PRE 2010 DOCSCity of Fridley, Minn.
6431 University Ave. N. E., Minneapolis, Minn. 55,132
BUILDING PERMIT
-Date: - Nov= gg22, _ 19Z2
Owner: Tri Go Builders Inr_ Builder S4=
,Address Z555 Van Buren Street N.E. Address Same
Na 7112 Street Syme nn -V StreetN E. Part of Lot
Lot 15 Block 5 - Addition or Sub -Division Me 1 o dv Manor
Corner Lot Inside Lot X Setback - _ 35' — _ Sideyard 10' & 5'
dAiaMevatiou 52.72 304"644IJA9" 855-72 Apprnx _
&e Top of Footing
;y.
To be Used as: 240 +
i1W pl I i,ng Front 401 Depth 24'Height _ _ 20' Sq. Ft. 960 Cu. Ft.
Gar-agP Front 241 Depth 241 Height 101_ Sq. Ft. _5761 _ Cu. Ft. _5760
Type of Construction Wood Frame Est Cost .._. 1,739.68 To be Completed 6 months
Stipulations: Provide a verifying survey before capping. Provide a hard surface
driveway. Follow notations sac, marked in red on the plan.
WATER LOCATION: 10 feet north of sewer service.
SEWER LOCATION: 160 feet.north of manhole (N. Inv. 851.92)
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 fo and in compliance ypi all provisions of
Ordinances of the city of Fridley. 0J y J \
In consideration of the payment of a fee of $A () 0 , permit is hereby granted t0_,TXj—CO Builders
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
I+`rYdley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of building
Q� city limits and this permit may be revoked at y time upon violation of any of the provisions of said
ding Inspector
TIARRFT MARK,
NOTICE:
This permit does not mover the construction, installation for whing, plumbing, gas heating, sewer or water. Be sure to as A
the building Inspector for separate permits for these items.
■
APPLICATION FOR REWENTIAL, ALTERATION1
OR ADDITION BUILDING PERMIT
CITY AR FRIDLETs MINNESOTA
�.,
STRW
1 5 $LOCK i J! 3iTION ea ,
COMM LOT; VOIDE LOT; SETBACK; R S SIDErfARD: /10 P4�
Afftiv,apt attach to thts f4m=_Two Certificates of Surv2X of Lot and proposed
b"JAUg iacatien d *a these Certificates,
DESCRIPTION OF BUILDING
BeTo Um*d As
nth®
Squama4t� e F 60` : `'o Cubic F"t;
Front :, 02 Depth; n Heightt.
4
Square.Feet; T76 Cubic Feet t.
eelZ,�'—�a.� st tod Cosi ? P
�� of Constx+�ctioa� F t : $
To Be 14tedz
TM u,00Wipjgna4 hereby rakes applicatlou icor, a permit for the work herein
speatfie4t, agreeing to do all work ih sttict accordance with the City of
1441ey Ordi*ano" and, zu ;rf the Department Pf Buil4nss, and hereby
doolareq dw* all they facts and representations stated ta Ws appllcati=
axe true m4 correct,if
P
SICNA
(bee Rewwoo We For Additional Infortgat% )
--BUIL DING PERMIT F9E SCHEDULE
SECTION 2. The Inspector of Agildings shall., before issuing permits for the
erection of any building or structure, or for any addition to any axisting
building or structure, or for any alteration or repairs to any existing
bus lding or structure, upon application therefore, require the payment by the
applic t for such permit of fees to the amount herein below set forth and in
the manner herein provided to -,vitt
UNIFORM BUILDING CODEr Type 1, 2 & 4 - $2.15 for each one thousand cubic
feet, or fraction thereof, in such cubical contents. Type 3 & 5 a $1.85 for
e4a one thousand cubic feet.
ADDITIONAL INFORMATION
For the purpose of computing fees for building permits, the cubical contents
of any building or addition, in determined by multiplying the ground area
covered from a point six (6) inches below the floor line of the basement
or the cellar to the average heights of the upper surface or to the average*
t t of the roof surface of the mann gable of a pitched roof,
Nor rWirs or alterations to an existing strisecture,- the fee shall be at the
rate: of $3,00 per each five h�mdred dollars ($500,00) or fraction thereof in
the c*4t of all proposed work,
In so case shall t1ae fee ch=Sed for au, permit as set forth in Section 2 be
than $5.00,
M
VSKF F ICAT I ON OF FOUNDATION
NMI rarmi.ts for construction will be issued a minimm of 24 hours from the
ttW of applications:, to allow for proper review of the proposed structure Aud
- of the construction site.
A Certif W Survey of the let,, ;,.,ging the l.ocatim of the: foundation, owe it
ban been r4wstpActed,, will be required before proceeding with the frsising.
CERTIFICATE OF OCCUPANCY
Application for a Certificate of Occupancy shall be made ten (30) 44yR prior
to the use or +occupa=y of o iy aMcture for which a building permit has been
issued; and said structure ithall, not be used or occupLed until a Certificate
of 4ecupan y has been issued.
P
Application for rower Pkmft and Heaft. Coang. VeDtiiati®n. R D aDd
Air Conditioning Systems and Devises
R
GRAVITY WARM AIR: RATZ TOTAL
Furnace Shell & Duct Work $10.00 $
Replacement of Furnace ... ..... ..... 6.00 $
Repairs & Alterations—up to $500.00 600
Repairs & Alterations each add. $500.00 3.00
P.i
Furnace Shell & Duct Work to 120,000 BTU ...... . .. $10.00 $_. 0 U
each add. 60,000 BTU .................... . 3.00 ;
Replacement of Furnace ... 6.00 $
Repairs & Alterations—up to $500.00 6.00 $
Repairs & Alterations each add. $500.00 .... .. 3.00 $
STEAM at HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. EDR Steam $10.00
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water 10.00 $_
Each add. 200 sq. ft. EDR Steam 3.00
Each add. 320 sq. ft. EDR Hot Water 3.00 $_
OIL BURNER—to 3 gal. per hour
over 3 gal. per hour -See Fee Schedule
GASB (up to MOW Iwo
over 199,000 BTU See Fee Schedule
GAS FITTING .
1st 3 Fixtures
Additional Fixtures
Gas Range to 199,000
AIR CONDITIONMG
FAN HEATING SYSTEM
TING SYSTEM
ALTERATIONS & REPAIRS
ROUGH
FINAL / `'�?f 71�
6.00 $ _
.. . a.Co $ deo
NO RATE TOTAL
-x$2.00 $ � U4
- x .75 $
- x$ 5.00 $
4
r
Fee Sc nh
$
TOTAL FEE $
(SURCHARGE $_.50)
Dept. of Bldga. Phone
7312 Symphony St. N.E.
City of Fridley:
The undersigned hereby makes application for a permit for the work :hereir
specified, agreeing to do all work in strict accordance with the City Ordinance:
and ruling of the Department of Buildings, and hereby declares that all the facts
and representations stated in this application are true correct.
Fridley, Affirm 1g�
Owner . Tri -Co Bldrs
Kind of Building Frame
Used as .. --- -- --- - `Dwg .
To be completed about __—_
Estimated Cost,
Old—NewXBuilding Permit No. Permit No.
o
DESCREPTION OF WORZ
HEATING or POWER team, Hot Water, Warm AirX No 1
Trade Name Singer Shm N® GB 1104-12B
Capacity Sq, n E.D.R_ 8 0, 0 0 0 BTU
E.P'.
Total Connected Load 45,846 of Fuel Nat. gas
BURNER — Trade Name Size No
Capacity Sq. Ft. E.D.R FM .
(REMARKS—OYER)
St Mill City Heating Co.
Business Pham 544-1501
Glass
HEAT LOSS CALCUIATIoMDEPARTMENT
OF
1NSPECTI®N
Weatherstrips
_
A' Guide
Construction No.
Floor W
Insulation
o�rs
130
Reference ®alt. Wall
Int.Wall (°eiling
rn I Length` -"Width
Roo$ Flooind
blow Applie
0
might
pawn
No. of L1nma1 ft. Area
IIghW of crack . a �
19_
F1.1
m Length Width
weight
.� l�
Windows and
rs—Crackage and Area
Windows and Doors—Crackage and Area
Width Height
i. of peas of ,•; o
No. of
ghts
Lineal f . Area
of a h e
Width
Height No. 06
Linmal ft. Arora
N
of Dane
of pane tights
of c
ek sq. QG
Total Btu. --
_&equirILM. k
F1.0
Windows and
Width �
No. of saws e
Infiltration
Glass
Exp. wall
Net exp. wall
Int. wall
or sq. lefts. W.A. ader area
,nl I Length °=-Width
—Crackage and Area
No. of Linealft. Area ®®
lights of a ck sa, tt.
Ceiling
Floor
Total Btu.
F
Windows and
Width 1
No. of pane m
mm
Glan
Exp. wall
Net exp. waU
1®t. wall
or sq. ins. W.A. Leader area I 6
mJlangth Width / lieu
-Crackage and Area
Nc. of Lineal ft. Area 1
lig to of crack sq. f
Infiltration
Glass
Exp. wall
�(
Net exp. wall
Int. wall
Ceilins
k
Floor W
X i s
Total Btu.
Requir
. E.D.R. or sq. ins. W.A. der area
Fl.l
rn I Length` -"Width
Windows a
oors—Crackage and Area
Width
No. of peso
might
pawn
No. of L1nma1 ft. Area
IIghW of crack . a �
LL_
Glass
Exp. waU
Net exp. wall
Into wall
Ceiling
Floor 7
Total Btu.
k
.
Total
n,
me®�
Glass
Exp. waU
Net exp. wall
Into wall
Ceiling
Floor 7
Total Btu.
Infiltration
Glass
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor
Total Btu.
—4—r It. -m or Sgt. fns. w.m. Leacier area f
Fl.l Doff r—Height
minEmm and ®Dors—trackage Ad Area
Idtlt e1sAt No. of Lineal ft. Area p0�
No of pane of no I[glnto of crack s$. t t�
Pi I GOPf!�
Floor
Total Btu.
Infiltration
Glass -
Exp. wan
Net exp. wall
Int. gall
Ceiling
Floor
Total Btu.
EM or ow.VA
M =
sw�`rrjzs�
-��111 7 =
Net exp. wall
Total Btu.
EM or ow.VA
M =
sw�`rrjzs�
Net exp. wall
0116-01,
M
MAI
'
eek �-
.,Windows
and Doors—Crackage and Area
l
Infiltration
Glass
Exp. wall
Net exp. wad
Int. wall
Ceiling
r
City Of Fridley
Applicaflmg
Dept. of Bldg@. Phone 960-3450
DESCRIPTION OF WORE 7.3®2 Y
tlNumber. Kind and Location of Fixtures Loc.,
I+I92 I Z 1a-iCI I�zz
IV a<Ig IVI I N I
G GAS MAC.
Base
R - felzf4!1
Bawer
CCUP001
PLUMBING FIXTURE RATES:
NO.
BATE
TOTAL
Number Fixtures ................
x $2.00
$ �®
Future Fixture Opening ...........
x $1.50
New Fixture Old Opening .......... _
x $1.50
$
Catch Basin ....................
x $3.25
$
C)
Water Heater (Up to 89,000 BTU) ....
x $3.00
$
New Ground Run Old Bldg.........
x $3.25
$
Electric Water heater ..............
a $2.00
8
:;AS FITTING FEES.
NO.
RATE
TOTAL
-2-U �
1st 3 Fixtures ............ • • • _
x $2.00
$
Additional Fixtures .................
x $ .75
$
Gas Range to 199,000 BTU,. . x $5.00 $
REPAIRS is kLTERATION6 —Refer to Cod®
Description ............................................... $
TOTAL FEE $ "Z'4% n
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 aR the fact
and representations stated in this application are true and correct
Fridley, Minn
• •/�
Owner / ft.C40 ti S1� f¢A'I1.a
Kind of Building re **"�
Used as Pajef.`®4C
To be completed about
Estimated Cost, $ �7 0d •
OWr--New. Building Permit No. Permit No. C
SignedLR/U40" J04Vr 000
By �./•R 4JtAriarif.. /i •
Business Phone
ROUGH
Building
$35.50.
PLUMBING
Permit No.2(.p����f�%
Inspections
— BATHTUB
RESIDENTIAL APPLICATION
Received B
763-572-3604
—DISHWASHER
_ LAUNDRY TRAY
CITY OF FRIDLEY
DREM U G 2
763-502-4977 FAX
EFFECTIVE 2-19-09
BATE 08/11/09
YOUR E-MAIL ADDRESS wnelson@larsonplumbing.com
51TE ADpRESS 7312 Symphony St NE
THIS APPLICANT IS:
Q OWNER MCONTRACTOR
PROPERTY
NAME: Marion Hancharek
OWNER/
TENANT
ADDRESS:- moony St .N.E__ _CITY Fridley STATEMN ZIP 55432
PHONE: 763-7864656
CONTRACTOR
NAME: Larson Plumbing Inc
SUBMIT A COPY OF
YOUR STATE
_
STATE LICENSE # 58757_.(_3341) EXP DATE
LICENSE, BOND AND
STATE BOND # EXPDATE
CERTIFICATE OF
ADDRESS: 3095162nd Lane NW cITY Andover sTATE MN ZIP 55304
INSURANCE
PHONE 763-427-7680 FAX 763-427-9448
PERMIT TYPE
tN SINGLE FAMILY E3 TWO FAMILY 0 TOWNHOUSE
TYPE OF WORK:
LI NEW 19 REPLACEMENT
DETAILED DESCRIPTION OF WORK Replace Water Heater
FEES ARE BASED ON $10,00 PER FIXTURE, EXCEPT WHERE NOTED.
$35.50.
BATH SINK/LAV
FLOOR DRAINS
— BATHTUB
_ GAS PIPING (NEED CITY LIC)
CLOTHES WASHER
_ KITCHEN SINK
—DISHWASHER
_ LAUNDRY TRAY
FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM FEE
SHOWER
�SWIMMINO POOL
WATER CLOSET
WATER HEATER ($35)
-_, WATER METER
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
WATER PIPING
_ WATER SOFTNER ($
BACKFLOW PREV.$I )
FOR IRRIGATION
—OTHER
I hereby apply for a plumbing permit and I acknowledge that the information above is complete and accurate, that the work will be in
conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is
not a permit but only an application for a permit and work is not to start without a permit on site; that the work will be in accordance
with the approved plary"e case o/f al v rk which ;pquireWreview and approval of plans.
SIGNATUREOPAPPLICANT i PRINTNAME Michael Maloniski DATE 08/11/09
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977
l `�
d
City of Fridley
3 607
AT THE TOP OF THE TWINS
BUILDING PERMIT
COMMUNITY DEVELOPMENT DIV.
i ♦V
INSPECTION SEC.
r PROTECTIVE
NUMBER
REV
DATE
PAGE OF
APPROVED BY
O� --- 1 CITY HALL FRIDLEY 35432
%.j 612-571-3450
910415
12/27/00
JOB ADDRESS 7312 Symphony Street NE
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION SEE ATTACHED
oescR.
15
5
I Melody Manor SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Marian Hancharek 7312 Symphony Street NE 786-2656
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO
Kaufman Roofing 2521 24 Ave S, Minneapolis, MN 55406 612-722-0965 9324
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
Reroof House & Garage (23 Sq) Tear-off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
Permit inspection Cards
III Be Mailed
To Homeowner To Post
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
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$2,352
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 EE
Licen S $5.00
$ .78
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDAtEI
HEN OPER LIDATED T IS IS/YY;7�rIT
_
/ L
BLOjf INSP' fiATE
S-GNATURE OF OWNER„i OWNER BUILDER, iD-�'
l `�
d
DEC -14-2000 12:24 FROM CITY OF FRIDLEY TO 7221021 P.02i05
NEW Effective 1/1/2000
ADON [ ] CITY OF FRIDLEY (763) 572-3604 Bldg Insp
ALTER (] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address: 7—
Legal Description:
Owner Name & Address: kv t (d r1 H0,iltkiA�e � � t F; y;,,'.,Sizi)Tel. # 1 `
.Contractor: Ctivt fG 1 I? ����klc� MN LICENSE # q 3 ��-
Address:f�> "� �40V Tel.#(f11-72-2-0 � ,
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: 1-ftkir /� ff t k' 4 A&4 6d-di"ated Cost: $
Driveway Curb Cut Width Needed: Ft. +6 Ft = Ft x $ _ $
DATE: APPLICANT: AM a/�% 62livw Tel. #. VU � Lj� 'D
&
CITY USE ONLY - 63) 572604 for Permit Fees if mailing in application f� gs
r ' /5-01
Permit Fee $ Fee Schedule on Reverse Side 1
Fire Surcharge .001 of Permit Valuation (1/10th'%)
State Surcharge $.50/$1,000 Valuation
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
$1100 per SAC Unit
$ 57 -0a $5.00 (State Licensed Residential Contractors)
$ Alt. "A" or Alt. "B" Above
H
$450.00 Conservation Plan Review
$ Fee Determined by Engineering
Sewer Main Charge $
TOTAL
STIPULATIONS:
Agreement Necessary [ ] Not Necessary [ ]
City of Fridley
SUBJECT
90732
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
RE/CEIP
• _ COMMUNITY DEVELOPMENT DIV.
INSPECTION SEC.
!�PROTECTIVE
`.� CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED 13Y
L J` 612-571-3450
910-F15
3/25/99
JOB ADDRESS 7312 Symphony Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
15
5
MelodyManor
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Ed Czarneski 7312 Symphony Street NE
786-2656
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Town & Country Roofing 7910 12 Ave S Bloominton MN 55425 854-9365
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO
20091282
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW O ADDITION ❑ ALTERATION ❑ REPAIR O MOVE O REMOVE
X
8 DESCRIBE WORK
Reroof House & Garage (24 Sq) Tear -off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
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.
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 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
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
00MM $2056
RTYX SC $1.03
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
Fin SC $2.06
PLAN CHECK FEE
TO7AFEE
�Li
C $5.
82.84
SIGNATURE OF CON'aACTOR OR AUTMORiZED AGENT ATE,
lz:�HE PRO
OG INS
VALIDAT THIS IS UR -PERMIT
qa�E
S-GNATURE OF OWNERJF OWNER BUILDER, IDATE,
Mar -19-99 11:23A
NEW j ]
A0DN [ ]
ALTER [ ]
ConstructionAddre
Legal Description:
Owner Name & Address:
Contractor:
Address: '7 9J0 /c
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R -Z
BUILDING PERMIT APPLICATION
P_07
Effective 1/ 1198
/0
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Tel. #
MN LICENSE
S • w, �h� �. Tel. #
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
Length Width Height
Length Width Hgt/Ground
-- e; "
G
Construction Ty;.Iel-- Estimated Cost: $ oe
Sq. Ft.
Sq. Ft.
Sq. Ft.
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DA'rE: APPLICANT: Tel. #
TOTAL $ec? �1.
. f5l�
STIPULATIONS:
CITY USE ONLY
Permit Fee
$
Fee Schedule on Reverse Side
Fire Surcharge
.001 of Permit Valuation (1110th%)
State Surcharge
$!�d j.�
$.50/$1,000 Valuation
SAC Charge
$ ��
$1000 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 j ] Not Necessary ( ]
TOTAL $ec? �1.
. f5l�
STIPULATIONS: