P - 44828�.i ! Y Vr r K1ULL�' Y
6431 University Ave NE
Fridley MN 55432
(763)572-3604 FAX (763)571-1287
MU V 1N (J �) DEMO [] PE IT APPLICATION
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Job Address : �Q ' � /�f (/ � � J'� � �/�
Legal Description: %� 4� �
Owner & Address: 1 Tel. #
Contractor• � Tel. #
Address: State Lic n #
DESCRIPTION OF BUILDING
HOUSE: Length � Width �,�` Height �� Sq. Ft. Cu. Ft.
GARAGE:Length Width Height Sq. Ft. Cu. Ft.
OTHER: ;Length Width HeigYit Sq. Ft. Cu. Ft.
Estimated Cost'�� Approx. Completion Date ,
CALL GOPHER $�.'ATE ONE AT 651-454-0002 FOR UTILiTY L�CATT(�NG f"nT.T. nr_T_
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Mov�ng Route:
APPROVAL(S) REQUIRED PRIOR TO ISSUANCE:
MPCA: NOTIFICATION OF INTENT TO PERFORM A DEMOLITION YES O NO
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'PERMITS MUST BE ISSUED PRIOR TO DEMOLITION.
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or Collect[$ �_ ]Signature _„� �
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Con ltions
Conditions
Conditions
The undersigned hereby makes application far 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 watef 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 OLITON DEBRIS INCLUDING FOUNDATION & SLAB SHALL BE REMOVED FROM SITE.
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` Movin� �'"-.-
Principle building into Fridley . . . . $300.00
Accessory building into Fridley ...$ 42.00
Through or within the City ......$ 20.00
Move a building out of City ......$ 20.00
` PERMIT FEE:
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