PRE 2010 DOCSCity of Fridley
SUBJECT
PER
16 3 8 4
AT THE TOP OF THE TWINS
B U I L D I N G P E R M I T
r
R E C?i;��
• COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
L 612-571-3450
910-F15
9/14/81
JOB ADDRESS 6610 Pierce Street N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
3
1
Alice Addition SHEET
2 PROPERTY OWNER MAILADDRESS ZIP PHONE
Burton Scherven 5960 Anna Avenue N.E. 571-8896
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Nordaas American Homes 507-462-3331
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESSSEPARATE PERMITS REQUIRE® PMh 't•,�L�l��NO.
^((����
8 USE OF BUILDINGHEATING, PLUMBIM AND �
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR REMOVE
R
8 DESCRIBE WORK
� i0cat q
Construct a 38' x 40' Dwelling and a 20' x 24' Garage glove mr.. G9 Etc-
rot%EM
by LAW
9 CHANGE QF USE FROM TO
STIPULATIONS GARAGE MUST BE SETBACK 17.5 FEET FROM SIDE STREET PROPERTY LINE UNTIL
VARIANCE IS APPROVED. Provide a hard surface driveway. Provide sod in the front
and side yards. Provide City with copy of verifying survey before capping.
SERVICES NOT PROVIDED
SEWER LOCATION: 10" CMP available on 66th Avenue, 10' S. of Center Line.
Approximately 20' Deep. M.H. Located @ centerline of 66th & Pierce Street
WATER LOCATION: 6" CIP located on Centerline of 66th & 10' West of centerline
of Pierce Street
DRIVEWAY DEPRESSION COST: N/A THIS C!?Y op k1r)j Y NCi
Gu,��AN1;�E
ACCt�RAC U1 vii iQCAttpl�lS
AM EMAftNs.
it11S OAtA 15 Q tIV Ytq RURMUS
ONLY AND,
PERsor�s ! rt SNtMItb vlt
ON THE Sitt �a>
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
Wood Frame
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
1
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
$52,050
$26.03
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 COW
$292.00
$425.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
$ 73.00
$816.03
SIGNATUREO CONTRAC A ORIZED AGENT ATEI
WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT
D
BLDG INSP D E
-' SIGNATURE OF OWN R IIF OWNER BUILDER) 1DATE)
MMISTERZD YNOM LAWG OF OTATR OF MINNMOTA
UCEN"D NY ORDINANCB OF CITY OF MINKRAFOUR
3616 EAST VOTH STREET PA. 4-4661
�ilL'btpOt'� Q�tl'Ht
HEREMY 4- - -
Lot 3Block 1,
xpu`vu
Beiote dtigging call RIC 1 GAS Etc.
ELECj �
�ELEPNQ�E' ED BY L A
R�Q�11R
wN. NO. 3600
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CITY OF FRIDLEY
Effective Aug. 1, 1981
APPLICATIM FOR RESIDENTIAL BUILDING PEMITS
(New, Alterations, Additions, or Repairs)
OW14ER: �,. � ���.;�� BUILDER:
ADDRESS: r�/,, U /�� ��. z� ADDRESS:
TEL NO: X71 fig -_2G TEL Id0: j—y7— VGZ 133/
Construction Location
STREET NO: O STREET: A��� - ,� Z-
LOT: �� BLOCK: �_ ADDITION: �p Cmc%ate
Corner Lot: Inside Lot: Setback: Sideyards:®f
Applicant attach to this form two Certificates of Survey of lot and
proposed building location drawn on certificates to scale.
DESCRIPTION OF CONSTRUCTION
'd Front: Depth: Height: 8 r ST 9
Square. Feet: /�/�, Cubic Feet:
aged 2e. Front: Depth: Zy Height: 57ud_c
Square -Feet: Cubic Feet:
szom od
Type of Construction: c ,(' ®3 Estimated Cost: $ ,
Tb 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 wort: in strict accordance with the City of rridley Ordinances and
rulings of t] -ie Department of Buildings, and hereby declares that all the facts and
representations stated in this application are true and correct.
DATE: � � SIGNATUM:
Stipulations:
P.9.0 ' aim 29Z.00
P.Q.
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CITY OF FRIDLEY
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
RATE SCHEDULE
PLUMBING FIXTURE RATES: NO.
New sixtures
Future Fixtures
Old Opening, New Fixture
Beer Dispenser
Blow Off Basin
Catch Basin
Rain Water Leader
Hydraulic Valve
Sump or Receiving Tank
Water Treating Appliance
Hot Water Beater /
Gas Range
Gas Dryer
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
It of Value of Fixture or Appliance
RATE
$ 5.00
$ 3.50
$ 1.50
$ 4.00
$ 5.00
$ 5.00
$ 5.00
$ 5.00
$ 5.00
$ 7.00
$ 5.00
$ 10.00
$ 10.00
Reinspection Fee $ State Surcharge
($15.00) TOTAL FEE
4001.10
Job Address ( 610 j
Department of Buildings
City of Fridley
Tel. #571-3450
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the City Codes
and rulings of the Department of Buildings, and hereby declares that all
the facts and representations stated in this application are true and correct
OWNER
KIND 0
Fridley, Mn. /�� Z— ` , 19 sl
USED AS
TO BE COMPLETED ABOUT
ESTIMATED COST —3000 —C> -C Q®DC>-C
OLD - NEW BUILDING PERMIT NO. PERMIT NO. (::576(7/
ROUGH INSP.
Date
FINAL INSP. ,6 — 2- - ?�
Date
APPROVAL FOR PERMIT
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $10.00
PLUS THE $.50 STATE SURCHARGE
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3rd
4th
(R) a Future Connection Opening
Connected with Sesser
(*) - New Fixture, Old Opening
Water
RATE SCHEDULE
PLUMBING FIXTURE RATES: NO.
New sixtures
Future Fixtures
Old Opening, New Fixture
Beer Dispenser
Blow Off Basin
Catch Basin
Rain Water Leader
Hydraulic Valve
Sump or Receiving Tank
Water Treating Appliance
Hot Water Beater /
Gas Range
Gas Dryer
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
It of Value of Fixture or Appliance
RATE
$ 5.00
$ 3.50
$ 1.50
$ 4.00
$ 5.00
$ 5.00
$ 5.00
$ 5.00
$ 5.00
$ 7.00
$ 5.00
$ 10.00
$ 10.00
Reinspection Fee $ State Surcharge
($15.00) TOTAL FEE
4001.10
Job Address ( 610 j
Department of Buildings
City of Fridley
Tel. #571-3450
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the City Codes
and rulings of the Department of Buildings, and hereby declares that all
the facts and representations stated in this application are true and correct
OWNER
KIND 0
Fridley, Mn. /�� Z— ` , 19 sl
USED AS
TO BE COMPLETED ABOUT
ESTIMATED COST —3000 —C> -C Q®DC>-C
OLD - NEW BUILDING PERMIT NO. PERMIT NO. (::576(7/
ROUGH INSP.
Date
FINAL INSP. ,6 — 2- - ?�
Date
APPROVAL FOR PERMIT
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $10.00
PLUS THE $.50 STATE SURCHARGE
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley. MN 5.5432
572-3604
Stories Closet . Urinal
Basement
Floor 1
Floor 2 i
Floor 3
Floor 4 I
PLUMBING FIXTURE RATES:
Effective On August 1, 1995
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARK NUMBER OF FIXTURES T0� BE INSTALLED ON EACH FLOOR
Lath _�__ —Wash Qr k ; ,I Floor Cater : Auto. Gas ' Gas 9Vlisc: ^Water tar
ub ;:Shower Sink; :Tia Fount:::: Orcin Basin `. Wash�rr I: -: Ran Fixt
NO. RATE TOTAL JOB
New Fixtures
Old Opening, New Fbdure
Beer Dispenser
Slow Off Basin
Catch Basin
Rain Water Leader
Sumplftec&ing Tank
Water Treating Appliance
Water Heater —Electric
Water Heater -- Gas*'
Gas Range—
Gas Dryer**
Back Flow Preventer Required ( )Yes () No
Type
$ 7.00
$ 4.00
$ 5.00
$ 7.00
$ 7.00
$ 7.00
$ 7.00
$10.00
$ 7.00
$10:00
$10.00
.$10,00
$15.00
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the city codes
and rulings of the Building Division, and hereby declares that all the facts
and representations stated in this application are Irve and correct.
/ - —
Owner
Building Used As
IEstin ated Cost PERMIT NO.
PLUMOR
Reinspection Fee S42.00/Hr SIGNED
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture orAppiiance Z.
Approved By _ Rough—in Date Final Date
State Surcharge
$ .50
TOTAL FEE
�-
MINIMUIN FEE
PLUS THE S.50
FOR ANY PLUMWN G/
STATE SUR ARGE
**COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 SO INCHES.
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As suitvaym sy us Tmis 13th - --Cktv cw March -A.D. 1964
F. C.
CITY OF FRIDLEY
8431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432
Mr. Burton Scherven
6610 Pierce Street N.E.
Fridley, PST 55432
TELEPHONE ( 612)571.3450
Re: Final Inspection at 6610 Pierce Street N.E., Fridley, PMT
Dear Mr. Scherven:
A final inspection was made on June 9, 1982 of the above noted address and
the following items were noted which must be completed before the
construction can be finaled out:
1. Provide the City with a copy of the verifying survey.
2. Post address numbers on structure.
3. Secure exterior porch door.
4. Provide a hard surface driveway by September 1,-,1982
We will expect items #1, #2 and #3 to be completed by July 1, 1982 and
item #4 to be completed by September 1, 1982 when reinspections will be
conducted to determine compliance.
If you have any questions on these items, please feel free to contact me at
571-3450.
Sincerely,
DARREL G. CLARK
Chief Building Inspection
DGC/mh
a• � ry`�
F
r'j
Ob'�M y4 r'v>4
June 14 1982
ria #Aµ2
k{
CITY OF FRIDLEY
8431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432
Mr. Burton Scherven
6610 Pierce Street N.E.
Fridley, PST 55432
TELEPHONE ( 612)571.3450
Re: Final Inspection at 6610 Pierce Street N.E., Fridley, PMT
Dear Mr. Scherven:
A final inspection was made on June 9, 1982 of the above noted address and
the following items were noted which must be completed before the
construction can be finaled out:
1. Provide the City with a copy of the verifying survey.
2. Post address numbers on structure.
3. Secure exterior porch door.
4. Provide a hard surface driveway by September 1,-,1982
We will expect items #1, #2 and #3 to be completed by July 1, 1982 and
item #4 to be completed by September 1, 1982 when reinspections will be
conducted to determine compliance.
If you have any questions on these items, please feel free to contact me at
571-3450.
Sincerely,
DARREL G. CLARK
Chief Building Inspection
DGC/mh
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432
Mr. Burton Scherven
6610 Pierce Street N.E.
Fridley, MN 55432
TELEPHONE ( 612)671.3450
Re: Final Inspection at 6610 Pierce Street N.E., Fridley, MN (SBOOND NOME)
Dear Mr. Scherven:
A final reinspection was made on July 1, 1982 to determine ccupliance with
our letter of June 14, 1982. The reinspection found the following items
still need to be completed before the structure can be finaled out;
1. Provide the City with a copy of the verifying survey.
2. Provide a hard surface driveway.
We will expect Item #1 to be completed by July 26, 1982 and Item #2 to be
completed by September 1, 1982 when a reinspection will again be conducted to
determine compliance.
If these items can not be completed by the scheduled dates, please contact me
at 571-3450.
Sincerely,
CDa;'W -
DARREL G. CLW
Chief Building Inspector
DGC/mh
SUBJECT
City of Fridley
25438
AT THE TOP OF THE TWINS
BUILDING
PERMIT(
rp
PT NO.
• COMMUNITY DEVELOPMENT DIV.
qc-jca
r I PROTECTIVE INSPECTION SEC.
NUMBER
REV
DATE
8/27/97
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
x.__.11.' '•�
612-571-3450
910-F15
JOB ADDRESS 6610 Pierce Street NE
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
3
1
Alice Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Berton Scherven 6610 Pierce Street NE
571-4480
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
The Gopher Company Inc 445 Malcolm Ave SE, Mpls., MN 55414 331-1555 8617
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
❑ NEW ❑ ADDITION O ALTERATION? REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Reroof House & Garage (29 Sq) 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
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
$2,418
$1.21
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.
$74.75
ire SC, $2.42
PLAN CHECK FEE
OTAL FEE
Lice ns SC
$ 00
$83.38
SIGNATURE OF CONT RACTORORAUTHORIZED AGENT IDATEI
P
Y VA Z;ED THIS IS Y U PERMIT_
1><HE
B^ INSPF
GATE
S.GNATURE OF OWNER OF OWNER BUILDERI IDATEI
NEW [ ]
ADDN [ ]
ALTER [ A
ConstructionAddress:
Effective 1/1/97
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION 9-7�4�
6 610 Pierce Street N. E. Fridley, MN 55432
Legal Description:
CITY USE ONLY
Permit Fee
Owner Name & Address: Berton Scherven
Tel. # 571-4480
Contractor: The Gopher
Company, Inc. MN LICENSE# 8617
Address: 445 Malcolm Avenue S. E. Mplq, MN 55414
Tel. # 331-1555
.001 of Permit Valuation (1/10th%)
Attach to this application, a Certificate of Survey of the
$
1.21
lot, with the proposed construction drawn on it to scale.
SAC Charge
$
DESCRIPTION OF E%IPROVEIVIENT
$950 per SAC Unit
LIVING AREA:
Length Width Height
Sq. Ft.
GARAGE AREA:
Length Width Height
Sq. Ft.
DECK AREA:
Length Width Hgt/Ground
Sq. Ft.
OTHER:
tPu.S 7Z �1 =E-
7"
1$450.00 Conservation Plan Review
Construction Type: Tear -Off & Re -Roof
Driveway Curb Cut Width Needed: Ft. + 6 Ft =
DATE:
Estimated Cost: $
Wee Schedule' ---6n Back)
_Ft x $ =$
APPLICANT: Tel. # 331-1555
STIPULATIONS:
-. .
CITY USE ONLY
Permit Fee
$
74.15
Fee Schedule on Reverse Side
Fire Surcharge
$
2.42
.001 of Permit Valuation (1/10th%)
State Surcharge
$
1.21
$.50/$1,000 Valuation
SAC Charge
$
$950 per SAC Unit
License Surcharge
$
5.00
$5.00 (State Licensed Residential Contractors)
Driveway Escrow
$
Alt. "A" or Alt. "B" Above
Erosion Control
$
1$450.00 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement Necessary [ ] Not Necessary [ ]
TOTAL
$
83.38
STIPULATIONS:
-. .
Building
BUILDING
Permit Na.: l' a % 1
Inspections
RESIDENTIAL APPLICATION
ReceitiedBi.
763-572-3604
CITY OF FRIDLEY
Date Rec'
763-502-4977 FAX
EFFEC11V,T 1-14)8
DATE 'S - ZS - O$
YOUR E-A•LAIL ADDRESS
sITF ADDREsS (®(01 O
P S E KC. E 5"C NE
THIS APPLICANT IS: )KOIWNM OCONTRACTOR
PROPERTY OWNER!
NAME: PA0L C -BALES L:tNC.oL_N
TENANT
ADDRESS: (AAO PT -ERC -6 --C NE Crn- 59=PLEY
STATE MNzip 5S43Z
PHONE: `1(o3 — 5 B % e JR 0-7 2 -
NAME: NAME:
ADDRESS: CITY
STATE? ZIP
CONTRACTOR
SUBMIT A COPY OF
PHONE FAX
YOUR STATE LICENSE
STATE LICENSE EXT DATE
PROPERTY TYPE
>10CINGLE FAMILY/NEW CONSTRUCTIONSIZE4 O O
D TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
D ADDITION 0 GARAGE SHED O WINDOWS
0 BASEMENT FINISH 0 ROOF 0 DRAIN TILE
` xDE(1: 0 SIDING 0 OTHER
0 SWIK96E NG POOL
TYPE OF WORK:
0 NEW HOME CONSTRIx- TON D ADDITION
0 MAINTENANCE REPAIR 0 REAK)DELING
DESCRIBE WORK BEING DONE: A DbZ T%) al of: R e G.{F AMD R e M OV cal.. +
RE r l A C f; ME t t T ®F 0 r' 0 v
SIZE OF 11JPROVEAIENT
LENGTH L4 Z °� WIDTH 12 � HEIGHT , SQ FT
ROOFING
0 HOUSE ONLY
BASEMENT
REMODELING SUBMIT:
NUMBER ()F SQL? ARES
0 HOUSE & GARAGE
1.
Egg Floor Pin
GARAGES
0 ATTACHED GARAGE 2.
Proposed now plan
PROPOSED SIZE:
0 DETA(IM GARAGE 3.
List of shuebral members to be used
PROPOSEDHEIGHT:
�• /� = 3? ��5� b0 FOR NEW CONSTRUCTION INCLUBING DECKS,
SIDING
�' �Q Ji, _ . ADDITIONS.
& PORCHES SUBMIT:
D Vinyl
D Aluminum
OSoffit
0 Trim 1.
Site PlanSan e} showing the esrstiag stmetmes
D Other
0 Fascia
and proper pm]ecL
2.
Two sets of coastroc8ion pians
RiNDOWS
3.
Energy Calculations
IN EXISTING OPENINGS DY es C No LOCATION OF WINDOWS
OR FOR NEW OPENINGS-DESCRRME SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NT TMBER OF N°INDO'W-S
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
ING THE 1997 UBC FEE SCHEDULE)
TOTAL JOB VALUATION $ ? ° i9a OCCUPANCY TYPE
Permit Fee $ p 1 See Back Page for Fee Schedule
Plan Review $ 65% of Building Permit Fee
Fire Surcharge $ .001 times the total job valuation
Surcharge $ - / d .0005 x Permit Valuation Minimum $.50
License Stucharge $ $5.00 (State Licensed Residential Contractors)
SAC Charge $ $1825 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 $ / i'0 X19 Make checks payable to: City of Fridley Attach Stipulations
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
I hereby apply for a building penult and I acknowledge that the mkrais ion 1=0.7.1ate and ate, that the work will be in conformance with the offices and codes
of the City of Fridley and with the Minnesota CQasUrrction Codes; that I and not a pemcit but only an application for a pmm3k and work is not to stad without a
permit on site; that the work will be in mance with p case of all work which requites review and approval of plans.
SIGNATURE OF
WCE