AF - 45878r,.
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City of Fridley, Minn.
BUILDING PERMIT
Date• Novexnber 21 _ ].967
Owner: Morris Ovick
g�� Morris Ovick
�� ���
ATo 9561
pddresa ,—,_,. Address 6..�79 Hi.ckox�v Drive
Fridley, Minn. 55432
LOCATION OF BUILDING
No. �Q$� 3tseet H� cko�^v i�x�,v� N• E. ._.�.. Part oP Lot
Lot �....�...—__ Block 1 Addition or Sub-Division .(?���n' s 3 rd AS3,�.;j, it on
Corner Lot � Inside Lot .+.�..X..._..__._ Setback __��- .���_ Sideyard _.....1.�- ? �
Sewer IIevation .� — Foundation IIevation
DESCRIPTION OF BUILDING
To be Used as:
'j�aP 11 i n.�u Front � Depth _.._2.� Height ? � Sq. Ft. _1, (L�i� Cu. F't �., R QO
Front Depth ._.._ fTeight ....._.. Sq. F� Cu. Fk
Type of Conatruction Frame ��, ��8,Q00 _ 0�.-- To be Completed '!Ka� 15 ? 1�6$
Sewer: 57' east of M.H. Sewer elevation: 852.28
Water: 10' west of sewer Top footing: 855.28
In consIderation of the issuance to me of a permft to construct the building described above I agree to do
the proposed work in accardance with the descrlption above set forth and in compliance with a'il provlafona of
ordtnances oP the dty oP Fridley. ����� �_ s��
w ���
$100.00 Sewer Connection Char�e
In consfderat[on of the paymeat of a fee oP $831...Q0 ., permit ie hereby granted to._. Morri c Ovick
to construct the building or addition as de�cribed above. Thia permit ia granted upon
the express condition that the peraon to whom it is granted and his agents, employees and worlmzen, in all work
done in, around and u�n said building, or anypa,r� thereof, shall conform in all respects to the orainances of
Frlciley� Minaesota regarding location, conatruct�on, alteration, maintenance� repair and moving of bufldings
wlthin the dty limits and tbis permit may be revoked atany time upon �of any Qf the ProvY�lona of eaid
ordivanc�s. / 1 �� �l /1
��S
Official
NOTICE:
'Nds permk do� aw eorsr ths ceesnneHoe, i�nllafioe hr wtrtae, plumb[ne, ea hssdne, ssw�� ee wmr. B� sun fo »�
�he Butldiu� Inspeetoe for pparafa pormtf� Poe t6as thna.
.
ApFLZCATION FOR BU�LDI1� P$RMIT
CITY OF FRIJLEY, �SOTA
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OWNEB' S NAML__��-�.�,`�� '� BUILDER �..�.� ��,�- ---
AUDRLSS �'• � . . . �. > , . , {: �ADDR� $£+ ���7���Q Q�/ �R�U�
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NC. � O � �*_ ° �T���'=` �, 'ir`.:. � ,��:�._� � F.�RT OF i3OT ,:.�• �
LOT � BLOCK . ADDITION OA SUSDIVTSION ��e��'�° �" �
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CORNER L �,� INSIA� ��4���� , SEZ'�ACR . -='�;, ��:• . SZDE-�YARD��O„�._�i��,_,
' ' . . �: . .
SEWLR LT.EVATION F017DIDATION ELEVATION
_ Applicant attach to tbit form.Two Certificates of Surve�r of Lot and prapased
. buildit:g �lflca�#on �drawi����� ��►ese � C`ei=��.ficeEes. ; : � �°.:.: f - . ° . . �
.�� �
_ . . _ "ir.,�. . ., c_ .�t�• r: . .. . . '►r � . . ,.:' '
•� . �. . . _�. : p '�,»� DE,5CRI,pTiON .'OF'�BU�DYN,G. T .. _
,
To Be'Osed A�;�., � . _� . .. . . ,:, ,. - .
� �� �0 2� . . , .
. , . �J. _ ` �, � _ Fraat . 1-f�- DeP�I� � �' flei,gh� : � �
� ���w.�r�t ��.y. t��.r.ri�r�w�i � �r �- �a� r �� �!.�i..�r � � � ' . i , � !■p i � iY,�r�.i�� ; . _ �
� � . _ .. . , � � S�.��Fr: `,�g-�--�= fDt''��: �u:.`�t, :,�`t_�4,80�
., . ... .. , .. �. ._
� . Fraat D�p�� � �eight
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. .. . . .. - - . , �.�..�y..��.
Sq. Ft . `Ctr. Ft : � - ' '= �
Type og Canstruc�ica � ��� '� . . . Estic�aCeei. Cogt' �� "` i�_:a d �
�,...`...__..�.._..�._..�
To Be Completed ` '
The undersigned herebq makes applicatioa for a permit for the �rork hereio epe�ified,
agreeing ro do all work in etzict accordaace with the CiCy of !'ridiey Ordiaences
and rulings of the Department of Buildings, and herebq declares that all ti►e l;acts
�d repreeestatiene etated ia thie applicat4oa are true and correet.
ne �...f,�..._..�_r_2.___�s� �l �-v►�.► ��,�.�
(Sch dule of Fee Costs
, ��
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$�3!
can be famd oa the 8everee Side).
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` BUII.DING PERMIT FEE SCHEDULE
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SECTION 2. The.Iaspector of Buildinge shall, before is�uing permitis�°��or
�,.
,.,. � �.:•� ..� -�.�t�e-•erett3on •of °�ay bui�dl�ig d� st'�i"e�ii�'e� •ar"?ior�'�iny eddition to any
existing structure os buiiding, or for any alteration or repairs to any
existing buiiding or.st�ture,�'u�aon apglicatioa thezefore, require t6e
the payment by the applicant for �uch permi-t of "€ees tv the amount herein
bel;ow �sset,a farth aad in the manner herin p�roviciQd eo-wit; �
. . .-. • , ._ , • . -. :_ . .
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-�• �� �� �'- Dnif�'� �Building Code: Tqpe �1, 2, b 4- $I.75 �for each one thousand cubic
feet,,.•or fraction thereof, in sut�►:cubical cont�ats: Tqpe 3� 5-�$1:50 �or
, . ' " ' . ' '.��ch one Chousand cubic '�eet :
d. � . { i•��.�. �� , . .1 ' � . ...
�. .� . .�s., ♦. . . . . . - _. . .. , . . . ..�y ..
S . � • s.. � . " . �: f� . . _ i .f !'i ,. �� •. .. . - + ' .
` r� For the purpose of cvmputing teee €or bui,lding perm�ite,� the- cubic��:: -�•�"
contents of any building or add3tion to a unifotm height throughnut by
multiplq3ng Che ground area crnrer8d .iram a point �six (6) inches belaw the floot
line of the basemeat or the c�llar "to the average heigbC of the upper eurface
or to the average height of the roof eurface of the main g�blet.Af a
pitched soof.
•- .� �For� repaiics or alterations tQ •a��'�isting strtic�iir�`;' the fee e�all� be �at��the
rate of $3.00 per each five hundred da%lars ($500.00) or fraction thereof
- . �4. .: ... in--t�e cbsC'`of..all Pra@asred work. � .
- - Id �no � rase s�11� the�'t�ee charged for •-'any� �permiE as �e� iortli � iri Sectian �2 be
less thau $5,00.
1�SSSD Cannectign Ch��C.ges, based an lecatian• Asea 1 or 2. ., .
. . , - . .. .r.... .. . . . . .._ _ ., . . . :.�.,.,.-.�,
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�:�: ��ULT`Ef�.�`�c�ASSC?�IATES, I N�.
iNCUSrnr��. JOHN'A: PETERSON FRANK R. LEN2. JR. e��rnac
�us�NESS LAIVG SURVEYOR5 _ . ��nM suayErs
ci7r �OtB RE6iSTEREO uNDEA LAWS OF STATE OF M1NNE507A ��KEeNOrt[
TOr061tAPMIC�M�A�PiN6 L�C@NBlC.QY OAD{N�NCfB OF dT�� OF�M�NNE4POLt9:� � - JUO1CIkl
330Q LYNDRLE AV�: 5�. MINNEAPCI�.IS,. MINN. 5�4as
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Caity of Fridley, Minn.
BUILDING PERMIT
Date: August 26, 1968
pwaer; Morris Ovick g�� Same
Ad�s 7083 flickory � Drive Address Same
N� 9903
LOCATION OF BUILDING
No. 7083 Street .�.. �ickory Drive � `_ p� of Lot
Lot _._..3 __ Block 1 � Addition or Sub-Div9sion .._.._ Os tman' s 3rd Addn .
Coraer Lot __ 7naide Lot
3ewer IIevation
Setback —..�.... Sideyard
Foimda.tion IIevation
DESCRIPTION OF BUILDING
To be Used as:
Garage �t 19' �p� 23' g�t 10' �, �-t, 437 ��•t, 4370
Front Depth FTeight Sq. Ft C:u. Ft
� og ����� Frame ��, �_ 1200.00 _ To be Completed
In consideration oP the issusnce to me of a permit to construct the building descrlbed above I agree to do
the proposed work in accor�dance wlth the description above set forth and in compliance with afl provis4ons of
oidinances of the dty of FrTdley.
^���7 � 1 �� �
Ea consideratfon of the payment of a fee oP $ �•�� , permit is hereby graated to Morris Ovick
to construct the buflding or addition as described above. This �rmft 3a granted upon
the expr�s condition that the person to whom it is granted and his agenta, employees and worl�en, 3n all work
done in, around and upon said building, or attypa� thereof, shall conform 3n all reapecta to the or8inanc� oY
Fridley, HRinnesota lacation, conatruct��on, alteration, maintenance, re moving of bufldinge
ct
within the dty limits aad permit may be revoked at a�y time upon violatio� of any f tl�e provisiona of said
ordinancea f
��_�_-.�._.._ � � �
C]�..rence Belisle
NOTICE:
This psrmti does not eovsr �6s eonsfrneHon, te�alldion te� wtrtng, Plumbtne, ea hsaHne, aw�e ee wdsr. B� wn to a�
tln Buildio� lasp�eto� for wpara» p�rmtu fo� �hem itfna.
� �
APP�I�ATION FOR B�ILI?IN� PERMIT
L ITY OF �`EIDLEY 9 MIIVPTESOTA
OWN.EFt tiS NANR�+ �o°' J,�-�,/r.t,� ��,. � � BULI�Eft �j% �
AnDR�ss �� p � �-� � � .��� ���ss _
LCCATsON OF B�T:II�Il�jC
140 o V � � "'�+�+.°'��. ./ O.�I � � dl.%1Aia
�a
1
LO'I� BLOCK� �DITIOIV OR SLTBDIVISIO� ��«.�� ��^�
��OB�'II� L(3T I�I��IDE I,OT � SE�I'BA�I�� f���I�E"�9P���? ��.,r -
SE4TER EI,E`TgT'IOPa TOP 0�' �'OGTI�'G ,� " � ��, ��9�`�
Ag�lica.r.st at-cach to thi� i��m. T��o C���tifi�at�� o�` S�vey oi �,ot a��.
p�opo��� bui�d�.�.�g° locatior dr�,r� o� �hes� �c;�ti�ieat�sa
�'o Be ����. A.s:
7ES JRIF°I' i ORT Qa B�TII,D��,TC
Front / :��?Ppth �.3 Height % G
�quare ie�t �ub�c FE�t
.Fr o:�t Depth Height
Squ�re � eet �,3 7 �ubie FePt 7` .� ��
�
Typ� oi Co:ri�truction /, z-/�� A� Estimated Cost`�� � cJ �
To Be Completed �,; ? �-�.— J
The under�ig.n.ed hereby ma.k�s applic�tion fo� a pexmit �or the �o�k
he�ein specifii�;d9 agree�.g to do all work i� strict accord�nn.�� �,�ith �hP
�;ity oi Fr^idley Ordin..a..rbees a,.nd rul�rz�g� o� the Departme�at o��° B-uilda:�..g�9
and hereby d.ecla.�es that all the �°acts ard r�p�ec�er�tation.s �tated in
thi� applica�Ciota axe true and coxzecto
DgTE ��. ��.GNg'i'URE ���.,� � .� � �
(SchEdule oi Fee Costs ca�? be fout�d on the Re�e��e Side�)
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BUII,DING PEftMIT �'EE SCI�IDTlLE
SECTION 2o The Inapector of Ruilding� �hall, b�fore i�su�ng pe�nit�
for the e:�ection oi any build.ixzg or st�u.cture, or° ior a.ny addition -to a�,y
exist�.ng �tru.cture or building9 or for a.ny a.lte:�ation or repair� to any
existing building os� st�uctu�ey upor� applicatiot� th�reio�w, yequire the
pa.yment by the �.pplicant for �uch perm.i-t oi fees to th� amount he�e��a
below set iorth a.nd in the ma.�x�.er here�.� provid�d to�wit:
Uniform Building Codea Type 19 2, & 4-$1075 ior eaeh one thou�a.:�d
eubic feet, or fraction thereoi9 in �uch cubieal c�ntert�o Type 3 8� 5-
$1050 for each one thousand cubic feeto
For the purpo�e of computi.ng fees for building permit�9 the cubica,l
contents of any buildi.ng or addition to a uniform height throughout by
multiplyi.ng the ground area covered from a point six (6> inches below
the floor line of the basement or the cellar to the avera.ge height of
the upper surface or to the avera.ge height o�° the rooi �uriace of the
main gable of a pitched roofo
For repairs or alterations to an exi�ting structure, the fee shall be
at the �ate of $3000 per each iive hundred dollara ($500000� or
fraction thereof in the cost of al1 proposed worko
In no ease shall the �ee charged ior any perm�t as aet ?orth in Section
2 be less than $50000
NSSSD Connection Chargea ba�ed on location -�z°ea 1 c�r 20
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City of Fridley � 14653
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T •
�
� � ECEIPT NO.
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COMMUNITY DEVELOPMENT DIV.
r � � � PROTECTIVE INSPECTION SEC. C�/ 2�
� i , � J
�l /'�'1 � CITY HALL FRIDLEV 55432 NUMBER REV. DATE .PAGE OF APPROVED BY
L""� � ,'� 812-560-3450
910-F15 4/27/78 � �
JOB ADDRESS �pg3 Hickory Drive N.E. �
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 3 1 OS'tID3ri� S 3rd Addi.tion SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Gerald Nalepha 7083 Hickoxy Drive N.E. 571-0900
3 CONTRACTOR MAII ADDRESS Z�P PHONE LICENSE NO.
5ame
4 ARCHITECT OR DESIONER MAIL ADURESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
8 USE OF BUILDINO
ReS1dG�,ri't1d�.
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
X
8 DESCRIBE WORK
Construct a 16' x 12' Deck
9 CHANGEOFUSEFROM TO
STIPULATIONS
Call for footi.ng inspection before pouring concrete.
W�R�l�� �
Before d4g��� caEl oc���� ���r��ES s;�A� PER�IITS REQUfRE[� F'4R WER1iVfa,
TELEF�-10[JE•4ELE���6C-GAS,�tc. �E�TIPIG. PLt1R�1�3lN(� AND SIGNS.
���t�1���� �� ��'w
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAI, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONINO. WOOC�
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTHUCTION
OR WOHK IS SUSPENDED OR ABANDONED FOR A PEHIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIPY THAT I HAVE READ AND EXAMINED THIS APPLICATION l. STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS 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 $2�000 $`Z.00
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON,
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $�.2. OO
PLAN CHECK FEE TOTAL FEE
$13.00
SI6NATUREOFCO TFACTORORAUTHORI EDA6ENT IDATE) WHEN PROP LY VALIDATED THIS IS YOUR PERMIT
� LI - �7- �fi �-+�, Icl�o� a _ �
SGNATUREOFOWNERII OWNER LDERI IDATEI A`- BLDG INSP DATE
�
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' f�"i'LiCnT�C�I� i 01� f?l:5l1)f_t1TInL LlJ1f_�;.iiG f'Cft1�1ITS .
' l°�'�L"W, �L6"I�f�P,7uUal:�, �L�U7TIUfd�, 01; ��EP/11IZS)
OG��I2�R: �j��%��� A/�L�.%��� J3UILllI>li: ���ZP �.
T�:�dr.es:; a%D �i3 �/ �Cf( D(� f%I�%1/� liddres� :�n�n r? ,
TCl. No. s s %i�' ���� �.
p��, ; Street: .
]LpT; � }3IAC}�: � ADUITTOi�: �`�—��,L, �,_ 3Y�_L�LGt',G�"e1�
COk211�:R L01': II�SIllT•� I�UT: SLT1311CI:: SII)L•'YI�P.DS: �
R�plica'r�L- attach to L-his form Z:ao CerLi�icste:, of Survey of Lot and proposed
bu3lding locaL-ian dra�m on these Certificatcs. �
a
DESCRI PTIOhd 4F BU? LT�I f�G
7�0 ]3e Used As: .
__1���= I'ront: j/ - DE�±r�: � ' Height: � �
Square Fe�t: � ci� Cubic Feet:
I'xon't: Depth: � Height:
' Squa�e Feei:: Cubic Feet: �
��pe af Construction: Estimated Cost: $����� �0
To �e Ca.npleted:
Pxoposed Drive�aay 1�;idth If IZew Opening Is Desired
Ali:. A Alt. B
$ $
(S�� P.�VERSE SIDE OF SHEET)
The undersiRned h�=eby makes ap�lica�ion for a pe<mit for the work herein
specii'ied, a�reeing to do a11 t�ork in strici: accordance wit]i the City of
Fridley Ordinances and r.ulings of the Dcpa�tricnt o� Fuildings, and hereby
declares Lhat all the wacts and representations �Lated in t.hic ��,plicaLion
are i.rue and correct. See xeverse side for aclditional i��fornlation,
��T�: � �7 SIGI�IATUF.E:
stipulations:
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BUILDI6JG PERl�IIT i�r_+= SCi-1EDi.1Li
S���TIt�N 2. The Inspector of BL1II.CIlriU,S Sha11, before issuing per,nit� for t.he erertion
o£ any Luilding or struct:ure, or for any addi.t�.on to a.ny existi_ng Luildinct or structure,
or £or any alteration or repairs to any e}sistinq I�uil�3ing or structur�, ur»n apPlication
therefore, require the payment by tl-ie applicant for such permit of fees to the amount
her�ir. below set forth and in the manncr herein �rovided to-wit:
NEW CONSTRUCTION: Single Family Homes and Garag�s: $4.00/1,000 cubic feet..
PLAN CHECK: 25 percent of building permit fee. '
DRIVEWAY DEPRESSION: (Concr:�te Curb Streets Only)
Alternate A: Removal and replacement of concrete curb and
.gutter only; Driveway width plus 6 feet x 514.5U
Alternate B: Removal and replacement of concrete curb and
gutter and install a 3 foot wide approach with
6 inch depth; Driveway width plus 6 feet x$17-20
_ADDIiIONAL INFOR�IATTON
For the purpose of computing fees for building permits, the cubical contents of any
building or addition, is determined by multiplying the gr�und area covered iro:n a
point six (6) inches below the floor line of the basement or th� cellar to the
average heights of the upper surface or to the average heigh� of the roof surface
of the main gable of a pitched roof.
For repairs or alterations to an existing structure, the fee shall be at tne rate
of $3.OU ;��er each five hundred dollars ($500.00) or fraction thereof in the cost
oi all proposed work.
In. no case shall the fee charged for �.ny permit as set forth in 5ection � be less
than $7.50 plus $.50 state surchar�e.
VER�F�CATION OF FOI,INnATTO
NOTE: Permits �or construction will be issued a minimum of 24 hours from the time
of application to allow for proper xeview of the proposed structure and of the
construction site.
A Certif_icate of Survey of the lot, showing the location of the foundation once it
has been constructed will be required before proceeding with the framing.
CtRTIFICATE OF �JCCUPANCY
Application for a Certificate of Occupancy shall be made ten (10) days �rior to the
use or occupancy of a,ny structure for which a building permit has been issued; and
said structure shall not be u.sec3 or occupied until a Certificate of Occupancy has
been issued.
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Wednesday, March 17, 1982
Mr. M. F. Nalepka
7083 Hickory Drive N. E.
Fridley, Minnesota
55432
Dear Mr. Nalepka:
Northem States Power Comparry
North Division
4501 68th Avenue No►th
Brooklyn Center, Minnesota 55429
Telephone (612) 561-7200
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Just a note to inform you that Northern States Power Company does
not object to a four foot encroachment into the easement behind
your home at 7083 Hickory Street N. E., Fridley, Minnesota.
You mentioned to me during our telephone conversation that the
structure you intend to build will not be under our primary line, but
may be under the service wires to your house.
I would like to remind you that we need at least three feet clearance
over the roof of any building under the service wires. If the wires
are closer than that, we ask that you install a mast, of either
wood or pipe, on the building that we can attach the wires on to
maintain the three foot clearance. Thank you.
Sincerely,
, o�� ,...�
L. M. Benson
Customer Service Representative
North Division
LMB/ kf r
�c Mr. Darrel Clark
Chief Building Official
City of Fridley
6431 University Avenue N. E.
Fridley, Minnesota 55432
sue�ecr PE T NO.
City of Fridley 16 5-
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
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� �L _.____ COMMUNITY DEVELOPMENT DIV.
r j � PROTECTIVE INSPECTION SEC. S��
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l-_-- A /�"1'� CITY HALL FRIDLE� 55432 NUMBER REV. DATE PAGE OF APPROVED BY
i �� � � 612-571-3450
910-F15 3/30/82 / /
JOB ADDRESS �pg3 Hic7cory Dr. LiI.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION
DESCR. 3 1 Ost�nan's . Third Add. SHEETTACHED
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Gerald Nalepka 7083 Hi.ckory Dr. N.�. F'ridley 55432 571-0900
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Oame r
4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
B USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW � ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK 5����
Construct a 12' X 17' �teage. shed.
9 CHANGE QF USE FROM TO
STI PU LATION S
SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUM8ING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING. WOOCl FY'3IaB
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOFi A PERIOD OF 120 DAYS AT li �.
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 PROVISIONS 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 ��.�OOO.00 �S`. r'JO
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-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. yS].%. SO
� PLAN CHECK FEE TOTAL FEE
�.8. ��
GNATUREOFCOpf7RA, TOR RAUTHORIZ AGENT IDATEI WHEN PROPERLY VALIDATED THIS IS�YOUR PERMIT
�„ �_.5��� � .6._1C4�� o Q ��s .j/��,�..
SiGNATUfiEOFOWNERiIfOWNE ILDER� IDATEI - BLDG iNSP �TTE
e
CITY OF FRIDLCY Effective Aug. 1, 19s1
APPLICATIO.J FOf; RCSIDL"NTI11i_ [3UILDIf1G PEFtf�1ITS
(We�r, Alter.atians, Additions, or Repairs)
Ol•1tJER: ������ /�i����j�iT [3UILOER: --- �!A/�� .
ADDRESS: ���.3 �/C�O�r ,Q�/�,v� ADDRESS: S�-y�?�
TEL n(0: ��/ '!� f'O� TEL IdO:
Construction Location
• STRI�T NO : �� � � STI2EET: /���,(�Q �'�,�j�� /A �
I,OT: � BLOQC: � r �p
ADDITION : ���.� / t
Corner Lot: Inside Lot: � SetbacY.: Sideyards:
Ap�licant attach to tliis form two Certificates af Survey of lot and
�roposed I��ing ],*�a 'on drawn on certificates to scale.
`�i �(' t'.� �'� .�� �
r� DESCRIPTIOtd 0� COt�JSTP.UCTIOPJ
� P Front: f .Z
Squane.Feet:
Depth : Height:
Cubic Feet:
, Front: Depth: Heiglzt:
Square• Feet: Cubic Feet:
Type of Constructien: �� ��Z_� Estimated Cost: $ l�lf��o��
Rb Be Oor.�pleted: � �Q
Alt. A Alt. B
Proposed Drive��ay Width If New Openinq Is Desired: $� $
. . SE� l�VERSE SIDE OF SHEET
7.3ie undersigned hereby ma3:e� application for a permit for the �:nrk� herein specified,
agreeinq to co,all work u, strict accordance with the City of I'ridley Ordinances �id
ruling� of the Department of IIuildine�s, and hereby declares that all the facts and
representations stated in this application are true and correct.
D.3TE: �� -3�°' fii oZ SIGNATURE:
SLiPulations:
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B�JILDING PERMIT FEE SCHEDULE
The Inspector of buildinqs shall, before issuing permits for the
erection of any building or structure, or for any addition to any
bxisting building or structure, or for any alteration or`repairs
to any existing building or structure, upon application therefore,
require the payment by the applicant f or such permit of fees to the
amount herein below set forth and in the m anner herein pronided to-wit:
TOTAL VALUATION
$1.00 to 5500.00
$501 to $2,000
$2, 001 to $25, 000
$25,001 to $50,000
$50,001 to $100,000
FEES
$10.00 Minivaum Fee $15.00 plus surcharge
$10.00 for the first $500 plus $1.50 for each
additional $100 or fraction thereof, to and
including $2,000
$32.50 for the fixst $2,000 plus $6.00 for each
additional $�,000 or fraction th ereof, to and
including $25,000
$170.50 for the first $25,000 plus $4.50 for
each additional $1,000 or fraction thereof, to
and including $50,000
$283. 00 for the first $50, 000 plus $3. 00 for
each additional $1,000 or fraction thereof, to
and including $100,000
$100,001 and up $443.00 for the first $100,000 plus $2.50 for
each additional $1,000 or fraction thereof
PLAN CHECK: 25 percent of buildinq permit fee
DRIV�+IAY DEPRESSION ESCROW: Concrete Glirb Streets Only
Alternate "A": Removeal and replacement of curb and gutter only
Driveway width plus 6 feet x$13.50
Alternate "B": Ranoval and replacement of curb and gutter and install a 3 foot
wide approach with 6 inch depth
Driveway width plus 6 f eet x$15. 75
VERIFICATION OF FOUNDATI�ON
Pezmits 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 4f the
construction site.
A Certificate of Suzvey 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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No�thwesterr� Bell
6540 Shingle Creek Parkway
Brook1yn Center, Minnesota 55430
March 24, 1982 .
Mr. Gev�a7d Nalepha :
7a8',3 N� �kory Dri ve
Fridley, Minnesota 55432 -- — --
� Dear Mr. Nalepha:
This is to inform you that the Northwestern Bell Telephone Company
does have an interest in the utility easement on the north side
of y�ur lot.
Hawever, upon field checking our facility in relation to your
planned building, we do not find any encroachment problems. Our
buried cable is in the utility easement and we would not have a
problem with any probable repair work or reinforcement.
On this basis, we are not opposed to your building in the easement
as stated in your letter,
Sincerely,
���� °
Manager�Disbtn-Engrg
�H�S GOQY FOR• � cc: Mr. Mark BurcFi �
Ass"t Public Works Director
City of Fridley
:�
� y .,
Wednesday, March 17, 1982
Mr. M. F. Nalepka
7083 Hickory Drive N. E.
Fridley, Minnesota
��432
Dear Mr. Nalepka:
Northem States Power Company
NoHh Dlvislon
4501 68th Avenue North
Braoklyn Center, Minnesota 55429
Telephone (612) 561-7200
Just a note to inform you that Northern States Power Company does
not object to a fowr foot encroachment into the easement behind
your home at 7083 Hickory Street N. E., Fridley, Minnesota.
You mentioned to me during our telephone conversation that the
structure you intend to build will not be under our primary line, but
may be under the service wires to your house.
I would like to remind you that we need at least three feet clearance
over the roof of any building under the service wires. If the wires
are closer than that, we ask that you install a mast, of either
wood or pipe, on the building that we can attach the wires on to
maintain the three foot clearance. Thank you.
Sincerely,
�� .
L. M. Benson
Customer Service
North Division
LMB/ kf r
Representative
cc Mr. Darrel Clark
Chief Building Official
City of Fridley
6431 University Avenue N. E.
Fridley, Minnesota 55432
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sue�ecT E N O.
City of Fridley _ 18 7 2 3
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 ` �
� /���1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVEO BV
�"""'� � ,�� 612-571-3450 910-F15 10/24/86 � �
108 ADDRESS 7083 Eiic3cory Drive N. E,
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 3 1 Ostsna,tl�s 3�'d Addition SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Gerald Nalepka 7083 Hickory D�ive N.E. 571-0�.00 �
3 CONTRACTOR MAIL ADORESS Z�P PHONE LICENSE NO. �
Same (Oak Tree Construction - Not Licensed in F�idley) 588-2519
d ARCHITECT OR DESIGNER MAIL ADDRESS ZIP RHONE LICENSE NO.
5 ENGINEER MAIIADDRESS ZIP PHONE LICENSENO.
8 USE OF BUILDING
RESIC�C�S3't7.3�.
7 CLASS OF WORK
❑ NEW � ADDITION ❑ ALTERATION � REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WORK
Reroof Dwelli.ng
9 CHANGEOFUSEFROM TO
SfIPULATIONS �o.� can be 2nd layer but not 3rd. Install �i,dged galvanized valleys.
SEPARATE PERMITS ARE fiEOUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. 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
ANY TIME AFTER WORK IS COMMENCED. • NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFV THAT I HAVE FEAD AND EXAMINED THIS APPLICATION 1, STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PpOVISIONS OF LAWS VALUATION SURTAX
AND.ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED y5`9OO $.SO
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
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-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. S�-F>+ OO
PLAN CHECKFEE TOTALFEE
$1Fs. 50
SIGNAtUREOFCONTR�°`� UTHOR12EDAG Nr �onrE� °-A -- - WHEN PROPER�Y LIDATED THIS IS YOUR PERMIT
`4 �o a � �� O �
SIGNATUREOFOWNERi1FOWNERBUILDERi IDATEI BIDG �NSP �aTE
N� [] City of Fridley Effective 4/1/86
ADDN. I l �R-1 AKD R-2
pLTER. � Building Permit Application
Construction Address: `�g� 1G�0� f��
Legal Description: ��� �%�'��' 1 '�r
Owner Name & Address : ._v���'�y ����` ' � - Tel . # �I��-Q���
Contractor: �iq��/P�� �Oyf�vG�DAi '� �%�/I% �/('D�N Tel. 4 S�' 2S19
Address•
LI9ING AREA:
GARAGE AREA:
DECH AREA:
OTHER:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to seale.
DESCRIPTIOA OF ZMPROYEI"IENT
Length y� �lidth �� Height Sq. Ft.
Length �( Width �-3 Height Sq. Ft.
Length Width Hgt/Ground Sq. Ft.
Corner Lot [] Inside Lot [] Ft. Yd. Setbaek Side Yard Setbaek
Type of Construction:
lQG 1�a0� D✓�/p !/if%� Estimated Cost: $ `��' Op
Approx. Completion Date: ��� '� 3O
Alt. A Alt B
Proposed DriveWay Width If New Opening Is Desired: $ $
See Back Page for Explanation
DATE: ��^�� � a � APPLICANT : Tel . �
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
SeWer Main Charge
F�•1!L
STIPULATIONS:
CITY DSE ONLY
� . Fee Sehedule on Reverse Side
$ 25� of Building Permit Fee
$ ��_ $.50/$1,000 Valuation
$ $475 per SAC Unit
� Fee Determined by Engineering
�
Agreement Necessary [ ] Not Necessary [ ]
$
;
; p� - ,,
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BIIII.DING PERMIT FEE SCHEDIILE
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 applicatio n
therefore� require the payment by the applicant for such permit of fees to the amount
herein belo� set forth and in the manner herein provided to-Wit: -
Total Valuation
�1.00 to �500.00
5501.00 to $2,000.00
$2,001.00 to $25,000.00
$25,00�.0o to $50,000.00
$50,00�.0o to g�oo,000.00
�100,001.00 and up
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.
�32•50 for the first �2,000 plus $6.00 for eaeh
additional �1,000 or fraction thereof, to and
including �25,000.
�170.50 for the first �25,000 plus �4.50 for each
additional $1,000 or fraction thereof, to and
ineluding �50,000.
�283•00 for the first �50,000 plus $3.00 for each
additional $1,000 or fraction thereof, to and
including�.�100,000.
��33.00 for the first �100,000 plus $2.50 for eaeh
additional �1�000 or fraction thereof.
DRIVENAY DEPRESSION ESCROY
(Concrete CurD 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 xith 6 inch d�g��� - Drivexay Width plus 6 feet times $15-75
11ERIFICATION OF FOONDATION
Permits for construction xill be issued a minimum of 2�+ hours from the time of
application to allow for proper reviex of the proposed structure and of the
construetion site.
A Certificate of Survey of the lot, shoWing tt�e locatio� of the f��ndation once it
has been constructed �ill be required before proceedin� vi�l� the framing.
SuB�Etr
c�ty of Fridley
AT THE TOP OF THE TWINS g U I L D I N G P E R
i�
� �
� ; v __�__ COMMUNITY DEVELOPMENT OIV.
r � � PROTECTIVE INSPECTION SEC.
i = ,
� �"'� � CITY HALL FRIOIEV 35�32 NUMBEF pEv
�.---� • •�, 612-571-3450 910-Ft5
JOB ADDRESS 7083 Hickory Drive NE
t LEGAL �OT N0. BLOCK TRACT OR ADDITION
DESCR. 3 1 Ostman's 3rd Additon
2 PROPERTY OWNER MAIL ADORES$
George Andrews 7083 Hickory Drive NE
3 CONTRACTOR MAIL ADORESS
.S 8.1Il2
I ARCHITECT OR DESIGNER MAIL ADORESS
S ENGINEER MAII
DATE
4/29/99
29340
�
PAGE Oi AVPqOVED BY
/ /
SEE ATTACNED
SNEET
Z�P PHONE LICENSE NO
tIP PHONE LICENSE NO.
21P PHONE IICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW ❑ ADDITION O ALTERATION �J REPAIR p MOVE O REMOVE
8 DESCRIBE WOFK
Reroof House & Garage (20 Sq) Tear-off
9 CHAN(iE OF USE FROM
STIPULATIONS
TO
Underlayment must comply with the State Buildittg Code.
CONSTRUCTION WORK HOURS: 7:00 am to 9:00 pm, Monday thru Friday; 9:00 am to
9:00 pm on Saturday; No work on Sunday.
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, MEATING, "rc vr a.a,rna� ,
VENTILATING OFi AIR CONDITIONING
THIS PERMIT BECOMES NUIL AND VOIO IF WORK OR CONSTRUCTION 20NING
AUTHOR12ED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OFI WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTEii WOqK IS COMMENCED N0. DWLG. UNI7S
I HEREBY CERTIFV TNAT 1 MAVE READ AND EXAMINED THIS APP�ICA710N 1
AND KNOW 1ME SAME TO BE TRUE ANO CORRECT. ALL PROVISIONS OF LAWS yALUATION
ANO ORDINANCES GOVERNING TMIS TYPE OF WORK WILL BE COMPLIEO 1 714
WITN WMETMER SPECIFIED HEREIN OF NOT. TNE GRANTING OF A pERM1T ��
DOES NOT pRESUME TO GIVE AUTMOqITY TO VIOLATE OR CANCEL TME pEiiMIT FEE
PROVISIONS OF ANY OTMER STATE OR LOCAI LAW REGULATING cor,. 56.75
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION �
SiGNATUpE Oa
ENi ��iTE�
STA�LS
P OCCUPANCVLOAD
CU FT.
f PARKING
GAHAGES
$.86
iAC CMARGE
Fire SC $1.71
'OT EE
9.32
i THIS IS yA PjpM
r
NEW
ADDN
ALTER
[]
Il
[l
ConstructionAddress:
Legal Description: _
Effective 1/1/99
CITY OF FRIDLEY
SINGLE FAMII.Y AND DUPLEXES R-1 AN�D R-2 �V
BUILDING PERMIT APPLICATION �
������
Owner Name & Address:
� s�� �„�el. # 5 iC% //S�
Contractor: " MN LICENSE #
Address: Tel. # �
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA:
GARAGE AREA:
DECS AREA:
OTHER:
Length
Length
DESCRIPTION OF IlVIPROVEMENT
Width Height Sq. Ft. .
Width Height Sq. Ft. .
Wi Hgt/Ground Sq. Ft.
-'� � 5 /���2-�►
�
Construction Type: � � (.,`,��.�� l ..P` Estimated Cost: $ , �l�
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: __ ___Ft. + 6 Ft = Ft x$________ __$
DATE: ` /� /
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATION5:
� � . ?s'
$ �� � /
$
$
$
$
$
$
$
� � ��
�
CITY USE ONLY
Fee Schedule on Reverse Side
Tel. �# � 7 //��j
.001 of Permit Valuation (1 / l Oth %)
$.50/$1,0� Valuation
$1050 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 [ ]
�
BUII.DING PERMIT FEE SCHEDULE
The Cluef 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 $50,000
$50,001 to $100,000
$100,001 to $SQ0,000
$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,OQ0 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 fia�st $500,000 plus $4.���.� each additional
$1,000 or fraction thereof, to and including $°��,000,000
$5012.25 for the fi�st $1,OOQ,,�Q 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 $15.50.
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 $23.25.
VERIFICATION Ofi 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.
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CHI�i I�Ti EY AND <STACS �RIFICATION
The undersigned hereby verifies that the existing chimney or stack:
1. Has been carefully e.camined Yes () No ()
2. Is free from rust or deterioration Yes O No O
3. Has no foreign ohj�cts_ lodged within Yes O No O
4. Is securely .supported . . Yes ( ) No ( )
5. Meets all currenr. Code requirernents for size -
and total �TU's connected Yes O No O
6 Has total heating BTU's of
All other BTU's
TOTAL BTU's
7. Has a liner been provided f:,r water heater
8. Has combustion air been provided �or water heater
Remarks:
List ALTERATIONS Being Do�e:
Yes ( ) l�n ( )
-Yes ( ) No ( )
HEATING CO:
Signed By:
Date:
Building
Inspections
763-572-3604
.
SI1'E ADDRESS _
1'HIS APPLICANT IS:
PROPERTY
OWNER/
TENANT
MECHANICAL
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
'_�_ • .I���
1
E-MAII. ADDRESS C� 4��,J�C'L � �
Permit N
Received By:
PHONE:
CONTRACTOR Co1�.vvx 1vnME:
SUBNIIT A COPY OF corrrACT rExsorr: _ DAVE'S HEATING� �R & ELEC'fRI�
YOUR STATE STATE LICENSE # 160137T" AVE NE ,���21
r.�c�xsE � ann�ss: COLUMBIA HEIGHTS, i�tN
APPLICATION � STATE ZIP.
PHONE ! �Q �' �� I' ��� I
PERNIIT TYPE I"'F'"""� FAMII.,Y O TWO FAMII.Y ❑ TOWNHOUSE
�rE oF wo�: I°1��'' ���-^^��T O ALTERATION/REMODEL
�►ILED DESCRIPTION OF WORK
t���,
� I � L�i�.c� �.
i(1-YY� ( ,� � �cL
PER MS 16B.665 the permit fee is a minimam of $15.00 or 5% of the total cost np to $500.00, whichever is greater, for the
improvement, installation or replacement of a residential fixture, excluding the fixhu�es. (This should reflect only the cost of labor )
Labor cost under $300 =$15.00. I,abor cost betww�n $300 to $500 = cost of labor x.OS =
FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURB, EXCEPT WHERE NOTED. FD{TURES: (INDICATE TOTAL
NUMBER OF EACH BELOVI�
Equipment Installed MFG: MODEL: SIZE/BTU
� C $25.00
_AIIt TO AIIt EXCHANGEER $15
_BOILER $35.00
CHIIVIlNEY LINER $10.00
DUCT WORK $10.00
MFG: MODII.:
MFG: MODEL:
FIREPLACE (GAS) $15.00
FIREPLACE (WOOD) $35.00
�GRNACE $35.00
_GAS DRYER $]0.00
GAS PIPIATG $10.00
RIT FEE PROJECTS FOR UNDER $5
Permit Fee $ ��.
Surcharge $
TOTAL DUE $ �(� :
SIZFJBTU
SIZFJBTU
_GAS RANGFJOVEN $10.00
NEW GAS GRILL $10.00
GAS iJ1VIT H1'R $10.00
_POOL HEAIBR $35.�
_VIIVTILATOR $15.00
PERMIT FEE FOR PROJECTS OVER $500
Number of fixtures @ $10.00 x $10.00 = $
Number of fixtures @ $15.Q0 x $15.00 = $
Number of fixtures @ $25.00 x $25.00 = $
Number of fixtures @ $35.00 x $35.00 = $
State Surchazge = $ .50
Tota1= $
TFIIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSID
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 a lication 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 cas �1 work w'c uires review and approval of plans.
1 �
SIGNATURE OF APPLIC PRINT NAME ATE � r� —
PLEASE
ARE REQUIRED FOR BUII,L
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977
MECHANICAL �VORK