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PRE 2010 DOCS77 City of F>iriclley, Minn. N° 8009 BURMING PERAUT Date: June 23, 1965 Owner: Mr, Fred Kranz Builder Willia* Kranz, Inc. Address Q. Rice geek Terrace Address 4038 bake Road LOCATION OF BUILDING No. _ _3_ Street Rice geek Terrace Part of Lot Lot Block Addition or Sub -Division Corner Lot _ Inside Lot Setback Sideyard Sewer Elevation Foundation Elevation To be Used as: DESCRIPTION OF BUILDING Front - Depth Height Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Fast. Cost $2,2000.00 To be Completed Storm damage repair In consideration of the issuance to me of a permit to construct the building described above I agree to do the pro= work in accordance with the description above set forth and in compliance with ill provisions of ordinances of the city of Fridley. A r ` . A o L", In consideration of the payment of a fee of permit is hereby granted to AM. Kra; Inc. 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 pmt thereof, shall conform in all respects to the ordhiances of Fridley, Minnesota regi location, conatruct%n, alteration, maintenance, repair asci moving of buildings within the city litmus and this permit may be revoked at any time upon violation of any of the provisions oP said ordinances. Allen Jensen InspectorBuffling NOTICE: %% pumh don sof sever the esnmucow, hubMan fee whtng, plumbing, gn hosting, sewer or wrier. Be ore to we the Balding kapn:er for sapan to pwmhs Icor thew item:. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAS Mr. RxPd gra.nZ BOYLDER __Willi Am Kranz Inc. ADDRESS DEQ Rice Creek Terrace ADDRESS_ 4038 Lake Road LOCATION OF BUILDING Na+ 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 Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. To be used as; DESCRIPTION OF BUILDING Front Depth, Height Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft.. Type of Construction Estimated Cost 92000.00 To be completed 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 correct. r !� �4 a (Schedule of Fee Costs can be found on the Reverse Side). I: ---.--,a Application for Power Plants and Heating. Cooling. Ventilation. Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work .......................... 8.00 $ Replacement of Furnace 5.00 $ Repairs & Alterations—up to $500.00 .................. 5.00 $ Repairs & Alterations each add. $500.00 ............... 2.50 $ NECK. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ each add. 60,000 BTU ....................... 2.00 $ Replacement of Furnace$ .................... 5.00 Repairs & Alterations—up to $500.00 ................. 5.00 $ Repairs & Alterations each add. $500.00 .............. 2.50 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam ...... 8.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $ Each add. 200 sq. ft. EDR Steam ...................... 2.50 $ Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $ OIL BURNER—to 3 gal. per hour ........................ 5.00 $ over 3 gal. per hour—See Fee Schedule s GAS BURNER (up to 400,000 BTU) 5.00 $ GAS FITTING FEES: NO RATE TOTAL ist 3 Fixtures ...................... x $1.50 $ Additional Fixtures . ............... x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $�_ ALTERATIONS & REPAIRS TOTAL FEE $ '� ROUGH FINAL Dept. of Bldgs. Phone SU 4-7470 City of Fridley: 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. Fridley, Minn- "/.3 19 bL Owner Rigi eA��e� Kind of Building Used as e<&! To be completed about 4 " .4-' / d c® 4 Estimated Cost, .$ 3 _T'® Old—New. Building Permit No. Permit No. DESCRIPTION OF WORK BEATING or Ps/O,,W.�/AER PLANTS -Steam, Hot Water, �.rmAlrNo Trade Name / �" Size No Capacity Sq. Ft. E.D.R g -5-M BTU H.P. Total Connected Load �K6'2/ �Z Kind of Fuel BURNER — Trade Name Size No - Capacity— o Capacity Sq. Ft. E.D.R- �2� BTU H.P. (REMARKS -OVER) Signed By�.�. .dQ4JN.42 zM Business Phone No- lY36 HEAT LOSS CALCULATIONS DEPARTMENT OF INSPECTION Weatherstrips A.S.H.V.E, Construction No. Guide WindowsI Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Yes—No Yes—No 19_ Y Cl I Ue D_ --IT ___.t . _ , Vfl:J.t s ,. u_:_t. V. 11Fl.1 Room Length Width Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights " of crack eq. ft. MINNEAPOLIS. MINN. Insulation Kind How Applied Windows and Doors—Crackage and Area Btu Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. 3 Glass Exp. wall a Net exp. wall Coef. Btu Infiltration % -3k3,6 Glass d� Exp. wall % Coef.1 Btu Net exp. wall Int. wall Ceiling y( O Floor 1 otal Btu. Required sq, ft. E.D.R. or sq. ins. W.A. Leader area F1.1 dja Room Length ,,Width Windows and Doors—Crackage and Area W[dth Height No. of Lineal ft. Area No. of pane of pane lights of crack an. ft. Btu Infiltration Glass Exp. wall '/ Net exp. wall Int. wall Ceiling Floor Total Btu. % Required sq. ft. E.D.R. or sq. ins. W.A. Leader area i F1.1 —,I, Room I Length i! Width i Height k Windows and Doors—Crackage and Area Btu - Width Height No. of Lineal ft. No. of pane of pane lights of crack Area sq. ft. Glass Exp. wall a Net exp. wall Coef. Btu Int. wall 733 Ceiling llosJ Floor Coef.1 Btu Infiltration Required sq. ft. E.D.R. or sq. 'ins. W.A. Leader area Glass Exp. wall Height V S Net exp. wall Int. wall Ceiling 7 V,(® Floor Total Btu. Reauired sa. ft. E.D.R. or sa. ins. W.A. Leader area Height Coef.1 Btu Infiltration /d Glass Exp. wall Net exp. wall Coef. Btu Int. wall 733 Ceiling llosJ Floor fl Total Btu. Required sq. ft. E.D.R. or sq. 'ins. W.A. Leader area I Fl.l Room I Lenath % Width t/ Height V Wind and Doors--Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration 1q,3 733 Glass Exp. wall ±— Net exp. wall fl Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F1.1 Room I Length ,,7- Z Width Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Infiltration Glass Exp. wall Net exp. wall Int. wall Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Btu P • D•S6 z e HEAT LOSS CALCULATIONS DEPARTMENT OF INSPECTION Weatherstrips A.S.H.V.E. Construction No. Guide Windows I Doors Reference Out. Wall Inc. Wall Ceiling Roof Floor Yes—No Yes—No 19 j I — Fl 1 R l Lh W'dth LJ -.-L ', �' '� n Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area M Flj1A', :,i(. Room I Length 7 / Width 7 Height 7 Windows and Doors—Crackage and Area oom engt t Windows and Doors—Crackage and Area Width Height No. of Lineal f . Area No. of pane of pane lights of crack sq. ft. ® .2- o� Glass Exp. wall' Btu Net exp. wall Coef. Btu Infiltration 7 kjr Ceiling j 1734 Glass za g-4 Int. wall / Exp. wall 2,0 _ Ceiling Net exp. wall Floor / Int. wall _37&__57_ & Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area M Flj1A', :,i(. Room I Length 7 / Width 7 Height 7 Windows and Doors—Crackage and Area Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. 02/ Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration Glass Exp. wall' Btu Net exp. wall — Int. wall 7 kjr Ceiling Floor za g-4 -1 otal Btu. y Required sq. ft. E.D.R. or sq. ins. W.A. Leader area A F1.1 Room I Length 1'1 Width /® Height 7 Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. ?_— / . Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef.1 Btu Infiltration Coef. Btu Infiltration P 3 7 kjr Glass Exp. wall Net exp. wall Floor / za g-4 Int. wall Ceiling Floor / Z _37&__57_ & Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area MINNEAPOLIS. MINK. Insulation Kind How Applied V__ I t e.. tL P-2 W;Ath i t4.;shr 7 Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. ?_— / . 32- 3 • P Coef.1 Btu Infiltration Glass Exp. wall ? Net exp. wall Int. wall 7 kjr Ceiling Tj Floor / / L Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area FI Room I Length -tri Width /.;g Height 7 Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. ?_— / . 32- 3 • P Coef. Btu Infiltratiott Glass Exp. wall Net exp. wall Int. wall / - ;t 6 40 Ceiling Floor 3 7 kjr Total Btu. Required sq. ft. E.D.R. or sq. itis. W.A. Leader area Fl.l Room I Length Width Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area A -W POC -1.11 4w Power Plants and Hoeft Cooling, YentiWons Reatgoe - aw Air Conditioning S"em and Devices PARTIAL RATE SCHEDULE Dept. of Bldow Phone W -3M GRAVITY WARM AIA: RATZ TOTAL Furnace Shell & Duct Work ............... .. $10.00 $ Replacement of Furnace .... ... ..... ........ 6.00 $ Repairs & Alterations—up to $.500.00 6.00 $_— Repairs & Alterations each add. $500.00 3.00 $--._ NECIL WARM ALA Furnace Shell & Duct Work to 120,000 BTU ........ ..$10.00 $ each add. 60,000 BTU .................... .. 3.W i Replacement of Furnace .... 6.00 $ Repairs & Alterations --up to $500.00 6.00 Repairs & Alterations each add. $500.00 .. .... 3.00 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam $10.00 $- Furnace Shell & Line—to 640 sq. ft. FDR Hot Water 10.00 $_ Each add. 200 sq. ft. EDR Steam 3.00 $ _ Each add. 320 sq. ft. IDR Hot Water 3.00 $_ OIL BURNER—to 3 gal. per hour 6.00 $ _ over 3 gal. per hour ---See Fee Schedule GAS BURNER (up to 199,000 BTU) ... . ...... . 6.00 $ over 199,000 BTU See Fee Schedule GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures .. x$ 2.00 $ Additional Fixtures x .7 $ Gas Range to 1999000 =$ &00 $ AIR COIfDITIONIMGP FAN HEATING SYSTEM See Fee Schedule v 171 LATING SYSTIEN $ ALTERATIONS & REPAIRS TOTAL. FEE ROUGH FWAL City of Fridley: The undersigned hereby makes application for a permit for the work :herein specified, agreeing to do all work in strict accordance with the City Ordinance, and ruling of the Department of Buildings, and hereby declares that an the facts and representations stated in this application are true and correct. Fridley, Minn_ Al Owner V' Kind of Building Used asTo be completed about _ ®®� �-3 Estimated Cost, $-/J/�/.0 ! New. Building Permit No. Permit No. DEBC EMON OF WORK HEATING or POWER PLANTS- BU mn, Hot Water, Warm Air—No Trade Name she Na - Capacity Sq. Ft. E.D.R BTU Hp. Total Connected Lnad gnd of Fuel BURNER — Trade Name Size No Capadty Sq. Ft. F.MJt- BTU �p (KiMAKKS-OVEN) SUBJECT PER O. City ®f Fridley 210 9 2 AT THE TOP OF THE TWINS BUILDING PERMIT r 1 , C E I PT -N0- COMMUNITY DEVELOPMENT DIV. 1 rr PROTECTIVE INSPECTION SEC. / L/o 9 r 1 � 1 C� NUMBER REV. DATE PAGE Of APPROVED BY ` CITY HALL FRIDLEY 55432 612-571-3450 910415 10/3/91 JOB ADDRESS 403 Rice Creek Terrace NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 8 1 Rice. Creek. Terrace Plat 3 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Larry Seaholm 403 Rice Creek Terrace NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Stock Roofing Inc. 289 Liberty St NE Fridley, 780-3561 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 8 DESCRIBE WORK Reroof Dwelling (24 Squgres) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with.State.Building Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SO. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION 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 VALUATION SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $1,248 $.62 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $31.00 Fire SC $1.25. STR N OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE )C.) - 3i $32.87 SIGNATURE OF CONTACTOR ACTOR OR AUTHORIZED AGENT (DATE) yyi.{ PROP L V 1T D T I IS YOUR PERMIT ' S..M.I &�� SIGNATURE OF OWNER IIF OWNER BUILDER) )DATE) SP MATE NEW [ J Effective 1/1/91 ADDN (] CITY OF FRIDLEY ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: Legal Description: Owner Name & Address: Ac 1 nn ��`� G` Tel. c����O�clrr� �,. T o .� Contractor: {�-�-} Tel. # Address: 1 se Z-�A A 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: Len,!Width Hgt/Ground Sq. Ft. OTHER: %'�1� { S%Xd Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback _ Type of Construction: Approx. Completion Date: Driveway Curb Cut Width Needed: Ft. + 6 Ft = Side Yard Setbacks Estimated Cost: $ ,, ,; z10 O a Ft x $ tom m ]kxt) = It q 11 DATE: 1 Ca - 3 - 1 APPLICANT: Tel. # Permit Fee $ 3).06 Fee Schedule on Reverse Side Fire Surcharge $ /, e2.5- .001 of Permit Valuation (1 / 10th %) State Surcharge $ t�a $.50/$1,000 Valuation SAC Charge $ $650 per SAC Unit Driveway Escrow $ Alt. "A" or Alt. "B" Above Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL STIPULATIONS: ,CITY OF FRIDLEY•INSPECTION DIViSION 6431 University Ave NE Fridley, MN 55432- APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 763-572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AVID DEVICES JOB ADDRESS let RATE SCHEDULE - (M OWNER��er, Residential Furnace Shell and.Duct Work, Burner - Also Replacement Furnace (Side Vent'- Fill Out Back) Gas Piping (Needed: with new furnace, but not replacement) Gas Range Gas Dryer *Air Conditioning - All Sizes All Others/Repairs & A.Iterations (LIST ON BACK) 1% of Value of Appliance or Work Commercial/industrial. 1.25% of Value of,Appliance or Work Rate TOTAL $ 30.00 $ 3rd - $10.00 $ $ 10.00 $ $ 10.00 $ $ 25.00 State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AlR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE�SURCHARGE REINSPECTION FEE $47.00/Hr *Air Conditioners 'can. not be placed in a side yard without written permission from adjoining property owner. $ Effective On January 1, 2001 BUILDING USED AS ESTIMATED COST PERMIT.NO. DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Pits Circle One (Steam) (HWater) arm r) Trade Name 6 nA Ch., Size No. .A BTU HP EDR Fuel Total Connected Load Burner trade Name Size No. BTU HP EDR 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 an rulings of the Building -Division, and hereby declares that all the facts and representations stated in this application are true and c erect. STANWD HEAN &AIA CONDITIONING 00. '2 5�0� 410 WEST LAKE STREP -i DATE MINNEAPOLIS, MN 55405.29 HEATING CO 612$ Si TEL #4141 A�C�i Rough In Date Final Dat e_pproved Bx_ BACK SIDE MUST.BE FILLED IN ON VENT SIZE, VENT CONNECTORS AND COMBUSTION AIR VERIFICATION COMMON VENT VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furance, the undersigned hereby verges that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes (.) No ( ) The, venting system .is plastic/PVC and. meets all current codes and manufacturer specifications including sizing, length, rnumber of elbows and termination. Yes. ( ) ; No ( ) The, undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA -LAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) The existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes () No ( ) When required to install a new combustion air, it will be sized and installed to meet the current codes and manufacturer's specifications. Yes ( ) No( ) When installing a new venting system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes ( ) No ( ) Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes( )No( ) Appliance Type and Size/Common Vent and Vent Connector Information Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or.;Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (Describe) HEATING CO: Signed By: Date CITY OF FRIDLEY PERMIT=:/2004 6431 UNIVERSITY AVENUE NE FRMLEY, MN 55432 DATE ISS 572-36U4 N'AX: (763) 571-1237 REPRINTED ON 10/27/2004 ADDRESS : 403 RICE CREEK TER NE PIN : 143024240044 LEGAL DESC : RICE CREEK TERRACE PLAT 3 : LOT 8 BLOCK 1 PERMIT TYPE : BUILDING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WINDOW/DOOR REPL VALUATION : $ 346.00 NOTE: PROVIDE SMOKE DETECTORS IN ALL SLEEPING ROOMS AND ON ALL LEVELS OF THE DWELLING PER 8317 OF THE 2000 INTERNATIONAL RESIDENTIAL CODE. CAULK AND FLASH ALL EXTERIOR OPENINGS. REPLACE WINDOWS WITHIN EXISTING OPENINGS. APPLICANT LAUER MECH MAINT INC 4052 9309 LYNDALE AVE S BLOOMINGTON, MN 55420 - OWNER LYN BUNDY 403 RICE CREEK TER NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of wort 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 provisions of any other state or local law regulating cons ction or the performance of construction. ApplicaantDate Bldg Insp Date L-1 BUILDING PERMIT FEE FIRE SURCHARGE STATE SURCHARGE, VALUE TOTAL SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 23.50 0.35 0.50 24.35 10/27/2004 08:44 9528849146 LAUER CONSTRUCTION PAGE 02 ®CT -2l,-2004 11=09 CITY OF FRIDLEY P.02/e5 New ( ] CITY OF FRIDLEY Effective 411/2004 AIDON [ j 8431 University Ave NE, Fridley, MN 65432 (763) 572-604 Bldg Insp ALTER [) SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287' FI� % BUILDING PERMIT APPLICATION ( x � w ` J�t/ 0 �"' Construesion Address: L0.3�ilrs�k /�2�,�;�, Legal Der,ariptlan; Owner mime & Address: / 4w Rve,,A ..mu�..Tom, Contractrrr, L,aur«.MN LICENSE# DSP— Add=8; 9-10 9 1(kAz l$A4 Attach to this applioation, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale, DESCRIPTION OF IMPROVEMENT WING AR M- Length Width _ Height _ Sq. FL OARAOE kJWJL- Length width Height___ sq. Ft DECK AREA: Length Wdth HgMround Sq. Ft OTHER: Construcdico Type:_&&ar.-�,� cd, a�w %a. Estimated Cosi: � �y1e. �" Driveway Curb Cut Width Needed: FL + 6 Ft m Ft x $ _ DATE: APPLICANT:'�4e Tet. # 21z :M ai47 QII (763) 57.2-$04 for P'ermtt Fes if mairng in application. Fax to 763.5714287 if using credit cad and we will can you for card number. Permit Fec Plan Review Fire Surcharge state Surci'arge SAC Charge License SL rcharga Curb Cut Escrow Erosion Cc+ntrol Paris Fee Sewer Main Charge TOTAL CITY USE ONLY - Fee Schedule on Reverse Side 65% of Permit Fee .001 of Permit Valuation (1/10th'yei $.50/$1,000 Valuation $1350 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 [ ] TiPULAT ON :