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PRE 2010 DOCSDate: Owner: wilder Address Address C:?> N? 7256 �5� ION OF 1 DING No. S 2 . P f Lot Lot _ Block _ Ld4l. or Sub -Division . Corner Lot _ Inside Lot Setback .4 � _ _i Sideyard Sewer Elevation Foundation Elevation 'TOP Q'P GDCrr-1 ;j o gi 9 LA.110 T �V Front Depth Height Sq. Ft. Cu. Ft- . Front Depth Heightt_ Sq. Ft Cu. g't Type of Construction _ Est Coat _ `�To be Completed In consideration of the issuance to me of a permit to construct the building described above, I agree to do the proposed work in accordance with the description above for and in complianc with all `provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of &-'L7--, permit hereby granted to to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work. done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any time upon viola�n of any of the provisions of said ordinances. � A d� e� Building Inspector NOTICE: This peemit does not cover the coed. Wan, hnh dlm for wiriow plumbing, gas heaft, sewer or water. Be sore to see the Buihitng inspector for separate pwnft for then Nems, Building .-•• .,r,,,-.... COST OF B LABOR Le �i BUILDING Plan Review pmt No•:0 G Inspections Fire Surcharge RESIDENTIAL APPLICATION 2 1 .001 times the total job valuation P,teed Hy: 763-572-3604 %. (��/ .0005 x Permit Valuation Minimum $.50 CITY OF FRIDLEY $ ria aM.AY 2(W DATE YOUR EMAIL ADDRESS _ $1675 per SAC Unit (Plans to MWCC for determination) SITE ADDRESS ArT r7m 11w ;FA Muzwfdn ft + 6 ft = ft x $21= $ THIS APPLICANT IS: -, ❑ OWNER CONTRACTOR $450 Conservation Plan Review PROPERTY OWNER/ NAME:-ra Fee Determined by t igmeering TENANT' $ Agreement necessary ( ) Non Necessary ( ) Total Due ADDRESS: ) CITY STATE7W 595Z4 PHONE: THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED CONTRACTOR NAME:ALOJ-1 ah.R Q/1'?e ' dY SUBMIT A COPY OF STATE LICENSE # ' 0/") �''L.CI 0 FOW DATE j Oeb AA) YOUR STATE LICENSE ADDRESS: s ✓'` "E.'.. CITY 4W061- L e= STAT 73E yr WITH APPLICATION PHONE �}^ — L4Q L1 --Q j3' FAX ) — t U � " M PROPERTY TYPE OLE F W CONSTRUCTION SIZE_ 9 TWO Y/NEW CONSTRUCTION 520RIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHEDOARAGE/SHED D WINDOWS ❑ BASEMENT FINISH jamop O DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑NEW ❑ ADDITION ❑ "NUN :PAIR ❑ REMODELING DESCRIBE WORK BEING DONE: r J Y 'Q STS Of IMPROVEMENT LENGM WIDTH 13EICrIn sq. Ft. � G H 'J W14OUSE ONLY NUMBER OP SQUARES _ �' t ❑ HOUSE &. GARAGE BASEMENT UMODELING SUBMIT., DAUM - ❑ ATTACHED GARAGE 1. Existing Floor Plan PROPOSED SIZE; O DETACHED GARAGE I Proposed floor plan PROPOSED HEIOHT: 3. List of stnictutal members to be used SI TNG FOR NEW CONSTRUCTION INCLUDING DECKS, ©Sown OVinchum ❑ Qthtr ADDITIONS- d Trim 1. & PORCHES SUA� Site P1adSmvey showing the exisfia4g st motim ❑ Fascia ut. To setsoonshction pluWM OPENINGS Dyes ❑No LOCATION OF WINDOWS 3. 6he ay Cakulatiow OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENINO CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS A i i _ MW L'c ADW b i c.c.s n.wa V7 • .:r . n.v,,..s. .--..,...._...,...,..,...� - _ - - Will • nuarr., LAA%1A, irli- UJANG "IME C O OR AND MATERIALS: (VSJIr 0,7 1997 .B.0 F9E SCHEDULE) rarunt rcc �i See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge _ $ 2 1 .001 times the total job valuation Surcharge $ %. (��/ .0005 x Permit Valuation Minimum $.50 License Suroharge $ CLQ $5.00 (State Licensed Residential Contractors) SAC Charge $ _ $1675 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $21= $ Erosion Control $ $450 Conservation Plan Review Park �'ee $ Fee Determined by t igmeering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due Mahe checks a able to: City of )rridley 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 application for a permit 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 vbjch requires rVZ and pprovaI of plans. ' t `,, �i �j SIGNATURE OF APPLICANT and NAME I` -'y }' t% s'w. WV L£ LS 6 LOOZ/L8/5 :9;8(1 i;lZ ' d OOLOti9�9 :wad