AF - 46819.
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� Cit of Friclle Minn. �
y Y�
BUILDING PER:MIT No
�� 7
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„�,
Date: --�_!�_...�...-~•-�------�..�-- ---- ---------- .__.... ---- ------..__..
Owner: - _ �/Cl�zzr�-� ..�_... - �- -- . . ._ .. Builder -- -- - - --- - - -/-- -�--�- --- �� - .-----
Address................--..............._....--�-----�----......._...----------��-------�-•-------------...._.... Address _ -- --- -- ... _.- __.. --.... ..._... -...._...._.... ..........................-�-� -
LOCATION OF, BUlLDING
No. ...,�,f ��G/._ - .. Street --- -.,� .. . -----��L.�Q.... - - - Part of t ..._.._...._.._.........
Lot ...._..._y._....._.... Block --------..�.._........_.._----..__.._.... Addition or Sub-Division .....� .. .....L�:QGe�C�
v• / -- ''
Corner Lot .. .._------ _...._.._....._. Inside Lot _....._._......._......._....--.. Setback -- - �,� -------------_---... Sideyard _._l...�_........_.....-J'l. -._.._- -._.-----_---
Sewer Elevation
Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as: �
._..��� . . ... - . Front ...!T (l1..... Depth
�, ...... ... �.... Front .�, :.[,�..... Depth
Type of onstruction _��J%�lyLQ_ Est.
�. �� Height _�.._. Sq.
_yZ�. Heighi ..�Q�- Sq.
Cost�y s.�a-. .__ To �
Ft. f L1�l.,�Q Cu. Ft. o!�.� ...�
Ft. _'����Q Cu. Ft. ..� .:�DQ
Completed ........
�� � i��� �-_�
THiS PER,^ �7 rJ- �-.. a✓-f.� �G '� �� �
_ _. _�L.-,T-
'� ^� � ., � � ;, .,
' '-� 'u LOV.EiVh:v_i S i'�NQ
�.�:ri✓ 'a t- 51 ti � I 1:i� �J.
In consideration of the issuance to me of a perrpit to construct the building des 'bed above, I agree to do
the proposed wark in accordance with the descriptiqn abov � t fo/LI�� 1' � s ll provisions of
ordinanoes of the city of Fridley.
_ ._ !
do
In rnnsideration of the payment of a fee of $.y��_"^r.._.., permit is hereby
to.
..----------------...---_..----------.....----...----...-----... to construct the building or addition as described above. T4�is permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, canstruction, alteration, maintenance, repair and moving of buildings
within the city limits and this pernut may be revoked at any time upon violation of any of the provisions of said
ordinances. �, _ _ �-'7
Building Inspector
NOTICE:
This permif does not cove� fhe eonsfrucfion, inafallafion for wiring, plumbiag, gas heafing, sewer or water. Be sure to see
the Building Inspecfor for separa}e permits for fhsse ifems.
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. . . �. - . . � . . � SUBJECT � .
c�ty of ���dl�y
;,
"TT"ETOPOFT"�7'","� gUlLDING PERMIT
�_ �
� `��_� _ - COMMUNITY DfVELOPMENT DIV.
r � � � PROTECTiVE INSPfCTION SEC.
� �
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� _ �"'`1 + CItY HALL FRIDLEV 55432 NUMBER rtEV. D�TE PAGE OF
�-----� � �'� si2�so-�so 910-F15 10/24/74 / /
JOB ADDRESS 19O Hal''�dll Cl.rC�..e N.E.
�- LEGAI , �OT NO. : BIOCK TRACT OR ADDITION
`.oES�a. ` 4 1 Sandhurst Addition
� � 2 ��i�?`ff C}tf�t�ER � MAIk�ADDRESS
: - La�xie R�kos 19fl Hartman Ci.rcle N.E.
3 CC��ITRACTBR ` MAII ADDRESS
Sob Ef.�enhser 2828 FIiqhway #10, Mpls. 55432
d ARGh11TEC7Of�DESlGNER MAILAbDRESS
5
MAIL ADDHESS
ZIP
ZIP
ZIP
PHONE
PHONE
t't1'iM
. 12'776
ECEIPT NO.
� ��
APPROVED BV
SEE ATTACHED
SHEET
LiCENSE NO.
LICENSE NO.
PHONE LICENSE NO.
� Ft@51$P.Il'tI.1�. '
7 CLASS OF WORK
❑ NEW Cx ADDITION O ALTERATION � REPAtR ❑ MOVE ❑ REMOVE
e oescR�ae woR�c
Construct an open porch.additi,on
9 CHANCiE QF USE FROM T�
STIPULATIONS
. Construction not to be enclosed
SEPERATE PERMiTS REQi1tRED FOR t�iERiN�.
H�ATIPJG, Pi.UM81NG AND SIGNS. .
&EPARATE PERMITS ARE RE�UIRED FOR ELECTRICA�, PLUMBING, HEATING, �PE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD
'VENTIIATING �R AIR CONDITIONIPIG: �OOC� Fr�le
'THIS PERMIT BECOMES NULL ANO VOlD IF WORK OR CONSTRUCTION ZONING S�. FT. CU. FT.
RUTHORIZEO IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
Oti WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT R l'.-
ANY T(ME A�TER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
F}(�R�BY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPUCATION 1 STA�LS GARAGES
AND KNCNiV 7WE SAAAE TO BE TRUE AN D CORRECF. ALL PROVISIONS OF LAWS yAtUATION SURTAX
ANQ ORDINANEES .S'abVERNING THiS TYPE OF WORK WILL BE COMPUED $2�3dQ 1.15
WITH VU}{E�F{ER SP�CfF{ED H£REIN OF± NOT. THE GRANTiNG OF A PERMIT
DOEB NQT PHESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC (
PR6VISIpN3 OF ANY OTHER STATE OR LOCAL lAW REGULATING CON- $'],S.00
STRUCFION OR THE PERFOAMANCE OF CONSTRUGTfON.
- PIAN CHECK FEE TOTA
-� � �:.,' $1., . fil�i�OPCQNTfiACTO - � AUTHORIZEDAGENT IDATEI . " .�y � E � P-{1 P� � AU �� TE�'TW1
� �.� � p � c,L—
- ': '�$ .H � .. -���hlEiINF�OWNEf:BUILDEPI . . � IQATEI lpG ty§P
�.� . .. . . �.._. q;n. . . � .
$16.15
APPLICATION FOR RESIDENTIAL, ALTERATTON,
OR AllDITION BUILDING PERMIT
�GO
CI.TY OF FRIDLEY, MINNESOTA � • ,39,��,!
�.�' ' �'��'�-� �'
OWNER'S NAME• BUILDER:. � �
ADDRESS: DRESS: :'�� ��' ��J � /(�
_ / /1 . ��l`�`-� SS�I �
� f ►�/1:!/!�/1�/!_//_117•�I_�//7���
� : �� � � � � �/j / �/ .r � �
CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD:
Applica.nt attach to this form �tao Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
HESCRIPTI�N OF BUILDING
' To Be IIsed As•
ront: Depth: Height:
Square Feet: Cubic Feet:
Front:
Depth• Height•
Square Feet; Cubic Feet:
v
Type of Construction: �i�C)O� �f1�v��.Q�Estimated Cost:���Q�J, �,
To Be Completed;
The undersigned hereby makes applicativn for a permit for the work herein
specified, agreeing to do all work in stiict accordance with the City of
Fridley Ordina.nces and rulings of the Department of Buildings, and hereby
dec2ares that all the facts.and xepresentations stated in this application
are true and correct.
DATE: SIGNAT[TRE •
. (See Reverse Side�For Additional Information,)
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