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PRE 2010 DOCS0 ®f Fridley, Minn.. • t3' Y� BUILDING PERMIT N® 6591 Date: Owner:+1 J6A Z& Builder ` --- --- Address Address (ON �OAIA UILDING No. �� Street P of t Lot _ _ _ _ _ Block Addition or Sub -Division 8 Corner Lot . _ ._._. Inside Lot _ . d� Setback _ _ _ _ Sideyard _ Sewer Elevation -- Foundation Elevation DESCRIPTION OF BUILDING T Used 0,0 A Front Depth Height Sq. Ft. Cu. Ft. nt ��/' Depth eight ! __ Sq. Ft. 06 cu. Ft. Type of onstruction �9!2� Est. -�� _ To 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 all provisions of ordinances of the city of Fridley. / '0�7 - 'Y � g�rr9 _ ri In consideration of the payment of a fee of $W , permit is hereby granted to to construct the building or addition as described above. This permit is granted upon Fress condition that the person to whom it is granted and his agents, employees and workmen, in all work 7:]d:l,thnances. Building Inspector • NOTICE: Ihhi permit don not corer the com*mcdon, hutaWon for wiring, phunhing, gn healln& sewer or water. Be sore to we the Building Inspocior for separaN permhs for those hams. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY,- MINNESOTA 01=71'S NAM/� , ,l �,-,.1, BUILDER ADDRESS ADDRESS .� LOCATION OF BUILDING No. Street Part of Lot Lot I;o,- _Block / Addition or Subdivision_/f Corner Lot Inside Lot -.L ---Setback Side Yard SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed build- ing 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 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). Application for Power Plains and Heating. Cooling, Ventilation. Refrigeration 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 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU :........... 8.00 $—X each add. 60,000 BTU ....................... 2.00 $ Replacement of Furnace 5.00 $ 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. IDR 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 GAS BURNER (up to 400,000 BTU) ....................... 5.00 $ GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x $1.50 $ Additional Fixtures ................. x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM ALTERATIONS & REPAIRS TOTAL ROUGH 1FINAL Dept. of Bldgs. Phone SII 4-7470 LocatiorL A� � ® — (",- O Y111 a 095 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 true and correct. Fridley, A inn- -P-6 ol „ 19 Owner /7-,q E .0 Kind of Building Ei A�9 f Used as PE_g To be completed about eg"— 3 ® -6 2: z Estimated Cost, $ Old ew Building Permit No. .5 Permit No. DESCRIPTION OF WORK HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No ®J^E­ Trade Name A Size NoAF'6 Capacity Sq. Ft. E.D.R d p`"'r` BTU H.P. Total Connected Loa_ ® Kind of Fuel BURNER — Capacity Sq. Ft. E.D.R BTU H.P. (REMARKS -OVER) Signe 4 Z 2M Business Phone No - r or !q. ins. W.A. Leader area ImTL.ength Width '�tattdow4, and Doo package and Area p, C�T Coef. Btu, HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS NUNNEAPOL IS. MM. Weatherstrips Reference Out. WAD Construction No. Jot. Wall Ceiling Roof Floor Kind Insulation I iw Applied Wn IAOI 19 ILI Om Rte, th 7- CIP Le z Width t r or !q. ins. W.A. Leader area ImTL.ength Width '�tattdow4, and Doo package and Area Dr et M o el`ne lights Lineal crack Area C�T Coef. Btu, ff Ild{lt�'eRi011 f . wnll Ne O". wall int, w efico-64 r IAOI R . or sq. ins. W.A.,Leader areal} as I Length fV,Width � Height R/prldm( and Doom--Cr$cke a and Area 1� IdRb! ele { oo of Lineal (t. Area l mane U hte of nffackqy tt. 74 It No. Infiltration Glass Exp. wall Net p:p. wall Int. wall Ceiling Floor ;7— FIR I evEl Windows and No. width I '1 of Dana_ or sq. ins. W.A. 1.444 � Length `1 i —Crackage and Area area J i / • IWAUmp1JI1� Net exp. wall r����r�:�►o ,;rte 14 icrImm- -R. Requi s . ors . iris. W.A. Leader ueal �'/ `► s I Length th Width' Windows and Doom --Cracks d Area width Helsht No. of (.Ines t Arra No. of ►n of. Dane hshte o cjc a . R. RAW:. ar XJ ` 1!Mhr mft 3401�..�� HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS iy Weatherstrips A.S.H.V.E, Construction No, Guide _ Windows Doors Reference Out. Wall Int. Wall Ceiling I Ro—of—I Floor Y s— o 0 19_ — •� oom I Length Width 14eiaht 6 t W ws and Doors—Crackage and Area II L 1_ wldt Height No. of Lineal rt. Area N0. papa 0 ne lights of cra sq. it. 0 Infiltration It�ltrs�tiot, Glass C� 17 Ex P. wall ,. i' Net exp. wa Int. all Ceiling Floor c v ZZ i to atti. EiegAired sq. ft. E.D.R. or sq. ins. W.A. Leader area Room Length Width Height W daws' and Doors--Crackage and Area 1.t Height No. o Lineal ft. Area t+fo ! n of pane lights of crack eq. ft. Coef. Btu It�ltrs�tiot, r ohm min, Nd .wall 5/ Int. wall - Ceilin Floor a I am utw sq. ft. RI.R. or sq. ins. W.A. Leader area F1. doom I Length Width Heiaht w► and n-•-Crackage and Area width' Relgot- No. of Lineal ft. Area 1fb s¢ o pe lights of crack sq. ft. Coef. Btu Infiltration r ohm Exp. wall Net exp. w ll17 Int. wall - Ceiling Floor a -,t1 t Windows and Nor Width Het ht N pane or pane /' ---� I C' 1 Infiltration MINNEAPOLIS. *MMM. Instdation Kind How Applied om Length - Widt --Crackage and Area -4e of VIP., Glass (' Exp. , Net exp. wall j Int. w 11 t Ceiling Floor7\ Tot Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area FI -I Room I Length Width Hecht ;' Windows and Doors--Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. .r Infiltration r Glass Exp. wall Net exp. w ll17 Int. wall - Ceiling Floor a total tftu.I ;;. Required sq. ft. E.D.R. or sq. itis. W.A. Leader area f F1.1 Room I Length Width Heiuht . Windows and Doors—Cracks a and Area ; Width Height No. of Lineal t• Area No. of pane Mone lights of crack . tt. � • Ittftltratipn Blau Eap. wa wall t, Malo - Cet'�ibg, . Floor SUBJECT PER of Fridley 17 4 4 8 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T rpCity T COMMUNITY DEVELOPMENT DIV. r 1 PROTECTIVE INSPECTION SEC. 1 � � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 4/9/84 JOB ADDRESS 1560 60th Avenue N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. West 73' L t 4 1 Van Cleave's Addition SHEET 2 PROPERTYOWNER MAIL ADDRESS ZIP PHONE Wes Long 1560 60th Avenue N.E. 571-0480 3 CONTRACTOR Netko IVAT'OSEoofing 3440 Russell Aven North PHONE 529L1m4�NO. 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILpI G rest ential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION X] REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK re-roof 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 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. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES VALUATION SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED 1400.00 '70 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- 23.50 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE c 24.20 SIGNATURE OF CONTRALTO OR AUTHORIZED AGENT (DATE) EN PROPERLY VALIDATED THIS IS YO R T _A BLDG INSP DATE SIGNATURE OF OWNERIIF OWNER BUILDER) IDATEI NEW [ ] City of Fridley Effective 4/1/84 ADDN. [ ] R-1 AND R-2 ALTER. Building Permit Application Construction Address: Legal Description: ,-r - -/( 0 17 Property Owner/Address: r� Tel. # S Contractor: 7�[ K n �J o-,' ° l n l- �� Tel. Address: 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: C� - Corner Lot [ ] Inside Loot [ ] Ft. Yd. Setback Side Yard Setback Type of Construction: RGi (t-Orit" Estimated Cost: $ ) (4 b Approx. Completion Date: Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation �t ��o-�� APPLICANT: D �� Tel. # DATE: �.. Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Main Charge TOTAL STIPULATIONS: CITY USE ONLY $ Z3. St) Fee Schedule on Reverse Side $ 25$ of Building Permit Fee $ . ?0 $•50/$1,000 Valuation $ $425 per SAC Unit $ Fee Determined by Engineering $ 27 .Z ® Agreement Necessary [ ] Not Necessary [ ] aye 3�'' 66 1 SUBJECT P City of Fridley 20402 AT THE TOP OF THE TWINS r BUILDING P E R M I T ��/ ______ COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. r CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910-F15 6/'4/90 JOB ADDRESS 156.0 a- 60th - Avenue N.E. 1 LEGAL LOT NO, BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 73k of 4 1 Van Cleave 1's Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE w.,esley Lang 15&0 — 60th -Avenue N.E„ 571-0480 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Jim Konold Construction 299-B N. 'Victoria St„ Roseville, MN 55113 484--7521 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 [�7 REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reside House & Garage. 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. ZONING SQ. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES VALUATI?N SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND IE S GOVERNING TYPE OF WORK WILL BE COMPLIED $5 $2.90 SPECIFIED EREINIS H00 WITH WHETHER OR NOT. THE GRANTING OF APERM 9 PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATEOR LOFALLTf REGULATING CON- $81.00 OR THE PERFORMAN OF C R ION. PLAN CHECK FEE TOTAL FEE �TRUCTION ( In $83.90 SIGNATURE OF CONTRACT OR AUTHORIZED AGENT IOATEI �. PROP RL LMHIS' IS YOUR PERMIT aE NS 07A TEX SiGNATURE OF OWNER IIF OWNER BUILDER) IDATEI NEW [ ] Effective 1/1/90 ADI [ ] R-1 AND R-2 ALTER [ ] Building Permit Application Construction Address: C' o �- A— V U _ lv legal Description: Owner Name & Address: C 0 Tel. #S 7 / -- a 54 Contractor: 'T/ /7 acv Tel. # <1c Address: 0255 iJ «�� o��`� S 7. /eoscE /r 11 1 Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVMG AREA: Length Width Height Sq. Ft. GARAGE AREA: Le rjth Width Height Sq. Ft. DECK AREA: length Width Hgt/Gro u d Sq. Ft. 07MM: 'f ance-'PC C'f o co Corner lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: Estimated Cost: $ 6 e Approx. C mpletion Date: Proposed Driveway Width If New opening Is Desired: Ft. $ $ Width + 6' See Back Page DATE: APPLSC U: 3-A C -z e-9 /<—. ~.p /Z Tel. # q- -9� - Permit Fee State Surcharge SAC Charge $ Driveway Escrow $ Park Fee $ Sewer Main Charge $ STIPULATIONS: �._ CITY USE ONLY Fee Schedule on Reverse Side $.50/$1,000 Valuation $600 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] SUBJECT PERMIT NO. City of Fridley 2975 AT THE TOP OF THE TWINS BUILDING PERMIT _9) r RECEIPT NO.� COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. ��/ y r PROTECTIVE i A � CITY HALL FRIDLEY 55432 NUMBEA 11EV DATE PAGE OF APPROVED By ---- L J` 612-571-3450 910-F15 6/22/99 108 ADDRESS 1560 60th Avenue NE I LEGALLOT Np 73 BLOCK TRACT OR ADDITION SEE ATTACHED oescR. • of Lot 4 1 Van Cleave's Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Wesley & Janice Long 571-0480 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO United Construction Inc. 1500 McAndrew Rd W #115 Burnsville 55337 833-2000 20160711 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 Ili REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house and garage (31 Sq) Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL. PLUMBING. HEATING. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD 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 I 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 $2709 $1.35 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 PERFORMANCE ONSTRUCTION $83 , 25 Fire SC $2.71 PLAN CHECK FEE TOTAL FEE License SC $5.00 1$92.31 SIGNAT R FCON' R R CTOROiZEDAGENT 10arE, WHEN/PROPER BL09 iNSP VALIDATED THIS IS V UR PERMIT RATE S.GNATURE OF OWNEROF OWNER BUILDER. iDATEi MAR -09-1999 1544 FROM CITY OF FRIDLEY TO 8928474 P.04i07 tvu ry L Ze' Effective 111199 ADDN [ ] CITY OF FRIDLEY %040 - /'v s/ Pn ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: Legal Description: Owner Name & Address: �5 � sA �� ko vTel. # /4/571- 0� Contractor: VlViT0. atjj MN LICENSE # kO %/ Address: -/6 -OD ;;17Z e- &d/t'6'14; IV 1,) u r'n S v i e Tel. #! /1 23 ZOOd Attach to this application, a Certificate of Survey o the 7 lot, with the proposed construction drawn on it to scale. DESCRIPTION OF E%MOVEMENT 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: $ D 7 (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE. APPLICANT: Tel. # �gl 93 ®� USE Permit Fee $ �� S Fee Schedule on Reverse Side Fire Surcharge $ i / .001 of Permit Valuation (1/10th%) State Surcharge $ $-50/$1,000 Valuation SAC Charge $ $1050 per SAC Unit License Surcharge $ 6" $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: 'A, 1 Engineering LOAD LIMIT Permit No.: 040 Department MODIFICATION APPLICATION A 763-572-3551 CITY OF FRIDLEY Received By:'___ 763-571-1287 fax EFFECTIVE 4/8/09 Date ' • APP 13 20 APPLICTATION DATE: �c 1 �d YOUR E-MAIL ADDRESS: THIS APPLICANT IS: ❑ HAULER ROPER TY OWNER ( djOAJT' CAOK- (& PROPERTY OWNER: j . ° " y -k JOB ADDRESS: % ® 1;0 MATERIAL TO BE HAULED: plZ 0— y C*soc- j /U C12A DATES TO BE HAULED (UP TO 3 DAYS): 111q 1 Ma THIS PERMIT IS ISSUED TO ALLOW AN INCREASE OF AXLE WEIGHT FROM FOUR (4) TONS PER AXEL TO (5) TONS PER AXEL OVER THE FOLLOWING DESIGNATED ROUTE: b �/T E 's-- 7-® ZoAeaw. NOTICE: This permit is valid only for vehicles enroute to construction address during the hours of 8:00 am to 5:00 pm. See Resolution #01-2004 and State Statute Section 169.87 PERMIT MUST BE IN VEHICLE WHILE HAULING ON ESTABLISHED ROUTE. NUMBER OF LOADS 1 $25 per load PERMIT FEE $ THIS IS AN APPLICATION FOR A PERMIT NOT VALID UNTIL PROCESSED I hereby apply for a load limit modification 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. I understand this isnot a permit but only an application for a permit and hauling on restricted roads is not to start without a permit. SIGNATURE OF APPLICANTJ PRINT NAME DATE APPROVED BY DATE % COPIES GIVEN TO: POL CE ❑ NGINEERING 1? fn1 01ir o ewT- PI o City of Fridley Engineering Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3551 FAX: 763-571-1287 CAL , rA) W/ cc- -ro P -fiq ,' OA) q)1q) C11r,-