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PRE 2010 DOCSBUILDING PERMIT 'Village of Fridley, Minn.,� N? 2163 Date. I .......................... OwnerBuilder ............ .................... .......... Address ........... Address ........ ............................. LOCATION OF BUILDING NO. Street 1. ............. Part of Lot ...................... L Block Addition or Sub-Division ...... 7 1.4 Comer Lot ....... .... Inside Lot ............. Setback sd-'.�:40W- ideyard 14.eme .............. DESCRIPTION OF BUILDING To be Used as: Front Depth - Height Sq. �Ft....... .. Cu. Ft . ........ ................... Type of Construct14 1'. Front ......... Depth ........ Height Sq.'Ft . ........ Cu. Ft . ........ Cost .. To be Completed. 7'w". .q Est .zlorZ In considerationjlof ill ii the issuance to me of a permit to construct the building described, above, I agree to do the proposed work ir ordinances the village accordance with the description above set forth, and in compliance with all provisions of Fridley. of of .................. ns r 0=prationb'�,, Aexproos�, the PaYrnex;of alewoi $.,./,40, permit is hereby grante : d to to construct the building, br ad ditldn as described above. This permit Is granted upon le ti 8 co tions that the to It con done in, around and p6rson* whom is- granted and his agents, employees and workmen, in all work upon said building, o r any part thereof, shall conform ordinances in all respects to the ordinans of Fridley, Minnesota r regarding in In the village limits location, construction, alteration maintenance, repair and moving of buildings with- I . �d this permit, may be revoked at any time u, on viola of any of the provisions of said ordinances. A Building Inspector NOTICE:, This permit dbes not cover the construction, installation or alteration for wiring, plumbing, gas heating, sewer or water. 81d sure to see the Building Inspector for separate permits for these items. y City of Fridley, t4m [30.'URDING PERMIT L74 a& 2V-.qd.& Builder Addr= Address OCATION OF BUILDING No. s Street Part of Lot Lot Block Addition or Sub- . on _ Corner Lot ._ Inside Lot setback Side4d' Sewer Elevation _ Fo dation Elevation DESCRIPTION OF BUILDING N? 6451 T beUsed as: ALL_ _ Front Depth J:.� Height �� Sq. Ft. Cu. Ft. .� Front Depth Qr Height Sq. Ft. cu. Ft. Type of Construction _ Est. _ To be Completed In consideration of the issuance to me of a permit to construct the building described above, I agree io do thh proposed work in accordance with the description above set forth and in compliance with allprovisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $ . '. , permit is hereby granted to— IV 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. Building Inspector NOTICE: 'fids peneh does not emer the construction, hmftU ton for whine, phnnbing, gas headuy, sewer or water. Be wre to we the Budding Impactor for separate permhs for thorn hems. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER' S NAME DQ i A' KR r 1 Z kV 84- C0 ADDRESS a al S% ADDRESS 4s -o lo A y C � LOCATION OF BUILDING No. _245_7 "% `;L, k /-)C-, , Street Part of Lot Lot J�� ;� Block Addition or Subdivision FIM � Corner Lot Inside Lot Setback Side Yard %S3 SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed build- ing location drawn on these Certificates. DESCRIPTION OF BUILDING Tom as Front f Depth Height Sq. Ft. Cu. Ft . Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Estimated Cost To be Completed v i 3 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. J (Schedule of Fee Costs can be found on the Reverse Side). Date: _.._ JULY 19, 1966 N° 8926 Owner: _ JOHN PARTYKA Builder BLANSKE CONSTRUCTION COMPANY Address 4757 - 22 St. N.E. Address 4029 Silver Lake Road Fridley, Minnesota 55421 St. Anthony Village, Minnesota LOCATION OF BUILDING No. 4757 street 2 2 Street N. E. — part of Lot Lot — 25 & 26 Block 7 Addition or sub -Division . Plymouth Addition Corner Lot -- Inside Lot — X Setback -- Sideyard Sewer Elevation — Foundation Elevation DESCRIPTION OF BUILDING To be Used as: FAMILY ROOM -BATH, t 3 2 Depth 12 Height 18 sq. g t, 3 84 Cn. Ft. 6,912 BEDR � 16-(J Front Depth — Height — Sq. Ft. — Cu. Ft. Type of Construction >RAME Est. Cost $7,500.00 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 set forth and in compliance with ail provisions of ordinaacas of the city of Fridley. � In consideration of the payment of a fee of $ 8 a 00 ___r.__., permit is hereby granted to NSKE__CQNSTRUCTION GOA - to construct the building or addition as described above. This Aermit 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 location, construct[on, alteration, maintenance, repair and moving of buildings within the city limits and tbU permit may be revoked at any time upon violation of any of the provisions of said ordinances. NOTIC& 1bb po mit den net cover the anstmWee, hwallolon for Wking, Plumbing, gas beano, rawer or webr. Be are to M the Building Insi rater Per aporete permlh ler thea Nemo APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MIWESOTA OWNEW S NAME r C> ItsA P /-v l I BU' ,''_nra U � ADDRESS o7zT_ �� ADD REv5/��� LOCATION OF BUILDING r N0, .,,LZ STREET AA _PART OF LOT LOT BLOCK ADDITION OR SUBDIVISION CORNER LOT INSIDE LOT_,Z SETBACK SIDE -YARD SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To be used as ffia _� � Jz aryQ Front Depth /a Height f4m-4-A-) Sq. Ft. 3, Cu. Ft. Front Dept h Height Sq. Ft. Cu. Ft. Type of Construction % •3-0 6 _T �.,u Estimated cost 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 rof Fee Costs canbefound on the Reverse Side). t. r App6ca cion for Power Plants and H g, Ventilation, .Re+Fri ®nd Air Conditioning Systems and Devic PARTIAL RATE SCHEDULE Dept. of Bldgs. Phone SII, 4-7470 ZJA ^ / All. GRAVITY WARM AIR: RATE TOTAL, Furnace Shell & Duct Work .......................... 8.00 $ Replacement of Furnace 5.00 $ Repairs & Alterations—up to $500.00 .................. 5.00 $ Repairs & Alterations each add. $500.00 ............... 2.50 $ MECIL WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ ✓ ° y each add. 60,000 BTU .... . .................. 2.00 $ Replacement of Furnace §.00 $ Repairs & Alterations—up to $500.00 5.00 $ Repairs & Alterations each add. $500.00 .......:..:... 2.50 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines -to 400 sq. ft. EDR Steam....... 8.00 $ Furnace Shell & Line—to 640 sq: ft. EDR Hot Water ... 8.00 $ Each add. 200 sq. ft. EDR Steam ...................... 2.50 $ Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $ OIL BURNER—to 3 gal. per hour ........................ 5.00 $ over 3 gal. per hour—See Fee Schedule ®® GAS BURNER (up to 400,000 BTU) ....................... 5.00 $ S2 . GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures �, .�_ x $1.50 $ Additional Fixtures ................. x 50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL FEE Ste® ROUGH FINAL City of Fridley: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Owner Kind of uilding Used as To be completed about Estimated Cost, $ . . O1d�New. Building Permit No. Permit No .� DESCRIPTION OF WORK HEATING or P3ffER PLANTS—S am, Hot Water, <m No --/— Trade Nam Size N • 11 IR S-7. 19!� ®0/)'N Capacity 1 S D.R• B H.P. Total Connected Load 16 Kind of Fue BURNER — Trade Name Size No (REMARKS -OVER) D - Si �' i By 2M 7-59 ►,ter Lrl?L City of Fridley, NUmn. BUILDING PERMIT Date: Sept, 7, 1967 N9 9438 Owner: John Partyka, Jr. Bid. Aqualan_d Pool Com. Address 4757 N. E. 2; St. Address 4740 W. 27th St. LOCATION OF BUILDING No. 4757 Street — 23,- St Part of Lot Lot 2.5 & 26_ Block ___ 7 _ Addition or Sub -Division _____ P1 smouth Ad_dn Corner Lot w Inside Lot _ Setback _.__ Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To be Used as: srd=i ng Pnnl Front, Depth 36 Height Sq. Ft. Cu. Ft. Front - Depth Height Sq. Ft. Cu. Ft. Type of Construction Steel Wgll,VinylEst, Cost $2000.00 To be Completed Oct 1967 Liner In consideration of the issuance to me of a permit to construct the building d cribed above, I agree to do the proposed work in accordance with the description ab o set forth and in anMee with all provisions of ordinances of the city of Fridley. e1 In consideration of the payment of a fee of $32,0Qpermit is hereby granted to Aqualand Pool Co. to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work. done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. CLARENCE BELISLE Bunftg Inspector NOTICE: 'Ibis perndt does not cover the condrucdon, iastallalton for wiring, Plumbing, gas hoMtog, sewer or water. Be alta to see the Building Inspector for separate permits for these hems. APr?"1C-V_1 ! .4 FOR MILDING prrsiT CIM OF T�'�C�.;1L�iJ ZZINNESCTA, �iY . OWNER S NAME C12�Pljli. uER ADDRESS �(� �� ADDRESS q c-0 - LOCATION OF BUILDING NO. 2 STREET �" , PART OF LOT 1. LOTBLOCK / ADDITION OR SUBDIVISION)-'' CORNER LOT INSIDE LOT SETBACK SIDE -YARD SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTIVN OF BUILDING, To Be Used Ag: Front Depth Height Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction r 1 Estimated Cost 006"z—' To Be Completed Z f 6 The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. i - DATE � 6 SIGNATURE. (Schedule of Fee Costs can be found on the Reverse Side). v 41 O ca I�1 ca I. i ''A 3i 1� c�N7 � I� KI ��$'� !ol 1 i � � '�,i�►, ,� ca QA AL 1i I j I I 1 G. .9-.L i9r -v '4 ; •-- � r,l I 1 _ � �-s_�--�-;� qp r 1 uZ _ �? z a a�1 f rn x8 f Vii. I I'at`� X I' 1 zI P a Lr cL tr 1�Ga i 1 `ALK �1 L t� to W _ w z A u= o a L n *- r cra �I n _ -�' T. v �+ o ; -_ ' ''�' I 411 c, �� Z o ?d,,.',Sr i `' I °Jf�'1, :' f �•� { t`� �_—� �'�—'�1� xv+ .w.� iq I V ♦ ' I / .1 L Y�y cr M is �f �_ �> CL21Z (Y,� ��� __"'i3Ned' :•A-.6 ` �"' 13Nbd .,9 �ilbrd � ni z L 7"" ii.M ^��� lC3'7 vptit�h' _A - t, PERMIT for Power Plants and Heating. Cool- ing. ventilation, Refrigeration and Air Conditioning Systems and Devices DESCRIPTION OF WORK No. o. Heating Plants to be installed—altered—repaired Make Oil fared__; Coal fired ; Gas fired ; Gas Authorization No. Remarks v Approved by Final Inspection Date , 19_ Inspector 1319 ss Permit N° 470 6 Fee $ Cif , ®ll Office of the Inspector of Buildings City of Fridley City of Fridley, Minn. AAA, 19� Owner Location 52�5'9 —im'M2 IV, Kind of Building '- 0 How Occupied Work to be Commenced—, 19— To be Completed ,19.E Estimated Cost, New, Building Permit No. Permission is hereby granted tom ./ to install—erect—use the material and devices described in the above statement. This permit is granted upon the express condition thaCjhe person to whom it is granted, and his agents, employees and workmen, in all the work done and materials used under this permit, and in the operation of the devices herein mentioned shall conform in all respects to the ordinances of the City of Fridley relating to or governing the work to be done and the operation of the devices herein named, and to the specifications set forth in the approved application for this permit on file in the office j'ice o f the Inspector of Buildings. Inspector of Buildings az 2M 11.67 V Effective Aug. 1, 1981 of Fridley sv.T Permit No. rPCity . .T THE TOP o► TMt Twaw WRECKING PERMIT APPLICATION Receipt No. ------- COMwNNITY DEVELOPMENT DIV, r rROTECTIV[ INSAECTION GM, CRT HALL FINVIAV ii@a ',�..f�•� .�-SGQ'b1i0 IRM= ain- 90 REV. *ATE 2115173 PAGE OF APPROVED BY ROO Job Address 2 Z Legal Lot No. I Block No. Tract or Addition Desc. 1245 A L ® M aw Address Ph ne Pro ertyer 6 -h AMR Cont4act6r� Address Phone Description Front Depth Seipht Sq. Ft. Cu. Ft. of Bldg. 210 2or No. of Dwelling Units Taxes Paid Tax Receipt No. Estimated Cost of Wrecking To Be Completed Utilities to be Notified and date Services Disconnected Mpls. Gas Co. N.S.P. Northwestern Bell Tel. Co. Engr. Dept. Cust. Bus. Ofc. Bus. Ofc. 372-4850 330-5540 332-4112 Date Date Date Wrecking Fees: $1.25 for each 1000 cubic feet or fraction For structures which would be impractical to cube, the fee shall be based on the total cost of wrecking such structure at the rate of $6.00 for each $500.00 or fraction. MINIM M FEB: $15.00 No State surcharge on Wrecking Permits. Approved By Water & Sewer Department: All Bills Are Paid Services Are Disconnected The undersigned hereby makes application for a permit to wreck the building described above, agreeing to do all work in strict accordance with the City Ordinances and rulings of the Department of Buildings, and hereby declares that all facts and representations stated in this application are true and correct. - C traf o 9.4 Date 2'w SUBJECT City ®f Fridley AT THE TOP OF THE TWINS BUILDING PERMITP` TRECEIPT COMMUNITY DEVELOPMENT DIV. ~ e 1 � PROTECTIVE INSPECTION SEC. I = � CITY HALL FRIDLEY 55432 L NUMBER REV. DATE 7/3/84 PAGE OF APPROVED BY 612-571-3450 910-F15 JOB ADDRESS4757 21-2 Street N. E. 1 LEGAL LOT / VNO7.� aulaPx BLOCK 7 TRACT OR ADDITION SEE ATTACHED Plymouth Addition SHEET DESCR. 2 PROPERTYOWNEA0 01 L0 MAIL ADDRESS ZIP PHONE Gary & Carol Geretschlager 4757 22 Street N.E. 572-8728 3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSE NO. same 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 C� ADDITION. ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK 36' x 21' attached garage a 12k x W Living Area Addition 9 CHANGE QF USE FROM TO STIPULATIONS 1. Provide a hard surface driveway variance approved June 26, 1984 (side yard 5' to 3') 1. Provide products or combustion fire alarm in sleep area in basement or existing house. ,EPERATE PERMITS REQUIRED FOR WIRING, HEATINGo PLUMBING AID SCCA. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. wood 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 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 Y 9 X0. 00 4.70 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 LOCAL LAW REGULATING CON- 80.50 STRUCTION OR THE PERfORMANCE OF ONSTRUCTION. PLAN CHECK FEE TOTAL FEE RE 2Q SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE). EN,ypPROPS Y V L. yJATED THIS 1 ERMIT� BLDG INSP SATE SIGNATURE OF OWNER IIF OWNER BUILDERI (DATE) 2'w NEW [ ] ADDN. [ ] ALTER. [ ] Construction Address: City of Fridley Effective 4/1/84 R-1 AND R-2 Building Permit Application Legal Description: 6 - Owner Name & Address: �-� ' Tel. d Contractor: �� Tel. # Address: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIEV5 0150` LIVING AREA: Length Width Height Sq. Ft. �"■°� GARAGE AREA: Length �� . _ Width �� Height _ Sq. Ft. Z� DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: v ® �� • Corner Lot [ ] Inside Lot Ft. Yd. Setback Side Yard Setback �� / Type of Construction: Estimated Cost: $ Approx. Completion Date: b;PA- - Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation DATE:APPLICANT: Tel.��' ITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Plan Check $ 25% of Building Permit Fee State Surcharge $ a $.50/$1,000 Valuation SAC Charge $ $425 per SAC Unit Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary G 7 Not Necessary [ 7 TOTAL $ STIPULATIONS: ' o t�ta rt,�,�t�uc�t A P Pr2.c�v� Coo ZG�B�I �1��.'#► ` 5 t-cice a*%4LC*'X Olt V 4� &A SUBJECT City of Fridley 29649 AT THE TOP OF THE TWINS BUILDING PERMIT � RECEIPT NO. `COMMUNITY DEVELOPMENT DIV. y ------ INSPECTION SEC�/V �q r PROTECTIVE 1 i CITY HALL FRIDLEY 55432 NUMBER REV DATEPAGE OF APPROVED BY 612-571-3450 910415 6/8/99 ,OB ADDRESS 4757 2 1/2 Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 25, 7 1 Plymouth SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Carol Geretschlae er 571-1056 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Suburban Exteriors 9701 Penn AveS Ste 107 Bloomingtnn 55431 881-8232 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 )(3 REPAIR ❑ MOVE ❑ REMOVE S DESCRIBE WORK Reroof house and garage 38 SO Tear-off 9 CHANGE OF USE FROM 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 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 WHETHSPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 3321 $1.66 DOES NOT P SUME 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 O CONSTRUCTION 97.25 Af F1 a SC $3.32 PLAN CHECK FEE TOP L FEE L' 107 23 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IOATEI THIS IS Y R P IT kne);T S /• OATS S,GNATURE OF OWNEROF OWNER BUILDER, IDATEI „ . $ 92,26-- FireSurcharge $ _ NEW [ ] Effective 5/10/99 SAC Charge $ ADDN [ ] CITY OF FRIDLEY Driveway Escrow $ ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Park Fee $ BUILDING PERMIT APPLICATION Construction Address: ups la�6D �,�� /� Legal Description: J i P- - itx4, 3 i o (� ✓1/A Owner Name & Address: -2rjQ±jLjgjo.Q g9— Tel. # Contractor: 8 MN LICENSE # Address: q �% D' 2-QJ-R� QAr2, -`1 / O Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Construction Type: DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft. Length Width Height Sq. Ft. Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ M .41 DATE: 6 - d 2- APPLICANT: Tel. #__6 / A - 9- 9- - -Fa Permit Fee $ 92,26-- FireSurcharge $ State Surcharge $ SAC Charge $ License Surcharge $ Q 0 Driveway Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ TOTAL $ lo?,2-3 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 [ ]