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
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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: