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PRE 2010 DOCSApplication for Power Plants and.. Healing, Coding, Ventilation, Reh igeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: BATE 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 $ MECH. WARM AIR Furnace Shell & Duct Work to 170,000 BTU ............ 8.00 $ ,r each add. 60,000 BTU ....................... 2.00 $ Replacement of Furnace ............................. .x.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 $ 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 $ Rw ROUGH FINAL Dept. of Bldgs. Phone SII, 4-7470 _� 7 Location -� L<,s c� zs';'. ! , 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. Fridley, Minn 19 _ Owner Miacole&J000a afa2INS Kind of Building Used as To be completed about Estimated Cost, $ Old New Building Permit No. Permit No. DESCRIPTION OF WORK BEATING or POWER PLANTS—,Steam, Hot Water arm Air—JXo. _ Trade Name ' IV A.P 0A Size Nod 7a%At" ` Capacity = Sq. Ft. E.D.R BTU H.P. Total Connected Load , IWO 4 MMKind of Fuel 'C-* BURNER — Trade Name SA �� Size No Capacity Sq. Ft. E.D.R BTU H.P. (REMARKS—OVER) Signer] By az TM 7-59 BuT0 4410 EXCELSIOR BLVD. MIMEA OLIS 16, MINN. WA- 0-6567 City of Fridley, Minn. BUILDING PERMIT N° (:5:7:7j Date: Owner: _AaAff va t Builder Address _____ Address — LO ION OF BUILDING No. -M Street _ _ Partx Lot Lot _ Block _ Addition or 5ub-Division _ Corner Lot _,_ _ .__ Inside Lot Setback = Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING T Used �� Front Depth _ Height -�r+ Sq. Ft. , cu. Ft. z dwe Front. Depth _ " eight _ _v CA Sq. Ft. _ ._ Cu. Ft. Type of Construction Est. CostJ� �"` 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 all provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $ , permit is 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 violatio y of the provisions of said ordinances.'' Inspector NOTICE: This permit does not cover the construction, Installation for whing, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these items. 4 0 -A=,:0 Owner' Addres APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA LOCATION OF BUILDING No. +--( Street �� Part of Lot P. Bloek Y Rdditior�iJ r subif4is Corner Lot Inside Lot--L.—Setback 35_ S ide-Yard SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this forth Certificate of Survey of Lot and proposed building location. To be used ass DESCRIPTION OF BUILDING Sq. Ft. L& V- Cu. Ft0— Front Depth FrontDepth Neight Sq. Ft. Cu. Ft. Type of Construction Estimated Cos-&1�__„_, To be Completed? 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 ruling of the Department of Build- Ings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE (schedule of Fee Costs can be found on the i6lverse Side). City of Fridley, Minn. BUILDING PERMIT • Date: May 26, 1965 • • Owner: Richard Mullee 1�° 7574 I&, -V AXL AJ ':1 Buildex Lakeland Brick and Stone Co. Inc. Address Q00 Humbold Ave. So. Mpla.= Adm 147 Cr�21 Enwi lr 5860 and LOCATION OF BUILDING No. 5862 4 Street 4th Street N. E. Part of Lot Lot _ Block Addition or Sub -Division Corner Lot Inside Lot Setback r._ Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Do bleb Front Depth Height Sq. Ft. Ca M Front Depth ��H�eirg►hht Sq. Ft. Cu. FL Type of Construction 'Fame Est, Cost _ 912 vscQeO—_ To be Completed Storm Dmnage Repair In consideration of the Issuance to me of a permit to construct the theproposed work in accordance with the description above ordinances of the city of Fridley. above I agree to do rlth :h provisions of In consideration of the payment of a fee of $ 10.00 , permit is hereby granted to Lakeldnd Brick & Stone CO. Inc. 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 ng location, construction, alteration, maintenance, repair and moving of buildings within the city limits andel this permit may be revoked at any time upon violation of any of the provisions of said ordinances NOTICE: 1Ub pwraft den not emu the comlroedon, hulaWan for vdrhi& phWbing, gn heathk, wwa w water. Be sun to see the Budding Mweeter for apwufe pwnft for thea dens. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME %A c. /f�'i%iQ�id s//4�L e ¢ BUILDe'4paql91WY La ADDRESS X 300 40iolalX®. "'V B. ADDRESS i % u��°_ew LOCATION OF BUILDING 44'4 Street dart of Lot Lot Block 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 build- ing location drawn on these Certificates. To -be used as; DESCRIPTION OF BUILDING Sq'. Ft.. Cu. Ft. 'Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Estimated Cost To be Completed 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. DA c,4M/r / F/'� — S J'Schedule of Fee Costs can be found on the Reverse Side). City of Fridley, Minn.. 5 5 5 6431 University Ave. N. E., Minneapolis, Minn. 55432 BUILDING PERMIT Date: July _21, 1972 Owner: _ Jon Page Builder Same Address _.__._.B.(L_ - 4th Street N.H. Address Same LOCATION OF BUILDING No. __5809_::_ street 4th Street N.E. Part .of Lot Lot Block _.___4__ _..__ Addition or Sub -Division $ennPtt Palmer Addition Corner Lot _________.___ Inside Lot ._._ X Setback — Sideyard Sewer Elevation _ Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Front _. 301 Depth 24' Height _ 10' _ Sq.; Ft. 720 Cu. Ft. 2QQ —__ Front ._ Depth Height Sq. Ft. Cu. Fi. Type of Construction Wo4S1 Frame Est. Cost $3, 261. To be Completed 3 months Stipulation: Provide a hard surface driveway. iEPMITE PERMITS REQUIRED FOR WIRING, 'HEATING, PLUMBING AND SIGNS. In consideration of the issuance to me of a permit to construct the building described above I a to do the proposed work in accordance with the description above set Jx1th and ' compliance with all pro ons of Ordinances of the city of Fridley. 1.63 ate Surchar e In consideration of the payment of a fee of $ �Q_, permit is hereby granted to John Pape 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 ordingnees 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. N_ - ----- a p�s�»attl� ding Inspector CLARENCE BELISLE NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to no the Building Inspector for separate permits for these items. TYPICAL SLAB DETAIL t The above is a substitute design for frost footings, however, it is not yet accepted by the State as an amendment to the Uniform Building Code, Section 2905,a. Therefore upon using this method of construction, I agree to hold the City of Fridley harmless of any possible claim for foundation failure or structural damage caused by foundation failure. c Witne Proper t - ate Address of P s yr i operty /Z gal Desc. APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNBR I S NAME : ILDER ADDRESS: �i—z ADDRESS: NO:. 2) b O , QISTREET: N�N e r r IAT; 1�k BLOCK: ADDITION: CORNER LOT: INSIDE LOT: —'>< SETBACK: SIDEXARDs Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. To Be Used As: DESCRIPTION OF BUILDING Front: 26 © s Depth: Z Height: Square Feet:n 20 Cubic Feet: Front: Depth: Height: Square Feet; Cubic Feet: Type of Construction: To Be Completed: Estimated Cost: $ w�IAIR !el 1Ra4 B The undersigned hereby makes application for a permit for the.work herain specified, agreeing to do all work in sttict accordance with the City Qf Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this applig4tion are true and correct. �� IGNA (See Reverse Side For Additional InTURE tion.) �1 / V SUBJECT al' City of Fridley KE1320 AT THE TOP OF THE TWINS PERMIT BUILDING ECEIPTNO.� COMMUNITY DEVELOPMENT DIV. INSPECTION r PROTECTIVE SEC. CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY L J\ 612-560-3450 910-F15 9/16/75 JOB ADDRESS 5860-62 - 4th Street N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 41 4 Bennett Palmer Addition SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE James Kordiak 5862 - 4th Street N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 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 [X REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Fire repair to garage 9 CHANGE OF USE FROM TO STIPULATIONS PERMITS REQUIRED FOR MIRING, SE PERATE PLUMBING AND SIGNS. HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Wood Frame 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 2 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 $2,000 1.00 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. 12.00 PLAN CHECK FEE TOTALFEE $13.00 SIGfATUREOFCONTRACTOR ORAUTHO IZEDAGENT (DATE) WHEN VALIDATED THIS IS YOUR PERMIT APROPERLY SIG ATUR F O VNEA fig OWNER BUILDER) (DATE) BLDG INSP DAT / V APPLICATION FOR RESIDENTIAL; ALTERATION, OR ADDITION BUILDING'PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME • �, /1 0�� BUILDER: ADDRESS : $ &a ADDRESS: NO: STREET: LOT: BLOCK: ADDITION : o� /%a�� Lt.H•� CORNER LOT: INSIDE LOT:. SETBACK: SIDEYARD: Applicant attach to this form Two Certificates of Survey of Lot and propose building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used AS: aL a' Liv. Front: Depth: Height: Square Feet: Cubic Feet: Front: Depth Height: Square Feet; Cubic Feet: type of Construction: stimated Cost: $ 00 To Be Completed: MO. 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: Z /275 SIGTTATURE •el V a, (See Reverse Side For Additional Information.) Ok 'A SUBJECT PERMIT NO. City of Fridley AT THE TOP OF THE TWINS BUILDING PERMIT i RECEIPT N COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. �o NUMBER REV. ATE PAGE OF APPROVED By CITY HALL FRIDLEY 55432 -...� 612-571-3450 910415 t4/8/94 JOB ADDRESS 5860-62 4 STREET NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2 4 Bennett Palmer SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE William Guenther 643 Rosedale Rd NE, Spring Lake Park MN 55432 786-0961 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential Duplex 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Install two egress wnidows, reroof building, reside three sides 9 CHANGE OF USE FROM TO STIPULATIONS Provide smoke detectors by sleeping areas in accordance to their listing. See notations on plan. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SO. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1,267 .63 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- Fire SC $1.28 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $31.00 PLAN CHECK FEE TOTAL FEE License SC $5.00 $37.91 OR IDATEI SIGNA U E OF CO�40FI OPE Y VALIDATED T -JS YOUR PE IT �RZEAGENT / 4 i gl , r/aTE Si 'NATURE OF 0 N ERIDA EI 'A NEW ADDN [ ]. CITY OF FRIDLEY ALTER [ ] 'SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: g� ®�� 4� S / ` tv e Legal Description: 4 O Effective 1/1/94 Owner Name & Address: WL" O 6v�1 /I - GUETN7 N F—(Z Tel. # 7 Ko p / 64a (ZoS&BALL RD. NE Contractor: f -j iE: 5 F LK- Pa a -K M N. S54.3. -k MN LICENSE # Address: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it.to scale. DESCRIPTION OF IMPROVEMENT Tel. # LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: CC X55 �l�h�zaw� ��+eo S�cIE� ��SicfE Corner Lot [ ] Inside Lot [ ] Type of Construction: Approx. Completion Date: _ Ft. Yd Setback Side Yard Setbacks Estimated Cost: $ r% (Cost on Back)" Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: 3101 Z ?I- APPLICANT: ,�.1 ��I �_ _ Tel. # '7 Fffo - 0 f9j/ CITY USE ONLY Permit Fee $ 31- 00 Fee Schedule on Reverse Side Fire Surcharge $ t .d E .001 of Permit Valuation (1/10th%) State Surcharge $ , $.50/$1,000 Valuation SAC Charge $ $800 per SAC Unit License Surcharge $ 5. $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 $ 3 � i STIPULATIONS: Pjd�w, `k�' � € ' ,-v m -GeeoW EE -,RISS �f��do�S j Silk - � R o So _ # SO b _ as`� X00 j2oo"F Ih G 18 soua2Eg To Cov-Pr I Irl 84 sc4 "F7, ?-.LL-3 ij _... Saa II 5�5 � $4 36 8 [ _J 6 7- �L.. G U�rJTII L 6020 (501 — 2d) 2FT OVERHANG -------------- --- ---------------------- 74 ,- I I ' , i BASEMENT ROOF LINE 14° OVER STEP' I I =LOOK 'LATE INT WAL 5850/62 4TH ST NE FRIDLEY SCALE: .021 (1/4' = 1FT) C�`a,� X 3-/0l WELL SUBJECT PE NO. City of Fridley 28133 AT THE TOP OF THE TWINS BUILDING PERMIT 672-3604. • COMMUNITY DEVELOPMENT DIV. � Ly ____ PROTECTIVE INSPECTION SEC. �oes NUMBER REV GATE PAGE OF APPROVED BY `L CITY HALL FRIDLEY 55432 ��"', 612-571-3450 910-F15 1017198 JOB ADDRESS 5860 4th Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR: 2 4 Bennett Palmer Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Bill Guenther 643 Rosedale Rd 786-0961 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Quality Contraciting 11380 West River Road Champlin MN 55316 427-7733 7035 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK O NEW 0 ADDITION 0 ALTERATION :IU REPAIR 0 MOVE O REMOVE 8 DESCRIBE WORK Reroof house and garage (28 Sq) Tear -off 9 CHANGEOFUSEFROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OFCONST. 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 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 $2399 $1.20 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS 0 A OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTIO R P RFORMA. E OF CONSTRUCTION 74, 75 ire s $2.40 PLAN CHECK FEE OTAL FE M17 Lice 5.0 83. SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT t 40 TEiENPPPERL IDATED IS YOUR PERMIT SIGNATURE OF OWNEROF OWNER SUROERi iDATE" BLDG r,AIF NEW ADDN [ ] ALTER [ ] ConstructionAddress: cr ption: CITY OF FRIDLEY SINGLE FAi1NIILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION © qt (1- Owner Name & Address: e %3 Ras 0, dot Contractor: Quality Contracting Address: 11380 West River Road ,ry Effective 1/1/98 Tel. # 71(- —,0 T% c ( MN LICENSE # 7035 Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IlMPROVEMENT Tel. # 427-7733 LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: eee v 0'f47 Construction Type: Tear off and reroof Estimated Cost: $ c 9?3 (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: Q 7 ip sr APPLICANT: (' Tel. # q27 -7-7 3 3 STIPULATIONS: CITY USE ONLY �%�%� Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ o) C16 .001 of Permit Valuation (1/10th%) State Surcharge $ o2 $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ LI) $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 $83.3Y - STIPULATIONS: