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SUBJECT E NO. City of Fridley 15 312 AT THE TOP OF THE TWINS BUILDING PERMIT r � DEVELOPMENT DIV. �Rt=�C �NOCOMMUNITY PROTECTIVE INSPECTION SEC. !� t i � CITY HALL FRIDLEY 55432 NUMBER REV, DATE PAGE OF APPROVED BY 612-571-3450 910-F15 7/5/79 JOB ADDRESS 7110 Riverview Terrace N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 4 1 Marion's Terrace SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE William V. May 184 - 71st Gray N.E. Fridley, MN 55432 571-5185 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 B DESCRIBE WORK Construct a 50' x 32' li d Dwelling and a 22' x 24' Garage ad rE+.DNaIZ ELECtRic •aAS Ft 9 CHANGE OF USE FROM TO ED 6Y �� STIPULATIONS Provide a hard surface driveway. Provide sod in the front and side( yards. Provide City with verifying survey before capping. SERVICES AVAILABLE BUT NOT STUBBED INTO PROPERTY LINE. DRIVEWAY DEPRESSION ESCROW: Surmountable Curbing SEPERATE PEhMI1'S REQUIRta IrOR M HEATING. PLUMGING AND SIGNS, TM11 arf -dr MDLEY OM NOT GUAWRC 11L ACCURACY OF 'Uh&ITY' LOCAANONS .AND IMATIc+4j, 7t,,i5 DATA IS f 0R-"N 0W"TION PURPOW ONLY . MD nitSONS USING It $l WO VM 1"I MCAMAU* ON THE 5111, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Wood Frame 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 R-1 1152 + 528 32,922 Total ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT EE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE Ont 32.92 $618.21 SIGNATURE OF ONTRACTO 11 AUTHORIZED AGEN (DATE) EN PROP R Y ATE THIS IS YOUR PERMIT • 9s!i; ?� BLDG INSP r)ATE NATURE OFO NERIIFO NER ILDERI (DATE) �r y CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL BUILDING PERMITS (New, Alterations, Additions, or Repairs) OWNER: a BUILDER: W/ ADDRESS:, TEL NO: TEL NO: Construction Location STREET NO: '07//0 STREET: LOT: BLOCK: ADDITION: / '°��'t �/!/ -S Corner Lot: Inside Lot: A,-*� Setback: Sideyards: Applicant attach to this form two Certificates of Survey of lot and proposed.building location drawn on certificates to scale. DESCRIPTION OF CONSTRUCTION IWfi a-1,07 Front:-3Depth:Height: =$ Squane. Feet: / Cubic Feet: % 9 Front: Depth: 4/ Height: Square Feet: Jam, ! Cubic Feet: 90 t Type of Construction: Q)_ Litz Estimated Cost: $ . ZO® To Be Completed: — �,-- Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: $ $ SEE REVERSE SIDE OF SHEET'_ 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 correctFF " 1 �_ A DATE: —�,/ �� / f :7 1� IGNATU RE : Stipulations: pev- ►;r- Ill, v, `31(00 P-0- 3,zA 130 Z� (o t8.2 I gQ "Vk#EAJ, . 9 .91 CITY UE FRIDLEY APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES PARTIAL RATE SCHEDULE GR:IVITY IWARM AIR: Furnace Shell & Duct Work Replacement of Furnace Repairs & Alterations -up to $500.00 Repairs & Alterations each add. $500.00 PIECiiANICAL T" ARM AIR: Furnace Shell & Duct Work to 100,000 BTL* each add. 50,000 BTU *Replacement of Furnace Repairs & Alterations -up to $500.00 Repairs & Alterations each add. $500.00 STy;Ai OR HOT l ATER SYSTEM: Boiler & Lines up to 100,000 BTU each adds. 50,000 BTU Boiler cnly up to 100,000 BTU each addn. 50,000 BTU OIL BURNEI:- to 3 gal. per hour each add. 3 gal. per hour CAS BURNER- from 100,000 BTU to 199,999 BTU (over.193,999 BTU see Fee Schedule) GAS FITTING FEES: RATE TOTAL Job Address $12.00 $ 7.00 $ 7,00 $ Department of Buildings 5.00 $ City of Fridley Tel. #571-3450 $12.00 4.00 7.00 7.00 4.00 $12.00 4.00 7.00 6.00 $10.00 10.00 $10.00 1st 3 Fixtures / x $ 3.00 Additional Fixtures X $ 1.00 Gas Range to 199,000 BTU X $10.00 AIR CO\DiTIONING PAN: ifEATING SYSTE"'IS See Fee Schedule E'EN 'ILATI NG SYSTE iS ALURATIONS F REPAIRS State Surcharge TOTAL FEE PDUGH INSP. REINSPECTION FEE Date ($10.00) FINAL INSP. 1-/ :g -go Date APPROVAL FOR PER14IT l MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE *Attached stack verification form Trade Name The undersigned hereby makes application for a permit for the work herein $ / ,2 - specified agreeing to do all work in strict accordance with the City Codes $7 and rulings of the Department of Buildings, and hereby declares that all the $ facts and representations stated in this application are true and correct. $ $ Fridleyy,,i Minn. � � � 19�� OWDIFR $ KIND OF BUILDING $ USED AS TO BE COMPLETED ABOUT -2 $ ESTIMATED COST $ �© OLD, - NEW B ILDING PERMIT NO. PER^:IT NO. $ — DESCRIPTION OF FURNACE/BURLUER $ HEATING or POWER PLANTS, Steam, Hot Water,ana Air- No. MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE *Attached stack verification form Trade Name (56&�,4f/_ /C- Size No. ,_1,r /1-10 �W, Capacity Sq. Ft. EDR BTU '410,A01 HP Total Connected Load Kind of Fuel &�, BURNER - Trade Name Size No. CapacityD /B U HP Company Signed By 'Tel. No. SUBJECT PE City of Fridley 16329 AT THE TOP OF THE TWINS _ . BUILDING PERMIT rp ECEIPT NO. `L _ COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. r PROTECTIVE CITY HALL FRIDLEY 55432 NUMBER REV, DATE PAGE OF APPROVED BY 612-571-3450 910-F15 8/6/81 JOB ADDRESS 7110 Riverview Terrace N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 4 1 Marion's Terrace SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE William V. May 7110 Riverview Terrace 55432 571-5185 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO, same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. same 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. same 6 USE OF BUILDING 3 season porch 7 CLASS OF WORK ❑ REMOVE ❑ NEW ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE B DESCRIBE WORK 3 season porch Addition (12' x 12') 9 CHANGE OF USE FROM TO STIPULATIONS variance granted August 3, 1981 TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, Frame 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 144 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 $1,440 $ WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT .72 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. PLAN CHECK FEE TOTAL FEE $25.72 one SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) PROPE L ALI AT D Si IS YOURPERMIT 2 1_ s R' /k JEN _ ___ / /iib SIGNATURE OF OW IF OWNER BU ERI (DATE) BLDG INSP DATE CITY OF FRIDLEY Effective Aug. 1, 1981 APPLICATION FOR RESIDENTIAL BUILDING PEW41TS (New, Alterations, Additions, or Repairs) OW14ER: �� L. BUILDER: ADDRESS:����� If�V_f-�� ADDRESS:i� TEL NO: • STREET NO: STREET: TEL NO: Construction Location 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 P,pFront: Depth: ZZ_Height: Squane.Feet: Cubic Feet: Front: Depth: Height: Square -Feet: Cubic Feet: Type of Construction: Estimated Cost: $ ` f�'��zv TO Be Cbmpleted: Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: SEE REVERSE SIDE OF SHEET . 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 applicatiW are true and correct. DATE� f zg SIGNI�TUrz : c Stipulations: S.a� SUBJECT PERMIT N _ City of Fridley r2_0 9 8 0 AT THE TOP OF THE TWINS BUILDING PERMIT r R COMMUNITY DEVELOPMENT DIV. _ r � � PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEV 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 7/31/91 JOB ADDRESS 7110 Riverview Terrace NR LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED 1 LEGAL DESCR. 4 1 Marion Is Terrace SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Dee Weaver 7110 Riverview Terrace NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Roto--Rooter 14530 27th Ave N, Plymouth, MN 55447 544-9551 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 O MOVE ❑ REMOVE S DESCRIBE WORK Interior Alterations. to Basement 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. Provide smoke ala= on upper level. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD 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 NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 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 $17f000 $8,50 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 LOCA LAW REGULATING CON- $180.00 Fire SC $17.00 TRUCTION THE P RMANC OF CO RUCTION. PLAN CHECK FEE TOTAL FEE !� $205.50 SIGNATURE OF CONTRACTOR OR AUTHORIZE AGENT IDATEI %A.HEN PROPERL I E HIS IS YOUR PERMIT I= 316r INSP SAT SIGNATURE OF OWNER OF OWNER BUILDER) IDATEI IM I I Effective 2/2/91 AMV R -I AM R-2 ALTER Building Permit Application omwtructicn Address: 52110 , f). 6 -- legal Descri Owner Name & Address: Tel. Contractor: Tel. Address: Attach to this application, a Certificate of azvey of the lot,, with the proposed construction drawn on it to scale. DF9CRIP1'NK CW — -MMM LTVM ATM: Length Width Height sq. Ft. GRFJM AIM: Length Width Height Sq. Ft. n= ATMU Lazath Width Hgt/Ground Sq. Ft. r TqM 0: Corner Lot [ ] Inside Iot_[X Ft. Yd Setback Side Yard Setbacks Type of Construction: IY54 7/it- Estimated Cost: $ Approx. Ompletian Date: 4!0?r /S 6n4 Proposed Driveway Width If New Opening Is Desired: Ft. idth + 61 See Back Page DATE: APPIZCANTI-- Tel. CMTY tM Permit Fee Fee SdvxUle on Reverse Side Fire Surcharge $ 12, 6e) .001 x Permit Valuation (2/10th State Surduairge, S7, $.50/$1, 000 Valuation SAC Charge $ $650 per SAC Unit 'Driveway Escrow $ Alt. "A" or Alt. "B" Above Park Fee $. Fee Determined by Sewer Main amrge $, --- I Necessary Not Necessary STTPLZAITCNS: 1. CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 Effective On January 1, 1991 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR PLUMBING FIXTURE RATES: New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas Gas Range NO. RATE TOTAL Gas Dryer Back Flow Preventer Required ( )Yes () No Type $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 $5.00 Reinspection Fee $30.00 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1 % of Value of Fixture or Appliance State Surcharge .50 TOTAL FEE $ z �1_5® Mie * /S, so JOB ADDRESS /� f U�� V ► eW Tetfrac 2 I E The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the city codes and rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. N � I 1991 Owner el- U e -V -- �J Building Used As er , Uc-tea- res c deme Estimated Cost "7` 75 PERMIT NO. �l L�' �l /3 PLUMBING COMPANY eb_�y _ 190a l ev- Co. SIGNED BY TEL N0. Approved By - Rough -In Date Final Date��� MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE CITY OF FRIDLEY Effective Date January 1, 1991 .APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE QESIDEbTIAL Furnace Shell and Duct Work, Burner (Also replacement furnace) Gas Piping (piping needed with new furnace) Gas Range Gas Dryer * Air Conditioning (all sizes) RATE TOTAL Job Address a /G ����� �l�� / ; $ 20.00 $ Building Inspection Div. 6431 University Ave NE Fridley MN 55432 Tel. No. 572-3604 $ 10.00 $ $ 10.00 $ $ 10.00 S $ 10.00 $ A, All Others/Repairs and Alterations l% of Value of Appliance or Work $ -2G COMMERCIAL/INDUSTRIAL 1• of Value of Appliance or Work State Surcharge REINSPECTION FEE $30.00: Rough Insp. Date Final Insp. Date Approval for Permit aj�d S $ .50 S MINIMUM FEE FOR ANY HEATING/COOLING/VENTING PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE *Air Conditioners can not be placed in side yard without written permission from adjoining neighbor. 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. 19 OWNER KIND OF BUILDING - - USED AS ry j TO BE COMPLETED ABOUT yC e ESTIMATED COST ®` " +-7a-a ®?/� co OLD - NEW BUILDING PERMIT NO. PERMIT NO. 1� Fill out back side for stack verification on replacement furnaces DESCRIPTION OF FURNACE/BURNER HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. Trade Name Size No. Capacity Sq. Ft. CDR BTU HP Total Connected Load Kind of Fuel BURNER - Trade Name Size No. Capacity Sq. Ft. EDR BTU HP Company atw_" Signed By Tel. No. 63i 1 Fill out back side for stack verification on replacement furnaces CHIMNEY AND STACK 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 connected Yes ( } No ( ) 6. Has Total heating BTU's of All other BTU's TOTAL Rema rk s I Company _ Signed By Date SUBJECT PER City of Fridley �60 AT THE TOP OF THE TWINS BUILDING PERMIT r ECEIP 116% _______ COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. r NUMBER REV DATEP AGE OF APPROVED BY 1--'1 CITY HALL FRIDLEY 55432 612-571-3450 910-F15 8/4/95 JOB ADDRESS 7110 Riverview Terrace NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 4 1 Marion's Terrace SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Weaver 7110 Riverview Terrace NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO RightWay Roofing Inc 16475 45 Ave N, Plymouth MN 55446 557-8678 3999 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 House & Garage (28 Sq) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, 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 ] 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 $2,240 $1.12 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 $74.75 Fire SC. $2.24 x _r, PLAN CHECK FEE TOTAL FEE � Y_� License SC51.y00 83.11 SIGNATURE OF CONTRACT AUTHORIZED AGENT IDATEI NPR PER VALIDATED THIS ISY UR PERMIT S]GNATURE OF OWNER IIF OWNER BUILDER] IDATEI BLD9r INSP DOTE NEW Ll ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Effective 8/l/95 1. Construction Address: -7 114 j�- r.yGg- at'eir—/, — Legal Description: Owner Name & Address: W Q; ck \0 C: 710 Py O , (j t a c4 -)TU -r. Tel. # Contractor: _ ��I �' fl-Lt'046 _ MN LICENSE # Address:( �� L1 +� ( ny 6'}`1�1�:� Tel. # J ;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: Length Width �_ Hgt/Ground Sq. Ft. OTHER: I` 5''Z5 (5:p 0 U' e,r�c� Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: Y' ^ Y,1:5 9�E Estimated Cost: $ Approx. Completion Date: C E': 0 (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ DATE: APPLICANT: a Tel. #�� CITY USE ONLY Permit Fee $ '%�• %7- Fee Schedule on Reverse Side Fire Surcharge $_ .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $850 per SAC Unit License Surcharge $, CACI $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 j ] TOTAL $ I STIPULATIONS: SUBJECT N City of Fridley C 29400' AT THE TOP OF THE TWINS BUILDING PERMIT `v .......COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. r PROTECTIVE 1 � NUMBER REV DATE PAGE OF APPROVED BY = CITY HALL FRIDLEY 55432 612-571-3450 910415 5/5/99 JOB ADDRESS 7110 Riverview Terrace NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 4 1 Marion's Terrace SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Larry Weaver 7110 Riverview Terrace NE 574-1694 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Sawhorse 4740 42 Ave N, Robbinsdale MN 55422 533-0352 2302 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO B USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW C ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 12' x 14' Addition and a 28' x 12' Deck 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. CONSTRUCTION WORK HOURS: 7:00 am to 9:00 pm, Monday thru Friday; 9:00 am to 9:00 pm on Saturday; No work on Sunday. WARNINK M` Before digging cell for AMMA 'E PERMITS ' REQUIRED FOR 0Iocatrons 4540002 454 WIRING, HEATING, PLUMBING AND SfGNS, RQ jIR BY. LAW SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING 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 1 STALLS GARAGES AND KNOW THE SAME TO E TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOV NING THIS TYPE OF WORK WILL BE COMPLIED $8 560 $4.28 WITH WH THER SP IF HEREIN OR NOT. THE GRANTING OF A PERMIT DOES T PRESU GIV AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROM I N 0 ER STA OR LOCAL LAW REGULATING CON- TRU H R RMANC OF CONSTRUCTION $149.75 Aire SC $8.56 PLAN CHECK FEE TAL FEE ' Lic e C $P $167.59 TUREOVITRACT0 A THORIZEO AGENT —IDA TE� WH P Y V I TED THIS IS Y UR P RM I& OG SNS r ' OarE S-GNATUAE OFOW NEA oFOWNER BUILDER, —.DATE, NEW [ ] Effective 1/99 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATIO ConstructionAddress: '� 1 a 7%VS2'U I6A J t:YLtL✓h �- Legal Description: 1~oT 4 Iia L oe y, (A sA saawal I mit dl.Aga Owner Name & Address: LAa&Ayam it to �Z�w�'a-v��w��'��� Tel. # ILas 4- Contract MN LICENSE # �� W2 Addres : 2 w;. - Tel. # -533-03 52 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 m Width 14- Height Sq. Ft. t o avhf-V GARAGE AREA: Length Width Height Sq. Ft. --s, �2 DECK AREA: Length 2Q> Width tZ Hgt/Ground Sq. Ft.. � yGyy.sy OTHER: g4 - Y Construction Type: W rip _Pm_ ^ &C Estimated Cost: $ Z� (Fee sghedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $, DATE:- • Z7- APPLICANT: `_..sew 1�-05�- Tel. #X133-03 Z - STIPULATIONS: CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ �', .001 of Permit Valuation (1/10th%) State Surcharge $ %fig $.50/$1,000 Valuation SAC Charge $ $1050 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors)` Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ STIPULATIONS: ITY OF F�.IDLEY INSPECTION DIVISION✓2� `� Efiective On January 1, 2002 o, 44J University Ave NE ridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, c1 163) 572.3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES IL �n JOB ADDRESS 7 10 lel V.P_r V rr LU, © RATE SCHED_U_LE /� OWNER GL..Gtrrq 4 IJe-e Wt&tle Y N residential Rate TOTAL Furnace Shell and Duct Work, Burner L� BUILDING USED AS Also Replacement Furnace $ 30.00 $ , (PERMIT N0, (Side Vent • Fill Out Back) ESTIMATED COST Gas Piping (Needed with new furnace, $ 10.00 $ but not replacement) DESCRIPTION OF FURNACE AND OR BURNER Gas Range $ 10.00 $ Q No. of Heating U 'ts Circle One (Steam) (Hot Wa epr� ( arm ) ~ Gas Dryer $ 10.00 $ Trade Name.((,Vlrl __ Size No. X1'1 V! -Z�S-BTU__LLQj CDC HP EDR cAir Conditioning• All Sizes $ 25.00 $� Fuel Total Connected Load All Others/Repairs & Alterations (LIST ON BACK) Burner Trade Name Size No. 1% of Value of Appliance or Work $ BTU HP EDR W A :ommercial/Industrial 1.25% of Value of Appliance or Work $ The undersigned hereby makes application for a permit for the work herein LL specified agreeing to do all work in strict accordance with the City Codes an 0 State Surcharge $ 50 rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. u TOTAL FEE $ F17'C. DATE 1156? CER9Tr��L ELECT n. . U_ IINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION HEA71NG CO ANO AVE• N.E. !EFRIGERATION/AIR CONDITIONING PERMIT IS 25.01) —' f, 'LUS THE $.50 STATE SURCHARGE Sig 07 / TEL # �' / © FAX # - �' 7 [ � % m !EINSPECTION FEE $47.00/Hr m Air Conditioners can not be placed in a side yard without Approved By Rough-in Date Final Date i tritten permission from adjoining property owner. EILL OUT BACK SIDE"F RST CK VERIFICATION ON REPLACEMENT FURNACE ,JPN-16-2002 Oe: 32 FROM CITY OF FRIDLEY TO r5'r5'Ml e. 04!102 THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED COMMON VENT, VENT CCINNECTOR AND COMBUSTION AIR VERIFICATION When rn la _ink an dsfiag furan _ , the undersigned hereby verifies 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 coaes and manufacturer specifications including sizing, length, number of elbows and termination. Yes, The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturees specifications. This does include AGA-GAiMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes ) No ( ) The existin nmb avian air is sized and installed to meet the current codes and manufacturer's specifications. Yes No( ) When required to' 11 a new combustion air, it will be sized and installed to meet the current codes and manufacturer's specifications. Yes No ( ) When nting s;s,ern, the undersigned hereby verifies that it is a lined asser`;bly and meets the current codes and manufacturer's specitcaticns. This does include AGA-GANIA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Ye4( ) 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. Yd No( ) Ap,pliance Tvpn_e and Size/ Common Vent aad Y=i cannectnr Information 4-9 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 �� QBia9� �T� �flf° �B ��,'T a fir`•^�: 1.1562 CENTRAL AVE. W.E. HEATING CO: ANOKA, MN 55304 Signed By: - Date TOTPL P.02 INSPECTION REPORT CITY OF FRIDLEY MINNESOTA (763) 572-3 ADDRESS OWNER BUILDER DATE PERMIT NO. // 116to ) DESCRIPTION IL, A I /.1-% _ ,i i A A //3/4 t= l% DATE as called for INSPECTION REPORT REPORT oris and make CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 (763)572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Effective On Jan 1, 2uu2 PLUMBING FIXTURE RATES:, NO. RATE TOTAL JOB ADDRESS '? % J 0 New Fixtures $ 7.00 The undersigned hereby makes application for a permit for the work herein Old Opening, New Fixture $ 4.00 specified agreeing to do all work in strict accordance with the city codes Beer Dispenser $ 5.00 and rulings of the Building Division, and hereby declares that all the facts Blow Off Basin $ 7.00 and representations stated in this application are true and correct. Catch Basin $ 7.00 Rain Water Leader $ 7.00 20 o 2— Sump/Receiving Sump/Receiving Tank $ 7.00 &yxvwe_4- Water Treating Appliance $10.00 Owner we*-b-eA4_, Water Heater -Electric � $ 7.00 Water Heater - Gas** $10.00 Building Used As Gas Range" $10.00 ��9° Gas Dryer*` $10.00 Estimated Cost PERMIT NO. Back Flow Preventer Required ( )Yes () No Type $15.00 PLUMBING COMPANY Reinspection Fee $47.00/Nr SIGNED BY R TEL N0 2� ALL OTHERS AND/OR REPAIRS AND ALTERATIONS FAX # 1.5% of Value of Fixture or Appliance Approved By. Rough -In Date Final Date State Surcharge $ .50 MINIMUM FEE F ANY PLUMBING/GAS PERMIT IS $20.00 TOTAL FEE $ W'fo PLUS THE $.50 STATE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED CQMMQN VENT VENT CBNNFCTQR AND r QMRIISTION AIR VFRIFI ATIr)N When re la .inganan axiisttng_f0ranets, the undersigned hereby verifies 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 plasticfPVC and meets all current codes and manufacturer specifications including sizing, length, number 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-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes( ) No( ) The existing rnmhustenn air is sized and installed to meet the current codes and manufacturer's specifications. Yes( ) No( ) When required to install a new cnmhiistinn air. it will be sized and installed to meet the current codes and manufacturer's specifications. Yes( ) No( ) When installing a new v _n in,g 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 #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 HEATING CO: Signed By: Date City of Fridley SUBJECT PE 3 4 01 8 AT THE TOP OF THE TWINS BUILDING PERMIT - ` RECEIPT NO. ` COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 � � NUMBER REVDATE PAGE OF BY CITY HALL FRIDLEY 55432 763-571-3450 910-Fi 5 I j 11/10/03 [APPROVED JOB ADDRESS 7110 Riverview Terrace NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 4 1 1 Marions Terrace SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Larry Weaver 7110 Riverview Terrace NE 763-574-1694 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Renewal By Andersen 1920 Co Rd C W, Roseville, MN 55113 651-264-4777 20130983 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 Q. REPAIR ❑ MOVE ❑ REMOVE X 8 DESCRIBE WORK Replace three 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. 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 1 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 $2.62 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $5,241 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- $125.25 Fire SC $5.24 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTALFEE License SC $5.00 $138.11 SIGN A TUBE OF CONTRACTOR OR AUTHORIZED AGENT MENPROPERLY VALIDATED THIS I$ Y UR LfOI /yEp�RMIT S-GNATURE OF OWNEROF OWNER BWLOER. , LDG INS gArE rV NEW[ ] Effective 5/10/99 ADDN [ ] CITY OF FRIDLEY - ALTER [ ] SINGLE FAAMY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: Legal Description: Owner Name & Address: L-Ot_ P, r -t( a Tel. Contractor:;MN LICENSE # 0013098 Address: 19 a G wes4:,c,5cv:rn,'� SS 11,7 Tel. # (csl • alo4 tf'i -+ Attach, to this application, a- Certificate of Survey of -the lot, with the -proposed -construction drawn% on it to scale. DES-C].ON tjF R!UVEIVNT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Rep1ccce 3 �\AnC ow3 vvJI n - Construction Type: S, Estimated Cost: $)a I . CyJ Driveway Curb Cut Width Needed: R. + 6 Ft = _ Ft x $_ = $ DATE: 4 -M-') .Ocs Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee $ Sewer Main Charge TOTAL STIPULATIONS: Tel. #gsa .-6%-(odq CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.501$1,000 Valuation $1050 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 [ ] Building $ BUILDING Plan Review Permit NoiEl Inspections Fire Surcharge RESIDENTIAL APPLICATION Received By -T(– 763-5c72-3604 1,915 License Surcharge $ D SAC Charge $ CITY OF FRIDLEY Curb Curt Escrow $ DATE YOUR E-MAiDRESS�� cnyv \ SITE ADDRESS 1:110 Park Fee $ THIS APPLICANT IS: ❑ OWNER IatONTRACTOR $ PROPERTY OWNER/ NAME: lAS` OYN l,e_.RJ $ TENANT ADDRESS: ^ CITY STATE ZIP PHONE: P NAME: Renewal By Andersen CONTRACTOR SUBMIT A COPY OF STATE LICENSE # 1920 County Road "C" West YOUR STATE LICENSE ADDRESS: Roseville, MN 55113 t STATE ZIP WITH APPLICATION PHONE License #20130983 ❑ SINGLE FAMILY/N0 PROPERTY TYPE ❑ TWO FAMILY/NEW C 651-264-4777 _ — ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS PERMIT TYPE ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK O SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK:❑ NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. Existing Floor Plan PROPOSED SIZE: ❑ DETACHED GARAGE 2• Proposed floor plan PROPOSED HEIGHT: 3. List of structural members to be used SIDING L3 Vinyl v��L FOR NEW CONSTRUCTION INCLUDING DECKS, ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim` _ a 1. Site Plan/Survey showing the existing structure 13 other WINDOWS ❑ Fascia Y `CX �� c��1� 2. and proposed project. Two sets of construction plans IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS (� 1 3. Energy Calculations 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.&C FEE SCHEDULE) TOTAL JOB VALUATION $ I l® ® OCCUPANCY TYPE Permit Fee $ 13 9. Plan Review $ Fire Surcharge $ Surcharge $ 1,915 License Surcharge $ 610 SAC Charge $ Curb Curt 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 i conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not permit but only an applicatio or a permit d work is not to start without a permit; that the work will be in accordance with the approve plan in the case of all work w ch requires a ew and approv plans. SIGNATURE OF APPLICANT NT NAME,/f &,C1r& DAT15an f) 15l 'M