AF - 47093.
m
Vil.l.age of Fridley, Minn.
BUILDING PERMIT �°• 19 7 8
°�''� �".�-
Date: ���i� �,,� .� � �s�. .. . !�• !�. .. .. .. . .
Owner . . �� . . . . . . . . . .. . . . .. . . Builder ;1�.. .'�: .`f t t�� .�; �. .i: �r �f�'. .'���.�"��� �. .
... .... ...... ..... � �•
Address...................................... Address .............................................
LOGAT[ON OF �U�DING
No. . : �1� ��. .� � � Street . G'�" .����: : �` �,�: � �: �.': . .�.�°: �' Part of Lot . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Lot . . . . .��.-: . . . . . . Blocl� . . . . . ��. . . . . Addition or Sub-Division <.�'`E�:�-?'d'-.�,� :�.�1'.. : �.!.�?:!�:�":� .. ..
Corner Lot . . . . . . . . . . . Inside Lot . . . . . . . . . . . Setback �,�� ���rr` Sideyard f a� .�.r:'��F:-: :°."'. . . . . . . . . . .
To be Used as:
.,�`�A:�'�..�����:�� . . .
.....................
Type of Construction
DESCRIPTION OF BU[LDING
Front .�;;a�L"r`... Depth��.�; I-Ieight��,�✓',�-',d"� Sq. Ft. ........
Front . .. .. Depth ....... . Height . .... .. . Sq. Ft. ... .... .
���`:� '°:f F. ". . . . . Est. Cost ,{� �'': .�''�:�: � . . .�y.�`"""°.�. . `. . . To be Completed,
!J A-� �
�'���-_�;;��--����
�C'.� ���8�-�'€> �i' '���`�t"� ,�4��
Cu. Ft ........
Cu. F� . . . . .
.�:'� ✓��.-� � �
T� consideration of the issuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordance with the description above set forth and in compliance with all. provisions of
ordinances of the village of Fridley.
.....................................................
�
In consideration of the payment of a fee of $��► ......, permit is hereby granted to .,� �€ �-f F:��='
�,/"'j ,':
�
+r c:'a�.�. �`?�' . iC�. S..t�,�a: �. to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and worl�en, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
F'ridley, Minnesota regarding location, construction, altera.tion, maintenance, repair and moving of build'mgs with-
in the village limits and this permit may be revoked at any time upon violation of any of the provisions of said
j�,
ordinances. _ _ ,
.��':�� '�,�,• .�':�..#;-:�£� ���. Building Inspector
NOTICE:
�his permit does nbt cover the eonstruction, installation or alteration for wi�ing, plumbtng, gas heating,
sewer or water. Be sure to see t.p�Building Inspector for separate permits for,fhese items.
_� �
�'`�`,
�
City of Fridley, Minn.
BUILDING PERMIT N° 3� 2 0
Date: . . . � . . .�.�. . � . . . . :� . . � . . . . . . . . . .
Owner �,! .��!7�sti�,,..�.���.��. . . �i'lder .............................................
Addre� ...................................... Address .............................................
LO�CATIQN F BUII,.D[NG
' �.�"� ��_
No. .,,� . Street . . . . . . . . . . . . . . . . . . . . .'. : Par�-of Lot . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Lot ............ B�ock .. ............... Addition or Sub-Dfvision .......................................
Corner Lot ............ 7naide I,ot .�......... Setback ............ Sideyard ...........................
DESCRIPTION OF BUILDING
To Used as: r _ . �/�/
�� . . . . . . . . . . . . . . . FSroirt �� � Depth ��.� F3eight l � . .r.�. ~ Sq Fk 7' 7 � . Cu. F't.�? : .�
.................... F'ront ........ Depth ........ Hdght ........ 5q. Ft. ........ G�u. Fk ........
Type of Consiruction .. Fst. Cost. .��� �. �
... .............. ..... To be Completed ...................
In consideration of Yhe issuance to me of a perrmit to consh uct the building desnbed above, I agree to do
the proposed work in aceordance with the description above set Eorth and in compliance with all provisions of
ordinances of the dty oP Fridley.
,�° , , `/, ,��r,.c�;- ;i:� .�.,���°'!': ��.°. : . . . . . . .
�
In consideration of the payment of a Pee oP $....��......., permit is hereby �ranted to ...................
. . . .. . . .. .. .. . . .. . . . . . .. . to construct the building or addition as described above. This permit is granted upon
the express conditfon that the person to whom it ia granted and his agents, employees and worl�en, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances oP
Fridley, Minnesota, regarding location, construction, alteration, ma3ntenance, repair and moving oP buildings with-
fn the city limits and this permit may be revoked at any time up on viola.tion of any oP thg�provisions o4 sa3d
ordinances. _ / � /
`l�`. . Building Inapector
' /i A � / .Y �• ✓a�•.0 • ;. _ . i/'
NOTICE:
Thia permit does not cover the construcllon, Installatlon or alteration fo� wiring, plumbing, gas heating.
sewe� o� water. Be sure to see the Bulldine Inspeotor fo� saparate pe�mlts fo� these Itema.
SUBJECT pE
City of Fridley ° 15118 `
AT THE TOP OF THE TWINS g U I L D I N G P E R M
i �
� •
EIPT NO
� `L _.�� COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC. (��� �
� /
1 i �
�` /'��1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY
L��_�� � ,�� 812-580'3450
910-F15 4/11/79 � �
JOB ADDRESS 5655 Jackson Street N.E.
1 LEGAL LOT NO. BLOCK TRACT OH ADDITION SEE ATTACHED
DESCR. Fj 5 Donna.y's Lakeview Manor SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Schmidt Construction Co. 926 Watson, St. Paul, 1�Il�T 55102 222-7209
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Llo d En ler 5655 Jackson Street N.E. Fridle NIl�i
4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
6 USE OF BUIL�ING
RC�3].CIP11'tldl
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATIOId ❑ REPAIR ❑ MOVE ❑ REMOVE
X
8 DESCRIBE WORK
Construct a 20' x 14 ` Addi.ti n to House
9 CHANGE OF USE FROM TO
STIPULATIONS
Install 5/8 inch fire code sheetrock on the inside of wall in
garage parallel to i�use. Existing service door in gaxage must be solid
core and have a closer.
SEPARATE PERMITS ARE REQUIRED 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 SQ. FT. CU. FT.
AUTHORI2ED 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 CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION ], STAILS 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 HER IN O NOT. THE GRANTING OF A PERMIT y�`% � Z�S y�`3. 5S
DOES NOT PRESUME TO GIVE UTH RITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER AT R LOCAL LAW REGULATING CON-
STR ON OR THE RFOR C OF CONSTRUCTION. � yS`42. 9O NONE
RLAN CHECK FEE TOTAL FEE
' � 10.73 $57.21
SIGNATUREOF NT A T RO AUTHORIZEDA6ENT (DATEI WHEN PROPERLV VALIDATED THIS IS YOUR/ PERMIT
�' � �SX.2r'C� 6 ' � � �- � /
SIGNATUREOFOWNERIIFOWNEHBUIL�ERI IDATE) BLDG. WSP pATE
CITY Of FftID�EY . �
' APPLICATIOP� FOR RESIllCNTIAL BUILDING PEft(�1ITS .
' (�VE1J, IILTCR/1TIONS, ADDITIOtJS; OR REPAIRS)
OWt7ER: L �Q YrD • [�ti f� L �r'L BUILD�R: ���/�% -C � '� 5i �c% �
. Address : � (� �S V F} C %cs � �� Address : TZ (v�7eSo � �Ta /�69 �/L
Tel. No. � 2 ��% �� %
s--=
No. : Str eet :
LOT: BIACY.: � ADDITION: �on�eVi�7S Lf�K� �/�����✓Z�,2,
COi2NER LOT: INSIDE IAT: � SLTBI,CK: SIDEYARDS :
Applica'r.t attach to this form Zt�o Certiiicates of Survey of Lot and propose3
building location drawn on these Certificates. .
DESCRIPTYON OF BUILDING
Zb 8e Used As:
�
� O De th: / /
�AA�'//L`� �r�� r� Front: p � Neight: �� -
T
Square Feet: � �� Cubic Feet: ���
Front: � Depth: � Height:
� 5quare Feet: � Cubic Feet: � �
.� •
�ipe of Construction: ��� q-� Estimated Cost: S °��'�
� � ! ��. � � �- ��
qb 8e Cc�mpleted: A1t. A' o Ait. B � j�
Proposed Driveway Width If New Openi.ng Is Desired $ $ •
. (SEE REVERSE SIDE OF SHEET)
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all �aork in strict accardance with the City of
Fxidley Ordinances and rulings of the Department of iui 'ngs, and hereby
declares that.all the facts and representations stated ' tl7�s application
are true and correct. See reverse sid�ar addi jt�onal i c�mation,,r
DATE: ���� SIGNATURE:
Stipulations:
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. BUILDING PER��IIT FEE SCHEDULE �
SECTION 2. The Inspector of Buildings shall,'before'issuing perntits for the erection
of any building or structure, or for any addition to any existing building or structure,
. or for any alteration or repairs 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:
0
NEW CONSTRUCTION: Single Fam.ily Homes and Garagesr $4.00/1,000 cubic feet.
PLAN CHECK: 25 percent of building permit fee. ,
DRIVEWAY DEPRESSION: (Concrete Curb Streets Only)
• Alternate A: Removal and replacement of aoncrete e�rb and
gutter only; Driveway width plus 6 feet x$�,�.75
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$17.85
�11 � G_ ► �; : �1
F'or the purpose of computing fees for buildi.ng permits, the cubical contents of any
building or addition, is determined by multiplying the grot:nd area covered from a
point si�c (6) inches below the floor line of the basement or the cellar to the
average heights of the upper surface or to the average height of the roof surface
of the mai.n gable of a pitched roof .
For repairs or alterations to an existing structure, the fee shall be at the rate
of $3.00 per each five hundred dollars-($500.00) or fraction thereof in the cost
of all proposed work. �
In•no case shall the fee charged for any permit as set forth in Section 2 be less�
�haa $7.50 plus $.50 state surcharge. '
_VERIFICATIO� OF FOUNDATION
NOTE: Permits for construction will be issued a miniminn of 24 hours from the time
of �.pplication to allow for proper review of the proposed structure and of the
construction site.
A Certificate of Suxvey of the lot, showing the location of the foundation once it
has been constructed will be required before proceeding with the framing.
_; + � 1 •��
Application for a Certificate of Occupancy shall be made ten (10) days prior to the
use or occupancy of any structure for which a building gezmit has been issued; and
saicl structure shall not be used or occupied until a Certificate of Occupancy has
been issued.
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SUBJECT PERMIT NO.
City of Fridley 15 7 7 6
AT THE TOP OF THE TWINS gU I L D I N G P E R �
�
� � RECEIPT NO.
� 1 L_____ COMMUNITY DEVELOPMENT DIV. �
r � � PROTECTIVE INSPECTION SEC.
� i �
1 /"�'1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY
!"""�� � ,�� 612-571-3450 910-F15 / /
6 11 $0
JOB ADDRESS 5655 Jackson Street N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 6 5 Donnay's Iakeview Manor SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Lloyd B. Engler 5655 Jackson Street N.E. 571-2961
3 CONTRACTOR MAILADDRESS 21P PHONE LICENSE NO.
Same
4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
6 USE OF BUILDING
RESI.C1P.11't1.�.1
7 CLASS OF WORK
❑ NEW O ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
X
8 DESCRIBE WORK
COnstruCt a 12' X 10' DeC
9 CHANGEQFUSEFROM TO
STIPULATIONS ,
S�PERATE PERMITS RE'QUIRED �OR WI�R1t�G,
HEATIIdG, P�.UMBiNG AhiD SIGNS. ��
B�torQ dp n ��
� 8 cel► locar utl!►t�e�
�tFPkONE - E[EC��rc .
RE�tlIRED �y ��t�.
��
SEPARATE PERMITS ARE REQUIRED 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 SQ. FT. CU. FT.
AUTHORI2ED IS NOT COMMENCED WITHIN 80 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 CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION �- STALLS GARAG�S
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 y�`FjOO �- �, ,�'�j
WITH WHETHER SPECIFIED HEREIN OFi NOT. THE GRANTING OF A PERMIT
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. `+� �.�
PLAN CHECK FEE TOTAL FEE
$8. �0
Si a REOFCON7RACTORORAUTHOR EDnGEtvT IDATEI WHEN PROPERLY VALIDATED THIS IS VOUR PERMIT
� � . C,.ti-s�-"�/ `' / � `�iJ
SIGNATURE WNERIIFOWNERB ERI D1T BLDG INSP �A E
_. . . _ _ _. :. _ ._. .. .. , � . _. s . _ .o. .. .._ _
_ _ _ ..
CITY Ot� f�RIDLEY • •
� . �� �
A(?PLICI1TIOfJ FOR RESIDCNTIN_ f3UILUIP�G PERMTTS
' (tJcv�, Altcr�ations, AddiLions, oi~ (tcpairs) �
Ca �,1
06J(dER: ��o = Le E3UILDER: , J� 9`� ��
ADDRESS: .S��SS' �c� CSC'So � ApDRESS: �
TCL rd0 : S 7/- Z r(� / TCL fd0: '
' Construction Location
• STRL'LT NO: 5 IpS> ST12��T: J� C�Svt� r_��-
. �
LOT: � ELOCY.; � ADDITION: f�d R.l�JO.� �S LG��� �r ecJ ���%C�.
Corner Lot: �_ Inside. Loto � SeibacY.: Sideyzrds:
Applicant attach to this form L-wo Certif_icates oi Survey of lot and '
proposed building �.ocation dra�an on certificates to scale.
DESCR�PTIOId OF CONSTRUCTION �
' �r '
�� C:.� Front: �� v� Depih: �/O Height: � 7 .
Squa�e. Feet_ C�ibic r eet:
Front:
�pt�: Height:
Square• Feet: GZib�c FeeL-:
� oc� � .
Type of Constxuc�ion: ���� � U `D e C� -�stunai.ed Cost: � d0, C� v
�b Be Cbmpleted: oZ /('faN°'E � .
' Alt. A Al�. I3
Proposed Driveway Width If New Opening Is Desi.red: $� $
� , SE� REVERS� SIDE OF SHEET .
The unde�:signed hereby makes application for a permit i'or the work he�:ein specified,
agreeing to cio all ��ork in stiict accordance with the City of �'ri.dley Ordinances and
rula.ngs oi the Department of Buildinys, and hc�xeby declares ihat all the iacts and
representations stated in this application are true and correct. ,
A�1T�: (p %�� � SIGNATU�'�:
_%
Stipulations:
� �,�J
, ,�J
�,
. �.��
. BU11_1)1NG PCRP�IT �Ci� SCfiF�DUI_E' .
51.C'�xOIJ �. '1'he 7�i:;)�Cr{;OY. OT Itt1�.IC1].II�J�: :.ha).7., beforc a. ;suing penn�,i:;; �or Lhe crecl:ion
of• any l�ui.J.cl�.ncJ or. :;t�LUCi:ure, or. �o�- a»y acic]i.L•ion Lo any er,i�L•inc� Luildi,ng oz' strucL-urc,
. ciz f�r. any alteratioi� or. rcpair.r, to •a�iy er.a.r,ti.»g }�ui.].cli.l��� ar. sL•r.ucturc, u���n ar�plicat9.on
'L•lier.efor.c, zcquxrc L}�c paymc��L• l�y the a1���].i.canL• for. :;tich per.mi.L• of tees L-o. 4:1�e amount
hexcin bcJ.ow �eL• for.L•h �ind �.» i:hc manncr. hcrci.n pioviclecl L•a--wiL•: �
I' 1�1;�1 COt•�S'i'1:(1C'J'ION: 5.i.ng].e 1'amil.y Ilomes� and Gar.ages : $4 . 00/1, 000 cubic tect. �
3.'7,A2� C1I1:CY.: ?.5 par.cenL• of }�ui.ldi.ng J�ezmi.L- fee. .
D121'V�l•111Y ll�I'RL•'SSxOId: (Concrete, Curb �treeL-s Only) � � '
� A1L-crnaL-e A: Removal and re�>laccmenL- of concrci�e curb and
gutter only; Driveway wicli:h plus 6 iee� x Y�S.e75
. Al�ernate I3: l:emoval and replacc�menL- of c�ncreL-e curb and
. ' gutter and i�istal�. a 3 f:ooL- widc approach �vii.h ��
' .. G i.r�clz ae�i:li; DrivcY�ay w5.dth plus G feeL- r. $17.85 �
• � . /�DDITZOt�!!1L IFdFOR��ftl"I0�
I'or the purPase of comput-a.ng tees for building p�rmits, the cubica]. conL-ents o� any
huilding or addiL-ion, is dctermi.ned by muli:iplying the ground area covered froni a
po�nt sis: (G) inches below the f7.00r line of the basemeiit oz th� cellar io the
average heights of the upper surface or i�o t-he average height of ihe rooi- surf_ace
o� the ;�ain gable of a pitched roo�.
For repairs or alterations to an existing sL-ruciure, the fee shall be at the rate
of $3 . 00 Per each five hundred dollars -� ($500.00) or fraction fihereoi in the cost
af all proposed work. . �. �
Tn •no case shal.l ihe fee charged for any pexmit as set iortli �.n Seci:ion 2 be less •
than $7.50 �lus $.50 state surcharge. '
• VERTFICAT���I OF FOUNDATION
PaOTEe Permits �or construci:ion �vi.11 be issued a minimtmi of 29 hours from t-lie time
of application to allow for proper zeview of i:he proposed structure anc� of the
construction si.te. -
A Cexti.iicate of Su�.vey of th� 10�, sho�aing �he location of the foundation once it
]ias been constnicted �vill be rec�uired Uefore proceeding with the £raming.
CkRT I f=1 C,�TE OF ��G��PANCY
npp�.ication for a Certificate oi Occupa»cy shall. Ue made i:en (10) da�►s prior to the
use or occup3ncy oi any sL-rucL-urc ior which a� building pei�tit ha� been i.ssued; and
said st_r.ucture sha].J. no� be used o� occupied un�Lil a. Certa�ti.cate of Occupzncy has
been a.ssued.
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4
y
City of Fridley
AT THE TOP OF TME TWINS
i�
� �
� • COMMUNITY DEVELOPMENT DIV.
� j V �"�� ,
r � � PROTECTIVE INSPECTION SEC.
� . ,
l."'�: �' �./ CITY NALL ffi1DLEV 65�32 Nw
L 612-571-3450
10B ADORESS 5655 Jackson Street
t LEGAL �OT NO. BLOCK TRACT OR/
DESCR. ( 5 Don a '
2 PROPERTY OWNER MAIL AODiiFS$
Medtronics
3 CONTqACTOR MAIL AODRESS
Swift House Moving 20845 Larkin Rd
A ARCNITECT OR DESIGNER MAIL ADDRESS
5 ENGINEER MAIL ADOfiE$S
8 USE OF BUILDING
Residential
� c�nss oF woRK
B DESCRIBE WOfiK
9 CHANOE OF USE FpOM
STIPULATIONS
M 0 V I N G
�U I G PERMIT
REV
910-F15
O�TE
8/4/99
ZIP
��
ZIP
21P
�
29999
����
Oi APPpOVEO 8Y
�
SEE ATTACMED
SNEET
PMONE
PHONE
LICENSE NO
2227
LICENSE NO.
LICENSE NO
❑ NEW O ADDITION O ALTERATION ❑ REPAIR � MOVE O REMOVE
TO
Jackson N to Carrie W to Quincy S to 57th W to 7th S to 57th W to TH 47 N to
73rd E to Cty 35 1�
Current Water Bill of $69.61 due 8/25/99 plus final bill after meter reading.
Clean site of all debris including foundation and slab.
SEPARA7E PERMITS ARE REQUIqEO FOR ELECTNICAL, PWMBING. HEATING, ''r� �r vv•V•
VENTILATING Oq AIR CONDITIONING.
THIS PERMIT BECOMES NULL ANO VOID IF WORK OR CONSTRUCTION ZONING
AUTHORIIED IS NOT COMMENCED V�1ITHIN 80 OAYS, OR If CONSTRUCTION
OR WORK IS SUSPENDED OR ABANOONEO FOR A PER100 OF 120 pAYS A7
ANV TIME AFTER WORK IS COMMENCED. NO OWLG. UNITS
I HEREBV CERTIFY 7HAT I MAVE READ AND EXAMINEO TNIS APPLICATION
ANO KNOW TME SAME TO BE TRUE ANO CORRECT. ALL PROVISIONS OF LAW$ ypLUATION
AND ORDINANCES GOVERNING THIS TYPE OF WpRK WILI BE COMPLIEO
WITH WME7MER SPECIFIEO MEREIN Oii NOT. TME GRANTING OF A pERM1T
DOES NOT PRESUME TO GIVE AU7HORITY TO VIOIATE OR CANCEL TME pEqMITfEE
PROVISIONS OF ANY OTHER STATE OR LOCA� LAW REGULATING CON-
STRUCT N OP TNE ERFO MANCE O CO TRUC710N �ZO.00
PLAN CNECK FEE
$�GN4i O�C �aACTOp • MOp4ED4GENT ATEi EN P
S�GNATUAE OF OWNEQ��F pWNEA BUiLDEfi� iDATE� � pi nf. roCP �
OCCUP
SO.FT
STA�LS
P OCCUPANCVLOAO
CU FT,
STREET PARKING
IGARAGES
;CMARGE
A� FEE
�.0
�+ S vO�J$ PE�
�� �
Effective 5/10/99
CITY OF FRIDLEY MOVING [] WRECKING [] PERMIT APPLICATION
6431 University Ave NE �
Fridley MN 55432
572-3604 �(� (f��
� �0
Job Address: e�'�,�°� C�cA� � s� �
Legal Description:
Owner & Address : j� � �'�PB � � � Tel . #�<a? ��„� �.� �=r
e
Contractor: �' � '�� Tel..#������,�`�(
Address: � �°c. � State License # �(��� '�
DESCRIPTION OF BiTII.DING
HOUSE: Length � Width � Height � Sq. Ft. Cu. Ft.
GARAGE:Length Width � Height �� Sq. Ft. Cu. Ft.
OTHER: Length Width Height Sq. Ft. Cu. Ft.
Estimated Cost $ ������ Approx. Completion Date �
UTILITIES City Water/Sewer Minnegasco N S P U S West
NOTIFIED: 572-3529 jq� 372-4720�] 330-5500J� Business-603-6000
Home-244-11�,1 [ ]
��� �cJ ���'� :l�d;,� ��� �� -'���
Water Bill Paid: Yes [] or Collect [$ �- �;,��.�..9 ] Signature �,�
Moving Route : s?�.��.��_ /�l �a � ,r � t� ('i✓ � d l�.a f°�-� � � S �a s'��� �
`r0 % rG� � °Yd l{%'F� C./""r -�a `� / ' �� {� �o �� � 4�� �r-U � ��� �
The undersigned hereby makes application for a permit to wreck/move the building described above, agreeing to
do all work in strict accordance with the City Ordinances and rulings of the Building Division, and the State
Code 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 conect. ALL
---��� te
Movin�g: Principle Building into Fridley .... $300.00
Accessory Building into Fridley .... $' 42.00
Through or within the City ...... 8�_,
Move a building out of City ... . $ 20.Q0
��
Wrecking: For each 1,000 cubic feet or fraction .:---�-Y��
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 $SOO.QO or fraction.
PERMIT FEE: STIPULATIONS:
Minimum Fee: $20.00
Minimum Fee: $20.00
TO:
FROM:
DATE:
SUBJECT:
MEMORANDUM
Mary Hina
Jon H.,�aukaas, Assistant Public Works Director
.dtro�
September 2, 1999
Properties Acquired for Right-of-Way
The following properties have been demolished and will no longer use water and sewer services:
5665 Quincy Street
5675 Quincy Street
5655 Jackson treet
5664 jackson Street
5665 Jackson Street
5674 Jackson Street
5675 Jackson Street
PW99-163
The properties were acquired for use as street right-of-way. They will no longer be residential properties.
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