AF - 41577�� n
City of Fridley, Minn.
$UII.DIlYG PERMIT N° 3 7 91
�te: ...�: ..../.�. :.. �.:. � .... .. .. .....
Owuer ��: �S y�� - — - •� . . . . . . Builder d•�'���
..... .. .... ... .... .... ..... .... .......
....
Ad�'c�ss .�.��.�o. �� . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
�j� �,,. ATI OF HUILDING
No . ............ Street ..... .... .. . .......{.f.r.�. Part o Lot ............ . .............
` f , �%�'
Lot �.�: �: � B�ock . . . . . .?�: . . . . . . . . . ,Additton or Sub-DivIsion �l�i�y:d'�i� . /.'���Q . � . . . . . . . . . . .
a Q /,r y
Corner I.at . . . . . . . . . . . . Inside Lot . .i�. . . .. .. . Setback --i.�: .� .� Sideya,rd .!. GP. : .� . . . . . . . . . . . . .. . .
DESCRIPTION O� BUILDING
T be Us as: �
e (�'> /� ) ,�/
e,
. . . . . . . . . F�ont . �`: :� �Depth ��. �. �� �Height � s. . � Sq. Ft. �Ld. �.�.�.� (,i�. F't. /. ��1. .�
.................... F'ront ........ Depth ........ Height ........ Sq. Ft. Cti. I't. .
........ .. .....
Type of Construction . . . . . . . . . . . . . . . . . . . Est. Cost. /�.���. .�.�. . . . To be Campleted . . . . . . . . . . . . . . . . . . .
In consideration of L'he iss�uance to me of a permit to construct the building desribed above, I agree to do
the proposed work in accordance with the description above set forth and ia compliance with a11 provlsions of
ordinances of the dty of Fridley.
�� .... �..9�:................ . . ....
�
�
In consideration of the payment of a fee oE $ ��.�. . . . . . ., permit is hereby �ranted to . . . . . . . . . . . . . . . . . . .
....... .......... ... .. ... to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his ageats, employe� and worl�en, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintena.nce, repair and moving of buildings with-
in the dty limits and this permit may be revoked at any time upon viola.tion of a.ny of the prnvisfons of sa3d
ordinances. s � ,
� w���T
/0� . r l' oi. �_ �;.- .
NOTICE:
Thls permit does not cover the oonstructlon, Inetallation or alteration for wiring, plumbing, gae heating,
sewar o� wate�. Be su�e to see tha Bullding Inspecrtor fo� separate permits fo� thess Itema
s
� _
�p ._
. � . �PPLICl�TION FaR BUTLDIlVG PERMIT : .
• . . CITY OF�FRIDLEY, MINNE50T� �: � �. . ,� . .
Ownera Name f��9LPl�l � �- $p,ti`�/i/.Sa'1V�,iilder /��� � ��i'- S���S @I�
Addrea$. 1r.� �I� .�f���--�� M Ad � ess /.�sC �'����'��'�° �,E . ��d.S ,
� • LQC�TIdN OF BUIZDING� � . :..
No. � � � 3treet ��.L.�..� . f : Part bf Let �..._. _-_-----_
Lot�',?.�. $].oc�k f' � Addi�ion or Sub. D3.v. „�J� I� !� P/i �t�+► ��0 C�T �
Corner::Lot� � ;:?naic�e L"ot � . .Set Back
Appl3cant�attach to th3.s form Certificate �f Svrvey ef Let and proposed
buildin� �:oea�ion.
. � � .DESCRIPTION OF BIIILD]NG
To �ae .uaed �as� . � , . . .
�� � �� Front �',.� Depth `�' � Height � �����'e�8,
Sq. Ft. � � °� � .� � Gt1. �. �.
� � � FS�ont ..�._...�. Depth � � He3ght .
Sq. � Ft. Cu.� F`t. � .
T�pe of Construction ��°� ��� L� ,�r. Esti�aied Co��� ����
. �,�,-"'_
Te be compietQd .�.���1..���� � ,
. ..; . � , _ .
The underaigned herebg makes applica.�ion�for a permit for the Work ,
herein specified�.agreeing to do all work in strict aecordance with the
City Ordi.nanceg and ruling of the D'epartment ef Buildings� and hereby
declares that all the faets �nd repres�nta.tio�s stated i.n thie appl3�ation
are true and�correc�. �. � ' ' �
Date �i�l� ���� � S � signature ' �
(A 5chedule of Fee Coets can be fovnd en the Reverse Side}
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N. �
BUILDING•P�RMIT E`EE SCHEDULE
3ection 2e The Inspector of Buildings shall, before issuing an� pqrmi.t
for the erection of any building or atructure� or f�r any additian to
any existing building or structure, or for an�r alterations or repair� to�
any existing building or structure, upon application therefor, require
the pa.gment bg the app�%cant for such permit of fees to the amount
herein below set forth and in the manner her�in provided to-wit:
w
2s1 For any such perr�it for ;the_erection of any fireproof building�
ather than a garage, warehouse� factory or grain elevator� or for the
erection of any fireproof addition9 for sitni.lax occ�.pancy� to any
existing b�.ilding shall be at �he rate of °�1.40 for er�.ch one thousand
cubic feet, or fra etion thereof, in such cubical contents. �
2,2 For any such permit ior.the�erection of any fireproof gaxage� war.e- -
houseg factory or grain�elevator, or for the erection of anar i'3.reproof
addition ior similar occupancy, to any existing building shti7.l be at the
rate of �p1e25 for each ons thousancl cubic feet, classified as "fireproof"
by Section 502 of the Minnee.Polis Building Code. �-
HOIISES
2�3 For any such permit for the erection of. any..non-fireprQOf building
other than.a.garage, warehouse,�factor� or grain elevator, or any :.. ,:
non-fireproof addition, for similar occug�cy,. to�a.ny existing building.
� Permit �1,00 for each one thousand cub3c feet.
GARAGE5 � •
2,/� For anp such permit for the erection of any non-fireprooi gaxe.ge�
warehouse, factory or grain elevator, or for the erection o£.any.non-
fireproof addition, for simi-lar' accupa.ncy.., to . any existing bu3.lding or
for each sucY� �- builc�3.ng or addi�ion. 1Vinety Cents for each one •
thousand cubic feet or fraction thereof� in the cubical corrte�ts thereof
with a minimur� of �4.00� . . . _ � �
For the purpose of computing fees for building permits the cubica�,.,., ,
contenta of an� building or addition to a uniform hei ht throughoui by
multiplying tfie ground aret�. covered from a point six �6) inc�hes below �
the floor line of the basenent or.cellar to the average height of the
upper surf�.ce"or to tri� average height of the roof surface of the �,in
gable of a pitched roof. . �'
2,5 For repairs or alterationa to an existing structure, �he fee shall
be at the rate of �3�00 for each Five Hundred Dollars (�5�.00)� ox�
fraction thereof in the cost of a.11 propo�ed work. �
2.6 In no case sha,�.l the fee charged for any�germit as
Section 2 be le��s= tha.n �1��00�
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� LOC ���ILDING
No. street .,�.� part t
Lot �" t' __ Block A tion or Sub-Division ��� T���- 'r'"�- c---
Corner Lot - 7ns�tde Lot Setback �..�� _ Sideyard .�°,L �����8
Sewer Elevation
Foundation IIevation
DESCRIPTION OF BUILDI(VG
To e , as;
Front �� Depth ��►� Height .J_-c� Sq. F't. Cu. F't �!,��
t Depth FTeight Sq. F� Cu. F�
Type of Construcl3on �.���, �y�!�� be Completed
In consideration of the issuance to me of a permft to construct the building described above, I agi�ee to do
'th� proposea work ffi accordance with the descrlptioa above aet�th and in compl�ance with all provisions of
cfr8inances oE the dty of Fr3dley. / ) � � d�
In consideration of the �yment oP a fee of
permit is hereby granted to
to construct the buflding or addition as described above. This �rmit is granted upon
'� �P� �dition that the person to whom it is granted and his agents, employees and workmen, in all work
daaie in, around and upon said huilding, or anypar� thereof, shall conform in all respects to the ordinances of
FridleY� M3nnesota regardtng laxition, construciaton, alteration, maintenaace, repair and moving of bufldinga
�� eitY 7imits and thia permit may be revoked at time upon vio �of any of the provisiona of said
Btaiiding Inspector
(�1 N0110E:
'llds per�f does no1 eorer 16s cooateueNon, testalHlion io� vrUdee. P�+b+e, 6+� bl�s. mwer or w�tsr. B� wn to ses
Nw Bui�din9 �e�ta� %r a4Wr+l+ p�r�is tor t6a� ihrtn.
✓
SUBJECT
c�ty of Fridley
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
i �
� �
i Ly _'�►�_�
COMMUNITY DEVELOPMENT DIV.
r j � PROTECTIVE INSPECTION SEC.
L.-__� ��"' �•� CITY HALL FRIOLE� 55432 NUMBER REV
i 612-571-3450
910-F15
JOB ADDRESS 511 Ely .Stxeet N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION
DESCR. ]_-t,� J Riverview Heights
2 PROPERTY OWNER MAIL ADDRESS
Ralph Swanson 511 Ely Street N.E.
3 CONTRACTOR MAILADDRESS
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS
5 ENGINEER MA�LADDRESS
6 USE OF BUILDING
DATE
4/17/86
786-2208
ZIP
ZIP
ZIP
PAGE OF
� �
PHONE
PHONE
PERM �1
_ _ �18379
ECEIPT N
� �
APPROVED BY
SEE ATTACHED
SHEET
LICENSE NO.
LICENSE NO.
PHONE LICENSE NO.
Residential
7 CLASS OF WORK
O NEW �] ADDITION ❑ ALTERATION O REPAIR O MOVE ❑ REMOVE
8 DESCRIBE WORK
Cbnst�uat a 21' x 16' Deck
9 CHANGEQFUSEFROM
TO
STI PU LATION S
Use treated wood or xedwood or cedar. Center post footing must be
2. 6 sq. ft. of 20 inch ���� .
���
��� �� �� ���1
, ��� �I N�'r � ����I ��'b
t������ ��� R
��G���
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CO
VENTILATING OR Alq CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING
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.
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS ypLUATION
AND,ORDINANCES GOVERNING THIS TYPE OF WORK 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 pERMIT FEE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION ��
�SIG E OF CONiRACTOR OR 7HORIZED AGENT (DATEI �
;'°�; �..� � /7 ��'
SiGNATURE _ N R� F OWNER BUILDERI IDATE�
���� �
��fore dd�girtg� call Icc�d utili'rEC�
TELEPHON� - EtECTRI�' � Gr ; ��,��
RE�UIRE[� ��° ���:��;
OGCUPANCY GROUP OCCUPANCYLOAD
SO. FT. CU. FT.
OFFSTREET PARKING
STAILS GARAGES
SURTAX
$. 65
SAC CHARGE
'2.00
TOTALFEE
$28.15
RL�ALIDATED THIS IS VOUR PERMIT
G
N�' I I
A�Dt;. [ ]
pLTER. I J
City of Fridley
�R-1 ABD R-2 j
Building Permit Application
Effective 4/1/84
Construction Address:� lf ��� � l. ��. ��r/�L r��� �✓1 N_ � s` �° 3�
Legal Description: L G( �% � 3`j' f�Gcc� °�''� f��l�r� (/�'�`�i, �} ( S � N,
Owner Name & Address : /�l �GP� 5 �/� �V � ° /✓ Tel . # � �-���' b
contractor:��i�` %�/f 5�,�¢ /� F �!v T�el . # � 5��22° �'
Address: .1�11 EL� r7' f• �!�- ��(1�Lf�� Mll/- �i��'3� -
LIVING AREA:
GARAGE AREA:
DECR AREA:
Attach to this application� a Certificate of Survey of the
lot, With the proposed construction dra�n on it to scale.
DESCRIPTIOR OF INPROVEMENT
Length Width Height
Length Width Height
Length � Width �_ Hgt/Ground ���
Sq. Ft.
Sq. Ft.
Sq. Ft. 'j °a� O
OTHER:
� '� � � � �` . ��� � -��� ,
Corner Lot [] Inside ot�[ ] Ft. Yd. Setback Side Yard Setback 3�
Type of Construction: Estimated Cost• $s°`�__ ` '?�
Approx. Completion Date: ��i� v2 �! �� $�
Al t . A � � � t�8
Proposed Drivexay Width If Nex Opening Is Desired: _$ �
See Back Page for Explanation
DATE: fl��l� lo, 1���' APPLICAh'T: - Tel. 8 7��`�22a�
, _�
CITY IISE ONLY
Permit Fee $ .�_,,., �.�ee Schedule on Reverse Side
-n
Plan Check $_ ,{..:T �,-�� Jr�25`� of Building Permit Fee
State Surcharge $ �, � •� �.50/$1,000 Valuation
SAC Charge � �425 per SAC Unit
Park Fee $ Fee Determined by Engineering
Sever liain Charge �
� Agreement Necessary [ ] Not Necessary [ ]
iv'r�, a ' �
STIPULATIONS• ,��
��� �
a� � �. � �� � �o�
�''� c , �'�`'`'''"�
BIIII.DING PERNIT FEE SCHEDIILE
The Chief Building Official shall, before issuing permits for the erection of ar.y
building or structure� or for any addition to any existing buil�ing or structure� or
for any alteration or repair to any existing building or structure� upon applicatio n
therefore, require the payment by the applicant for such permit of fees to the amount
herein belor+ set forth•and in the manner herein provided to-xit:
Total Valuation
=1.00 to �500.00
�50,.0o to a2,000.00
Fees
�10.00 (Minimum Fee is �15.00) /
�10.00 for the first �500 plus �1.50 for each
additional �100 or fraction thereof� to and including
�2,000.
�2,001.00 to $25,000.00 332.50 for the first �2,000 plus �6.00 for each
additional �1,000 or fraction thereof, to and
including a25,000.
�25,001.00 to �50,000.00 �170.50 for the first �25,000 plus ��1.50 for each
additional �1,000 or fraction thereof� to and
including �50,000.
550,001.00 to $100�000.00 a283.00 for the first �50,000 plus �3.00 for each
additional �1,000 or fraction thereof, to and
including �100,000.
�100�001.00 and up
d
�y33.00 for the first �100,000 plus �2.50 for each
additional �1,000 or fraction thereof.
DRIVEWAY DEPRESSION ESCROtii
(Concrete CurL Streets Only)
Alternate "A": Removal and replacement of curb and gutter only - DriveWay width plus
6 feet times �13.50
Alternate "B": Removal and re�lacement of curb and gutter and install a 3 foot Wide
approacl: xith 6 inch depth - Drive�ay xidth 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 allo�r for proper revieu of the proposed structure and of the
construction site.
A Certificate of Survey of the lot, shoWing the location of the foundation once it
has been constructed will be required before proceeding with the framing.
�
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HARVEV A. CARTWRIGHT C����� & OiiSON ��M��~�~� r~[ �[cowos os
•MOicw touNTr su�vcrs .1. E. NILL. Civi� EM��ticc�
M[NNt►IN COUMTT fURV[Yf L� ���D S L'R �'E }•URS ��`���~�O t�N
. �+INN[A►OLIi suwv[rs C. F. SANDNpFF
.
lt10 PI�LM iT1�fET•M w. A�Q��1tA[D YNDtA LAM/� OF •fATt OF MINN�{OfA ��V�L EN('i1N6[11
fUMSt� 4•7666 LK(N1t0 •I OROIN.►MCi pI �ITf OF MINh(A►OLIt n"���s~[O 1� '
Owh[• "' •
- , 326 PLVMOUTN OU�LOING : iEocww� 6•8721 . �AMES NELSON
� �r SURYt�OR
INDN�TI��AL - �tJD+CU►L HENNEPIN AT SIXTM . MINNEAPOLIS 3 MINNESOTA , ��`���nMio ��u
�us:M[ss - io►oaRA►Ntcwl ' �b(�[ OT� � MIETRpPOLITAN LAND
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SuBJECT
City of Fridley
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
i �
� �
; i �_��__ COMMUNITY DEVELOPMENT DIV.
f � � PROTEC7IVE INSPECTION SEC.
�` ,�` �'�'1 � CITY HALL FRIOLEY SS132 NUMBER REv
i.��.J �•� �./
763-571-3450 s�aF�s
108 ADDRESS 511 Ely Street NE
1 LEGAL ��T NO. BLOCK TiiACT Ofi ADDITION
oescR. 1,2,3,4 J Riverview Heights
2 PFOPERTY OWNER MAIL AODRESS
Ralph Swanson 511 Ely Street NE
3 CON7RACTOR MAIL ADORESS
Same
a ARCHITECT OR OESIGNER MAIL AODFESS
5 ENGINEER MAIIADDRESS
8 USE OF BUILOING '
Residential
7 CLASS Of WORK
O�TE
10/23/02
ZIP
ZIP
v�GE OF
/ /
�3320�
'RE T NO.
�9� �
APPqOVEO BY
SEE ATTACMEO
SHEET
PHONE
763-786-2208
PHONE LICENSE NO
PHONE IICENSE NO
PHONE LICENSE NO
O NEW ❑ ADDITION D ALTERATION �7 REPAIR O MOVE O REMOVE
B DESCRIBE WORK
Reraof House & Garage (27 Sq) Tear-off
8 CHANGE OF USE FROM
STIPULATIONS
TO
Underlayme�t must comply with the State Building Code.
SEPARATE PEHMITS ARE iiEOUIREO FOR ELECTRICAL. PLUMBING, HEATING, TYPE OF CONST
VENTILATING OR AIR CONDITIONING
THIS PERMIT BECOMES NULL ANO VOID IF WORK OR CONSTRUCTION ZONING
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
Ofl WORK IS SUSPENDED OR ABANDONED FOfi A PERI00 OF 120 DAYS AT
ANY TIME AF7ER WORK IS COMMENCED NO DW�G. UN
I HEREBY CERTIFY THAT I MAVE READ AND EXAMINED 7HIS APPLICATION 1
AND KNOW THE SAME TO BE TiiUE AND CORRECT. ALL PROVISIONS OF LAWS yp�UATION
AND ORDINANCES GOVEFNING THIS TYPE OF WORK WILL BE COMPL�EO
WITM WNETHER SPECIFIED MEREIN OR NOT. THE GRANTING OF A PERMIT �3 � 126
DOES NOT PqESUME TO GIVE AUTMORITY TO VIOLATE OF CANCEL THE pEiiMIT FEE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STqUCTION OR TME PERFORMANCE OF CONSTRUCTION �9J.ZS
E O�� ON7/7ACTOp O UiHOQ4ED oGENT IDAiEi
�i� r� � �- 3�
O� avNEA��iOWNEABUILDEp� IDAiEi
s �
SO.
STALLS
VAL
NCYGROUP OCCUPANCYLOAO
CU FT
OFFSTFEE7 PAqKING
GARAGES
SURTA7(
$1.56
SAC CMARGE `'
F�re SC $3.13
TOT FEE
$ 01.94
IOATE THIS IS YOUR P MIT
N� [ I CITY OF �RIDLEY Efl'ective 1/1/2002
ADON (] 6431 University Ave NE, Fridley. MN 55432
�� ' R�i �2�604 Bidg Insp
I I SINGLE FAMILY AND DUPLEXES R-1 AND R 2
BUILDING PERMIT APPLICATiON
Construction Address: � i �
�/l �L / s�i ,� � �'�"i��,�/. /
Legal Description: ?
Owner Name � Address: _��}� P/f 5'�,¢N�'e%� Tel. #�� 3-� SC-�2 0 8'
_�' � .
ConVactor.
MN LICENSE #
Address: ��-�Z � v Tei. #
LMNG AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Construction Type:_,
Attach to this application, a Certificate of Survey of the
lot, with the p�oposed constructian drawn on it to scale.
DESCRIPTiON OF IMPROVEMENT
Length _ Width - Height _ Sq. FL
Width Height __ Sq. Ft
�
Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x$ _$
nnr�: �6 �� APPUCANT: �/�L�'� �� � �G !�- Tei.# �G'3-7�!'-��oS
Call (763) 5T2-3604 for Permit Fees if mailing in application or Fax to 763-571-1287 if using credit ca�d and we will
call you tor card numbe�.
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Controi
Park Fee
Sewer Main Charge
$ � � �S°�
$_ �. /3
$ .%�_
$
$
$
$
$.
$
CITY USE ONLY -
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1200 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conseniation Plan Review
Fee Determined by�Engineering
Agreement Necessary [ ] Not Necessary [ ]
TOTAL $ ! �%� STIPULATIONS:
BUII.DING PERNQT 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 co-wit:
TOTAL VALUE
� 1 to $500
S�O1 to $?,000
�'_.001 to. $2�,000
$25,001 to $50,000
550,001 to $100,000
$1(�,001 to $500,000
�500,001 to $1,000,000
FE ES
$23.50
�23.50 for first �500 plus �3.05 for each additional $100 or
fraction thereof, to and including $2,000
�69.?� for first �2,000 plus � 14.00 for each additional $1,000
or fraction thereof, to and including $25,000
$391.25 for first $25,000 plus $10.10 for each additional $1,000
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 $100,000 plus $5.60 for each additional
$1,000 or fraction thereof, to and including $500,000
�3,233.75 for the first $500,000 plus $4.75 for each additional
�$1,000 or fraction thereof, to and including $1,000,000
�1,000,�1 and up �5,608.75 for the first $1,000,000 plus $3.15 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Removal and replacement of curb and gutter only - Driveway width plus 6 feet�"times $17.00.
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 construction site.
A Certificate 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. New Houses Onlv
�
� CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
572-36U4 FAX: (763) 571-1287
PERMIT NO.: 2004-02074
DATE ISSUED: 1 U16/ O�
��
- -- __
ADDRESS :- 511 ELY ST NE
PIN : 033024320001
LEGAL DESC : UNAVAII.,ABLE
: LOT BLOCK
PERMIT TYPE : PLUMBING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDITION/ALTERATION
VALUATION : $ 0.00
NOTE: COMBUSTION AIR SHALL BE PROVIDED PER UMC CHAPTER 6 AND TABLE 6-A
# ELEC WATER HEATERS 0 VALUE OF FIXTURE/APPLIANCE
# NEW FIXTURES (EXIST OPENINGS) 0 # GAS WATER HEATERS
# GAS DRYERS 0 # GAS RANGES
# OF NEW FIXTURES 0 VALUE (F'OR MINIMIJM CALC)
# WATER TRMT APPLIANCES
APPLICANT
H P PIPEWORKS
3670 DODD RD STE 100
EAGAN, NIN 55123-
(651) 365-1340
OWNER
SWANSON RALPH G
511 ELY ST 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 aiier 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 presume to give authority to
violate or ancel the provisions of any other state or local law
regulating co truction or the performance of construction.
Arplicant Date_�
Bldg Insp
0
PLBG PERNIIT 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
PAID WITH CHECK # 10133
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
s-
0
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
e
0
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