0 �a a . 0 � M � Q H �� N � 0�0 a ° � �w � � � a o w � � � v� o N f.r 3 � w ro N 3 � �.d 3. b � U 4p' U �.�1 C a�i c � o o ro � O d � H tg u � � a� 3 � � U 9 L1 T1 7] .i' � v m C N a1 ti N M v 0 0 , y y � � • � � � ' 5 �a - w � a � � a � a � O � a .� N N � � � � a. � O w W � � n c � O � 0 E• N IA N N N tA V! t? � t/} y N, fA f!} N 4T f? . . • � w o 0 0 0 00 0 0 0 0 0 o Qo E-! O O O O O O O O O •, O O O O O � N'1 N tV Uf �f1 O Y� Uf ' t!1 M �-1 O tA N N N N N N.-1 t? f? N fA N'1 S? K N . y x x �Q k k iC k �C 9Q �C ?S �0 � � z � � I v z U � � � O N Y � N a W ' � � � z� d� � . �� � � • a� ¢ al o �' a"� � o � H a� .� ° � � � z w ,� et � a rn !� � d. 0� +1 v/ o+ .-1 �. Cl o H N �.y O � N o� O W' O'D 37 � O �3 � 41 O E+ ' O � W ' � o+ p� O H. � M� i C� � r� v w v,� � H o°o x � u. � •-a o .-r ►-1 L y�i Q1 C 11 O W 'G[1 .'C � lM� i-1 6 p y � tw G� a.�i N Ol �� O y U ~ .1 C U �.1 'i0 x w oe o v► � a � w o � �► v •Z-a � s�i w.� u.°i H c7 � .. n ai � a u� ti u d w u � .� a � ,� ,� � „ "' „ i � N '.• ► u ,�, �'z�9� � �w � :l�c� ��� a sue�ecr P City of Fridley � 15 41'7 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. � � �ti: � -�- r � � PROTECTIVE INSPECTION SEC. t � � � /�"1 � CITY HALL FRIDLEY 5S4$2 NUMBER REV. DATE PAGE OF APPROVED BV �"'""� � ��� 612-571-3450 910-F15 8/27/79 � � JOB ADDRESS 255 Craigbrook Way N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. ],9 6 Peasson's Craigway Esta.tes 2nd SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE John West 255 Craigbmok Way N.E. 571-7408 3 CONTRACTOR MAILADOHESS Z�P PHONE LICENSENO. Viking Home Improvement Co. 4832 - 2�t 5treet N.E. 560-3794 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. 8 USE OF BUILDING RPSICIP.T1't,].d�. 7 CLASS OF WORK ❑ NEW ❑ ADDITION � ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Install soffit and facia 8 CHANGE OF USE FROM TO STIPULATIONS TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING. VENTILATING OR AIR CONDITIONINO. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. 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 ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I 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 HEHEIN OR NOT. THE GRANTING OF A PERMIT S�BO. OO $. SO DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMiT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGUTATING CON- STR CTION OR THE PERFOR ANCE OF CONSTRUCTIO . $%. SO � PLAN CHECKFEE TOTALFEE �8.�0 SiG TUAEQFCON7RACTORORAUTHOR12EDAGENT IDATEI WHEN PROPERLY V�DATED THIS IS YOUR PERMIT / � ' ° - � _� .l%f . �' � SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI BIDG INSP �pT CITY OF FRIDL•EY • - APPLICATION FOR RESIDENTIAL BUILDIPdG PERMITS . � (P�ew, Alterations, Additions, or Repai'rs) . , P � . . ` � OWNER: �°'� BUILDER: -��/C �� � �o � �,� � ADDRESS: �,� ,� � � L� AUDRESS: �7'D.��— ���5 %�� . TEL N0: 5���°�%�D � TEL N0: --�� ����� - ST�T NO : �� � STRE , LOT: � f BLOCK: Construction Location ;T: �,� s �c� � — -� - - � 1� g' / ' �. . ' � �b ADDITION : �l��G�i�� f ����� � � • Corner Lot: Inside Lot: Setback: Sideyards: Applicant attach to this form two Certi£icates of 5urvey of lot and proposed buildi.ng location drawn on certificates to scale. . DESCRIPTIO�d OF CONSTRUCTION � �'i �� r��'' Front: � Depth: Height: Squa�e. Feets C�bic Feet: ' Front: Depth: Height: Square• Feet: Cubic Feet:. ' f�� 1�.�+✓T N, ►�,.,. . C�0 . Type of Construction: Estimated Cost: $��� �— 7.b Be O�mpleted: Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: $� $ . , SEE REVERSE SIDE OF SHEET . 7�e undersigned hereby tnakes application for a pezmit for the work� herein specified, agreeing to do all work i.n strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. ^ DATE: �-,�7- %� SIGNATURE ; 5tipulations: ���A``' `j • '�� �U • �� s�b �Uf� ,�,_ ' � . BUJLDI(JG f'ER��IIT f=EE. SCHEDULE� , S�CTION 2. T}iQ Ins�,�ector or 13uilding� shallr before issuing permiL•s for �he erecLion oi any Uui].ding or uL-ructure, or for any additiion to any exis�ing building or strucL-ure, . ox for any alteration or repair� to•any exi�ting bui.lding ar structure, upc,n application 'therefore, require the paymen� by tlie applican� for. sucl� permiL- of fees to. the amount herein beJ.ow set forL-h and in the manner herein provicled L-o-wit; � N�P7 CONSTRUCTTON: 5ingle rami�.y IIomes and Garages: $�.00/1,000 cubic Leet. . PL71t� CH�CY.: 25 percent of bui.lding permit fee. D12IV�WAY D�PRLSSIOII: (Concrete, Curb Stxeets Only) �' • ' Alternate A: Reinoval and replacGment of concrete eurb and qutter only; Driveway width plus 6 feet x Y1�.75 -. Alternate B: Removal and replacemr.nt of cancrete curb and � •� gutter and install a 3 foot�wide approach with �' � .- 6 inch depth; Driveway width �plus 6 feet x$17.85 ' • . �DDI T IQNAL I NFOR�IAT I ON For the purpose of computing fees for building permits, the cubical contents of any building or addition, is d�termined by multiplying the ground area covered from a , poznt sir. (6) inches below the floor line.of the basement or th� ce].lar to the average heights of the upper surface or to the average heic�ht of the r.00f surL-ace of the main gable of a pitched roof. � For repairs or alterations to an existing stn�cture, the fee shall be at the rate of .$3.00 �er each five hundred dol.lars �� ($500.00) o"r fraction thereof 9n fihe cost of all proposed work. . , � Tn •no case shal.l t}�e fee charged for any permit as set forth in Section 2 be less than $7.50 plus $.50 state surcharge. . • ��Z ' : � � � � 1 � " NOTE: Permits for construcL-ion tvill be issued a minimimn of 24 houxs from the time of application to allow for proper review of the proposed structure and of the cons�ruction site. A Certificate of Survey of the 10�, showing the location of the foundaiion once it has been constructed c,rill be required before proceeding with the £raming. � _�ERT I F I CATE OF OC��J NCY ' � ' Application for a Certificate of O.ceupancy shall be made ten (10) days prior to the use or occupancy of any structure for which a building peYmit has been i.ssued; and sa�d structure shall not be used or occupied until a Certificate af Occupancy has been issued. � . • ' � ` . • � ' 0 sue�ecr RMIT NO. City of Fridley � 17 2 6 3- AT THE TOP OF THE TWINS g U I L D I N G P E R M I T � ' � R � � • � ' COMMUNITY DEVELOPMENT DIV. � LV � � r � � PROTECTIVE INSPECTION SEC. /D %�� 1 = � � �'���1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY �----� • •�� 612-571-3450 910-F15 9/26/83 � � JOB ADDRESS 255 Craigbrook Way N. E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDIT�ON SEE ATTACHED DESCR. ]_9 6 Pearson's Craigway Estates 2nd Addn. SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE Janet lniest 255 Crai. brook Wa N.E. 3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO. Mortenson Home Im rovement Mad'so - 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING s.' d 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION O REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK ro f 9 CHANGEOFUSEFROM TO STIPULATIONS Roaf can be 2nd layer but not 3rd. Install ridged galvanized valleys. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ASPh3�-t THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZpNING S�. FT. CU. FT. AUTHOFiIZED 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. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I 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 $`$OO y�`.SO WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- �`1S.00 TR CTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $15.50 SIGNATUREOFCONTRACTORORAUTHORIZEDAGENT IDATE---=� WHEN PROPER ALIDATE THIS IS YOUR PERMIT �� SIGNATUREOFOWNER�IFOWNERBUILDERI IDATEI BLDG �NSP �pT CITY Of FItIDLCY NPPLIG11TI0:� FOft RCSIOL'iJTl/'w I3UILDliSG PCiLiITS (I�ch�, Alterations, Additions, or Repairs) Ot�r�ER: �� � �� ADJP. S : � /�,� [,Q� , ,�' ��� TEL A0: . �� S�- STIiI�T NO: STItEF.T: Effective Aug. l, 1981 't3UI LDER : �?v ADDRCSS: � �� .�' � _ ��� TEL t20: ��/ ��6 �% Construction Location L07': BLOQC: ADnITION : Corner Lot: Insidc Lot: _ /\ Setback: Sideyards: �L.��� Ap�licant attach to tl�is form two Certificates of S�rvey of lot and p:oposed building location drawn on certificates to scale. DESCRIPTIO�� OF COi�lSTF:UCTIOW Front: Depth: Height: Squarc Feet: Gtibic Feet: Front: Depth: Height: Square Fe�t: C13bic Feet: Rype of Con: truction : �, Estimated Cost: �� Zb Be Nr.�pleted: Alt. A Alt. B Proposed Drivevay �iidth If New Openinq Is Desired: $ $ , , S�� PF.VF:1Li: SIDi OF S}IE�T . 19ie unde�rs'igned hereby mal;c� appliclticn for a per�it fcr the �:ork herein specified, agreeing to do .all v.ork ir, strict accordance ��ith the Ci�}� of I'ridley Ozdinances ei�d zulii�a� of tlie Department of Duilclings, and hereby declares that all tl�e facts and represes� t.Ztiens' stated �n this appLication�re true and correct. D.�TE: so�/ � D � SIGNATUI.�.: Stii�ulations : � f / S� �� s� I�� � y ,. � � •�?���7!'_�f-l�"��� _ � I � • - ' The ChieP Building Official ahall, bePore issuing permits for the erection of any building or structure, or Por any addition to any existing building or atructure or for any alteration or repairs to any existing building or structure, upon application therePore� require the paymeat by the applicant for such permit of fees to the amount herein belrn+ aet tortb and ia the manner herein provided to-xit: , Sotal Valuation #1.00 to �500.00 �501 to �2,000.00 Fees =10.00 (Minimum �15.00) a10.00 for the first a500 plus �1.50 for each additional a100 or fraction thereof� to and including �2,000 �2�001 to �25�000 �32•50 for the first a2�000 plus �6.00 Por each additional �1,000 or fraction thereof, to and including a25,000 �25,001 to �50,000 a170.50 for the first �25, 000 plus ��.50 for each additional �1.000 or fraction thereof, to and ineluding �50,000 �50�001 to �100�000 a283.00 for the first a50, 000 plus �3.00 for each additional �1,000 or fraction thereof� to and including �100,000 �100,001 and up �433•�0 for the first �100�000 plus �2•50 for each additional �1,000 or � fraction thereof Plan Check: 25 percent of building permit fee. Drive�ay Depression Escrov: Concrete curb streets only. Alternate "A": Removal and replaeement �f curb and gutter only - DriveWay width plus 6 Peet times �13•50 Alternate aB": Removal and replacement oP eurb and gutter and install a 3 foot Wide approach �ith 6 inch depth - Driveway width plus 6 feet times �15.75 •, � �. .. .� Permits for eonstruction rill be issued a minimum of 24 hours Prom the time of application to a11oW Por proper revieW of the proposed structure aad oP the constructioa site. A Certificate oP Survey of the lot, ahoxing the loeation of the loundation onee it has been eonstructed vill be requfsed before �roceedinR rith the framing. - , � � G MINDER.EN�INEER.INC�r CO.,INC. ENGI NEERS AND SURVEYORS �.wN� avave�nNo CIVIL i�. MUNICID/►L QNOIN[ERINd 6418-SGT" AVENVE N. , MINNEAPOLIS 21. MINN. KE 7- 3637 �!'r�i���d��i�� 1�� �S ���1l� CA R L BEN/VE T T CONST. C0. � 2ss� GIPi9�� a�,'00� w�y .� �, :- ...;; :� �.,;�:. ; ... . , �,��,-� . • • `� � • , so��e TesTiNo LANO PLANNINO - � . ; ��w• ; �` . �y , ti.� n'1 �� � ` � �� 6 ti. � ��� " �'�, � 4�i 4�; 11 ` • ,, , , �,. ', :�^ _pr ` � ai , �,1 S' ry � '� ,v �s . � � ; b� `��'� ; �rn . , ,\\ � � \ `i. ti /;a,� � `��;� ,�o i�; . N �C:ALE I��=4G .��./ ` v �� %� �- ' o ,�, / �° .,\ �. :�°� � �� x , . ., ��.�4�" �� B�K 6�PEARSQN.S'CRr�IC�WAY ESTATES � Nd ADt��O�l. � ��li� HERlO'if � ClRTIFY TNAT 'rN�s �S A tRUE IWO CORRECT R,EPRESENTI�TION OF A SURvEY OF THE BOUN�NRIES OF TNE UWD AQOVE OpS�QI$ED AN� � OF 7NE LbCATION OF ALL BUII.DIN6S � IF {WY, THEREON , AND A1.1 VISl6LE ENCROACHMENTS� �F �w,r, FROM dRON SIUO U1ND.� MINOER E�JGtNEERING CO., INC. or►�o TM�s_� or� os S� _MBFiQ � n�o.���y ENa�N a .,N� av a . ' � . .. � � � � � . C, - �' �. � "� BUILDING PERNIIT FEE SCHEDULE The Chief Building Official 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 permit 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,�1 to $25,0� $25,001 to $50,000 $50,001 to $100,�0 $100,001 to $5�,000 $500,001 to $1,�0,000 $1,000,001 and up FEES $23.50 $23.50 for first $SUO plus $3.05 for each additional$100 or fraction thereof, to and including $2,0� $69.25 for first $2,�0 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 addirional $1,000 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 $1(K1,000 plus $5.60 for each additional $1,000 or fraction thereof, to and including $5�,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 $5,608.75 for the first $1,000,000 plus $3.15 for each additional $1,000 or fraction thereof CURB CUT E5CROW (Concrete Cbrb 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 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 proce�ding with the firaming. New Houses Onlv NEW ADDN ALTER [] CITY OF FRIDLEY �� �� �E� e 4/1/2004 [ J 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp [] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION Construction Address: � �„J�%v �.S Legal Description: Owner Name & Address: �'t? � i17B Z.`1�i � c e�.� S C� � a� I. # 7G3 S�� 7S�l� Contractor. �'e� A a 11�rr ����'�'i h�' MN UCENSE # Address: �SS �ra'o� �v ��IC ' �F ��., r��� . �I,C� ���/3� Tel. # �/����7�-�' -7Sy� Attach to this application, a Cert�cate of Survey of the bt, with the proposed constructuon drawn on it to scale. DESCRIPTION OF IMPROVEMENT — O I��� � . � LMNG AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft T r —�t DECK AREA: Length � Width � Hgt/Ground Sq. Ft `"/��� OTHER: ��.�p ���sr�� �or�rin � Gc.r� �.�w�� �� � ����Z�� j ► �I� ry x /3--_�_ �-- ��, _ _ , . Construction Type: fiVO�a � _ Estimated Cost: $� X �;i `1,3. DD � _ � ��7�•l�� Driveway Curb Cut Width Needed: Ft + s Ft = Ft x� _$ DATE: d% APPLICANT: Tel. #'_7/�—�}/'� 7S�i� Call (763) 572-3604 for Permit Fees if ma ng in application. Fax to 763-571-1287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee Plan Review Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge TOTAL ,� $ Fee Schedule on Reverse Side $ 10� . 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 [ ] $ ? � STIPULATIONS: ADDRESS PIN LEGAL DESC PERMIT TYPE PROPERTY TYPE CONSTRUCTION TYPE CITY OF FRIDLEY 6431 iJNIVERSITY AVENUE NE FRIDLEY, MN 55432 ,63) 572-3604 FAX: (763) 571-1287 : 255 CRAIGBROOK WAY NE : 033024430031 : PEARSONS CRAIGWAY ESTATES 2 : LOT 19 BLOCK 6 : BUII.DING : RESIDENTIAL : ADDITION/ALTERATION -� \ PERM N0.:2004-01161 DATE ISSUED: 07/21/2004 VALUATION : $ 8,576.00 NOTE: SEE NOTATIONS ON PLAN. CALL GOPHER STATE ONE AT 651-454-0002 FOR UTILITY LOCATIONS. PROVIDE SMOKE DETECTORS IN ALL SLEEPING ROOMS AND ON ALL LEVELS OF TI� DWELLING PER R317 OF TI-IE 2000 INTERNATIONAL RESIDENTIAL CODE. CONSTRUCT A 10' X 6' THREE SEASON PORCH ADDITION AND A 14' X 13' SCREEN PORCH. APPLICANT JOHN & VERA, WATKINS 255 CRAIGBROOK WAY NE FRIDLEY, MN 55432 C�l:'/►1�:7 JOHN & VERA, WATKINS 255 CRAIGBROOK WAY NE FRIDLEY, NIN 55432 AGREEMENT AND SWORN STATEMENT This pemut becomes nu11 and void if work or construcrion 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. [ hereby certify that I have read and examined this application and laiow the same to be true and correct. AIl provisions of laws and ordinances governing this type of worl� 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 Bldg Insp BUILDING PERMIT FEE PLAN CHECK FEE FIltE SURCHARGE STATESURCHARGE,VALUE TOTAL PAID WITH CHECK # 5179 �d I „ e. � SEPARATE PERNIITS REQUIRED FOR WORK OTI�R THAN DESCRIBED ABOVE. 167.25 108.71 8.58 4.29 288.83 ADDRESS PIN LEGAL DESC PERMIT TYPE PROPERTY TYPE CONSTRUCTION TYPE CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 r631572-3604 FAX: (7631571-1287 : 255 CRAIGBROOK WAY NE : 033024430031 : PEARSONS CRAIGWAY ESTATES 2 : LOT 19 BLOCK 6 : BLTII.DING : RESIDENTIAL : WINDOW/DOOR REPL PERMIT N'b��2004-01905 DATE ISSUED: 10/18/2004 VALUATION : $ 7,766.00 NOTE: PROVIDE SMOKE DETECTORS IN ALL SLEEPING ROOMS AND ON ALL LEVELS OF THE DWELLING PER R317 OF TI� 2000 INTERNATIONAL RESIDENTIAL CODE. CAULK AND FLASH ALL EXTERIOR OPEI�TINGS. REROOF DWELLING (19 SQ) TEAR-OFF, AND INSTALL WINDOWS WITHIN EXISTING OPENINGS. APPLICANT MARK WATKINS 255 CRAIGBROOK WAY NE FRIDLEY, MN 55432 � ./�I �I: Ma� wa�s 255 CRAIGBROOK WAY NE FRIDLEY, MN 55432 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 l�ow 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 locallaw re�nstruction or the performance of constquctio�n. Bldg BUII.,DING PERMIT FEE FIRE SURCHARGE STATE SURCHARGE, VALUE TOTAL PAID WITH CHECK # 5245 �:.> C a ' SEPARATE PERMITS REQUIItED FOR WORK OTI�R THAN DESCRIBED ABOVE. 153.25 7.77 3.88 164.90 N� [ l ADDN [] ALTER [ ) Construction Address: Legal Description: Owner Name & Address: Contractor. 11 ��:7�_� GARAGE AREA: CITY OF FRIDLEY Effective 4/1/2004 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION s� �+� ► g_����,� �� .,�� � � 5 � � � # 7Lo3 � 7</— �5�� MN LICENSE # Tel. # '7G3 — 7��� �Sf�r/S Attach to this application, a Certific'ate 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 DECK AREA: Length Width HgUG`ound Sq. Ft OTHER: � _ S - , � �Q I`d(3� /,9 �'9P��! w � o�� �ar?� � . ` �- � - , V ° � Construction Type: � i 4�G%G�7S' Estimated Cost: $� .`� ��� � ='� = � �Ga �:°°] �7 � �o Driveway Curb Cut Wdth Needed: Ft + 6 Ft = Ft x$ _$ � DATE: `�� � � � APPLICANT: Te�• # Call (763) 572-3604 for Pennit Fees if mailing in application. Fax to 763-571-1287 ff using credit card and we will call you for card number. CITY USE ONLY - Permit Fee Plan Review Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge TOTAL $ � E o Fee Schedule on Reverse Side $ � � 65% of Permit Fee $ , .001 of Permit Valuation (1/10th%) $ o $.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 [ J � �1 STIPULATIONS: � BUII.DING PERMYT FEE SCHEDULE The Cluef Building Official shall, before issuing pernaits'� for the erection of any building or structure, or for any addidon to any existing building or structure, or for any alteradon or repair to any existing building or structure, upon applicadon therefore, require the payment by the applicant for such pernvt of fees to the amount herein below set forth and in the maziner herein provided to-wit: 3 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 $5�,0� $5�,001 to $1,000,0� $1,000,�1 and up �� °' $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.W for each additional $1,000 or fracdon thereof, to and including $25,� $391.25 for first $25,000 plus $10.10 for each additional $1,�0 or fraction thereof, to and including $50,000 $643.75 for first $SO,OQO plus $7.00 for each addidonal $1,000 or fraction thereof, to and including $100,0� $993.75 for first $100,OQ0 plus $5.60 for each addidonal $1,000 or fraction thereof, to and including $5�,000 $3,233.75 for the first $500,000 plus $4.75 for each additional $1,�0 or fracdon thereof, to and including $1,�0,000 $5,608.75 for the first $1,000,000 plus $3.15 for each additional $1,000 or fractio�n 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 minimwn of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. VERIFICATIOl� 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 ti CITY OF FRIDLEY ' 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 (763) 572-3604 FAX: (763) 571-12�7 ADDRESS , PIN , LEGAL DESC . PERMIT TYPE , PROPERTY TYPE . CONSTRUCTION TYPE . REPRINTED ON 11/19/2004 255 CRAIGBROOK WAY NE 033024430031 PEARSONS CRAIGWAY ESTATES 2 LOT 19 BLOCK 6 HEATING RESIDENTIAL ADDITION/ALTERATION PERMIT NO.: 2004-02137 DATE ISSUED: 11/19/2004 R610� VALUATION . NOTE: AIR CONDITIONERS CAN NOT BE PLACED IN A SIDE YARD WITHOUT WRITTEN PERMISSION FROM ADJOINING PROPERTY OWNER. COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A: # A/C UNITS 1 VALUE OF APPL OR WORK 0 # FURNACES # GAS RANGES APPLICANT CHANGING CLIMATES INC. PO BOX 491056 BLAINE, MN 55434 (763)434-2485 OWNER MARK WATKINS 255 CRAIGBROOK WAY NE FRIDLEY, MN 55432 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 conect. All provisions of laws and ordinances governing this type of wor� will be complied with whether specified herein or not. The ganting of a permit does not presume to give authority to violate or cancel the provision of any other state or local law regulating construc�n or th�erfor�ance of construction. Bldg 1 # GAS DRYERS 0 VALUE (FOR MINIMUM CALC) HEATING PERMIT MINIMUM FEE FURNACE SHELL/DUCT WORK GAS RANGE FEE GAS DRYER FEE AIR CONDITIONING FEE HEATING REPAIRS/ALTERATIONS STATE SURCHARGE, MECH FLAT GAS PIPING FEE TOTAL PAID WITH CHECK # 8969 0 4000 0.00 35.00 0.00 0.00 25.00 0.00 0.50 10.00 70.50 0 .N ` . � � �: Z � � O � � � W v W W � � U � � � � � Z � �k oa � U� � Z W 1� QH � W � _ � Z Z Z Q O � � � go 0 Z o o a � U o W � 3a a Q� o zo � Q Q �•W U � a � a w ¢ � z 0 U W a Z C9 � Z N 0 � J ti � �' m t�o ti W Z � J � N �+- � ¢ ��� � � ` � li > z m O � � ti �� � m � c� V c�p �i � � � J� � � � 0 ., �C v N � � m � Z � � � W a d� � 0 U O W ,� Q � � w � � �� 4� 9 � � � OI "� �' H fA iA �I °o, o°, � m � � � � � C W x � H � � a� L m � 3 °' U �+ co U ` � �i v +-' c � m � � � U � N m � U � �� c aNi g � � � �o � a� � c ai U co a � � N U N C � � 3 N Z � a N m � � � � 3 v O �Z .� m � z 3 ii) ,,°,, m ° �° v O � J Z � � Q � W � U � � � � � � a c� � O = m � � H z ° O U� a � � w -\ � �.. 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NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. # INSPECTIONS 1 APPLICANT MARK WATKIlVS 255 CRAIGBROOK WAY NE FRIDLEY, MN 55432 OWNER MARK WATKINS 255 CRAIGBROOK WAY NE FRIDLEY, MN 55432 AGREEMENT AND SWORI�T 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 conect. 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�construction or the performance of construction. Applicant Date Bldg Insp Date STATE SURCHARGE, ELEC FLAT ELECTRIC FORM FEE ELEC PERMIT FEE - MIN (RESI) TOTAL ��YAKA l� Y�KMI l � li�llUll(�U rUK W UKK V l ri�K l HAN ll��(;K1J3�U At3UV�. 0.50 1.00 20.00 21.50 � CITY OF FRIDLEY 6431 iJ1vIVERSITY AVENUE NE -�' FRIDLEY, MN 55432 (763) 572-3604 FAX: (763) 571-1287 ADDRESS PIN LEGAL DESC PERMIT TYPE PROPERTY TYPE CONSTRUCTION TYPE : 255 CRAIGBROOIC WAY NE : 033024430031 : PEARSONS CRAIGWAY ESTATES 2 : LOT 19 BLOCK 6 : PLUMBING : RESIDENTIAL : ADDITION/ALTERATION PERMIT NO.: 2004-02273 DATE ISSUED: 12/13/2004 VALUATION : $ 0.00 NOTE: COMBUSTION AIR SHALL BE PROVIDED PER UMC CHAPTER 6 AND TABLE 6-A HOME OWNER DOING WORK PH 763-5747546 # ELEC WATER HEATERS 0 VALUE OF FIXTUREIAPPLIANCE 0 # NEW FIXTURES (E7QST OPENINGS) # GAS DRYERS # OF NEW FIXTURES # WATER TRMT APPLIANCES APPLICANT MARK WATKINS 255 CRAIGBROOK WAY NE FRIDLEY, MN 55432 OWNER MARK WATKINS 255 CRAIGBROOK WAY NE FRIDLEY, MN 55432 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 lmow the same to be true and correct. AIl provisions of laws and ordinances governing this type of wor� will be complied with whether specified herein or not. The granting of a permit cioes not presume to give authority to violate or cancel the provisions of any other state or local law regulatingconstruction or the performance of construction. Applicant Date Bldg Insp Date 0 # GAS WATER HEATERS 0 # GAS RANGES 0 VALUE (FOR MINIMUM CALC) 0 PLBG PERMIT MINIMUM FEE PLBG FIXTURES (NEW OPENINGS) PLBG FIXTURES (EXIST OPENINGS) WATER TREATMENT APPLIANCE WATER HEATER - ELEC WATER HEATER - GAS GAS RANGE FEE GAS DRYER FEE PLBG REPAIR/ALTERATIONS STATE SURCHARGE, PLBG FLAT TOTAL � SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 1 0 300 0.00 0.00 0.00 0.00 0.00 35.00 0.00 0.00 0.00 0.50 35.50 0 0 N � Q Q N a U � w « � W a c� z � � Q C Z Q Z � J � O Z O F- Q ci J a a a � � ti, H � U `� � W r a � Z � } W v w Z � J � �Q �� ���� a LL � Z ecfl`,� � O? � � } a� � F_ci v� U c� ti � 0 C u ] C a u s � C u a � u � F u � � LL LL C � w m � � Z Y � � � �a � � W � � Q m 0 c .� N U m = v .� p V t �s � - y �U fp � � Nw � � t O +-� �' "- m € �' c`o o- c a�i � m v � .,� o � � o�� _ ��� .Q N � � c c 0 aNi `' �' '� 3 ' � � , E � �,' � � � ' N � � ' � O �� r m -o � a� t rn � o . .� � N � m ,c � U � u� �-a• F'� N fC ♦ � H ✓ 0 � � W Z 0 � w � � C7 Z 0 J 5 m 0 Z F= � � w a �' b � � l� � O U � W � � w `� C9 �' Z m m � � � W � Z c? a v� J � Q fl o � � 0 0 0 0 0 0 0 0 0 0 0 0 0 W o 0 0 0 0 0 0 0 0 0 0 0 0 �- o000000uiuiuioo �ri Q e- e- ��- e- �-- r- M('7 C7 r r-. � a EA EA t!3 EA f!�? EA tA t9 Ffi EH ER EiJ EA z IIII Z I I I I I ,-. � I I I N a� � ,-. w � F- `= � '� � U � W � C � V � ` _ �i N F- 0�,. � N C �~ Z� -a rn Q W(9 a� � � � c � � � � (9 m � � m c�'m '� a; a? *� d m � ° �'�m °��`__ �°' ° � ����-�� Q-a`� a`� a`����c � � U C N N N V f- O � y N � �. . a ZOmmU�c'n���C�C�m � Z � � w J Q � C QfQ cn Q �Q a� �a � 2 w a� O � � O � 'r �Q`LL �� o a� Z � � Q � c�j o � ,� :�, w o U � � o C � N � 1 P Q m �o � N C LL m � 0 � � r rn � 0 � � m a > 0 a ¢ 0 � cfl N rn m � � � � .u? � � � w W LL J ia— O Q c� W J m H � Z Q Q � 0 � Z O � U w � U � � � L1J a 0 w 0 � � W m J J _ � � Q z O � � m � U i , FILL IN COMPLETELY FOR REPLACEMENT FUEL BUF�NING APPLIANCE PERMITS COMMON VENT; VENT CONNECTOR AND COMBUS710N AIR VERIFICATION Vl/hen replacina an existina furnace, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. � The venting system is plastic/PVC and meets all current codes and m�nufacturer specifications including sizing, length, number of elbows and terminatidn. The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This dbes include AGA-GAMA Category I Central Fumace Venting Tables for fan assisted and natural draft appliances. The existina combustion air is sized and installed to meet the current codes and manufacturer's specifications. When required to install a new combustion air, it will be sized and installed to meet the current codes and manufacturer's specifications. Yes ( ) No ( ) Yes ( ) No ( ) Yes ( ) No ( ) Yes ( ) No ( ) Yes ( ) When installinA a new ventina svstem, the undersigned hereby verifles that it is a listed assembly and meets the current codes and manufacturer's� spec�cations. This does include AGA-GAMA Category I Central Fum�ce V�nting Tables for fan assisted and natural draft appliances. � Yes () IS the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent ar�d vented separately as per current codes. No ( ) No ( ) Yes ( ) No ( ) A�pliance Tvpe and SizelCommon Vent and Vent Connector Information Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Tdal Btu Input 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• (Describe) HEATING CO: Signecl By: Date : FEB-24-2006 0i:27P Fl�M: .�� .. . j;� ......... - -- rr• . D���,�,1 :.�, � Ixispections 'Ib3-572-3604 ��� �,����5: ONVNF.�t1 - 1'E1�tA1+�'� &t1g,µZ'I' �l COPY OF � Youu� sra� LIt:�1S� WJ7'El .- Ap'PLICAFK?N �:• . pE'RNIIT 7'YP�: � � � 1YP� C1F'WOYtK; . 1 t��r�� T0:7635711287 P:2�2 � =0I !�T =ZZ Ic'!� 900i'b�°8�� i Ii.�� 4r iii� , ��a�if RESIU�rT'�`IAL A,PPi.ICA`�'IO� c��rx o� ��a�rx - - - �.,�,,,. 0 oa� Per�i� N� ��� Date Rec'd: NAN�- .. ' � _5'fA7� Z1P' :4DU�: � --- P1�CIN2: �,urrwu�r:_' K1ine Corp. � — . ccrn'ACr P�� � DBA: Praciir.�l Systems . srnrE�.�c��^ 4342B Shady Oak Road _— --- --srA� � ,��5;� Hopkir�s, MN 55343 —r---�� �� �r_ 952-933-1$68 .�—�— . I�SII�tO1.E BA�LY C3 Tw0 FAMtt.Y D'rowrMOUSE D'NE�► O REPLA� �ALIERA170�'�UEL OF WOitlC ,t iee is s minimwo o! 535.08 or 5� d! me totst cost Qp to S50R-00. ��� g�� �� p�R M516�.655 �na pesm � lmprover�ea�, �S�I�on or r�placemmt Of s r�sideaEial fixture, excludi�g c�a flxcures. ("i'bis aha9ld saaact o�ly et�e ce� of t�bor � x .05 � L�D � � L,abor cost �mder 5300 � Sl s.0a. Le�b�or c�t berween S3(�0 to SSOU =�st of i�bor �—� rr• • FOR PR015LT5 WH� �R ��S SS00. FQ� Ait� $.ASF.f3 � Sl4.W PFR FiXTURF, h�CCk�'T W1iER8tdC['EL� FD�tdRF�: (�ICA'[8 MikIDFRdF PACH SELOR� �G: � M4DE1.: ���D��AI� S�Y'ta,�,�.� Bqu�Pa�a�i�uu+i�d �:����� Moar'.�.: ,�-�-r-. SIt.�.lBTV� • �: �� M�DEL: �� �GAS RAI�GP�bVEA� t10.00 NC SZ5.00 FfREpLACta (0 ��5� s� � �q► GAS GRQL 514.00 !�4lR TO AIIt fliCl•TANGFbR S13 �FlltFP1.AC� (w GA5 t313�i' i�R 530.00 AOII.ER 535.00 FUR1�+4G�'i3i.00 "�'PfJ[1L 1�►'1�1t SiS.O� � "`+(;}�Qv�Tf LtNBlt 3lO.oD GAS DRYFR S14.00 �'tOR SIS�O . "�et�CT vVA1tIG S1 a0D dAu PTF'11�� SI 0.00 . � SurCharSe 'f�.? i'AL PUE � � .. ��....r..._.-, - - - Nu�abar off�es �S1a.o0 x • � -- S�' 0 Number of fnteues (a� �15.00 x 515.04 ��„�.^ s Numlxr o!' fnccut�s ��"15.00,� ��5,00 6 S��_ � —�'� Nnmber oifxcures (a� �3s.o0 x S3s.00 ��� s�f.� sw�ct�rga - s�� Tortal = 5��-------- • THLS L5 AN ApPUCATIC�N FqR A PERMIT Nf�T VALtD UN'f1L PROC� � tba# ttt� wor3t w'�1 be in I l�r,reb'Y el�A1Y fot a bw'ldipg p�� aud 1 aek�nttwtcdg,e that �he infnrmatioa above is eompIr�cs �d ar.carpte; • ConiornaaACe with tha tudiagnas ae f�eogr��a�f �e�nd�.vQrflcFs �ot tu�strsrt=•wi hou�A pcnaie rl�a� t t�h�� �+'��l�bc m accardd�with th� �� nat.� P�'�n byt aaly aa app�r,a�on which s reviey► and app�oval vf� �7� . appro�red plan !st tba cas�all w� �° _ lA r� ._,, r �!"� , e ue /'~ �e��` �� �U(lJ -- ' SIdNA'NRE OF . � �.r Ld Wd6ti:tit 9� b� 'G�d c,� �� F�,�{�y �n4idin� Inspec#ions Dapartimeat : b431 Univtrsity Avei�ue NE, Fridley. MN 5543Z 763-572-3604 FA�C: 7G3-502-4�77 �S?i 6G.Ss�:+�.: 'ON �Skl�1 � R�11�1aj ,}o fizl�; wp�,�