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N : x : � . m : m • h : o : a ►y7 . r: � • � e � I �� N � � � � � �p �+7 �� O � w� � N � o � o � : o . � : : � : : � iE �a oa N r � o O O � � � H H � ►i � t% �y M z� � z� z x � � � � � � � ��`° � � m � ��. � � `° � . � � � R' � � y �a : � �° : !+1 ~ �j' P/� [a . � • ?. W o : � : � o . . . oa ° : . : : � . . . . : Gd : : : : : � : : : : � �a �e x �a �e x w ta w r+ r� �J C�11 p C�71 O O O � {f3 {fl {!i {A ifl H H � � � � � x D � 1'D!°', � m N n 2 m C r m � � � O � � °� � � � g a � � � m �. � �' w 7q � � � I �� ! ��... M � Y = ; �� : .i'�l�� • `��■� ' ' �l.�i■� � : �,�� „ .. .�,:\='� � �� 9 � � 8 ►+ M J ❑ R• p, � � h ORAtNS �� BASINS AUTO WASliER GAS APPL GAS RAWGE GAS OPENINGS � • Z • �y V� D A � � aa� � � � �¢� ° � ° °�y�� * 'a p, Cs' �p � O � R� � � �� er ��yO � � is''i � � � � � R7 O"A �'� p � �' o � � � d s' '�, O lD y ��w b �� (�p � (�p M e* L� � C� T �� w �y�M � �i+'i � � el �. � °� � ;� � �' d � A �� a� Rx � �°n °� � M 1•O� � � � � �: �i � � � (7 � � {0 � � � � � t� � � � � � � �� 6 � � { '-1' _ � CITYOF FRIDLEY CIVIC CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MINNESOTA 55432 • PHOI�TE (612) 571-3450 J�e 15, 1988 Mr. Michele E. Do�uwardt 6654 East River Road N.E. FYidley, NN 55432 Re: Gazebo (]anstructio� at 6654 Fast River Road N.E., FY�idley Dear Mr. D�o�t�rwaxrlt: On J�e 14, 1988 we inspected a gazebo in your yard at 6654 East River Road. The inspectio� was pm��ted by a ooa�esned caller. The gazebo has been detp*m.�*+� to be in a very serious state of repair and awst eitt��er be c�g>letely repaired oz reroved fran th,e prenises. It was also mted t1�at there was sane accurn�lation of debris in and around tY�e structure which Aaist be re=roved fram tt�e prenises. Yaur 000peratioai in abating this situatio� will be �eatly appreciated. If yau have any questioa�s an this matter, glease call me at 571-3450. We will reinspect the praperty oai or about July 11, 1988 and will hope to find a �uch impraved vonditio�. Si.ncerely. / ��,,! ,� �� l , � � _ ..�.� .. .� . •. - . ... . i. ��. SUBJECT City of Fridley AT THE TOP OF THE TWINS B U I L D i N G P E R M I T �� r � �• COMMUNITY DEVELOPMENT DIV. REC r � L � PROTECTIVE INSPECTION SEC. �� i � ' � �'��1 � CITV HALL FRIDLE� 55432 NUMBER pEV DATE PAGE OF APPROVEO BV �"""� � �'� 612-571-3450 9t0-Ft5 5/22/96 � � JOB ADDRESS 6654 East River Rd N 1 LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED oesca. pt 7&9 Auditor's S d SHEET 2 PROPERTV OWNER MAIL ADDRESS Z�P PHONE Karl Foster 6654 East Ri e - 3 CON7RACTOR MAIL ADDRESS Z�P PHONE LICENSE NO Sussel 1852 Co A 645-0331 1934 a ARCHI7ECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS Z�P PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION � ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE R B DESCRIBE WORK Construct a 26' x 3' D 9 CHANGEOFUSEFROM TO STIPULATIONS Provide a hard surface driveway. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT CU. FT AUTHORI2ED 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 CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORREC7. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIEO WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 13 821 ( DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pEFM1T FEE SAC CHARGE PROVISIONS F AN OTHER STA E OR L CAL LAW REGULATING CON- RU TION O THE PERFORMANC OF C NSTRUCTION. Z _` `� PLAN CHECK FEE TOTAL FEE � \/ SIGNATUEIEOFCON'RACTORORAUTHOA�2EDAGENT IDATEI EN PERL V DATED THIS IS YOUR PERMIT • � �� S�GNATUFIEOFOWNEAi�FOWNERBUILDERi IDATE� � G SP qaTE � � NEw ADDN ALTER � [l �l CITY OF FRIDLEY SINGLE FAMII.Y AND DUPLEXES R 1 AND R-2 Building Permit Application ConstructionAddress: � � ��/ � o �� v �2 � p. Legal Description: Effective 3/1/96 Owner Name & Address: y��. �A.2 L�-v s�� Tel. # S 7/ - l�/c Contractor: � �5 � � MN LICENSE # /�3y Address: /zs5 vZ ��n o .1� c � a ��r�-� �/2� � 5 i� �s Tel. # �� -S�S - e� �� `� � LIVING AREA: GARAGE AREA: DECK AREA: OTI�R: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRII'TION OF IlVIPROVEMENT Length Width Height Sq. Ft. Length a(� Width � G Height i� Sq. Ft. 7� G�C � 7� � Z Length Width Hgt/Ground Sq. Ft. � l3� �l, �� Corner Lot [] Inside Lot �f � Ft. Yd Setback Side Yard Setbacks Type of Construction: C.�/,�� C-7� Estimated Cost: $ /� S�� 13��2/, �� Approx. Completion Date: � e�ru � (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: �j � �G�p APPLICANT: �,�j,J� � �� Tel. #��s - �3 � / Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Gharge TOTAL STIPULATIONS: � ��, 2� � %3o�Z � � .�l $ $ �,.'� $ $ $ $ � �3�, l � CITY USE ONLY Fe� Schedule on Reverse Side .001 of Permit Valuation (1/lOth%) $.so/$1,OD0 valuation $900 per SAC Unit $5.00 (State Licensed Reside�ial Coniractors) Alt. "A" or Alt. �"B" Above $450.00 Conservation Plan Review Fee Determined by Engine�ring Agreement Necessary [ ] Not Necessary [ ] �, � BUII..DING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing �rmits 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 applicaxion 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 $2,001 to $25,000 �Z• Z { $25,001 to $50,000 $50,001 to $100,000 $100,001 to $500,0{JO $500,001 to $1,000,000 $1,000,001 and up 0 $21 (Minimum Fee is $21 plus surcharge) $21 for first $500 plus $2.75 for each additional $100 or fraction thereof, to and including $2,000 $62.25 for first $2,� plus $12.50 for each additional $1,000 or fraction ther�f, to and including $25,� $349.75 for first $25,000 plus $9.00 for each additional $1,000 or fraction thereaf, to and including $50,000 $574.75 for first $50,000 plus $6.25 for each additional $1,000 or fraction thereof, to and including $100,000 $887.25 for first $100,000 plus $5.00 for each additional $1,D� or fraction thereof, to and including $500,000 $2887.25 for the first $500,000 plus $4.25 for each additional $1,000 or fraction thereof, to and including $1,0OO,Ot)0 $5012.25 for the first $1,000,000 plus $2.75 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete G�rb Streets Only) Alterna.te "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50. Alternate "B" : Removal and replac�ment of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $15.75 . VERIFICATION OF FOUNDATION 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 constiuction site. A Certifica.te of Survey of the lot, showing the location of the foundation once it has it has been constructed will be required before proceeding with the framing. � 1 � S 1852 COMO AVENUE ` ST. PAUL, MN 55108 Permit by��— u Legal Descr(ption_ Lo t. Bik Add'n Value Type Const. �S AB: B,y SUSSEL ❑ By Owner Approx. Oln 2-STARTING POINTS ONLY S. P. L. � S.S.P.L. R.P.L. Alley House �_(, F. Street Other ❑ Square With � j�.. ❑ Sod Rem. - By ❑ A.B.U. O � Grade Point U Blocks: LIBy Owner OBy Sussel OWtr.proof: �By Own, �By Sus. ❑Backfill: OBy Own. �By Sussel ❑ Maintain 8' Total Wall Height Including Blocks OR O Maintain 8' Wall Height on Top of B�acks Block Size (Top course) ❑8" �6M' p4� Wall lieight other than � � ---� ❑ � ❑ ❑ ❑ U Existing garage: No O U Detached ❑ Attached Yes O Siae of existing: x Existing garage will be: ❑ Left as is C7 Converted to L.S. • By owner L7 Removed By: Owner�0 Sussel O Junk Must Be Removed By Owner Stakes visible - O Yes O No Survey available • ❑ Yes ❑ No O Soecial instructions from Cement Man — 0 WO' NAME�L JOB ADDRES BLDO CODE I SALESMAN_ —1- .' � I " �_ � � ._C_ � I i , ' I L � I I �' i_i � ' — �—. I ; l . � � —�i__i., i _._J _ �__� .1-- l—� I I _ _�i_ �' , ��—i � L_�r_ ! —I. i_:_i_ i i _ _ ,_ _ -1-1_ �._, _L • _I I -r � ,-- _� _ � !_�_ �__; _�_. _i_J Mr. Karl Foster #6424 6654 E. River Rd. Fridtey, MN 55432 571-1710 30x26 Det. Allbilt W/Conc. 4/30/96 Dennis Jarnot ! � , L _ L. I L �_ L.:� L I I_.L_ � ' .� ' � • � . . '. __ I I _t-. . ,.--� �_ � ' ' ^ J� ,. L _I IJ '.. � � � � � � � � � � � � � I � I � I � � � � �'� � �_��!_.a' ��' --�--- �� , �,� �1,1�1,i ,I�; ,� � ,_��-i--�. � =J , ,' a s- 'I '_ �.l � , ;'/ , � ' I I : a__' _ 1_ � , �_, , � I � �. � � i_� ._l_ j_ � --i--� � � ' ' i ' � i ; I ; _a �_ :!�illia' � ;'� ' i� '�_'_� � i.. _ I-J � � � � } i � � _L � --1 �. _�__.I .�_ .i _ i .1.. __�_._I ,� .i ; � � � _ � y —I--U--�—� _ .� . �i I i �. � I , I �� ( 1. � . � � i I � I � •' } i I � ' t i ' , �� i , � I ' ; � � � i�� - � i-�, � , �� ' , � , � ,_� ,_� ,_ ��►��, �� f ��;;i� ; ; ; � � i ! �f; i_j; 'I!.I ; _ { ir �v�'�"1, � (a_�-:�-=1: —i � , � , , — _ � iy � -��-i � �I-� .� - C__��!f_`�� i I -�-� i � i I I i t 1 � � � � _ ��l 1 �-- l ,_ ! —�— �— ,_ �. , __ �__ _ ._�_ i � � � �_ .l I �- � I ,. � I 1 i f I I! � i _� I / i i� I J_ � + � /�, I �� j ,_I_ !-� :_. I_ � � i -_ t__ �-_i i--l.- 1�--"_I �� ', I � I �rt � � ,_ _; I �- I � I , . ! ! _� � i � i i I !- - � i I ' � I � .�._.__'_ _ _ ,_ . �- - - i � I � ! ! � I i I I � � i I � --- _ _ _�-- -� _. _� i ; � '. I. I I I � I I ! � � � ' � I - - - ..I.�.�-J�...J��__J— �-..'; . � _I � � � � 6_ I _.I j I I i ! ; i I I I - - __. � -I -�--'--- -�.._ ACCESS O Good ❑ Fair ❑ Poor PURCHASER'S INITIALS: " _i. c �� , ..., ��. . �_ ''� _,� ' \�``� ,,,� . .�. .... ,- , _ __— �.�,.�,e,.e;�. � ROOF; GABLE REVERSE GABLE HIP �, :' '+� N � EAVE OVERHANG: � RAKE OVERHAN(3: � SEAL DOWN SHINGLES WITH PLYWOOD OR WAFERBOARD ROOF SHEATHING AND 15 LB. FELT �� Roof Sheathing � - Seal Down Shingles � I Manufactured Trusses --/ 2" x 4" Double Top Plate ' � , NOTE: 1j Roof approved by Minn. State Building Dept. as meeting Minn. State Code Requirements of 30# snow load. 2) Hip roofs consist of 2" x 6" rafters, 2" x 6" cross ties 48" O.C., 2" x 8" hip r�iters �nd no plywood gussets are used. �> RAFT�RS: /Tru es � 24" O. .°�j� %�� Ce/'1"T�� Z Sly��l� C I I STUD�u: 2" x 4" 16" O. . 24" O.C. �� WAIL SHEA H�NG: . . SIDING: OVERHEAQ DOOR HEADE : Double 2" x 12" o Z' � i� �N cro Lams x ,�it/C� �.�'I�S iSlab {on grade construction approved per Minnesota State Code. Refer to State � Build�ing Code Letter Number it. �, ' SLAB: 4" WITH MESH 6" x 6" #10 Gauge , i � 45 Trim 1"x4" Sub Fascia -.,� Fascia \— Sofiit 3/4" Cove 2" x 4" Studs Siding �i�/ 7 � ��'il�� i �,� �� L � �, . � 1 i2" x 7" Anchor Bolt 2" x 4" Treated Bottom Plate ri �i � L_, ` � Grade . ` '� �/��/��/ � ��/ � 4' � �� -� i �.�.� : � . . . . ■ �1 �� ■ il �� i ■ �I 1!� ��\� ■ �1 �i17 �� ■ �I �� o�� .�.�C..■... �■ ■� �.. o■■■ .�.��...... .... C::: .... FRCIM :City of Fridley FAX N0. :7635711297 Feb. 13 2��6 �19:06AM P3 Buzlding Inspections 763-572-3604 srrfi nnz�RSSS,� TH1S APpLiCAT TT 1S; OWiVEIt� 1�NAN't' sv�rrar A cap�t or• YavR s�'a.� UCENSE 9�'TTH /�PFUCATfON PER.NIIT TYPE ?1�E UF W ORK: IVIECI�AI�ICAL R,�SID�N'i'I.�L AP�'LiCATION CITY �F F��Y ��_ Yev�s.n�a.nnn�s �Z��e � awrt�.x �coNr�r+L lu� 1�1AME?; � � �R�; cr�,t PHO1v�; — — �^.�.� Cot+��tr��: ,l�'� Sea��1Ce�,�.—_ coNrACr rs�esax: � f � � �-- STATE L.tCI�VSB 41 �' pAT& _„ anD�S: � — 15�a hC e�d � ct�^ rHCr� � ' S?� � - ¢�►x .��:�2� ❑ NEW FAMyLY OTWOFANIII..Y UETAILED DESCRIP`t]ON UF VNaRK D TO'�7�iHOUSE O AL7'�ATIOAURgMOriII. pErmit Nv.: ite�eivcd ay:, De,te Rec�d: � �' i�t�►u�n /� ��- 9 �1 �f'.�' � J, -._.^- ,__. ,^..—r.^ PEIt MS I6B.66S tbe �ntt'Fca is a�iQimum df 515.00 or 5�% af the tot�l cozi ap ��q� direflect n�cost f]alwr ) y�nprovanent, insrallatiion or repleo�macit of a re�Edcntial �i�cture, exah,ding tba fixtur�. i Y.abar ca`t under 53ti0 � S15.Ob. Lubar c�stbetween $�� tio $340 � co$t of labar, x. � �'13R,#'itQJSC'fr 1�7i�3tE LAB(}R EXC�DS $500. FE�S A.RE SAS� ON S 30.00 PFR FiXTU1tE, EXCg'T WI°�RE AtOTEA. FQC7'f JRES: (�1DiGA'IE TOTAL NUMBFdt OP EACH B�Ldu'J MODEI., „^,^.� S1�EIBTU ...., - Lc}Wpmant]ne�llod . �� ^---- MCl1�7.: r„�.�.� S)ZBJBTU,�,.,_ A!C �zs.00 �x Ta a� �cct�c��x s� s �aon.sx �as.oa C}.�/p��Y LBVif3R S10.D0 '—nvCT woltK S1Q�00 3urcharge TOTAL DUE MFG. _,�� : �_ 51ZFJBTIJ �'' �---� 4AS RANQFtC)VEN S7.(1.OQ� F��ri..ACE tan31$1s,oU Yae�a �as (r�RBr. Sio.o� �Pw�r►c� twc�onl s�s.on a�as t�rrt�rree s1o.ao ^FURNAGE 535.00 p00L I3EAi'ER S35.W GiA5 TIRYBTt $iQ.�! —°'��,ATOR S13.OQ r/ ��, F Numbts of �i�res Qa �! D.04 x$10.� � 5_,,,i„a. �� Number �f fixh�rea Ca3 � 15.00 _ x $13.�0 � $ $ � _ Nurqber of fixtures � $25.00 x �25.� _ $ Nw'nbar of fixtures (a� $35.00 � x �35.00 = � � . State Surcd�ar�e'� $� Tot�►J = $ ' TH1S 16 AN APPI.ICATIUN FOR A FBitMIT�IOT YA,LID UNT[L PROCE�SED t hereby apgly for s building }�m1t a�►d I acimowlcdgo ih�t th� informatian above is complaL� and aacurate; that the 'e'+'o�rk wlll be fn c.�afcmaance aith the ordinancos and codes of th� City of Fridley and with the Minnesata �Gasj��pruct{an Gndca; t�,et I understend this is not a permit but only a� ►ieatton f�r a permit and work i� nul: tt� at�rt witlsnut e�?ea�it; �t ibe work wiA be in aecordeace �lth thc �ppruved pi� in the case ll wark wk�ic quires review end p�v�1 of ��I�-�, ��/J ��,�3 �� a SIGTIA'NRL� OF APPLiCA . � . _ .. - C� Of Fridley B�ilding ��aspections Department 6431 University Avenue NE� Fridlery, Iv�hi S543Z . 76�-572-�604 FA,�C: 763�502-4977 3uilding nspections �63-572-3604 ,A� �� ` 0 ITE ADDRESS S 'HIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACI'OR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PROPERTY TYPE PERNQT TYPE �rYrE o� woRx: BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY YOUR E- ADI�. F�ESS _ � �ii..s� ' � <" y rrf�� 17 % .E, �� ❑ O OCONTRACTOR � =t� ��G � �'l ,,� ji �Fec• ,_ S� /i � S� : v e y Ci7'Y �/ i � y NAIv�: STATE LICENSE # E}� DATE Permit No.: Received. By: � �- � Date Rec'd: �� / `�� ' ADDRESS: CITY STATE ZIP, YMEW 0 BASEMENT FMISH � ROOF O DECK ❑ SIDiNG ❑ SR�D�IIvI DESCRIBE WORK BEING SIZE ARPROVEMENT G� 0 ❑ DRAIN TILE O OTI�R �-n�/o �S VJIDTH HEIGHT Ft ROOFIlVG �J d� HUUS� UNLY NUMBER pF SQUARES / ❑ HOUSE & GARAGE RACF� ]�ODELING SUBMIT: GARAGES ❑ ATfACHED GARAGE 1. Exisling F7oor Plan � DETACf�D GARAGE 2. �� r plea PROPOSED S1ZE: 3. List of str�cmral members to be used PROPaSED i�IGHT: FORNEW CANSTRUCI'iON INCLUDWG DECKS, �- �Soffrt �niTi[)NS & PORCI�S SUBMIT' ❑ Vinyl ❑ Aluminwn O Trim 1. Site PlanlSurvey showing the existin� struetures O Other O Fascia and proposed pmject 2, Two seta of wnstroction plans WIIVDOWS 3. Energy Calculations IN E3�S7TNG OPENINGS I�Yes ONo T�O QF WIN OW6 OR FOR NEW OPEMNG&DESCRIBE SIZE OF = D i��"'� � � a O y�I .' XD G� OPENWG CHANGES 8c �" TYPE OF WIIJDOR' TO BE 1NSTALLED � ER OF WD�IIIOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (LTSING THE 1997 .B.0 FEE SCAEDULE) TOTAL JOB VALUATION $.,Z �t`�� C�� T�E Permit Fee Plan Review Fire Surcharge Surcharge License Sutcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Dne $ � 3�� See Back Page for Fee Schedule $ 65% of Building Permit Fee $ � lp � .001 tunes the total job valuation $ ( _ � .0005 x Permit Valuation Minimum $.50 $ $5.00 (State Licensed Residential Contractors) $ $1550 per SAC Unit (Plans to MVJCC for determinaxion) $ ft+6ft= ftx$21=$ $ $450 Conservation Plan Review $ Fee Determined by Engineering $ Agreement necessary ( ) Non Necessary ( ) $ , �� Make c6ecks payable to: City of Fridley Attai THIS IS AN APPLICA770N FOR A PERMTT-NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I aclmowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application f r a rmit and work is not to start without a permit; that the work will be in ac�ordance with the approved plan in the case of all work ' r ' s re ' w d approval of plans. q r �/ p_y��,�•� ✓ � SIGNATURE OF APPLICANT PRIIJ'f NAME U Y'�- cl� DATE / I�/ /' � Page 2- Building Residential Application BUII..DING PERMIT FEE SCHEDULE The Chief Buildi.ng Official shall, before issuing pernuts for the erection of any building or strueture, 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: VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the ti.me of application to allow for proper review of proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the existing founda.tion will be required before proceeding with the framing. New Houses Onlv City of Fridley Building Inspections Department 6431 University Avenue NE Fridley, MN 55432 763-572-3604 Fax: 763-502-4977 •� ��, _ CI7YOF FR(DLEY FRIDLEY MUIVICIPAL CENTER • 6431 iJTTIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763� 571-1287 BUILDING PERMIT APPLICANT: PROPERTY OWNER �, �-e-- '/" I �.��-ls understand that the State of Minnesota require that all residential bui ing contractors, remodelers and roofers obtain a state license unless they qualify for pe�ifc e em tion from the li nsing requirements. As the owner of the property at � �S � G� = ti�Y � , Fridley, I am exempt from the state licensing requirement only if I am not building or improving this property for purposes of resale. By signing this document, I attest to the fact that I am improving this house for my own use and do not intend to sell it. 1 hereby claim to be exempt from the state licensing requirements because 1 am not in the business of building or remodeling on speculation or for resale and that the house for which I am applying for this permit, isl the first residential structure I have built or improved in the past 24 months. I also acknowledge that because I do not have a state license, I forFeit any mechanic's lien rights to which I may otherwise have been entitled under Minn. Stat. 514.01. Furthermore, I acknowledge that I may be hiring independent contractors to perForm certain aspects of the construction or improvement of this house and I understand that some of these contractors may be required to be licensed by the State of Minnesota. I understand that unlicensed residential contraating, remodeling, and/or roofing activity is a misdemeanor under Minnesota law, and that I would forFeit my rights to reimbursement from the Contractor's Recovery Fund in the event that any contractors I hire are unlicensed. I have also been informed and acknowledge that by listing myself as the contractor for this project, I alone will be responsible to the City of Fridley for compliance with all applicable building codes and city ordinances in connection with the work being performed on this property. o , / Name � Date �� / �� o�