2015-00273City of Fridley
PURCHASE ORDER
Date: 04/08/15
Purchased By: Ron Julkowski
Phone:
BILL TO:
City of Fridley
ACCOUNTS PAYABLE
6431 University Avenue NE
Fridley, MN 55432
COM DEV
Vendor: ELDER JONES BLDG PERMIT
SERVICE, INC
1120 East 80d` Street
Bloomington, MN 55420-1498
Vendor #:
ACCOUNT
NUMBER
PROJ
CODE DESCRIPTION
AMOUNT
101-0000-322-1041
Building Permit Fee
32.20
101-0000-205-0000
State Surcharge Fee
5.00
TOTAL $ 37.20
COMMENTS:
Job was cancelled for this address - refunding state surcharge fee and permit fees @ 80%
Permit 2015-00273 on 02/20/2015
By signing this document below I here do authorize payment and that the goods and services have been received
or rendered and all City guidelines have been followed in the procurement of the listed items.
Purchaser/Supervisor Department Manager/Date
PINK COPY TO ACCOUNTS PAYABLE
Elder -Jones
Building Permit Service, Inc.
February 26, 2015
Fridley, City of
6431 University Ave. N.E.
Fridley, MN 55432
To: Building Department
I am requesting a refund for cancelled building permits 2015-00273, issued on 02/20/15.
(Homeowner Canceled Job) The permit was for a window at the residence of:
Babekuhl
6437 E River Road NE
Fridley, MN 55432
Enclosed is a copy of the original permit. Please make the check payable to Elder -Jones
Building Permit Service, Inc. If you have any questions or need more information, please
call me at 952-345-6047.
Thank You, J
Oe
C
Jodi Sletten
Elder Jones Permit Service
Elder -Jones Building Permit Service, Inc.
1120 East 80th Street Bloomington, Minnesota 55420-1498
952-854-2854 ° FAX: 952-854-4909
S- y'
Elder -Jones Building Permit Service, Inc.
1120 East 80th Street Bloomington, Minnesota 55420-1498
952-854-2854 ° FAX: 952-854-4909
Permit No. :
CITY OF FRIDLEY *201S-00273*
6431 UNIVERSITY AVENUE NE DATE ISSUED: 02/20/2015
FRIDLEY, MN 55432
OWNER
BABEKUHL, CHRISTOPHER M
6437 E RIVER RD NE
FRIDLEY, MN 55432 -
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construction
authorized is not commenced witin 180 days or if construction
or work is suspended or abandoned for a period of 180 days at
any time after work is commenced.
1 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 work
will be complied' whether specified herein or not. The
granting oJ1,4 of,permit loes not presume to give authority to
violate or can cl he provisions of any other state or local 1 w
regulating cons u • ion or the performance ofconstructio .
Applicant Dale
13ldg Insp.
(763) 572-3604 FAX: (763) 502-4977
ADDRESS
6437 E RIVER RD NE
PIN
153024420095
LEGAL DESC
BROTTLUND ESTATES
LOT 1 BLOCK I
PERMIT TYPE :
BUILDING
PROPERTY TYPE :
RESIDENTIAL
CONSTRUCTION TYPE :
WINDOWS/DOORS
VALUATION :
$ 994.00
APPLICANT
BUILDING PERMIT FEE
FIRE SURCHARGE
�%cf�
38.75
0.99�
THD AT-HOME SERVICE, INC.
2690 CUMBERLAND PKWY
STATE SURCHARGE, BLDG VALUE
ZD
0.50
STE 300
LICENSE SURCHARGE
'3�
5.00
ATLANTA, GA 30339-
TOTAL
45.24
(952) 345-6047
Payment(s)
Minnesota State License #: GENR-CR268257
CHECK 70370
45.24
OWNER
BABEKUHL, CHRISTOPHER M
6437 E RIVER RD NE
FRIDLEY, MN 55432 -
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construction
authorized is not commenced witin 180 days or if construction
or work is suspended or abandoned for a period of 180 days at
any time after work is commenced.
1 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 work
will be complied' whether specified herein or not. The
granting oJ1,4 of,permit loes not presume to give authority to
violate or can cl he provisions of any other state or local 1 w
regulating cons u • ion or the performance ofconstructio .
Applicant Dale
13ldg Insp.
%PITY OF FRIDLEY
This sign shall be displayed on building or building site until construction is completed,
and shall be posted not less than 6 ft. nor more than 10 ft. above the ground
in location plainly visible from the street.
City of Fridley
Phone (763) 572-3604