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P - 48010�.� � Y vr r iuUL�: Y MU V 1N U(] DEMO [] PERMIT APPLICATION 6431 University Ave NE � - Fridley MN 55432 ' , (763)572-3604 FAX (763)571-1287 �REC'D NO V 3 0 2011 Job Address : ����.���5f;1� f�, � Legal Description: Owner & Address: j��2 x,qpT� � ,c�U� � Tel. #,����5'/�y/ Contractor: �..��j�� ���� � � Tel. # Address : State License # �Q� y��'"�j "?(,� 3-- ���-� �9 S��^ CRIPTION OF BUILDING HOUSE: Length Width Height Sq. Ft. Cu. Ft. --°GARAGE : Length �_ Width �_ Height �! Sq . Ft . L�0$ Cu . Ft . OTHER: Length Width Height Sq. Ft. Cu. Ft. I, Estimated Cost $�)'� Approx. Completion Date ' CALL Moving Route: STATE ONE. AT 651-454-0002 FOR UTILITY LOCATIONS. DISCONNECTS BEFORE WRECKING/MOVING STRUCTURE_ APPROVAL(S) REQUIRED PRIOR TO ISSUANCE: � MPCA: NOTIFICATION OF INTENT TO PERFORM A DEMOLITION O YES O NO WATER AND SEWER DISCON�ECT PERMITS MUST BE ISSUED PRIOR TO DIIKOLITION. ii ❑ Wate Bill a d: ❑ Bldg Offic al ❑ E . g ❑ Fire Ma al [ ] /or Collect [ $ _ � Signature f Conditions Conciitions Conditions PT.T• The undersigned hereby makes application for a pernut to; wreck/move the building described above, agreeing to do all work in strict accordance with the City Ordihances and rulings of the Building Division, and the State �ode which requires any water well on the property to be sealed by a State licensed water well driller, and hereby declares that all facts and representations stated in this application are true and correct. ALL DEMOLITON DEBRIS, INCLUDING FOiJNDATION & SLAB, SHALL BE REMOVED FROM SITE /���'1l _ Date S��na �re - Movin� Principle building into Fridley . . . . $300.,00 Accessory building into Fridley ...$ 42.00 Through or within the Ciry ......$ 20.00 Move a building out of City ......$ 20.00 � , PERNIIT FEE: O Effective O1 /O1 /2011 . Wreckin� For each 1, 000 cubic feet or fraction. .....$1.25 For structures which would be impractical to cube, the fee shall be based on the total cost of wrecking at the rate of $6.00 for each $500.00 or fraction. � MINIMUM $20.00 Office Use Only: SAC-D form completed