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PRE 2010 DOCSr',, BUILDING;!, PERMIT Village of Fridley, Minn. N° Date.. . .............................. ownerA WOO•i►1 Address :'., ....... ......... 2254 Builder........... .........................'..... Address......................................... LOCATION OF BUILDING NO...... . Street . ........... . Part of Lot ........................ Lot ........ Block ... Addition or' Sub -Division Corner Lot ....... .... Inside'Lot ......... ... Setback . .. j .. Sideyard' . �t-. fa '' ............ DESCRIPTION OF BUILDING To be Used as: Front Depth ,F%eight f't.... Sq. Ft..:...... Cu. Ft. 4 .... Front . . Depth ... #eight :........ Sq. Ft. .... Cu. Ft.... . Type of Conatructi r � � : ► . Fat Cost. . ... To be Completed f In consideration the proposed work i ordinances of the vi ,I of the issuance to me of a permit to construct the building described above, I agree to do a accordance with the description above set forth and in compliance with all provisions of Mage of Fridley. .. .. ....r.: ... In considerall of,the payment of a fee of $. �,•�,. . ,., permit Is hereby granted to '. �►;tr ... . wm " construct the buildin�dfr'a@clition as described above. Thist��i�t, ?s� t upon •the expi- � the person to whom it is &g anted and his agents, employees and workmen, in all work dpne int around .an uppn said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota egarding location, construction, alteration, maintenance, repairand 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. Building Inspector NOTICE: This permit sewer or water. a s not cover the construction, Insolation or alteration for wiring, pluming, gas heating, sure to see the Building Inspector for separate permits for these Items. .i i • 0 0 City of Fridley, Minn.. BUILDING PERMIT Date; September 11, 1969 Ile78-/ N9 10399 Owner: Mr. Jack Chambers guilder Western Construct!on Addrm 55) -57th Avenue N.E. Address 3017 Lyndale Avenue South LOCATION OF BUILDING No. 550 street 57th Avenue N.E. _, part of Lot Lot 16 Block 10 — Addition or Sub -Division _ Donn ey i s Lakeview Manor Corner Lot _ Inside Lot X Setback --_ Sideyard Sewer Elevation _ _ _ _ _ Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Garage Front _ 24' Depth _ 26, Height 10_ sq. Ft 6A r Cu. Ft. 62110! Front Depth Height Sq. Ft Cu. Ft Type of Construction Frame Est Cost T$2,500.00 __ To be Completed 45 Days Paved Driveway In consideration of the issuance to me of a permit to construct the building described bove I agree to do the proposed work In accordance with the description above set forth and in compliance th a�l provisions of ordinances of the city of Fridley. / In consideration of the payment of a fee of $-.2 - 00 , permit is hereby granted to Mel Hen d ri ok son 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 Fridley Minnesota dreugpaor saia�tion gcons tryuctionn,, alteration, mteenoanncen pair amend mooviing oofnboildcinaofs within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. r C A REN CE BEL I SLE NOTICE: M porno does not cover the construction, installation for whine, phunbing, gas heating, sewer or water. Be sero to no the Building Inspector for separate permits for these home. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER IS NAME 0 BUILDER ADDRESS Y 67C3 X57 7 aye IV l; ADDRESS .3 c I ? 07%0- -Ca LOCATION OF BUILDING NO. f -r o STREET .5 7 LOT 16 BLOCK / C' ADDITION OR SUBDIVISION V'C��L® r CORNER LOT INSIDE LOT E! SETBACK_ SIDEYARD____, SEWER ELEVATION TOP OF FOOTING 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: —&� ; Front 4i Depth a6 Height d Square feet a G! Cubic Feet Front Depth Height Square feet Cubic Feet A Type of Construction 4(>2,m41KQ, Estimated Cost J-, 0 O, a 0 To Be Completed d J'- The ~ 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 appl'cation are true and correct. DATE o —! SIGNATURE' (Schedule of Fee Costs can be found on the Reverse Side.) 0o 40 3 11 560-3450 ANOKA COUNTY 6431 UNIVERSITY AVENUE NE FRIDLEY, MINNESOTA 55432 August 28, 1975 Mr. Jack Chambers 550 57th Avenue N.E. Fridley, Minnesota 55432 Re: Property Restoration Dear Mr. Chambers, As you are aware, a street improvement project is currently under way in your area. Because of this con- struction, a certain amount of restoration is required on the individual properties affected. Our normal procedure # of landscape restoration is too slope back on a yard where a cut has been made at a maximum grade of 3:1. Because you have expressed a desire to maintain the existing slope of your front yard by personally constructing a timber retain- ing wall, the City will furnish the materials for this structure up to a value equal to the savings incurred by such a construction. Calculations performed by our Engineering Department indicate that the money available for purchasing the materials amounts to $205.00 for your lot. Based on the price quotations for the various size of timbers and measurements taken in the field on August 21, 1975, this will purchase approximately 28 6"x6"x8' timbers at $6.50 each and 82 nails at $0.28 each. You will find a purchase order for that total enclosed. The white copy is to be forwarded to the vendor and the yellow copy shall be re- tained by you and returned to the City upon receipt of the materials. This money is being made available for your requested retaining wall with the mutual agreement to the following stipulations: 1. The face of the wall shall lie a minimum of 5' from the back of the existing concrete curb and gutter. f Page Two To: Mr. Jack Chambers From: Thomas A. Colbert August 28, 1975 2. The property owner assumes and will perform any and all maintenance and/or repair to the structure as needed. 3. The City, in its restoration stage of the street improve- ment, will perform and provide the normal landscaping from the back of the curb to the face of the retaining wall only. Any landscaping along the side property line and driveway will be performed by the property owner. 4. The material purchased by the City shall be used for the construction of the retaining wall along the front footage only of the lot in question. 5. All labor and materials required for the construction of this wall will be provided by the benefited property owner. 6. This retaining wall shall be installed by September 15, 1975. If not installed by this date, the City retains the right to perform its normal restoration as directed by the Engineering Department, and to disallow any claim for materials purchased by the property owner for this referenced retaining wall. If you have any questions or concerns regarding this agreement, please do not hesitate to contact me. s Sincerely, (i( THOMAS A. COLBERT Assistant City Engineer TAC/as Enclosure SUBJECT MIT City of Fridley 19 6 3 9 AT THE TOP OF THE TWINS BUILDING PERMIT i - � r`y COMMUNITY DEVELOPMENT DIV. (j r PROTECTIVE INSPECTION SEC. � 1 � V ` I CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY L 612-571-3450 910-F15 8/19/88 JOB ADDRESS 550. - 57th Avenue N.E. 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 16 1 Lakeview Mayor kDo..nays) SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Scott Fldward Fuerstenberg 550 - 57th Avenue N.E. 574-0159 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. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW E� ADDITION ❑ ALTERATION O REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 24' x 26' Garage Addition 9 CHANGEQFUSEFROM TO STIPULATIONS Variance approved by Appeals Commission for 1,248 sf of garage area - Council approval 6/20/88. Provide a hard surface driveway. 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 SQ. 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 1 ISTALLS 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 $8,271 $4.48 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- $108.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. LAN CHECK FEE TOTALFEE $112.48 'G NATURE OF COITRACTOR OR AUTHORIZED AGENT IDATEI WHEN PROPERLY VACtDATED THIS IS YOUR PERMIT i'NATUREOF UERIIF OWNER BUILDER) (DATE) BLDG INSP np NEW ] City of FYidley Effective 5/1/88 AMN [ ] R-1 AND R-2 ALTER ] Building Permit Application Construction Address: ��,o r .S% /�� Legal Description: Owner Name & Address: 5c074,11- %Jvl�Sf/✓ a� Tel. # S 17j11/s9 Contractor: __ 1q!S;re,1j.SC)k11 �1 S'� Tel. # Address: -Fr Iwe j/ / Attach to this application, a Certificate of Survey of the lot, with the proposoed construction drawn on it to scale. DESCRIPTION OF IMPRWIIMMT LIVING AREA: Length Width Height sq. Ft. GARAGE AREAL: Length Width 2 Height sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. SZr]3FH;. Cbrner Lot [ ] I9nside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: wb6y IrY-4vYe Estimated Cost: 5 � 4C7 OC Approx. Completion Date: _ Alt. A Alt. `Proposed Driveway Width If New Opening Is Desired: $ 5 Width + 6' See Back Page ,� DATE: APPLICANT: C' -moi Tel. # 97 Permit Free State Surcharge SAC Charge Driveway Escrow Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ _ 0,_F S 5 5 5 5 CLTY USE CILY Fee Schedule on Reverse Side $.50/511000 Valuation $550 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] X1.4 .K 10, D0914AYIS LgotME d JA04ow A�3fltTi�t.�_ C-`E-COULTER & ASSOCIATES. INC. wovaTlfau JC*M A. PETERSON 'LAND SURVEYORS Nu►RRAK R. LENZ JR, rTtu,a wslMEss ^F. C/!Y LO►� .. .. IAlhl •YIIYEtI A1GISTEREO.UMXR LAWS OF STATE OF MINNESOTA �wRr wort[ T4FOOMftlIIC, YwMYpo --,. NCtM 'EO MY P A M"S Of CITY OF MII.ME&POLSO 1YOICIAL 3''300 LYMDALE AVE. 50. iblNNEAPOLIS. MINN. 38408 - 024.0370 to - .. - �tttltepot'�c lttttiffuttt � � o� � S77'L4 'AVE 1. woI M`~ FiI • .1404L r 1-5-F10 LA -' �.+ ool''' Z4,(o6 9. 7 1lo Ay�' SG4LF 1'�=301 . - Qa' O `�pp , • D! IO T'ES iitp l log :40 pRoftsw Lt - SA&Aal 1 y.f oy6b r1(9fAW�Dr O � ` dot 16, dock 10. DOt*ky' - LAK£VrM VANOR ADDITION, Anoka COUnty, Minnesota, subject �► to e0sements and restrictions sof record, if any. . - i.hereby.`Ee1Yy that this survey, plan,'or report sas prepared by me .or ur.8-er my direct gape,#isiun and that�l am a duly ~' RtgistezVd Land Surdsyor uad®r .-the laws of - ;',.:'the State cf'11inne:so#a - DateP,�' ALR Re �o .,Q, K . �•. a� 3' i CITY OF FRIDLEY Effective Date May 1, 1988 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE RESIDENTIAL Furnace Shell and Duct Work, Burner (Also replacement furnace) Gas Piping (piping needed with new furnace) Gas Range Gas Dryer * Air Conditioning (all sizes) RATE $ 20.00 $ 10.00 $ 10.00 $ 10.00 $ 10.00 All Others/Repairs and Alterations 18 of Value of Appliance or Work COMMERCIAL/INDUSTRIAL 18 of Value of Appliance or Work State Surcharge TOTAL FEE Reinspection Fee ($15.00) Rough Insp. Date Final Insp. Date Approval for Permit MINIMUM FEE FOR ANY HEATING PERMIT IS $15.00 PLUS $.50 STATE SURCHARGE *Air Conditioners can not be placed in side yard without written permission from adjoining neighbor. TOTAL Job Adares� 0/ $ Department of Buildings, 6431 University Ave. N.E., Fridley, MN 55432 Cityof 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. TA Nu A 2 Y OWNER A/0 G/ ,J/ A Y 0C) m 00d N! .e S KIND OF BUILDING USED AS g 6r 7—A i C_. -5-TO 10- 6 TO BE COMPLETED ABOUT /)'I A !� C K / P? O ESTIMATED COST �l 4 D O O OLD - NEW BUILDING PERMIT NO. PERMIT NO. RA-PZ-ACO nri /Roc F 1-011�': 19 AZ 2,.7- W 1 T- 14 (1. o T -0N Q00FToP u",r S CS 6' fLp.vf� DESCRIPTION OF FURNACE/BURNER HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. Trade Name if 0 Size No. 16..5/ 13=�3—Z7D �qea Capacity Sq. Ft. EDR BTEb?) OX O HP Total Connected Load Kind of Fuel P Ar G A S BURNER - Trade Name Capacity Size No. Sq. Ft. EDR BTU HP Company J N L AI CC O /► ? 6r b Signed By Tel. No. 'or Fill out back side for stack verification on replacement furnaces 4 1 CHIM14EY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack; 1. Has been carefully examined Yes () No ( ) 2. Is free from rust or deterioration Yes ( ) No ( ) 3. Has no foreign objects lodged within Yes ( ) No ( ) 4. Is securely supported Yes ( ) No ( ) 5. Meets all current Code requirements for size and total BTU connected Yes ( ) No ( ) 6. Has Total heating BTU's of All other BTU's TOTAL Remarks Company Signed By Da to . SUBJECT IT ­Z City of Fridley6 4 3 2 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. _ _ COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. ��� r I � NUMBER REV DATE PAGE OF APPROVED BY I = I---1 CITY HALL FRIDLEY 55432 A, j 612-571-3450 910-Ft5 7/2/98 JOB ADDRESS 550 57th Ave NE i LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 16 10 1 Lakeview Manor (DOnna % SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Lind 6540 Race Rd Fridley 571-6276 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. gzj�ftsrwm Siding 13570 Grove Dr #116 Ma le Grove 55311 689-0195 20093753 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 ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Siding, soffit and fascia 9 CHANGE OF USE FROM TO STIPULATIONS Install building wrap and call for inspection before covering. Install soffit ventilation to meet the State Building Code. 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 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 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 ISTALLS 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 PERMITQ 9Q DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PER I FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $56.75 Fire SC $1.80 ®PLAN CHECK FEE TO ALFEE 4&_�s Li C $5 0 64.45 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI E RO VAL - -OG IN D THIS IS YOUR PER 7�I �iA E SIGNATURE OF OWNERIIF OWNER BUILDERI IDATEI NEW [ ] ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY -AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: 55- 0 - S_`7 ���� � Ovc� F2 L Legal Description: Owner Name & Address: Contractor: &4mi Address: — Effective 1/1/98 Tel. #L c 6 smdv ` ow MN LICENSE # 37 Tel.# �9-/�/9.- Atiach 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: Sq. Ft. Sq. Ft. Sq. Ft. Construction Type: �i jp�.; c7 , ���a o PffcA Estimated Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: 7 APPLICANT: Tel. # TOTAL $ STIPULATIONS: CITY USE ONLY Permit Fee $� e�S Fee Schedule on Reverse Side Fire Surcharge $ Pty .001 of Permit Valuation (1/10th%) State Surcharge $ 0/0 ` $.50/$1,000 Valuation SAC Charge $ $1000 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: Building BUILDING Permit No.:2601-0-0 v Inspections RESIDENTIAL APPLICATION Received By: 763-572=3604 DateffLm MAY 17 200 CITY OF FRIDLEY DATE - / YOUR E-MAIL ADDRESS Dlevi / A'7!S' / CGrn SITE ADD fS THIS APPLICANT IS: ❑ OWNER ONTRACTOR PROPERTY OWNER/ NAME:Ch ja b ::S n e 4 TENANT ADDRESS: 44c, 1522"'7 d4 L- P CITY IS'b/'AzSTATFA LZIP-16-1� aj PHONE: !Z 3 - 59zl — 2;,.? - CONTRACTOR NAME: ,, SUBMIT A COPY OF STATE LICENSE #e3 S( EXP DATE 3v % YOUR STATE LICENSE ADDRESS,40i6 0i6 Gi!! 7!'• CITY erbc STATES WITH APPLICATION PHO FAX PROPERTY TYPE WINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK. ❑ NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: ,. �� tq vc, a 4 l 0L,.rr � 4 cl ��/u 0),ecJ SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES J<HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. Existing Floor Plan 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other . ❑ Fascia and proposed project WINDOWS 2. Two sets of construction plans IN EXISTING OPENINGS ❑Yes []No LOCATION OF WINDOWS 3. Energy Calculations OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS L FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: 3(P SJR -fes ��Le. (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ OCCUPANCY TYPE Permit Fee $ ` . �3 7 See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ .001 times the total job valuation Surcharge $_ .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $1675 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $21 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ / ' %. Make checks payable to: City of Fridley Attach Stipulations . THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work w ' requires rev w and approval of plans. SIGNATURE OF APPLICANT INT NAME 1-1114 ✓I; S DtA(446U /J4DAIM �`? Q