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PRE 2010 DOCS0 City of Fridley, Minn. 0 W 0 BUILDING PERMIT N® 4476 Date: .0 ......... ..... 9� 4 . . ....... . ........... . ............. . ............. . .. Owner: .......... �.)i . .... .. . . . . ... . ................... Builder Address .......................... - -_ Address .................. S .. 101 TION OF BUILDING No I 11"JG ........... .............. Part of Lot .............................. .Street Lot 7 ............ Block ..... . ....... ....................................... Addition or Sub -Division Comer Lot - --------------------------------- Inside Lot ----- ..... Setback ............. Sideyard ............... . ............. . ........... Sewer Elevation ....._.........r, . . ................... ................................. Foundation Elevation ........... A --T........................------........_.. DESCRIPTION OF BUILDING T Front Depth Height /-f ......... Sq. Ft. Cu. Ft. 111.34 Front ....................... Depth . ........ Height Sq. Ft. ... ...... ............. Cu. Ft . ........................ Type of Construction co ............ To be Completed ............................... ........ . ........ . Est. /7" 71 7 7177� V� ,D LA71 - 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. eJ In consideration of the payment of a fee of $ N t is hereby granted to ... ..... ........................ to construct the building or additioxf 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 time upon violationany of the provisions of said ordinances. ii A '/' I - 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 for these items. 4q Ci Fridley u tY of Apocation for Plumbing and Gag %ting Perndt Dept. of Bldgs. Phone SII 4-7470 DESCRIPTION OF WORK Number, Kind and Location of Fixtures Location, PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. 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) ...... Z' x 2.00 $ �r Q C) New Ground Run Old Bldg . ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 $ �' S d Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code City of Fridley: r' Theundersigned 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 �e°� , 19— Kind of Building. Used as To be completed about _ Estimated Cost, $ 01 New.` wilding Pe: U No 19 APR 2 2 1950 Description................................................$ TOTAL FEE QW11 POST IM -12-58 N U' ? N WATER HTR. GAS ELEG Base 1st 2nd 3rd 4th • Future Connection Openings New Fixture, Old Openings Connected with Sewer PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. 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) ...... Z' x 2.00 $ �r Q C) New Ground Run Old Bldg . ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 $ �' S d Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code City of Fridley: r' Theundersigned 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 �e°� , 19— Kind of Building. Used as To be completed about _ Estimated Cost, $ 01 New.` wilding Pe: U No 19 APR 2 2 1950 Description................................................$ TOTAL FEE QW11 POST IM -12-58 Application for Power Pfa nts and' Heeding. Cooling, Ventilation, Refrigerasion 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 $ MECIL 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 0.0� GAS BURNER (up to 400,000 BTU) ....................... 5.00 $ 6- GAS FITTING FEES: 1st 3 Fixtures ...................... Additional Fixtures ................. Gas Range to 200,000 BTU ........... AIA CONDITIONING FAN HEATING SYSTEM VENTILATING SYSTEM ALTERATIONS & REPAIRS ROUGH— OUGH FINAL— FINAL NO NO RATE TOTAL - x $1.50 $ _ x .50 $ - x 2.00 $ $ See Fee Schedule TOTAL FEE Dept. of Bldgs. Phone SU. 4-7470 T-Ma#inw /3 S.5or .5--3 do-e- 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 �t�correct. AiD Fridley, Minn -/ 19 Owner Kind of Building Used as To be completed about Estimated Cost, $ Old—New. Building Permit No. Permit DESCRIPTION OF WORK HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No Trade Nam Y' 7L S4 ��� Size No- le c oe-6 Capacit� 1q. Ft. E.D.R BTU H.P. Total Connected Load Bind of Fuel�l� BURNER —Trade ame i Size No Capacity Sq. Ft. E D.R BTU H.P. (REMARKS—OVER) 4z ZM 7-s9 Business Phone ' 15572 Building Job .Report ADDRESS i OWNER BUILDER DATE PERMIT NO. DESCRIPTION G • Q �( P INSPECTION RECORD DATE REPORT <` 6 / A/I-e OWNER -REP. G' f INSPECTOR 7e 30 City of Fridley, Minn. 6431 University Ave. N.E., Minneapolis, Minn. 55432 BUILDING PERMIT Date. Q� ly29 1.- 971 OWM: _ Mr_ Ray Nelson Builder Bond Builders Address _ 1385 -53rd Avenue N.E. Address 3312 Hopkins Crossroads, Mtks. LOCATION OF BUILDING No 1385 Street 53rd Avenue N.E. part of Lot Lot 17 Block 2 Addition or Sub -Division Swanstrom's Court Addition Corner Lot Inside Lot x Setback 36' — Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Garage Front 21' -5" Depth 24 Height ._._..10 t Sq. Ft. _... 504' Cu. Ft. 5040' Front Depth Height Sq. Ft. _. Cu. Ft. Type of Construction Wood & Stucco Est. Cost_ , 32500 00 To be Completed 30 days. Stipulations: Provide a hard surface driveway. Approved by Board of Appeals and City Council. In consideration of the issuance to me of a permit to construct the building described above, I agree to do fhe proposed work in accordance with the description abo Ordinances of the city of Fridley. -- 1 -19 St a Sur huge In consideration of the payment of a fee of $ q _ 50 , permit is hereby granted to Bond Builders 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 ante city limits and this permit may be revoked at any time upon violation of any of the provisions of tsaid �✓ Building Inspector QLARENCE BELISLE NOTICE: This permh does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these hems. r APLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME :-2 E � � �, % BUILDER: �3 ,., � a �� L A �, ADDRESS:,3,1y- !Y F ADDRESS 7 r" NO: /dam �S` STREET: LOT: BLOCK: ADDITION:_ CORNER LOT: INSIDE LOT:SETBACK: (o 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: GayAaC_ Front:- 1/.' 6- Depth:2 -VHeight• � Square Feet:_6_.0 Cubic Feet: Front: Depth: Height: Square Feet; Cubic Feet: Type of Construction: c9;; o Estimated Cost: j. 6 B _6 a To Be Completed: a ,, -3, The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in sttict 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 : ' 5 - / (, - -It SIGNATURE : °i (See Reverse Side For Additional Information.)`' a a U r � Y. yty yy,` rR. N } � 1 � t t, '• j � 1� ..�+ 'ir.• .! J r ! � I fiS 5 ,�d 7,t rl Y 1�` i.) ! ,}r iF Y t,:. <yl C "r �. `'. r � ` : f y 7• i "a '� E'1'� � k�A W� •, Y J'Y 1 >i V - ,. � Ate. 11 j �...: �' 1 r °r`' 6 1 -.� r: ,._ 3 '� • I 3 g a 4 al.cxc�' �1+ t A'[r✓' y,rfr -. ,iw n � f I n 1 f jj F. f j � } Z _ 44 l� 4 r r AF Xr� IVk--6 •V. p t F. O - i� � YS �t�-u._ 53-84-s-915.51 Citi of lhdlor: PARTIAL RATE SCHEDULE PLVJ9MG riXTUM IMTWa M06 "Im Tcrr" Numbw to a ................ a no ...®:...... a�AQ �_. w" ybdwm ad copprAft ......... trateh Kala .............:...... s iS �i fes® Aatee Heatrf !'e1� � � BTl1Z. • .. : �W $ New G6oamd flue tW Bk ........ x $S25 Ste_ z6dv*w&t s•Ksolsr.............. a I= t cm !'&r=G nm&- X06 RAW TOTAL bt i rmtw ..... • ............ 1 a: am 62,00 � AddWoad -NO-75 t am RMW to tlaM Bru ....... I... a X6.00 $- -state Surcharge $ .50 1E►A:d f AL'tQLnOfA--fir �s b'iMa ._ Install (1)� Glowas Ranke .............. 3.00 20MIL rm 6 5.50 Kind of KuMing Fr. und w Res. ro be com*ew about 7/29/73 Estimated coat. E 10.00 J . Building PMM NOL Mond OVW Surcharge .5ag SUBJECT PERMIT NO. City of Fridley o 15486 AT THE TOP OF THE TWINS BUILDING PERMIT rp RECEIPT NO. fr _ COMMUNITY DEVELOPMENT DIV. �7� r PROTECTIVE INSPECTION SEC. 7 l--•.� `•j CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY ��'��� L 612-571-3450 910-F15 19/26/79 JOB ADDRESS 1385 - 53rd Avenue N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 17 2 1 Swanstram's Court Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Raymond Nelson 1385 - 53rd Avenue N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. MIlton L. Johnson Co. 2513 Central Avenue N.E. 781-9548 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 8 DESCRIBE WORK Tnstall aluminum trim 9 CHANGE OF USE FROM TO STIPULATIONS 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 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 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 $2,000 $1.00 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SACCHARGE PROVISIONS OF ANY 0TH R STA E OR LOCAL LAW REGULATING CON- STRUCTION OR THE P RF MA CE OF CONSTRUCTION. $12.00 PLAN CHECK FEE TOTALFEE $13.00 SIGNATLIRE OFCONTRAC IVR OR AUTHORIZED AGENT (DATE) HEN PROPERLY VALIDATED THIS IS YOUR PERMIT SIGNATURE OF OWNER I IF OWNER BUILDER) (DATE) f0ATE C1,1"Y 0I y RI1:�.E°Y ° APPLICATION (=0(t Ri_cJ")i:NT1AL TWILDIi�IG PERMITS (Niw, ALTD( AT1OIJS, ADDITIONS, OR RCPA116) MMER; Raymond Nelson i;ddress : 1385 - 53rd -Ave N E 11o.: 1385 Street; BUILllJ:!Z: Milton. L. Johnson -Co. Address: 2513 Central Ave N E Tel. No. 53rd, Ave NE I,OT: BLOCK: ADDITION: COPNER IDT: IASIDE LOT: SETBACK:' SIDEYARDS: Applicaht attach to this form a\qo Certificatc,s of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: Front . Depth : height: _ Square: Feet:: Cubic Feet: Front: Depth: Height: Square Feet: Cubic Feet: Type of Construction: Aluminum trim Estimated Cost: $ 2,000.00_ To Be Completed: Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired $ $ (SEE r-MVERSE SIDE" OF SHEET) The undersigned hereby makes application for a permit for the wort: 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. See reve=rse side for additional information;. DATE:- �1v.°-7 4 SIGNATURE: a F Stipulations: l00 l� .c)� CITY OF FRIDLEY APPLICATION FOR PWML'ING AND GAS FITTING PERMIT PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE Number Fixtures / x $3.00 Future Fixture Opening New Fixture, Old Opening Catch Basin Water Heater - to 99,000 BTU 100,000 BTU to 199,000 BTU Water Softener New Ground Run Old Building Electric Water Heater GAS FITTING FEES: lst 3 fixtures Additional Fixtures Gas Range to 199,000 BTU REPAIRS $ ALTERATIONS First $100.00 each add. $100.00 or traction x $2.00 X $2.00 x $5.00 T m x $10.00 x o X k N $5.00 Water Tel. No. ` S $ E Date $ ;z�'�� 9 Heater S APPROVAL FOR PERMIT $ R 3 O U.Oi (groj G�1 3a pO -.�1 01 N C .i 7 O O JJ N ij NW N N o a w c o w° u[i w u w 4 3 c� as lec c'n U iu 1st 2nd 3rd 4 th (R) = Future Connection Opening Connected with Sewer (*) - New Fixture, Old Opening Water PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE Number Fixtures / x $3.00 Future Fixture Opening New Fixture, Old Opening Catch Basin Water Heater - to 99,000 BTU 100,000 BTU to 199,000 BTU Water Softener New Ground Run Old Building Electric Water Heater GAS FITTING FEES: lst 3 fixtures Additional Fixtures Gas Range to 199,000 BTU REPAIRS $ ALTERATIONS First $100.00 each add. $100.00 or traction x $2.00 X $2.00 x $5.00 X $5.00 x $10.00 x $7.00 X $5.00 x $5.00 x $3.00 x $1.00 x $x:0.00 State Surcharge TOTAL FEE REINSPECTION FE8 ($10.00)• $5.00 $2.00 Job Address /,3S Department of Buildings City of Fridley Tel. #571-3450 The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct Fridley, Mn. /z 19 Ad OWNER KIND C USED A TO BE $ MINIMUM FEE FOR AMY PLUMBING PERMIT IS $7.50 PLUS $.50 STATE SURCHju?zE $ .50 ESTIMATED COST L Cie -� TOTAL OLD - NEW BUILDING PERMIT NO. PEP14IT NO. $ Company $ Signed By ,O/ �1 Z& ZZQ3 $ Tel. No. ` S $ ROUGH INSP. Date $ ;z�'�� FINAL INSP. Date S APPROVAL FOR PERMIT $ $ MINIMUM FEE FOR AMY PLUMBING PERMIT IS $7.50 PLUS $.50 STATE SURCHju?zE $ .50 CITY OF FRIDLEY Effective Date may 1, me APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE Furnace Shell and Duct Work, Burner (Also replacement furnace) Gas Piping (piping needed with new furnace) Gas Range Gas Dryer • Air Conditioning (all sizes) All Others/Repairs and Alterations li of Value of Appliance or Work l COMMERCIAL/INDUSTRIAL 11 of Value of Appliance or Work RATE TOTAL $ 20.00 $ C�P.0-V $ 10.00 $ $ 10.00 S $ 10.00 $ $ 10.00 $ State Surcharge —6Y_o E heinspection Fee ($15.00) Rough Insp. Date q Final Insp. Date Approval for Permit MINIMUM FEE FOR ANY HEATING PERMIT IS 515.00' PLUS $.50 STATE SURCHARGE *kir Conditioners can not be placed in side yard without written permission from adjoining neighbor. S Job Address Department of Buildings, 6431 University Ave. N.E., Fridley, MN 55432 City of Fridley Tel. #571-3450 •The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes and rulings 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 &a037`1 KIND OF BUILDING USED AS S TO BE COMPLETED ABOUT ESTIMATED COST $ .50 OLD - NEW BUILDING PERM/IT NO. PERMIT NO. / d 6Cd2 DESCRIPTION OF FURNACE/BURNER HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. / Trade Name ` („/fir✓�'�rL Size No. "cZt') Capacity sq. Pt. EDR BTU HP Total Connected Load Kind of Fuel BURNER - Trade Name Size NP. Capacity Sq. Ft. CDR 9V HP Company Signed By — d/-,�rr�� Tel. No.f� Fill out back side for stack verification on replacement furnaces I 01, SUBJECT City of Fridley 30396 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. COMMUNITY DEVELOPMENT DIV. w-----_G�O f PROTECTIVE INSPECTION SEC. � 1 =---1 CITY HALL FRIDLEY 55132NUMBER REV GATE PAGE OF APPROVED BY 612-571-3450 910-F15 10/13/99 10B ADDRESS 1385 53rd Avenue 'NE I LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 17 2 ISwanstrom's Court SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ray Nelson 571-1117 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Nutzmann Bros Constr. 736 1st Ave NW New Brighton 55112 651-628-0128 20043453 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 XX REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Reroof house and garage 25 S Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the 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 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 $2185 $1.09 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- STRUCTION R TH ERFORMA E OF CONSTRUCTION PLAN CHECK FEE TOTA EE License C $5.00 $0.53 SIGNATURE OF CONTRACT OR AUTHORIZED AGENT (DATE, EN PROFVALIDAT HI$IS y�R PM VL S-GNATURE OF OWNEROF OWNER BWLDERj 10ATEj OLDINSO riAtE I 01, NEW [ ] Effective 5/10/99 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMELY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address:/ 3�5—,5�3rd & J� Legal Description: Owner Name & Address: 1 / -�/V Tel. # iZ S71-111 7 Contractor: ,, II MN LICENSE # 2 (� Address: 1 St N�7l Tel. #� Attach to this applic 'on, 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: Construction Type: Estimated Cost: $ 'UV U Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ l DATE:Jh/13L92 APPLICANT: Tel. #'�2 — CITY USE ONLY Permit Fee $ r-2-5 Fee Schedule on Reverse Side Fire Surcharge $ cl .001 of Permit Valuation (1/10th%) State Surcharge $ 1,09 $.50/$1,000 Valuation SAC Charge $ $1050 per SAC Unit License Surcharge $ �j , CDC $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 $ a STIPULATIONS: