AF - 45093��.�,w�.-
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City of Fridley, Minn.
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BUII.DING PERMIT N°• 3 4 7 5
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t)vvner ....................................... Buiider � �. ................ ...............
Ad�lrees ...................................... Address .............................................
'`"} LUCATIOI�[ OF BUILDII�IG
No. �� 3. � S�t . . /. ",�: �y-�:t .,�. .�'.J. .'� . . . P� o� t . . . . . . . . . . . . . . . . . . . . .
Lot . . l �. . BYock . . . . . . �. . . . . . . . . Addition or Sub-Division . . . . ./. .•.'""� . . . . . . . . . . . . . .
Corner Lot ......... ... Inside Lot . .. �.. ..... Setback .�3 �. �. Sideyard . ��.� ....... .. ......
DESCRIPT[ON OF BUILD[hIG
o be sed as: � �. �
N . . . t . . . . . . F�'ont ��. : .� Depth .°�. . y�`�Height .l.�' � Sq. Ft. �'��7 . Cu. Ft, �� � �•�
. . . . . . . . . . . . . . . . . . . . Fran�:�':`. . . . . Depth ��� fl.rf• • : t � . . . . Sq. Ft. . . . . . . . . Cu. Ft. . . . . . . . .
4j►pe of Construction . .. . .... . ��t, J . .. .. .. . To be Completed . . . .. .. . .. .. ... . .. .
In conaideration of ti►e issuance to me of a permit to construct the building desribed above, I a�eee to do
�ise proposed work in accordance with the deacrtption above set fo and in compliance with all provisions of
ordinances of the city of Fridley.
?S. � . � .�.. ..... . ........
o'O
In consideration of the payment of a fee oi a.�.�.... ,., permit is hereby granted to ... .. ...... ........
..........:.............. to construct the building or addition as descrfbed above. This perinit is granted uppn
the express c�nndition that the per�on to wha�t it is granted and t�ia agents, employees and worlunen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordin�nces of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repafr and moving of buildings with-
in the city limits and this permit may be revoked at any time npon violatfon of any the provisions of said
ordinances. . .
.........�...
NOTICE:
Thls permit does not cover the const�uctton, installation or alteration tor wi�inp, plu �as htating,
sewer or water. Be suro to see the Buildinp Inspeoto'�i '�'or �e�arate permits tor these
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SuBJECT
City of Fridley � �� � -;� 2
AT THE TOP OF THE TWINS B U I L D I N G P E R M I T � ��
f
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• COMMUNITY DEVELOPMENT OIV. +�
1 � v � PqOTECTIVE INSPEC710N SEC. J�.�,s j
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' � ����1 � CITY H ALl FRIDLE� 55<32 NUMBER NEV DATE PAGE OF APPROVED B�
�""�' �'� 612-571-3450 9�0-Ft5 7/12/95 / /
J08 AD�RESS 5231 Fillmore Street NE
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
oescR. 10 4 Horizon Heights SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Donald Ward 5231 Fillmore St NE
3 CONTRACTOR MAIL ADDRESS Z�P PMONE UCENSE NO
A-Line Construction 637 East River Rd 4�116, Anoka, MN 55303 422-9944
d AfiCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO
20032753
5 ENGINEER MAIL ADDHESS ZIP PHONE IICENSE NO.
6 USE OF BUILDINCa
Residential
7 CLASS OF WORK
O NEW ❑ ADDITION �7 ALTERATION ❑ REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WORK
Reroof Dwelling (22 Sq) Tear-off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
TYPE OFCONST. OCCUPANCV GROUP OCCUPANCVIOAD
SEPARATE PERMITS ARE FE�UIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTII.ATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OFi CONSTRUCTION ZpNING SO. FT. CU. fT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 OAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENOED OR ABANDONEO FOR A PERIOD OF 120 DAVS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
1 NEREBV CERTIFV THAT I HAVE READ AND EXAMINEO THIS APPI�ICATION STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVEFNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPEGFIED HEREI HE GRANTING OF A PEFMIT 1 640 . HZ
DOES NOT PRESUME TO GIVE AUTHORITV TO E OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR �OCAL LAW R TING CON-
�j�iUCT10N OF THE PEHFORMANCE OF CON RUCTION , 0 Fire S 1.6
�� (�, // PLAN CHECK FEE TOTAL FEE
V �
SIGNATUAEOFCON'RACT OAAUTHOR EDAGENT �DATEi n y�IHEN PAOPER ALIDATED THIS IS YOUR PERMIT
11 `
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SiGNATUREOFO�NNEA�IFOWNEABUI�DE�71 IDAiE1 Bl0 �NSP f�47E
NEW
ADDN
ALTER
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Construction Aadress:
CITY OF FR[DLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
S� 3, � Id �r�g Pe�m��it_ S p�licati� �
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. .� _, ,�--_____r__.�.�. _.��.. � � i � C�
Effective 1 / 1 /95
-�-`
Legal Description:
Owner Name & Address: Q a�. a, 1� �..� c�- C� Tel. #�'� �"` ��`t __
Contractor: I � - �--, ^�- � c��.� �"'"z '�� c� � MN LICENSE # �� ���5.�
Address: % � � c � � uP� r e� . `�- � 1 Co Te1. # �l � � � � f3[ �� '��
LIVING AREA:
GARAGE AREA:
DECK AREA:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construcdon drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height
I.,ength Width Height
Length Width
�-�
Sq. Ft. _
Sq. Ft.
^ � . �t. w�4\ fl ^r
r-,�„�r
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OTHER: �� � � � t`� r C� � �- � � �e. _ w�� �
� �a S� .
Corner Lot [] Inside Lot [] Ft. Yd Setback Side Yard Setbacks
Type of Construction: i c� c� �-•' �.� Estimated Cost: $ _
Approx. Completion Date: 1-- � �l _°� � l�'' `��� ;�%Z,
� {Cost on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ =$
DATE: �r �'� r g T_ APPLiCANT: / � '�- Tel. # � I a�-^ ��'i �
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
s 3 . ac�
$ l � � `/
$ �'j �
$
$ �,(��
$
$
$
$
$ �{� . ���
Ci�Y USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1i1()th%)
s.soisi,000 v��aon
$850 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: . .
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