PRE 2010 DOCSCity of Fridley, Minn.
BUILDING PERMIT
Date: ....�.. 0..... ......
owner.......................................
Address......................................
0
N® 3429
Builder.. .. .. .... ...........
Address ............................................
��]]
LOCATION OF BUILDING
No. 4 ? . !. -i;�. Street ...,,.pp.-�!�....... ................ Part of Lot .. ............ .............. .
Lot ... .... Block .. a:1 ............. Addition or Sub -Division
Corner Lot ............ Inside Lot ............ Setback ............ Sideyard ...........................
DESCRIPTION OF BUILDING
To be Used as: / e ��1
.. Front :d.. "Depth R,17.110/Height /g �6 Sq. Ft. {.&-T-Ycu. no?0OC-2d—
........... ...... Front ........ Depth .... .. Height ........ Sq. Ft. ........ Cu. Ft. ........
Type of Construction ................... Ast. / . .. To be Completed ...................
In consideration of the issuance to me of a permit to construct the building desribed bove, I agree to do
the proposed work in accordance with the description above set fo and in� pH th all provisions of
ordinances of the city of Fridley. /s/
ao "// /
In consideration of the payment of a fee of $1V ......, permit is
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 with-
in the city 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 wiring, plumbing, gas heating,
sewer or water. Be sure to see the Building Inspector for separate permits for these Item&
City of Fridley, Minn.
BUILDING PERMIT N°' 9 31
Date:
Owner: uilder „ 'A'Z,
Address Address
L CATION OF BUILDING
No. Street_ Part Lot —
Lot _ Block Addition or Sub -Division %,►
Corner Lot Inside Lot ��"'Setback- � Sideyard — Of
Sewer Elevation
Foundation Elevation
DESCRIPTION OF BUILDING
To a as.
• }r _
Front Depth Height �C 40 Sq. Ft. Cu. Ft 4E
Front ___ Depth eight __. Sq. Ft. Cu. Ft.
Type of Construction Est. Co 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 of l 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 ooffiorm in all respects to the ordinances of
F
dley,hin inances.
meq= Building Inspector
NOTICE:
This permit does not cover the construction, installation for wl&W, p1'umbing, gas heating, sewer or water. Be sure to see
the Building laspector for separate permits for these items.
,0 . 4 46 y
owner's
Address
APPLICATION FOR BUILDING PERMIT
CITY OF.FRIDLEY, MINNESOTA
Name B ilder �.
Address
LOCATION OF BU ZING
�
1: z No. Street G
Lot— Block T� Addition or Subdivision
of Lot
Corner Lot Inside Lot Setbackv Side -Yard `5 �
SE14HR 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 bens as:
Front Depth ' Height
1
Sq. Ft. Cu. Ft.
yze:�?
Front Depth Height
S Ft. Cu. Ft.
Type of Construct io 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.
DATE' % SIGNATURE
(Schedule of Fee Costs can be found on the Reverse Side).
a e 10 0 0
9 57 kca
City of Fridley, Minn. N° 3319
•
BUILDING PERMIT
Date: AUGUST 5, 1965
Owner: RICHARD ERICKSON Builder HAROLD E. JULIEN
Address 6873 - 7th St. N. E. Address 1975 Bronson Driye
Fridley 32, Minnesota Moundsview, Minnesota
LOCATION OF BUILDING
No. 6873 Street 7th St. N. E. Part of Lot
Lot 3 _ Block 5 Addition or Sub -Division — Rice Creek Terrace, Plat 7
Corner Lot Inside Lot Setback Sideyard
Sewer Elevation — Foundation Elevation
To be Used as:
Type of Construction
DESCRIPTION OF BUILDING
Front Depth Height Sq. Ft. Cu. Ft.
Front Depth Height Sq. Ft. Cu. Ft.
Est. Cost _ 18 000.00 _ To be Completed
• REBUILD ON ORIGINAL FOUNDATION
•
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 comp with all provisions f
ordinaaoes of the city of Fridley. / & �7� w
In consideration of the payment of a fee of 10.00 , permit is hereby granted to HAROLD E - JULIEN
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 aII work
da a in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Blinnesota regang k+cation, cronstruction, alteration, maintenance, repair sad moving of buildings
wl� dty limits aad hath permit may be revoked at any time upon violation of any of the provisions of said
ALLEN G. JENSEN Building inspector
NOTICE:
M perm* does net sever the Bond rustloe, hauftlton for whirrs, phmrbl ne, ees howdo& wwer or water. Be arra to see
the Buildln8 lespeator for sopwwo permhs for thew home.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAMES , �' BUILDER
ADDRESS 7 ADDRESS s
LOCATION OF BUILDING
NO. STREET PART OF LOT
LOT BLOCK ADDITION OR SUBDIVISION
CORNER LOT INSIDE LOT SETBACK SIDE-Y'ARD
SEWER ELEVATION FOUNDATION ELEVATION
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 Depth Height
Sq. Ft. Cu. Ft.
Front Depth Height
Sq. Ft. Cu. Ft.
Type of Construction Estimated Cost_�� �o a
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 SIGNATURE
(Schedule
of Fee Costs can be found on the Reverse Side).
_04
v 0. i
�. _...+
0
City of Fridley
AT THE TOP OF THE TWINS
SUBJECT
C
BUILDING PERMIT
P .12534
v _---- COMMUNITY DEVELOPMENT DIV.
r t PROTECTIVE INSPECTION SEC.
t = �
CITY HALL FRIDLEY 55432
�---- �'J 612-560-3450
RE O.
•(I,�
NUMBER
910-F15
REV,
DATE
5/10/74
PAGE OF
APPROVED BY
JOB ADDRESS 6873 7th Street N: -F.
1 LEGAL
DESCR.
LOT NO.
3
BLOCK
5
TRACT OR ADDITION SEE ATTACHED
Rice Creek Terrace N.E. SHEET
2 PROPERTY OWNER MAILADDRESS ZIP PHONE
Laurence Doth 6873 7th 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 JI ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
1316" x 141 redwood -deck
9 CHANGEOFUSEFROM TO
STIPULATIONS
SEPERATE PERMITS REQUIRED FOR V91 RI NGo
HEATING, PLUMBING AND SIGNS.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
ZONING
SO. FT.
CU. FT.
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
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
VALUATION
600
SURTAX
• 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-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
'$6.00
PLAN CHECK FEE
TOTAL FEE
$'6.50
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE)
N/jP�ROOPERLY DATED THIS IS YOUR PERMIT
BLDG )NSP DATE
SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE)
APPLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER' S NAME: 0 06-4--r—A BUILDER : ,La-ro`t-ei
ADDRESS:- 69 73 % - '7`9 - �, . ADDRESS.
NO:.
STREET:
LOT:
13
BLOCK: .5 ADDITION:.
CORNER
LOT:
INSIDE LOT:_( 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 Be Used As:
13� p l � g
Front: Depth.-_ Height:
Square Feet: Cubic Feet:
Front: Depth: Height:
Square Feet; Cubic Feet:
Type of Construction: Estimated Cost: $ (5?6e0 d
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.
:LjZaL
DATE: Is-- G? SIGNATURE :
(See Reverse Side For Additional Information.)
10
J
SUBJECT
_
City of Fridley
AT THE TOP OF THE TWINS
B U I L D I N
PERMIT
7
f
y
NO.
�
• _ COMMUNITY DEVELOPMENT DIV.
� � PROTECTIVE INSPECTION SEC.
r
1 � �
CITY HALL FRIDLEY 55432
NUMBER--T-
REV
D TE
PAGE OF
APPROVED BV
612-571-3450
91l5
/17/97
/ /
JOB ADDRESS 6873 7 Street NE
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
3
5
1 Rice Creek Terrace Plat 7 SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Larry & Julie Doth 6873 7 Street NE
571-1821
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
East Long Lake Enter Inc 1491 94 Ln Blaine MN 5 449 784-2696 5274
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 O, REPAIR ❑ MOVE ❑ REMOVE
%
8 DESCRIBE WORK
Kitchen alter; install patio door
9 CHANGE OF USE FROM TO
STIPULATIONS
Provide smoke detectors in each sleeping
area and on each level
of house to meet the State Building Code. Providesolidbearing under headers.
I
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. Ill 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
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$2,800
$1.40
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-
STRUCT!OR TH RFORMANCE OF CONSTRUCTION.
$74.75
Fire SC $2.80
PLAN CHECK EE
TOTAL FEE
Licp-rlSC
.00
$83.95
SIGNATURE OF CONTRACTOR OR AUTHORIZEDAGENT IDATEI
WMPtRLYIVAPATED%
THIS IS YOUR PERMIT
16
711 I P
6 - f
DATE
_
SIGNATURE OF OWNER of OWNER BUILDERI IDATEI
J
NEW [ ] Effective 1/1/97
ADDN [ ] CITY OF FRWLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R -2a
BUILDING PERMIT APPLICATION
ConstructionAddress:
Legal Description:
Owner Name & Address: ( y eG c;'t Q e'T14- Tei. #
Contractor: 'EhS% C �'�j Lid %� g ;t�� l =f s� I �e�� MN LICENSE # 7Y
Address: c7 /3 L/A"P err /V. 5S�/� Tel. # G 7�
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF 11"ROVE WENT
LIVING AREA:
Length
Width Height
Sq. Ft.
GARAGE AREA:
Length
Width Height
Sq. Ft.
DECK AREA:
Length
Width Hgt/Ground
Sq. Ft.
OTHER:
k, �G �cJ�-'
i�% S� �/�J '� lac�•� �- /�,�t
G �° 'l��o yv
Construction Type:ERQ Estimated Cost: $ �;P oo .
(Fee Schedule .on Back)
Driveway Curb Cut .Width Needed: Ft. + 6 Ft = . Ft x • $ = $
A
DATE: APPLICANT: ( Tel. #% 7 C
Permit Fee $ Eq.
Fire Surcharge
$ (,�-o .
State Surcharge
$
SAC Charge
$
License Surcharge
$ �• ��
Driveway Escrow
$
Erosion Control
$
Park Fee
$
Sewer Main Charge $
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%) G'
$.50/$1,000 Valuation ,
$950 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 [ ]
TOTAL $ d 9S
STIPULATIONS:
Builder's Interior Resourse
1491 94th Lane N.E.
Minneapolis, Minnesota 55449
612-784-26961 Fax 612-784-2261
PROPOSAL SUBMITTED TO LARRY DOTH
6873 7TH ST NE
FRIDLEY.MINN
INSTALL NEW PATIO DOOR
MARVIN — •,
INSTALL 2 - 9.5 LAM BEAMS
REDO NEEDED SIDING
SHEETROCK AND TRIM „
INSTALL NEW KITCHEN WINDOW — 3Z
INSTALL 2 2 -BY 10 HEADERS ABOVE
PATCH SIDING
PATCH SHEETROCK AND TRIM WINDOW
TOTAL COST
WE PROPOSE Hereby to furnish material and labor- complete in
accordance with above specifications,for the sum of
payment to be made as follows' 1/2 down on acceptance -
remainder when iob completed
2800.00
(A) ANY PERSON OR COMPANY SUPPLYING LABOR OR MATERIALS FOR
THIS IMPROVEMENT TO YOUR PROPERTY MAY FILE A LIEN AGAINST
YOUR PROPERTY IF THAT PERSON OR COMPANY IS NOT PAID FOR THE
CONTRIBUTIONS.
(B) UNDER MINNESOTA LAW YOU HAVE THE RIGHT TO PAY PERSONS WHO
SUPPLIED LABOR OR MATERIALS FOR THIS IMPROVEMENT DIRECTLY AND
DEDUCT THIS AMOUNT FROM OUR CONTRACT PRICE OR WITHHOLD THE
AMOUNTS DUE THEM FROM US UNTIL 120 DAYS AFTER COMPLETION OF
THE IMPROVEMENT UNLESS WE GIVE YOU A LIEN WAIVER SIGNED BY
PERSONS WHO SUPPLIED AND LABOR OR MATERIAL FOR THE
IMPROVEMENT AND WHO GAVE YOU TIMELY NOTICE.
'CITY OF FRIDLEY INSPECTION DIVISION
6431 University Ave NE
Fridley, MN 55432
572-3604
RATE SCHEDULE
"yG Effective On January 1, 1 sge
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES ? ��
JOB ADDRESS &7 / S�
TOTAL FEE $
MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $42.00/Hr
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
BTU HP EDR
KRAEMER HEATING INC.
7441 DALLAS COURT
HEATING COMPANY MAPLE GROVE, MN 55311
(612) 42u-buri
Signed By Tel No.
Approved By Rough—In Date
FILLOUT BACK SIDE F R STACK VERIFICATION ON
REPLACEMENT FURNACE
e 40
Final Date /
The undersigned hereby makes application for a permit for the work herein
Residential
Rate
TOTAL
specified agreeing to do all work in strict accordance with the City Codes and
Furnace Shell and Duct Work, Burner —rulings
Also Replacement Furnace
of the Building Division, and hereby declares that all the facts and
$ 30.00
$30,00
representations stated in this application ar a and c rrect.
(Side Vent — Fill Out Back)
— (—� ,1998
Gas Piping (Needed with new furnace)
$10.00
$
OWNER
Gas Range
$10.00
$
BUILDING USED AS
Gas Dryer
$10.00
$
*Air Conditioning
ESTIMATED COST PERMIT NO
— All Sizes
$ 25.00
$ .
DESCRIPTION OF FURNACE AND OR BURNER
All Others/Repairs & Alterations (LIST ON BACK)
1 0
1 % of Value of Appliance or Work
$
No. of Heating Units 1 Circle One (Steam) (Hot &ter rm Air)
Trade Name Size No. G�G
Commercial/Industrial
1.25% of Value Appliance Work
0C:�
BTU GHP EDR .
of or
$'�35
Fuel Total Connected Load
State Surcharge
$ .50
Burner Trade Name Size No.
TOTAL FEE $
MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $42.00/Hr
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
BTU HP EDR
KRAEMER HEATING INC.
7441 DALLAS COURT
HEATING COMPANY MAPLE GROVE, MN 55311
(612) 42u-buri
Signed By Tel No.
Approved By Rough—In Date
FILLOUT BACK SIDE F R STACK VERIFICATION ON
REPLACEMENT FURNACE
e 40
Final Date /
i
The undersigned hereby verifies that the existing chimney or
1.
2.
-3.
4.
5.
Has been carefully examined
Is free from rust or deterioration
Has no foreign objects lodged within
Is securely supported
Meets all current Code requirements for size
and total BTU's connected
Has total heating BTU's of
All other BTU's
TOTAL BTU's
7. Has a liner been provided for water heater
8. Has combustion air been provided for water heater
Remarks:.
tQauj
Yes No ( )
Yes No ( )
Yes No ( )
Yes No (`)
Yes No ( )
Yes�4 No ( )
Yes No ( )
List ALTERATIONS Being Done:
v
KRAEMER HEATING INC.
7441 DALLAS COURT "a
MAPLE GROVE, MN 55311
(612) 420-5871'
HEATING CO:
Signed By:
Date:
SUBJECT
,
City of Fridley
(_�
3 0392p
AT THE TOP OF THE TWINS
BUILDING
PERMIT
�
RECEIPT NO.
v -------COMMUNITY DEVELOPMENT DIV.
INSPECTION SEC.
r 1 PROTECTIVE
vvv
CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BV
612-571-3450
91 415
10/13/99
JOB ADDRESS 6873 7th Street NE
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
3
5
Rice Creek Terrace Plat 7
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP
PHONE
Lawrence R. Doth
571-1821
3 CONTRACTOR MAIL ADDRESS
ZIP
PHONE LICENSE NO
Owner
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 ❑ ADDITION ❑ ALTERATION 421 REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof house and garage 25 S Tear -off; Gutters
8 CHANGEOFUSEFROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
SEPARATE PERMITS ARE REOUIREO FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAO
VENTILATING OR AIR CONDITIONING
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT
CU FT.
AUTHORIZED IS NOT COMMENCED WITHIN BO 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
$2185
$1.09
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
$83.25
FirA SC $2.19
PLAN CHECK f
TOT L FEE
0/6.53
jS'CGUOFCON'RA OR TH G NT IDATEI
EPR
VALID THIS IS YOUR PER�jMITQ
tT
g
P�r4GNATURE
OF OWNEROF OWNER BUILDER. IDATEI
B G .NSP
OAtE
NEW[ ] Effective 5/10/99
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION �D "
Construction Address: Z P73 9 �'`� �F" AY, Rd wiz r 21.9-
Legal Description:
Owner Name & Address:ZA(,J/ZF-,r}e< Tel. # (�1 2-S?/ -l%/
Contractor: MN LICENSE #
Address: 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:
XOTHER:
Construction Type:
DESCRIPTION OF RdPROVEMENT
Length Width Height Sq. Ft.
Length Width Height Sq. Ft.
Length Width Hgt/Ground Sq. Ft.
Driveway Curb Cut Width Needed: Ft. + 6 Ft =
DATE: 0 ^% `
Estimated Cost: $ l S
Ft x $
Tel. # 4e2 -59/
STIPULATIONS:
CITY USE ONLY
Permit Fee
$ r
Fee Schedule on Reverse Side
Fire Surcharge
$ :,?. /9
.001 of Permit Valuation (1/10th%)
State Surcharge
$ / D
$.50/$1,000 Valuation
SAC Charge
$
$1050 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
$
STIPULATIONS:
NEW [ ]. CITY OF FRIDLEY JL
ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-304 Bldg Insp
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax
BUILDING PERMIT APPLICATION
Construction Address: 3 " fV Z
Legal Description:
Owner Name 4,A
(_nnfrartnr-
Tel. #
MN LICENSE#
iy - Tel. # Sr 3 q-1
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: 'AJvw5
Construction Type: Q A.) owls Estimated Cost: $ A -s-o U
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
t c�
DATE: _ \"U APPLICANT: Tel. # S � r7 3 I I y
`fro a I✓ Y 1 it
Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call
you for card number.
CITY USE ONLY -
Permit Fee
Fee Schedule on Reverse Side
Plan Review
$
65% of Permit Fee
Fire Surcharge
$ 14, '5-0
.001 of Permit Valuation (1/10th%)
State Surcharge
$ '1'1
$.50/$1,000 Valuation
SAC Charge
$
$1450 per SAC Unit
License Surcharge
$ 6
$5.00 (State Licensed Residential Contractors)
Curb Cut 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
$�®
STIPULATIONS: