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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT Date: .4 ...� IQ Owner: .....� "''.:..._ ............."" _....._..:..:... Address _..j N° 4'769 Builder _............ ..... Address _......_...... LOC TI N OF BUILDING - ' � . SLI.. No. _. .. Street _ _ �._. Part o t . d Block on or Sub -Division ._. Lot --- " ..... , , Block, ,._. ...--------.......... Addition on � �-•9k low� / •,� Corner Lot ._.... _-_ Inside Lot ...._.::..._...._ ................. Setback .....4j .. ......... Sideyard +r ......a.. Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To beUsed as:. ..: Front ••eg.--. Depth Height ...:. Sq. Ft...`t' Cu. Ft.,6� ................... ........................ Front ....... Depth ..... _.. . Heigh ��,TSq. Ft. ............. ........ Cu. FL ...................--- Type of Construction % Eat. Cost... o be Completed ....._ ............._............._.. . _.... C .' , ' D N THIS PERT [-.-,)L,, N01 AUTHORIZE VIOLAT- ION OF ANY PRkATE LAND COVENANTS AND BUILDING RESTRICTIONS. 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., et &1690 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: pon Vipla�f any of the provisions of said ordinances. Building Inspector NOTICE: This permit does not cover the construction, installation, for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits fairthesehems. r� 4 APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Owners Name )74 CO— Builder �%� 6 - Address c=fr,;�-r2n- Y0 _6� )f f Addressa® �•�`-� LOCATION OF BUILDING No.�S®® Street % Part of Lot Lot_ Block Addition or Sub.Div Corner Lot__!�_Inside Lot Set Back �;.? Side -Yard SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. DESCRIPTION OF BUILDING To be used as: Front 2 Depth a:­5� Height Sq. Ft. Cu. Ft. 0 Sq. Ft. Front Depth Height 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 Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representa- tions stated in this application are true and correct. DATE --AZ�/-- - SIGNATURE (A Schedule of Fee costs can be found on the Reverse Side.) City of Fridley Application for Plumbing and Gas Fitting Permit Dept. of Bldgs. Phone SU 4-7470 DESCRIPTION OF WORK � Number, Kind and Location of Fixtures Location in 61 yy Z m Z N N �4a 3 1- Y FZ sp LL N O�QQa LL p _ u 0 S S� Q 3 `a 6° i� Q `�QZ 6' Z O F N WATER HTR. GAS ELEG Base ®� 1st 2nd 3rd 4th Future Connection Openings New Fixture, Old Openings Connected with Sewer El Cesspool El PARTIAL RATE SCHEDULE PLUMBING FIXTURE BATES: NO. RATE T AL Number Fixtures ...................... x $1.50 Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ............................ x 3.25 $ Water Heater (Up to 200,000 BTU) ...... x 2.00 $ �_ New Ground Run Old Bldg . ............ x 3.25 $ 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 $ REPAIRS & ALTERATIONS—Refer to Code Description .................................$ TOTAL FEE 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 applicatio true and co•rect. Fridley, Minn Owner v� ✓ 19— Kind 9Kind of Building . 119— Used as To be completed about - 17 —1'/✓� Estimated Cost, $ Old e . Building Permit No- / By `�� ' Business Phone Connection Permit No . ....................................................... �i �' °✓ 1 �'''� ��° � " � ' Water Z� ° Sewer---Sr!!� - "k -V Meter Deposits E 11 IM -8-58 */?"l City of Fridley Application for Plumbing and Gds Fitting Permit RRi 9 4 Dept. of Bldgs. Phone SU 4-7470 DESCRIPTION OF WORK Number, Kind and Location of Fixtures Location .� K x m Z Number Fixtures ...................... =? F Z cy s m Z �n Z w O= x w z y WATER HTR. GAS ELEC. Y F Vl QG,...77 3 Z Vl <m '� Y Z `�� 3 Z sp = R New Ground Run Old Bldg. ............ x 3.25 $ F N GAS FITTING FEES: U m m N F- LL N LL O U m 6 3 G Q U' a4 (J O Gas Range to 200,000 BTU .............. x 2.00 Base 1st 2nd 3rd 4th • Future Connection Openings Connected with New Fixture, Old Openings Sewer El Cessp001 El PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: O. RATE TOTAL Number Fixtures ...................... x $1.50 $� Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ............................ x 3.25 $ Water Heater (Up to 200,000 BTU) ...... x 2.00 $ New Ground Run Old Bldg. ............ x 3.25 $ 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 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL FEE $ 6 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, 1VCnn 19 Owner Q' 19— Kind gKind of Building -- 19— To be completed about - �d✓ Estimated Cost, $ Old�uilding Permit Connection Permit No . ....................................................... Water !_ --Sewer— lip(}' II Meter 0 j 11 1M-8-58 r Application for Power •� Apph Plants and _Heating, Cooling, Ventilation, .Reffigerathon and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE Dept. of Bldgs. Phone SU. 4-7470 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 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ each add. 80,000 BTU ....................... 2.00 $ Replacement of Furnace P.00 $ Repairs & Alterations—up to $500.00 ....e ............ 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 BTL) ....................... 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 8r REPAIRS TOTAL FEE ROUGH 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 Kind of Building��� Used as Zd-64-1& To be completed about z9� Estimated Cost, $ l9Dd x-4-1 Old eW. uilding Permit No. Permit No. �Z DESCRIPTION OF WORK HEATING or POWER PLANTS—Ste of Water. Warm Air—No,.! Trade Name Size No " Capacity ® Sq. Ft. E.D.RBTU H.P. To Conn teed4 oloae f � .� ' /Ll Y /4 ?� . Kind of Fuer BURNER — Trade Size No Capacity Sq. Ft. E.D.R BTU H.P. 2 2M 7-59 4 &C -:a FINAL � (REMARKS-OVER) >F Application for Power Plants and. Heating. Cooling, Ventilation .Refrigeration and Air Conditioning Systems and Devices • PARTIAL RATE SCHEDULE 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 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ 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) ................('3) . 5.00 $ GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x $1.50 $ Additional Fixtures ................. %fix .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL FEE $ ROUGH FINAL Dept. of Bldgs. Phone SU. 4-7470 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, Owner 'CV 0/ Kind of Building Used as W To be completed about / Estimated Cost, $ Old New Building Permit No. Permit No. / l DESCRIPTION OF WORK HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No Trade Name Size No 18 o Capacity Sq. Ft. E.D.R- BTU A.P. Total Connected Load Kind of Fuel BURNER — Trade Name . Size No Capacity Sq. Ft. E.D.R BTU H.P. (REMARKS -OVER) Signe " By 2. 4 2 4M �.se Business Phone No- l pity 04 Fridley .., -- — --•- D®pl. of Bidv. Phone SM -3430 DES Cal PT, OF V1011 Lox�o� Humbbzr. Y,'id dnd Locrikm of Fimtares . Fur=* Ccr :sci'.-a Gj; alr.� Sowar * Na® Fiz:-ara. Old Ccupool 0 PARTIAL RATE SIC.0"HEDULE City of Fridley'.. The undersigned hereby makes application for a permit for the- work her -el specified, acr eeing to do all work in strict accordance with the Cita O:d?r-an:a and ruling of the Department of Build..'nzs, and hereby declares that 14 Lhe fac and representations stated in this application are true arxl correct' Fridley, Minn. �� • 1� Owner Kind o1 Building --- Used as ' To be completed about Estimated Casi, S Old New. Building Permit No. permit 2.'.0. PLUM F'I;CTJ?E RATES: NO. RATE TOTAL .7 WATER HER. ~ " Ix p I` t 8 z 5< `� 7 V z z 7" c7 5 o ► s H GAS MC. x $1.50 I f c c v< 3 0 u a BusinPhone 1ew Fixture Old Opening. 150 S _..- - Catch Basin .................... - -- x $3.25 $ -- E3sr . Water Beater 'Vp to 99,000 BTU).. • • x $3.00 $ -- ROUGH few Ground Iiun Old 81dg....:.... x 3.25 S_----- Eleetrie Water Haatar• • ...:........ a $2.00 $ FINAL - AS nTTI`%G FEES: 130. RITE TOTAL Ist 3 Fixtures .......... a • • • • • • ---- x 52.00 , Additicnal Fixtures ............... ---- x $ .75 S Gas R:.:.ge to 199.000 BTU .......... .---- x $5.00 S 2r.d : .50 State Surcharge r - v�'?A:R3 � ALTERATIOMS—P.afor !o Codd . —� • .Yic:.crip:lon...............:........................., • TOTAL FT:.:. 3:d !.h Fur=* Ccr :sci'.-a Gj; alr.� Sowar * Na® Fiz:-ara. Old Ccupool 0 PARTIAL RATE SIC.0"HEDULE City of Fridley'.. The undersigned hereby makes application for a permit for the- work her -el specified, acr eeing to do all work in strict accordance with the Cita O:d?r-an:a and ruling of the Department of Build..'nzs, and hereby declares that 14 Lhe fac and representations stated in this application are true arxl correct' Fridley, Minn. �� • 1� Owner Kind o1 Building --- Used as ' To be completed about Estimated Casi, S Old New. Building Permit No. permit 2.'.0. PLUM F'I;CTJ?E RATES: NO. RATE TOTAL Signed Number Fixtures ................ Future Fixture Opening ....... x $1.50 By -N�o�.� - - - BusinPhone 1ew Fixture Old Opening. 150 S _..- - Catch Basin .................... - -- x $3.25 $ -- . Water Beater 'Vp to 99,000 BTU).. • • x $3.00 $ -- ROUGH few Ground Iiun Old 81dg....:.... x 3.25 S_----- Eleetrie Water Haatar• • ...:........ a $2.00 $ FINAL - AS nTTI`%G FEES: 130. RITE TOTAL Ist 3 Fixtures .......... a • • • • • • ---- x 52.00 , Additicnal Fixtures ............... ---- x $ .75 S Gas R:.:.ge to 199.000 BTU .......... .---- x $5.00 S . : .50 State Surcharge - ' - v�'?A:R3 � ALTERATIOMS—P.afor !o Codd . ' • .Yic:.crip:lon...............:........................., • TOTAL FT:.:. suedEcr PERMIT City of Fridley 13834 AT THE TOP OF THE TWINS PERMdl r BUILDING ECEIPT NO. `L _ COMMUNITY DEVELOPMENT DIV. 73 r PROTECTIVE INSPECTION SEC. 1 � � CITY HALL FRIDLEY 55432 � NUMBER REV. DATE PAGE OF APPROVED BY L••"� ,'J 812-560-3450 910-F15 10/19/71 JOB ADDRESS 5400 - 7th Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 14,15 9 Hamilton's Addn. to Mechanicsville SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Bert M. Virgillo 5402 - 7th Street N.E. 3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSE NO. Gorco Construction Co. 3384 Brownlow Avenue, St. Louis Park 55426 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 6 DESCRIBE WORK Construct a 361 x 22' Garage 9 CHANGE OF USE FROM TO STIPULATIONS Provide a hard surface driveway. w IX Blmfore digging.call local utiiii�.g SEpERATE PERMITS REQUIRED F.4�. WIRING, TELEPHONE . ELECTRIC • GAS Etc, MEATINGII PLUMBING AND SIGN& REQUIRED BY LAW ---IMPORTANT-- NOTIFY THE FRIDLEY ENOR, DIVISION REGARDING CURB REMOVAL AND REPLACEMENT AT DRIVEWAY OPENINGS. 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 50 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT 792 7920 ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 3 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 $2.93 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $5,860.80 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. $31..68 PLAN CHECK FEE TOTALFEE 4-19.746 $34.61 SIGNATURE OF CONTRACTOR OR HORIZED AGEN (DATE) A WHEN PRO PERL V LIDATED THIS IS YOUR PERMIT I /p- 1q-9 L9 BLDG INSP DATE SIGNATURE OF OWNER (IF OWNER BUILDER) (DATE) CITY qF FRIDLEY APPLICATION FOR. RESIIDENTIAL BUILDING PERMITS NEW, ALTERATIONS, ADDITIONS, OR REPAIRS) OWNER'S NAME: ADDRESS: NO:. 5400 STREET: LOT • y 15 BLOCK: CORNER LOT: W_ INSIDE LOT: Gored Cv wd' 'C= ADDRESS: Im,.- Av-..' TEL. NO.: ADDITION: Lj"./+,,..s Adel •fie Me�ilnnieSv.1/t ETBACK: SIDEXARD: Applicant attach to this form 7.t,7o Certificates of Survey of Lot and proposed building location drawn on these Cert'ficates. To Bq Used As: DESCRIPTION Front • 3(.1 D Square Feet: OF BUILDING the Z.1' Height: /d' Front: Depth: Cubic Feet: -7,92,0 Square Feet; Cubic Feet: .Height: Type of Construction: Fro.mt Estimated Cost: $'q(. p =-O To Be Completed: 'Heti. The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in stxict 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: 1 8 - l S • SIGNATURE: , (See Reverse Side For AdditInform ion.) —j'108 0(' ��.q3 CERTIFICATE OF SURVEY ' 8713 DUPONT AVENUE SQUTH AW60K OIC _ 188-2084 - ARLSOM. 55,420 LAND SURVEYORS Survey for: GORCO CON`:TRUCTION CO. 31 j 3e. ' -570. Z TPK* t1I,S'd� --- , - s �► S®, ... a � 1 w 39. z G.o - %dr1 i C r Descriptio%: Lot lb and 15, Block 9, "HAMILTON'S ADDITION TO MECHANICSVILLE" including the East .Half of vacated alley adjoining. 6. We Hereby certify that this is a true and correct representation of a survey of the*boundaries of the land above described and of the location of all buildings; if any, thereon and all visible encroach— ments, if any, from or on said"land. 1 Dated this 15th day of Ocotber, 197F. be Innes a{ egistration No. 901. N° :Z1,f4 /,57--.-7a i GORCOCONSTRUCTION COMPANY, INC. L� Garage Building Contractors 929-7868 JOB ORDER JOB a 1304 NAME: 5402 - 7th Street N.E. CUSTOMER'S PHONE: 561-3098 DATE: 9- -STREET: Bert M. Virgil.l.o CITY: FSridlmy STATE: Mien SALESMAN' Nod Sorrell HOME PHONE: 929-3830 SUB -CONTRACTOR WORK SHEET JSITE DIAGRAM I ( N ) I L INFORMATION *PROMISED STARTING DATE: Soon as Possible WORK SPACE (1) 361x 221x 21 Slab & Apron (1) Course 6" block North.West & South NOTES: - A ' ' ' { ---- --� t�,; - # Place belts for partition walls as pictured =, below. Call Ned night before starting so he may i arramge to meet you on job. # See Attached survey for lines. WORK SPACE ' SUBJECT i City of Fridley =6� AT THE TOPOF THE TWINS BUILDING PERMIT 72m36�4 COMMUNITY DEVELOPMENT DIV. p�® r PROTECTIVE INSPECTION SECvj' E , NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910415 11/20/98 JOB ADDRESS 5400 7th Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 14, 15 9 1 Hamilton's Addn. to Mechanicsville SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Van ie Nicklow 475-9903 3 CONTRACTOR MAIL ADDRESS 533-6422 ZIP PHONE LICENSE NO x Lund's Handyman Service 4009 Louisiana Ave N New Hnpp 55427 20113674 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 ❑ NEW 0 ADDITION ❑ ALTERATION 7x REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof triplex and garage 33A S Tear -off 9 CHANGEOFUSEFROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REOUIREO 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 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 $2828 $1.41 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 $74.75 Fire SC $2.83 PLAN CHECK FEE ;TjA L FEE SIGNATURE OF CONTRACTOR OR AUTHORQED AGENT (DATE, I MEN RO Y VALIDAT THIS ISYOUR PERMIT S,GNATURE OF OWNER,IF OWNER BUILDERi iOATE, BL G INSF' f,A�E NEW " [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: 61400 h ST N, , Legal Description: 'Tx Owner Name & Address:Tel. # 4-75-9103 Contractor: MN LICENSE #_ 2011 3(077 N Address: Lo lJ )'s "d_ n ca, Nyt N� , Tel. # U Z Sl3 � q ZQ 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: Length Width Hgt/Ground Sq. Ft. OTHER: Fe Does- fry )2)Qx 4- 2Y'ckq:p_ 3 ? Ste- Tas 2=== o�' Construction Type: R� ---� Estimated Cost: $� (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: l 125 `6 APPLICANT: , S4-etjP_n L -U ''101 Tel. # 53 3 CITY USE ONLY Permit Fee $ 2.77 Fee Schedule on Reverse Side Fire Surcharge $ 3 .001 of Permit Valuation (1 / 10th %) State Surcharge $ 1,4111 $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ $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 $ '760 7 STIPULATIONS: