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PRE 2010 DOCSCity of Fridley, Minn.. N® 9 613 BUILDING PERMIT Date: February 21, 1968 Owner: Deitmar Waldstein Builder Clemron Inc Address Address 701 Columbia Blvd, LOCATION OF BUILDING No. 7373 Street ____ Memory Lane part of Lot Lot 4 Block 4 — Addition or Sub.Division .._._.._ Melody Manor 3rd Corner Lot —_ Inside Lot _ X Setback 35' _ Sideyard .__ 10' Sewer Elevation 874.00 877.00 Top of Footing DESCRIPTION OF BUILDING To be Used as: Dwelling Front 26 ' Depth 42' Height 20' SQ, Ft. 1092 Cu. Ft 21840 Garage Front 27 ' Depth 22 Height 10' Sq. Ft. 594 Cu. Ft 5840 Type of Construction ____ Frame Est Cost _ $29,400.00 _ To be Completed SEWER LOCATION 84' West of Manhole WATER LOCATION 94' West of Manhole In consideration of the issuance tome of a permit to construe a building described abo - l agree to do the proposed work in accordance with the description above set forth and in ce wit�ya'll provisions of ordinances of the city of Fridley. $100.00 Sewer Connecta n Charge In consideration of the payment of a fee of S 42.00 , permit is hereby granted to Clemron, Inc . 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 of within ti i ntheMinnesota city limits anddtth s 1permit may be revoconstructioked at raa�tiyotime n, violation ot ,any of tand liee moving provisions of said f'� N it A._ 1 ButidB' Official Jan, Gi sterland NOTICE: M permit does not cover the construction, Installation for wiring, plumbing, gas heating, sewer or water. Be acre to no the Building Inspector for separate permits for those hems. K' APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAMEZ%�Z�� ���/�'����%J� BUILDER ADDRESS ADDRESS LOCATION OF BUILDING .�G'1/yuPl� a0 71140 NO. STREETAoezl,"�Zl PART OF LOT 141 LOT -BLOCK ADDITION OR SUBDIVISION d CORNER LOT INSIDE LOT_k::�_SETBACRS' SIDE-YARD��> SEWER ELEVATION E �� FOUNDATION ELEVATION 7 / - 06 Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING 7o7bed as; Front. _Depth ! D Height Sq. Ft. Cu. Ft. t� Front Depth,�� Heigh/t/�"� Sq. Ft. ��` Cu. Ft. Lrj 7 v 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, declares that all the facts and representations stated in this are true and correct_ and hereby application A vy. Q&' z � z/ X (Schedule of Fee Costs can be found on the A Reverse Side) Application for Power Plants and Healing, Cooling, Ventilation. ReFrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work ........................... $10.00 $ Replacement of Furnace ............................. 6.00 $ Repairs & Alterations—up to $500.00 .................. 6.00 $ Repairs & Alterations each add. $500.00 ............... 3.00 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ $10.00 $ .� each add. 60,000 BTU ....................... 3.00 $ Replacement of Furnace 6.00 $ Repairs & Alterations—up to $500.00 ................. 6.00 $ Repairs & Alterations each add. $500.00 .............. 3.00 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam ...... $10.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water — 10.00 $ Each add. 200 sq. ft. EDR Steam ...................... 3.00 $ Each add. 320 sq. ft. EDR Hot Water .................. 3.00 $ OIL BURNER—to 3 gal. per hour ........................ 6.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 199,000 BTU) ....................... 5.00 $ over 199,000 BTU See Fee Schedule GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ..... ................ x$ 2.00 $ Additional Fixtures ................ x .75 $ Gas Range to 199,000 ........... x$ 5.00 $ IR CONDITIONING %� " �i �l fir'" `, $ N FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL FEE $ ROUGH FINAL (REMARK O Dept. of Bldgs. Phone 560-3450 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 Ordinancek and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. 1/4 Fridley, Minn- Owner ( _-� �'%� 1.+x i -A(- � Kind of Building Used as To be completed about Estimated Cost, $ / Ol New. uilding Permit No. —%SL / Permit No. wo 7 DESCRIPTION OF WORK HEATING or POWER PLANTS --Steam, Hot Water, Air—No Trade Name_- i _-- Size No- a', s_✓r- r Capacity Sq. Ft. E.D.R �%�� ' `. BTU / H.P. Total Connected Load Kind of Fuel,% r BURNER — Trade Name ± `�.` Size No—,4=- Capacity o- -4=-Capacity Sq. Ft. E.D.R.- �" � BTU H.P. RAY N. WELTER HEATING CO. Signed 4637 ZFRL'AU B,,,1NNKAP0L1® 9. MINNENCOTA C4130. « Business Phone No City of Fridley Application for Plumbing and Cn Ming Permit Dept. of Bldgs. Phone 560-34M DESCRIPTION OF WORK Location 7-173 e0�yof 0 Number, Kind and Location of Fixtures pq YYe7I C Number Fixtures ....... .............. x $2.00 y Future Fixture Opening ................ x $1.50 Y New Fixture Old Opening .............. 8dp' Z VI 5 ?1� x $3.25 W 0U' ? �O x $3,00 N WATER HTR. GAS ELEG Base a $2.00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $2.00 .Ov Additional Fixtures .................... x $ .75 $ Gas Range to 199,000 BTU .............. x $5.00 $ / 1st I 2nd 3rd 4th • Future Connection Openings New Fixture, Old Openings I Connected with Sewer ❑ Cesspool ❑ PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ....... .............. x $2.00 $ �• 0 9 Future Fixture Opening ................ x $1.50 $ New Fixture Old Opening .............. x $1.50 $ Catch Basin ...... ..................... x $3.25 $ Water Heater (Up to 99,000 BTU) ...... x $3,00 $ 3.06 New Ground Run Old Bldg. ............ x $3.25 $ Electric Water Heater a $2.00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $2.00 .Ov Additional Fixtures .................... x $ .75 $ Gas Range to 199,000 BTU .............. x $5.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................ .Oi TOTAL FEE $� 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 are true0oand correct. Fridley, Minn- t 0# 14 Owner [ Z , ` 40 Al Kind of Building l� ee Used as To be completed about Estimated Cost, $ Old—New. Buildine Permit No_ �3 Permit No. Y-5--�93 ROUGH FINAU-- QM 42 By---7� ". Business Phone 0 City of Fridley Application for Plumbing and Gas Fitting Permit Dept. of Bldgs. Phone 560-3450 DESCRIPTION OF WORK Number, Kind and Location of Fixtures 0 m I p( 3 Future Fixture Opening ................ x $1.50 $ New Fixture Old Opening .............. Y 8yp Z 0 GG Uv; MO1 < �U' w �U' K ? �O • F • N WATER HTR. GAS ELEG Base $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures ...... ................... 2 x $2.00 $ 2.00 Additional Fixtures .................... x $ .75 $ Gas Range to 199,000 BTU ..............— x $5.00 $— 1st conii yd 1 to & zrill 2nd 3rd 4th • Future Connection Openings New Fixture, Old Openings I Connected with Bower El* Cesspool 0 PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... x $2.00 $ Future Fixture Opening ................ x $1.50 $ New Fixture Old Opening .............. x $1.50 $ Catch Basin ............................ x $3.25 $ Water Heater (Up to 99,000 BTT) ...... x $3.00 $ New Ground Run Old Bldg. ............ x $3.25 $ Electric Water Heater a $2.00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures ...... ................... 2 x $2.00 $ 2.00 Additional Fixtures .................... x $ .75 $ Gas Range to 199,000 BTU ..............— x $5.00 $— REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL FEE $ Location 7373 Memory In 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 are true and correct. 16 Oct 68 19_ Fridley, Minn Owner Dick Tail atei n Kind of Building fr Used as res To be completed about 21 Oat Estimated Cost, $ ten. Old—New. Building Permit No Permit Sia""4LT-1 • By Business Phone No ROUGH FINAL 42 11526City of Fridley, Minn. 11152- 6431 431 University Ave. N. E., Minneapolis, Minn. 55432 BUEWE% PERMIT 'Date: _ August t -25, 1971 Oma: Dick Waldst in Builder Minnetopka Pool Company Address 737.3 Memory Lame N_ E Address - 10820 Wayzata Boulevard LOCATION OF BUILDING No 7373 Street Memory Lane N.E. _ _ part of Lot Lot 4 Block Addition or Sub -Division Melody Manor 3rd Addition Corner Lot — Inside Inside Lot X Setback Sideyard Bawer Elevation Foundation Elevation DESCRIPTION OF BUILDING To be Used as: SWImming P n n 1 Front ___16L_ _ Depth 32_ Height V-6" -6" Sq. ,Ft. _— Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Steel & ViU1 _ Est, cost X3,900.00 To be Completed Stipulations: Per Health Officer's memo that is attached. In consideration of the issuance to me of a permit to construct the building described above, I agree to do Vie proposed work in accordance with the description above set forth and in compliance with all provisions of Ordinances of the city of Fridley. r-) ",2 In consideration of the payment of a fee of $ 24, 00--, permit is hereby granted to N Minnetonka Pool Co. 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 Vkldley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildiIIgB .within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordiaances. Ba'ding Inspector CLARENCE BELISLE NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building inspector for separate permits for these items. Plan review for Dick Waldstein pool at 7373 Memory Lane N.E. No specifications submitted which makes review almost impossible. Poor plans and specifications - should not be accepted. 1. Provide at least one skimmer and a main drain from deep point. 2. Provide at least a twelve hour turnover. 3. Provide at least one return outlet and preferably two. 4. Keep lip of fill spout at least 6" above overflow edge of pool. 5. Skimmer as well as filter must be N.S.F. approved. 6. Provide ladder & steps to get out of pool. 7. Ground electrical equipment per Electrical Inspector. 8. Any gate.in fence must be self closing and latching. 9. Provide safety equipment. Approved subject to above comments. 8-24-71 Harvey J. McPhee APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER' S NAME: DW -1L YJA Z CI ..� //=1w BUILDER: I /VIV c /a-ty 4 ADDRESS: -3 O .9/i// ADDRESS: /e g,?!? O NO ° . Z3 Z3 STREET: L0T: BLOCK: ADDITION: 1%-leely Ai 411er 3yc� 7 CORNER LOT: INSIDE LOT: X SETBACK: SIDEYARD: Applicant attach to this form Two Certificates of Survey of Lot arid proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: uJfrAl/�'llA/ D� Front : / 5 2 Depth • % /C� // Height: Square Feet: Cubic Feet: Front; Depth: Height: Square Feet; // Cubic Feet: Type of Construction: ,j r- qt G//n�rl� 2eNE stimated Cost: $ To Be Completed: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all Mork in sttict 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: (See Reverse Side For Additional Information.) ��, V 0 1'1130 HIGHWAY NORTHE, I iCern" c^,te of Survey D 1 C K W A L D -Sr E: 1 d 1-4 LAND SUR '/EYORS "�ESDTA Tei,- - 784-5480 ,tl 9 SCA L F- 2393 -158 -3 2 2393-158-32 --T D E No-rEs I-RON �1 Lo r 4, B Lock 4, Melody Marcor 3rd Addition Anoka County, Minnesota -EFS• CER"Fl - THIS IS A COF -�.-r :.. -ti TaT10 CF THE 3C -jt--- ,::.FS C= 30V; D LAND A^+,- .A T._ ,iN. AN .D AL;- �I ErriTS IF - OR ON Y t ` Li } -'EYCRS I . [all DICK -WA L JDS-F F I rf THIS ISA L AN D. DR ON m 7' -7"Sis LAND 784-5490 SCALE i"�-30� 239 LF- 2393-1-58-3 D 9 NOTES TROW Lot 4, BLock A. Melody Manor 3rd Addition Anoka COW-tY) MI r`50 to T H E s! r—' E, L Plan review for Dick Waldstein pool at 7373 Memory Lane N.E. No specifications submitted which makes review almost impossible. Poor plans and specifications - should not be accepted. 1. Provide at least one skimmer and a main drain from deep point. 2. Provide at least a twelve hour turnover. 3. Provide at least one return outlet and preferably two. 4. Keep lip of fill spout at least 6" above overflow edge of pool. 5. Skimmer as well as filter must be N.S.F. approved. 6. Provide ladder & steps to get out of pool. 7. Ground electrical equipment per Electrical Inspector. 8. Any gate.in fence must be self closing and latching. 9. Provide safety equipment. Approved subject to above comments. 8=24-71 Harvey J. McPhee -------------- ----------- - -- - " I for I t2 0 2 - i d SUBJECT P NO. City of Fridley 2 �. 5 2 7 P,AT THE TOP OF THE TWINS B U I L D I N G PERMIT Ir NO. _ COMMUNITY DEVELOPMENT DIV. ti' INSPECTION SEC. 'PROTECTIVE NUMBER REV. GATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 9/3/92 JOB ADDRESS 7373 Memory Lane NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 4 4 Melody Manor 3rd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Jeremy Powers 7373 Memory Lane NE 780--0732 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 ❑ ALTERATION Ij REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House (24 Squares) 2nd Layer 9 CHANGE OF USE FROM TO STIPULATIONS Roofing can be. 2nd layer but not 3rd, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SO. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES VALUATION SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $1x272 $.64 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SACCHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $31.00 Fire SC $1.27 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE $32.91 TUR OF CONTRACTO�ORAUTHORIZEDAGENT IDATEI PROPERLY V IID�AT�ED THIS IS YOUR PERMIT • l r � �.GNA AHEN �1A`��,V�' 0.SLOG INSP �- DATE T EOFOWNER lIFODER, IDATEI d NEW [ ] ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: -737S Legal Description: 6c) l Owner Name & Address: �c�C Contractor: Address: (a c (- I I M JCA , Effective 3/1192 Tel. # MN LICENSE # Tel. # Attach to this application, a Certificate of Survey of the K 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: 5C?U-� Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback _ Type of Construction: I i er��SS S�i�I tej Approx. Completion Date: Side Yard Setbacks Estimated Cost: $ %,212;� "- (Cost on Back) Driveway Curb Cut Width Needed: Ft. + b Ft = Ft x $ _ $ DATE: �3 �Z APPLICANT: c� Tel. # l Z- Permit Fee $ 0e) Fee Schedule on Reverse Side Fire Surcharge $ a% .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $700 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ TOTAL STIPULATIONS: $ ,3" •' / Building Permit Fee BUILDING Permit No��'➢ -�,` Inspections $ RESIDENTIAL APPLICATION Received By: C� 763-572-3604 .001 times the total job valuation CITY OF FRIDLEY Date Rec'd: 763-502-4977 FAX License Surcharge $ S ,Egp $5.00 (State Licensed Residential Contractors) SAC Charge EFFECTIVE 1-1-09 $2000 per SAC Unit (Plans to MWCC for determination) // DATE (Q - S - d 9 YOUR E-MAIL ADDRESS SITE ADDRESS % 3 -7 3 [h (Sg-1 I� l.� �- t- �L L- M U • 5 3 Li THIS APPLICANT IS: ❑ OWNER ONTRACTOR PROPERTY OWNER/ NAME: v F t LA %W Les TENANT ADDRESS: '73i3 M EMD 1✓!:� 9 A0 it Q E CITY z,-6 L E-,, STATE IMI) ZIP SS 3 LJ Q $ PHONE: iG> Z' -719 - 0.7 S CONTRACTOR NAME: STb my" STATE LICENSE # b 3 �'(�C>�'i EXP DATE - 3 (_ 0.0 I D SUBMIT A COPY OF YOUR STATE LICENSE AND CERTIFICATE OF ADDRESS: 7ES 16 R& S t -t' I �- CITY �O LO _STATE M0 ZIP S'S 12Z INSURANCE PHONE (, E l - % - t (® QJ " FAX 1— 1 e2 33 PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES i. PERNM TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITIONS ❑ MAINTENANCE/REPAIR ❑ REMODELING �p DESCRIBE WORK BEING DONE: TE4;Ne_- D P P& - SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES at ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan GARAGES ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, 13 Vinyl ❑Soffit ADDITIONS, & PORCHES SUBMIT: ❑ Aluminum E] Trim I . Site Plan/Survey showing the existing structures ❑ Other 11 Fascia and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes []No LOCATION OF WINDOWS OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.C FEE SCHEDULE) TOTAL JOB VALUATION $ F2ACA r OCCUPANCY TYPE Permit Fee See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ .001 times the total job valuation Surcharge $ .0005 x Permit Valuation Minimum $.50 License Surcharge $ S ,Egp $5.00 (State Licensed Residential Contractors) SAC Charge $ $2000 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $21 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ Make checks payable to: City of Fridley Attach THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit on site; that the work will be in accordance with the approved plan in the case of all work which requires review and approval of plans. 7- �j SIGNATURE OF APPLICANT �AA �i A o PRINT NAME AU&S C A--rnA V, DATE �'' U