PRE 2010 DOCSFRIDLEY POLICE DEPARTMENT �!
COMPLAINT REPORT
Number 64-8-185
Nature of Complaint Open well Location 5835 Main St.
Complainant Carol Trulson
Address 5866 - 2nd St. Phone No.
Report Ree l d by Kennedy How Red d Person
Date Reported 8-28-64 Time Reported 7:58 p.m.
DETAILS
Comp showed me a well in the backyard of 5835 Main St that is open
and quite deep, possible hazard to children.
8-31-64 Building Inspector notified. Mr. Hensley called and he
states this will be taken care of tomorrow. Twin City Federal
is being called by him at this time and house will be bulldozed on
the let if nothing is done.
Officer handling Kennedy Follow-up by
Disposition: Copy to Building Inspector. Given to Mr*.Hens&by.
. Reported by;
4. Name of Violator:
7. Nature of Complaint;
H E A L T H C O M P L A I N T '•
ty
9
CITY OF FRIDLEY, MINNESOTA En
. Aaaresss
5. Address:
. Phone No.
6. Phone No.
8. Complaint received by; 19. Complaint Referred to; 110. Date
11. Report of Action Taken; (Specify date of action)
12. Report Made by:
3. Date
1. Reported by:
H E A L T H C O M P L A I N T
CITY OF FRIDLEY$ MINNESOTA
2. Address:
. Phone No.
W
T
4. Name of Violator: S, Address: 6. Phone No, w
7. Nature of Complaint:
8. Complaint received by: I9. Complaint Referred to: ILO. Date
11. Report of Action Taken! ('Specify date of action)
12. Report Made by: 3. Date
Nix
'40
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`t Novem r Ss l bs
D/_Sc .
Twin
city radl?rai, SavlM� d3w, �� ' ;A.SS�ir
8C1 1�arquette Ave, �
A�innea.polis , ix�,«!i}t
":re« 535 din 3I%t 1t� %ot, Lots' int 24, .Block 24
Cycle Park Adr�. ridleg.., No 194=485- 3
GentlemeI1 « 9
i
The City of i� Fridley isfoxC �, the,health taws o�
viae city and the Mate of 1:innevoti , to asais`t in keeping Friale�► .
D a gore healt�nful place in _whic_h t6 ,,,ive� In this connection,
and by aan�r�ia int, this Sosrd has made a survey o , the subject
property.
s
die 67eil.i �,'sas. condemned and ordered abated on
July 17t 1994. Tete. were lnformed by._ one of your representatives
that fOrecl09'ure Would - be . completed and _ action takers . or the ,
houseit has a beef roe a year &W othi has, been done.
lhis ;dl►elling, is ` heavi y inkeited ' W'th rodents and is in
very dilapidated concis ion.
It i:� hereby!j s ester that y'ou elther' 8bate this
nuisance or sena. this �vard written authorization 'to abate it.
Unless action Is taken i by November 20-.i-. 19650 this ward will
have pts voice but to aue0 said nuisapce to be abated, .
We sh€ ll ' be 8lad to disks any . c�oe�timns, or di€fif
culties You may hsve in d6-,, lying .vdth the nia�n� health
laces ``of this city ;and ihe` Mate of %1'�aesota. Your.' cooperation
will help prevent the Oeterioration of perry values this
area and _ help veep Fric%ley a =ore i lthf ut -and :beautify . place
�.n which to live, � ::�`; � . ,
'•
In n
sr. Veit'y tt' y'ows
,y dames H• Hensley
City of Fridley &sacci mf,+e81th
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City Manager = a
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City of Fridley, Minn. N° 8685
BUILDING PERMIT
owner: Homewood_ Realty Builder Homewood Realty
Address _2W2 F-Immth An. N,, Mgt Addrew 2402 Plymouth Ave. N. -j X 1.s,=
LOCATION OF BUILDING N z of 22 and
No. __,583 ... Street Maim StrAe tr� Part of Lot S a of 24
Lot 2 3 _ Block 24 Addition or Sub -Division _ yd'o Fa rtr
Corner Lot _ Inside Lot — x Setback 35 f t — Sideyard 10 ft.
Sewer Elevation _ Foundation Elevation
DESCRIPTION OF BUILDING
To be Used ae:
Dbl. ,n iij nra I Front 30 Depth .-50 height M— t.. Sq. Ft. 15W— Cu. Ft. -30y0 p
Gara&e Front 22 Depth _Va___ Height lO ft. Sq. Ft. 528 Cu. Ft. 45, 2M
Type of Construction F'S"aw Est. Cost --` a O"""" — To be Completed 51Z' 7.r46,_
In consideration of the issuance to h e e a permit to conativ the building �d cubed above I agree to do
the proposed work in accordance with the description abov orth and is //cpt/npl3�aace� all provisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of 8 236,t.o-._, permit is hereby "ted to Homewood
Realty 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, conatruct[on, alteration, maintenance, repair and moving of buildings
within the city limits nd this permit may be revoked at any time upon violation of any of the provisions of said
ordiaanc m
ADEN G. JENSEN Buiidia8 inspector
NOTIC&
'fhb psneh don not mm the aondmedon, duh0atten for wirtae, pt m"g, en heatine, ower or water. Be ars to tee
dw Building l qww for ap"de pemih for these Nems,
a
OWNER'S NAME
ADDRESS
APPLICATION FOR BUILDING PERMIT
CITY OFjz?.IDLEY, MINNESOTA
BUILDER
ADDRESS
q7
V LOCATION OF BUILDING
N0. �d �— STREET S74 PART OF LOT Zf Z -'
LOT BLOCK �T• ADDITION OR SUBDIVISION
CORNER LOT INSIDE LOT ✓ SETBACK 3 � SIDE YARD ZP
SEWER ELEVATION FOUNDATION ELEVATION.
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To be used as;
Front- Depth Depth 1-5� Height�Q
Sq. Ft. Cu. Ft.
Front 2 �� Depth �-Y Height—
Sq. Ft. Cu. Ft. ,5-�L-Y-b
Type of Construction Estimated Cost 078-0
To be completed
U
The undersigned hereby makes application for a permit for the work 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 application
are true and correct.
DATE t/G� SIGNATURE_
(Schedule of Fee Costs can be found on the Reverse/ Sid
Date:
Owner:
City of Fridley, Minn..
BUILDING PERMIT
RENEWAL OF PERMIT #8685
JANUARY 20, 1967
Builder
HOMEWOOD REALTY
6's -
'N9
'No 91 Sri
Address _ — Address 2402 PLYMOUTH AVENUE NORTH
MINNEAPOLIS, MINNESOTA
LOCATION OF BUILDING
No. _5835 Street _ MAIN STREET N. E. .� _ Part of Lot N3, OF LOT 22, and SA', of
Lota11 of 23_ Block 24 Addition or Sub -Division _r._ HYDE PARK Lot 24
Corner Lot ____ Inside Lot — X —Setback 35' _ _ _ Sideyard ___ 10-'
Sewer Elevation
Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
DOUBLE BUNGALOW Front ____ 32 Depth 50 Height 20 Sq. Ft. 1,600 Cu. Ft. 32,00
GARAGE Front 22 Depth 24 Height 10 Sq. Ft. -428 Ca. Ft. 5,280
Type of Construction _ FRAME Est. Cost _ _.$23, 375 _ To be Completed
In consideration of the issuance to me of a permit to construct the b ' ding described above, I agree to do
the proposed work in accordance with the description above s4 forthaiff in compliance with all provisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of $ 20.00 , permit is hereby granted to HOMEWOOD
REALTY 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 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 Inspmtor
NOTICE:
This permit does not cover the construction, huteQation for wiring, plumbing, gas heating, sewer or water. Be cuto me
the Building Inspector for separate permits for these items.
Phone: GReenwood 3_8352
ARLEIGH C. SMITH
Registered Professional Engineer and Land Su
2030 East Wayzata Boulevard rveyor
Wayzata, Minnesota
PLAN' as SURVEY
OF PROPERTY OF' T' / —
/SFk�fJC7r�1 1l1.n �i
t _
described as
2. DF �OT �•Z ALL G
Z
3 ,-A-nr
r
Scale: 1 inch Q feet.
f
S `raJ
7
a' 1 4
tu
q
7 � I
CERTIFICATE OF LOCATION OF BUILDING
SURVEY r�
I hrrLe' certiPt' that on �f t-' Z CERTIFICATE OF r
N ,ur%ey of the. r.�, 19 j
P tw,ed locution of the building I hereby certify that o
e rg thy t+t�> c dl•' th c! 1•rol �.rty +nd that the Location tom.,_. 8 ��
surveyed the property described above a 19 ``= 1
► to curie -ro r.h.�.,,•n d the ab that the a
above plat is a correct representation of said survey.
W'e plat,
e
v Gti�liai`ii� 0:1 do �[sOL
oaa
xxO"i 30 X1300 P9:4acn1:482 : [gitqua
P' -sag
APPLICATION FOR BUILDING IFERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME B A -DER
ADDRESS ADDRESS
LOCATION OF BUILDING
N0. STREET PART OF LOT
LOT BLOCK ADDITION OR SUBDIVISION
CORNER LOT INSIDE LOT SETBACK SIDE -YARD
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To Be Used Ad:
K�l Front_
Depth Height
Sq. Ft. Cu. Ft.
Z .
k'
Sq.. Ft._ Cu. Ft. ,. 3 cl) ...
Type of Construction Estimated Cost _ 73 /r S
To Be Completed
The undersigned hereby makes application for a.permit for the work 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 application are true and.correct.
DATE 1 moi; ,SIGNATURE
f
(Schedule of Fee Costs,.rcan be found on the Reverse Side).
;'�' I "-d 0 1 r -? " e w & !V )/
f
Phone: GReenwood 3-8352
ARLEIGH C. SMITH
Registered Professional Engineer and Land Surveyor
2030 East Wayzata Boulevard Wayzata, Minnesota
PIAT OF SURVEY
OF PROPERTY OF ,� i� E �•'or.0 A 4 ,� — ? �D % c �� 7 ,a /)
described as follows: _TAIC
�f 4/-!/z Of I- o -r ZZ o k o r Z �?. AND TNS
S�Z F oT Z4 , LOC t
—2-
ZZE— /PAP_K
Scale: 1 inch = .30 feet. I
t_
I
wit
L1 I
Ole
q
e
0
S
ro
VA
V
24 is
CERTIFICATE OF LOCATION OF BUILDING
I hereby -certify that on19.�" I
made a survey of the proposed location of the building
on the above described property and that the location
of said building is correctly shown on thea plat.
a"LAR�'U_
__
CERTIFICATE OF SURVEY
I hereby certify that o fib' �' y 19 1
surveyed the property described above and that the
above plat is a correct representation of
said survey,
4 F 0
y
I
Application for Rawer Plants and. Heating, Cooling, Ventilation, 199 igei anion 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 $
,y
each add. 60,000 BTU .... . .................. 2.00 $
Replacement of Furnace 0.00 $
Repairs & Alterations—up to $500.00 ....e ............ 5.00 $
Repairs & Alterations each add. $500.00 .............. 2.50 $
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. IDR 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 $
Additional Fixtures x .50 $ �ro
Gas Range to 200,000 BTU ........... x 2.00 $
AIR CONDITIONING
FAN HEATING SYSTEM,
VENTILATING SYSTEM
ALTERATIONS & REPAIRS
ROUGH
FINAL
See Fee Schedule
TOTAL FEE
Dept. of Bldgs. Phone SU. 4-7470
L 3 7
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.
Owner
Kind of
Used as
Fridley,
19' %
To be completed about G'l/ ?
Estimated Cost, $ 900 &IV
01d New Building Permit No. 91," 'O'A Permit No.
DESCRIPTION OF WORE
HEATING or POWER PLANTS --Steam, Hoot Water, �armNo
Trade Nam Size No
Capacity Sq. Ft. E.D.R4 'LTU H.P.
Total Connected Load �/0 Kinn of Fue
BURNER — Trade Name Size No
Capacity Sq. Ft. E.D.R BTU H.P.
$
(REMARKS -OVER)
42 2M 7-89
Sign
By
Business Phone No
f
(REMARKS -OVER)
42 2M 7-89
Sign
By
Business Phone No
f
COMMUNITY DEVELOPt•CNT DIVISION
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NOPUTdEAST
FRIDLEY, MIWNTSOTA 55432
NOTICE OF NON-COMPLIA14CE
Name Noe S i5 L_g t Date 14-.
Address �O ` �t'� 57- Date & Timie of Inspection
20 0 3 %3� fir►,
An inspection by this Department has indicated that you are in non-compliance with
the following checked (x) sections of Chapter 113, Refuse Disposal, of the city code.
You are hereby notified to take whatever action. is necessary to correct any violations
on or before 0752etL ,Z�'��o Failure to comply with this notice may result in
legal action by the City Prosecutor.
() 113.02 Provide sufficient containers for the storage of all refuse
(including garbage) accumulated on the premises between collections.
(A-') 113.02 All refuse containers shall be water tight, have a tight fittinsi
lid, be impervious to insects, rodents, vermin, and absorption of
moisture, be fireproof, and not exceed 30 gallons in size (unless
otherwise specifically authorized).
( ) 113.02 All refuse shall be stored in approved containers, with the cover
in place.
(�) 113.08 Containers shall not be placed or maintained as to interfere with
the use of adjoining property. For the purposes of collection .
only, the containers may be placed a maximum. of 3 feet in front
of unit,
(jO() 113.07 The contents of storage containers shall be collected at least
once every week, or more frequently if necessary.
( ) 113.09 Containers without covers, in poor repair, corroded, or otherwise
defective shall be repaired or replaced.
Other A240,DE-0 Ajl01A1 9tswSt-,Pj=,j Qn'T `h a7�T o G�4c. �srvt7#[e&\'ep' brtT,F
If you have any questions concerning this matter, please feel free to call on -us at
571-3450, extension 164.
C -C . _74-16S r`S D"!>(9
123C-41 W &-)4JM Lb:�- D6?_
MOVLt 61001.rc Ss�6
By:
Inspectionrtment
STEJ��ttTpeo>&- !v
�!d (! i e2oN LT4L d JCFl C4-�
A
COMMUNITY DEVELOPMENT DIVISION
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NORTHEAST
FRIDLEY, MINNESOTA 55432
NOTICE OF NON-COMPLIANCE
Name.5�� �v� �c �R 97ivo r Date 1 I. l�` /Ve
Addressr �; Date & Time of Inspection
2 c t
An inspection by this Department has indicated that you are in non-compliance with
the following checked (x) sections of Chapter 113, Refuse Disposal, of the City Code.
You are herebyotified to -take whatever action. is necessary to correct any violations
on or before Za Z4 1e?9b Failure to comply with this notice. may result in
legal action by the City Prosecutor.
(�) 113.02 Provide sufficient containers for the storage of all refuse
(including garbage) accumulated on the premises between collections.
(IV) 113.02 All refuse containers shall be water tight, have a tight fitting
lid, be impervious to'insects, rodents, vermin, and absorption of
moisture, be fireproof, and not exceed 30 gallons in size (unless
otherwise specifically authorized).
( ) 113.02 All refuse shall be stored in approved containers, with the cover
in place.
( k) 113.08 Containers shall not be placed or maintained as to interfere with
the use of adjoining property. For the purposes of vo_llection..
only, the c�nta;nPrs may be placed a_maximum of 3 feet in front -
of elli.nq unit.
(ff) 113.07 The contents of storage containers shw all�be collected at least
once every week, or more frequently if necessary.
( ) 113.09 Containers without covers, in poor repair, corroded, or otherwise
defective shall be repaired or replaced.
( ) Other l�od�p�'tFCr/A[�lTi4lN ,�U [C!�t�CT sy1E'f 30��c. i'+:ryT,iitLdr @ 1-y1T.,f
L I DS 121 STcar A -t- 44ACB of t -E -e 1ZaL 8�Tl� GS C ' GGE'Gi7
If you have any questions concerning this matter, please feel free to call on. -us at
571-3450, extension 164.
C -C . T'4"t;r 2) ZAP C.E7
/h;4QC,e G'2e0_,
SS'.7G%
By:
nspection i5ex6artment
5'7'E0o�iv - 04Xo1v
C Al ✓ r 2C,"MC-Ae7'?_f_ 0 e -ex"
'Al.
6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432
.Mr. Lorin Senn
5837 Main Street N.E.
Fridley, MN 55432
TELEPHONE ( 612)571-3450
Re: Automobile Repair & Body Shop Home Occupation at 5837 Main Street N.E.
Mr. Senn:
It was brought to. the City's attention and confirmed by an on-site inspection
on June 16, 1980 that you were operating an automobile repair and body shop
at your residence.
Although the City does permit certain home occupations, it should always be
remembered that'the purpose of a residential area is to provide a living
setting away from the noise, clutter, or traffic of a commercial district.
Therefore, please read the following Section of the Fridley City Zoning Code
which defines a home occupation.
Section 205.02 defines a home occupation as, "Any gainful occupation or
profession engaged in by the occupant of a dwelling at or from the dwelling
when carried on within a dwelling unit and not in an accessory building, e.g.
garage,'and which is clearly incidental and secondary to the residential
use of the premises and does not change the character thereof, provided that
no signs other than those normally utilized in a residential district are
present, no stock in trade is stored outside the building, over the counter
sales are not involved, and entrance to the home occupation -is gained from
within the structure. Such use includes professional offices, minor repair
services, photo or art studios, dressmaking, or teaching and similar uses;
however, a home occupation shall not be interpreted to include tourist
homes, restaurants, or similar uses. Teaching shall be limited to four (4)
students at any given time. No home occupation shall be permitted that
results in the need for more than two (2) parking spaces at any given time
in addition to spaces required by the occupant (family). Occupations
requiring the hiring of employees other than members of the immediate
family shall not qualify as home occupations.
It is expected that in the future this property will be operated in a manner
consistant with the above listed City -Code. We are confident in your
cooperation on this matter, and if any questions or problems arise, please
contact me at 571-3450.
Failure to abate this violation may result in this matter being turned over
to the City Prosecutor for his legal consideration.
Sincerely,
14TFR7FAT .T (1T_CCt1 , _ R -.q
_
SUBJECT
PER
City of Fridley
26273
AT THE TOP OF THE TWINS
BUILDING
PERMIT CNO.
r
I?
COMMUNITY DEVELOPMENT DIV.
~ PROTECTIVE INSPECTION SEC.
��� 10
r
1 . �
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 85432
J 612-571-3450
910-F15
6/17/98
JOB ADDRESS 5835-37 Main Street NE
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
22,2 24
24
Hyde Park
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Ron Kerntop 1423 Rosewood Ct, New Brighton
633-3947
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Scott Construction 5545 Knoll Dr, Shoreview MN 55126
780-4800 20131822
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 Q
❑ NEW ❑ ADDITION ❑ ALTERATION X REPAIR ❑ MOVE ❑ REMOVE
X
B DESCRIBE WORK
Reroof House & Garage (32 Sq) Tear -off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY 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 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
2
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
$1.33
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$2,668
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STAT OR LOCAL LAW REGULATING CON-
$74.75
Fire SC $2.66
STRUC ON OR THE PERFORMAN E OF CONSTRUCTION.
PLAN CHECK FEE
OFVOTAL FEE
'
Lice S $5.
$83.74
SIGNATURE OF CONTRACT O AUTHORIZED AGENT MATEI
ENY
V L ATED THIS IS PERMI
B G INSlr
�� •70
ATE
SIGNATURE OF OWN ERIIF OWNER BUILDERI IDATEI
NEW [ ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: IJ B 3 S— 5 8 3 ^l M N' T.I. t. N L_ -V- V-1 A
Legal Description: 4 a k -O X ,
Owner Name & Address: c\7 0 -1`las C� #
Contractor:codi MN LICENSE # 01 ti 31.
Address: j 5IJS � ` �, S �no� ey i -e w . m v_ Tel. # gCi- ED O
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF EWROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Len `Width Hgt/Ground 1 Sq. Ft.
OTHER: ��b c) 0,3 's a, N C\ Cm � � _=�_1
v �►-f�L- +cry
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Construction Type: R-'?_Co1zX Estimated Cost: $
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: 6 APPLICANTA Tel.
Permit Fee
$ '74
Fire Surcharge
$
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State Surcharge
$
SAC Charge
$
License Surcharge
$
5
C-, C<�
Driveway Escrow
$
Erosion Control
$
Park Fee
$
Sewer Main Charge $
TOTAL $ 3 - 2
STIPULATIONS:
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1000 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 [ ]