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BUILDING PERMIT Village of Fridley, Minn. N° 2911 Date ...... �.....� �... .......... Owner r,94�. . (h ..Y... fes . . Builde Address ......................................... Address . f Wr7..,�,/`��%�r'i LOCATION O BUILDING NO. ..... Street a!fr: ...................... Part of Lot ....: ..... . Lot ..... / ......... Block ........ Addition or Sub -Division . . Corner Lot Inside Lot .......... Setback ..>.,.. Sideyard� I DESCRIPTION OF BUILDING To be Used as:� . ............Front Depth 02.4.0 Height ......... Sq. Ft. -� �.� Cu. Ft. .'. ��$ .................... Front ........ Depth ?.v . Height ......... Sq. Ft. �.�. �.. Cu. Ft........ . Type of Construction st Cost ..... �. . r� �. ...... To be Completed ... 7pr. 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 d in compliance with all provisions of ordinances of the village of Fridley. In consideration of the payment of a fee of $J.�a ® permit is hereby granted to .. to construct the building or addition as described above. This permit is gzarFedupon 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 with- in the village limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. NOTICE: This permit does not cover the construction, installation or alteration for wir , plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these items. CITY OF FRIDLEY 41 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND .AIR CONDITIONING SYSTEMS AND DEVICES PARTIAL RATE SCHEDULE ' GRAVITY WARM AIR: RATE TOTAL Job Address Furnace Shell & Duct Work $12.00 $ Replacement of Furnace 7.00 $ Repairs & Alterations -up to $500.00 7.00 $ Department of Buildings Repairs & Alterations each add. $500.00 4.00 $ City of Fridley Tel. #571-3450 MECHANICAL WARM AIR: The undersigned hereby makes application for a permit for the work herein Furnace Shell & Duct Work to 100,000 BTU $12.00 $ specified agreeing to do all work in strict accordance with the City Codes each add. 50,000 BTU 4.00 $ and rulings of the Department of Buildings, and hereby declares that all the Replacement of Furnace 7.00 $_�o�� facts and representations stated in this application are true and correct. Repairs & Alterations -up to $500.00 7.00 $ 27 194 Repairs & Alterations each add. $500.00 4.00 $ Fridley, Minn. u , STEAM OR HOT WATER SYSTEM: OWNER bti2 AGi de Boiler & Lines up to 100,000 BTU $12.00 $ KIND OF BUILDING 1/L2 Q each addn. 50,000 BTU 4.00 $ di".) Boiler only up to 100,000 BTU 7.00 $ USED AS each addn. 50,000 BTU 6.00 $ TO BE COMPLETED ABOUT MvC/ , OIL BURNER- to 3 gal. per hour $10.00 $ n cTT each add. 3 gal. per hour 10.00 $ ESTIMATED COST GAS BURNER- from 100,000 BTU to 199,999 BTU $10.00 $ 00 OLD NEW BUILDING PERMIT NO. PERMIT NO. (over 199,999 BTU see Fee Schedule) $ GAS FITTING FEES: 1st 3 Fixtures �— x S 3.00 Additional Fixtures x $ 1.00 $ Gas Range to 199,000 BTU x $10.00• $ AIR CONDITIONING FAN HEATING SYSTEMS See Fee Schedule $ VENTILATING SYSTEMS $ ALTERATIONS $ REPAIRS $ State Surcharge $ .50 TOTAL FEE $ `jC , I ROUGH INSP. Date FINAL INSP. Date APPROVAL FOR PERMIT DESCRIPTION OF FURNACE/BURNER HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. /� Trade Name ter/Pd rle ll Size No. VA Lo Capacity Sq. Ft. EDR BTU 100,600 HP Total Connected Load S �L7 Kind of Fuel �� 5 BURNER - Trade Name Size No. REINSPECTION FEE Capacity Sq. Ft. EDR BTU HP ($10.00) < / I C> Company Signed By Tel. No. IF2 -2-G5-4 MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE A'�-' �y 'SAT Lilo Cpi.JLAI®1 (DEPARTMENT OF iNSPECTI01iT P e a .:veatha rate�pf+ A.S. V Construction NO. Ioadatitaa "' Guide ` mdowa Doors Reference 00. Wall Int. WaU Ceiling Roof Float Kind diose► Applied Room I length a)I i WAWI loi�lae , Vii. Roam Length ' Width Mai$hD ' " .,,Windows alsd Doors—Craekage and ea ; ` Windows and flare,--Gear lsa�o and AreaWidth Helght No. of Loneal ft. Aron Width Height No. of , Lineal ft. Aces, ° + of paae' of pane lights of crack sq. It. oYpnne of pan* Itkhte of crack. . tip. [t.. DD c ck d 'G ' t.. w•,,, Com den " hratiote"'y� -� 77,771 In6ltratioa A • :Glees BS 0 Gloss Epp wall ��,^9 ' '1i4 cap. Wap haw Net esp. wall ' Int. wall IC Ceiling r r,oasr Floor oral Btu. Total Btu. ` :r Required sq. k I:.®.R. or sq. ins. WA. Leader area Required sq. ft. E:.®.% or sq. ins. W.A. teader area 7,� ` � .j��'-- Room Lely 4� 11 Width � `� 6$eigbt F1.1 Roo (length Width:: H ht, Windows and Doors—Crackage and Area Windows and Doors—Crackage and Area t Width eight No. of Llnoml tt Area Width. Height" No. of Lineal [t.. Am. 1�b of pane of Zane tight® 02 eraelx tip: tt No. of ane of pane ll.hta of erects'' sp. Cu. , f F p d. r - 4y 1P . C,�r P gym" .. _ ,•� Y'� -J4 ,: Coaf. Btea -in6lerat[on� Infiltration F ;,, _ P. Glaris' b 0 C) Glass . E up. Wali 'l�i,r gip. wad Net exp. Wall Wall' p Iot. wall ceiling Ceiling F 'FDcar "`%illtu, , •� Total E"It" Required sq. ft.' ED.'R. or sq, ills. W.f#.Regasued 1h:E;.D.R:or sq.nti: W { yy Rooms Lengseh �/ldth. iYelght Fi. Roowu l i�ength Width. .; i$tdsrVs' ahf7 (Doors'---Cracharia i6d Area 0:r + y Y Windows attd tiaor-Crackaige an Area Width H®9gght No of Lineal ft. Area tiro Width eight No. Of Unew ft. Ares r dJ of plc%s of Dana llghta oYeraek tip ft. l { `,k v r N0. of ns of pans Ilshts Ot er; ck sp. [tr P > ' k:7 t ryy CME EkU Coe �' ttatlob Glass: In�6ltratton s .i 'BB1, Glave ` �N � ..ill ` Na *%vallV-: •;mal( gra. tr ' `' '{' iL1L�" t8 ,�r �. r. Ceiling C 45, r T Floor' �ttU.. TOW Btt1. s • + 4 �� h uireal f>a ft..It. ase set. its: W.A.1�eaalar'area Re�tsired sq.,h: t:.D.R or sft. ince. W.AA L.endai area a ��1'c � ..�l�Ft�k+:W., ,_ .. { � i :Ra ., _a `ij. . ! . +, J". PE,a.ar '.` '.p' L +44 41, . t,.•+ I, }., S•y*� '," zM'?}w i Y+' -1.'r f' 1 i' W7 � r . �-d v. Y a, �.:. � ,. •.'��� A .�yr�z ,�a J m; f � r Idl �A.,, .p ;A. a ! 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I �•rdq.' iif 'WI d F ��,1'} e .4 , �.u, r+MS^ � , < a ti`Er 1 y •4� G4l��T' y P��- ,/�'. iY%, fa{$�. i4+�+1 y.�l z I •a,. .' r :q. ,"1 �d ,-(•,� £'.. � r� r (a1 . �;drti� ";x s' ; 7, o�.,�. e ,4r f�'+�;�" i!� , @�„ ,�1 M,��,�, - .J 4 t �,+ rry a� j17' :,IUJ c c � Y r .,: :ti �y�*' �!f,. q,.w.i "6�1R,id',�.,��u • ,.'3 X�,_�i{� � o ��T�y {, b�" 8' "�,p r th't. � I' 7 ,'�iM�`�'�., r,y ,���.W��e�T��.�li�5� $�f''h:MkT,i�'rT� 6 "'�, `'r'�� F•'1Sf e �' Armed( (' � �,:.. 5, T ;.ifp:' Y d `�, p�-• a ! � i '"m3- L lT 1 1 �G�� � y}�. �1 � ��pp��,, � .... IF'4•'�I�ai`�� 4 +`4 Sd J n it'r � � �. .�"1'�'L�°aAle.7A 'ry x. . •e �+.-. NEW [ ] Effective 1/1/93 ADDN [ ] CITY OF FRIDLEY g L3 ALTER[ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: ,`� 9 Legal Description: Owner Name & Address: Contractor: Address: Tel. # MN LICENSE # Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVING AREA: Length GARAGE AREA: Length DECK AREA: Length OTHER: Comer Lot [ ] Inside Lot [ ] ,Type of Construction: ' Approx. Completion Date: A 3 Driveway Curb Cut Width Needed: ID Ft. + 6 Ft = DESCRIPTION OF IMPROVEMENT Width Height Sq. Ft. Width Height Sq. Ft. Width Hgt/Ground Sq. Ft. Ft. Yd Setback Side Yard Setbacks Estimated Cost: $ (Cost on Back) Ft x $ % 7 = $ DATE: -3--30-9,3 APPLICANT: Tel. # CITY USE ONLY Permit Fee $ Fire Surcharge $ State Surcharge $ SAC Charge $ License Surcharge $ Driveway Escrow $ Park Fee $ Sewer Main Charge $ iffITA- 0 STIPULATIONS: Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) ' $.50/$1,000 Valuation $750 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] 1 sueJEcr City of Fridley 217 9 9� AT THE TOP OF THE TWINS BUILDING PERMIT , RECEIP F • COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. r 1 � 1 i NUMBER REV DATE PAGE OF APPROVED BY = 1 /�"i CITY HALL FRIDLEY 55432 IL""� 612-571-3450 910-F15 tI 4/20/93 JOB ADDRESS 5932 7 Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 7 5 Bonny Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Roland Hardel 5932 7 Street NE 571-6812 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 �7 REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof Dwelling (23 Squares) 9 CHANGEOFUSEFROM TO STIPULATIONS Underlayment must comply with. the State Building Code if tearing off existing roofing. If not tearing off existing roofing, new -roofing can be the 2nd layer but not the 3rd, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD 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 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 1 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 $1� 242 $.62 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SACCHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $311Q0 Fire SC $1.24 STRUCTION OR THE PERFORM NC OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE ` $32,86 SIGNATURE OF CONTRACTOR R AUTHORIZED AGENT (DATEI WHEN PRO RLY VALID A ED THIS IS YOUR PERMIT BLDG INSP GATE SIGNATURE OF OWNS R))F OWNER BUILDER) IDATEI 1 NEW [ ] Effective 1/1/93 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: 0/ 3 7 7-� S 7- A/ E ,/1, w Legal Description: L.©% 7 �� 5 �6� i � ��� ?i d h Owner Name & Address: 626 / -r4 crly Tei. #Z -- Contractor: S 2 / MN LICENSE # Address: Tel. # 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 GARAGE AREA: Length Width Height DECK AREA: Length Width _ Hgt/Ground OTHER: I n F 1 /1 } Comer Lot [ ] Inside Lot [ ] Ft. Yd Setback _ Type of Construction: / 5 Approx. Completion Date: Sq. Ft. Sq. Ft. Sq. Ft. Side Yard Setbacks Estimated Cost: $ 2' 2 - (Cost (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: 04zo --23 APPLICANT: 6L" ��� Tel. # &7/ / Cn Z Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Park Fee Sewer Main Charge $. TOTAL $ z STIPULATIONS: CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $750 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] U -;K 7 96-6920 G SUBJECT P _ � � � �.% City of Fridley AT THE TOP OF THE TWINS BUILDING PERMIT COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC r CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910-F15 7/9/97 JOB ADDRESS 5932 7 Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 7 5 Bonny Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ronald Hardel 5932 7 Street NE 571-6812 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Renewal By Andersen 350 73 Avenue NE, Fridley, MN 55432 571-7816 20040630 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 Ek REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Replace 5 windows with pocket insert windows 9 CHANGE OF USE FROM TO STIPULATIONS Replacement sleeping room windows must meet the State Egress Code. Install smoke detectors to meet the State Building Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD 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 1 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 $3,040 $1.52 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 STATE OR LOCAL LAW REGULATING CON- P STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEETOTAL E License $5.06.81 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) EN OPE Y ALIDAT IS IS YOUR PERMIT j4TLDG INSP DATE S)GNATURE OF OWNER 0F OWNER BUILDER) IDATEI G ITY OF FRIDLEY TEL: 612-571-1287 Mar 20.96 9:48 No .001 P .M/02 NEW [ ] Effective 3/1/96 ADDN [ ] CITY OF FIMLEY � ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 !"�3A Building. Permit, Application ConstructionAddress� ':+1 ST Nom.. �PR1��1` tAN SS'43a, Legal Description;Sl DE✓N�CI �` W �NOUw iZ�P 1riC Owner Name & Address: _RW R Lb 1±6 R D E L — Sq 3a - ' ST• N •E Tel. # !o I of • S-- I. 6P) I Q _ Contractor: 'ems[ Pr N 'Del;. S ei-A MN UCL-NSE#Qoc4 O 1e 3 0 Address: &5p- --3 �° �v E • MJ DLr_-`f *A,,N 5-G�Ll 301 Tel. # to (P- • S-+ I - 3- L_„ Attach to this application. a Certificate of Survcy of the lot. with the proposed construction drawn on it to scale. DESCRIPTION OF EMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGF, AREA: Length ^ Width Height Sq. Ft. DECK AREA: Length Width _ Hgt/Ground Sq. Ft. OTHF.R: RJI�RLA CE 9S W \ s,&L) L- L -j&1 ` w �1_[ A PoCX-ET ��5�2T W t1VO0�NS . Corner I.ot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: _ Estimated Cost: $_ 30 �4 Q. Approx. Completion Date: $ • iS • I-+ (Cost:. on .Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x DATE: APPLICANT: _ Tel. # Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: CITY USI+'.. ONLY $ c7 9• Fee Schedule on Reverse Side S $ .001 of Pcnnit Valuation (1/10th%) $ Z $.50/$1,000 Valuation $ $900 per SAC Unit $� S_ $5.00 (State Licensed Residential .Contractors) $_ Alt. °A° or Alt. °B" Above $ $450.00 Conservation Plan Review $ Fee Determined by Engine -en' $ Agreement Necessary (J of Necessary ] SGS SUBJECT PE NO. - City of Fridley 26962 AT THE TOP OF THE TWINS BUILDING PERMIT ' , O 1 _ COMMUNITY DEVELOPMENT DIV. ~ PROTECTIVE INSPECTION SEC. //1 -7 NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 "'' 612-571-3450 910-Ft5 7/30/98 JOB ADDRESS 5932 7 St NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 7 5 Bonny Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Bud Hardel 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Top Gun Inc 5014 Parrish Ame NR Rogprg 9S174 428-4599 20128211 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 X1 REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house and garage (26 Sq) Tear-off 8 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with 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 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 $216$ $1.08 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 FireA SC $2.16 PLAN CHECK FEE TOTA F E License 5.00 .99 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI P PER LIDA HIS IS YOUR PER 4e,14 - �__1, 1 S.GNATURE OF OWNER OF OWN ERBUILDERI IDATEI I 3-L"M7 NSP GATE NEW 1 J Effective 8/ 1 /95- ADDN 1 i CITY OF FRIDLEY ALTER 1 1 SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application ConstructionAddress: -5938 Legal Description: — Owner Name & Address: ��-�-�. SG 3 Z "ti-�` -C-,+, IV � Tel. # " Contractor: %®P 60 C- — MN LICENSE # �,®/ Address: 5614 PSS 421"Ut® Tel. # �L�' LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Attach to this application, a Certificate of SurvEYOf the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Length Wim Height Length Width Hgt/Ground Sq. Ft.* Sq. Ft. Sq. Ft. Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: Estimated Cost: $ Z / 6 Approx. Completion Date: (Cost on Back) Driveway Curb Cut Width Needed: Ft. 5 Ft = F . $ _ $ DATE: 30 APPLICANT: Tel. # YZf- 66 CITY USE ONLY Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $850 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 [ ]