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PRE 2010 DOCSBUILDING PERMIT Village of Fridley, Minn. N° 2 916 Date ...................... . Owner....... ....... Builder ...... ...................... Address �� ®.... �. ... Address ...? ......................... LOCATION OF BUILDING Part of Lot ........ �...... 3 '� �:�... ....................... No. ` ...... Street . .... .. . S Lot ../ ......... Block .. Iff ........... Add tion or Sub -Division y Sideyard .. �.� r . Corner Lot ......... Inside Lot ..... .... Setback ..... .. .,,,,,,,, DESCRIPTION OF BUILDING To be Used as: . " ..... ... Front . e.0... Depth . Height Sq. Ft.. /. t�`� Cu. Ft. ........ 704 .................... Front ........ Depth ..,,,./.... Height ......... Sq. Ft......... Cu. Ft, ........ Type of Construct! o e�?? :. Est. Cost /. . ....... To be Completed ... ........ :'� In consideration of the issuance to me of a permit to construct the building described above, I agree to do the proposed work in accordance with the description above set forth and in compliance with all provisions of ordinances of the village of Fridley. .... ... ..... ... ... .� � In consideration of the payment of a fee of $ . permit is hereby granted to .. .. y�� d ^....... ....................... 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 with- in the village limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. NOTICE: This permit does not cover the construction, Installation or alteration for r sewer or water. Be sure to see the Building Inspector for separate permits for f Items. Inspector gas heating, City of Fridley, Minn. BUILDING PERMIT N°5263 �) Date: AFa f Owner: r)VII, 46f Builder �` ' F? - _..__-_— t.w . ....t ._._ Address _ __ _ _ f Address No. + Street .Part of Lot ---- Lot _ _Block ddition or Sub-1)1,vjsion V Corner Lot . Inside Lot _ Satback , Sideyard -.. ---- Sewer Elevation _ _ _ _ _ Foidation Elevation _ DESCRIPTION OF BUILDING Tot y° Front Depth Height Fi. -� Cu. Ft. _._...._.. ntDepth- Height Sq. Ft. Cu: Ft'. Type of Construction - t- - Est. _- To be Completed In consideration of the issuance to me of a permit to construct the building described above, I agree to do the proposed work in accordance with the description above set forth and in compliance with all provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $ .. , 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 buildings within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. , � xwi` Building Inspector NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to we the Building Inspector for separate permits for these items. .QW4 Z t A APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Owner's Name2Builder Address 3 Address �: �c LOCATION OF BUILDING No. � 3 Street ;. Part of Lot Lot Block Addition or Subdivision Corner Lot Inside Lot Setback Side --Yard SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. DESCRIPTION OF BUILDING To be used as: TrontZ � Depth__2 Height / 6 Sq. Ft. Cu. Ft. Height � � 00 Sq. Ft. � Cu. Ft. � 7 `* Type of Construction—,57 Estimated Cost �_ To be Completed — ze 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. -1--n (A Schedule of Fee Costs can be found on the Reverse Side.) . . , ` r,.,......s.- +e..w w r•~ ■ f r r w wrrr.w� r BLOCK , QAi iAiIai Tyn 0-,"' -X7 4 ..................................................................................................................................................................................................................... 04thePlease advise the customer before starting the Job of approximate amount of extra fill and extra concrete and get the OK to go ahead. When the Job is completed, notify the owner and also Arlene of the exact amount of extras used. 0& t Al — 4 . &A a SUBJECT P IT NO. City of Fridley ® 18670 AT THE TOP OF THE TWINS BUILDING PERMIT _ RIPT NO. COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 , ` CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY j 612-571-3450 910-F15 9/30/'86 JOB ADDRESS 6331 Quincy Street N.E. 1 LEGAL LOT NO. TRACTOR ADDITION SEE ATTACHED DESCR. 12 IBLOCK1 8 Christie Addition SHEET 2 PROPERTYOWNER MAIL ADDRESS ZIP PHONE Mary Ann Pierson/Richard Pierson 6331 Quincy Street N.E. 571-5607 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 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 6 DESCRIBE WORK Reside Dwelling/Garage. and Alter Garage 8 CHANGE OF USE FROM TO STIPULATIONS SEPARATE PEliMITS'S PRE-01-11-RED FOR WING, HEAVING, PLUMBINNG AND SIGNS, 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 SQ. 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 1 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 $800. QO $ 50 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMITFEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE $15.50 SIGNATURE FCO TRACTOR UTHORIZED AGENT (DATE) • - +WHEN PROPERLY LIDATED THIS IS YOUR PERMIT BLDG INSP r)AT SIGNATURE OF OWNERIIF OWNER BUILDERI (DATEI NEW [ I City of Fridley Effective 4/1/8c ADD?:. [ ] IR -1 AND R-2 j ALTER. W Building Permit Application Construction Address: ✓ - - Legal Description: ��iI / S i / e /4 Op C i'T V ,�.ra ? f BI -K a C 1181 S 77 Tel. # Owner Npme & Address: � Tel. # Contractor: Address: `s T Al r Attach to this application, a Certificate of Survey of the lot, With the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEHER'T i LIVING AREA: Length Width A y GARAGE AREA: Length j Width DECK AREA: Length ____� Width. OTHER: X .1 4- — Z, Height f Height -IrL_ Hgt/Ground Corner Lot [ ] Insid� [�Q Ft. Yd. Setback - Type of Construction: Estimated Cost: �a C-')' ® o Approx. Completion Date: Sq. Ft. %� U Sq. Ft.��'- 8 Sq. Ft. Side Yard Setback Alt. A Alt P Proposed Driveway Width If New Opening Is Desired: See Back Page for Explanation a DATE: APPLICANT: Tel. # CITY USE ONLY Permit Fee ! eFee Schedule on Reverse Side Plan Check 25% of Building Permit Fee State Surcharge $ 1VU 5.50/$1,000 Valuation SAC Charge $475 per SAC Unit Park Fee Fee Determined by Engineering Sewer Hain Charge Agreement Necessary [ ] Not Necessary [ J TOTAL STIPULATIONS: C)K SUBJECT R&RMff NO• City of Fridley 26526 AT THE TOP OF THE TWINS BUILDING PERMIT r pT NO. _ COMMUNITY DEVELOPMENT DIV.�� L PROTECTIVE INSPECTION SEC. 1 NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEV 55432 612-571-3450 910-F15 7/9/98 JOB ADDRESS 6331 Quincy Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 12 8 1 Christie Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Kevin Sadowski 6331 Quincy Street NE 574-1752 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 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 ❑ ALTERATION � REPAIR O MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House (19 S) 2nd Layer 9 CHANGE OF USE FROM TO STIPULATIONS Roofing can be the 2nd layer but not the 3rd. 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 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 $1,190 $.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- $40.25 Fire SC $1.19 STRUCTION OR THE PE MANCE OF CONSTRUCTION. r c 9 9� PLAN CHECK FEE TOT L FEE $42.04 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI NOP +LD INSP VALIDA. THIS IS YOUR PERMIT qA, SIGNATURE 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• �a31 &&_//Uf� Legal Description: Owner Name & Address: APVIAI � �s,��° s�-�� �s �1ay� ve- Tel. # Contractor: MN LICENSE # Address:. Tel. # 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. /7 GARAGE AREA: ' Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: i Construction Type: O` R'y �a ye,-- Estimated Cost: $ (Fee Schedule, on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: APPLICANT: Tel. # TOTAL STIPULATIONS: CITY USE ONLY Permit Fee $ f Fee Schedule on Reverse Side Fire Surcharge $ , ` .001 of Permit Valuation (1/10th%) State Surcharge $ . 66 $.50/$1,000 Valuation SAC Charge $ $1000 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 STIPULATIONS: SUBJECT N . City ®f Fridley - 2 9 8 91 AT THE TOP OF THE TWINS B U I L ®I N G PERMIT Ir � Vd RECEIPT NO. COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. � / _ `�� j PROTECTIVE 1 i NUMgEFREV DATE PAGE OF A PROVED BY 1 "'1 CITY HALL FRIDLEY 55432 i "'' 612-571-3450 910415 7/19/99 JOB ADDRESS 6331 Ouincy Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 12 8 1 Christie Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Kathy Walksmuth 502-0033 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Steve Bodinski Const. 2 15 135th Lane NW Andnypr 953M 794-RC)17 a 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 O NEW O ADDITION EX ALTERATION XZ REPAIR O MOVE O REMOVE B DESCRIBE WORK 8 Windows; Sheetrock and new sub -floor in 1st floor bathroom 9 CHANGE OF USE FROM TO STIPULATIONS Install smoke detectors to meet the State Building Code - in each sleeping room and on each level of the house. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD 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 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 $10,000 5.00 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SACZ,�, GE PROVISIONS.. OF^ ANY OTHER STATE OR LOCAL LAW REGULATING CON- MANCE OF CONSTRUCTION STR;VIW 81 5 $10.00 PLAN CHECK F S TOT L EE 25 �y�/� ��a�` 44 de SIGNATURE OF CONTRACTOR OR AUTMORIZEO AGENT IDAtE) E RR LIDA E HI$ I$ LIR Q IT 9L iNSo DATE S-GNATUAE OF OWNEROF OWNER BUILDERi iOATEi NEW [ ].. ADDN [ ] ALTER [ ] Construction Address: Legal Description: Effective 5/10/99 CITY OF F UDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION 9 !9 r r. Owner Name & Address: 5-40% W I- , Tel. # �;O — ® 613 Contractor: 5%'�Le4-e-•� f/1"' MN LICENSE # mad •%9Q 6 I' Address: 74 A or r �k�e �� ����� `$f 6'14" Tel. # Attach to this application, a Certificate of Survey of the (l�6� ��G-� yJ• 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: r el �Vs If Construction Type. v61,, t AWt, AAb l/®r lh Estimated Cost: $ elo-o / Ar Rooks &Q - Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: APPLICANT:Zol�eTel. #`�� CITY USE ONLY Permit Fee $� - Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $1050 per SAC Unit License Surcharge $ 0 0 $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 $ STIPULATIONS: G7YOE FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (763) 571-3450 • FAX (763) 571-1287 February 21, 2003 Ms. Catherine Wachsmuth 6331 Quincy Street NE Fridley, MN 55432 Re: Final Inspection at 6331 Quincy Street NE Contractor: McGuire & Sons Dear Ms. Wachsmuth: A plumbing permit was issued on November 20, 2001 to install a water heater at your address. According to Section 4715.2800 of the State Plumbing Code, a final inspection shall be conducted on the work authorized by this permit. A final inspection was conducted on May 13, 2002, which noted the following correction: Provide combustion air to any fuel -burning appliance. The permit fee that was paid covers the inspection to make sure the work was completed according to the Codes. Please contact us within 30 days to set up the reinspection on this correction. To set up the inspection or to have any questions answered, please contact the Building Inspection Division at (763) 572-3604. Sincerely, DJ/mh CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Effective On January 1, 1999 Gas ;:>SAIsc> Water Heater Range Ft" > Gas I Elec Reinspection Fee $42.00/Hr SIGNED B ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance Approved By Rough -In Date _ State Surcharge $ .50 MINIMUM FEE F R ANY PLUMBING1 TOTAL FEE $ PLUS THE $.50 STATE SURCHARGE Final "COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. MINIMUM SIZE.9 SQ INCHES. r PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS ° New Fixtures $ 7.00 The undersigned hereby makes application for a permit for the work herein Old Opening, New Fixture $ 4.00 specified agreeing to do all work in strict accordance with the city codes Beer Dispenser $ 5.00 and rulings of the Building Division, and hereby declares that all the facts Blow Off Basin $ 7.00 and representations stated in this application are true and correct. Catch Basin Rain Water Leader _ $ 7.00 $ 7,00 / /;0 Sump/Receiving Tank $ 7,00 ,1-999 Water Treating Appliance $10.00 1t Owner Qi"(�e Eli re - Water Heater -Electric $ 7.00 Water Heater - Gas**_ C� $10.00 Building Used As Gas Range** Gas Dryer** $10.00 $10.00 I�rrk Estimated Cost V PERMIT NO. Back Flow Preventer Required ( )Yes () No Type $15.00 `M PLUMBING COMPANY r, \C( -r ,kte &-- Reinspection Fee $42.00/Hr SIGNED B ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance Approved By Rough -In Date _ State Surcharge $ .50 MINIMUM FEE F R ANY PLUMBING1 TOTAL FEE $ PLUS THE $.50 STATE SURCHARGE Final "COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. MINIMUM SIZE.9 SQ INCHES. SUBJECT PE City of Fridley 32985 AT THE TOP OF THE TWINS BUILDING PERMIT r 1 COMMUNITY DEVELOPMENT DIV. 1 PROTECTIVE INSPECTION SEC.Mo r NUMBER REV DATE PAGE OF APPROVED Br CITY HALL FRIDLEY 55432 763-571-3450 910-F15 8/13/02 JOB ADDRESS 6331 Quincy Street NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 12 8 Christie Addition SHEET I 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Catherine Wachsmuth 6331 Quincy Street NE 763-502-0033 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Same 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 j] ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 14' x 14' Deck 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. wumqu e 6 Before degg'ng call f0F SEPARATE PERMIT T all utality locations REWIRED FOR: 4WO02 AND E LAVA PLUMBIINd SIG S 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 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 $2,254 $1.13 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 $83.25 Fire SC $2.25 PLAN CHECK FEE TOT "L FEE $86.63 4ATURE F CONTRACTOR 'ORAGENT (DATES E PRO VALI T D THIS IS UR PERMIT BLQt INSP OAtE S,GNATURE OF OwNER,1F OWNER BUiLOERi iDATE. NEW [ j CITY OF FRIDLEY ADDN (J 6431 University Ave NE, Fridley, MN 55432 ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: Legal Description: Effective 1/1/2002 (763) 572-360�)Bldg Insp Owner Name & Address: Tel. #1�.3-spay Contractor. elwe-s 6 MN LICENSE # Address: Tel. #26S - -s-11 - a2 LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft Length Width Height Sq. Ft Length Width Hgt/Ground ;I / Sq. Ft 196 Construction Type: 4 -' Estimated Cost: $ C:zD 59 Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ _ $ DATE: —� APPLICANT:Z/Y� �Y.G�-S/_ ° Tel. #�%ypG����- ��SJ Dam"�y�[n�� Call (763) 572-3604 for Permit Fees if mailing in application or Fax to 763-571-1287 k using credit card and we will call you for card number. CITY USE ONLY- Permit NLY- Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1200 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 [ ] TOTAL $ STIPULATIONS: