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PRE 2010 DOCSCity of Fridley, Mian.. BUIIDING PERMIT Owner: K&:a1Z?'VW 3-"7�,e — Builder Address Address L T NP1 BUI G No. of Lot _ ........._. Lot __ Block clition or Sub-Divisia Corner Lot _ Inside Lot Setback �— Sideyard �® Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING Front Depth Height Sci. J ~CI' it Depth Hfilght Sq. Ft CU. Ft. Est Type of)&S�C�ion A . - - ;i 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 fTW and in compliance all provisions of ordinances of the city of Fridley. , '/"' 0, �Lv 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 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 timeupone�8�n of any of the provisions of said orddinanc es. 101"% Building Inspector NOTICE: 'fhb permh deet not cover the construction, Instalbilon for rdrk% plumbing, ga hooting, rower or Be are to stn I. ,i the Building Inspector for aprrah pannus for thea hems.` e Miro MT 77 APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA ADDRESS ADDRESS No. Lot Block Addition or Corner Lot Inside Lot Setback Side Yard Part of Lot SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed build- ing location drawn on these Certificates. To be used as: DESCRIPTION OF BUILDING Front Depth Height Sq. Ft. Cu. Ft. Front Depth Height 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, 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 represent4tions stated in this application arue and corn DATE ST(MATURP T - (Schedule of Fee Costs can be found on the Reverse Side). City of Fridley Application for Plumbing and Gas Fitting Permit Dept. of Bldgs. Phone SII 4.7470 DESCRIPTION OF WORK Number, Kind and Location of Fixtures pY12 +� 3 ��� c� 1 8p[ Z o°4c Z S < (�9 •� w �Sa ? �0 • F • N HTR. GAS LEWATER EG Base f 1st 2nd 3rd 4th _ • Future Connection Openings e New Fixture, Old Openings Connected with Sewer E] Cesspool E] City of Fridley: The undersigned hereby makes application for a permit for the work herei 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 jire true and correct. Owner 6 z/ Kind of Used as To be completed about 19 A5 PARTIAL RATE SCHEDULE Estimated Cost, $ ��c.J New ding Permit No Permi o. PLUMBING FIXTURE RATES: RATE TOTAL Number Fixtures $1.50 $ Signe Future Fixture Opening ............... zfxx 1.20 $ �?- G By , New Fixture Old Opening .............. x 1.00 $ Business Phone No Catch Basin ............................ x 3.25 $ J Water Heater (Up to 200,000 BTU) ...... �� x 2.00 $ U ®� ` New Ground Run Old Bldg. ............ x 3.25 $ ROUGH aU FINAL 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 ................................................ 1-4 TOTAL FEE $ I a z 2M Cj _ Application for Power Plants and Healing, Cooling, Ventilation, Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE Dept. of Bldgs. Phone SII 4-7470 GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work ............... I .......... 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 $11 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 J 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 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL FEE $� ROUGH FINAL 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 arejrue and correct. Owner Kind of Building �� T Used as To be completed about Estimated Cost, $ r � Old—New. Building Permit No. Permit No. ,3Oj DESCRIPTION OF WORK 19 �3 HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No Trade Nam Size No 1y • - J0 Capacity_/ ,� 2 Z ? C' d Sq. Ft. E.D.R BTU H.P. Total Connected Load d/L� ® Kind of Fuel v" BURNER — Trade Size No Capacity Sq. Ft. E.D.R BTU H.P. /l' (Z) //1 '-'G�rrG� Signe SUBURBAN' t:Li,i, `'7 t:: SNLET MEW By 8419 e _ . r .kl� 42 YM Busines MWQDriLIS 32, M114NESOTA (REMARKS -OVER) ass .;.., 4 2- HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS ® r Weatherstrips A.S. Guide' Construction No. Guide Windows ( Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Kind es No a No 19— p _ 7iIVIIA % Fl,t , a Room I Length -:2/f Width, Height r II i Fl.l Room I Length 45� `W and Area %3,,p e) FRIDLEY, MINN. Insulation Windows Ad Doors—Crackage and Area Width Height No. of Lineal tt. Area No. of Dane of pane Ilghts of crack I eq. ft. Width Helght No. of Llneal f . Area No. of pane of p1a�ne lights of crack eq. it. J 7 � / r f a ®• Coef.1 Btu Infiltration oy Coef. Btu Coef.1 Btu Infiltration Ceiling 911 Glass Floor d Glass Floor Int. wall Net exp. wall f Exp. wall Int. wall Net exp. wall Ca , Floor Int. wall Ceiling Floor 1 otal litu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area / Fl.l y ` Rnnm I I .onr4h Of / / W;d►I, )/ / Ie;..I,r 0– i Windows and Doors—Crackage and Area Width Height No. of Lineal tt. Area No. of Dane of pane Ilghts of crack I eq. ft. Width Height No. of Lineal ft. Area No. of pane of pane, llghte of crack eq /ft. vG Coef.1 Btu Infiltration oy Coef. Btu Infiltration Exp. wall Net exp. wall Int. wall �D Ceiling 911 Glass Floor Ceiling Exp. wall Floor Int. wall Net exp. wall f Ceiling Floor Int. wall Ceiling Floor 1 otal litu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area ' I F1.I .zi 11410. 4n II wn.th /P / W..IaL -7 LL:—L. Windows and Doors—Crackage and Area Width Height No. of Lineal tt. Area No. of Dane of pane Ilghts of crack I eq. ft. a- Coef.1 Btu Infiltration oy Btu Glass Exp. wall Net exp. wall Int. wall Glass J Ceiling 911 ® 1e Floor _Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area // Windows and 1 Wldth H N/o� of pcane of z Coef. Btu Infiltration 7 Glass Exp. wall Y Net exp. wall le V/ Int. wall Ceiling 0 Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl.l _ Room I Length ,�ff ' Width 44 / Height R/ Windows and Doors--Crackage and Area Width Height No. of Lineal ft. Area No. of pane of lights of crack sq.' ft. �pane Coef. Btu Infiltration Btu Glass Exp. wall Glass J Net exp. wall , - r Int. wall Ceiling Net exp. wall Floor Total Btu. Gjp Required sq. ft. E.D.R. or sq. ins. W.A. Leader areae F1.1 Room I Len>:tth Width Heiaht Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration Glass J Exp. wall Net exp. wall �y Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area I /,el, City of Fridley, Minn. BUILDING PERMIT Date: May 22, 1965 Owner: _ Jack Green Address 7820 Melody Drive N® '7497 Builder Random, inc. Address Bos 1 Circle Pines LOCATION OF BUILDING No. 7320 Me1gtDrije Part of Lot Lot 12 _ Block 4 Addition or Sub-DivisionMelody Manor 2nd Addition Corner Lot Inside Lot __ _ Setback _ _ _ Sideyard Sewer Elevation — Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Front Depth Height — Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Est. Cost --1726-60 _ To be Completed Reconstruction. Tornado damage In consideration of the issuance to me of a permit to cons build the proposed work in accordance with the description above se a>Wd in ordiaances of the city of Fridley. e7 I agree to do provisions of 10.00 Random, Ind. 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 pari 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 NOTICE: We permit doe not eorer the construction, Installation for wiring, plumbing, ge heating, sewer or water. Be aura to ane the Building Inspector for separate permits for thea flame. V � , APPLICATION FOR B'-; ING PERMIT. CITY OF FRIDL&Yi NNESQTA OWNER'S NAME BUILDER zeo�'7 ADDRESS ADDRESS LOCATION OF BMDIN(.; 'z'e' �zoledt� No. Street Part. of Lot Lot « Block Addit.iorr or Subdivision Corner Lot Inside Lot .:._Sett/ ck Side -Yard SEWER ELEVATION FOUNDATION ELEV'AT'ION Applicant attach to thie form, Two Certificates of.Survey of Lot.and proposed build- ing location driven or► these Certificates. Te be used as: DESCRIPTION OF BUILDING d Front Depth Height Sq. Ft. Cu.. Ft. Front Depth Height Sq. Ft. Cu. Ft. J Type of. Construction Estimated .Coat %% !J _.To- be -Completed v The undersigned hereby makes application for a permit for the work herein specified, agreeing to coo all work ift strict accordance with the City of Fridley Ordinances and rulings of the Department'of Buildings, and hereby declares that:all the facts and. representations *Zated in this application are true and correct. 'Scbe'dule of Fee Costs can be found on the Reverse Side). 4 CITY. iuF FRIDLEY INSPECTION DIV, Effective On January 1, 1993 r 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING. COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS RATE SCHEDULE The undersigned hereby makes application for a permit for the work herein Residential Rate TOTAL specified agreeing to do all work in strict accordance with the City Codes and Furnace Shell and Duct Work, Burner — ®� rulings of the Building Division, and hereby declares that all the facts and Also Replacement Furnace $ 20.00 $_�� representations stated in this application are true and correct. Gas Piping (Needed with new furnace) $10.00 OWNER Gas Range $10.00 $ 131JILDING USED AS s Gas Dryer $10.00 $ ESTIMATED COST r � b � ` -' � PERMIT NO, *Air Conditioning Ali Sizes $10.00 $ r DESCRIPTION OF FURNAQEAll Others/Repairs & Altomflons (LIST ON BACK) r 1 % of Value of Appliance or Work a $ Nc►. of Heating Units c Trade Name Commerc�Vtndustrtal HP. 1 of Valise of Appliance or Work $ `upF e ' T j' State Surcharge X5_0 _ Burner Trade Name BTIJ r TOTAL FEE �%� `'� ROI, HEATING CoMPANY . . MINIMUM FEE FOR ANY HEATING/C001LINGMENTILATIIOAi _ BF REFRIGERATION/AIR CONDITIONING`PERMIT IS $15.00 Signed By' PLUS THE $.SO STATE SURCHARGE' REINSPECTION FEE $30.00 *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. Sh Approved By 6X4 Rough -1n Date Final Date FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE Date V6aGuhleC.otwtrttdiee No. ' ` ' mdowi Door Reference Qat. WO Int.WaU ME Roof leo � 9 Floor — 1 ;;. F1.1 Room Length 35 Width, F1.1 Windotw a d Door--Ct 4 n ac: go and Area Ilahb et ettalt Width e• ieentfor a tCii amb tgs r' r' 1 3, CMEI Btu '� In6ltrat�n 2 ^ Glaze —� .36, 27 Cod- Btu n6ltratlon Iat. waU 0 -to Ceiling .IAtf - exp. waU InOttation tp. wall wall Ia'e:p, wall P. wall 10 ,at. wall.....,, `I $g71 wan wall -fling Ivor wall ^tal Btu. s�''.' d� i fix+ F r lsndae" Kind Han Applied Room I Length Width Height Wallows and Doon—Crac6ge and Area Ilahb et ettalt Ito. of lana steCaaa "0. et track SMI L fl. r' t Na. of Cana CMEI Btu '� In6ltrat�n 2 ^ Glaze 'Phar.Ow .. Net ev. wan BW 'f` Iat. waU 0 `Ceiling Ceiling Floor It, - ',quired sq. ft. ED.Jt or sq. int WA: Leader iitoa`=' w '�' a "'I` tat Btw Required sq. ft. EDA or sq. ins. WA Leader area Room Length t . -;.W , h Heist Windows and Donn--Craekage uetl Ates ' RomW4 Width t at .Ighe e. e ' ar a°�� ,� Wiadows and Doer—Craekasa and Ates o Cane of "ons Ilahb et ettalt adc tt. r' t Na. of Cana coof Bto 2 ^ tration 'Phar.Ow .. Cee(. BW 'f` 0 titration Ceiling z - exp. waU InOttation ' • as wall -JIM P. wall 10 `I $g71 wan wall wall lot. wall cling � x.,, .._ ._ . � Ceiling Picot, ,al Btu. z ePy�SQt`, tri26}a �� "° TolW Btu. h wired sq. ft. ED.R. or sq. ins: W.A. Lde1�"litter '�� Rrp. N. E.D.R. orhis. WA. Leader zeta sq• �. Rom Length ' £Width ` Height FI. Room (Length Width if Btu. ralited sq. ft. ED.R. or sq. int. W.A. Leader alta Windows and Doors--�Gacka Width eight a o _ of Cana or vane llfthq ttvftj `61("f e d y ; ^�h,�»,,VP �;5+a l4 coof Bto Cod Btu tration 'Phar.Ow .. 0 wall Ceiling z Floor exp. waU wall ng 10 `I $g71 Srr ' , tlrnv�l And ekage and Area URW IL �1b. of tk of VAN 1 bra et emit a�tt. coof Bto �'' 1tt61ttetion 'Phar.Ow .. low crap Ceiling Floor Total Btu. Required uq. ft. ED.R. or sq. inr..A. Leader area SUBJECT PERMIT NO. City of Fridley 28459 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. r`COMMUNITY DEVELOPMENT DIV. V ___ � INSPECTION SEC. r � � PROTECTIVE I . , CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY j 612-571-3450 910415 10/28/98 10B ADDRESS 7320 Me odv Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 12 4 1 Melody Manor 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Dennis & Deb Kudak 785-1066 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Four Seasons Roofing & Rem LLC 7930 Univ. Ave NE Fridley 55432 795-9410 20138780 4t 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 1EK REPAIR O MOVE O REMOVE B DESCRIBE WORK Reroof house and garage (27 Sq) Tear-off 9 CHANGEOFUSEFROM 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 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 $2313 $1.16 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- ON THE PERFORMANCE OF CONSTRUCTION STP-INATURE 74.75 Fire SC $2.31 p PLAN CHECK FEE TOT L FEE Licens S 5. 3.22 O CON CTOa OR AUTHORi1E0 AGENT iDa TES EN ROP VALIDAT D THIS IS YOUR PERJM��I)T BkEG INS v�V nATE S-GNATUAE OF OWNER,IF OWNER BURDERi 'DATE' NEW [ ] ADDN [ ] ALTER [ ] ConstructionAddress: CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Legal Description: Owner Name & Address: Dw a l5 u. beb i�U d A`a.IC _ Effective 1/1/98 Tel. Contractor: �-o.) 5e�'!S � }-t ,r„ MN LICENSE # Address: !2q3(' aN1 lySl Tel. # yam- Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVENIENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground ,pSq. Ft. OTHER: 42-M A\ IV e GL I id -p -'n IG P ' _ �9 q -S4 jlvidp o, Construction Type: 1L Estimated Cost: $_ (Fee Schedule 3 /3. 'v on Back; Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x S DATE: & aq APPLICANT: Tel. # CITY USE ONLY Permit Fee $ % Fee Schedule on Reverse Side Fire Surcharge $ ";7.:3 l .001 of Permit Valuation (1/10th%) State Surcharge $ /, A� $.50/$1,000 Valuation SAC Charge . $ $1000 per SAC Unit License Surcharge $ 496 $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 $ STIPULATIONS: - SUBJECT P City of Fridley 3 2 7 �'_ AT THE TOP OF THE TWINS BUILDING PERMIT r rr � •COMMUNITY DEVELOPMENT DIV. -----� Vr r � PROTECTIVE INSPECTION SEC. � CITY HALL FRIDLEY 53432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910-F15 7/8/02 JOB ADDRESS 7320 Melody Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 12 4 1 Melody Manor 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADORES$ ZIP PHONE Dennis & Debbie Kudak, 7320 Melody Dr, Fridley, MN 55432 763-785-1066 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO NuWay Development Inc, 8200 Long Lake Rd Mounds View. 55112 612-860-7965 5775 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 fel NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Re -roof part of roof (8 sq.) on house (tear -off) 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with 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 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 I STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS 7LUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $858.00 $.50 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF A THER STATE OR L A LAW REGULATING CON- Fire SC W $.86 STRUCTION OR THE PER OR AN F UCTION $35.70 PLAN CHECK FEE T TAL FEE P%- �'� ®�� ice 5.00 42.06 SIGNATURE OF CA7RACIOFIOROeUTHORIZEO AGENT tOATE, P LY VA D TED THIS IS YOUR PERMIT ZG- :.. - SjGNATURE OF OWNER o6 OWNER BUILDER1 tOATE, NSP - riAtE 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: ?,3a® P 6 LO Y Dido I F Legal Description: Owner Name &Address: - V Tel. #� `�� 7 ��-' �O(® Contractor. ()ELOO M &AJ f MN LICENSE # 57 % Address: Fina L -00&I -*Xe jib A lo,JA �J S M64) PM�d Tel. # G/Z - 960 ^ 796 5 - 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: s ,-o k Construction Type:k,6 P -0®r Estimated Cost: $ Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ _ $ DATE: APPLICANT: Tel. # Call (763) 572-3604 for Permit Fees if mailing in application or Fax to 763-5714287 if using credit card and we will call you for card number.35-26 -�.1CrTY USE ONLY - Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ : 50 $.50/$1,000 Valuation SAC Charge $ $1200 per SAC Unit License Surcharge $ 5.60 $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'Engineedng Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ 4a. b STIPULATIONS: