PRE 2010 DOCSCERTIFICATION OF STATUS
OF SUBDIVISION OF
LAND p
I. Property PIN No. l5 302 V StZ fP1at No. 56_ (5Parcel No. 2_U 20
2. Applicant Tele. No.
3. Type of Document:
0 Deed
D Contract for Deed
❑ Other (Specify)
4. Date of Document
5. Grantor:
6. Grantee:
7. Received by City Clerk of )r -,7v 11/ !'
Date:
By:
8. Action Dy city:
Approved:
Date:
9.
Time:
Rejected:
Date: Z
Time: - Q
By: • By:
(If approved - complete stamp on Document)
Reasons: (Cross out inappropriate words)
Qa. Subdivision Regulations (do - ) apply.
b. Subdivision (ate - not approved). (If approved - attach
certified -.copy of Resolution.)
c. Restrictions (waived - not waived) by Council. (If waived -
attach a certified copy of Resolution.)
10. Conditions Imposed:
❑ Combination with PIN No. (Petition of Owner
Others: (Specify) should be attached.)
[]
NOTE: IF SUBDIVISION INVOLVES TORRENS LAND, CONTACT THE EXAMINER OF
TITLES AT COUNTY COURTHOUSE FOR FORM OF DESCRIPTION. (MINNESOTA
STATUTES SECTION 508.47)
SUBJECt
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City O1 Fridley
WRECKING
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AT THE TOP OF THE TWINS
P E R M I T
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COMMUNITY DEVELOPMENT DIV.
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NUMBERDATE
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PAGE O:
APPROVED BY
CITY HALL FRIOLEY 55132
612-571-3450
910-F15
8/9/01
jOB ADDRESS 58 M Mississippi Way NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
1;,3
12
Fridley Park SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Redeemer Lutheran Church 61 Mississippi Way NE 763-574-7445
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO
Varian Companies 669 Winnetka Ave N STE 210 Minneapolis, MN 55427 763-541-9552
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO
8 USE OF BUILDING
Church
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR O MOVE REMOVE
8 DESCRIBE WORK
Wreck Garage
9 CHANGE OF USE FROM TO
STIPULATIONS
All demoliton debris, including foundation & slab, shall be removed
from site. Well and septic tank must be capped and filled in per Code.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
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
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
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-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
PLAN CHECK FEE
TOTAL FEE
20.00
S1 A AE OF CON 'AA A A THORIRIEDACINT IDA i i
WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT
54 107 t) Ie
G TUAE OF OWNERoF NERBU DERE ID E,
BLDG-NSPFIArk
Effective 1/1/01
CITY OF FRWLEY MOVING [ ] WRECKING [ ] PERMIT APPLICATION
6431 University Ave NE
Fridley MN 55432
(763)572-3604
Job Address:
Legal Description:
Owner & Address:
Contractor:
Address:
HOUSE: Length Width
GARAGE:Length Width
OTHER: Length Width
Estimated Cost $
State License #
DESCRIPTION OF BUILDING
Height Sq. Ft.
Height Sq. Ft.
Height Sq. Ft.
Approx. Completion Date
Tel. #
Tel. #
Cu. Ft.
Cu. Ft.
Cu. Ft.
CALL GOPHER STATE ONE AT 651-454-0002 FOR UTILITY LOCATIONS. CALL ALL
UTILITIES FOR DISCONNECTS BEFORE WRECKING/MOVING STRUCTURE.
Water Bill Paid: Yes [ ] or Collect [$
Moving Route:
] Signature
The undersigned hereby makes application for a permit to wreck/move the building described above, agreeing to
do all work in strict accordance with the City Ordinances and rulings of the Building Division, and the State
Code which requires any water well on the property to be sealed by a State licensed water well driller, and
hereby declares that all facts and representations stated in this application are true and correct. ALL
DEMOLITON DEBRIS, INCLUDING FOUNDATION & SLAB. SHALL BE REMOVED FROM SITE.
Date
Signature
Moving Wrecking
Principle building into Fridley .... $300.00 For each 1,000 cubic feet or fraction ...... $1.25
Accessory building into Fridley ... $ 42.00 For structures which would be impractical to
Through or within the City ...... $ 20.00 cube, the fee shall be based on the total cost
Move a building out of City ...... $ 20.00 of wrecking at the rate of $6.00 for each $500.00
or fraction.
PERMIT FEE: MINIMUM $20.00 STIPULATIONS: