PRE 2010 DOCSDate.`. v ..
Owner .......
".6r z
Address 5 41 t
No.
Lot x ....
Village of Fridley, Minn.
BUILDING PERMIT �� 1 2
Builder...............................................
...e.. Address .............................................
LOCATION OF BUILDING
..r r ................... Part of Lot ...... .. ..... ... .
. . , ............ Addition or Sub -Division
Corner Lot .... . !'d'.. � de Lot ..*r ....... Setbach�. � .
..... ������
`2c tic a
� . Inside - - - -
DESCRIPTION OF BUILDING
To be Used as: u
.. t ront ........ Depth ........ Height ........ Sq. Ft......... Cu. Ft. ........
.. 4 Front ....... Depth ........ Height ... Sq. Ft. ........ Cu. Ft. ........
Type of Construction ........../ ...... Est. Cost ..................... To be Completed i ,f�. /_ `S 1.. .
4
OPT
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
the proposed work in #ccordance with the description above set forth and in compliance with all provisions of
ordinances of the village of Fridley.
In consideration o the payment of a fee of $ : s permit is hereby granted t6Z?i . `.
.. to construct the building or addition as described above. This permit is granted upon
the express condition • • t the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and u n said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota re ding location, construction, alteration, maintenance, repair and moving of buildings with-
in the village limits an this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
n
•�: t :: . . ... Building Inspector
NOTICE:
This permit doe 3 not cover the. nstruction, Installation or alteration for w , plumbing, gas heating,
sewer or water. Be sure to see tFuiiding Inspector, for separate permits for Items.
1 ]
City of Fridley, Minn.
BUILDING PERMIT
Date: JANUARY 242 1966
FARRELL SCROGGINS
Builder SAME
Address _ 305 West 27th Street Address
Minneapolis, Minnesota
LOCATION OF BUILDING
13"q --'2 y6
N° 8658
No. - 56Q6-08 Street 6th Street N. E. Part of Lot 9, 27' of Lot 12
Lot --& -Lot 13 Block 2 Addition or Sub.Division HAMILTON' S ADDN. TO MECHANICSVILLE
Corner Lot - Inside Lot Setback Sideyard
Sewer Elevation _. Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as: REPAIR BUILDING AS TO COUNCIL ORDER - December 13, 1965
Front Depth Height Sq. Ft. Cu. Ft.
Front Depth Height _ _ Sq. Ft. Cu. Ft.
Type of Construction Est. Cost _$3, 000 _ _ To be Completed
REPAIR AS TO SPECIFICATIONS ATTACHED
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 a'll provisions of
ordinances of the city of Fridley. � _ A7 .
Inconsideration of the payment of a fee of S 18.00 —,permit is hereby granted to F
ARRELL
SQW 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 ordinancesof
Fridley, a city eta regarding location, may construction, ealteration,tany upon violation of rand acy of thmeeproovisions of ea�d
ordinancos city Iianits and this
ALLEN G. JENSEN Building Immector
NOTICE
lble permit does net eowr the candrueHoe, bahA m for wbing, plumbing, gas 6edhgb awn or water. Be ars to ase
the Building hupetor for aparate permits for tbese Beret.
213
APPLICATION -FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME - BUILDER
ADDRESS -36,3 2 ADDRESS
LOCATION OF'BUILDING
No._ �I,r Street- Part of Lot
r
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
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To be used as;
Front Depth Height
Sq. Ft.. Cu. Ft.,
FrMt Depth Height
Sq, Ft. Cu. Ft.,.
Type of Construction Estimated Cost L-99151)
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.
DATE 3' %-SIGNATURE
(Schedule of Fee Costs can be found on the Reverse Side).
SUBJECT
PERMLLWD,
City of Fridley
® 3379
AT THE TOP OF THE TWINS
BUILDING
PERMIT
�
RECEIPT NO.
• COMMUNITY DEVELOPMENT DIV.
r � PROTECTIVE INSPECTION SEC.
t �
'-�;•J CITY HALL FRIDLEY 55432
i
NUMBER
REV.
DATE
PAGE OF APPROVED BY
---.
L J \ 612-560-3450
910-F15
10/1/76
JOB ADDRESS 5606 -086th Street N.E.
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
12,13
2
Hamilton's Addn. to Mechanicsville SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Gary D. Skay 5432 Bryant Avenue North
3 CONTRACTOR MAIL ADDRESS
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 ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
111
6 DESCRIBE WORK
Construct a 24' x 24' garage
:v
9 CHANGE OF USE FROM TO
STIPULATIONS provide a hard surface driveway. Double garage for a double bungalow
has been approved as the bungalow is existing.
--IMPORTANT--
NOTIFY THE FRIDLEY ENGR,
DIVISION REGARDING CURB
REMOVAL AND REPLACEMENT
SEPERATE PERMITS REQUIRED FOR WIRING,
AT.ORIVEWAY OPENINGS,
HEATING PLUMBING AND SIGNIS.
r
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
Wood Frame
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
576
5760
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
2
ISTALLS 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
$41262.40
$2.13
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 STAT OR LOCAL LAW REGULATING CON -
STRUCTIO OR THE PERFORMA E OF CONSTRUCTION.
$23.04
PLAN CHECK FEE
TOTALFEE
ZZ If7e
$25.17
SI ATUREOFCONTRACTOR RAUTHORIZEDAGENT (DATE)
HEN PUP VALIDATED THIS IS YOUR PERMIT
6 A
BLDG IN SP
�1 %C) -(0 -?i
DATE
SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE)
• ' :APPLICATION FOlt. RE-SI'DENTIAL., -ALTL'fZATION,
• OR ADDITION. BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAr1E• BUILDER:
ADDRESS: ADDRESS:
a s
NO :. STREET:
LOT: BLOCK: ADDITION:
CORNER•LOT: INSIDE LOT:. 1/ SETBACK: SIMARD:
Applicant attach to this form n-io Certificates -if Survey -of Lot and.proposed
building location c:zawn on these Certificates. _
DESCRIPTION OF -BUILDING
To Be Used As:
Front: 02 `/ Depth: oq Height: # l
• Square Feet:,:� Cubic.Feet:
Fxont:_� Depth: Height:
Square Feet; Cubic Feet:
Type of Construction: / /� Estimated Cost:_$
To Be Completed; ��
W o
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 Za
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. `48
DATE: 02� ��� SIGNATURE
.(See Reverse Side For Additional Information.} �� q
�. 13 �"` '
AGREEMENT
I' , owner of the property located
at vZ — have no objection to the City allowing
the construction of a to be located at , j D(o 11- 1-:5r6 ds
without the required certificate of survey that the
City ordinarily requires for all new.construction.
igna re
si
g5fitness
0
AGREEMENT
I, e� , owner of the property located
at 5`6 /a G Z�,V have nonobjection to the City allowing
the construction of a to be located at
without the required certificate of survey that the
City ordinarily requires for all new construction.
Sigmfture
Address
Date
Witness
SUBJECT
Po
City of Fridley
13811
AT THE TOP OF THE TWINS
PERMIT
•
r
S Z
BUILDING
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
l A/'��,,� CITY HALL FRIDLEY 55432
NUMBERREV.
DATE
PAGE OF
APPROVED BY
--_•
i J\ 612-660-3450
910-F15
10/6/76
JOB ADDRESS 5606-08 6th Street N. E.
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
13 & 12
2
Hamilton's Addn. to Mechanicsville SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Gary Skay 5606-08 6th 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 X] ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Install hardboard siding and a brick front
9 CHANGE QF USE FROM TO
STIPULATIONS Provide adequate support and protection against frost heave for
brick front.
SEPERATE PERMITS REQUIRED FOR `VIRiNGs
HEATING, PLUMBING AND SIGNS.
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
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
2
ISTALLS 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
$500
$.50
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-
STRUCTIO OR THE PERFORMAy2t OF CONSTRUCTION.
$7.50
PLAN CHECK FEE
TOTALFEE
If 7,,-
$8.00
SI 4TURE OF CONTRACTOFe6RAUTHORIZEDAGENT (DATE)
) WHEN PR PERLY VALIDATED THIS IS YOUR PERMIT
pAj 4J6
BLDG INSP
I&e,� /0—&—%
DATE P
SIGNATURE OF OWNER (IF OWNER BUILDER) (DATE)
l.i 1 T UP rmiULCT
APPLICATION FOR RESIDENTIAL ALTERATION,
ADDITION, OR REPAIR BUILDING PERMIT
OWNER'S NAME• BUILDER:44���Zx�Zz
ADDRESS: �� 6�o T 045 G ,0a VeADDRES S :
NO:. / - 0. � /, ,
• • DD •
CORNER LOT: INSIDE LOT: L/ SETBACK: SIDEYARD:
Applicant attach to this form Two.Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To Bier Used As:
Front :__�Depth:_ 041 Height: 9
Square Feet: ®QQ Cubic Feet:
ZFront: Depth: Height: &,Z. -e-1
V It11
Square Feet; Cubic Feet:
Type of Construction:
To Be Completed: -Z-U / z."
Estimated Cost: $ D,' —
The undersigned hereby makes application for 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 -
(See Reverse Side For Additional Information.
cz-. X0
57 -/Au 1- 477,01V S
l,AAAJ19 t&,t- 6.e cle. • de-Aill-£4
I
rig
CITY OF FRIDL.EY
6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432
January 27, 1982
Mr. Gary Skay
5432 Bryant Avenue North
Minneapolis, MN 55430
TELEPHONE ( 512)571.3450
Re: Detached Garage Construction, 5606-08 6th. Street N.E., Building Permit
#13791 Issued 10/1/76
i•
Dear Mr. Skay:
An on-site inspection was conducted on January 27, 1982 to check the
status of the above noted construction. It was determined that the
construction was discontinued before completion of the detached garage.
A building permit becomes null and void if work or construction authorized
is not commenced within 60 days of issuance, or if construction or work
is suspended or abandoned for a period of 120 days at any time after the
work is commenced.
Therefore, the above noted building permit has become void and a new
building permit must be obtained before continuing with the completion
of the detached garage.
If you have any questions on this matter, please feel free to contact me
at 571-3450.
Sincerely,
OaAA
DARREL G. CLARY:
Chief Building Official
DGC/mh
SUBJECT
PE
City of Fridley
o 1819 4
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
HEC
• _____ COMMUNITY DEVELOPMENT DIV.
PROTECT VE INSPECTION SEC.
l
r
99
1 . i
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
9/9/85
JOB ADDRESS 5606 - 6th. Street N. E,
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
Pt. 12,1
2
Hamilton's Addn. to Mechanicsville SHEET
2 PROPERTY OWNER a MAIL ADDRESS ZIP
PHONE
James Pearson 5606 - 6th.Street N.E.
735-1466
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 Double.
7 CLASS OF WORK
❑ NEW ❑ ADDITION Ij ALTERATION ❑ REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
ISKHR Construct a 241 x 24" Garage
9 CHANGEOFUSEFROM TO
STIPULATIONS Credit for existing slab. Provide a hard surface
driveway.
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
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
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
$5 850.
$2.93
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.
$56.50
LAN CHECK FEE
TOTAL FEE
$59.43
SIGNATURE OF CONTRACTOR RI EDAGENT IDATEI](�`1s
WJi EN PROPERLY
THIS IS YOURPE MIT
C�IaAtOR^)AUTH
/�/
y —N%., W 6 ! '°� v
I
=THIS
L ����
SIG MRE OF OWNER IIF OWNER BUILDER) I A E)
BLDG INSP
DAT
NEW [ City of Fridley Effective 4/1/84
ADDN. [ ) R-1 AND R-2 i
ALTER. [ J Building Permit Application
Construction Address:_ _SO& (044 N Ne ?:041t y
Legal Description:
Owner Name i Address : JAPW-S Pertesen Tel. #
Contractor:__ SAS. —Tel. 9qq _7034
Address:— SA"%t
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 2Y Width 2Y Height J-1 460116 Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER: q
Corner Lot [ ] Inside Lot 04f Ft. Yd. Setback Side Yard Setback
Type of Construction: NEW &**A^�t� Estimated Cost: $ :-
Approx. Completion Date: CSC' i5�ta e
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: $ $
See Back Page for Explanation
DATE: � le APPLICANT: '�'� �"'#'#�"ie �"'� Tel. # W-ty "
CITY USE ONLY
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee -
Sewer Main Charge
TOTAL
STIPULATIONS:
Fee Schedule on Reverse Side
25% of Building Permit Fee
$.50/$1,000 Valuation
$425 per SAC Unit
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
Y fp. �
FN
SUBJECT
PE O�
City of Fridley
20022
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
RECEIPT NO.
>r ______ COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
1
i CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
L 612-571-3450
910-F15
7/26/89
/ /
JOB ADDRESS 5606-08 6th Street N.E.
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
Pt. 12,1
2
Hamilton's Addn. TO Mechanicsville SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
James Pearson 5608 - 6th Street N.E.
572-8642
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 Ij ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 24.' x 91811 Addition to Rear of Garage
9 CHANGE OF USE FROM TO
STIPULATIONS
See notations on plan. Provide a hard surface driveway.
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
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
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
$1
$.85
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
1700
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-
$3900
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
$39.75
SIGNATURE OF CONTRAC2UTHORIZEDAGENT IDATEI
WHEN PROPERLY VAL TED THIS IS YOUR PERMIT
�
iG ATURE OF OWNER IIF OWNER BUILDERI IDATE"i-'-
BLDG INSP
SATE
FN
NEW [ ] Effective 5/1/88
ADDN [Xj H-1 AND R-2
ALTER [ ] Building Permit Application
Construction Address: 5606- 5601? 6(A► Slr. t,)E
Legal Description: Pt [Z- a 13 O(Lr_ - a t4A M L+Ov► S
ame & Address: -TA"s R?ar5oy., 6(,o 8 ro- Sf : iJC Tel. # 57.2 -9rogA
Contractor: .SArnv- Tel, #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPPION
OF naROVEMENr
LIV M AREA: Length Width Height Sq. Ft.
onm AREA: Length a4-' Width A'4 i 8 u Height _1 Sq. Ft. 1
DECK AREA: Length Width Higt/Ground Sq. Ft.
OTHER:
Corner Lot [ ] Inside lot Ly] Ft. Yd Setba Side Yard Setbacks
Type of Construction: MoD Feq^e Estimated Cost: $ � r
Approx. Cmpletion Date: IAV Is+
Proposed Driveway Width If New Opening Is Desired: Ft. $ $
Width + 6' See Back Page
DATE: APPLICANT: CJ • ¢.et.c�eTel . # S 72 - 8(
Permit Fee
State Surcharge
SAC Charge -
Driveway Escrow
Park Fee
Sewer Main Charge .
TOTAL
CITY USE ONLY
Fee Schedule an Reverse Side
$.50/$1,000 Valuation
$575 per SAC Unit
Alt. "A" or Alt. "B" Above
Fee Determined by Erxgineering
Agreement Necessary [ ] Not Necessary [ ]
sTIPULATIONS: Via,
/ .00
e
M
gra►, ?(AAA (f
06 Laln
9
y -s•- ta-®