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PRE 2010 DOCSk' Village of Fridley,, Minn. N° 13 6 6 BUILDING PERMIT' .. Date. , ..-..... L- ..�: .. ,.. Il^ Owner `'`. .,,"t'rs y:-'�'�- .Builde +�"" % ": �* �f ........ Address......... ............................ Address .............. . ............. LOCATION OF `BUILDING No. Street . ! . _ . .. Part of t' . . Lot ......lock ..... ..... Addition or Sub Divisn �� .. Corner Lot ........... inside Lot ... Setback Sideyard'• ................. DESCRIPTION OF BUILDING To ,PQ,,Weed as �...�:`" ,� Fronts Depth Height . Sq. Ft. : Cu. Ft. . ............. z �+" .. Frt ...... Depth ........ Height . Sq kt. Cu. Ft. ....... Type of Constructio .�;d Est. Cost .z i- To be Completed .. .. a r In consideration • of the issuance to me of a permit to construct the building described above, 1 agree to do \ the proposed work ' accordance with the description above set forth afid in compllance' with all provisions of ordinances of the vil ago of Fridley.. " o consideration • • • . • . • ...... � of the a ent of a fee of .. p ym ...: permit is hereby granted . r _,.: . :. to construct the building or addition as described above. This permit is granted upon the express conditio tht 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 garding location, construction, alteration, maintenance, repair: and moving of buildings with- in the village limits d this permit may be revoked at any time upon violation of any of the provisions of said ordinances. t ]3uilftg Inspector NOTICE: This permit coes, not cover the 'construction, innalla#ion or alteration for wiring, piurnbingy gas heating, sewer -or water. Ile ,sure: to see th uiltling •inspector for separate permits for!' items. '- --3 716 City of Fridley, Minn. N9 9475 BUILDING PERMIT Date: SEPT. 29, 1967 Owner: Ross Haidle Builder Snt Pr Ci ty Hu3,lders Address 5714 West Moore Lake Drive Address 35 Highway 10 LOCATION OF BUILDING No. 5714 Street West Moore Lake Drive _„ Part of Lot Lot 4 _ Block 5 Addition or Sub -Division Donnay ' s Lakevie-w manor Corner Lot — Inside Lot Setback Sewer Elevation To be Used as: Sideyard Foundation Elevation DESCRIPTION OF BUILDING Garage Front 12 t Depth 24' Height 10, Sq. Ft. _288_ Cu. Ft _ 2880 Breezeway Front 81 Depth 14' Height 101 Sq. Ft 112 Ft. 1120 Type of Construction Frame Est. Cost $2959.00 To be Completed Nov. 1, 1967 In consideration of the issuance to me of a permit to construct the building described above I agree to do the proposed work in accordant with the description above set horth and in compliance with gYlons of ordinances of the city of Fridley. �J In consideration of the payment of a fee of $ 6.0Q-4, permit is hereby granted to In -e,- City 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 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 violation of any of the provisions of said ordinances NOTICE: 'fids permit does not ewer the construction, InstaWan for wiring, phanhing, gas heating, sewer or water. Be sure to as the Building Inspector for separate permits for thus Items. 1 Yi;_t ,3i3-1s,D.vING x 7 01? i',Z..*j.'X,.. Y', 14-_NZi ESCTA 0I11IE2',' S IyAi,t�o. l 'lIiI'i'. ! ADDRESS /� 1x� ��dh��.Ar1Ji.Ess�_��I%Gf�� CORNER Los INSIDE 1.01 SETBACK SIDE -YARD, SEWER ELEVATION FOUNDAT102-NI ELEVAION Applicant attach to this fora Two Certificates of•Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used Ad: I`� Front Depth Height t / V Sq. Ft ._w r Cu. Ft. e Front Depth 1Y Height U Sq. Ft.- %` Cu. Ft.- Type t._Type of Construction Estimated Cost To Be Corrpleted__ l 6 7 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 (Schedule of Fee Costs can be found on the R_ erse Side), L0CAI'ION OF UU11:D1�K= N4... W 21 .___, _STREET rf_%'/� �P�1RT O Lam__., .. LOT BLOC: ADDITION OR SU iDIVI:SION CORNER Los INSIDE 1.01 SETBACK SIDE -YARD, SEWER ELEVATION FOUNDAT102-NI ELEVAION Applicant attach to this fora Two Certificates of•Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used Ad: I`� Front Depth Height t / V Sq. Ft ._w r Cu. Ft. e Front Depth 1Y Height U Sq. Ft.- %` Cu. Ft.- Type t._Type of Construction Estimated Cost To Be Corrpleted__ l 6 7 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 (Schedule of Fee Costs can be found on the R_ erse Side), SUBJECT PERMI City of Fridley 17 0 9 AT THE TOP OF THE TWINS BUILDING PERMIT . � t b COMMUNITY DEVELOPMENT DIV. L .____ INSPECTION SEC. ! r � , PROTECTIVE / �� CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 I 8/17/83 JOB ADDRESS 5714 West Moore Lake Drive N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 4 5 Donnay's Lakeview Manor SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ross Haidle 5714 West Moore Lake Drive N.E. 571-3169 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. M. L. Mallam & Sons 1742 - 171st Avenue N.E. 434-3406 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 Install new roofincr over 1 lqyex of existing Partial 9 CHANGE QF USE FROM TO STIPULATIONS Reroof can be 2nd layer but not 3rd. Install ridged galvanized valleys. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION ] STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $600 $.50 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCA LAW REGULATING CON- $15.00 T CTION OR THE PERFORMANCE F CON UCTION. LAN CHECK FEE TOTALFEE 1 ° ��- $15.50 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEIN WHEPROPERLY V P TED THIS IS YOUR PERMIT. SIGNATURE OF OWNER IIF OWNER BUILDERI (DATE) BLDG INSP �A7E CITY OF FRIDLEY APPLICATI94 FOR RESIDENTIAL BUILDING PEfL'fITS (Neer, Alterations, Additions, or Repairs) OWNER: Ar, C/ ADDRESS: Ile - TEL 90: Effective Aug. 1, 1981 d BUILDER: %i 11g � V.: exl-r' ADDRESS: 1;717 -1,7114f --r &-" /V/' TEL NO: zz/z .i ! 0 Construction Location STREET NO: ! 7 1 V STREET:` LOT: BLOCK: ADDITION: DO /N-//aj'A 11� ir'© l )l *19 1✓� m4tjG'�" ,4 d ,V 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 COI-ISTPIJCTIO14 Front: Depth: Height: Square Feet: Cubic Feet: Front: Depth: Height: quare Feet: Cubic Feet: _ k®"ma/�° Type of Construction: Xe 7;t;WAZ� Estimated Cost: $ 4b Be Completed: Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: $ $ SEE PEVFRSE SIDE OF SHEET Mie undersigned hereby makes application for a permit for the %.,ork 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 he facts and representations stated in this application are true an correct. MTE: / /s SIGNATUIE: Stimulations: 157 v 4 CS �: � s CITY OF FRIDLEY APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND I AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE RESIDENTIAL Furnace Shell and Duct Bork, Burner (Also replacement furnace) Gas Piping (piping needed with new furnace) Gas Range Gas Dryer RATE Tam S 20.00 S 01"p, S 10.00 $ $ 10.00 S $ 10.00 $ a Air Conditioning tall sizes) )--r^ S 10.00 All Others/Repairs and Alterations It of Value of Appliance or Mork COMNERCIAL/INDUSTRIAL It of Value of Appliance or Mork State Surcharge 'POT1iL M Reinspection Fee ($15.00) Rough Insp. Date Final Insp. - �- 0 Date Approval for Permit <4 MINIMUM FEE FOR ANY HEATING PERMIT IS S10.00 PLUS $.50 STATE SURCRARGE _; f S S S .50 $ J�'To S Attach stack verification fon with replacement furnace 1wrmits 6Air Conditioners can not Iwo- placed in eidr yard without written prnsission from adinining rrtgid+or. Effective Avq. 1. 19RI Job Address -5 f /L�� _ �- Department of Buildings 64n university Ave. N.E., Fridley. HN S51I2 City of Fridley Tel. 1571-3450 The undersigned hereby maked application for a permit for the work herein specified agreeinq to do all work in strict accordance with the City Codes and rulings of the Department of Buildings, and hereby declares that all thk facts and representations stated in this application are true and correct. �Fridley. Kinn. �el-� . Is Xi OWNER ®/ ✓�-TI fi-,%_l�e� KIND OF BUILDING' USED AS To BE COMPLLTED ABOUT l - � tl ESTIMATED COST A e s OLD NEW BUILDING PERMIT NO. PERMIT NO. DESCRIPTION OF FURNACE/BURNER HEATING or POWER PIANf'S. Steam, Not Slater, *arm Air- No. Trade Name �;,z_n'IZ4 Eine No. / ZZ,- . T - 7S Capacity Sq. Ft. EDR BTU a HP Total Connected toad Kind of fuel 4992Z2_ BURNER - Trade Name Size No. Capacity Sq. Ft. EOR BIV NP Company �igned By D� HEATING & AIR CONDMO" -- . 8910 WENTWORTH 0!a, �- MINNEAPOLIS, PbiPl 5�1�O�Q CITY OF FRIDLEY APPLICATION FOR HEATING REPLACEMENT CHIMNEY AND STACK VERIFICATION .. THIS FORM MUST ACCOMPANY STANDARD APPLICATION FOR HEATING PERMIT FORM. LOCATION -71ZZ)..zaz at -DATE OWNER 2/� ADDRESS The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined 2. Is free from rust or deterioration -- 3. No foreign objects are lodged within 4. That it is securely supported 5. That it meets all current Code requirements for size and total BTU connected 6. Total Heating BTU All Other BTU TOTAL REMARKS a- HEATING PERMIT I ZDD )o 0 vv SIGNED Licens -U by Address HEANG & AIA 2 8910 WENTVVG T Telephone MINNEAPOLIS, Puff, dbl-WW Fridley City License. SUBJECT PE .- City of Fridley 2 8 936 AT THE TOP OF THE TWINS BUILDING PERMIT r IPT NO. `y COMMUNITY DEVELOPMENT DIV. ------ PROTECTIVE INSPECTION SEC. r � 1 = 1 "'1 CITY HALL FRIDLEY 55432 �'' NUMBER HEv DATE PAGE OF aPPn0YE0 BY t"""11.� 612-571-3450 910-F15 2/23/99 JOB ADDRESS 5714 West Moore Lake Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 4 5 DonnayTs Lakeview Manor SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ron Haidle 5714 West Moore Lake Drive NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Exterior Design Service 6391 Monroe St NE, Fridley, MN 55432 571-3220 3237 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 (20 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 yALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $1, 714 $.86 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROV1S11OL4S OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $56.75 Fire S�,' $1.71 OR RANCE OF CONSTRUCTION WSI-GNATU4R-E,dFC-40�i-R-;AC--S-��—R-AUT-H-OR-[Z-E--D-AG-E'NT PLAN CHECK FEE TOTAL FEE License SC $5.00 $64.32 iDaiEi WHEN /�P,R�OPER a BL -NSP Y VALI ATED THIS IS YOUR P RMIT ze y OATE S.GNATURE OF OWNERO; OWNER BURDERI iDATE, NEW [ ] Effective 1/1/99 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 - BUILDING PERMIT APPLICATION q� ConstructionAddress: 59//-/ 0- Aa-. 64 Ae Legal Description: Owner IS Contract Address: MN LICENSE # z�J % ? Tel. #12i' -! 02d O 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: Len!;? Width Hgt/Ground Sq. Ft. OTHER: CJ Construction Type: Estimated Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: �3 �' APPLICANT: Tel. # Permit Fee $ .l6 • �-r-'- Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$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 [ J CITY OF FRIDLEY INSPECTION DIV. 60 6431 University Ave NE Fridley, MN 55432 4� . 572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Effective On Jan 1, 2000 PLUMBING FIXTURE RATES: NO. RATE New Fixtures 2 $ 7.00 Old Opening, New Fixture $ 4.00 Beer Dispenser $ 5.00 Blow .Off Basin $ 7.00 Catch Basin $ 7.00 Rain Water Leader $ 7.00 Sump/Receiving Tank $ 7.00 Water Treating Appliance $10.00 Water Heater -Electric $ 7.00 Water Heater - Gas** $10.00 Gas Range" $10.00 Gas Dryer** $10.00 Back Flow Preventer Required ( )Yes ( ) No Type, $15.00 Reinspection Fee $47.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance TOTAL s �d State Surcharge $ .50 JOB ADDRESS -,'-;71Y /y/ z oee'&- 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. 3 :.--> / ,20 Owner Building Used As ZA0477� Estimated Cost / PERMIT NO. PLUMBING COMPANY SIGNED BY//i TEL N0. S Approved By Rough -In Date Final Date TOTAL FEE $ e, '��' 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 COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furance, 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 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 combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes () No ( ) When required to install a new combustion air, it will be sized and installed To meet the current codes and manufacturer's specifications. Yes () No ( ) When installing a new venting 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 Type and Size/Common Vent and Vent Connector Information 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 ALTERATIONS: (Describe) HEATING CO: Signed By: Date : SUBJECT P City of Fridley 3 075 0 AT THE TOP OF THE TWINS BUILDING PERMIT �� RECEIPT NO. COMMUNITY DEVELOPMENT DIV. SEC. f PROTECTIVE INSPECTION � I CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED 8 612-571-3450 910-F15 3/20/00 f' JOB ADDRESS 5714 West Moore Lake Drive NE 1 LEGAL LOT NO, BLOCK TRACT OR ADDITION SEE ATTACHED DIE 4 5 1 Donnayl s Lakeview Manor SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ross Haidle 5714 Moore Lake Dr West NE 571-3169 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Murphy Bros Building & Remodeling Co 1613 93 Ln NE, Blaine, MN 55449 780-3262 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE N0. 3416 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION! ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Remodel Bathroom 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. �qA T EQUj�� WjkjjG �EA� R.• �LGAQQ2 � sNG 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 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 $4.00 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $8,000 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- $153.25 Fire SC $8.00 STRUCTION OR TH€ PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOT71,70.25 EE Licens $5.00 SIGNATURE Vc ON-RACIP94OR AUTHORIZED AGENT IOA E, ENP OPER LIOAT D IHIS IS YOUR PERMIT S-GNATURE OF OWNERIIF OWNER BUILDER, ,DATE, BI OG fN P 011rAtE NEW[ ] Effective ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND BUILDING PERMIT APPLICATION Construction Address: ' Legal Description: Owner Name & Address: Contractor: M y 114 M un W i;. W "fes i (t� Address: 0 SII) t4ftNib , r jjpsy° UN V r�r)44� Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. Tel. #l-�I1y�1 MN LICENSE # SO 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, N�dl W1� 1r l��t(�l i Estimated Cost: $ 000 Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ DATE: /�i7)1 00 APPLICANT: AAWY F7W,, Tel. # -710 --3ZP 7 - CITY USE ONLY Permit Fee $ /25��, 7, 5' Fee Schedule on Reverse Side Fine &Lrcharge $ A?. `}p .001 of Permit Valuation (1/10th%) State Surcharge $ 0 $.50/$1,000 Valuation SAC Charge $ $1050 per SAC Unit License Surcharge $ '5-� OCA $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 $ `7©• S— M120PNOONITI