PRE 2010 DOCSCity of Fridley, Minn. N° 8046
BUILDING PERMIT
Date: dune 28. 1965
Owner: Art. Larsen Builder Clemron, Inc.
Address 7382 Memory Lane ASS 30,. Columbia Blvd
LOCATION OF BUILDING
No. 7382 Street Memory Lane Part of Lot
Lot 3-7 _ Block 3 Addition or Sub -Division M010dY XQMr
Corner Lot — Inside Lot Setback Sideyard
Sewer Elevation Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
Single Dwelling__ Front Depth Height Sq. Ft. Cu. Ft.
Att. qtL a Front Depth Height Sq. Ft. Cu. Ft.
Type of Construction - FrOM . Est. Cost$24y M.0fl -- To be Completed
New Dvel2ing
In consideration of the issuance to me of a permit t=got-
In
e I agree to do
the proposed work in accordance with the description ab, I provisions of
ordinances of the city of Fridley. consideration of the payment of a fee of26
$ .00 , permit is hereby granted toQ W=M s ne- •
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
ordinanoea
NOTICE:
1h8 permb den not em er the eoostrucden, hnda[Wien for whum ppb & gas heating, sower or mater. Be sore tb see
fhe BuildUng I I I P r for separate panffdu for thea items.
s
APPLICATIQN FOR BUILDING PERMIT
. CITY OF FRIDLEY, MINNESOTA
LOCATION OF BUILDING
of Lot____�_.�
LOTADDITION OR SUBDIVI ON �' 7
Corner Lot Inside LOT Setback c Side-Yard__��
.SEWER ELEVATION FOUNDATION ELEVAT10111
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building.location drawn on these Certificates.
DESCRIPTION OF BUILDING
To be WWd as
Sq. Ft._ Cu. Ft._
4&::e���Front" Depth, Height it /®
Sq. Ft._G/G� Cu. Ft._ �f
Type of ConstructionEstimated Cost.�����
=—r
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 corre-M7.
DATE_ $ SIGNATURE
T- T
(Schedule of Fee Costs can be found on the Reverse Side).
4 � +
From: City of Fridley Tc: 7637542908 Page: 4/4 Date: 4/1612009 11: 00:10 AM
Buildm' Ly PLUMBING
InspeCtions RESIDENT kL APPLICATION
76'.-U- 2-3050A _'L OF F LEY
763-502-4977^ A.1;
EE•FECTIVE=_19-oc'
DATE F�
SITE: ADDRESS
HIS APPLICANT IS:
PROPERTY
OWNER/
TENANT
❑ OWNER
NAME: �CK T 144
ADDRESS: -'f 3SZ
YOUR E-MAIL ADDRESS
Permit No. 01 -VI:
Received Bv: p�
DateECD: M 2009
A
EXP DATE
EXP DATE
STATE .I "LIP
PERMIT TYPE ,SINGLE FAMILY 11 TWO FAMILY 13 TOWNHOUSE
TYPE OF WORK: 12 NEW �REPLACEMENT
DETAILED DESCRIPTION OF WORK TYIY%i Ick -h ir, 04 ren I ap-em 4- hot -f* head
FEES ARE BASED ON $10.00 PER FIXTUR: EXCEPT WHERE NOTED. FIXTURES: ('INDICATE TOTAL NUMBER
PHONE: J' 4-6 OSLI-�
CONTRACTOR
NAME: �%lV{,(i (%t�1 P1t�yylbi�?•
SUBMIT A COPY OF
YOUR STATE
STATE LICENSE if
LICENSE, BOND AND
STATE BOND It
CERTIFICATE OF
2
ADDRESS: `6 i�Q "IVI Vr CITY
INSURANCE
PHONE �5�� 2lq°I FAX
Permit No. 01 -VI:
Received Bv: p�
DateECD: M 2009
A
EXP DATE
EXP DATE
STATE .I "LIP
PERMIT TYPE ,SINGLE FAMILY 11 TWO FAMILY 13 TOWNHOUSE
TYPE OF WORK: 12 NEW �REPLACEMENT
DETAILED DESCRIPTION OF WORK TYIY%i Ick -h ir, 04 ren I ap-em 4- hot -f* head
FEES ARE BASED ON $10.00 PER FIXTUR: EXCEPT WHERE NOTED. FIXTURES: ('INDICATE TOTAL NUMBER
OF EACH BELOW). MINIMUM FEE
$35.50.
SINIULAV
DRAINS
_SHOWER
_WATER PIPING
_BATH
_FLOOR
PIPING (NEED CITY LIC)
SWIMMING POOL
_ WATER SOFTNER ($35)
-BATHTUB
WASHER
_GAS
SINK
_
WATER CLOSET
PREY. ($15)
_CLOTHES
DISHWASHER
_KITCHEN
LAUNDRY TRAY
aWATER HEATER ($35)
_BACKFLOW
FOR IRRIGATION
_
_
WATER METER
OTHER
THIS IS AN APPLICATION FORA PERMIT -NOT VALID UNTIL PROCESSED
I hereby apply for a plumbing 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 Codd; 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.
SIGNATURE OF APPLICANT �� `� PRINT NAME � �(il, DATE ' ^� / Ili'
City of Fridley
.wilding inspections Department
6431 University avenue NE, Fridiey, IMN 5_5433
763-572-3604
FAX: 763-502-4977