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PRE 2010 DOCSSUBJECT PERMIT City of Fridley ® 17868 AT THE TOP OF THE TWINS BUILDING PERMIT r RE T • _____ COMMUNITY DEVELOPMENT DIV. `>t: - r PROTECTIVE INSPECTION SEC. 1 � = CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 3/8/95 JOB ADDRESS 291 Rice Creek Terrace N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 1 Rice Creek Plaza. South Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE arles Aspenson 6370 Starlite Boulevard N.E., Fridley 574-9706 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 C NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR -1REMOVE ,` y 8 DESCRIBE WORK t Construct a 40' x 281 Dwelling and a 301 x 241 Garagee�0ee dagg n��!i iia= t. ' . RI!, 9 CHANGE OF USE FROM TO STIPULATIONS Provide sod in the front and side yards. Provide City with a copy of a verifying survey before capping. Provide a hard surface driveway. SEWER LOCATION: (.Approx. 21' Deep in Street) 33' W. of M.H. (Inv. 831.15) WYE ELEV: 831.25 TOP OF FOOTING: 835.25 Minimum WATER LOCATION: 43' W. of N.H. 10' W. of Sewer Service DRIVEWAY DEPRESSION: N/A THE CITY OF FRIDLEY DOES (JOT GUARANTEE T,, --- 'ACCURACY ACCURACY OF UTILITY LOCATIONS AND ELEVATIC PAR �P�RATE THIS DATA IS FOR INFORf',J aTION PURPOSES O +f' Y, PER�D9�1"S RE01ARED �(� AND PERSONS USING THIS INFORMATION SHOULD HEATINGJ, PLLJM-SING � � VERIFY IT ON THE SITE, .SIGNS. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. Wood Frazee 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 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 $110,05055.03 55.03 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 CON- $460-50 $425.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE $115.13 $1,055.66 SIGN U OFCO TRACT RAUTHORI2EDAGENT IDATEI!F WHEN PROPERLY V(A1,H,%ATED THIS IS YOUR PER IT s , V LL SIGNATURE OF WNERIIF OWNER BJKDERI (DATE) BLDG INSP 7A7E NEW tl ADDN. [ ] ALTER. [ ] Construction Address Legal Descriptio Owner Name & Address: City of Fridley �R-1 AND R-2 Building Permit Application 63- 7a Effective 4/1/84 zo, ,147 Tel . # Contractor: Tel. # Address: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Iles 0 LIVING AREA: Length 00 Width �Height Sq. Ft. GARAGE AREA: Length -10 WidthP Height Sq. Ft. 20 DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Corner Lot [�] Inside Lot [ ] Ft. Yd. Setback 3S' Side Yard S tback /®f �°% e%1 Estimated Cost: Type of Construction: A /j � �1 Approx. Completion Date: 3 Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation p DATE: �" / r �s APPLICANT: Tel. CITY USE ONLY Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Main Charge STIPULATIONS: n Fee Schedule on Reverse Side 25% of Building Permit Fee $•50/$1,000 Valuation $425 per SAC Unit Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] Effective Aug. 1. 1781 CITY OF FRIDLEY APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION; REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE PATE , RESIDENTIAL TOTAL Job Address Furnace Shell and Duct Work, $ 20.00 $ Department of Buildings, 6431 University Ave. N.E.. Fridley, MN 55432 Burner (Also replacement furnace) City of Fridley Gas Piping $ 10.00 $ I 6 Tel. 0571-3450 (piping needed with now furnace) $ 10.00 S Aar The undersigned hereby make9 application fora permit for the work harem Gas Range specified agreeing to do all work in strict accordance with the City Codes $ 10.00 $ and rulings of the Department of Buildings, and hereby declares that all the Gas Dryer // facts and representations stated in this application are true correct. r$ 10.00 S ® /and 7,,� Fridley, Minn. • Air Conditioning (all sizes� All Others/Repairs and Alterations OWNER if of Value of Appliance or Work $ KIND of BUILDING COMMERCIAL/INDUSTRIAL USED AS 1% of Value of Appliance or Work $ TO BE COMPLETED ABOUT State Surcharge $ .50 ESTIMATED COST O - NEN LDING RMIT N0. PERMIT NO. TOTAL FEE $ _ Reinspection Fee ($15.00) $ � DESCRIPTION OF FURNACE/BURNER Rough Insp. Date Final Insp. Date Q Approval for Permit �J MINIMUM FEE FOR ANY HEATING PERMIT IS S10.00 PLUS 6.50 STATE SURCHARGE Attach stack verification fon with replacement furnace permits whir Conditioners can not ba placed in side yard without written permission from adjoining neighbor. HEATING or POWER PLANTS, Steam, Not Mater, Nan Air- No. ` Trade Name Size No. Capacity Sq. Ft. CDR BTU NP Total Connected Load Kind of Fuel BURNER - Trade Name Size No. Capacity Sq Ft. EDR BTU HP Company Signed By Tel. No. SUSUR4:AN AIR C0tN01Ti0N61�a coo 8419 CENTER DRIVE MINNEAPOLIS, MINNESOTA 55432 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, 1998 PLUMBING FIXTURE RATES: New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater—Electric NO. RATE TOTAL 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 Reinspection Fee $42.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge JOB ADDRESS 6��e 745 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 true and correct. / �c'" '1998 Owner Building Used As CHASE, PATRICK 291 RICE CREEK TERRACE FRIDLEY, MN 55432 ry (612) 572-8762 15� i Z Estimated CostPERMIT NO. y. PLUMBING COMPANYNW Isn0di3NNIV1 W *3" n13Wuvr) nran9 �%t� E£0-LZt i G9F)i SIGNED BY *� n�T&�i(in-% _j 2A14ft-te4e e0%Ae V l /J Approved ByRough—In Date Final Date 't Jig $ .50 IUINIMIIM FFF CSR ANY PI 111URINC.1.A3 PPRIUIT 1A ton nn TOTAL FEE $ 20 So PLUS THE $.50 STATE SURCHARGE NORBLOM PLUMBING CO. **COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 SQ IN61 2) 327-4033 C 5 GARFiELD AVE. SO. NNEAPOLL% MN •55405 �" SUBJECT P City of Fridley 28710 AT THE TOP OF THE TWINS BUILDING PERMIT r E � `y______ COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. NUMBER REV DATE PAGE OF APPROVED BY f CITY HALL FRIDLEY 55432 612-571-3450 910415 12/3/98 JOB ADDRESS 291 Rice Creek-lex-rang 1 LEGAL O.BLOCK TRACTOR ADDITION Rice Creek Plaza S. Addition SEE ATTACHED DESCR. rI 1 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Chase 572-8762 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Needham Re -Roofing - 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 O ALTERATION 3 REPAIR O MOVE O REMOVE 8 DESCRIBE WORK eroof house and garage -(28 Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REOUIRED 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 I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2399 $1.20 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS F ANY OTHER ST OR LO AL LAW REGULATING CON- Fire SC $2.40 STRUCTION THE P RFORM CE'OF CO TRUCTION $]�}, ]5 PLAN CHECK FEE TOTAL FEE "/j 9" License SC $5. 0 1$83.35 SIG ATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE, WHEN PROPE JQIAL DATED THIS IS YOUR PERT BiAIG -NSP ' - GATE S,GNATU RE OF OWNER, -F OWN ERSU4DERt (DATE) NEVA ADDN [ ] ALTER [ ] ConstructionAddress: Legal Description: CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Effective 1/1/98 Owner Name &Address: S Tel. #.:r'7 vI - R Contractor: / )r- f-' Ap -leb 0 d,G... MN LICENSE #,;Lbl Address:1 f- . 3 51,6 A,) I/*/ �S /.4.'� &U-) 'b aj IM /� . 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. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Construction Type:AkAAQZEstimated Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee $ Sewer Main Charge $ TOTAL STIPULATIONS: $ eS,3� Tel. # 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 [ ] SUBJE&'PERMIT NO.---,,. City of Fridley 30978 AT THE TOP OF THE TWINS BUILDING PERMIT f o • R IPT NO. _ COMMUNITY DEVELOPMENT DIV. v----- . INSPECTION SEC. o�16 3 f � � PROTECTIVE CITY HALL FRIDLEY 55432 NUM4ER REV DATE PAGE OF AbPROVED BY 612-571-3450 910415 5/24/00 JOB ADDRESS 291 Rice Creek Terrace NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 1 1 Rice Creek Plaza South Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Patrick Chase 291 Rice Creek Terrace NE 572-8762 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Custom Remodeling Inc 474 Apollo Dr, Lino Lakes, MN 55014 784-2646 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO B USE OF BUILDING Residential 7 CLASS OF WORK O NEW O ADDITION O ALTERATION Cj REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Reside House 9 CHANGE OF USE FROM TO STIPULATIONS Per Section 1402, 1997 Uniform Building Code, requires that a weather resistive barrier be placed over exterior sheathing to protect the interior wall covering. Exceptions for this provision would be if sheathing is an approved weatherproof panel or when the siding is an approved weather barrier. Vinyl siding is not a weatherproof covering unless the manufacturer states this in their application guidelines. Call for inspection of wrap before covering. e e`11 • � Cards �i'ill To No 'In 01100 SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL. PLUMBING, HEATING. TYPE OF CONST, OCCUPANCY GROUP UPANCY 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. OWLG. 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 $ lO,O56 $5.03 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 CON. $05.25 F e SC $10.06 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE DTAL FEE Lice SC $ 0 $215.34 SIGNATURE OF CONTRACTOR OR AUTMORIIED AGENT IDATEI HE O Y VALI ED THIS IS YOUR PERMIT SIGNATURE OF OWNER IIF OWNER BUILDER, IDATEI BL G INS pAT NEW [ ] Effective 5/10/99 ADDN [ l CITY OF FRMLEY ALTER [ ] SL TGLE FAIMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: ) fVA 5MkAt'# Legal Description: Owner Name & Address: Contractor: Address: 4 MN LICENSE # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF BIPROVEMENT 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: 7sc-"�M L l Estimated Cost: $ Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: �3 _ ®� APPLICANT: _ Tel. # CITY USE ONLY Permit Fee $ 1 Fee Schedule on Reverse Side Fire Surcharge $ ®. .001 of Permit Valuation (1/10th%) State Surcharge $ �'. 03 $.50/$1,000 Valuation SAC Charge $ $1050 per SAC Unit License Surcharge $ 4 0 Q $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 $ Aig 13 STIPULATIONS: Building Inspections 763-572-3604 DATE____W_6i SITE ADDRESS THIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PERMIT TYPE MECHANICAL RESIDENTIAL APPLICATION CITS' OF F IDLEY YOUR E-MAIL ADDRESS 0 OWNER 13CONTRACTOR Permit Received By: Date Rec' ADDRESS: CITY STA PHONE: '2 _,. `L_ % — k%(, 7 - COMPANY NAME: CONTACT PERSON: F b: @ e O 0. S te9 STATE LICENSE # ��°°°� a r ,%r JJAI L �rI , 5543 Y STATE—zip, ADDRESS: PHONE (763) 754-2`99JDAX Fax (763) 75429®3 TYPE OF WORK: 1 0 NEW FAMILY ❑ TWO FAMILY DETAILED DESCRIPTION OF WORK REPLACEMENT O TOWNHOUSE O ALTERATION/REMODEL .4. A-%. 0 PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor ) Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor X.05 = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) SIZEBTU 104 d d0 Equipment Installed MFG: MODEL: MFG: s MODEL: Z SIZEBTU MFG: MODEL: SIZEBTU A/C $25.00 _FIREPLACE (GAS) $15.00 . _GAS RANGE/OVEN $10.00 _AIR TO AIR EXCHANGEER $IS _FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00 _BOILER $35.00 I FURNACE $35.00 ,_GAS UNIT HTR $10.00 _CHIMNEY LINER $10.00 _GAS DRYER $10.00 POOL $15.00 OOL HEATER $35.00 DUCT WORK $10.00 GAS PIPING $10.00 Permit Fee $ &'p- Number of fixtures @ $10.00 x $10.00 = $ Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ _• Number of fixtures @ $25.00 x $25.00 = $ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .50 Total = $ THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building 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 Codes; that I understand this is not a permit but only an application for a permit and work 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. SIGNATURE OF APPLICANT �at PRINT NAME DATE 'Z \ City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Building Inspections 763-572-3604 763-5024977 FAX PLUMBING RESIDENTIAL APPLICATION CITY OF FRIDLEY DATE YOUR EMAIL ADDRESS SITE ADDRESS ( y THIS APPLICANT IS: O OWNER JOCONTRACfOR OWNER/ ADDRESS: ,C /(J7H, TENANT PHONE: 7162�S z. �7KZ CONTRACTOR NAME: f .e SUBMIT A COPY OF STATE LICENSE # ✓� YOUR STATE LICENSE, BOND AND STATE BOND # v, CERTIFICATE OF ADDRESS: /1,%J ,al. 1'%9c2�%S INSURANCE ,,..,,..,. /_ '/ - Al fl- =, nL7 PERMYr TYPE W?ftiGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: 0 REPLACEMENT DETAILED DESCRIPTION OF WORK N1 Permit DATE DATE 111 FEES ARE BASED ON $To oo PER FDCI mK EXCEPT WHERE NOTED. FDnURES: (INDICATE TOTAL NUMBER OF EACH BELOW} MINIMUM FEE $35.50. BATH SINIULAV FLOOR DRAINS � WATERPIPING _ —SHOWER PIPING (MEED CTFY LIC) SWIMMI VG POOL —WATER _BATHTUB CLOTHES WASHER _GAS _ RITCHEN SINK WATER CLOSET" _.VB OW PREVt($I5) —DISHWASHER _ LAUNDRYTRAY WATERHEATER(M FORIRRIGATION WATER METER —OTHER THIS IS AN APPLICATION FOR A 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 Codes, 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 f all work which requires review and approval,9f plans, � p SIGNATURE OF APPLICANT A. PRINT NAME OIJL �✓ DATE :�;' Z ZW City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAM 763-502-4977