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Village of Fridley, Minn. BUILDING PERMIT ° 1866 Date: r!. ,��' ......... ......... Owner Builder .......`........ Address...................................... Address...........�............................ _�L✓�O �4TION OF BUILDING No. ¢� �. �. `" L 2- 'a . ZX —e ....... ............................. �.? . �. Street .. .� ... Part of of Lot ... Vit'. ,a ...... Block ............ Addition or Sub -Division ...... .................. Corner Lot ........... Inside Lot ... Setback Sideyard ... ...................... DESCRIPTION OF BUILDING To be UsZi- Pei. _;. .... Front °�/..� .. Depth al�j,.'� Heighd. 7� .' .. Sq. Ft. ........ Cu. Ft. ........ ..................... Front ........ Depth ........ Height ........ Sq. Ft. ........ Cu. Ft. ........ Type of Construction ..... , ..... Est. Cost ..���� : � ........ 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 all provisions of ordinances of the village of Fridley. CIO In consideration of the payment of a fee of $.�-, permit is hereby granted to, 4eyi&��='... ......................... to construct the building or addition as described above. This permit Z 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 buildings with- in the village limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. ........ ........................ Building Inspector NOTICE: This permit does not cover the construction, installation or alteration for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these items. I a J/(o City of Fridley, Nffim BUILDING PERMIT N? 7109 Date: / '' x—.. —4-1 J 1 i lwner:t .fir. • ._.�i/i� �,BuilderAddress. Address i CATION F,JUILDING Street Part of Lot Lot .---- Block Addition or Sub -Di on .__._� I — corner Lot , Inside Lot $*tback _ _ Sideyard` d Sewer Elevation _ Fouddation Elevation DESCRIPTION OF BUILDING To U Front y Depth Height 4Q Sq. F't. Cu. Ft Fro Depth el Height Sq. Ft. Cu. Ft. Type of Construction r Fst. s� �"ro be Completed In consideration of the issuance to h e e a permit Ff builidi�c pllTn above I agree to do the proposed work in accordance with the description ab veo and n/yc JdFnp ail provisions of ordinaao� 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, in all work done in, around and upon said building, or any Bart thereof, shall conform in all respects to the ordinances of Fridley, Minnesota reg location, construction, alteration, maintenance, repair and moving of buildings within the city limits and permit may be revoked at any time upon vio" of any of the provisions of said ordinances. / e a / 11 NOTICE: Ibb penmlt don not cover the construedon, mon for wiring, phtmbing, gas haling, www or water. Be sure to see the Building Inspector for mepwaft permhe for theme Items. l� I C 11 T T O F F R I D I E T 6431 VINM IT AVWW N, E, FRB , FCS° SOCA 55421 360-3450 Mr. Perry Colstro 5750 Madison St. N. E. Fridley, Minnesota 55421 December 139 1966 Res Euilding Permit go, 7109 lssueds , June 2& 196"4 Mdrasss 5750 Madison St. _N, E. For; — Dead Ga�a�a�ID Draw Sirs nis office has been informd by the City Asaaeaor that the work outlined on the abcaptic d bulLdiag permit has not as yet been emplatod. As F*u know, a building permit to valid for a =w y*&T powisd from the date it wffis isa"Od. EiwAl.y got in touch with this office for renewal of this permit before Jaminary 19 1967. if any ahagga of design cc entent of work are plavned9 pl@&ae submit this jaarmtim alang with eatimted cost of so* so that cur records will correspond with the City AsaeaaOr"s If there are any queations with refereme to thin tatter. kindly call this office. CS o cies youre very truly® 3("3?;�- City of Fridley, Minn- X9 9126 BUILDING PERMIT Date: — JANUARY 4, 1967 Owner: _ PERRY COLSTROM Builder SAME Address 5750 MADISON ST. N E Address FRIDLEY, MINN ESOTA 55421 LOCATION OF BUILDING No. 5750_ StreetMADISON STREET N. E. _ part of Lot Lot ___. 13 Block $ Addition or Sub -Division .—_ DONNAYS LAKEVIEW ADDITION Corner Lot __ Inside Lot Sewer Elevation Setback -- Sideyard Foundation Elevation DESCRIPTION OF BUILDING To be Used as: FINISH GARAGE Front _ Depth Height — Sq. Ft Cu. Ft Front _ Depth _ _ Height — Sq. Ft — Cu. Ft Type of Construction FRAME Est, Cost ` 25.9 __ To be Completed In consideration of the issuance to me of a pe,0 co et the building described above, I agree to do the proposed work in accordance with the descriptio above t forth and in compliance with all provisions of ordinances of the city of Fridley. Al // �J a r In consideration of the payment of a fee of $ 4.00 , permit is hereby granted to PERRY COLSTROM to construct the building or addition as described above. This permit is granted upon the express condition that thele to whom it is granted and his agents, employees and workmen, in all work. done in, around and upon said bwllding, 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 violation of any of the provisions of said ordinances. CLARENCE BELISLE Building Inspector NOTICE: 'fids permit does not cover the conshuctlon, Installation for wiring, plumbing, gas heating, sower or water. Be sun to as the Building Inspector for separate permits for than ham_ - . .. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY,.MNNESOTA OWNER'SvY to Y o c BUILDER °+ ADDRESSNAME27s0yo w ; i .Soh J �-A/ ADDRESS k- LOCATION OF B&LDING NO. STREET PART OF LOT LOT BLOCK ADDITION OR CORNER LOT_ INSIDE LOTySETBACK SIDE -YARN SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot an proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used Ad: Front Depth He Sq. Ft. Cu. Ft Front Depth . Leight Sq. Ft. Cu. Ft. Type of Construction Pstimated Cost To Be Completed r •- r The undersigned hereby makes application for a permit';#or.the worherein specified, agreeing to do all work in strict accordance with the City of Fri ley Ordinances and rulings of the Department of Buildings, and hesrobye.declares t at all the facts and representations stated in this application are .trge..and corre t. DATE % SIGNATURE A ? �; _i :: x• (Schedule of Fee Cos can be found on the Reverse Side). ;:�y«3 J� C6 9 ��a ut Ak-&� tb �-c tt�" e ur" SLixf-g ti�eutAkecl ��LdWu'L J� e rLLL t l 64 e �ev�e�ed wt . l P Lit a ��� �� � c� C.� U C vvI e jb G� ^� �' G� LUQ U V r— I �1` , SUBJECT City of Fridley WRECKING -i556039 AT THE TOP OF THE TWINS P E R M I T r )B9& • _ COMMUNITY DEVELOPMENT DIV. �,: ----- r � � PROTECTIVE INSPECTION SEC. 9 9/x,6 /---t CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE - OF APPROVED BY 612-571-3450 910-F15 4/3/80 JOB ADDRESS 5750 Madison Street N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 13 8 DOnnay ' s Lakeview Manor SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Perry Colstrom 5750 Madison Street N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Milleon Construction 6700 Penn Avenue, Richfield 861-3628 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 ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE fKl REMOVE 8 DESCRIBE WORK Complete the demolition of fire damaged house 9 CHANGE QF USE FROM TO STIPULATIONS Complete the demolition of fire damaged house. New house permit to be taken out to be built on same foundation. TYPE OF CONST. OCCUPANCY GROUP OCCUPANrY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. 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 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 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 $1,500 NONE 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- $21.00 NONE STRUCTI OR THE PERFORMANCE OFC NSTRUCTION. ` d PLAN CHECK FEE TOTAL FEE ell, Y-,3- NONE $21.00 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI WHEN PROPERLY VALIDATEDTHISIS YOOUR' PERMIT h vBLDG INSP DATE SIGNATURE OF OWNER IIF OWNER BUILDERI (DATE) 1,19 11-11 CARY of Fridley $W4ECT Permit No. r�d AT THE TRP RR THE TWIH9 's `q___ WRECKING PERMIT APPLICATION Receipt No. L-- --COMMUNITY DEVEGOr"'"ENT DIV, I PROTECTIVR MA19 ON MT, CITY MALL 6ESICLEY 0MZ `.,--Jj ' .J qta-000-305Rwt m Inay. a DATE J PAGE OF J J70OVED ®Y Job Address Legal LotNo. Block No. T act or Addition Desc.N� Property Owner Address Phone Gcw.STR ��vI - 21 76 Contractor Address Phone 62o 6 F6�.In1 f 61 3 C-2- .zDescription Description Front Depth Height Z o Sq. Ft. 1ti 0 Cu. Ft. of Bldg. �� 02 O No. of Dwelling Units Taxes Paid Tax Receipt No. Estimated Cost of Wrecking To Be Completed Utilities Notified: State whether notified and date . Minneapolis Gas Company Engineering Department 372-4850 Northern States Power Company Customer Business Office 330-5540 Northwestern Bell Telephone Co. Business Office 332-4112 Approved By Water & Sewer Department: All Bills Are Paid Services Are Disconnected The undersigned hereby makes application for a permit to wreck the building described above, agreeing to do all work in strict accordance with the City Ordinances and rulings of the Department of Buildings, and hereby declares that ;all facts and representations stated in this application are true and correct. /7i'/G�ir c ry' Cc�us'u eT�r. J �^ //��o I Contractor �/ .V p< -- "2 g- T Date Cdr SUBJECT PERMI of Fridley 1P5 720 AT THE TOP OF THE TWINS BUILDING E R M I T _ rCity RECEIPT NO • COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. s� PROTECTIVE 1 . � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 5/13/80 JOB ADDRESS 5750 Madison Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 13 $ Donny's Lakeview Manor SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Perry Colstrom 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Milleon Construction 6700 Penn Avenue South 861-3628 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 ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE X 8 DESCRIBE WORK Construct,a -40' x 28' Dwelling (Garage is existing) 9 CHANGE OF USE FROM TO STIPULATIONS Provide a verifying survey before capping. Provide sod in the front and side yards. Provide a MM bard surface driveway. Variance approved on 3/11/80 for front yard setback of 33 feet. Before digging sap Wal AftSEPERATE PERMITS REQUIRED FOR WIRING, TELEPi NE - ELECTRIC `' Eta HEATING, PLUMBING AND SIGN& REQUIRED BY LAV TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, Wood Frame VENTILATING OR AIR CONDITIONING. 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 1080 12,960 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 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 $27,500 $13.755 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- $51.54 NONE. STRUCTION O HE PERFORMANCE OF CO TRUCTION. PLAN CHECK FEE TOTAL FEE � J' 13 _A $12.96 $78.55 S URE OF CONTRACTOR ORAUTHORIZEDAGENT (DATE) WHEN PROPERLY LIDATEDTHIS IS YOUR PERMIT I n� r 1 V -4v SIGNATURE OF OWNER OF OWNER BUILDER) (DATE) BLDG )NSP DA % CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL BUILDING PERMITS (New, Alterations, Additions, or Repairs) OWNER: PEA r,y CdC57: City of Fridley SUBJECT PER . o 16 21 AT THE TOP OF THE TWINS B U I L D I N G P E R M I T i R E CSELN ' COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 S i , CITY HALL FRIDLEY 55432 L NUMBER TREV DATE PAGE OF APPROVED BY 612-571-3450 910-F15 5/29/81 JOB ADDRESS 5750 Madison Street N.E. 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 13 8 Domay Is Lakeview Manor SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE Perry Colstrom 5750 Madison Street N.E. 571-2170 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. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Dfeiel ]rig Construct a 16' x 14' Deck onto Rear of 9 CHANGE OF USE FROM TO STWU LATION S SEPFR H�RTII�VG PE'jq�1TS #� dote di���trE E1 �AS�ic. • pt(/�8, ��0# �E OAE.EL MRS R�Q,V�REp 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. AUTHORIZED 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 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 $1120 $.56 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- $9.00 NONE STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $2.25 $11.81 G AT E FC - R AUTHORIZED AGENT (DATE) WHEN PROPERLY LI DATED THIS IS YOUR PERMIT C b 'Z1z✓e 2 =� C- BLDG INSP ATE SIGNATURE OF OWNER OF OWNER BUILDER) IDATEI CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL BUILDING PEIU41TS (New, Alterations, Additions, or Repairs) OWNER: ADDRESS: O TEL NO: BUILDER:. �• co� K9 l s� ADDRESS: 12 TEL NO: <_7 / r a / :2 a Construction Location ` STRUT ,NO : STREET: rj %! c_o Al eazj2,�zz4 %7 2' LOT: 13 BLOCK: ADDITION: &o 611,��y� � o� 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: Square. Feet: `ZZ Depth: height:y Cubic Feet: Front: Depth: Height: Square -Feet: Cubic feet: _ 22� 11 'Lv Type of Construction: i ��i--0�� Estimated Cost: $- To Be Completed: Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: $ $ SEE REVERSE SIDE OF SKEET Mie undersigned hereby makes application for a permit for the %.nrk'herein 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 applic do areArue and correct. ��-� . DATE:'- SIGN11TUi2k:: Stipulations: Q-96� PAQ„ 2.14 SUBJE6T PfRMIT NO. City of Fridley 11481 AT THE TOP OF THE TWINS BUILDING PERMIT COMMUNITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC, 1 � T CITY HALL FRIOLEY 55132 NUMBER NEV DATE PAGE Of APPROVED BY 612-571-3450 910-F15 11/5/99 / / JOB ADDRESS 6750 Madison Street NE I LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 4 5 1 Rice Creek Terrace Plat 6 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Dave & Lillian Selnes 571-5790 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Alliance Home Values Inc 6250 Starlite B1vd.NE Fridle 55432 571-4335 825 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 ❑ ADDITION ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Remove window and replace with sliding glass patio door 9 CHANGE OF USE FROM TO STIPULATIONS Provide smoke detectors in all sleeping rooms and on all levels of the house. SEPARATE PERMITS ARE REOUIRED 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 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 WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1700 $.85 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- TION OR 7ME PERFORMANCE OF CONSTRUCTION $60.10 Fire SC $1.70 luk- PLAN CHECK FEE TOTA EE 9 Licens $5. 0 $ .65 URE Of CON'RACTO A AUTHORIZED AGENT iDATEi EN OP Y ALIDAT THIS IS YOUji P IT S.GNATURE Of OWNEROF OWNER SURDERI iOATE, BLD NSF OATf NEW[ ] Effective 5/10/99 ADDN [ ] CITY OF FRIDLEY " ALTER [ SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: (,nMD SCD S+, Legal Description: Owner Name &Address: SAP` Tel. # Contractor: AN, qL4c.a- U MN LICENSE # Address: (n 7,W Q j c.r j, Tel. # S 1 k— 4 3 3 so Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVING AREA: Length DESCRIPTION OF IMPROVEMENT Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: P fL" o U AW i �c� a w `A? 1�-tPll Qe.� t.J � 3 Le�:�v�� 4 43 s V'Ab % cL o o v., Construction Type:Estimated Cost: $ ( 'l n -C"> do Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ DATE: 1�-1r— I APPLICANT: ( GU�Yf Tel. # 5l k— y 3 3 S Permit Fee Fire Surcharge $ /.10 State Surcharge $ . ASS SAC Charge $ License Surcharge $ . on Driveway Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ TOTAL STIPULATIONS: CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1050 per SAC Unit $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 SUBJECT P City of Fridley AT THE TOP OF THE TWINS BUILDING PERMIT 3086 2 O. COMMUNITY DEVELOPMENT DIV. INSPECTION SEC, r I PROTECTIVE 71 1 i �CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED er ....... L 612-571-3450 910415 4/26/00 JOB ADDRESS 5750 Madison Street NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 13 8 Donnay's Lakeview Manor SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Perry Colstrom 5750 Madison Street NE 571-2170 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 8 USE OF BUILDING Residential 7 CLASS OF WORK 1 NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 20' x 12' Shed 9 CHANGE OF USE FROM TO STIPULATIONS See attached shed requirements. Use treated bottom plates and anchor bolts. SEPARATE PERMITS QU REIRED FOR; WIRING HEATING ANSG 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. AUTHORIZED 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 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 $1,000 $ WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT .50 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROV11 ANY OTHER STATE OR LOCAL LAW REGULATING CON- $38.75 Fire SC $1.00 TR CTION O TME PERFORMANCE 0 CONSTRUCTION PLAN CHECK FEE T AL FEE $40.25 GNAT RE O COW RACTO uT iZ AGENT ®DATETEP HE P O FKY VALI ED THIS IS YgOR PERMIT r, S SP rgAiE VG./ GNATURE O� NERi OW NEA BUR ERS MATEi NEW [ Effective 1/1/2000 ADDN [ ] CITY OF FRIDLEY (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: _ e Legal Description: �22 ly -e Owner Name & Address: Contractor: eo 6 - Tel. # CZ/ 2/20 MN LICENSE # Address: 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: Length Width Hgt/Ground Sq. Ft OTHER: <,1 o2% G'G� 2 d k / Z \1 % 3 <,- v Construction Type: Estimated Cost: $ Driveway Curb Cut Width Needed: + 6 Ft= Ft x $ _ $ DATE: ^ Z �o "- APPLICANT:a4 �, Tel. # 7 % x217 CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application Permit Fee Fee Schedule on Reverse Side Fire Surcharge .001 of Permit Valuation (1/10th%) State Surcharge $ ,,576 $.50/$1,000 Valuation SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ $1100 per SAC Unit $ $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 [ r SUBJECT P City of Fridley 31 _' 5 41,,,- AT THE TOP OF THE TWINS BUILDING P E R M I T r? CEIPT NO. `y COMMUNITY DEVELOPMENT DIV. _ f � � PROTECTIVE INSPECTION SEC. NUMBER REV DATE PAGE OF APPROVED BY �'� CITY HALL FRIDLEY 55432 1 „ 612-571-3450 910-F15 10/31/00 JOB ADDRESS 5750 Madison Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 13 8 Donnay T s Lakeview Manor SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Perry Colstrum 5750 Madison Street NE 763-571-2170 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 ❑ ADDITION O ALTERATION C REPAIR O MOVE O REMOVE B DESCRIBE WORK Reroof House (21 Sq) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. 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 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 DWLG. 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 147 $2,147 $1.07 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- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTAL FEE r_'_� — -7 - / '0' 86.47 /' - RE OF CON RACT R O A O iZED AGENT (DATE- H P . LY VA 10 D THIS IS YOUR PERMIT A,GNAT BIOG .040 /40-,31 ryAtE $,GNATURE OF OVV4ER,IF OWNER BUILDER, IDATE, r NEW [] ADDN [] ALTER [ ] Construction Address: Legal Description: r Effective 1/1/2000 CITY OF FRIDLEY (763) 572-3604 Bldg Insp SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Owner Name & Address:--kzlza C OZ j/� Tel. # / Contractor: _,41,.0 v -e MN LICENSE # Address: Tel. # LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft. Length Width Height Sq. Ft. Construction Type: Estimated Cost: $ C� /`/ Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: .9—,?1-2--c Tel.# <-1'7 //0 CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ - `�� .001 of Permit Valuation (1/10th%) State Surcharge $.50/$1,000 Valuation SAC Charge $ $1100 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ ®�-q STIPULATIONS: sueJECT P MIT NO. City of Fridley 3295 AT THE TOP OF THE TWINS BUILDING PERMiT r ` RECEIPT NO. • _ COMMUNITY DEVELOPMENT DIV.® r E PROTECTIVE INSPECTION SEC. E . � NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 763-571-3450 910-F15 8/5/02 JOB ADDRESS 5750 Madison Street NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 13 8 Donnay's Lakeview Manor I SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Perry Colstrom 5750 Madison Street NE 612-366-5697 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO New Covenant Construction 2534 Cowern P1 E, N St Paul, MN 55109 651-748-8699 d ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 2006112 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION] ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Replace garage roof per attached plan (trusses, plywood, shingles) 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. Roof replacement must be completed by 8/31/02. Storage bin must be removed by 9/8102. 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 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 DWLG. 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 $5,000 $2.50 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMITFEE SACCHARGE PROVISIONS OF ANY OTH STATE OR LO AL LAW REGULATING CON- $111.25 F e SC $5.00 STIR N OR bE P ANCE O STRUCTION PLAN CHECK FEE T TAL FEE License 5.00 $123 5 IGNA URE OF CONCTOR OR AUTH RIZEO AGENT (DATEi NPR ERLY ATED THI S Y URLERMIT Z S.GNATURE OF OWNERIF OWNER BWLOERi iDATE, BLOC jASP GATE NEW [ ] CITY OF FRIDLEY Effective 1/1/2002 ADDN [) 6431 University Ave NE, Fridley, MN 55432 (763) 5722604 Bldg Ins ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION r Construction Address: S 7%! c m4 l a 1 3% �= Legal Description: 6.4 d -A:d5' 7 Owner Name & Address: 212-4,0--Y' C - 'To- e, Tel. # Contractor. D^#-/ -L C, t,,, C!7- ci'gj cam? MN LICENSE # c 0 6 Address: S 3 ct oo L -L -j 5 %.X- P C, / PO S `r t o^ w Tel. # 5 _ i SF g, - tai 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 _ . Length 9- 2- Width a " Height 1 3 Sq. Ft DECK AREA: Length Width Hgt/Ground Sq. Ft OTHER: L7y S 7" /Q G, pao/¢GD> ice' A®a Tc �0 SS r� 2_ ea Construction Type: I; Estimated Cost: $ P"Of Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ =$ DATE: �i , q - 0 2, APPLICANT: %ir &40J &12a Tel. #7 IY S- - k6' P Call (763) 5722604 for Permit Fees if mailing in application or Fax to 763-571-1287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee Fee Schedule on Reverse Side Fire Surcharge $ S��C� .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $$1200 per SAC Unit _ License Surcharge $ � , 60 $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by'Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ /�3'STIPULATIONS: 7 SUBJECT c -� City of Fridley 33127 AT THE TOP OF THE TWINS BUILDING PERMIT r � RECEIPT NO. COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. r _7aa 6�� I NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 763-571-3450 910-F15 9/27/02 JOB ADDRESS 5750 Madison Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 13 8 Donnay's Lakeview Manor SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Perry Colstrom 5750 Madison Street NE 763-571-2172 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Same e ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK CX NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 12' x 20' Storage Shed 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. SEPARATE PEWSWAHN FOR.- E1efore digging call for WIRING HEATING all utility locations 6�dUMBING� AND StG�fS 54.0002 BY LAW IRED 811 TYPE OF CONST OCCUPANCY GROUP OCCUPANCYLOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING. VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU FT AUTHORIZED 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 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 1 OOO SO 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. $38.75 Fire SC $1.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN 6ALFEE 40.25 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI HE PR Y VALI ED THIS IS UR RRMMIT B INSp W S.GNATURE OF OWNER..F OWNER BUILDER. IDATEI 7 NEW [ ] CITY OF FRIDLEY Effective 1/1/2002 ADDN (] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: �� MA PI --9 6 ?7 .3 T; WZ ' Legal Description: k - C Owner Name & Address: �!2 D L- S 1—k v Tel #217;a Contractor. 0 MN LICENSE # Address: 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: Length Width Hgt/Ground Sq. Ft OTHER: 3" S r rZ v c T t 2-'^j o' 5! s'v o r. -S, i Construction Type: W o 6 4 F v-& J Estimated Cost: $ 1 4D 8 0 � Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ _ $ C� DATE: T APPLICANT: T I• �? 2-1 '? r� Call (763) 572.3604 for Permit Fees if mailing in application or Fax to 763-571-1287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1200 per SAC Unit $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 [ ] TOTAL $ --210, / 0. 9�: STIPULATIONS: OCT 02 "91 10:57 BOLTON/MEN; METR['. 612-890-8065 P.1 Land Planning��?, 6875 Highway No.65 N.E. Land Surveying �� � � Minneapolis, Soils Testing `-' Uj2e/C/�S�` g All , Minn. 55432 Soils Engineering Telephone 784-6066 CiviArea Code 612 Municipal Engineering EngineerEngineers& Surveyors Certificate of Survey formrs. Poxlojon Coistrom � �r�ljiso� A ��O I POW@r Pole on Gor'ner. caJe� 1 ine,h= 30 Feel" Denotes iron monument Lof 13 , elooK 9, DonnaJs 's Lakeview Manor AAd'Iton Anoka. County I hereby certify that this is a true and correct representation Wl a survey of the boundaries of the above described land, and of the location of all lbuildings, ther6on, and all visible encroachments, if any, from or on said land. As surveyed by me thisj�doy of,I;,y> __A.D. 101L. SUBURBAN ENGINEERING, INC. Engineer � $ur�jvs L334%Q . 25.7 0 � do 1 ' 1 let4l �tiD Storage 2 L ( Sherds G u t` Q M ( LE sr- o _.l� pi ti \ i g 211.15 15.1 10.1 24.2± b 44 37.4 1B A ��O I POW@r Pole on Gor'ner. caJe� 1 ine,h= 30 Feel" Denotes iron monument Lof 13 , elooK 9, DonnaJs 's Lakeview Manor AAd'Iton Anoka. County I hereby certify that this is a true and correct representation Wl a survey of the boundaries of the above described land, and of the location of all lbuildings, ther6on, and all visible encroachments, if any, from or on said land. As surveyed by me thisj�doy of,I;,y> __A.D. 101L. SUBURBAN ENGINEERING, INC. Engineer � $ur�jvs L334%Q . y CITY OF FRIDLEY PERMIT NO.: 2005-00010 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: 01/05/2005 572-3604 F'AX: (763) 571-1257 ADDRESS 5750 MADISON ST NE PIN 233024130070 LEGAL DESC DONNAYS LAKEVIEW MANOR ADD LOT 13 BLOCK 8 PERMIT TYPE ELECTRICAL PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE ADDITION/ALTERATION VALUATION NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. HOMEOWNER DOING WORK # INSPECTIONS 1 APPLICANT COLSTROM PARIDON & CAROL 5750 MADISON ST NE FRIDLEY, MN 55432 OWNER COLSTROM PARIDON & CAROL 5750 MADISON ST NE FRIDLEY, MN 55432 STATE SURCHARGE, ELEC FLAT 0.50 ELEC PERMIT FEE - MIN (REST) 20.00 ELECTRIC FORM FEE 3.00 TOTAL 23.50 PAID WITH CHECK # 7605 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of worl will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. Applicant Date Bldg Insp Date Jr,rAKA 1 C MK1V111 J K=; U1KGU PUK WUKK U 1 HtK THAN UESUKIBEL) ABUVE. 05-004 NEW [ ] CITY OF FRIDLEY ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER �[�] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION Construction Address: Legal Description: J22 Owner Name & Address: Tel. #744-� 5-7 D/ Contractor:yU--yl R Imo-, r MN LICENSE# Address: A 60y P Tel. # C'� i Z3�'�� 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: Length Width Hgt//Grround ` I Sq. Ft OTHER: 17 /V S TA 6--/i ♦E 1--,� 1-( LC2 /7' © in J L4 402A Q4 Construction Type: AW ,0 Estimated Cost: $ Driveway Curb Cut Width Needed: 6 Ft = Ft x $ —=$ DATE: APPLICANT: Tel. # Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee Plan Review Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Fee Schedule on Reverse Side 65% of Permit Fee .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1450 per SAC Unit $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 [ ] TOTAL $ 4 0 ,�)5 STIPULATIONS: