PRE 2010 DOCSBUILDING PERMIT
Village of Fridley, Minn. No 2 P S 7
Date..... .... ..� ...... .......
Owner .... R R... ........... Builder ...
Address .... (q3:33 .... ! .Qti� -Z ........ Address
LOC TI OF BUILDING
No. .. � �.! ..... Street .....�i/ c i . ...................... P of
Part Lot .......................
Lot .... �� ..... Block .....3 ........ Addition or Sub -Division .. .......
Corner Lot ............ Inside Lot .. Setback ... .... Sideyard :,0.41put r+ ..............
DESCRIPTION OF BUILDING
To be Used as:
r
.. Front . �l Depth Height 4-k.,,
Sq. Ft. /1d Cu. Ft. ........
32. 9 .e.... Front 4�?0... Depth .. Height _Sq. Ft. Cu. Ft. .....
Type of Construction l... Est. Cost .. . f. r . ... To be Completed ... .... .
Co? e4'�.o
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 anin compliance with all provisions of
ordinances of the village of Fridley.
.......y.. v .-....� ... ... .. ........ .. .
r Ne
In consideration of the payment of a fee of $ 1.6 .. C iermit i hereby granted to .... �� .: .. .... .
.. g *-.a ....... 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 ther conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alter tion, ma tenan d moving of buildings with-
in the village limits and this permit may be revoked at ny time on vi lat n y oi�/ the provisions of said
ordinances. / _ ��ioav , # _
Building Inspector
NOTICE:
This permit does not cover the construction, installation or alteration f r wiring, plumbing, gas heating,
sewer or water. Be sure to see the Building Inspector for separate permits for these items.
SUBJECT
P
City ®f Fridley
16 5.2 5
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
R
• _____ COMMUNITY DEVELOPMENT DIV.
;v-
� � PROTECTIVE INSPECTION SEC.
"Ir
yr
i
i---. ---,'� CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
L 612-571-3450
910-F15
4/15/82
JOB ADDRESS 6721 - 2nd St. N.E.
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION SEE ATTACHED
DESCR.
25
3
Rice Creek Plaza. South SHEET
2 PROPERTYOWNER MAIL ADDRESS ZIP PHONE
Raymond Beyer 6721 - 2nd St. N.E. Fridley 55432574-7455
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Milton L. Johnson Co. 2513 Central -
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
❑ NEW 12 ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE.
8 DESCRIBE WORK
Reroof
9 CHANGE OF USE FROM TO
STIPULATIONS
Roof can be second but not third. Provide ridgid galvinized valley.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
Asphalt
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 $1.00
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$2,000.00
eft"
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 P RFORMANCE OF ,CONSTRUCTION.
$32, 50
PLAN CHECK FEE
TOTALFEE
ems' P3 6r
)NwC9-'_z
..
SIGNATURE OF CONT TOR OR AUTHORIZED AGENT (DATE)
WHEN PROPERLY VALIDATED THIS IS YOUR
/PERMIT
BLDG INSP DATE
SIGNATURE OF OWNER 0F OWNER BUILDER) (DATE) a
CITY OF FRIDLEY
APPLICATION FOR RESIDtNTIAL BUILDING PER4ITS
(New, AT terations, Additions, or Repairs)
OW14ER: L AM AJ BUILDER: . � � c-�` o� � • �.% H „, s�,�
ADDRESS: L 7,-;Z /- ii. ADDRESS: Ce N ?-/t f L i L4
TEL NO: �'�� - 7 �i �s TEL 140:
Construction Location
STRES, T NO: e5'7z- STREET: 7 t� o /(-"E: e
LOT: . BLOCK: ADDITION:—E 5•
01
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: Depth • Height:
Square.Feet: Cubic Feet:
Front: Depth: Height:
Square - Feet: Cubic Feet:
Type of Construction: Estimated Cost: $
To $e Cbrupleted: 0 clflw
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 tvrk*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 angl correct.
DATE: - T'(S- Y i/ SIGNATURE: U k�zl
Stipulations:
or c2
�e go
1
suBJECrRMIT
-11
NO.
City of Fridley
2 9 7 3 6
AT THE TOP OF THE TWINS
BUILDING
PERMIT
i �
R
r t
• _____ COMMUNITY DEVELOPMENT DIV.
� VV
� PROTECTIVE INSPECTION SEC.
r �
NUMBER
REV
GATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
L „ 612-571-3450
910-F15
6/21/99
JOB ADDRESS 6721 2nd Street N
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
25
3
R7 C
SHEET
2 PROPERTY OWNER MAIL ADORES*
ZIP
PHONE
Maureen Manion
-
3 CONTRACTOR MAIL ADDRESS
ZIP
PHONE LICENSE NO
Manions Masteroo i
-
a 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
O NEW O ADDITION O ALTERATION n REPAIR
❑ MOVE O REMOVE
8 DESCRIBE WORK
Reroof house and garage(20 Sq) Tear -off
8 CHANGEOFUSEFROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
SEPARATE PERMITS ARE REOUIRED 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
1 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
$1748
$.87
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-
STq H PERFORMANCE Of CONSTRUCTION
$63.15
Fire SC
$1.75
PLAN CHECK FEE
TOTAL FEE
VTION
License SC
5.00
70.77
SG ATURE FCONTRA--RAUTHORIZ GEN* +DATA
WHEN PROPERLY
A
BLO :- µ5o
LIDATED
THIS IS
YOe PERMIT
v r,ATE
S-GNATURE OF OWNER dF OWNER SUROERI (DATE.
NEW[ ] Effective 5/10/99
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
s
Construction Address:
Legal Description:
Owner Name 8A Address: Tel. # ,-�'7 r
Contractor: ®co C' MN LICENSE # J�'f 1-f f
Address: Tel. # 7 r( -7Z 2-T
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF EVIPROVEMENT
LIVING AREA:
Length
Width Height
Sq. Ft.
GARAGE AREA:
Length
Width Height
Sq. Ft.
DECK AREA:
Length
Width Hgt/ ound
Sq. Ft.
OTHER:
Construction Type:
Estimated Cost: $
f 17z 7C)/0
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: APPLICANT:
Tel. #
CITY USE ONLY
Permit Fee
$ /�
Fee Schedule on Reverse Side
Fire Surcharge
$ S-
.001 of Permit Valuation (1/10th%)
State Surcharge
$
$.50/$1,000 Valuation
SAC Charge
$
$1050 per SAC Unit
License Surcharge
$ . 005
$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 $ 9,
STIPULATIONS: