PRE 2010 DOCSBUILDING PERMIT
Village of Fridley, Minn.
te
Datet. �jr�� ..............................
Owner . irF.Jr" .. a....... Builder ..................
2149
Address l -0--r Address ...................... .
LOCATION OF BUILDING
No. .. F` I /........ Street x-:�itarrR °' L V... Part of L .......................
Lot .......# ...... Block .. �P 9 " ........ Addition or Sub -Division' s Of& ............
Corner Lot ............ Insidd Lot ............ Setback .. ..... Sideyard.......................
DESCRIPTION OF BUILDING
To be Used as:
Front j , ... Depth . J,.Ze. Height �! ,` .. Sq. Ft. .
V
l ...... Cu. Ft.........
.................... Front ........ Depth ........ Height ......... Sq. Ft. ..... Cu. Ft. ........
Type of Construction . sash Est. Cost 'ff VW..4 ....... To be Competed
1-4
In consideration of the issuance to me of a permit to construct the building
the proposed work in accordance with the description above set forth'and in co
ordinances of the village of Fridley. „en
eo ideration of the payment of a fee of $... �' . , permit is ereby granted to
+'..... to construct the building4g�addition as escribed above. Th
Joe&ress con tion that the person to whom it is granted and his agents, employees
done in, around and upon said building, or any part thereof, shall conform in all respe
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and
in the village limits and this permit may be revoked at any time upon violation of any
ordinances. a- I
..e le At
NOTICE:
This permit does not cover the construction, Installation or alteration for wiring,
sewer or water. Be sure to see the Building Inspector for separate permits for these
I above, I agree to do
with all provisions of
Wmit is granted upon
workmen, in all work
to the ordinances of
ring of buildings with -
the provisions of said
P. Building Inspector
Ing, gas heating,
AK V I U L. GAS LUN d AGN INC.
3200 FRANCE AVE. SO.
3rd.
STREET
CLEARVIEW STREET
N. E. '
w
z
w
01
SUBJECT
P IT
City of Fridley
15 615
AT THE TOP OF THE TWINS
BUILDING PERMIT
_
f
CEIPT NO.
�
______ COMMUNITY DEVELOPMENT DIV.
v
-70
r I PROTECTIVE INSPECTION SEC.
Q
i I ,
"1 CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
I.J 612-571-3450
910-F15
2/27/80
JOB ADDRESS 187 Panorama. Avenue N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
4
5
Carlson's Su mit Manor South Addn. SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Mary Tomato 187 Panorama. Avenue N.E. 561-4246
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Richard Hastings 6331 Riverview Terrace N.E. 574-9966
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO,
5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof and Reside structure
9 CHANGE OF USE FROM TO
STIPULATIONS
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
$3,200
$1.60
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-
$21.00
STRUCTION OR THE PERFORMANCE F CONSTRUCTION.
%J
PLAN CHECK FEE
TOTAL FEE
UJ,/% /fir
$22.60
SIGNATURE OF CONTRAC&A OR AUTHORIZEDAGENT IDATEI
WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT
BLDG )NSP DATE
SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE)
01
CITY OF FRIDLEY
APPLICATION FOR RESIDENTIAL BUILDING PERMITS
(New, Alterations, Additions, or Repairs)
OWNER: BUILDER:,
ADDRESS: ADDRESS: G•�
TEL NO: •A Y TEL NO: S' 7 y — 9
Construction Location
STRUT NO: STREET:
LOT:'' BLOCK: ADDITION: / Jj SU yu -5 *4, r M AA,;,; R S
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 CONSTRUCTION
Front:
Square.Feet:
Front:
Depth:
Height:
Cubic Feet:
Depth: Height:
Square - Feet: Cubic Feet:
Type of Construction: Estimated Cost: $
To Be Completed:
Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired: $ $
SEE REVERSE SIDE OF SHEET
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 rrect.
DATE: ; r/ SIGNATURE:
Stipulations:
r
SUBJECT
PERMIT iT.'r
City of Fridley
2 7 5 3 8
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
/
r PROTECTIVE INSPECTION SEC.16
4
1 �
NUMBER
REV
DATE
PAGE OF
APPROVED BY
=
I 1 CITY HALL FRIDLEY 55432
I'J 612-571-3450
910415
9/3/98
10B ADDRESS
187 Panorama NE
1 LEGAL
LOT NO. BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
4 5
Summit Manor_South
SHEET
2 PROPERTYOWNER MAIL ADDRESS
ZIP PHONE
Tomala572-9716
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Viking Home Im r
-189() 4779
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 X4p REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof house and garage 17 SO Tear-off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlaymen¢t must comply with the State Building Code.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REOUIRED 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 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
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
1456
.73
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,
$48.50
Fire SC $1.46
PLAN CHECK FEE
TOTAL FEE
License SC
5. 0
1155.69
SIG A URE v 66INT,RAC?O OR AUT GRIZEDAGENT IDAT I
WHEN PROPEPnffl VA IDATED THIS IS YOUR PERMIT
BL G INSP
�" OATE
S,GNATURE OF OWNER OF OWNER BUILDERI IDATEI
NEW Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: /97 A4,0 006+01-4
Legal Description:
Owner Name & Address: To X4/,1 Tel. # jrra—Im(
Contractor: 4/ x i� /W A, - --' . MN LICENSE # t,/ 7 7 Z
Address: "j a, A k' 'Sn ,cJ r,� > Tel. # cM -rfr a -o
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:%2 Z7 Estimated Cost: $ /7 g&
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $
DATE: APPLICANT: - Tel. #,572— /920
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
$ LIS-,
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 [ ]
l
Su9jECT
PE
City of Fridley
1054
AT THE TOP OF THE TWINS
BUILDING
PERMIT
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
INSPECTION SEC.
733
r PROTECTIVE
1 � �
NUMOEN
REV
DATE
PAGE of
APPROVED 8Y
CITY HALL FRIDLEY 55432
L J` 612-571-3450
910-F15
6/13/00
JOB ADDRESS 187 PANORAMA AVE. NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
4
5
Summit Manor - South
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP
PHONE
Marvin & Elenore Tomala 187 Panorama Ave. NE
763-572-8716
3 CONTRACTOR MAIL ADDRESS
ZIP
PHONE LICENSE NO
Window Lite 8400 - 89th Ave. N #460 Brooklyn Park, MN 55445
763-425-2227 20039258
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP
PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP
PHONE LICENSE NO
8 USE OF BUILDING
7 CLASS OF WORK
O NEW O ADDITION ❑ ALTERATION] REPAIR
O MOVE O REMOVE
8 DESCRIBE WORK
12 Replacement Windows
9 CHANGE OF USE FROM TO
STIPULATIONS
Provide Smoke Detectors in all sleeping rooms and on levels
of the dwelling
per Sec. 310.9.1.2 1997 Uniform 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 rLG. UNITS
OFFSTREET PARKING
1 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
$7,673.00
$3.84
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
PLAN CHECK FEE
TAL FEE
Lice I $
7$169.76
SIGN A TURE OF CONTRACTOR OR AUTHORIZED AGE NT
H N
Y VA D TED THIS IS YOUR PERMIT
:iDATE,
S-GNATURE OF OWNER SIF OWNER BUILDER$ EI
DG $NSP,
oATE
l
NEW [) Effectiv 1/1/99
ADDN [ ] CITY, OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION l
ConstructionAddress: k$, 1 CL(\ p C CAW\ A -AJt. N E V
Legal Description:
Owner Name & Address: Marvin t 1 en cr•e. 1 o m c AQ Tel. # 5-7Z -2 -7 1 to
Contractor: \wJyr\ myj Lit _ MN LICENSE # 200 SCIZ 5 $
Address: $yoo SSW\ A` e. N. %"4tpo 'grm\A�lrn %rK tAw , t;41Tel. # (731 Li2S -2227
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:
�� �Q�p
��K,;f ),' stimated Cost: $ (x75.00
(Fee Schedule on Back)
Driveway Curb Cut Width Needed:
Ft. + 6 Ft = Ft x $ _ $
DATE: 5-30-Z000 APPLIC
Tel. # —63YI-A-Z.2Z 3'
CITY USE ONLY
Permit Fee
$ 159, d
Fee Schedule on Reverse Side
Fire Surcharge
$ 9, & —
.001 of Permit Valuation (1/10th%)
State Surcharge
$ 3, 1'q-
$.50/$1,000 Valuation
SAC Charge
$
$1050 per SAC Unit
License Surcharge
$ 51 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 Engineering
Sewer Main Charge
$
Agreement Necessary [ ] Not Necessary [ ]
TOTAL $
STIONS c1�0!//O�` //fit rrrtVft12?X—
120=Nc- 04wo div ALL
N
SUBJECT
City of Fridley
31760 '
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
_ COMMUNITY DEVELOPMENT DIV.
�0®
RECEIPT NO.
r PROTECTIVE INSPECTION SEC.
1 �
1 ; �
CITY HALL FRIDLEY 55432
�p
NUMBER
REV
DATE
PAGE OF
APPROVED BY
612-571-3450
910415
4/24/01
JOB ADDRESS 187 Panorama Avenue NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
4
5
Carlson's Summit Manor South Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Marvin Tomla 187 Panorama Ave NE 763-572-8716
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO
Above All Roofing 5089 Salem Ln, Greenfield, MN 55357 763-498-8888
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
20180384
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION xp REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reside Garage; Reroof Garage (4 Sq) Tear-off; Replace Garage Door
9 CHANGEOFUSEFROM TO
STIPULATIONS
Call for building wrap and ice shield inspections before covering.
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 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
1 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
@2,209
$1.10
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
W
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
ROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON.
$83.25
Fire SC $2.21
TR CT OR THE PERFOR NCE OF CONSTRUCTION
PLAN CHECK FEE TOTA EE
Licens $9 .56
TURE OFC 'RACTOR OR AGENT IDATEi
��ii$5.00
ENVO E ALIDAT D HIS IS YO P MIT_/
BLDjr NSp GATE
GNATURE OF OW NER„F OWNER BUILDER, (DATE,
N
NEW []
ADDN [ ]
ALTER [ ]
Construction Address:
Legal Description:
Owner Name & Address:
Contractor:
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Construction
Effective 1/1/2001
CITY OF FRIDLEY (763) 572-3604 Bldg Insp
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
03
Tel. # %l
MN LICENSE # Q—W 1 5?�9R
_Tel. # 76 3 W
Attach to this application, a Certificate of Survey bf the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
f� P
Length Width Height /�
9Sq. Ft.
Length Width Heigh,// --Sq. Ft.
Width H round Sq. Ft
a,q,M ac o
-A E&Zsff
Estimated Cost: $
Z?o
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x
DATE: `"� APPLICANT: ��'� Tel. #4
CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application
Permit Fee $ Fee Schedule on Reverse Side
Fire Surcharge $-/ .001 of Permit Valuation (1/10th%)
State Surcharge $ /. $.50/$1,000 Valuation
SAC Charge $ $1150 per SAC Unit
License Surcharge $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 $ %, 67
STIPULATIONS:
CITY OF FRIDLEY COMMUNITY DEVELOPMENT DEPARTMENT
TOTAL P.01
P LU M BI Nl%Pe�trttif
umber
RESIDENTIAL APPLICATION
Roca" By
City of FridleyR�L
OD � 2008
NOTE: IF PROPERTY IS NOT OWNERfOCCUPIED- A LICENSED CONTRACTOR MUST OBTAIN THE PERMIT.
DATE YOUR E-"L ADDRESS
SITE ADDRESS
THE APPLICANT IS: (CIRCLE ONE) OWNER pNTRAC70
NAME —WQrV1K �0`%'1
PROPERTY OWNER/
TENANT
ADDRESS c] % �•�lU Y�/l,✓yZ
CITY STATE_
PHONE
NAMELICENSE #
CONTRACTOR
ADDRESS
CITY mpg -010., ATE t7P,_,_�
PHdNE #1-1 llly 0040Z
754F
PERMIT TYPE
v -:_SINGLE FAMILY TWO FAMILY TCWNHDUSE
Q NEW REPLACEMENT
TYPE OF WORK
DETAILEDNOF WORK , 01121? 4-�
FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED
FIXTURES: (INDICATE TOTAL NUMBER OF EACH)
BATH SBIKMV —FLOOR DRAINS SirQWER WATER PIPING
BATHTUB GAS PIPING (Need City Ueanae) swtellUMG POOL WATER SOF IENBR ($S5)
CLOTHES WASHER KITCHEN SINK WATER CLOSET BACKPLO1W PRE/. ($15)
D1SIf WASHER LAUNDRY TRAY WATER HTR (SM FOR IRRIGATION
WATER METER OTHER
® v
Permit Few $35 MINIMUM: $18.00 or 3% of cost of the Improvement-whichever is
Plan Review $ greater on work less than $300
Surcharge S •80 `
TOTAL DUE S , Make checks payable to: City of Fridley
THIS IS AN APPLICATION FOR A PERMIT — NOT VALID UNTIL PROCESSED
1 hereby apply for a plumbing permit and i acknowledge that the information above Is complete and aoourate: that the work will be in conformance vitt►
the ordinances and codes of the Clty of Fridley and with the Wrinesote Construction Codes: that I understand this is not a permit but only an
application for a permit and vmW is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work which
requires review and approval of plans.
NAME OF APPLICANT ( 4� )"— DATE / cJ
Please type ar pri t
SIGNATURE OF APPLICANT fe,
CITY OF FRIDLEY COMMUNITY DEVELOPMENT DEPARTMENT
TOTAL P.01