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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT 'N? 5 2 o i Date: W"—'y •.. i Owner: Builder _ Address Address LO OF BUILDING No. StreetPart o Lot Lot _ Block _ Addition or Sub-Di�vid Corner Lot — Inside Lot Setback y„ —f Sideyard _4&7- _ Sewer Elevation _ __ Foundation Elevation DESCRIPTION OF BUILDING T be 'UOf/ Front Depth 1r,4Height /0— Sq. Ft/&j Cu. Ft. 40 ,rout Deptht Sq. Ft. Cu. Ft. Type of Construction _ Fit. Cost ! be Completed In 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 city of Fridley. 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 his agents, employees and workmen, ut 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 within the city limits and this permit may be revoked at any time upon violet of any of the provisions of said ordinances. Building Inspector NOTICE This permit does not cover the construction, installation for wirhtg, plumbing, gas heating, sower or water. Be sure to we the Building inspector for separate permits for these items. 4 — APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, KMNESOTA Owners Name Builder . Address Address ^I` r►� LOCATION OF BUILDING No. Street 1' Part of Lot B %� Lot � Block. -, � Addition or Sub.Div. Corner Lot_ Inside Lot "t Back Side Yard ✓ ® y1-4 ` SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. DESCRIPTION OF BUILDING C 0-2- To be used as: Front Depth Height Sq. Ft. Cu. Ft. Front Depth Aeight Sq. Ft. Cu. Ft. Type of Construction Estimated Cost To be completed The undersigned hereby makes application for a permit for the work herein specified, 4 agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representa- tions stated in this application are true and correct. DATE �L I SIGNATURE (A Schedule of Fee costs can be found on the Reverse Side.) Application for Power Ptants and Heating. Coding, VentiWon..Rehiigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL, Furnace Shell & Duct Work .......................... 8.00 $ Replacement of Furnace 5.00 $ Repairs & Alterations—up to $500.00 .................. 5.00 $ Repairs & Alterations each add. $500.00 ............... 2.50 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $� each add. 60,000 BTU ....................... .................. 2.00 $ Replacement of Furnace ............................. ,5,.00 $ Repairs & Alterations—up to $500.00 ................. 5.00 $ Repairs & Alterations each add. $500.00 .......:....... 2.50 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam- ...... 8.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $ Each add. 200 sq. ft. EDR Steam ...................... 2.50 $ Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $ OIL BURNER—to 3 gal. per hour ........................ 5.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 400,000 BTU) ....................... 5.00 $— GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x $1.50 $— K Additional Fixtures ................. x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING FAN HEATING SYSTEM VENTILATING SYSTEM ALTERATIONS & REPAIRS ROUGH F1 AL See Fee Schedule r TOTAL $� 11o„4_ of waw Wknw. Ai? a.7A7n City of Fridley: The undersigned hereby makes application 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 declares that all the facts and representations stated in this application are true and correct. Fridley,_ 'nn ��' , 19 c-/ Owner Kind of Building / l� Used as To be completed about Estimated Cost, $ Old—New. Building Permit No. o� Permit No. DESCRIPTION OF WORK HEATING or POWER PLANTS --Steam, Hot Water, 9� o 4515r� Trade Name — Size No- (5 y %®® C Capacity Sq. Ft. E.D.R 4W 0&0 BTU H.P. Total Connected Load Y-� 6 i Kind of Fuer ° BURNER — Trade Name Size No Capacity S( (REMARKS—OVER) a z 2M 7-59 Business Phone No- �� G `S—® z HEAT LOSS CALCULATION DEPARTMENT OF BUILDINGS.= Weatherstrips A.S.H.V.E. Construction No. Insulation Guide ows Iwz,rs Reference Out. Wall Int. Wall Ceiling Roof Floor Kind How. Applied No a '' o 19_ �� A1.1 1- /%n Room I Lengthd/— Width Height - ;�t I FII " Room Length Width ; `Height �' Windows and oors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane ligh1p of crack sq. ft. �f® / O, ,o �C�® ij / Ilk // 1f �® /.L" /'� Btu Coef. Btu Infiltration Glass ,7® Glass 000 -1"p Glass Exp. wall�- Net exp. wall Exp. wall .® 9 0 Exp. wall 3-6-19 Required 4 4JE.D.R. or sq. ins. W.A. Leader area �P Int. wall endows and Doors—Crackage and Area Net exp. wall Floor °` Ceiling /Q Int. wall Floor Btu Infiltration �` / / Ceiling / --T6- -T'Exp. Exp.wall Floor Net exp. wall Int. wall Total Btu. Require p/. EeD.R. or sq. ins. W.A. Leader area JR -1111- P\I Mrn 11 PnOt� /,7",-AXIJth. -nP j1 P;aht S Windows Q Doors—Crackage and Area Width Height No. ofLineal ft. Area No. of pane of pane lights of crack sq. ft. Btu Ilk // 1f Glass Coef.1 Coef. Btu Infiltration /sem' Net exp. wall Glass ,7® Glass Exp. wall q -1"p ,79,E-® Exp. wall�- Net exp. wall Exp. wall Total Btu. Net exp. wall J® Required 4 4JE.D.R. or sq. ins. W.A. Leader area OX -0 Int. wall endows and Doors—Crackage and Area Floor °` Ceiling Floor Btu Infiltration �` Total Btu. Required Mft E. .R. or sq. ins. W.A. Leader area FI.I f 1Y FNORoom ILenath 49 2 Width Heiaht AKI Windows and Doors—Crackage and Area WidthHeight No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Btu Infiltration �'/ // 1f Glass Coef.1 Btu Infiltration /.� Infiltration Net exp. wall Glass /,� .® Exp. wall q Ceiling Net exp. wall Exp. wall Total Btu. Int. wall J® Required 4 4JE.D.R. or sq. ins. W.A. Leader area Ceiling Width / Height o'Pl endows and Doors—Crackage and Area Floor °` Int. wall Total Btu. -07 Required sq. ft. E.D.R. or sq. ins. W.A. Leadet area Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. AleCoef. Width Height No. of Lineal ft. Area No. of pane of pane lights of crack SQ. ft. Btu Infiltration �'/ // 1f Glass / ® fSO Exp. wall /.� Infiltration Net exp. wall 1,01 Int. wall Glass Ceiling Floor Exp. wall Total Btu. J® Required 4 4JE.D.R. or sq. ins. W.A. Leader area Room I Length Width / Height o'Pl endows and Doors—Crackage and Area /® Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Int. wall Coef. Btu Infiltration �` / / Glass / --T6- -T'Exp. Exp.wall Net exp. wall Int. wall Ceiling Floor /eJ yid` Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area /Fl.1 X.,q Room I Length 2'�i Width f° Height , 5 " Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack SQ. ft. Z 542- Coef. Btu Infiltration gf Glass Exp. wall Net exp. wall /® Int. wall Ceiling �` jp Floor Total Btu. I .,v S '-I K Required sq. ft. E.D.R. or sq. ins. W.A. Leader area City of Fridley Application for Plumbing and Gas Fitting Permit Dept. of Bldgs. Phone SII 4-1 DESCRIPTION OF WORK Number, Kind and Location of Fixtures 1 V] _ S } Z z 8� WU' Z O t F t N WATER HTR. GAS ELEG Base 1 1st f 2nd 3rd 4th Fuiure nings Coanedion Ope Now Fixture, Old Openings I Connected with Sewer Cesspool El PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures x $1.50 $ Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ............................ x 3.25 $ Water Beater (Up to 200,000 BTU) ...... x 2.00 $ New Ground Run Old Bldg . ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 $ /, Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ...........$ TOTAL FEE $ City of Fridley: The undersigned hereby .makes application for a permit for the work beret specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this application are true and correct. Owner Kind o Used a To be completes about Estimated Cost, $ Old—New. Building Permit r ROUGH -67- / / - % t FINAL as 2M. Business Phone City of Fridley, Minn. N9 9826 BUILDING PERMIT Date: — July 10, 1968 Owner: Norman Rausch Builder Same Address 103 Lyndde Drive — Address Same LOCATION OF BUILDING No. 1031 Street _ Lynde Drive _ ____„ part of Lot Lot 14 __ Block 1 Addition or Sub.Division . Lyndale Blders 6th Addn. Corner Lot — Inside Lot _ __ _ Setback —_ Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Garage Front 22 Depth 24' Height 10 ' Sq. Ft — 5 20 Cu. Ft. 528 Front Depth Height .+ Sq. Ft. Cu. Ft Type of construction Frame Est. Cost _$1 00. 0__..____ To be Completed In 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 a'll provisions of ordinances of the city of Fridley. Ilk In consideration of the payment of a fee of $ 8.00 , permit is hereby granted to Norman Rausch 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 workmen, 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 buil within the city limits and this permit may be revoked at any time upon violation ordinances. aay�f the provisions of d l� � of \\ arence Belis NOTICE. This permit does not corer the construction, Installation for wiring, ping, gas heating, sewer or water. Be wee to see the Building inspector for separate permits for these hens. /03 / APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MIIMSOTA OWNER'S BUILDER ADDRESS IO. , MDRESS LOCATION OF BUILLDING NO. /0 / STREET 44P -A— Z rt v006 LOT BLOCK _ ADDITION OR SUBDIVISION CORIMR, LOT 1VSIDE_ 1OT SETBACK SIDEYARD SEWER ETMATION TOP OF FOOTING Applicant attach to this form Two Ceragicates.of-Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used Ass C, �A dR. W-1 �a Front '' :r -Death - Heieht i Square feet- rLCubic Feet T = Firodt' Depth Heigh.. ' j •. = it . Square.'feet Cubic'. Feet Type of ConstructionEstimated Cast /�.. n . . --�- To Be Completed t d' The undersigned hereby makes applicatioxi-for a permit for the work here*p• specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE ` _SIGNATURE _ (Schedule of Fee Costs can be found on the Reverse Side)., ..,Iz- 6 0 / - 413 -. is 1k AT 7 SUBJECT City of Fridley ri6- - AT THE TOP OF THE TWINS BUILDING PERMIT r � R COMMUNITY DEVELOPMENT DIV. ��(] r PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 7/30/82 JOB ADDRESS 1031 Lynde Drive N.E. 1 LEGAL LOT NO. BLOCK TR ACT OR ADDITION SEE ATTACHED DESCR. 14 1 Lyndale Builders 6th SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Norman Rausch 1031 Lynde Drive N.E. 571-0434 3 CONTRACTOR MAIL ADDRESS ZIP 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 BUILDING Residential 7 CLASS OF WORK ❑ NEW l ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 13' x 8' Kitchen Addition 9 CHANGE OF USE FROM TO STIPULATIONS SEPERATE PERMITS REQUIRED FOR WRIM HEATfaG, PLUMBING AND SIGfyS. WARiMG Before dieing call local utilities TELEPHONE - ELECTRIC - GAS Ett REQUIRED BY LAW TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITSIARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Wood Frame THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION 104 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 1 ISTALLS 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 $3,750 $1.88 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 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- $44.50 NOS' STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $11.13 $57.51 SIGNATUREOF CONTRACTOR OR AUTHORIZED AGENT (DATE) HEN PRO A D D THIS IS YOURPERMIT BLDG INSP DATE SIGNATUREOF OWNER(IF OWNER BUILDER) (DATE) 7 CITY OF FRIDLEY Effective Aug. 1, 1981 APPLICATIal F014 RESIDENTIAL BUILDING PEFU41TS (Neer, Alterations, Additions, or Repairs) OWNER: NORM,4)4 �,�VScf/ ADDRESS: , /® 3 Q. A. Z. TEL NO: 7/ --d 4013 e,04 BUILDER: ® w Nt---& ADDRESS: TEL NO: Construction Location STRITT NO: /403/ STREET: L jY 14 ,fie 0 A i LOT: BLOCK: ADDITION: Corner Lot: Inside Lot: Setback.: Sideyards: Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTION OF CONSTRUCTION Front: / J Depth: Height: Square. Feet: Cubic Feet: Front: Depth: Height: Square -Feet: Cubic Feet: _ 317/.0 %f SlSd Type of Construction: 4P0g7'o`.r Tr® ffia0,1�A/ Estimated Cost: $ 7b Be completed: 3.0 0 - Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: SEE REVERSE SIDE OF SHEET . Mie undersigned hereby makes application for a permit for the ♦aork•herein specified, agreeing to co,all work in strict accordance with the City of Fridley ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE: , A 5— SIGNATURE: Stipulations SO VC00 HOUSE HEATING TEST RECORD ADDRESS G N=7� ?�w APT. FLOOR CITY orb UBURB OCCUPANT --OWNER HEAT LOSS DA E HTG. INST. 9'ILe SOLD BY GZ�V INSTALLED BY Electrical Werk By Gas Lino By TYPE OF HEAT GA FA _.�M_Hw STEAM SPACE HTR. UNIT HTR. OTHER GAS DESIGN CONVERSION MAKE - -I MAKE OF BURNER MoJei ST:� Y14t/ ®%d"/0q' Model Swial /Zoqj7;�7/3 1 Max. BTU Rating INPUT 60 61; r`�c, MAKE OF FURNACE. Model / CONTROLS THERMOff T Heat Ploy Volvo `�— 6 Limit 0 _ Limit Setting !�®m Fan Setting Pitot Type Pilot Make Pilot Model Vent Size KIND OF LINER SIZE NONE Draft Haod+c��—� Rpuletor Filters Size &sazSf Numior Chimney Location Inside f%0 Outside almney Construction Spillage or— Smoke fSmoke Bomb t/ Wiring l� Pilot TimingDraft C� Test Tog L.W. Cut Off Door Pressure Lighting Inst. Pressure Percent Co Date Tested 2 Input CFH Percent 02 Lr Company Testing Stuck Temp. Percent CO Name of Tearer Certificate of Compentency_ #ifZ, CITY OF F,PIDLEY INSPECTION DIV, 6431 UMversity Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner — Also Replacement Furnace Gas Piping (Needed with new furnace) Gas Range Gas Dryer *Air Conditioning — All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work Commercial/Industrial 1% of Value of Appliance or Work JOB ADDRESS / The undersigned hereby makes application for a permit for the work herein Rate TOTAL specified agreeing to do all work in strict accordance with the City Codes and rulings of the Building Division, and hereby declares that all the facts and $"200 $ representations stated in this application are true and correct. ,1993 $10.00 $ OWNER 9JT7 L41'✓ 5'7 / i® 3 $ 10.00 $ BUILDING USED AS $ 10.00 $ $10.00 ' State Surcharge TOTAL FEE ESTIMATED COST �7I 0� PERMIT NO.�L� " DESCRIPTION OF FURNACE AND OR BURNER $ No. of Heating U,its_1 _ Circle One (Steam) (Hot Water( =(Warrn Trade Name (_�' AA I Size No. BTU 1-7 D - HP EDR $ Fuel+_ibis Total Connected Load $ .50 MINIMUM FEE FOR ANY HEATING COOLINGIVE.NTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE 430.00 *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. Burner Trade Name Size No. BTU tip EDR Approved By Rough—in Date Final Date FILL OUT BACK SIDE FOR STACK VERIFICATION O REPLACEMENT FURNACE SUBJECT R M I T NO. City of Fridley 3 2 2 3 6 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. COMMUNITY DEVELOPMENT DIV. r 1 a. ______PROTECTIVE INSPECTION SEC. 572-3604 178 F) IA .r"','� CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY .--. J`, L 612-571-3450 910-F15 10/10/01 JOB ADDRESS 1031 Lynde Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 14 1 1 Lyndale Builders 6th Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Norman Rausch 1031 Lynde Drive NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Croix Valley Roofing 101 Croixview Dr S, Afton, MN 55001 651-436-1351 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 20265881 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW O ADDITION O ALTERATION [j REPAIR O MOVE O REMOVE B DESCRIBE WORK Reroof House & Garage (25 Sq) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REOUIREO 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 SO. FT CU FT. AUTHORIZED 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 OWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS 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 HEREIN OR NOT. THE GRANTING OF A PERMIT $2,680 $1.34 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF,"Y OTHER TATE OR LOCAL LAW REGULATING CON- Fire SC $2.68 STRUCTION HE PERF R NCE OF CONSTRUCTION $53.25 PLAN CHECK FEE T07M. FEE Licen S $5 92.27 GNATURE O O OA Op uTHORiZED AGENT iDATE� EgAg'b THIS IS YOUR PEERMIT/40SIGNAIUAE OF OWNEROF OWNER BUILDER1 1DATE1 BLO rj&TE NEW [ J Effective 1/1/2001 ADDN [ ] CITY OF FRIDLEY (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: Dll� 3 / L-� 'Vy E '0 Legal Description: Owner Name & Address: 11 o ILMcAO (Av4 C14 6 3 i L y VOt! O2 Tel. # Contractor: C-94;4 V,4 L i d( -i y s!��� G MN LICENSE # a 0 Address:/ 0 i @ 901 4V/Vit-✓ 10L S !q Arb/j Mi.1 Tel.# Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: LengthWidth —I P . 1— OTHER: Sq. Ft. Construction Type 44 U+'�� �� ���F _ Estimated Cost: $ Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: Z' �% @ - 0 APPLICANT: CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: Call (763) 572-3604 for Permit Fees if mailing in application Tel. # 651- � -?6- 1-7'1 $ _�S Fee Schedule on Reverse Side $ .001 of Permit Valuation (1/10th%) $ $.50/$1,000 Valuation $ $1150 per SAC Unit $ S7,60 $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above $ $450.00 Conservation Plan Review $ Fee Determined by Engineering $ Agreement Necessary [ ] Not Necessary [ j 6 - 2, --/ - 61 2- -7- M4It"olk clev7_1 Yt -41too '000-h —I/.. �j ar i I L.W-- of 6e�