PRE 2010 DOCSCity of Fridley, Minn.
BUILDING PERMIT
Date:
Z
f �. ..: «. «_. I F. .. tJf a
1
Owner: , ._ : + �. .. _.._. Builder _..
Address_ Address ... .... ,_........................ --... _......................... _..«.._..-.._..._................_............_...
g LOTION OF BUILDING
No...-... Street n .... ....... t.._..... Part f Lot
Lot ......... .; ..----... Block ......... `.._................. Addition or Sub -Division ` e. _ .. ..::.. --� - ...:
ee
Corner Lot .................................... Inside Lot ....._.... ........... Setback ..._ ......._........ Sideyard - ..:.::__............................... ._......
Sewer Elevation....._............._......._...._......._.._-..._.._...._............._............._........ Foundation Elevation
DESCRIPTION OF BUILDING
ZoUsed',_.. :_. :,..... ..... Front "..._�:..._.. Depth ._...."_.. Height ...�,- Sq. Ft„,.�_.5) Cu. Ft.c. c
Type of Construction ^�' �e-l�.r... Y.... Est. Cost Height o Ft ..::: Cu: Ft
............ Front . Depth.............
.. �' � .. � .. :.. To be Completed ............ _...... _.................... ............
c l7 rS.
a_ _ �\I i
7—iE J P ERF s Y 7 a1Y L �—�
t_i'd"0 COV G
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. ,s
I............. _................. .«_.«._..._...---._...._.._..._....
In consideration of the payment of a fee of 47, ..., 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, r air and moving of buildings
within the city limits and this permit may be revoked at any time upon viola on f any of the Provisions of said
ordinances. ,'? d
Building Inspector
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see
the Building Inspector for separate permits for these items.
4
,_t -
1
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
Owners Name a ms �'� � � �� Builder _4<3 A- e-
Address Address -- l
LOCATION OF BUILDING
No. �� Stxeet ® ��a a Part of Lot .c
Lot Block —.I Addition or Sub.Div.
Corner Lot Inside Lot_., Set Back Side -Yard � ° 5
SEWER ELEVATION �FOUNDATION ELEVATION -
Applicant attach to this form Certificate of Survey of Lot and proposed building
location.
DESCRIPTION OF BUILDING e,
To be used as.
e (r_...._. , Front Depth„ Height.X, '-
Sq. Ft. �Cu. Ft.
Front Depth Height
Sq. Ft. Cu. Ft.
Type of Construction T �- �� �- Estimated Cost _
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 Ordinances and ruling of
the Department of Buildings, and hereby declares that all the facts and representa-
tions stated in this application are true and correct.
DATE„
(A Schedule of Fee costs can be found on the Reerse Side.)
0'
City of Fridley
Application for Plumbing and G�n Fitting Permit
Dept. of Bldgs. Phone SU 4.7470
DESCRIPTION OF. WORK ��
Number, Kind and Location of Fixtures Locatio°'
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures 4 x $1.50 $ ' "
Future Fixture Opening ................
x 1.20
$
New Fixture Old Opening ..............
x 1.00
$
Catch Basin ............................
x 3.25
$
Water Heater (Up to 200,000 BTU) ......
x 2.00
$ '
�G
x 3.25
UN'
R
N
WATER HTR.
GAS
ELEC.
1st 3 Fixtures ..........................
Additional Fixtures ....................
x .50
w
$�
OnLL
$
LL�
REPAIRS & ALTERATIONS—Refer to Code
<3
Description .......
O
TOTAL FEE $
Base
1st
2nd
_
3rd
—
4th
• Future Connection Openings
Connected with Sewer
New Fixture, Old Openings
Cesspool
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures 4 x $1.50 $ ' "
Future Fixture Opening ................
x 1.20
$
New Fixture Old Opening ..............
x 1.00
$
Catch Basin ............................
x 3.25
$
Water Heater (Up to 200,000 BTU) ......
x 2.00
$ '
New Ground Run Old Bldg . ............
x 3.25
$
GAS FITTING FEES:
NO. RATE TOTAL
x $1.50
-$ /` `0
1st 3 Fixtures ..........................
Additional Fixtures ....................
x .50
.$
Gas Range to 200,000 BTU ..............
x 2.00
$
REPAIRS & ALTERATIONS—Refer to Code
Description .......
...........$
TOTAL FEE $
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 AY 2 1960 19_
Owner
Kind of Building -
Used as
To be completed about E - /` (4a
Estimated Cost,
Old—New. Building Permit No S Permit No.
Signe JONDON PLUMBING CO.
By ?�'
Business Phone No
ROUGH MAY 9 1960
FINAL
a z 2M 7-59
City of Fridley, Minn. _
BUILDING PERMIT N 5234
Date: C
Owner: `' Z! Builder
Address. _ _ _ Address•—•-. -- .-...----------
LOCATION OF BUILDING
No. Street --? �°_ _. ._ Part . t
Lot _ .._ Block Addition or Sub-DhAllogn t :` -
Corner Lot __ _ ___ Inside Lot ___.►"�"" Setback Sideyard
Sewer Elevation _ _ _ _. Foundation Elevation
DESCRIPTION OF BUILDING ._
CFront - _ Depth Height _ Sq. Ft. Cu. Ft.,,,._*
Front Depth #eight --- Sq. Ft. _ Cu. Ft.
Type of Construction."
..,rr�r::.. Est. Cost _......,.,.tom.-.•-..--- 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 $.ate _ _ , 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 uqn violatiozr•of any of the provisions of said
ordinances. ", 1 J� i.
k ,��^ding Inspector
NOTICE:
This permit does not cover the construction, Installation for wiring, plumbing, gas heating, sewer or water. Be sure to see
the Building Inspector for separate permits for these Item.
OM04
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
Owner Is Name f.Zt aj, --- L_ Builder
Address t a' r C-1iJe / e ie cm - Address a g «-7w i e - -
LOCATION OF BUILDING
No. Street Part of Lot
Addition or Subdivision
Corner Lot Inside Lot Setback �1 Side -Yard
SEWER BLEVATION FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and proposed building
location.
To be used as:
DESCRIPTION OF BUILDING
P
c,7 k? Front J i De�oth r��0 _
Sq. Ft. Cu. Ft.
FrontDepth Height
Sq. Ft. Cu. Ft.
PA
Type of Construction ,9G4 e, �G(�s'� IF stimated Cost ,[11? ad
To be Completed Veal,"._
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. a � A---�
.4-
(A Schedule of Fee Costs can be found on the Reverse Side.)
01
SUBJECTI
City of Fridley
88193
AT THE TOP OF THE TWINS
U I Z D I� I %� D C D A A I T
BUILDING
�
D L ' v v r C"'v,
ECEIPT
�
COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
�
i1 =
/"'1•� CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
_-_.�
L 612-571-3450
910-F15
9/6/85
JOB ADDRESS 958 Rice Creek Terrace N.E.
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION SEE ATTACHED
DESCR.
4
3
Brookvew Terrace 2nd Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Dick Dus.et 958 Rice Creek Terrace 571-1275
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Greco Construction 41 - 70th.. Way N.K., Fridley 571-1914
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 Q ALTERATION ❑ REPAIR ❑ MOVE 13 REMOVE
8 DESCRIBE WORK
Install a bow window -
9 CHANGE of USE FROM TO
STIPULATIONS
Install according to manufacturer's instructions.
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
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
$750
$.50
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.
$15..00
PLAN CHECK FEE
TOTAL FEE
$15.50.
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
}
WHEN PROPERLYyALIDATED THIS IS YOUR PERMIT
/� l( it X „5,�.1f
SLOG INSP
SIGNATURE OF OWNER IIF OWNER BUILDERI (DATE)
qaT
01
NEW [ ]
ADDN. I ]
ALTER. [ ]
Construction Address:
Legal Description:
Owner Name & Address:
�V
City of'Fridley
R-1 ANDa`R-2 i
Building Permit Application
Effective 4/1/84
Tel. S 71- /z 7."
Contractor: 6fxeco Tel. • Sir' /��
Address:
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:
Corner Lot [ ] Inside Lot [ ] Ft. Yd. Setback Side Yard Setback
Type of Construction: �OLU f.0Estimated Cost: $
Approx. Completion Date:
�Sr 7_J
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: $ $
See Back Page for Explanation
DATE: q& � APPLICANT: Tel. i S
CITY USE ONLY
Permit Fee
$
"�� �'�
Fee Schedule on Reverse Side
Plan Check
$
25% of Building Permit Fee
State Surcharge
$
��
$.50/$1,000 Valuation
SAC Charge
$
$425 per SAC Unit
Park Fee-
$
Fee Determined by Engineering
Sewer Main Charge
$
�� � �
Agreement Necessary [ ] Not Necessary [ ]
TOTAL
$
•
STIPULATIONS•
"�
SUBJECT
PERMIT
City of Fridley
0 413
AT THE TOP OF THE TWINS
BUILDING PERMIT
_18
r
COMMUNITY DEVELOPMENT DIV.
RECEIPT
r L PROTECTIVE INSPECTION SEC.
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATEF77-
APPROVED BY
j 612-571-3450
910-F15
5/5/86
JOB ADDRESS 958 Rice Creek Terrace N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
4
3
Brookview Terrace 2nd Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Dick Doucette 958 Rice Creek Terrace N.E.
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Greco Construction Inc. 7070 Brooklyn Boulevard 560-6178
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 ElREMOVE
E❑
8 DESCRIBE WORK
Remo de 1 Kitchen-Add bow window
9 CHANGE OF USE FROM TO
STIPULATIONS
SEPARATE
1�1ITS
WIRING,
N�AT� REQUo�
�G,
PLU' j13�NG A
N®
'k2NSa
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 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
$1,000
$.50
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-
STRUC OR THE PERFORMANCE OF CONSTRUCTION.
$155.00
PLAN CHECK FEE
TOTAL FEE
4 '�
$15.50
SIG U ONTRACTORORAUTHOR12EDAGENT (DATE)
WHEN ALI�DA,TtEDa_THIS IS YOUR PERMIT
\\P,nROnPERLY
)NSP
SIGNATURE OF OWNER 0F OWNER BUILDER) (DATE)
BLDG OAT
NEW I ]
ADDN. [ ]
ALTER..[ 7
Construction Addre
City of Fridley Effective 4/1/86
�R-1 AND R-2 I
Building Permit Application
Legal Description: L-01 "7, 4)1_0 CW -�J�
Owner Name & Addr s :� �=�� Tel. #
Contractor • �&'e_�. � �����® � �� Tel. #
Address • -7eJ 70
LIVING AREA:
nARAGE 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 Sq. Ft.
Corner Lot [ ] Inside Lot [ ] Ft. Yd. Setback
Type of Construction:
Approx. Completion Date:
Proposed Driveway Width If New Opening Is Desired:
Side Yard Setback
Estimated Cost: $
Alt. A Alt B
$ $
See Back Page for Explanation
DATE: APPLICANT: - Tel.
CITY USE ONLY
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
Fee Schedule on Reverse Side
25% of Building Permit Fee
$.50/$1,000 Valuation
$475 per SAC Unit
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
P
CITY OF FRIDLEY
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO.
RATE
TOTAL
New Fixtures
_
$ 5.00
ea
$ /0
Future Fixtures
$ 3.50
$
Old Opening, New Fixture
X
m
$�
water
$ 4.00
S
Blow Off Basin
$ 5.00
E
Catch Basin
m
�]
o,
u
a
w
$
Hydraulic Valve
Heater
a
$
Sump or Receiving Tank
$ 5.00
m
Water Treating Appliance
.9 a
3
$
Hot water Heater
ee
$ 5.00
u
Gas Range
m
$ 10.00
Gas Dryer
$ 10.00
1.re
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1% of Value of Fixture or
Appliance
w
aces
State Surcharge
$ .50
Reinspection Fee $
o
a�
to
u
FEE
to
c�
3
a w
m
u tq
3
s
lec
1st
2nd
3rd
4th
'
(R) a Future Connection Opening
Connected with Sewer
(�) - New Fixture, Old Opening
Water
RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO.
RATE
TOTAL
New Fixtures
_
$ 5.00
ea
$ /0
Future Fixtures
$ 3.50
$
Old Opening, New Fixture
_�_
$ 1.50
$�
Beer Dispenser
$ 4.00
S
Blow Off Basin
$ 5.00
$
Catch Basin
$ 5.00
$
Rain Water Leader
$ 5.00
$
Hydraulic Valve
$ 5.00
$
Sump or Receiving Tank
$ 5.00
$
Water Treating Appliance
$ 7.00
$
Hot water Heater
$ 5.00
$
Gas Range
$ 10.00
Gas Dryer
$ 10.00
$
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1% of Value of Fixture or
Appliance
$
State Surcharge
$ .50
Reinspection Fee $
a�
($15.00)
TOTAL
FEE
$ j'�f
Effective Aug. 1, 1981
Job Address
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 appliicc bion are true and correct
Fridley, Mn. 37/,/,fir �� , 19
OWNER 4 // ""C--` -
KIND OF BUILDING /J'
USED AS
TO BE COMPLETED ABOUT
ESTIMATED COST
OLD - NEW BUILDING PERMIT NO. PERMIT NO.
Company
Signed By
Tel. No.�'�r
ROUGH INSP.
Date
FINAL INSP. h 3
Date
APPROVAL FOR PERMIT
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $10.00
PLUS THE $.50 STATE SURCHARGE
City of Fridley
AT THE TOP OF THE TWINS
sueJEcr
BUILDING
PERMIT
P MIT NO.
®_ 18763
r
COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
"'1 CITY HALL FRIDLEY 55432
IL""'11.� j 612-571-3450
RECEIPT NO.
NUMBER
910-F15
REV.
DATE
12/12/86
PAGE OF
APPROVED BY
JOB ADDRESS��
1 LEGAL
DESCR.
LOT N
BLOCKTRACT
OR ADDITION ,,/� SEE ATTACHED
KLZall SHEET
2 PROPERTY OWNER MAILADDRESS
ZIP PHONE
MAILADDRESS-
3 CON RACT��
ZIP PHONE LICENSE NO.
y
CO++R
soo
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO,
6 USE OF BUILDING
7 CLASS OF WORK
❑ NEW ❑ ADDITION ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
9 CHANGE OF USE FROM TO
STIPULATIONS
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
TYPE C2F CONST.
OCCUPANCY GROUP
�,
a,
OCCUPANCYLOAD
�
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
ZONING
((��
DJ�/,
SO. FT.
CU. FT.
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
AND,ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
VALUATION
;sb
SURTAX
p
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
RUCTION.
STRsz-��
PERMIT FEE
NC^�
��11
SAC CHARGE
9
( Gr
NATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE)
y
PLAN CHECK FEE
A r-1
TOTAL FEE ray
eems'
. WHAN PROPE
BLDG NSP
L I AT
THIS IS YOUR PERMIT
)ATE
SIGNATURE OF OWNER 0F OWNER BUILDERI (DATE)
City of Fridley Effective 4/1/6(
ACP!;. I ] FR -1 AND R-2 1
A;,TER. Building Permit Application
Construction Address:
Legal Description:
owner Name i Addzess:
'C- nc Tel. * -SZ/--/7-7)
Tel.
Contractor:
Address:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTI0N OF IMPROVEMEt.'T
LIVING AREA: Lengti. ______.
Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length
Width - Hgt/Ground Sq. Ft.
OTHER:
k Side Yard Setback
Ft. Yd. Setback Corner Lot ( ] Inside Lot ( ] _
�� -C41 t 4~4t -Estimated Cost:
Type of Construction: 17e to t4;
Approx. Completion Date:
Alt. A Alt P
i --i
Proposed Driveway Width If her: Opening Is Desired: See Back PaEe for Explanaticn
DATE:
G� l 7 . APPLICANT: Tel.
CITY USE ONLY
Permit Fee pp ,s Fee Schedule on Reverse Side
I�, 1 25% of Building Permit Fee
Plan Check
State Surcharge �.� $.50/$1,000 Valuation
SAC Charge U75 per SAC Unit
Park Fee __ Fee Determined by Engineering
Sewer Main Charge -
® Agreement Necessary [ ] Not Necessary [ ]
TOTAL '
STIFULATION'S: `�) o®
��� �` 0V
SUBJECTRMIT
NO.
City of Fridley
AT THE TOP OF THE TWINS
BUILDING PERMIT
_19043
i �
COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
1 ` �
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
6/30/87
JOB ADDRESS 958 Rice Creek Terrace N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
4
3
Brookview Terrace 2nd Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Richard C. Doucette 958 Rice Creek Terrace N.E. 571-1275
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Greco Construction (NOT LICENSED TO WORK IN FRIDLEY)
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
Construct a 36' x 201 Deck (650 sq. ft.)
9 CHANGE QF USE FROM ` TO
STIPULATIONS
See notations. on plan
WARNING.
Before digging calf local utilities
TELEPHONE - ELECTRIC -GAS Etc.
REQUIRED BY LAW
SEPARATE PERMITS
REQUIRED R
WIRING, HEA*rING, PLUMBING 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
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
$2.25
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$4,500
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-
$50.50
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTALFEE
12.63
$65.38
SIGN ONTRACTORORAUTHORIZ AGENT (DATE)
d WHEN P O R A ATED THIS IS YOUR PERMIT
��URE
P
BLDG WSP pa TE
OF OWNER OF OWNER BUILDERI cDATEi
NEW [ ]
ADDN. L ]
ALTER. [ ]
Construction Address:
Legal Description:
Owner Name & Addess:
Contractor:
Address
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
City of Fridley
R-1 AND R-2
Building Permit Application
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
Effective 4/1/86
Tel.a S
Tel. # -
DESCRIPTION OF IMPROVEMENT
Width Height Sq. Ft.
Length -- --
Length Width Height Sq. Ft.
Length .n/ Width Hgt/Ground 2,—GZ Sq. Ft. J�
Corner Lot Inside Lot
Ft. Yd. Setback Side Yard S - k
[ ] [ ] --
Type of Construction: Estimated Cost:
Approx. Completion Date:
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: $ ---------- $
See Back Page for Explanation
DATE:
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
APPLICANT:
CITY USE ONLY
Tel. #
.�, Fee Schedule on Reverse Side
25% of Building Permit Fee
$.50/$1,000 Valuation
$ $ 525 per SAC Unit
$ Fee Determined by Engineering
$ Agreement Necessary [ ] Not Necessary [ ]
$
a Q
K 30
�0•
SUBJECT
ER
City of Fridley
(,,27204
AT THE TOP OF THE TWINS
BUILDING
PERMIT
P
RECEIPT NO.
�• _____ COMMUNITY DEVELOPMENT DIV.
ti
r PROTECTIVE INSPECTION SEC.
� �
1 �
NUMBER
REV
DATE
8/17/98
PAGE OF
APPROVED BY
= CITY HALL FRIDLEY 55432
612-571-3450
910-F15
JOB ADDRESS
958 Rice Creek Terrace NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
4
3
1 Brookview Terrace 2nd Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP
PHONE
Dick Doucette
571-1275
3 CONTRACTOR MAIL ADDRESS
ZIP
PHONE LICENSE NO
Roof Design Partners LLQ 4026h St NE Columbia 14ts
MN 59421
789-6566
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 ja REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof house and garage (23 Sq) Tear-off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with 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 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 ORDI A CES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WH H R SPECIFIED HER NOT. THE GRANTING OF A PERMIT
1918
.96
DOES NO P ESUME TO GIV AUTHO ITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIO S F ANY THE STA R LOCAL LAW REGULATING CON-
STRUCT THE P FO MAN F CONSTRUCTION.
62.25
Fire SC 1.92
`
1'2
PLAN CHECK FEE
TOTAL FEE
-90
License,-90
5.0
.13
TUREOFCONTRACTORORAUTHO IZEDAGENT (DATE,
I
INSp
LIDA
ED HI$ I$�R PERMISIGN
6aTE
TURE OF OWNER IIF OWNER BUILDE IDATEIk<WNOPAA
NEW [ ]
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: Tel. # �'� q
Contractor:�� no -s), nn' a-+neY:5) u.L
MN LICENSE #��
Address: s Tel. # �--
Attach to this application, a Certificate of Survey of eat
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:� ,CAS [) a Q
nd 41 ®YDOf
Estimated Cost: $
f
i lou 5e — e (,-;?,3
)
(Fee Schedule
on Back)
®
Driveway Curb t Widdf Needed:
Ft. 6 Ft =
Ft x $
= $
DATE: APPLICANT: Tel. #
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
$
$1000 per SAC Unit
License Surcharge
$ 5,00
$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
P MI .
City of Fridley
7245
AT THE TOP OF THE TWINS
BUILDING
PERMIT
RECEIP�
� `y -------COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
j
1 . �
NUMBER
REV
DATE
PAGE OF
APPROVED By
CITY HALL FRIDLEY 55432
I''
612-571-3450
910-F15
8/18/98
JOB ADDRESS
958 Rice Creek Terrace NE
I LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
(�
3
Brookview Terrace 2nd Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Dick Doucette
571-1275
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Greg Wills Exteriors 4246 Royce
-
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 faA REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBEWORK Aluminum soffit and facia
9 CHANGE OF USE FROM TO
STIPULATIONS
Install soffit ventilation to meet 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 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 1 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
1600
.80
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.
$54.00
Fire SIC $1.60
.
-/`� 9�
vt
PLAN CHECK FEE
TOTAL FEE
License SC,$5.00
ofl
$61
SIGNATURE OF CO ACTOR OR AUTHORIZED AGENT (DATE)
R PER V DATED T 1$ YQUR P MIT
BLDG SP
ryA
SIGNATURE OF OWNER OF OWNER BUILDER) IDATEI
NEW [ ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [) SINGLE FAMILY AND DUPLEXES R-1 AND R-2 �15
BUILDING PERMIT APPLICATION
ConstructionAddress:
Legal Description:
Owner Name & Address: t �/� �C�C�GG" �7'�''�� Tel. #
Contractor: Cg r �l/ S �� i `e9S MN LICENSE #
Address: 4%a Ald C.E �' — S ti _S` W)Tel. # 7
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF 51PROVEMENT
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:j��& mMstimated Cost: $ r
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $
DATE: PPPLICANT: Com/
Tel. # -7e
TOTAL
STIPULATIONS:
CITY USE ONLY
Permit Fee
$
5/-/00
Fee Schedule on Reverse Side
Fire Surcharge
$_ 160
.001 of Permit Valuation (1/10th%)
State Surcharge
$
86
$.50/$1,000 Valuation
SAC Charge
$
$1000 per SAC Unit
License Surcharge
$
66)
$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
PERMIT NO.
City of Fridley
AT THE TOP OF THE TWINS
BUILDI N G PERMIT
3 172'
P
F ,
R E-brPTIVOY.
_ COMMUNITY DEVELOPMENT DIV.
572-3604 iiR
r PROTECTIVE INSPECTION SEC.
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910-F15
4/5/01
JOB ADDRESS 958 Rice Creek Terrace NE
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION SEE ATTACHED
DEscR.
4
3
Brookview Terrace 2nd Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Michael Dubak 958 Rice Creek Terrace NE 763-502-0129
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO
Window Lite Home Imp. 8400 89 Ave N STE 460, Brooklyn Park, MN 55445 20039258
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO
763-425-2227
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW O ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Replace 5 windows within existing openings
9 CHANGEOFUSEFROM TO
STIPULATIONS
Provide smoke detectors in all sleeping rooms and on all levels of the
dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code. Caulk
and flash all exterior openings.
Permit Inspection Cards
Will Be M3119d
TO iso eo nw To Post
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 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
$3,873
$1'94
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-
FireAC
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
PLAN CHECK FEE
TOTA EE
Lice e C $5/fi
8.06
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
HEN 0 Y ALIDAT HIS IS Y RMIT
BLD IIFiSv jVnA E
S-GNATURE OF OWNER of OWNER BUILDERI IDATEI
NEW [ ] 16u"�
ADDN 351
ALTER [ ]
ConstructionAddress : 9C
Legal Description:
Owner Name & Address:
Contract
Address:
4010
1199P // ffective 1/ 1/99
CIW OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION v�
Tel. #l0<3
ENSE #
Tel. # — =377�—Z 2 Z7
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: , �` Estimated Cost: $
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = _
DATE: � Z APPLICANT K�—Idokl�
Ft x $
t
Tel. #Z,5— X39/- FS/ty
TOTAL $
STIPULATIONS.
=3l6.9• /. ��-� • ��-���-vim ����/�
CITY USE ONLY
Permit Fee
$ 9
Fee Schedule on Reverse Side
Fire Surcharge
$ 3r
.001 of Permit Valuation (1/10th%)
State Surcharge
_
$ �$.50/$1,000 Valuation
SAC Charge
$
$1050 per SAC Unit
License Surcharge
$ �rj, Od
$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.
=3l6.9• /. ��-� • ��-���-vim ����/�
-f1IP97
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 AND DEVICES
RATE SCHEDULE
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 & Alterations (LIST ON BACK)
1% of Value of Appliance or Work
'Commercial/Industrial
1.25% of Value of Appliance or Work
Rate
$ 30.00
$ 10.00
$ 10.00
$ 10.00
$ 25.00
State Surcharge
TOTAL FEE
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION
REFRIGERATION/AIR 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, 2002
JOB ADDRESS
OWNER
TOTAL
BUILDING USED AS
ESTIMATED COST PERMIT N0. IS06
DESCRIPTION OF FURNACE AND OR BURNER
No. of Heating Ui s r Circle One (Steam) (Ho Water) (Warm Air
$ Trade Name c� Size No. ��
BTU %l?,�® 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
$ .50 rulings of the Building Division, and hereby declares that all the facts and
$ representations stated in this application are true and correct.
DATE
HEATING CO SEQGVXK H 7. )NG &AIR QQNDITIM;"�3 Cis
8910 Wentworth Avenue youth
Signed Minneapok M9F. S _
FAX # (952) 881-9000
Approved By i Rough -In Date Final Date- �a
0
CITY OF FRIDLEY
permit No.: r
• BUILDING
���� Received By:
speetion�s BESYDEN'TLAL AI"�"Y.Y�CA.'I'IUl�
13-577-3604 C1W OF EE+ Y� Date kec'd:_
YOUR TWAH. AMRM
'E ADDMS d ie r, L-1 C
IS APPT ICANT I5: D �}VMM NI P+OTOR
?,0MTY OWNER/ 1140M. a STAiiE
TENANT fig:
PHONE:
�■ S �1 �17 i !.9
CA
>ESCR BE WORK
ma OF IMPROVE
a VIA'
*,:t) rZ(h
W—ING
3 MMM)
3 MuMiBUM
309=
=Me OPEW03 13YOS t3No
�R Volt MW OPMUNGS-DESCME SIZE OF
Z)PEN►NG CWNr,P& & - - — -
11,
Plan Review
Surcharge
Fite Surcharge
License Stege
SAC Charge
Curb CutEsWow
Frosiom Control
Park Fee
Sewer Main Charge
O SM(3
n SwINM
&/17 rl
�T3 GIST . Ft.
LENGTH
550MOMY
to HOUM dt GAItA(M I Ei g
11 ATrACHEsD GARAGE 2 Proposed Amp to i wed
D DETACI GARAGE 3. Li�E o�
FOR NEW CONS'TItUCMNINCLUDING MIC".
MgEd 1. Sim Plasma u,,ey sbmft to adgIng 'h"
ElTrim ❑ Fascia aad P uP0W Pr*Ct
2. T`wo Scb of Wamuc6on Pum
3. Esu a Catamta m
LOCATION OF WRWWS
VALUATION, INCLU li(; TM CM OF i,ABO1Et AND
(USINGTHX X997 U.B.0 FEE SCMDULE)
g Cq See Sack Page for Fee Sd1WWe
S 65,YOofBuRdingPenmit Fere
S T (.0005) times the total job valnauon _ Mh'o'$.SO
$ .001 x Permit Va on (1/100/9)
$5.00 (Stria Licensed Residential Contra)
$1450 ger SAC Ut& (PIM to M'WCC for doWz'aadon)
$ _ft + 6 S = ft x $20 = $
S $450 Camservatian P18U Review
S Fee Determined by Engineering
$ Agreement mecessuY ( ) Non Necessary ( )
k i navable to: 00 of FPAIM Attar
TM IS AN APPLiC TJON FOR A PFRI- NOT VALID UNTIL PROD
and I aekaowledge that the information above is c =Mete and acxmm% that the work will be in
I hereby apply ft a buRding permit COdes; *aa I vnd d this is rmt a
conformance with the mdWuww and codes of the City of Fridley and with the M wesm Cousttvets with the approved
pamit but only an applicat€on a permit and work is not to start without a permit; that a work wilt be in accordance
plan in the case of all woz% w approval of pi=- A/AZ&
SIGNAT{JitB OF