PRE 2010 DOCSDate
Owner
Address
BUILDING PERMIT
Village of Fridley, Minn.
.... .
4 ..... . . .
'00�-� ..:..
.. ..
No.��......
Lot ...... A....
Corner Lot .......I
To Used as:
Type of Constructia
In consideratior
the proposed work i
ordinances of the vi
N° 230
Builder...........................................
Address.........................................
LOCA'1ION, . OF U(L G
Street .�+ ......`. .....+.
A
•• art of Lot ... .......
Block ...... A ...... Addition or Sub -Division .. !........ ...... .
a3 6- of
.... Inside Lot ............ Setback ......... Sideyard ..........................
DESCRIPTION OF BUILDING
Front ........ Depth . .Height Sq. Ft. �... Cu. Ft........ .
ont ....... Depth . �7.. Height. , ...... Sq. Ft. 0?. Cu. Ft........ .
Est. Cost ........................ To be Completed ....................
ti of the issuance to me of a permit to construct the building described above, I agree to do
accordance with the description above set forth and in compliance with all provisions of
age of Fridley.
-__.______._.-___.. f A ....... ........ ....... .... .fir. ....... ....
tion 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 conditio that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and lupon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota garding location, construction, alteration, maintenance, repair and moving of buildings with-
in the village limits d this permit may be revoked at any time upon,, tion of any of the provisions of said
ordinances.
f ..... .. "` Building Inspector
42
f 6+/
NOTICE:
This permit oes not cover the construction, Installation or alteration for wiring, plumbing, gas heating,
Fewer or water. lie sure to see the Buliding Inspector for separate permits for these Items.
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
571-36U4 r'AX: (763) 571-1237
PERMIT(0.-.2004-01367
DATE ISSUED: 08/18/2004
ADDRESS
: 55153 AVE NE f
PIN
: 233024430062
LEGAL DESC
: OAK II LL ADD
: LOT 3 BLOCK 3
PERMIT TYPE
: BUILDING
PROPERTY TYPE
: RESIDENTIAL
CONSTRUCTION TYPE
: ROOFING
VALUATION
: $ 2,623.00
NOTE: UNDERLAYMENT AS PER STATE BUILDING CODE. REROOF HOUSE & GARAGE (22 SQ) TEAR -OFF
APPLICANT BUILDING PERMIT FEE 83.25
MILNER JOANN T FIRE SURCHARGE 2.62
551 53RD AVE NE STATE SURCHARGE, VALUE 1.31
MPLS, MN 55421 TOTAL 87.18
PAID WITH CHECK # 9855
OWNER
MILNER JOANN T
551 53RD AVE NE
MPLS, MN 55421
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construction
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time after work is commenced.
I hereby certify that I have read and examined this
application and know the same to be true and correct. All
provisions of laws and ordinances governing this type of wort
will be complied with whether specified herein or not. The
granting of a permit does not presume to give authority to
violate or cancel the provisions of any other state or local law
regu a cgruction or the performance of construction. , ,
SEPARATE PERMITS REQUIRED FOR WORK GTHER THAN DESCRIBED ABOVE.
NEW [ ] CITY OF FRIDLEY )�—'Nt4469 Effective 4/1/2004
ADDN [] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
ALTER 10/ SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax
BUILDING PERMIT APPLICATION
Construction Address: 5�5� l' � y
Legal Description: oc./deIve- e-
Owner Name & Address: �d V V MIL MER Tel. # '710 �� 2
Contractor. n 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 Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft
DECK AREA: Length Width H t/Ground Sg. Ft
OTHER: J /
Construction Type: OV I!> / `t7o Estimated Cost: $ 4 SOD,
Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ —=$
DATE: �'"��� APPLICANT: Tel. #
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
Plan Review
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Fee Schedule on Reverse Side
65% of Permit Fee
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1350 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 1 STIPULATIONS: