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AF - 47658� � City of Fridley, Minn. BUII�DING PERMIT nate: . . / � �. . .�.E. .�. .'. :-S �. . . . . . . . . . Owner................................ ..... Address...................................... � N° 3499 Builder . �. . . . . . . ,��, ,�,!•4e!'�:1. . . . . . . . . . . . . . . Address.... 1%� ............................... LO�CATION OF BUILDING No. /. . (..�. ./. . . Street . . . . !/ . . . . . . . . . . . . . . � . �/. . . . . Part of Lot . . . . . . . . . . . . . . . . . . . . . . Lot . ��. . . . . Biock . . . � . . . . . . . . . . . . Addition or Sub-Dfvision IC.Z . . . . . . . . : � . . . . . Corner Lot .X. . . . . . . . . Inside Lot . . . . . . . . . . . . Setback . � : v. � Sideyard .L. � g � . /. �' . . . . . . ,r •4 ST � w/�' S T DESCRIPT[ON OF BUILDING To be Used as: ;s!� -�`' , -, , y � . . . . . . . . . �or,t . �� q?,?;= 6. x�ght «. 8 sQ. Ft. 1�'.`� ct�. �.�,?. oo�s"' .................... Front ........ Depth . Height ........ Sq. Ft. ........ G�. Ft. ........ 7`ype of Construction . . . . . . . . . . . . . . . . . . . 's� � �O� !. �! !. . � . . . . . To be Completed . . . . . . . . . . . . . . . . . . . In consideration of the iss�uuance to me of a permit to construct th il g sribed above, I agree to do tkie proposed work in accordance with the desce3ption above set fo pliance with all provisians of ordinances of the city of Fridley. .!a". ..................................... In consideration of the payment of a fee of $.��.�.., permit is hereby granted to ................... . . . .. .. .. .. .. .. .. . . . . . . . . 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 h�is agents, employees and worlunen, 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, construction, alteration, maintenance, repair and moving of buildings with- in the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. ' � :f��,l.�'�!. �. . . .� . . Building Inspecbor NOTICE: This permit does not cover the constru�tion, instailation or alteration for wirinp, plumbinp, gas heatin�� sewer or water. Be sure to see the Buildin� Inspector fpr rcw�rate permits for these Itema ► � i ,t . . �• / sue�ECr PERMIT N City of Fridley 19 6 8 5 AT THE �OP OF THE TWINS g U I L D I N G P E R M I T r i . � � � • � �y ___�� COMMUNITY DEVEIOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. O��� � i-.-- �,��'��� ;,j CITY HALL FRIOLEV 55432 NUMBER REV. OATE PAGE OF APPfiOVED HV L •�� 612--571-3450 910-F15 9/27/88 / / JOB ADDRESS �Ol Kennaston Drive N. E. t �EGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 14 1 Brookvie�z Terrace SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Robert Miazga 701 Kennaston Drive N.E. 571-7410 3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO. Sussel Co oration 1920 Como Avenue, St. Paul� MN 645-0331 4 ARCH�TECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CIASS Of WORK X NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE S OESCRIBE WORK Canstruct a 24� x 24' Garage 9 CHANGEQFUSEFROM TO STIPULATIONS Pzovide a hard surface driveway. �SEpAI�/�i�' �ER�1175 RLQUI��D FOR 8efor � Q� WIRING, HEATING, PLUMBING AND �1G,�S. TFlFp � d'Agi��`�`��'�!�,j u�, R '�°�'F, g �ii � � ��7�✓!� �l��,rR��►����t,;;�.. t�b �� �,����� s �� � SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, TVPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OF CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONEO 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 1. STALLS GAfiAGES AND KNOW THE SAME TO BE TRUE AND CORFECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WOFiK WILL BE COMPLIED [�.1[� WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $8�27�" $ DOES NOT PRESUME TO GIVE AUTHORITY TO VIOIATE OR CANCEL THE pERM1T FEE SAC CHAFGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUC N OR THE PERFORMANCE OP CONSTRllCT10 . $ZOB.00 \ � �/ LAN CHECKFEE TOTALFEE � � � 75 $1�.2.1� . ATUREOFCONT AGTORO AUTHORIZEDAGENT {DATEI .M WH N PR P ALI TED THIS IS YOUR PERMIT ` 9- �� SiGNATURE OF OWNEA IIF OWNER BUILOERI IDATEI BLDG INSP I�ATE � t�v [ ] � !:�,, ALZER ( ] City of �idley R-1 Ai�ID R-2 �,; � ding Permit Ap�al ication Effec�.ive 5/L88 Gbnstruction Address:__ � 0 � ��I� ��Zj � r��- Legal Description:_ L 0� /(,� 1�3%k / /�IZ � t�lc U, Q� �'�?fl.� -� Owr�er N�ne & Address: �1 � ��-�c� yY►i �-Z���. 7� / ,��—n����i� ��z �.. � ��/� �c,�,v �ntractor: �—e.� l'.r1 �� �,, lo S � d33� A�dress s �� Zt� �° v/!n J /�-�I Q f�� Attach to this appl icati�, a Certif icate a� :�rvey of the 1�, with the proposoed oonstructiori drarwn on it to �cale. �► �:�; ru !;� !-' ti�*; �.�����+�� LIVIl� AREA: Length Width Heic„�t St�. Ft. C�RAC� A�• I�9th W1��h �_ Hei�t f o %�- , s�. I,t. J� � pFx[c 1�: Length width Hgt/Gromd SL�. I�t. � /�� ► 1► J� 't . Z 5' S � t, lYl.et � tbr�r Lot [�J Inside Lat [] Ft. Y� Setk�aCk Side Yard Setbacks 2� °� � S%�� Type o� G�onstruction: r�( � Estimated Cost: S� 1�pprox. Completi� D�ate: _T/.,�1 _ 2 C'� ZfX $,'Z71.'3(� Prop�sed Driveway Width If New Opening Is Desired: S_ Width + 6' � DATE ; r-- 2 C4 � lS Y ApPLICAt�: CLTY DSE �E,Y Peno3.t l�ee State Surcharge SAC Ct�arge Driveway Escraw Park I�1ee Sewer Mai.n Qlsrge TO►�AL BTIPtTI.�I�i.S: s �D�.00 S `�• i � � S $ � � //�. �� �,� S �pc�{�L w � y Al� A Alt. B S See Back Page Tel. � �o ��� O 33 / Fpe Scheclule on R�verse Sicle 5.50/51,000 Valuation S55Q per SAC Unit Al� '�" or Al� "B" Ab�ve F1ee Determirnd by F�gir�eering Agreeaent 2+i�oessary [ l Nat Neoessary [ 7 ., . SUSS$LC�A►�t��GES 1920 Como Ava., St. Paui, Minn. Pe�mit by Legal pescri tion_ lot. Blk Add'n Value S��o• �d _ Type Const. SLAB: �By SUSSEL �Bq Owner Ap�rox. O tn 2•STARTING POINTS ONLY S.P.L. S.S.P.L. R.P.L. Alley House F. Street Other O Square With � ❑ Sod Rem. • By ❑ A.B.U. 1-166 Grade Point LJ Btocks: L�y Owner By Sussel ❑ Wtr.proof: OBy Ow OBy Sus ❑Backfill: ❑By Ow . �By Sussel C7 Maintain 8' To Wali Height Including Blo s OR ❑ Maintain 8' atl Height on Top of BI ks 81ock Size op course) ❑ e• ❑ s�� a �� Wall Fieight other than 8 r O Freme with full wall height soid OR ❑ Cut studs as required for OHD clearance �O.H. Dr Offset OS.D. Location ❑ WindoN�s O Att Gar Roof Tie-in Drawn on attached pictures Existi�g garage: No r� O Detached O Attached Yes C Size of existing:—._x Existing garage v:ill be: ❑ Left as is O Converted to L.S. • By owner C7 Removed By: Owner ❑ . Sussel O Junk Must Be Removed By. Owner 0"Specify removals by Susse! or Owner - trees, bushes, etc. ❑ Show approx. dist. garage to house and al) prop. lines Stakes visible • ❑ Yes O No Survey available - O Yes ❑ No O Special instructions from ownes: Slab A8U Sod Rertroval SAnd Fill WORK ORDER HOME PHONE � �/ � � �l O �' f NAME �� U��� rn�'a 2� g BUS. PHONE: 3�� � JOB ADDRESS �� � ���� N�'5��� F��� B�DG CODE ARE ��' � SALESMAN A CONTRACT DATE �/�� IZE�ZL. � °` :.., � _ — FOR OFFICE USE pNLY ,:,� - •' Blocks D.W, Biks. Delivery S.W. Waterproof Ftg. �,.._ Back Fill Re-bar - Other • TOTAL � , � ._, .. � ' � �_.� � { ' , � � � ; _. ( � i I • . . �� i. i � �._ , � i � � � � � � , ��,� i,l, _� . . � �. . . , t � } . � , � � � � � ;; � _ ' 1;_ 4 f:,_ I_y�, � i i;,�, , � �_ _y : � i � -- . � . - .„� .. � �„�..�.�' .r i , � � ,. " � � : � � � � - t � ` _ . � � , � _�-- - -- t � + �_ � ' �; ,_� �.�. ,.. � � _._ � � � � F .- __� _ . : � , ..._ 7 t_ ,__ ; ��. _!,, _. _ � . , . �� � � � ._. . _� � . _' � ' {�., i �_ _ _ _.;_ b.,., _...,;._.�...,..,. _.� M �..r.., , i � t i , � � i � � �� ��� �_��� �.. � : � ; � � �_ . �_ ; _}__}. _ , _ . ,_�_ _ � � _ : � �__ � 1 _ ; � �-- � __ , t. � � ; � _ , , _ , .__ _ _, : _�.._ � .m,, � _ i _ .,, . , � +—�....._. �.. � � .,.,1.,, : �._i � , ._ � � , ._- - �- - j _. � . p � : _ � _. � _ � 1 � � � ' �- � i. A� ! ._� � � � � � i . s � , _ � _.� �_ _i_ _ � ��� . ( � k E.�-�'1'1.� } _+ e �� . �1Y7 � .,, � .a- � ' � ' ' � ; ��� ( � ( � � i� - t � � � ;- � � � �, �� ! a i ' C��n, � .� � � , + (��'j �} ' .,_ � „ . ti . , . � t � � � ��� � . , _ ; , _,_. � i� � 1 . � . � . � _.� } � � �___ � . � , � ;, l.. < < _ � � ' ,; � . i _ � � ( � , _ , � � 1 �._! � � . , r , , � .'._ � ' � ! . � � �_ f � , , , � . ;i , � � ` � �� � ��� � �+- -� '�AGCESS , .� j.,� ..�.. ,. 1..�....! . � ` --� �CI Good � �. ! � � � 4. � :C) Fair � ! 1 � � � ; � . � � , i f �. " 3 � } .. , � DPoor, ��� �� '' . � � . ,. _ :; � ,a-- ,. _ , ,{ . ,. , , ; �-f ; j . _a. � .i , , . _ � . !, . ! s .. . ... .._, ,� . ,. �_ ...� r.�...:.,...�,.�. PURCHASER'S 4NlTIALS: '������������i � ■����i������ i ��� �� � r 1 ■/� � I �� ��I � � - � �....� ■+�� �Mw��wwu w��mwne�eeesa�s �SS��I���J��� �S 5 5 ROOF: GABLE REVERSE GABLE �"` � HIP EAVE OVERHANG: I�--" � �:. � `. RAKE OVERHANG:�. SEAL DOWN SHINGLES WITH P�YWOOD OR ;. WAFERBOARD ROOF SHEATHING AND 15 LB� FELT :.�;. _ ` . _�;;� �...,... �.. ' _ . . K w... , . . � _ ��;� Roof Sheathing Seal Down Shingles Manufactured Trusses --� 2" x 4" Doubte Top Plate — ; NOTE: 1) Roof approved by Minn. State Building Dept. as meeting Minn. State Code Requirements of 30# snow load. + 2) Hip roofs consist of 2" x 6" rafters, 2" x 6" cross ties 48" O.C., 2" x 8" hip �afters and no plywood gussets are used. RAFTERS: usses � 24" O.C. STUDS: " x 4" 16" O.C. 24" O.C. � WALL SHEATHING: SIDING: I2- M O. C�� � OVERHEAD DOOR HEADER Double 2" x 12" or _� Gluelam beam x . ' Slab on grade construction approved per Minnesota State Code. Refer to State Buitding Code Letter Number 11. . SLAB: 4" WiTH MESN 6" x 6" #10 Gauge � __ � � �� 45" ` ' ' ' �,,F., Trim tj",x4" Sub Fascia � � s,., Fascia; .; .�d t . �. Soffl� �'��'� � t�` � � '� :f�, � � `��,,� �� �s�� ` 3/4" Cove �;�� . ; � ��°��- � =r"t i#� '3t "t' .. 2" x 4" Studs y- , , � Siding �.�� �� � �;.: : �., .. � ' ;�;x . � ,�x "�.'`: ;t�� +° ' a � tF�`�t� , �'�`��f3g�i: +, . _ 1 .. . . wx:i:;.�iM+tr�..,. ., ... � . � 1/2" x r•' Ancnor solt};. ;, z � . �.��,�,. � � �� P`� , . . 2„ x 4" Treated Bottom Plate ' � ,,, ; 'v Grade - 'v /���������/ � ��% f ,...�,�� �, . �, - .►1 �� /� ��� �� � �� �;:::s�s ..s��... H����� ■�■��/�� ������ �e�iiii �i�i�e�s� o■■■■■ '� hI��Y �a •�� ��� �ry r ��wy����.�1�W I�� ���.�. ..• ��,.���.,� '�. . ��� �;c��,�. �, �•.. ;,. , .• , . � . �,� i�s `� s. ; � ��`� , ������• 1 ��. . � /�� � � ; • J .•' � • .�� . • � • C1 -t . '� � � : � �u �C � • ; �� • � � (� i CC Q w • �� • ���I � �' i .— /U �li 1�1 : a •. )1 ' ., � • IU j �/1 !: •� . : • N "�.,�� : �-� � : i7 �.. . . 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N .� � : . . : ,��'�'. . , � � � "a „ 'cs+ � _ � , � . , •�� �' �,� 7'r ,. , . ' : �.. • , �:i (S rr1:s. � . �• .;.�, ,r. . . . ! } �• t � ;�: : � • ., :, `� ' ' �• r : i`i ;ieT.• �r'" Y,1 �. • ' � �.� . . .t 1"� . *� �j,�• �':�, ' , i"- .' ' i . � � �, , •�'+��.�.0 "�" �,` c; '�; r . � �'•. ,�'""" � i' � I *� .'" L. ., � ''�L'� � . � . •.. . � . � :��'V'� .',Pi�i • . f�#`3.� , • . . ,t .,.' �,.4�i �� F � � �,A • �1T � ,' . ��1. . �^• �'X. �'� . � . .:��..y ', y.'„ . . ' ' '.L � ' � y ,;, !--_' • � r , � , , ! � • . .�• '�rl. �.�� • �,. . . . . � . , . . `�� � , �' �' . • �s��������rr - �W /'� � � . � . . . . . .. /���I ��. �' . HOUSE HEATING TEST RECORD ADDRESS ,%� �—,� ��o,--. 1�-=-� -� APT. FLOOR CITY SUBUR � � OCCUPANT OWNER HEAT LO55 DATE HTG. INST. GAS CO. METER BADGE #- SOLD BY INSTALLED BY f � Electrical Work By Gas Line By /f .�aT1 f .� TYPE OF HEAT GA FA � HW STEAM SPACE HTR. UNIT HTR. OTHER � GAS DESIGN CONVERSION MAKE MAKE OF BURNER Model � .$ � �/� Model ' Ssriol �;��'7 Max. BTU Roting INPUT ��-'S G2�n MAKE OF FURNACE Model --�-��� CONTROLS THERMOSTAT ��..f! Heat Plug Vent Size �� Valve �� -�-�t�/ �F �-5-� �` KIND OF LINE SIZE�—NONE Limit L '�C] � � Drah Hood Regularor `�j �--�' L, -� � �� Limit Ssriiag ,��� ° Filters Size Number Fan SetTing �'1'�� � L�� Chimney Loeation Insi `'"� Outside Pilot 7ype ��, Chimney Construction Pilot Make ��� -- -�--- Pilot Model /P Smoke Bomb '�� Wiring �"� Pilot Timing �i? ,rZ`,.CG Draft `� Test Tap � L.W. Cut Off Door Preswre """ Lightin9 inst. �/� Preasure „� � ��—Pereent CO2 Date Tested —�,�_��r,� Input CFH 1 Om Percent OZ - d Company Testing Staek Temp. �¢m Pereent CO �• CL— Name of Tester �Z^K l..� �G��.�----� :.� Form 235 .r{� _ � G MINDER�JNGINEERING CO.,INC. ENGi NEERS AND SURVEYORS ��NO auaveviNo CIVIL L. MVNICIOAL ENOINQERINO 6418-5GT" AVENUE N. MtNNEAPOUS 'Zf, M►NPi• � ;�'=� � KE T- 363T �"h����' �C��r�e�i�c,��� �IF lt�r�►+� � ���, � - � �';,� : � ;�' � '.��' :, � �� � - =' ; �G P� . �.'' ik- � L�'� ..► � �`'� � i �� � �`� i ��1...�. �, � � �,�; {ron ► � 6} ; �� _� �� �C � -� ��, �� � � � '►�^ � ,.¢i_ • � _. . .._... _---- � (o�Ut; ,;'� � Grair7; � Gc�iSdr/;tr;T } N *� -�,+ �� � ' � � � �' � � ' ' _ J J � '- - ` i � • � I 4'.? 3 � ����� � tp �, j �ro po` ect , % m 1 i ; ` _L �a/— °� 1� yo . G1,�@, p �o- � � � � ; .�. �, ; � , _�_ ,a. � ; I i i � -�� ._�o�-. �.�rJl�'H�T0��1 �,��VL soi�a TESTiNa LANp PLANNINO 1 , �r?n 1 � I 1 1 � , 1 '�, �� � i i !--� � � S�f e: I "��'�' m � L�—f" I � � � L�3�. JL J� ��OJi�`✓i �il�d �� �('LAG� � WE MEREOY CERTIFY TNAT TMIS tS A TRtfE AN� CORREGT REPRESENTt�TtON OF A SURVEY OF TME 60UM�N2IES'� TMf 1.l1N0 t$OYE OESGRtBED AHO OFTlIE LOCA7tOtJ OF ALI. BUtIOINGS, IF A*lY, THEREON , AN� ALL V1518LE ENCROACNMENTS� �F ,�,r, F aoM � oN SNO V►ND. J M t�.D�R EN G l N EE R I N G CO., I N C. O�TED Z1M5 On�f oF OG'�D (7 CV A.O.qS p� v EN6�N �ERS AND ' SU0.Vt ORi ' {,,, . ,� !� �-�' - - �J'L c a_. _ - ..� - i�' �...�:� - --- —.�r ...�, �� � �.. � :� ���4 k. a 'r; J F�{ �� � , FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(612) 571-3450 • FAX (612) 571-1287 June 24, 1996 Robert & Patricia Miazga 701 Kennaston Drive N.E. Fridley, MN 55432 RE: Vision Safety at Kennaston Drive and Monroe Street Dear Mr. & Mrs. Miazga: A recent inspection revealed that shrubbery at #he southwest corner of the above referenced property appears to be creating a visual obstruction at the intersection ofi Kennaston Drive and Monroe Street. This obstruction extends into what is called the "vision safety zone" {see enclosed definition) restricting a clear sight path for motorists at this intersection. Please take th� appropriate action to bring this property into compliance with the enclosed ordinance. I will be reinspecting on or shortly after July 10, 1996, at which time compliance is expected. Feel free to call me at 572-3595 if you have questions or wish to discuss this further. Thanks for your cooperation! Sincerely, Kurt Jensen-Schneider Code Enforcement Officer KJS:Is C E-96-207 sue�ecr P City of Fridley 29124 � AT THE TOP OF THE TWINS g U I L D I N G P E R M I T ,, ,� � � • COMMUNITV OEVELOPMENT DIV. � � �: ----- � C6 � / r � � pROTECTIVE INSPECTION SEC. � � , � � �"'1 • CITY MALL FRIOLE� SS�J2 NUMBEp pEV D�TE P�GE OF �PVROVEO Br �""�"� �'' 612-571-3450 910-Ft5 4/1/99 / / �oe nooRESs 701 Kennaston Drive NE t LEGAL LOT NO. BLOCK tRACT Oq AODITION SEE ATTACMED o�sca. 14 1 Brookview Terrace SNEET 2 PFOPERTY OWNER MAIL ADORFS$ IIP PHONE Robert Miaz a 701 Kennaston Drive NE 3 CONTRACTOR MAIL ADORESS ZIP PHONE LICENSE NO Advance Aluminum Su 1 Inc 7701 Main St NE Fridle MN 55432 571-3440 ?983 � ARCNITECT OR DESIGNER MAIL AOOqESS 21P PMONE LICENSE NO. 5 ENGINEER MAIL AODFESS IIP PMONE LICENSE NO 6 USE OF BUILDING Residential 7 CIASS OF WORK p NEW O ADDITION O ALTERATION l� REPAIR O MOVE O REMOVE 8 DESCRIBE WOfiK Reroof House & Gara e(18 S) Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. CONSTRUCTION WORK IiOURS: 7:00 am to 9:00 pm, Monday thru Friday; 9:00 am to 9:00 pm on Saturday; No work on Sunday. TYPEOFCONST. OCCUPANCVGROUP OCCUPANCV�OAO SEPARA7E PERMITS ARE fiEOUIflED FOR EIECTRICAL. PIUMBING, HEATING. VEN7ILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONSTFUGTION 20NING SO. fT CU iT. AUTHOqIZEO IS N01 COMMENCED VjIITHIN 60 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDEO OR ABANOONED fOR A PER100 OF 120 OAYS AJ ANV 71ME AFTER WORK IS COMMENCED. NO OWLG. UNITS OffSTREET PARKING I HEREBY CERTtFY THAT I HAVE READ AND ExAMIN�O THIS APP�ICATION 1 STA��S GARAGES AN� KNOW THE SAME TO BE TAUE AND CORRECT. ALL PROVISIONS Of LAWS VA�UATION SUpTAX ANQ ORDINANCES GOVERNING TMIS TYPE OF WORK WILL BE COMP�fED @ , @ WITM WHETMER SPEC�FIED HEREIN Op NOT. TME GRANTING OF A PERMIT W1,542 y�.77 �OES NOT PRESUME TO GIVE AUTHORITY TO VIOIATE Oi; CANCEL TME pEqMITFEE SACCMARGE PROVISIONS OF ANV OTHER STATE OA LOCAI LAW REGUUTING CON- $51.25 Fire SC $1.S�F STRUCTION OR THE PERfOfiMANCE OF CONSTRUCTION P�AN CMECK fEE TOTAI FEE License SC $5.00 $58.56 $iGNAiUQEOFCON'N�(;TOQOA�UTtiOp�iED�GENT �OATE� WMEN CROPERLV LIOATED THIS IS VOU P AMIT �rr• �%l � :� S�GN4tUAE Of OwNEQnc OWNERBURDER� iD��E� - .. g� ��� �a5o � � r�itE A,rD�N ALT�P [) [� [l $ 612 571 2260 ADURNCE ALUMINUM CITY OF FRIDLEX SINGLE FAMILY' AND DUl'LEXES R-1 AND R-2 BUILDING PERMIT APPLICATION _,�.. _ z� r•�•:�'iv'� g n'^' .D� � , _ Description: � � r Name & Address: � /�'�� % /�? //y� C'� ' ..�~ Tel. � � ; ictor: ,O�i�g�,,c,.� � ��,a•i,�� ,,, v o,c�� .�L MN LICENSE #�� $ 3 ss: � � i�• T ti� �'3�. Tel. # S"�i�3YYa 01 E�feccive 1/1/98 �� � � a � � �� � � ` � a`� �� . a- i� � AREA: 3E �AREA: A�'LEA: �. Attach co this applicacion, a Certifica[e of Survey of �hc lot, with the proposed construction drawn vn it to scale. DESCRIPTION OF IMPROVENIENT I.en$th ,_________ Width Height Sq. �t. � �n$�h � Width l�ieight Sq. Ft. � �.engrh _, Width Hgt/Ground Sq. Ft. ; -� a / $yGr . ! r on Type:,�_ Si�"�" a�+��� Estimated�Cost: �� S� (Fee Schedulc on Back) G'�irb Cut Width Needed: Fc. + 6 l�t = Fc x$ _$ AATE � ' _ APALICANT: Tel. � .$� �'%/� jy�a �----- CITY YJSE OM�Y Fernnit ee Fire S harge State S rchazge SAC C arge License Surcharge Urivew y Escrow Erosion Control Park F Sewer ain Charge � �1 � aS� �ee Schedule on Revecse Side $ .f S'� .00 l of Permit Valuacion (1 / l Och %) $ �% $.50/$1,000 Valuation $ $1000 per SAC Unit $ , 0 $5.00 (State Licensed Resid�ntial Con[rac[ors) $ Alt. "A" or Alt. "B" Above $ $450.00 Conservation Plan Review $ Fee Det�rmined by Engineering $ Agreement Necessary [ � Not Necessary [ ] $ �S-.�� X'1'I Vl 11 A'1'1( )N\• Jn ,_�. D� �jb, cv�; ,Ca�/� ,,a,,t7u�-c� T .�fi�� ,�'�' � AJ a t �- Building Inspections 763-572-3604 DATE �' � � O SITE ADDRESS _� THIS APPLICANT TS: PROPERTY OWNER/ TENa�vT CONTRACTOR � � � �% PLUMBING RESIDENTIAL APPLICATION CITY �F FRIDLEY ❑ OWNER ADDRESS: E-MAIL ADDRESS �,J Permit No.: ` ` � - �, Receivec�.By: Date Re��� � � SUBMIT A COPY OF STATE LICENSE �i � i i . �� -� E� DATE / ADDRESS: L' � � , �° � � - �G� STAT�f�ZIP � i : �'� YOUR STATE �T. , C ii�� ; /� i C' � E_ d� , CITY ,%'�i� .�'lL :��-� LICENSE WITH PHONE �> �`',; _ �.=;_S� �%��iG FA3c � rTi Tl� � Til1l.T � � � �� . PERMIT TYPE +��GLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: I � �W DETAILED DESCRIPTION OF WORK �LACEMENT PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $SOO.00,:whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should.reflect only.the cost of labor ) Labor cost under $300 =$15.00. Labor cost between $300 to $500 = cost of labor x.OS = FORPROJECTS WHERE LABOR EXCEEDS'$SOO;�EES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE �IQ'I�D. ;RI�Cf�Ik£S:-.(WDICATE TOTAL NUMBER OF EACH BELAV� BATH SINK/LAV _FLOOR DRAINS SHOWER WATER PIPING BATHTUB GAS PIPING p✓�eo cmucsrvsE) SWIMMING POOL WATER SOFfNER (S35) CLOTHES WASHER KITCHEN SINK WATER CLOSET BACKFLOW PREV. ($IS) DISHWASHER LAUNDRY TRAY WATER HEATER ($35) FOR IRRIGATION WATER METER OTHER Permit Fee TOTAL DUE Number of fixtures @ $10.00 x $10.00 = $ .50 Number of fixtures @$ 2 5.00 x$ 2 5.00 =$ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .50 Tota1= $ THIS IS AN APPLICATION FOR A PERMTT-NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge 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 apptication 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 case of a1 ork whic uires eview and approval of p s. SIGNATURE OF APPLICANT �Q PRINT NAME DATE �� Y/� D( City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 ���,�