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AF - 45363SUBJECT City of Fridley , 12098 AT THE TOP OF THE TWINS g U I L D I N G P E R M i f � � RECEIPT NO. � ; v _.__�_� COMMUNITY DEVELOPMENT DIV. � ��d r � � PROTECTIVE INSPECTION SEC. ,y 1 = � �� /"�'1 � CITY HALL FRIDLE� 55432 NUMBER REV. DATE PAGE Of APPROVED BY •"'� � ,'� 612-580-3450 910-F15 4/13/73 / / JOB ADDRESS 2 1 n o S e 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED oescR. 15 16 H Riverviesa Heights SHEET 2 PROPERTYOWNER MAILADDRESS 21P PHONE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Drake Desi ns Inc. 7226 Riverdale Place 4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Dwallin 7 CLASS OF WORK � NEW ❑ ADDITION ❑ ALTERATION ❑ HEPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct dwelling 24x43x20 9 CHANGE OF USE FROM TO STI PU LATION S Provide a veri£ication survey. Provide hard surface driveway. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. WOOCl f1"8IDe THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING Sa. 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 Z�OLO 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 PHOVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $I.G SOZ.$$ H.�FO DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $38 � OO $L]S • OO STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. � PLAN CHECKFEE TOTALFEE 4/13/73 $321.40 SIGN REOF ON oR ORIZEDAGEN7 (DATEI HE PROPERLY VAUDAT IS YC�UR PERMIT � ✓� � SIGNATUREOF NERIIFOWNERBUILDERI IDATEI - 0 � c� " ' . —"` - �-� ----' --' � .' w3 —',-Y._...��_.. .._. —"__ � '--_ --`�_--_ — . _ ° �_-�-: _ .. _ _ ., :i,, B. H. BRADLEY ` , CIVIL 6NOIN�R AND SURVEYOR ��I�t°Il� � '�C'7 L' �+Ir`CS �4 �.'� ��`�f � �� f�C � 5828 -24TH AVENUH SOUTH MINNBAPOLB. IdQ�NE8C1'A 88�0 � ,r'y di `fi ,�4° i �G�.3 ��.",�( C! �� j�.�C'' !7 £: }� � ti, � 724-2189 a � � �� '" � " - ---�'�° ".�,.'"°`��—""„'°-� z+-„ ..,� � a, i '� ,. •°9 fl � a �� ft � 7' '� _ � F'� � � �- �'`t.� +� t.� �'. s i � y: �. _ . .�. f t. �� . ,�:..:.. ..' � � Q ku� O K,t� �+. ;. r� ",�� 7�►�� c��t��`e sha�v.� t'h� ln�tfa� o� �"�� ,�.�e�e�t �� o z` s/5' ��f t�� 3ldc% i� �t veh�rr er,�+ �{�Igl, ts� ��;r t�ie C''df� a� ��cl��tf �5 �/�ec�e�(7 a � �� e � �� ' I�d � fi7.t. �.� � 1 � ��r �:;�•'.��.�.�.t�vj ��', �f��.-�� .tl�� .,, � B. H. BRADLEY � y //J� i /� CIViL ENOIPtETaR AND SURVEYOR ��! Y�J /G; B�J g'�r P� a F�� // �I � IfS �� C� 3829-24TM AVENUESOUTH tl �� MIMiBAPOL1e. MINNfieOTA t9d01 �%�� B �e r�� j� �� — I � 724•2169 p ��!0? �� fi; .�d 'r� �?� "�,` e � y�6�M"+�r �I� c�C � �� f � s �� L e r` [i' � �� , � ..e .�,.s. � Lot /6 �I � a.��i.�.:.°_�.. � � �� 1/O` ��, �...... _...._ ��' I y3� ib� � � � � ---� � 4I ' o V S � l � �r � � � �n g 'U �539 � 23 jbe�eb� cart�� °�aat f�JSS IS �/ Coht�' t�praseN�$irow +f �► s�,«-�oY o,� co rs l5dr�.l 16, �?/ock M� Rivavview �feeyl,ts� �i� �f%d 1etr. �s s��e�e� by .+-,� th� �Z "d a�' l"1ar+ch l�73• , - %�.//r ��.� l�a�. Jvrv�ot %i�o.//�� 0 r . � � � r 0 i �� i z� � r °� � � �F.��T��T�� R��IA�N��. �LT��ATI��, Q� A�A�T��N BUILDT�G P�RMTT G�TX pF F�T��Ye MINN��QT� IJy�TF,�!' S�: 1�UTLDEft s�af� �v° C� ' � C, �n�ss : ��ss: �j�2� ��,- a l e , P� � �v►�,� � �� s�T� I nGo--�^ , . , A-. .�. _ . „ . , _ �, . . . 4A/�+R� �� /CO J�LW�l1•� �� ` ��M396�r.1.Ma'��^yw�lfi�iT.Li �.L�T� �a�e� / � �GA�NER LOT: �� LOT:� � SETBACR� 3� SIDEY�RD: ��O ,��3,� 8,�t�c�i �, ��+R��„a Certificates af SusveY of Lat amd propp��d �m�i,�� .+aeatiox� d� �a �ese Cer�ificates, � ��dIPTI�N OF BUILDI�JG � � t3te� � : �YU �' i i Yl � , � �� n�+� = '� � ��t � 2° Sq�aace �'�� / 0 2° Cubi� F�eg3 Frantt Depth; Height: . �cjua�s �eet; Cubic Feeti. 2�� OOV, O p �d{� o� �io$ti9t1Z1C�i,d�� ,�r_..a�.l�'1-"�.+ Fietim,aCed G08�:, S , � ��,. l: r'' �.';: � � � l� : �� 'l��d a ,_..,.......�� y l :� �. ,..� � _ � s�+�ig��d hereby �lc+� ra�l�tcat.��an #or, $ pe�.t €o� the w��k h�rein #��,�� ag�ee� t�c+ da a$�, wt� i� att�.ct acco�cdance witt� �h� �,i.k�► af $s'�d�s�i' 4i6"�.�� lst� �f t�e ]aaP'arl�aea� Af Bu��dis��, +�d '�ezeby ��,�� all �hs �gcts a�d s�reaenta�ia�s stated i� t.�,'►ie ap�+I�,catipn a� � ett�d cpnect„ . �,�',� �/Z `�3 �I�G��: - --�� $�1�f0�� aL' Acid�R�onal Info�tigatiaa.) �` '`,� � � Fa•� �� , L/ �`I ,,;' �; ti � ,ZV � / � (s r2 . _ � � � �� F� ,¢ , � � , � jr/ J � �. n ,r �UI�AIN� P�RMIT F�� GH�DU�E �T��QN 2, The Inegect4� pf �ui.ldiags sk�al�, befozQ issuir►g permitm for �he ��.on o$ a�y bu�lding �x �tructure, ox for any addition to any �isC�.�$ '4��.�.d� ox stx�Gture, o�r fo� any alteratio�. or xepair� �o any exi�ti�.g �e�3,1�� ox st�ctuxe, uparA �ppl.�&a.tion theref�se, xequire the pa�A� by �he ��.i.��t �p� such pex�,t of� �ees Lro the aipount herein below sat for�h �d ix� �� na.a�a�� hec��e�.n g��►vided � �o4wi� � UNi�ORM Bi]�LDi�TG CODEz �Pe 1.�, 2� G-$2.15 for each catae thous�d ct�bic �Ee��a �+� ��;action th��c�a�, ia �u+ci� cubical con$ents, �pe 3& 5-$�..85 fo� �acb o�a t�vuaand �b�.c iseC. , � . A�D � T �UNA� I �IF1��tMAT � ON F�� fi�t� pu�@o�e o£ �ompu��t� €ees for building permi.ts, the cubical contents oi a�y building or addition, i� d.etermined by mul�$plyin� �he �round area Qoy��ai ��q a poi�� :&ac (( j in�ies below the f lcavr line a� the basement � t'�.�� +��la� �v �he average jneights of the uppe�c surface or to the averap�.� �3,�� t�� e gcoo� �aA��ace o� �he maiA �abk� pf a pitched xoo�. ��ira Qx' al��ea��o�s � an existin� s�tuare� �ae f�e shall be a� �he ��,�e v� $�,�0 �e �+� ��ve h�dxed dollax� ($3QO.Qt3) � f��io�. ther�o£ �.n i�,� ca�� al�. p�o�sed w��t.� %� cat�e sha�.l �� s fo�c at�y pe�it as set fQ� �an Se��an 2 be � �au $S.�i. � V�R.��TiQ�i 0� ��iJNAATI(iN �� e�rsi►its �o� �c�st�u�g�tau wil� be i�$ued a m�.� oi� �4 �raurs fxam ths �f� o# �pplicat#.on, �v a�$aw �o� pra�er r+ev�ew of the �,xapo��d a��u&�re �d �� e �stxuction &i�e. ' � C��,�i� Su�v� vi_' $� �.��, �a�i:t$ t� �ocati�; c�� he �auuctatir�x#, u�� #� l� ��t �s'i��d� wiii �a ge+�nired be€m�e tsroceedin� w�h ti�e �r�3�, , a� � C�RT'TPI��i� UF (��PAN�Y �a��.i.s�at�.o�a �cs� a G��ataa c►1 Uccuparrcy �hal l bs mads tea (i4) �ay� pxi ox �o �h� �se . c�x �c�upa�eee�r af ��r�cP.u�re far which a bu�.ld� pe�uti� has besn isaue+�� sa��d sl��t�ut� �'#al� tsot be usea o� occup�ed uatil a Cs�ti.ficate af p��upa�cy � b� �ssaed. p v � . � � � � A � ! ^ frl 69 c.�t . � � s i� � � � � m r � � � � � � �� p � � _ � � � � • � C` � � � � � � a � � � � W � s9 � �� '3� 4��i � ��. � � � �� o �� .. o� ��'. . ��',�,� � � ��., � C o � �� .. - _ � � � E � � � w � O $ � � � � � M M �°� Yq `� � e � �o V� c I. �� . O i � � � � � 4 � � � � � � � � � � � � � �� ti 8 � � � � � ,� � � - (� o� � � � � a� a � � � �a� � � � � .,� Q�� .�� .,� � .� � �� ' � � � �� w � o � �s�� M � M i �� I ( I i � � , m � i , � � i �' � � � « „ i � � � � � I d ;O � � �c� i I��i�. : � 0 J � � � V`, �� ,� � � � �• � R• R• � �'�� ,�� ,�� .R .� � ,. �a � m� �� : � �� :� e� �a ;� ee � �s�� 0 � � � � � M . � a � A �:� � � � � �• � ��q m � fUd A � � �� R�� ' � � � ` � � � � �� ,.� � � ��. � �� w o � �� , � � i � � � � a n � �� » �� o��. ��W� p� A �d �� .� �� e o � � y�� `� � � �' � � �°'�� o�� (1`� � ( ��m �'� ��. � ��, �� . �� "' � � � �� . �� ;� .� 4- <<�� y�, ,:� ��_, __F� ,� �� C:� �, � � �� . � � � �� .� o � � �v�— ��-�- .�a 9 �'/��*.�.� �� %� . n.ss z s �'l/ff L HEAT LOSS CALCULATIONS DEPARTMENT OF INSPECTION �/�/� /��jy�N]VEApQLj$� MINN.' Weat6erstrips A.S.H.V.E, Conatruction No. Insulation Guide Windows Doors Reference Out. Wall Int. Wall Cxiling Roof F1oor Kind How Applied Yes—No I Yes—No 19_ Fl.� � v Room � Length �Width Height �' / Fl.� ��;,� Room Leagth Width � Height G Windows an Doors—Crackage and Area Windows and Doors—Crackage and Area �Vldth Helght No. of Llneal ff. Area Wldth Helght No. ot Llneal 1t. Aeea Na. o[ pane of pane lighte o[ crack eq. ft. No. ot pane ot pane llghte of crack eQ. [t. Zo �' / 3� /" �0 3 b / / / 3-� 6-dr o �r ao Z 2 � �,� / 2� s,p Infiltration Glass Eap. wall � Net exp. wall Int. wall Ceiling � Floor Total Btu. Coef. Btu ,3�' a� /0 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl.� �,�� Room� Leagth Width y Windows and Doors—Crackage and Area W(dth Helght No. ot Llneal tt. Area No. ot pane ot pane lighte ot crack sq. tt. Infiltration Calaaa Eap. wall Net exp. wall Iat. wall Ceiling Floor Total Btu. � Bc� Required sq. ft. E.D.R. or sq. ina. W.A. Leader area Fl. Room tLe�gth Width � Height- - Windows and Doors—Crackage and Area W1dth Helght No. ot Lineal it. Area No. ot pene o[ psne Ifghte ot crack eq. it. Z ZU CLn / 2-�/ /G 1n61tration Glaas �p. Wau Net eap. wall Int. wall Ceiling � loor Total Btu. Required aq. ft. E.D.R. or aq. ins. W.A. Leader area Bcu ��Z ❑� Coef.� Btu Infiltration Glass r Exp. wall a2 f ,,J�e Net esp. wall Int. wall _,, –�eiling ;� �d'/ Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area ' Fl.l Room ( Length p Width � Windows and Doors—Crackage and Area Width Helght No. ot Lfneal tt. Area No. ot yane of Dane Ilghte ot crac!c eQ. tt. � Z �l YO / 2� f�' In6ltration 3� Glass Eap. wall y��(/ � OD Net esp. wall ��Z /p Int. wall Ceiling �O ,1(/ S" /,r'r/ /2 Floor " ° g^d Total Btu. Required sq. h. E.D.R. or sq. ins. W.A. L.eader area / Fl.� Room I Length /Z Wi�lth - Windowa and Doora—Crackage and Area Wldth Hefght No. ot Lineal tt. Ares No. ot pane oL paae Ilghte of crack ea. [t. Infiltration Z � � C,lass 5�--� Fap. Wall /f.�/�' �'�i Net eap. wall Z �o Int. wall Ceiling � Z �Z Floor � 'fotal Btu. Required sq. ft. E.D.R. or sq. ins. WA. l.eader ana �v . , Heighc � Btu �a � ZO L , City of Fridley �, 4T T� roP or rMC Tw�+o � � ' rL----•--� cowwa+irr oev�w�w�Nr o�v. � . �t � MOT�CTIVR �NtI�CT10N OpT. l i �.--- ; Cmr MA�.� F�u0�R1► �MR {..�...�.� `J N3-b�0'3M0 ii��J�� .i�, .fL - � �� Contractor Kind of Bu on 1 � i � PLUMBIiVf, PERf1IT APPLICATIt�id -r iori � � � [Lt�� Ad ress ress Use stimate ost� , �� `7 — '7�{ � ,� �t� 7 - . --� � - C - -- — - - - -- - --- Plumbin Fixture Rates: Np, RATE TOTAL Number Fixtures $ � s i.� ,� x $2.00 � Future Fi�ctures x $1.50 New Fixture-Old Open. x $1.50 Catch Bga#n x $3.25 Water Heater-99,000 BTU x $3.00 � °� �� Ground Run Old Bldg. x$3.25 Elec. Water Heater x $2.00 Gas Fitting Fees: lat 3 Fixtures � x $2.00 �? � �} —_� Additional Fixtures __ X $ .75 Gas Range-199,000 BTU __ x ,55.00 Repaira � Alterationa See Description: Code State Surchar�e .50 TOTAL FEE $ � The undereigned hereby makes application for a permit fos �he woxk herein apecified� agreeing to do all work . ia atrict accordance w ith Che City Ordinances and rulin of the Department cf Build;tnge� and hereby declare that �11�the facte and repreaentatione atated in this I �pplication are true aad correct. � ' 3 °-°� — ?�°�� 7-3 Date r � SuBJECT PE . - c�ty of Fridley � 2 5 9 01 �' AT THE TOP OF THE TWINS g U I L D I N G P E R M i T r ; � RECEIPT NO. � ; y _ COMMUNITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. /�� 1 i r � /"'1 � CITY HALL FRIDLE� SS43P NUMBER NEV DATE PAGE OF APPNOVED BV �"'"� � �'' 612-571-34b0 910-F15 4/6/98 / / JOB ADDRESS 529 Glencoe Street NE t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACMED oesca. 15,16 H Riverview Heights SMEET 2 PROPERTY OWNER MAIL ADDRES$ ZIP PNONE Lee Turbin 529 Glencoe Street NE 786-7698 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS 21P PMONE LICENSE NO. 5 ENGINEER MAII ADDRESS ZIP PMONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK �J NEW ❑ ADDITION O ALTERATION ❑ REPAIR O MOVE D REMOVE 8 DESCRIBE WORK Construct a 10' x 12' Shed 9 CHAN(iE OF USE FROM TO STIPULATIONS Shed must be at least 3 feet from the side or back property line. Install anchor bolts or tie downs on all four corners. SEPARATE PERMITS ARE fiEQUIRED FOFi ELECTRICAL, PLUMBING, NEATIN(i, �PE OF CONST. OCCUPANCY (3ROUP OCCUPANCY LOAD VENTILATING OFi AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDEO OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. OWLG. 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 VAlUAT10N SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WOFiK WILL BE COMPLIED @ WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT �700 y�.SO DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. �LG.SO Fire SC �.SO P�AN CHECKFEE TOTALFEE $27.50 SIGN TUREOFCO i ACTO RAUTMORIZEOAGENT IDATE� FIEN PROPEfiLY V ATE THIS IS VOUR PERMIT — � � �i � G , ��° � �, Ce�/ �� y ��- �� SiGNATUREOF WNERpFOWNERBUILDER� �DATEi a �'�BLDG �SD -� qaTE NEW ADDN ALTER [l [l [] CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Effective 1/1/98 ��r�l �S,d ConstructionAddress: So2 °1 G l e►r�G� � C,i Legal Description: 51�� Owner Name & Address: L,�' �'t�J�� Tel. # �8�� 76��i�' Contractor: ,� D �v�� MN LICENSE # Address: Tel. # LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length Width Hgt/Ground Sq. Ft. sh�� /o X � � X � Construction Type: �,�d o d _ Estimated Cost: $ �UU � (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 t= Ft x =$ DATE: �� APPLICANT: � Tel. � ��G°� �6 �� Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL . STIPULATIONS: $ `� � � � , � I $ a -�� _ $ � i�v $ $ $ $ $ $ r $ � CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Val�ati�n (1/lOth%) $�SA/-�Y,000 Valuation k�� _ � $1Q00 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 [ ] � s BUILDING PERMIT 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 $2,001 to $25,000 $25,001 to $SO,Q00 $50,001 to $100,�0 $1�,001 to $500,0� $500,001 to $1,000,000 $1,000,001 and up FEES $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 $2,0� plus $12.50 for each additional $1,000 or fraction thereof, to and including $25,000 $349.75 for first $25,000 plus $9.00 for each additional $1,000 or fraction thereof, 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 $1,000 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 $1,000,000 $5012.25 for the first $1,000,000 plus $2.75 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Alternate "A" : Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50. Alternate "B" : Removal and replacement 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 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. �_., . - � : � . i s,.-. ., . , , y..... . -...• y+u.,..d4+. „ � �..ixrm.'4r�;'•+�'w"�d.s:"�aw--�'-d►.: ......� • . .... ,. �:.y..., .:�� M • �S Ml}�y .�tw.T�ra. �.�. J�l/�...' 7n'^ - � ♦ + � . j B. H. BRADLEY ' �►1",� �'O D�ar�C D�i� kS 1 pt. �ryy� {NO�N�I! /�WD 6URVt1fOR Y r . 8819 - sarw wveNUt aou'rti M�,.�..=��.e.a �� Rt+�re�l�r/e "J�'aad �s�� . � �,. � :.� � �` "�� ...; . • :� 0 1 •, ' � �� + -- w � � � b � • 0 u s � 1 � : * . . . , . � ,.,r `,'\ . ; . . ;:�, �-. . . � � • � v�er�4 ,.p�r�+�t� '�°''. "�. � �'�� :, �*;, : . � � � ,. �� ,�� ; . . . � � � �1��': '�''�a. .1��".�� '�� ; . . .. . �� a�� , . t , � - , ... ; . . . � �+' � t� ��°k � I �M►+i;±�: . ��r �� . �W `"'.- '��;�_:: _ � �s� . / . : . '� -�� .r,.�';: �j� � e f'�1►e d�'f'�k. ��'�4'� � . _�::_. ,. : ,�Y! �c�i�� '°��` . . ' .. `5� • � � � +,}��` Y 4,.. r / J1�:7 ' ' . . .. . . ' . , .. . . . .. . . . • .. .• ' ' • , . . . .•%' �: '►. � ` � ' .) ' .. �.. ,. •..}� � .��'• �� , < � . , •! . � - �` •. . . � . •r �' � � ' •� , . � .. . '? �.�'.7_�.-. . . ... ^rp�" . . . " _. . � � . ' � ��►.��'� � _ . � :�.�� ►- .:�:. ��. - �.- . ..�� . . . . � � _ . � =�.:_ . O� � �U � �� /,�'' � ��L. Ya�UC,��4 �RV�.�'� a, �`� oC. . �+�.��-4- e � ?�� ,�� _� JI '\ Y�v. T� ; / �� : P �� ' j �j ,I '/y,�, � �'� ��;��_ f 1 � 1 �,; �, �"� E� �,!.,� �•�,, � � ��',_..- � . s � r - .' �� /�� ❑ �';'%%�;;;+1.' � SuB�FCT . � ,,�- �ERMIT�I 0� City of Fridle� � 32785 ' AT THE TOP OF TME TWINS �� D I N� P E R M I T r � � ECEIPT NO � `v __��_ COMMUMITY QEYELOPNI�NT DIV. /� r � � PROTECTIVE INSPECTION SEC. d�� ' �.� i . , i.-_- A � °�,'� CITY MALL FRIOLE� SSI$$ NUMBEii - pEV DATH PAGE Oi AVPqOVED 8� l �� 612-571-3460 910-F/5 7/16/02 � � 109 ADORESS 529 Giencoe St NE . 1 LEGAL �OT NO. BLOCK TRACT OR AOOITION SEE ATTACMED oesca. 15,16 H Riverview Heights Addition SMEET 2 PROPERTV OWNER MAII ADDR�S$ Z�P PMONE Fred Turbim, 529 Glencoe St, Fridley, MN 55432 763-786-7688 3 CONTRACTOR MAIL ADDRESS 21P PMONE LICENSE NO Fred Turbin (same as above) a ARCHITECT OR DESIGNER MAIL AODRESS ' 21P PMONE LICENSE NO 5 ENGINEER MIAII ADORESS ZIP PMONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK � O NEW O ADDITION 0 ALTERATION ❑ REPAIR p MOVE O REMOVE 8 DESCRIBE WOFiK Reroof - 2nd layer (16 sq) 9 CHANC3E OF USE FROM TC STIPULATIONS Roofing ma.y be 2nd layer, but not 3rd layer. SEPARATE PERMI7SARE REOUIRED FOR ELECTRICAL. PIUMBING. HEATING, '�cv� vv�a�. v�.�.uri VENTILATING OR AIR CONOITIONING. 7HIS PERMIT BECOMES NULL AND VOIO IF WQRK OR COf�STRUCTION 20NING S0. fT AUTHORIZEO IS NOT COMMENCED VtIITHIN 80 DAYS. OR IF CONSTRUCTION � OF1 WORK IS SUSPENDED OR ABANQONQO fOFi A PEAIOD OF /20 DAY$ A7 ANY TIME AFTER WORK IS COMMENCED. ` NO DWLG. UNITS I HEREBY CER7IFV THAT I HAVE REAO AND EXAMIN�O THIS APPLICATION STA�L$ AND KNOW TME SAME TO BE TF1UE AND CORRECT. ALL PAOVISIQNS OF LAW$ ypLUATION ANO ORDINANCES GOVERNING TMIS TYPE OF WORK WIG4 9� CpMP�IED @1� 288 , 32 WI7H WHETHER SPECIFIED HEREIN OR NOT. TNE GRANTING OF A PERMIT 'Y DOES NOT PRESUME TO GIVE AUTHOFITY TO VIOLATE OR CANCEL THE pEqMl7 FEE PROVISIONS OF ANY OTMER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION ��FJ .�O P�AN CMECK FEE S�GNATUAE CO CTOpO 4UTMOp�2E0OGENi �OATb MEN P OPE I ! � � 5� O EA NENBU�LDEAi iDA1E� � �' g-. A B��G rYSO � )UP OCCUPANCVLOAD CU FT �FSTREET PARKING IGARAGES JRTAX $.64 1C CMARGE Fire SC $1.29 )TAL F E � . 8'� IS IS VOUp PERMIT %'/�-+D a— NEW [] ADDN (j ��R I J Cohstruction Address: CITY OF FRIDLEY Effectivve 1/1/ZQ02 6431 University Ave NE, Fridlsy, MN 55432 (763) 572�604 Bidg Insp SINGLE FAMILY AND DUPLEXES R-1 AND R 2 BUILDING PERMIT APPLICATION G-C �� G �.. n. r� c Legal Description: Owner Name 8� Address: �/L� f✓� � I/V S z9 �% Tel. # 7��7(,��t` Contractor. � O �U� MN LICENSE # Address: Tel. # LIVING AREA: GARAGE AREA: DECK AREA: onieR: Construction Attach to this application, a Certiflcate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT length / � Width � Height Sq. Ft / � Length Width Height Sq. Ft Length Width S Hgt/Ground Sq. Ft If��,• � ' ated Cost: �� EsUm $ �. Driveway Curb Cut Wdth Needed: Ft + 6 Ft = $ _$ � �DATE: `I� "�"��/ APPLICANT: �- Tel. # Call (763) 572-3604 for Permit Fees if mailing in application or Fax to 763-571-1287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL $ �'7� �� $ l, a.9 $ . l�� $ $ $ $ $ $ � � 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 Conservation Plan Review Fee Determined by�Engineering Agreement Necessary [ ] Not Necessary [ ] STIPULATIONS: - ..� ._ �, BUII.DING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erecrion of any building or structure, or for any addition to any elcisting building or structure, or for any alteraxion 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,� $2,001 to $25,000 $25,(l01 to $SO,OQO $50,�1 to $100,000 $100,001 to $500,000 $5�,001 to $1,000,000 FEES $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 $14.00 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 $1,0� or fraction thereof, to and including $50,000 $643.75 for first $50,(�0 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 $1,000,001 and up $S,C�8.75 for the first $1,�0,000 plus $3.15 for each additional $1,0� or fraction thereof DRIVEWAY DEPRESSION.ESCROW (Concrete Curb Streets Only) Removal and replacement of curb a.nd gutter only - Driveway width plus 6 feet times $17.00. Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the praposed structure and of the construction site. • VERIFICATION OF FOUNDATION A Certificate of Survey of the lot, showing the l�ation of the e�cisting foundation will be �Equired before proceeding with the framing. New Houses Onlv � , � w Building Inspections 763-572-3604 DA�T--� ` I V `— SITE ADDFFSS � v THIS APPLICANT IS: BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY PROPERTY OWNER/ I Hp,nqE:= TENANT a�nDxFSS: CONTRACTOR SUBMIT A COPY OF STATE LICENSE YOUR STATE LICENSE ADDRESS: WITH APPLICATION pg��.� PROPERTY TYPE PERNIIT TYPE TYPE OF WORK: �_� YO�MAIL ADDRESS� ❑CONTRACTOR : � v ,� ��Ij � �/COx� � — — D .� >�D T-v�.,�,� _ EXP DATE �-ci r.�%UV c c7 -�?2�r_ <�lS�.� ❑ TWO FAMILY/NEW ❑ ADDITION ❑ BASEMENT FINLSH ❑ DECK DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT ,..�.,. ..... NUMBER OF SQUARES ��% S/ �% GARAGES PROPOSED SIZE: PROPOSED HEIGHT: SIDING ❑ Vinyl ❑ Aluminum ❑ Other 'f7 SIDING ❑ SWIMMING ❑ ADDITION ,pAIR ❑ REMODELI _�;Z /Loc�� 3 �;�— LENGTH ; OUSE ONLY ❑ HOUSE & GARAGE ❑ A'1°I'ACHED GARAGE ❑ DETACHED GARAGE ❑Soffit �"irim ❑ Fascia WII\DOWS 1N EXISTING OPENINGS ❑Yes ONo IACAITON OF WINDOWS OR FOR NEW OPENINGS-DESCRIBE SIZE OF OPENING CHANGES & Pernut No. Received By: Date Rec'd: STORIES ❑ WINDOWS ❑ DRAIN TILE ❑ OTHER v�'r✓L$ %3� �'T � � b -� r�'I'g _ HEIGHT STATE Z1P, BASEMENT REMODELING SUBMTf: 1. Existmg F1oor Plan 2. Proposed floor plan 3. List of stivctura] members to be used F� FOR NEW CONSTRUCTION 1NCLUDING DECKS, ,P�i�i)TfIONS & PORCHES SUBMTT: l. Site Plan/Survey showing the existing structures and proposed project. 2. Two sets of construction plans 3. Energy Calculations TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS I ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (LTS � �E/ 1997 U.B.0 FEE SCHEDiJLE) TOTAL JOB VALUATION $� �/ � C� OCCUPANCY TYPE Permit Fee Plan Review F'ue Surchazge Surcharge License Surcharge SAC Charge Curb G�t Escrow Erosion Control Pazk Fee Sewer Main Charge Total Due $ $ $ $ $ See Back Page for Fee Schedule 65% of Building Permit Fee .001 times the total job valuation .0005 x Pemut Valuation Minimum $.50 $5.00 (Sta.te Licensed Residential Contractors) $1550 per SAC Unit (Plans to NiWCC for determination) ft+6ft= ftx$20=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks payable to: City of Fridley Attach THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge 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 Mi.nnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work wluch requ' e re iew a approval of plans. � SIGNATURE OF APPLIC T r_PRINT NAME�✓L�d% I� 2°/ �`� DATE ..a Building BUILDING Permit No.: ° Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Dat��Dd: R``� � 1 DATF{ UI V(/L � �1 � b"� � YOUR E-MAIL ADDRESS �SA! �t hA'G�/bt� @�d�n�a r�Ai� •(�JVf� srrE nunxESS �2� E�IC�l�1CD� � N� � d�c� mN S�3 z-- THIS APPLICANT IS: OWNER OCONTRACTOR PROPERTY OWNER/ NAME: OL� /�0 ✓ � TENANT nnnxESS:_ J.�`i C 1C'l�C:.�t' S1 iv � crrx �1v�i�^I�C�v1 STATE�l��JZ PHONE: �� '?j��?" �G'I� ` CONTRACTOR NAME: D VWi 1� 1�' i C,l�l SUBMTf A COPY OF STATE LICENSE # EXP DATE YOUR STATE LICENSE ADDRESS: CITY STATE ZIP WTfH APPLICATION pHONE FAX PROPERTY TYPE SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMII.Y/NEW CONSTRUCTION STORIES PERNIIT TYPE ❑ �DTI'ION ❑ GARAGE/SHED WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TII,E ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ��' O ADDTfION MAINTENANCE/REPAIlt ❑ REMODELING DESCRIBE WORK BEING DONE: QQ,dt(�'l C IMnG1�0i�6d In Ph-hr L hpv��i , it'DI L� CE'- l�li�i t: �� r rn�, � j°l SIZE OF IMPROVEMENT LENGTH WIDT'H �`�� HEIG�� S. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES � A1"1'ACHED GARAGE 1. Existing Floor Plan PROPOSED SIZE: ❑ DETACHED GARAGE 2. Proposed floor plan PROPOSED HEIGHT: 3. List of strucwral members to be used SIDING � FOR NEW CONSTRUCTION INCLUDING DECKS, Vinyl �� L� �� ❑Soffit ADDTI'IONS. & PORCHES SUBMTf: ❑ Aluminum � C� �h�; a y� f' ❑ Trim 1. Site Plan/Survey showing the existing shvctures ❑ Other ❑ Fascia and proposed project. L �flJ Y1^ � 2. Two sets of construction plaos WINDOWS �/ IN EXISTING OPENINGS Cdri'es ONo L ATION OF WINDOWS 3. Energy Calculations OR FOR NEW OPENINGS-DESCRIBE SIZE OF ��P GP�G �/G! t� OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED �l30/7 NUMBER OF WINDOWS I � ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ 061� OCCUPANCI� ��TYPE S/ri I��in-� // Permit Fee $ , 7 See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surchazge $ . � .001 times the total job valuation Surcharge $ ,!� .0005 x Permit Valuation Minimum $.50 License Swcharge $ $5.00 (State Licensed Residential Contractors) SAC Chazge $ $1675 per SAC Unit (Plans to MWCC for determination) Cwb Cut Escrow $ ft+ 6 ft= ft x$21 =$ Erosion Control $ $450 Conservation Plan Review Pazk Fee $ Fee Determined by Engineering Sewer Main Chazge $ Agreement necessary () Non Necessary () Total Due $ �. i. Make checks uavable to: Citv of Fridlev Attach Stiouls THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge 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 Construcrion Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work w'c equ' �es rev' and a prov�l o,f /plans. SIGNATURE OF APPLICANT , j � � ' �C�" �n�r rr,aME ✓ `�, �% � ( i/%['�i DATE '�' I I J � �� r� p. _.. P Building PLUMBING Permit No.: � � " Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRII)LEY Date � APR 3' o�% DATE �� .1� YOUR E-MAIL ADDRESS ��/11/�1 MA�1 I b�� (1/�Gt V'Li (�/-s W N'� SITE ADDRESS �I � MN Z THIS APPLICANT IS: OWNER ❑CONTRACTOR PROPERTY Np�: S A��► I IO�,VA ��E� ADDRESS: SOI W1C G S � V G CI1'I' STATE ZIP TENANT PHONE: (,�1- �?}b ` ��I�1'� CONTRACTOR NAME: (� P 1n PVl PV1,1m b 1 V� q o Le S��I � Ir 1� e- SUBMTf A COPY OF STATE LICENSE #�� O�� P�� EXP DATE I7. I� 1 I Zd�' YOUR STATE nnnx�ss: 224 S M q iv, � S�' CTfY �� CV STATE�IP�Q� LICENSE WITH pHONE ��"�%�Og7 FAX �—I "�@S � Z��I�F APPLICATION PERMIT TYPE �SINGLE FAMILY � TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: � NEW �REPLACEMENT �� u0 DETAILEDDESCRIPTIONOFWORK i�(J(QICt Z�p1�F'tc�ji'�t�dLL �-'�Xt'�'i�► i�bS, rtniac� z �vu-uw� �1d� , vi�lat2 l W� ��nw . v�n�acc � iauv,d�n.r Ff,nb, a�T��j,ct 1 cl�crnwt��, PER MS 16B.665 the pernut fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor ) Labor cost under $300 =$15.00. Labor cost between $300 to $500 = cost of labor x.OS = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL Iy,�JMBER OF EACH BELOVI� �ii BATH SINK/LAV _FLOOR DRAINS � SHOWER WATER PIPING � BATHTUB GAS PIPING (N�DCnr�rC�se) _ SWIMMING POOL _ WATER SOFTNER ($35) CLOTHES WASHER L KITCHEN SINK WATER CLOSET BACKFLOW PREV. ($IS) � DISHWASHER 1 LAUNDRY TRAY _WATER HEATER ($35) FOR IRRIGATION _ WATER METER _ OTE�R P�RIvIIT �EE PRC>JECT�' FdR UNL?ER $SOU P'ERMI`T FEE Ft3R PRQJECTS �VER �500 Permit Fee $��. Number of fixtures @$10.00 x$10.00 =$ Surchaz e . 0 Number of fixtures @$15.00 x$15.00 =$ TOTAL DUE $ % ` . Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .50 Tota1= $ THIS IS AN APPLICATION FOR A PERMTI'-NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge 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 for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of o k which requires review and approval of plans. SIGNATURE OF APPLICANT °� RINT NAME�``� (✓1� '��G�`YI DATE �°f b �� vo�: �� rs a� � �or� BuiLnnv�, �r��c�r�c�, �rm �ca�r�ic�., wo� ; City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 MINNESpTA DEPARTMEIYr OF LABOR AND INDUSTRY - BONDIPlG AND IN$URANCE CERTIFTCATE This is to certify that Michael F. 0'Br��n, Mastet^ Plumber L1Cense � No. PMOd40�.4, representing 0'Brien Plumbing af LeSu�ur Inc., has fi1�d a �25,000 bond with the Commissioner of L�bor and Industry on December 1.9, 2006 and provided evidence of Publi.c Liability YnsuranCe, including Products L�abili�y �nsurance of at least�$�50,OOO,per�person and $100.000 p�r occurrence and Prop2rty Damage Znsur�nce. of ��a'�. ledst 510,.OQ0 ',for the year 2007 in accordanCe with the provi.sions�of:Minnesota��Statuies, Section 326.40. BO�ID N0. MN 18102 � Merchants Bonding Camparry. Des Mo7nes, Iowa MR MICNA�L F 4'BRIEN �� 0'BRIEN P�UMB�N6 OF LESUEUR iNC.�� 224 SOUTH MArN STR�ET � � l.ESUEUR MN 56058 ' �.��V,,. ,� �' � � � POl.ICY�.NO. ACP7111767444 A.11ied Mutual Insurance Greg�Murphy, Minneso'�a Agent Eden Prairie. iNinneso�a Scott Brener, Cpmmis5ioner � ��acx�. of ��it��x� . �in�,o� ��p�rt of �r a�b �Jrr�D�u�rp ' PL�YNG UNIT 443 T�A�'XYETTE ROAD NORTFI, ST. PAVL, MN 551.55-4�343 ' Master plutnber License LICEIITSE NO �00409,�PNI YJi�. MiChael F. 0'Brien 224 South M�ia � � ��,eSueur, NIl�T 56058 �FFECTIVE.DATE oi/oi/�oo� 8�' 'T'ES�'ER 1D NO 00982�' 1F.2/37a./�00�� Z00 'd �6�Z599L05�X�'� �I�I1,��H � ��IHi�f1Td N�I�SO �d 50��0 �IlZ GOOZ-Ot-�db 4 .. I , „��r � ,; � 4 W3 '4� i� � -. t � Vf. • , FRIDLEY MUIVICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287 BUILDING PERMIT APPLICANT: PROPERTY OWNER �, � �� 7 understand that the State of Minnesota requires that all residential building contra�tors, remodelers and roofers obtain a state license unless they qualify for a specific exemption from the licensing requirements. As the owner of the property at G��'t �-> >� v�� S� �; C , 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. I hereby claim to be exempt from the state licensing requirements because I 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 contracting, 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. Name,� �" �� ''� l � �� Date l/I,'�/il � �°✓ c�(�(�