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AF - 47585. City of �ridley .r �T TME TOP 0�' TME TwIHY � i` r �'L'-""'� COMMVNITV DEYIL6IhFENT OIV, ( � � MOTECTIV! Wtl�'iCTipN p�IT, �� r"'C i CITV NAII. fR10l.RY �� ._._.11.� .! Na-fsO-�.so iU0.1[GT - ' Permit No. !'LUMB I idG PERf1 I T � PPL I CAT I��i� Job Address � � `� -� �= `�`��- ., % ne�� Ad ress �/f — (i!j �.�; �?� bin on �-c1 ��.,�-1 � �� re , � � Kin�i'of Building Comp etiun Date �! - I ; I � ; � � � I !i � . W I I ! _' __�, � � W i i I ` < ' 3° �`, • � I ' I` a�Nra ' � � � s�� I � � I �� ---- � ��, 'iddYl � � � I I �O o��I + , � � ; � � •asiwl ( ( I I . t —f' � •saoil I � � i ' �•MNrva I � m� y, I SNIBVBI � k � H�iw�l IRiw. ..��QNIV?JO � ;Q O � - tloo,� �� o �w � ,(i � ( Stl3MOH$ � ip �' �""� •iNnoe` q d HNtaol ,� � ' �� s�vai Iq m NsvMl� ; z SNNIYI I sant Hl W NIYfl I -,- O L1D � � c� Ii I LL � � — a i � B � � ( � _— � _�_ �� - , • , ,. d � ,� c� � � � � � se 15 3 1 1 $00 P one P ane � .� .�:� � ��, ��-�-�Z- ' nc r • .; Plumbing Fixture Rates: N0. RATE TOTAL I� ,! Number Fixtures �� x $2.00 � I� Future Fixtures� �_ X $i.so , S� I' New Fixture-Old Open. x$1.50 ? Catch- Bastn x $3.25 � Water Heater-99, 000 BT[T � x$3. 00 ,� .�a �! � Ground Run Old Bldg. x$3.25 f i Elec. WaCer Heater x$2.00 � 'j Gas Fitting Fees: � lst 3 Fixtures �_ x$2.00 �� U� � � Additionaf Fixtures x $ .75 j fGas Range-199,000 BTU x$5.00 ! Repairs &-Alterations See � Description: Code fState Surcharge �50 , TOTAL FEE $ o�a . D (� � . �The undersigned hereby makes appl�ication for a permit 'for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declare that all'the facts and repreaentations atated in thia application are true and co ect. ',�'�,�, �`/`�- 'Sig ure Date � . `��'""_ �" � sue�ecr P E . City of Fridley ° 12446 AT THE TOP OF THE TWINS g U I L D I N G P E R M I r ; ;, EIPT NO. � i y_��_� COMMUNITY DEVEIOPMENT DIV. r � PROTECTIVE INSPECTION SEC. �%O U�� , � /'�'1 � CITY HALL FRIDLE� � 55432 NUMBER REV. DATE PAGE OF APPROVED BY � "—'�' ,�� 612-5603450 910-F15 3/5/74 � / JOB ADDRESS 617 Janesville Street N.E. 1 IEGAL LOT NO. BLOCK ` TRACT OR ADDITION SEE ATTACHED oescR. 33, 34 E Riverview Heights Addition SHEET .__.... ._..,�. _ 2 PROPERTY OWNER MAIL ADD . ESS 21P PHONE Gary Irene 71 - 66th Way N.E., Fridley, Minn. 3 CONTRACTOR MAIL ADDRESS ZiP PHONE �IG£NSE NO: Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE UCENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. 6 USEOFBUILDING Residential 7 CLASS OF WORK �] NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a x & Dwe ing NO E 9 CHANGE QF USE FROM TO STIPULATIONS provide a hard surface driveway. Provide a verifying survey before capping. SEWER LOCATION: 43' � West of Manhole "Y" Elev: 930.94 Top of Footing: 933.94 Minimum Inv. Elev. of Ma.nhole: 828.65 WATER LOCATION: Stop Box 10' West of Sewer 57.4' N.W. of Manhole 54.2' S.E. of S.E. corner of house ��615 SEPERATE PEf�MITS REQUIREQ FOR �IIIRING; TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. WOOCI Fi�le THIS PERMIT BECOMES NUIL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTpUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PEfiIOD OF 120 DAYS AT R- �- 964 1.9 � ZHO 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 WIIL BE COMP�IED $19 053.LO 9.S�F WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT � DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pEqMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR �OCAI LAW REGULATING coN. 36.00 300.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $345.54 SIGNATUREOF ONiRA ORORAUTHORIZEDAGENT (DATEI i EN P O L LI TED THIS IS YOUR PERMIT r � � � /� � SIG F WNERIIFOWNERB IL RI IDATEI BLDG INSP nATE � �`` t� i M ..• t� � � c `� � \ � � � -- � �1 � ` J � � � � � V � � APPI,ICE�TION FOR RI:SIllEN'I'IAL, AL'T�:IZa't�I�1:ti`, OR �1i)lll"I'IQN �UII,DING P�ItMIT �I'!�Y OF 1�1:JULf�1', ?1INNESO'Tf1 OWN��t 1 S NAME : �.d � BU ILDER : � , . AADRESS : � I� ^ • ADDRESS : I� Gt I � i �1Q ; . T S TREET : � , T.Q�: RLOCK; � ADDITION: CORNER LOT;____�_INSIDE I.OT: SETBACK:_��SIDEYARD:,�,S�^ Agp].ican� attach to this Iorm Ztao Certificates of Survey of Lot and pxoposed bu�.ldi�ig location drawn on theae Certificates. � �ESGRIPTI�N OF BUILDING To Be Used As: �' Front: � Depth:i � Height: 2" � i Square Feet:__�� Cubic Feet• � � .� � "�� ' � Front• Depth:��,,/ Height: � _ � Square Feet; '� i� Cubic Feet:_ ��,4 �,� �`ype o� Construction: Estima.ted Cost: �o Be Cpmpleted: � /�. /%� � � b �� •� � c9 , o s�< < � The undexsigned hereby makes applicativn for a permit for the work herein, 8pe�ified, ag7reeing to do all work in strict accordance with the City of k'xidley Ordinances and rulings of the Uepartment of Buildings, and hereby declaxes that ,�11 thi: facts and representations stated in this application ax� true and c�rrtct. UATF : -'��'--�-�-Z� S IGNATURE: . � (See Revexse Side For Additiona.l Inforniation. ) � ' "" •'" � �� -�'� �` �`'� � / � �' � /� �. . . `� � 1 �� ! f �1� ��,� /} � � « � � �F "" �' � � � / I� � n y �' f..- 3G, ov�3�'---� �� t �4�J �r��,r.�r.n �n•+....... 3y 5��" �� 9 f �% � � � -f �*+ � � � 2 � � v f�rz ► A�c�.�-� � "�` _ � ; �° .�� : � t � �� , � ,�� ' , r � „� �: . ,� � �'% "� . sc�i.a: � lNCNa_ 5o r:� LE R�Y H. �iNIAi�1�R $� ASSO�li�7E5� I�dC. J0�3 NO. _74=..o_g__�..._ o Dw�ot�• iron pip• �� Regisfered Unds� lows of SI� inntsOta BK. . A_3!... ��. ._ z� ..._.. 8398 Center Drive • Minneapotis, Minn. 55432 Phone 784-0210 CERTI�ICATE t3F SU�t�/EV i SURVEY FOR: G. D. I. Builders DESCRIBED AS: Lots 33 and 34, Hlock E� Riverview- Heights� Anoka County, Minnesota. � " _ lto fo d \ � �G V . 7� � � � • > �� : � 3� 3� � _ . G� c�,�-,.�-. 3- S'-� y. - s oo � - � , , o`,_;� �y ,_ � _ ; J �L^ ; `, � � L �f� j ~ z '' Z ,� � �. , ' �.. � � .�G .�1 ! �• J`'�� a3 "' �- aa : . a � 0.�, i o M � D� � � (� { T�ON ! °O..Ia�v f � ,�_ :i(v� , i ; � , ,, ; ; � ; �; �;'! � _ � � ;,;� � so ` 3a ; ao ' ao ---so.00 P a .---- � 59.70 MEAS. i JANESVILLE � ° �TREET � i _ ( �o ; � , � Q I hareby corti#y rhor on ��,� �9 ! I j 0 1 aurvsyad the prop:rtY de+ cribo�( ai�ove os�d tfxet ths Y_ . � � cbave plct is a correct r�x�s�r►satia� o� said swv��ryr. . � C ,'�� .�„7'L�yt.��.." � U4PaD SIfRV�7�R It::�,. ��Ni��4� . .� ��`� � - � _. _ r �,v �� :: �_ f 3 i� ' r _ `` �13 �% " �l i : � ,: ;�� , � , `t �( r T�P Gt° �� uY � r�i� r�fir(�t. f� C.r(/, �'f33� �r K �(+f vr �:` L C V, o r� ,/�,n, f.l .�`� �', ��,.' � �Cr �- r f°. , < -� � ,� � U� c;�� t:� s� G�^ 5 � w`� '^. S 7; i-f ' /�� v�, o�� ''r' � r� �cs�� j, c=, � S�L . �-� ��st. �6�� a � � . �� `� C, z� � `-�.2`� �� G�_�"—�- G�d.�Gl � .•, � aA ;•. 'r, r��- -r +lr;l '+.w. � .. ,�. .�. yl..:�. :�. ,. . ..' �,; � . _ .,� : ,y:,; � . � . � .3. : '': .ix' , :�; ..,JR , -...i:.. �� `t . H , ei"- �t, q �p : � : �f:, �'� y �,c = y,;; PARTIAI RATE SC�;E��1E.E G1tA1R'!T W1►AM AIA: lU1'PE ?O?AI.. �raacc S}se21 dc Durt Work . .. . . .:IQ.00 � Rrplacement of Flirnace . 6.00 � Rcpairs & A)tcrations--up to =500.00 g.pp � Repairs & Alterations each add. t500.OQ . 3� ; MLCii. WJ►itM JIIIt plunace SheIl d� I?ttct Work to 130,000 BTIJ araCh add. 60,000 BTU . .. .... .. RepLcemeat of Fl�rnace Repairs & Atterations—up !o f500.00 , Rrg�airs dc Alterations each add. ;500.00 . .510.00 ¢ /0 • r'v 3.W ; 6.00 : s.00 t 3.00 = STEAM o: HOT WATER $YSiEM �rr:ace Shell Sc Lines—to 400 sq. it. �'.DR Stesm �20.�J0 S Flunace Shell & Line---to 640 sq. ft. EDR Fiot Water 20.00 3. Each add 200 aq. tt. EDR Steam R.0() i Each add. 320 sq. ft. EDR Hot Water 3.40 ;.�_,_„� _ OIL SUAKER—to 3 gaL per hour 6.0p s � over 3 gal. per hour--See !'ee Schedule GAS BIIitIfER C�p to 199,000 BTU) 6.Qp =,r5� � avcr 199�OQ0 B1'[J S�e FN Sch�dul� GAS FI'iTING £EF.�: !IO RATE TOTAL lst 3 F�xtures ' x= 200 E°�'- � Additionai Fi�ct� � x .7d i__ _ Gas Range ta 199.000 si 6�.QP : un coxnrnoRUea rur x8ntuca s�� Y�Til.i?i�6 s7f8i�1f u�urroxs k n�rxnes govax t�n�,� �- /�- 7 State Surchaxge .50 t s« r« srtre�d: TOT�I. !EB � / ' ' � � z. Dept. of Bkl�. Pitos►o �D-3�Q , J� „) City ot Fridtry: ' The undersigned hereby makes application for a permit ios the work Aere�r specuied, agreeing to do all w�ork in strict accordance with the City Or�ifaanc�= and ruling of the Depattm�nt �t Baildings, asid hereby declar2s that aIl tb� faci� and repres?niatiuns stafed in this apptication are true and correct. �idleY. Minn— ��' ' „14�! ,,, � (%wner �-vs'J�� . Kind �t Huilding Used as � // To t�e completed about, �/ /7T Estimated Cos� E O r Of New Building Perrrtit No, ___ P�rmit No. O V �CASPTIOR OF Vf10�tR i�ATTNG or 1'OWER PI.ANT3—St�am, FYot Water� �No Trade Name--��6E� - � Size No-U�"L//G �� CapacitY-.� 7�°�— Sq. P't &D.R�.._ BTU HF TotaI Connected Loeod��t...��"'v Iiind o! lwe1��.?-_/� ,�— BURNER — 1Yade Name Siu PIo CapacitY Sc1. !'t. E.D R B'i'�7 �F f1�iMw0ltf--OV[R� l � B, �.rE'.r. ��. .,, �.` : � . _.: . � rs� �- �a�"—�.333 � 560-3d50 �� [� ANOKA COUt�TY � 6431 UNIVERSI7Y AVENUE NE October 9, 1974 FRIDLEY, Il91NNESOTa ;i543� Minneapolis Post Office Dapa.rtment �Superintendent of Delivery ' . : lst & rlarquette Avenue ' ' Minneapalis, Minnesota 55402 � . Re; Change of Address City of �Fridley � � � Gentlemen: We are listing the following change of address in the City of Fridley; . NAME: Mr. & Mrs. Earl Kothman FROM: 617 Janesville Street N.E., Fridley, Minnesota T0: 595 Janesville Street N.E., Fridley, Minnesota• LEGAL AESCRIPTION: T,ots 33,34, Block E,: Riverview Heights We have notified the occupant of this change and we �vould appzeciate it very much if you would change your records accordingly. � . Sincerely, � DARREL G. CLARK � Community Development Adm. DGC/mh CC: City Water Billing Dept. City Assessing Department ' Minneapolis Gas Company - Brooklyn Park Office Northern States Power Company I�orthcaestern Bell Telephone City Voters Registra�ion : Homeo�oner Sb0•3454 �� O �NL(��e � � ANOKA COUNTY 6431 UNIVERSITY AVENUE NE October 9, 1974 fRIDLEY, MINNESO7A 5542t Mr. & Mrs. Earl Kothman _ 617 Janesville Street N.E. Fridley, Minnesota 55432 Re: Change of House Numbers � Dear Mr. & Mrs. Earl Kothman: � It has been necessary for this office to chanqe the address of your house FROt4 617 3anesville Street TO 595 Janesville•Street N.E. LEGAL DESCRIPTION LotS 33,34, 81ock E, Riverview Aeiq_hts We have notified the Post Office Department, Minneapalis Gas Company, Northern States Power Corspany, Nortfiwestern Bell Telephone Company and various departments in City hall of this change. Sincerely, DA G. CLARK Cor�munity .Development Adca. DGC/mh � SUBJECT MIT� City of Fridley . 12,�� AT THE TOP Of THE TWINS B U I L D I N G P E R M I T r i � , � RE . • COMMUNITY DEVELOPMENT DIV. i ; V �� . . ��l!/�� r � � PROTECTIVE INSPECTION SEC. �` � /"'1 � CITY HALL FRIDLE� 55432 NUMBER REV. DATE PAGE OF APPROVED BY "-�"'�'� ,'� 612-560-3450 910-F15 10 18 74 � � JOB AODRESS 595 Janesville Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED �escR. 33, 34 E Riverview Heights SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE Earl K,�thman 595 Janesville Street N.E. 3 CONTRACTOR MAI� AODRESS Z�P PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILOING Residential 7 CLASS OF WORK [� NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DE3CRIBE WORK Construct a 22' x 24' Garage 9 CHANGEQFUSEFROM TO STIPULATIONS Provide a hard surface driveway. SC�ERATE PER(v]i TS HEt�UIREi� �UR IiVIRlfJG, HEATING, PLtJ�IB�NG _AND 51GNS. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. OOCI FY'aIIl@ THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITH{id 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONEO FOR A PERIOD OF 120 DAYS AT R�1 SZH �JZSO ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING Y HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION �' STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS �ALUATION SURTAX AND OFDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2�7g8 �'.52 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. � ��-O. OO NA PLAN CHECK FEE TOTAL FEE $11.52 _�SIGNATUREOF N�RACTORORAUTHORI EDAGENT � IDATEI WHEN PROPERLY ATED TyIS IS YOUR PERMIT -��j,�. �� ,�,� �O �� SIG ATUREOFOWNERUFOWNE BUILOERI IDATEI BLDG.INSP DATE APpLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA QWNER' S NAME : �--f�� / )c�7`�/Yl�%� BUILDER : annz�ss : �9d- �igivEdU�%� �nDxESS : � � � No -_ ys S�ET : �1��,�r �, � �,� _ LOT : �3 a 3 L BL(�K : � � ADDITION : ^ �� CflR1VER LOT: l/ INSIDE LOT: SE1'BACK: SIDEYARD: Applicant attach to this form �wo Certificates of Survey of Lot and proposed' - building location drawn on these Certificates. , - : HESCRIPTION OF BUILB�ING � To B� us�a as: � �'�/ � C��,�� Front : ��- Depth : � `� / Height : /� Squar�e Feet, Jj Cubic Feet: �dc�� Front: Depth: Height: `Square Feet; Cubic Feet: � Type af ConsCruction: Estimated Cost; $ e? %g '° To Be Completed: o? ?�'X��K-��/ 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 Ordinances and xulings of the Department of Buildings, and herebq declares that all the facts and representations stated in this application are tirue and correct. DATE : _ C� • /is I �7� SIGNATiJRE • �G�(� Oi�� (See Reverse Side For Additional Tniormation.) �� . : O ,� �✓� O . . .. � � � � � .. , . _� � �. . � � • , .�.V � � . . . . � .. . . . . . . . . . . � .. . . . � . . . . , . . . . . . . . . . . . . . . . . . � (� . . . . . . . .m..... .. . . . ..... . . .. ... ...._ ...., �, . ..>.... ___.. _ �_:_ _.. .. . . _ ._, �.. . , ......... , .. . _. . �.. .. . � . . . ... . �. ....._.,'+�'7F..._. acAt�: ��NeH� 50 raaT «��i �. �,/�d��i��:t c�e AS��i��t�7�� i��. �'O3 NO. _?4`�9�_�_... o D�or�, ��o� ata. �CU�uz �� plu. ,.�ll.�l'� B'st. _ A _�... P^v- -- �� --.... Regislered Undsr tows of Sto}a ot Minnssolo 8398 Center Drive • Minneapolis, Minn. 55432 Phone 784-0210 ��'9��C�TE O� 5�l��Y SU�'YEY F��: G. D. I. Builders • DESCR18E0 AS; Lots 3� anci 34� Block E� Riverview He?ghts, Anoka County, Minnesota. � t� o - - �o '_Y__.'--r...- �G� � 7�' � � .� . ,t � � . � . � > 4�,,,,.,._.._• ,�'� . . . . . ' . . - . � � . . - . ' � .. �. , 3�S`�Y 5O 3' 3 � � �� -::': ' " - 6 ix� � ,` ` �"�'�'�f � . � ' 1 �fl '' j�.. �1 �- � . � , �t� � �,,,+j �. �, _ , �-��J � � � . � � � �' �----? �- _ �� ;; w r� �' '" ] , J;.'�� aao^- E QQ . _ Q � o •� o �S`p a� - . `� EU';L�� G `r o�+ o . M CATIO�! oo -. i � � �� ; - .l ��1� 1 , v - ; � �� ;n � �, i � . � � � � i - � t � � : � 50 � ;Q � 30 � 30 `--60.00 F'LAT---. - 59.70 MEAS. JAi��SV{LLE � ° STREET ° _ � � t haroby cortifr ti�t on �•�'i� .� l% �q %�- � � � � � " __ . 1 survvYad the crer�rtv c+ad.-.:!-�.► ,.�---- --• � , _ � [ ' � , , -- ----- ----t_...,..teva_��_ ---- Building BUILI�Il�G Permit Ato.� Inspections RE�IDENTIAL APPLICATION Received By� 763-572,3604 CITY OF FRIDLEY Date Rec'd�' 763-502-4977 FAX EFFECTIVE 7-1-2010 DATE [' _ 1[? YOUR E-MAIL AADRESS ��A K 1°.I -ir � C�,a1 � l� �ci srrE nnn�ss _�-�"-, �j ,�. � h <<�„s��c��N� Frr �l� , . , THIS APPLICANT IS: �OWNER OCONTRACTOR PROPERTY OWNER/ N�; � ` TENANT �n�ss: 5 95 ��.� ;.f' �(�. S� . N� Crrx��,�STATE�Ld yLIF 55 4�� PHONE: �lc �� %�S- U '� q � coxTx�c�ox N�: SUBNIIT A COPY OF $TATE LICENSE # EXP DATE YOUR STATE LICENSE AND CERT�ICATE OF ADDRE�SS: CITY STATE ZA' ]NSURANCE PHONE FAX PROPERTY TYP'E � SINGLE FAMII.Y/NEW CONSTRUCTION SIZE ❑ TWO FAM[LY/NEW CONSTRUCTION STORIF.S FERMIT TYPE O AuDiTION 47 GARACiF1SI�D wulnows ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TTLE ❑ DECK '�I SIDING O OTEIER ❑ SWINII�IING POOL TYPE OF WORK: 0 NEW HOME CONSTRUCTION CI ADDITJON ❑ MAINTENANCE/REPAIR C] REMODELING DESCRIBE WORK BEINCi DdNE: a i�. i i f.r'h r��r..rP c> �� S� SIZE OF IlVtPROVEM�NT LENGTH WIDTH HEIGHT FI' CI HOUSE ONLY g��T gEMOD �1N MPf � NRU�M�B�ER OF SQUAR$S ❑ HOUSE 8c GARAGE 1 Fxim+�nw F�ppr plmt �AI AGi � ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSEA SFZE; O DETACHED GARAGE 3. List of structura! raemb�s to be used PROPOSED HEIGHI': FOR NEW CONSTRUCT[ON INCLUDING DECKS, Vuryl �Soffit �r;.�,ONS. IPt POBCHES SUBlv I�T�. O Aluminum [1 Trim 1. Site Plan/Survey showi� ihe exisling � D Other J@' Fascia � ProP�s� P�.1� 2. Two sd.c of consuuctioa pla� WINDOWS 3. Eneagy Calculations IN EXISTING OPENING5 j�Yes ONo LOCATTON OF WINDOWS FOR WIIVDOWS - PROVIDE O-VALiIE AND OR FOR NEW OPENINGS-DESCRIH& StZE OF MANUFACTURE STICKER ON WINDOW. OPENING CHANGES 8c . a� I. 5 cl �ytdu5ctti � Scrri� TXPE OF WINDOW TO BE INSTALLID NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR MATERIALS: 'OTAL JOB VALUA' Permit Fee Plan Review Fire Surcharge Surcharge License Surchazge SAC Chazge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Tatal Due (USING THE 1997 U.B.0 FEE SCHEDULE) . C)08 OCCUP. $ /(�' 7�1 � $ee Back Page for Fee Schedule $ 65% of Building Permit Fee di $ .001 times the total job valuaxion $ .0005 x Pern►it Valuarion Minimum $5.00 / $ $5.00 (State Licensed Residential Cotrtiactors) $ $2100 per SAC Unit (Ptans to MVUCC for determinatio!►� $ ft+6ft= ftxa24=$ ��U�� $ $450 Conservation Plan Review 1 $ Fee Determined by Engineeriag $ Agxeement necessary ( ) Non Necessary ( ) $ 7 411�� Make checks uavable to: Citv of Fridlev Attac6 Bti� TFIIS IS AN APPLICA'FION FOR A PERMIT-NOT VALID UNTIL PRO�FSSED I hereby apply for a building pemut and I acknowledge that the information above is complete and accurats; that the Wtork will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construckion Codes; tttat I undersiand this is not a perntit but oaty an application for a permit and work is not to start wlthout a permit on site; that the work will be in accordance with the approved plan in the case of r�which re res view and approval of p� I p� SIGNATURE OF APPLICANT a��.�� PRINT NAME. '/ slte! ,��L2r/ DATE !— ID —�Q