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City of Fridley, Minn. BU LDING PERMIT Date: .....(� . .:�. tai.... ............ Owner ....................................... Address...................................... Builderr . N® 3928 LOCATION OF BUILDING No. /15 . Street . ...... Part of Lot . ....... : ... . . .. ... ........ . Lot ......... Block ...... ......... Addition or Sub -Division' Corner Lot ............ Inside Lot............. Setback ............ Sideyard ........................... DESCRIPTION OF BUILDING To be Use �® <, �// � � 4's � � _ . .... .. Front .. % . P Depth '.ii Height /;`.® Sq. Ft. /W Cu. Ft. 12t'4 34� .................... Front ........ Depth ........ Height ........ Sq. Ft. ........ Cu. Ft. ....... Type of Construction .......•........... Fist. Cost ...� To be Completed ................... In consideration of the issuance to me of a permit to construct the building desribed above, I agree to do the proposed work in accordance with the description above set fo and all prions ordinances of the city of Fridley. In consideration of the payment of a fee of �.evv ... 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 with- in the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. _.e NOTICE: This permit does not cover the construction, Installation or alteration for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these Items. City of Fridley, Minn. BUILDING PERMIT Date: April 29, 1968 owner: — Redor ftfighlBuilder r—• Address 151 Rickard Road Address LOCATION OF BUILDING No. 155 — Street Rickaxd Road _ _ _ Part of Lot Lot _ _ Block 1 Addition or Sub -Division •U>WV XOML40 Adit. Corner Lot ._ Inside Lot I Setback ___ Sideyard Sewer Elevation ____ ___ — Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Detached Gang Front 221 Depth 241 Height 10# Sq. Ft. 526 Cu. Ft. 3280 Front Depth __ _ Height Sq. Ft. — Cu. Ft. Type of Construction FramS Est. Cost __ �% _ __ To be Completed — JUne 15 1968 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 21 provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $B.OQ , permit is hereby granted to Peder Opeohl 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, mainrepair ce, and moving of buildings within the city limits and this permit may be revoked at ,y time u, X! titinof�the provisions of said ordinances. G I4 i k NOTICE: 'fids permit does not cover the construction, installation for whing, plumbing, gas heating, sewer or water. Be sure to ses the Building Inspector for soperate permits for these Nems. APPLICATION FOR BUILUMG-PERMIT CITE' OF FRIDLEY, MIN111ESOTA ,OWNER'S NAME BUILDER i.� .@� - ADDRESSDRESS LOCATION OF BUILDING NO. Z . _.,.:.STREBI � LQT_BLOCt _ / ADDITIONOR SUBDfiVISION; oki-MR LOT INSIDE LOT �SETBACK sIbEYAD SEWER ELEVATION TOP OF FOOTING Applicant attach to this form Two Ceptificates of Survey of'Lot.And proposed bvilding'location drawn on these Certificates. ` DESCRIPTION OF BUILDING To Be Used As: oe -: r fa Front Depth ` Height_- Square feet =, 7� �_. Cubic Feet Front Depth Height Square feet Cubic Feet Type of Construction , rte- Estimated Cost To Be Completedr_,!�(�" 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 an co ect. DATE-- —SIGNATURE` _ _ ..�,....... (Schedule of Fee Costs can be found on the Reverse Side). City of Fridley Apcatian fow Plumbing and Gas Fitting Permit Dept. of Bldgs. Phone SU 4-7470 DESCRIPTION OF WORM{ Number. Kind and Location of Fixtures Locaiio < N y 0 ? WATER HTR. O iii n 3 ou ui u o m 3 G°d Uga UO N GAS ELEC. Base 1st 2nd 3rd 4th • Future Connection Openings Connected with New Fixture, Old Openings I Sewer El Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... —— 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 $�? C2 AUG b ` 1959RourTh New Ground Run Old Bldg. ............ x 3.25 $ City of Fridley: I 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 applicatiow are true and correct. Fridley, 1Vlinn Owner vl�� Kind of Building Used as To be completed about Estimated Cost, $ Old New wilding Permit NoS='- a2 - GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures ..........................T x $1.50 $ Cj Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU-- ........ x 2.00 $ REPAIRS & ALTERATIONS—Refer to code Description ................................................$ TOTAL FEE $ ' / ;Z S'® 11 POST 1 M-12-58 176'0 B Y Business Phone N-1 19 19- 19— City of Fridley Application for Plumbing and Gas F'tfing Perndt D f f Bld Ph SU 4 7470 DESCRIPTION OF WORK Number, Kind and Location of Fixtures y, 0'� F tea m Z � _} z �a pZ jZ oS .j U' O 4c ~ �j 3 z Z • a F N WATER HTR. GAS ELEC. Water Heater (Up to 200,000 BTU) ...... iii �,F w 3� o 0 5 « U' °d o OO 1st 3 Fixtures .......................... x $1.50 $ Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ Base 1st 2nd AVe 3rd r 4th Future Connection Openings Coanec with ewer r-1New Fixture, Old Openings Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... 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 1st 3 Fixtures .......................... x $1.50 $ Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL FEE ` 'T CJ ep . o gs. one Lecatinn % ``i 'P� ( d ff-4 City of Fridley: o /v/ r C '' The undersigned hereby makes application for a permit for the work here! specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this application are true and correct. Fridley, Minn. 19-0 er Kind of Building . Used as To be completed about EEstimated— TCost, $ ed ew. Building Permit No. Permit oo�. Signed' By �io%�r ' Business Phone No. 3 ROUGH FINAL ivttd I f'tln.�h't,J � � �' • S7UIil�ssas!irdf A E fL-hI;tr✓P riJ ,. y A1t i /v %� I JP/i.5 S/r-I�l ENGINEERING, INC. .411mu�iofo tIr/ t, A$ -2.- %t ' .n r7 �`� � t, .�+ t �O ��f: SUi1.G.'f 4'-i.�lE*ei !hji hi t7/:y F ! ql` lee ss L SV! Y [. V.%.� ul.o v s L / herrhy cerhey f t tJ¢ Id: ti p aJ� CJ ovt e iT : eiw esen LJ f cn C t O S:1/ vfli'%Z be tJJt:O�JE'S a� �fha Otto tfi:; robed 7,td . omd a . ..aa�� ?,.'.•�'' !t 4 .'t1n ."J IiI1 :lUi/i '? j . %`it ''JP. • a+',7(..?�i Yf: !t� t' �'.'i:"'CC<.f, J17L'iT.ij' . J•:L/. jt-.vn 0r en Said ::rnd. Ai SL`/'i'L yed :�?'( f77e cly 53-81j -S-915.51 City of Fridley pli � for r1lambbg cmd Gm Mig Dept. of Bldga. Phone M-3450 DESCHIPTIO14 OF WORK 155 N. E. Rick/ard Road Number, Kind and Location of Fixtures i8 O < w 3 Z N$. z c r Q . o � O f Z 3 0 I < W V$ o I •P1 MLEC GASTEA Base, 1st Tin s tat lasGr11 2nd 3rd 44th_ • Future Comma Oponinp + Now Fixture, Old Opmnings Conmeeted wish i;ewes � Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ................. x $2.00 $ Future Fixture Opening .......... x $1.50 $ _. New Fixture Old Opening .....:.... x $1.50 $ Catch Basin .................... x $3.25 $ Water Heater 'Up to 99,000 BTU) • .. • x $3.00 $ New Ground Run Old Bldg....... x $3.25 $ Electric Water heater .............. �.: a $2.00 $ 3AS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures x $2.00 $ Additional Fixtures .................. x $ .75 $ Gas Range to 199.000 BTU ............ x $5.00 $ City of Fridley: The .undersigned hereby makes application for a permit for the work herei specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and ' hereby declares that all the fact and representations stated in this application are true and correct Fridley, Minn 6-24 -74 18. owner Thomas k. Meuleners Kind of Building Frame Used as Res. To be completed about 7-1-74 Estimated Cost, $ 10.00 . Old—=W. Building Permit No. Permit No. ROUGH FINAL 3` a 3- 7 L REPAIRS is ALTERATIONS.--Reies to Code .50 State Surcharge Install Gas Grille 5.00 Description ....... ................. $ TOTAL FEE $ 5.5o Clas3 -' " Surcharge .50, Signed By Business Phone No suedEcr PERM I City of Fridley 2916 AT THE TOP OF THE TWINS BUILDING PERMIT r ECEIPT NO. COMMUNITY DEVELOPMENT DIV. INSPECTION r i PROTECTIVE SEC. 1 . � NUMBER REV, DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-560-3450 910-F15 4/25/75 JOB ADDRESS 155 Rickard Road 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2 1 Elwell's Riverside SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE Thomas Mueleners 155 Rickard Road N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. John Dehl 8540 Hastings Street N.E. 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 a El NEW ❑ ADDITION x ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Install masonry fireplace 9 CHANGE OF USE FROM TO STIPULATIONS SEPERATE PERMITS RE UIREn FOR WiNk7. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Masonry THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION 720NING 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 �- 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT .50 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMITFEE SAC CHARGE PR VIS[ANY OTHER STATE OR LOCAL LAW REGULATING CON- $6.00 STRUCION R E PERFO ffCONSTRUCTION. / PLAN CHECK FEE TOTAL FEE _ $6.50 IG ATURE OF CONTE?ACTOR OR AUTHORIZED AGENT (DATE) WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT BLDG. INSP I DAME SIGNWRE OF OWNER (IF OWNER BUILDER) (DATE) APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY. OF FRIDLEY, MINNESOTA OWNER'S NAME gt d BUILDER: _ ADDRESS:. ADDRESS: `;O NO: STREET: 4-i LOT: r'Z BLOCK: ADDITION: ' CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD: Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: 24CL42—. Front: Depth: Height: Square Feet: Cubic Feet: Front: Depth: Height: Square Feet; Cubic Feet: Type of Construction: Estimated Cost: $ /t"— To Be Completed: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in st-kict 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. DATE: – Z 5-- % �;_ SIGNATURE (See Reverse Side For Additional Informa n.) pffa 1 r-, 6 °CA., I–AK . 10 MMMEGASCO 53-84-s-915,51 City of Fridley Applsc.ian for Plumbing =0 GM rllaiag Per Mnllt Dept. of Bidga. Phone 5£0.3450 DESCRIPTION OF VIOR; 155 Rickard Road Number, Kind acid Locetien of Fixtures 1.ocmtia:. �_•3 s a S. a N,3 0. S O u aN Z WATER -Tit. Gni [lrc — l 3 .. i a Futuro CAaaactiata Oponings """"�`•"' ieS9eY Now Fixture. Old OponinP Ccotipool C] PARTIAL RATE SCHEDULE .l?MBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ......... _x$2.00 $ Future Fixture Opening ............ x $1.50 $ _. New Fixture OId Opening.......... x $1.50 $ _ Catch Basin .................... x $3.25 $ Water Beater !Up to 99.000 BT'U?.... x $3.00 $ New Ground Run Old Bldg. ....•..:. x "'1'5 $ Electric Mter Heater .............. z $2.00 $ RS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures x $2.00 $ . Additicnal lIxtures ............... Gas Raage to 199.000 BTU ......... x 55.00 65.00 FPAIRS & ALTERATIONS --Rotor to Code City of Fridley: The undersigned hereby makes application for a permit for the work herei specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that all the tact and representations stated In this application are true and correct' Fridley, Minn 5-19-75 19_ Owner Thomas A. Meuleners ' Kind of Building Fr Used as Res, To be completed about 5-26-75 - Estimated Cost, $ 10.00 Old Building Permit No. Permit No. Signed Byh� -- Business Phone No ROUGH FINAL .50 State Surcharge Description • . s ................... ...........► ......3 7 rAL FZE y 5.50 smocnairp 500 C lass. C SUBJECT City of Fridley 135517 AT THE TOP OF THE TWINS PERMIT ' , BUILDING 11 CEIPT NO. COMMUNITY DEVELOPMENT DIV. r 1 PROTECTIVE INSPECTION SEC. 1 i � NUMBER REV. DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 812-560-3450 910-F15 6/1/76 JOB ADDRESS 155. Rickard Road N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 2 1 Elwell's Riverside Heights Plat 2 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Thomas Meuleners 155 Rickard Road N.E. 3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSE NO. Sparkle Pool Installers Route 6 Anoka Mn. 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Swimming Pool 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE X 6 DESCRIBE WORK' Install above ground pool I 9 CHANGE OF USE FROM TO STIPULATIONS Subject to stipulations of Environmental Officer's letter dated 6/1/76 SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. Steel/Vinyl 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 I 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 $2,000 $1.00 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- TRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $12.00 PLAN CHECK FEE TOTALFEE / 04MA-, ' 7 d ( $13.00 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) PROPERLY VALIIDA%TED THIS IS YOUR PERMIT �\//\�\/�/WgHgdIE�N p, : 1— SIGNATUREOF OWNER (IF OWNER BUILDER) (DATE) BLDG. INSP BATE APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME: oS BUILDER:, -S. ADDRESS: /5Y ADDRESS: r . NO• STREET: Z . 57 /- LOT: BLOCK: ADDITION: uS° CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD: Applicant attach to this form Two Cert-ificatcs of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING ToBe Used AAs� Front; Depth: �7 Height: Square Feet: Front: Depth: Cubic Feet; Height; Squa e Feet; Cubic Feet: Type of Construction, PEstimated Cost: J` �' 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. DATE: SIGNATURE (See Reverse Side For Additional. Information.) -/d6 - / c; _ Av. a • r �, June 1, 1976 F49i 6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432 Mr. Charles Kussman Sparkle Pool Installers Route #6 Anoka, Mn. 55303 Re: Swimming Pool at 155 Rickard Road N.E. Dear Mr. Kussman: TELEPHONE ( 612)571-3450 This letter is to reiterate our conversation of June 1, 1976 and to make clear this departments requirements for the swimming pool construction at the above address. 1. As discussed, two (2) skimmers approved by the National Sanitation Foundation will be provided. 2. As discussed, two (2) inlets of approved design for'fresh and/or repurified water will be provided. 3. The filter and pump shall be approved by the N.S.F. and be of sufficient capacity to provide a minimum turnover of at least two (2) times in 24 hours. This departnent recommends a turnover rate of 6 - 8 hours. 4. A deck of at least 3 feet wide, measured from the pool water's edge shall be provided which extends completely around all private residential pools; provided that above ground private residential pools may be provided with decking of a minimum size of 4 feet by 4 feet at pool entry points and provided that such decking has the approval of the Health Authority. 5. A fence or other suitable barrier, a minimum of six (6) fee -t high, that affords no external hand or foot holds and which is impenetrable by toddlers must be provided around the entire perimeter of the pool. All gates and other accesses shall be equipped with self-closing and self -latching devices whidh are capable of being locked. 6. An automatic chlorinator should be provided with a suitable test kit. 7. All electrical and plumbing installations shall be inspected and approved by the City Inspection Department. 8. All electrical lines must be 10-20 feet or more away from the pool surface. 9. The pool fill spout must be air gapped or protected by a vacumn breaker. 10. Suitable safety equipment to include but not limited to a ring buoy and rope that is ll� times the pool diameter, and shepards crook pole must be provided and maintained with the pool at all times. Furthermore, these and any other requirements must meet the provisions of the Fridley City Code, Section 115, Swimming pools. The building permit is approved contingent on final inspections and approval by the City. Mr. Charles Kussman June 1, 1976 If any questions or problems arise from this letter, please feel free to contact me at 571-3450, ext. 170. Sincerely, i STEVElf J. OLSON Environmental Officer SJO/mh CC: Mr. Thomas Meuleners 155 Rickard Road N.E. k Page 2 'St N a, a. f, - ENGINEERING, INC. u ve "r-6 Y cie.-sr-t2ta2cate qa b / -.- LIP ayed "11,71 iNl— I� SUBJECT PER T NO. City of Fridley Q i66,05 AT THE TOP OF THE TWINS BUILDING PERMIT r � RE ' '______ COMMUNITY DEVELOPMENT DIV. I � r PROTECTIVE INSPECTION SEC. I � � CITY HALL FRIDLEY 55432 NUMBER REV. DATE OF F77 APPROVED BY 612-571-3450 910-F15 6/1/82 / JOB ADDRESS 155 Rickard Road N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 2 1 1Elwell's. Riverside Heights Plat 2 SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE Thomas Meuleners .155 Rickard Road N.E. 571-6092 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 X 8 DESCRIBE WORK Construct a 15.711 x 18' Three Season Porch. Addition 9 CHANGE OF USE FROM TO STIPULATIONS WARN144 Before digging caii IOCai tea:': ;C �EPEPA`iE PERMITS TELEPHONE -ELECTRIC, �4':;) Eii - HEATiiVG, PLUI�i�� ,� REQUIRED ��� i#�ri C�, REC `UlR BY LA ND SiG�.S. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, Wood FRam 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 I 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 $1,400`70 WITH WHETHER SPECIFIED HEREIN OR NOT. THE. GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $23-.50 NONE STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE AL FEE 88 30.08 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) _ WHE PROPS YADEHIS IS YOUR PERMIT SP DATE SIGNA11URE OF OWN OF OWNER BUILDER) �- (DATE!BLD I� CITY OF FRIDLEY Effective Aug. 1, 1981 APPLICATIM FOR RESIDENTIAL BUILDING PER4ITS Vim. Alterations, Additions, or Repairs) OWIIER.—S ®c> S m \e�ge�S BUILDER: SQ_Af: ADDRESS: Vis R,, ADDRESS: TEL NO: TEL NO: Construction Location • STRICT NO: S STREET: LOT: BLOCK: �� ADDITION: Corner Lot: Inside Lot: Setback.: Sideyards: Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale.. DESCRIPTION OF CONSTRUCTION Front: �J.f7lf Depth: Height: J Square. Feet: %d Cubic Feet: Front: Depth: Height: Square- Feet:is Feet: �.�, 0: cubic 14-=S0%.9 q 6 l ��® -Z l c.�. � R C1, 4 Type of Construction: Estimated Cost: $ 2 To Be C c)mpleted: (� Alt. A Alt. S Proposed Driveway Width If New Opening Is Desired: SEE REVERSE SIDE OF SHEET Mie 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. DATE: Le -1h SIGNATURE: Stipulations: `' PC, 90 . r� Effective May 1, 1990. CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT RATE SCHEDULE PLUMBING FIXTURE RATES: NO. e TOTAL New Fixtures Iron tr a a a to Future Fixtures -ci .i .N a w to $ Water Heater a H w rororoc $ Beer Dispenser $ 4.00 3 ~~ B ro w w $ Catch Basin $ 5.00 $ Rain Water Leader $ 5.00 $ u e $ u w $ 5.00 $ U 5 oa 00a $ Hot Water Heater o w b[i g u 4 3 $ o $ Gas Dryer -A_ $ 10.00 $ Back Flow Preventer Required. Yes ( 1 No ( U. u ani Type s Elec S 5.00 $ ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1% of Value of Fixture or Appliance $ Reinspection Fee $ State Surcharge 1st ($15.00) TOTAL FEE $ 2nd 3rd 4th (R) m Future Connection Opening Connected with Sewer (f) m New Fixture, Old Opening Water RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures $ 5.00 $ Future Fixtures $ 3.50 $ Old Opening, New Fixture $ 1.50 $ Beer Dispenser $ 4.00 $ 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 -A_ $ 10.00 $ Back Flow Preventer Required. Yes ( 1 No ( ) Type S 5.00 $ ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1% of Value of Fixture or Appliance $ Reinspection Fee $ State Surcharge S .50 ($15.00) TOTAL FEE $ Job Address Department of Buildings City of Fridley Tel. 0571-3450 The undersigned hereby makes application for A permit for the work herein specified agreeing to do all work in strict accordance with the City Codes and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct Fridley, Mn. ` 'a f� , 19 / ® r_ I OWNER 0 1 KIND OF BUXIVNG USED AS TO BE COMPLETED ABOUT ESTIMATED COST o3 j OLD - NEW BUILDING PERMIT NO. PERMIT NO. ( 4_7/ ComPanyt n ft c7 Signed By ROUGH INSP. Date Tel. No. FINAL INSP. 2 71_?10 Date APPROVAL FOR PERMIT i 8A(NfstEGA800 MINIMUM FEE FOR ANY PLUMBING PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1991 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATIO14 AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE Residential Rade Furnace Shell and Duct Work, Burner - Also Replacement Furnace $ 20.00 Gas Piping1(Nbeded with new furnace) $10.00 Gas Range $10.00 Gas Dryer $10.00 *Air Conditioning - All Sizes $10.00 All Others/Repairs & Alterations (LIST ON BACK) I % of Value of Appliance or Work Commercial/Industrial I % of Value of Appliance or Work State Surcharge TOTAL FEE TOTAL $ $ $ $ $ .50 MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $30.00 *Air Conditioners can not be placed In a side yard without written permission from adjoining property owner. JOB ADDRESS /J3' 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 ruling of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. i ,1991 OWNER z. -A ec`<.s v xc BUILDING USED AS ,l ®a ESTIMATED COST 0Z60- PERMIT NO. f INP DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units_Ircle One (Steam) (Hot Wate (Warm Air) Trade Name Z���� ��� X_ e_• ys Size No.e&yh1�� a BTU HP EDR Fuel _ - Total Connected Load sus Burner Trade Name Size No. BTU HP _ EDRA HEATING COMPANY Signed By�4 tel No.� Approved B Rough -In Date Final Date ci qlcl FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE 0 IF CHIMNEY AND BTACR VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes ( No ( ) 2. Is free from rust or deterioration Yes ( No ( ) 3. Has no foreign objects lodged within Yes No ( ) 4. Is securely supported Yes (� No ( ) 5. Meets all current Code requirements for size and total BTU's connected Yes (4 No ( ) 6. Has total heating BTU's of " ---� All other BTU's �W -✓� " TOTAL BTU's Remarks List Alterations Being Done: 14506 list Avenue li omit Snide 222 HEATING COMPANY PlymOW4 MN 66447 Signed By Date WELL OR BORING LOCATION MINNESOTA DEPAWMENT OF HEALTH Minnesota Well find Boring WELL AND BORING SEALING RECORD Sealing Na Unique Weo. ll No. Minnesota Statutes, Chapter 1031 or W-Series No. (Lem9 Wank Antal known) H � � County Name TP M Township No. Range No. Section No; I Fraction (sm. -> Ig.) Date Sealed Date Well or Boring Constructed Numerical Street Address or Fire Num#er and City of Well or Boring Location ISS RICKMO ROJO Depth Before Sealing Lid ft. Original Depth ft. Show exact location of well or boring Sketch map of well or boring n section grid with °X°. location, showing property lines, roads, and buildings. N� I W - - +; ; �- E i A% -r- --�- -i - -i-- - i S ""11 mile I _ AOUIFER(S) Single Aquifer ❑' Multiaquifer STATIC WATER LEVEL Measured ❑ Estimated ft. bek)w above land surface WELLBORING Water Supply Well ❑ Monit. Well. ❑ Env. Bore Hole 0 Other CASING TYPE(S) Steel. E] Plastic rile E] Other CASING(S) . Diameter Depth Set in oversize hole? Annular space initially grouted? � in. from � to ' ft ❑ Yes No ❑Yes ❑ No ❑ Unknown in. from to - tt. ❑ Yes ❑ No J❑ Yes ❑ No ❑ Unknown in. from to - - ft. ❑ Yes ❑ No i❑ Yes ❑ No ❑ Unknown P WNE�R'SNA Property, owner's mailing address 0 different than well location address indicated above. - V55 F"Dwy, 5"32 SCREEWOPEN HOLE Screen from to I IL A ft. Open Hole from to OBSTRUCTIONS ❑ Rods/Drop Pipe ❑ Check Valve(s) ❑ Debris ❑ Fill No Obstruction Type of Obstructions (Describe) Obstructions removed? ❑ Yes ❑ No Describe. ELL O ER'S NAME Well owner's mailing address if different property owner's address indicated above. (.; PUMP Tye Removed ❑ Not Present E3Other HARDNESS OF FROM TO GEOLOGICAL MATERIAL LOR FORMATION If not known, indicate estimated formation li'g from nearby well or boring. METHOD USED TO SEAL ANNULAR SPACE BETWEEN 2 CASINGS, OR CASING AND BORE HOLE: 11ANo Annular Space Exists ❑ Annular space grouted with tremie pipe ❑ Casing Perforation/Removal in. from to ft. d Perforated ❑ Removed I in. from to ft. Q Perforated ❑ Removed Type of perforator NUC K 0 1-5 CLAY JS 30 SAM/CLAY 301 ❑ Other GROUTING MATERIAL(S) (One bag of cement - 94 lbs., one bag of bentonite = 50 Ibs.) lis Grouting Material from to ft. yards bags from to ft. yards bags from to ft. yards bags i from to ft. yards bags �I L REMARKS, SOURCE OF DATA DI ULTIES IN sEALING r WA IN ' DATE WATM 02/13/e _ CODE / — %---.-XEA, LED y�FF Accordingto MN � e OTHER WELLS AND BORINGS nu or boring on property? [I Yes No How many? LIC SVER ONTRACTOR CERTIFICATION . alis well or boring was sealed in accordance with Minnesota Rules, Chapter 4725. Thelinformation contained in this report is to the best of my knowledge. R.H. MMM SCM, MC 41015 Contractor Business Name ,r rise or Registration Pro. 9 ntellVe g Authorized E=,IKWM WIPPE LOCAL COPYName I H 173,109 - of Person Sealing Well or Boring - I a City of Fridley 32198 AT THE TOP OF THE TWINS B U I L ®I N G PERMIT M r V RECEIPT NO. � • ____ COMMUNITY DEVELOPMENT DIV. j PROTECTIVE INSPECTION SEC. 240 F . � NUMBER REV DATE PAGE OF APPROVED BY i i--'I CITY HALL FRIDLEY 55432 612-571-3450 910-F15 9/26/01 JOB ADDRESS 155 Rickard Road NE I LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2 1 Elwell's Riverside Heights Plat 2 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Dan Saplis 155 Rickard Road NE 574-6939 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Thomas Mooney/Moon Roofing 3709 Welcome Ave N, Crystal, MN 55422 763-533-6363 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 20098632 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK O NEW O ADDITION O ALTERATION REPAIR 0 MOVE O REMOVE 8 DESCRIBE WORK Reroof House (16 Sq) Tear-off 9 CHANGEOFUSEFROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU FT AUTHORIZED IS NOT COMMENCED WITHIN 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 $.86 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1,715 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. $63.15 Fire SC $1.72 STRUCTION O HE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTAL EE hl / Licens $5.00 .73 SIGNATURE OF CONTRACTORORY061ORIZED AGENT IOATEI _ HEN ROPE ALIOAT D HIS I$� PERMIT r/��j ', �6 INSP MATE S-GNATURE OF OWNERoF OWNER BUILDERI IDATEI a NEW [ l Effective 1/1/2001 ADDN [ ] CITY OF FRIDLEY (763) 572-3604 Bldg Insp ALTER [ j SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: &jafz Legal Description: Owner Name & Address: ,©Ati fib% Tel. # Contractor: 7/1M � %%�®sem MN LICENSE # Address: Zza %91e -come Ae-AL V Tel. # (7*V 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: ,D ch. ® Estimated Cost: $ Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ =$ DATE: / "' —�, APPLICANT: Tel. # CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application Permit Fee $ .3. �✓Fee Schedule on Reverse Side Fire Surcharge $ /.,72 .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ / $1150 per SAC Unit License Surcharge $ 9.404 $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 $ %-6 - 73 STIPULATIONS: CITY OF FRIDLEY PERMIT NO.( 200401700 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: 09/30/2004 (763) 572-3604 FAX: (763) 571-1287 ADDRESS 155 RICKARD RD NE PIN 103024120007 LEGAL DESC ELWELLS RIVERSIDE HGHTS PL2 LOT 2 BLOCK 1 PERMIT TYPE BUILDING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING VALUATION : $ 954.00 NOTE: UNDERLAYMENT AS PER STATE BUILDING CODE. REROOF GARAGE (8 SQ) TEAR-OFF APPLICANT BUILDING PERMIT FEE FIRE SURCHARGE 38.75 0.95 DAN SAPLIS 155 RICKARD RD NE STATE SURCHARGE, VALUE 0.50 FRIDLEY, MN 55432 TOTAL 40.20 PAID WITH CHECK # 2425 OWNER DAN SAPLIS 155 RICKARD RD 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 work 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 regula ' e perfoance of co c . 310j, 04 ansction, Applicanti 15 DAJ4 Bldg InspA Daq[lh SEPARATE PERMITS RE D FOR WORK OTHER THAN DESCRIBED ABOVE. NEW [ J CITY OF FRIDLEY Effective 4/1/2004 ADDN 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ j SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax . g i� BUILDING PERMIT APPLICATION L Construction Address: ' RD Legal Description: Owner Name & Address: Aim �. `� Tel. #� 574 Oq Contractor. 0 ( e GSC G' CLIC NSE # 'Iel. # -7(o---'5 755 1F52 7— � — � I— 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 y Sq. Ft OTHER: RC •C _ cw Q (a �a l - E 44 C ®'� Construction Type: '05 �A ct=r4 1., E S Estimated Cost: $ 11 Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: q - --6(r-®APPLICANT: AN4 � uS Tel. #-70a ��--'� 39, Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee Plan Review Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge $ 0c Fee Schedule on Reverse Side 65% of Permit Fee .001 of Permit Valuation (1/10th%) $.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 [ TOTAL $ STIPULATIONS: Building BUILDING Permit No.: qLeXl Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd: DATE ®C® YOUR E-MAIL ADDRESS Sc Oti - SITE ADDRESS THIS APPLICANT IS: ❑ OWNER XONTRACTOR PROPERTY OWNER/ NAME:_,yp ADDRESS: CITY STATE—ZIP- TATEZIPPHONE: TENANT PHONE: CONTRACTOR NAME: STATE LICENSE # EXP DATE SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: . 7 �l I l 1521f!' P- -1r11Q- i../ CITY_STATEOA-ZIP .3-3�-0 3 WITH APPLICATION PHONE 1-1,9- 363 A FAX -7 (L, - 4:)0 01 W3,1 PROPERTY TYPE 1XSINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH °'M:ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION MAINTENANCRREPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: -74A',-, SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING OUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. 2. Existing Floor Plan Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes []No LOCATION OF WINDOWS OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ L-0 Q _ 00 OCCUPANCY TYPE Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due See Back Page for Fee Schedule 65% of Building Permit Fee .001 times the total job valuation .0005 x Permit Valuation Minimum $.50 $5.00 (State Licensed Residential Contractors) $1550 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$21=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks payable to: City of Fridley Attach 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 applicatWU--�-e rmit 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 s lew and approv plans. -' J �/ SIGNATURE OF APPLICANT PRINT NAME ����� �1 s DATE 8