Loading...
PRE 2010 DOCSDate: _June 3. 1968 Owner: Address City of Fridley, Minn. BUILDING PERMIT Builder ___. C l emron . Inc. Address 701 Columbia Blvd. LOCATION OF BUILDING No. 7376 —street Memory Lane _ _. _ _._._ Part of Lot No 43 �s � 9770 Lot 1 __ Block Addition or Sub -Division _ Kelo8V Xi nnr 3rd Corner Lot ____ Inside Lot __ —. X Setback O°__ Sideyard — 15' 0" & 12' 0" Sewer Elevation Top of Footing DESCRIPTION OF BUILDING To be Used as: Dwelling Front 261 Depth 421 _ Height 2ON' Sq. Ft. 1092 Ca Ft 21.840 A t t f a ra ri _._,_, Front 2.7! Depth 26' Height 10' Sq. Ft. 792_ Cu. Ft. --7-,= Frame $24,500-00 6 Months Type of Construction _.._ Fit. Cost .— ___.�..__ To be Completed SEWER LOCATION - 75' S.W. of Manhole WATER LOCATION - 63' S.W. of Manhole In consideration of the issuance to me of a permit to cons a building described ve gree to do the proposed work in accordance with the description above fo and in co with ons of ordinances of the city of Fridley. r _'V _ In consideration of the payment of a fee of $_.3.00 , 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 buil within the city limits and this permit may be revoked at any time upon violation of any of the provisions of d ordinance=s. C CE BELIS NOTICE: This permit does not cover the construction, installation for whing, Plumbing, ea heating, sewer or water. Be ams to no the Building Inspector for separate permits for these Ruane. APPLICATION FOR BUILDING PERMIT CITY. OF.FRIDLEY, MINNESOTA MOS ADDRESS ADDRESS LOCATION OF BUILDING NO. �� STREET /�. PART OF LOT LOT BLOCR ADDITION OR SUBDIVISIONS CORNER LOT INSIDE LOT�ETBACR SIDE -Y 1 42,® SEWER .7l• 7 16? --'v -tvoTI !l Applicant attach to this form Two Certificates of Survey oft and proposed building location drawn on these Certificates. n I ... 5• L. 75` S,ul. o� VhR�Iho z- yq, L. 1,3 5, IJ• a� AIAAo lE DESCRIPTION OF BUILDING To be used as; i Front DepthZjZ-/,7Heightn0= e Sq. Ft. AI Cu. Ft. r ���`�`0 � r Front Depth�Height_&� Sq. Ft. &%-'�. _ Cu. Ft. 7G�a� Type of Construction��� Estimated Cos%�i,�R ®� J-) 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 X SIGNATURE (Schedule of Fee Costs can be found on the Reverse Side). (tf 9-76� Application for Power Plants and Heating. 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 $ 11�� 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 $ AIR CONDITIONING FAN HEATING SYSTEM VENTILATING SYSTEM ALTERATIONS & REPAIRS ROUGH FINAL See Fee Schedule Ok TOTAL FEE $—z�' Dept. of Bldge. Phone 560-3450 City of Fridley: The undersigned hereby makes application for a permit for the work hereir. specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereb declares that all the facts and representations stated in this application are try�fyand correct. 1962 Fridley Owner Kind of Building�i Used as To be co ��UM Estimated Cost, $ 17110-1, Old -4&'. Building Permit No. Permit No. _ t 106 DESCRIPTION OF WORK HEATING or PO PLANTS—Steam, Hot Water, �No Trade Name- Size Size No Capacity Sq. Ft. EM.R.. BTU H.P. Total Connected Loa "7 Kind of Fu 4'e BURNER — Trade Nam ��� Size No -12111� Capacity Sq. Ft. EM.R -� BTU H.P. eQjjDb42 RKS—O �Y N.\INELTER HEATING CO. 4637 CHICAGO AVE. -- 13116 7 MINNESOTA By Business Phone City of Fridley Application for Plumbing and Gas Ming Permit Dept. of Bldgs. Phone M -UM DESCRIPTION OF WORK Number. Kind and Location of Fixtures WATER HTR. City of Fridley: Vo < � y � Y Z � Q Z $ 3 Z O 7 J w 7 N Z le a 4 P + N GAS ELEc. LLo <~ Voi �J' U' Z t C/K t90 Base 1st 2nd 3rd 4th • Future Connection Openings Connected with I Sews * Now Fixture, Old Openings Cesspool 0 PARTIAL RATE SCHEDULE 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 a e true and correct. Fridley, Minn' 1� Owner ��®� Kind of Building Used as To be completed about Estimated Cost, PLUMBING FIXTURE RATES: NO. RATE TOTAL f%IA--New. Building Permit No Permit No. Number Fixtures .... . . . . . . . ........... � x$2.00 _ , 0 d Signed__.T /�A *2 o 6 A Al Future Fixture Opening ................ x $1.80. $ B Y New Fixture Old Opening ..... x $1,80 $ Business Phone No- Jt R_���_ t� �--'�: `��`�` a a;. ��:.x �.�,-• �, '�y::; {� .�:� - s '�, 2"' ,�. .;"M d"ue � ,�A: of x ,- l"`. "�- -��'� - _ . 1. 4 t . �•_"�' `_� � x -.. _tr: � _. �. :: _ ,,.... :..;; �:. ,. -..w ,t - �.,_ ?; j.w.:� is `�1 - ,p 6�+'_'r � ��;''�Sa < �7K a.���$� is ri r��` ts�' "? %,? n �Y .. ryi ... n3s ,. :. ���� �'.., 3 .- �- _.e• `.;.\.� _ ..2 _- ."" �:.��., `� _ _ &,fit.. �, _ .s'y - _ +�" ^,�a4# 52-84-5915.51 City of Fridley Application for Plumbing and Comas Ming Permit Dept. of Bldgs. Phone 560-3450 DESCRIPTION OF WORK Number, Kind and Location of Fixtures N I x $1.50 $ x $1.50 12 x $3.25 Y 9U�' x $3.00 n Z `inn ru<�i�i x $2.00 w ? • F • N WATER HTR. GAS ELEG < °d C�h e� �O Base 1st 2nd 3rd _ 4th • Fugue Connection Openings Connected with I Sewer El New Fixture, Old Openings Cesspool El PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ....... ............. Future Fixture Opening ............... New Fixture Old Opening ............. Catch Basin ...... .................... Water Heater (Up to 99,000 BTU) ..... New Ground Run Old Bldg. ........... Electric Water Heater GAS FITTING FEES: x $2.00 $ x $1.50 $ x $1.50 $ x $3.25 $ x $3.00 $ x $325 $ x $2.00 $ NO. RATE TOTAL 1st 3 Fixtures .......................... x $2.00 $ Additional Fixtures .................... x $ .75 $ Gas Range to 199,000 BTU .............. 1 x $5.00 $ 3.00 REPAIRS & ALTERATIONS—Refer to Code Location__7376 Memory Lane 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. Fridley, Minn 9-3-68 19_ Owner R Stifter Kind of Building f rams Used as res To be completed about 9-8-68 Estimated Cost, $ 10.00 / Old—New. Building Permit No Permit No. 7 3 By Business Phone No ROUGH FINAL Description ................................................$ TOTAL FEE $ 3 • az Application for Power Plants and Heating. Cooling, Ventilation. Refrigeration and Air Conditioning Systems and Devices Y��" 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 ®6 GAS BURNER (up to 199,000 BTU) ....................... 5.00 $ s7. over 199,000 BTU See Fee Schedule GAS FITTING FEES: NO RATE TOTAL Ist 3 Fixtures ...................... x$ 200 $ �•©® Additional Fixtures ................. x .75 $ Gas Range to 199,000 ........... x$ 5.00 $ AIR CONDITIONING $ B FAN HEATING SYSTEM VENTILATING SYSTEM ALTERATIONS & REPAIRS ROUGH FINAL See Fee Schedule $ TOTAL FEE Dept. of Bldgs. Phone SM -3480 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 Ordinancesc and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application tru d correct. 1/3 Fridley, F Owner.. lwd- A445L, Kind of Used as To be cc Estimated Cost, $�4:�'nen e2 Ol New. Building Permit No. Permit No. %J DESCRIPTION OF WORK HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No Trade Name.��zyj"MtA t.O 5 X Size No `� –V 4 ,ftCapacity. * ✓ -.ado i l �, eta Total Connected Load Kind of Fuer BURNER — Trade Name Size No Capacity Sq. Ft. E.D.R BTU H.P. (REMARKS -OVER) 54Business Phone No 52-84-5915.51 Application for Power Plants and Heating. Cooling, Ventilation, Refrigeration 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 $ 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 GAS BURNER (up to 400,000 BTU) ....................... 5.00 $ •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 I / – O – %U Dept. of Bldgs. Phone SU 4-7470 Location , 7376 Memory Lane 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. Fridley, Mnn 11-13-68 19 Owner R Stifter Kind of Building frame Used as res To be completed about 11-18.68 Estimated Cost, $ 10.00 Old—New. Building Permit No. Permit No. DESCRIPTION OF WORK HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No Trade Name LarHarco Garage idtr Size No Capacity 20, 000 Sq. Ft. E.D.R BTU H.P. Total Connected Load Kind of Fuel BURNER — Trade Name Size No Capacity Sq. Ft. E.D.R BTU H.P. Signe By MINNEAPULIS GA W. 42 2M Business Phone No (REMARKS -OVER) City of Fridley Application for Plumbing and Gras Fithing Permit 5915.51 Dept. of Bldgs. Phone 560-3450 DESCRIPTION OF WORK 7376 memory is Number, Kind and Location of Fixtures Location PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ..................... Future Fixture Opening ............... New Fixture Old Opening ............. Catch Basin .......................... Water Heater (Up to 99,000 BTU) .... . New Ground Run Old Bldg. ........... Electric Water Heater GAS FITTING FEES: x $2.00 $ x $1.50 $ x $1.50 $ x $3.25 $ x $3.00 $ aU' ? 00 • R r N WATER HTR. GAS ELEG Base lee as incinerator 1st In ga#uge 2nd 3rd 4th • Future Connection Openings New Fixture, Old Openings Connected with I Seger Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ..................... Future Fixture Opening ............... New Fixture Old Opening ............. Catch Basin .......................... Water Heater (Up to 99,000 BTU) .... . New Ground Run Old Bldg. ........... Electric Water Heater GAS FITTING FEES: x $2.00 $ x $1.50 $ x $1.50 $ x $3.25 $ x $3.00 $ x $3.25 $ a $2.00 $ NO. RATE TOTAL 1st 3 Fixtures .......................... x $2.00 $ Additional Fixtures .................... x $ .75 $ Gas Range to 199,000 BTU .............. _� x $5.00 • oo REPAIRS & ALTERATIONS—Refer to Code 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. Fridley, Minn 27 Dec 6a 19_ Owner E• Stift,er Kind of Building fr Used as res To be completed about 2 Jan 69 Estimated Cost, $ 5900 Q' Old—New. Building Permit No Permit No. O By . Business Phone o Co. ROUGH FINAL—JL-L-2- 3?? CJ Description ................................................$ TOTAL FEE $ 5 • DD A z '60 SUBJECT P MIT NO. -41 City of Fridley Ni' 16977, AT THE TOP OF THE TWINS BUILDING PERMIT rp REC � •COMMUNITY DEVELOPMENT DIV. �y------_ y r � � PROTECTIVE INSPECTION SEC. I =� ----I CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 4128 JOB ADDRESS 7376 Memory Lane N.E. 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 15 3 1 Melody Manor 3rd Addition SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE Clyde Pricer 7376 Memory Lane N.E. 786-9573 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Northwestern Ccmpany 6336 Lakeland Avenue 536-8979 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 Reroof Dwelling 9 CHANGE OF USE FROM TO STIPULATIONS Roof can be 2nd layer but not 3rd. Install ridged galvanized valleys. 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 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 $3,000 $1.50 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- $38.550 RUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE ,� C.-�-•�. " r,., . $40.00 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) WEN PROPERL VALIDATED THIS IS YOUR PERMIT mea BLDG I DATE SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) CITY OF FRIDLEY Effective Aug. 1, 1961 APPLICATION FOR RESIDENTIAL BUILDING PERMITS (New. Alterations. Additions. or Repairs) OWNER: &� & P,e,`r-, �!- ' ADDRESS: _ -7376 /%� /per, C �✓�i-ia TEL 00: ;�jp6 _ MILDER: ` ADDRESS: TEL 110: 6- 3 G_ k F Construction Location - STRICT NO: �.i STREET: LOT: S� BLOCK: �` S' ADDITION: 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 MMSTRUCTION Front: Depth: Height: Square Feet& Cubic Feet: Front: Depth: Height: Square Feet: Cubic Feet: 'type of Construction: jo s -(?7` Estimated Cost: Zb Be Completed: Alt. A Alt. 8 Proposed Drivm.;ay Width If New Opening Is Desired: S S SEE MVERSE SIDE OF SHEET Zile undersigned hereby mages application for a permit for the »ork herein specified, agreeing to do ,all Work Ira strict accordance with the City of Fridley Ordinances and rulings of the Deiy-artment of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Dr -&TE: zl azlf3 Stipulations: SUBJECT PE City of Fridley 2 88 AT THE TOP OF THE TWINS BUILDING PERMIT t 1 1 I. �� ______; COMMUNITY DEVELOPMENT DIV. `3 I;PROTECTIVE INSPECTION SEC. �t .'lJ 1 � _ CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910-F15 9/21/98 JOB ADDRESS 7376 Memory Ln 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 15 3 Melody Manor 3rd SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Mario Pricer 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Scharacon 16700 N Hillcrest Ct Eden Prairie 55436 949-8668 20103863 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 O NEW O ADDITION O ALTERATION Ck REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Reroof house & garage (24SQ) 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 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 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 $2 056.00 $1.03 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- $74.75 Fre SC $2.06 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTAL 'E 6_�-.�— °`oZ Licens S $5.00 $82.84 SIGNATURE O CO RACTO O AUTNORIZEOAGENT IDATEI N I UR P 6PMPER�MI.S SLOG NSP / y GATE S-GNATURE OF OWNER --F OWNER SUILDERI IDATEI NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER (] SINGLE FAMEL Y AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: 73 76 rpt ,�-7 m 4�-c Li- � Legal Description: Owner Name & Address: 0 4-r- c V\ PF e- (Z 7 3 2,6 t'k f M £-Y LA -;'j Tel. # Contractor: "A-9 - --4-1 MN LICENSE # '2 01 p 1!0 Address:? 3 76 m i tu LA'A)S Tel. # 9?'9 -S'Mr 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: Construction Type: Estimated Cost: $ '?0 (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: q -J- I- %k APPLICANT: Sd 9A -f �- l ®11 Tel. # I Y q - ka?- Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control $ S-ao Park Fee $ Sewer Main Charge TOTAL STIPULATIONS: i 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 [ ] �J