PRE 2010 DOCSVillage of Fridley, 31 nn.
WELDING PFRXrr
N? 306 Office of INSPECTOR OF BUn DINGS
Owner
Architect 6 Fridley, Minn., 19
a
Builder
/ y LOCATION OF BUILDING
No. Street (�(D "� 1�C�1.C( Part of Lot
Lot Block _Addition or Sub -Division
IJCRil'TION OF BUILDING
Front • Depth height I Stories Manner of Construction
To be used as ' " & x` / To be completed f"° Estimated Coat
ly,�✓ v•si'4N�LrR:" ! •�Y k'�"V .R�..ry''„'�sQtw. �J;'�t .a,�-a*f°�F... tJ�'
Permit is hereby gamed to
the building `���'.� ` described in the above statement. This permit is granted
upon the express condition the pens do tow 'm it is granted, and his agents, employees and workmen, in all
the work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordi-
nances of Fridley, Minn., regarding the construction, alteration, maintenance, repair and moving of buildings
within the city limits, and this permit may be revoked at,,any time upoviolation of any of the provisions of said
ordinances.
6
Inspector of Buildings.
AGREEMENT AND SWORN STATEMENT
In consideration of the issue and delivery .to me by the Inspector of Buildings of Fridley of
the above permii, I hereby agree to do the proposed work in accordance with the description
above set forth and according to the provisions of the ordinances of Fridley, and, being first duly
sworn, I hereby state and say that the facts stated by me and contained in the above permit are
true as therein stated.
j, ;
Q ±a
Subscribed and sworn to before me at Fridley, Minnesota, this
a.
day ofA.D. 19 Lc F &4 A�,l
•
11
•
City of Fridley, Minn.
BUILDING PERIIIT
Date: June 16, 1965
Owner: Donald F• Hinz Builder 0•R. Anderberg C o
Address 372 66th ;Ave. N.z. Address 2923 Oakland Ave.
LOCATION OF BUILDING
No. 372 Street 66th Ave. N.E. Part of Lot
Lot Block Addition or Sub-Dividon ! 'Ce Creek Terrace
Corner Lot _ Inside Lot Setback Sideyard
Sewer Elevation Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
c2 5F® =-;)5—
N° '7905
Front Depth Height Sq. Ft Cu. Ft
Front Depth Height Sq. Ft. Cu. Ft.
Type of Construction Fst. Cost —2400__ To be Completed
Repair Storm Damage
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 et-fe an compliance with aft provisions of
ordinaaoes of the city of Fridley.,
In consideration of the payment of a fee of $ x=00 , permit is hereby grans0-11- �derbePg Co.—t'-
to construct the building or addition as described above. This Permitis 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 paw thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota location, construction, alteration, maintenance, repair and moving of buildings
within the city limits and th s permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
Allen Jensen Building r
NOTICE:
This permit don not emm the eonatreetion, IesidWiee hr wMh& plumbing, an hunting, ewer or wrier. Be sire to me
the Building impnter for apmft pwndit for thea Mem&
r -. -. :' 0
r
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME Donald V Hinz BUILDER 0. R An.derberg-Co,.
ADDRESS_ 372 - 66th Ave. N. E. ADDRESS 2923 Oakland Ave.
LOCATION OF BUILDING
No. 372 Street 66th Ave. N.R. part of, Lot
LOT BLOCK ADDITION OR SUBDIVISION
Corner Lot._Inside LOT Setback Side -Yard
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
To be 'used ass
DESCRIPTION OF BUILDING
Front Depth Height
Sq. Ft. Cu. Ft.
Front Depth T_Height
Sq. Ft. Cu. Ft.
Type of Construction__Reroof & misc. repairs Estimated Cost 2,000.00
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.
-15-65
(Schedule of Fee Costs can be found on the Reverse Side).
M1MMASCO
53 -8b -S -915.51
Cil y of Fridley
Appli6c'eTnor P1e>rning cmd �1�y •j Nit
Dopt. of Bldoz. Phone 560-3450
DESCRIPTION OF WOr.�i. 372 N. F. 66th, Ave,
Hurnbor, Kind and LocrSion of Fixtures Lola
Y
o
N
N
S3
�
°s
W
7<
N
�
7
�
0
N
WATER MTII.
GAS
EEG
:r
Istll
RaAge
d
3
t
rut=* ConaoCIL-n Openings Consoc:od wiYis
f•Ymsser
New Fixture, Old Openings Cccapool C]
PARTIAL RATE SCHEDULE
.UMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures ................ x $2.00 $
Future Fixture Opening ............ x $1.50 $ _.
New Fixture Old Opening ......e x $1.50 $--
Catch Basin .................... x $3.25 $
Water Beater '.lip to 99,000 BTU) . • .. x 13.00 $
New Ground Run Old Bldg....... x $3.25 3
Electric Water Heater........... a $2.W S
A.S FITTING FEES: NO. RATE TOTAL
City of Fridley:
The undersigned hereby makes application for a permit for the work herei
specified, agreeing to do all work in strict accordance with the City Ordinance
and ruling of the Department of Buildings, and hereby declares that all the fact
and representations stated in this application are true and correct
Fridley, Minn 12-10-75 19..
Owner Donald V. Hinz
Kind of Building Frame
Used as Res.
To be completed about 12-17-75
Estimated Cost,. $ 1.0,00
Old-->lQnrxZuilding Permit No. Permit N �
Signed
By MINNEGATO
Business Phone No
ROUGH -
FINAL _& , -t - 7 (-, .
lst 3 Fixtures ............ • • • • • • x S2.00 $
Additional Fixtures ................ x $ .75 $
v
Gas Range to 199.000 BTU ........... • 1 x $5.00 $ 5•
HAIRS is ALTERATIONS—Rater to Code .50 State Surcharge
Description .......................................
• TtJrTAL ) EE • 0 '
;Class "fiF Surcharge .500
SUBJECT
City of Fridley20343
AT THE TOP OF THE TWINS
BUILDING P E R M I T
i
RECEIPT NO.
_ COMMUNITY DEVELOPMENT DIV.
v
r PROTECTIVE INSPECTION SEC.
CITY HALL FRIDLEY 55432
NUMBER
REV
GATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
5/8/90
JOB ADDRESS 372 ^ 66th. Avenue Ns E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
10
3
Rice Creek Terrace Plat 2 SHEET
2 PROPERTY OWNER MAIL ADDRESS PHONE
ZIP 571-2224
Elsie Ruck 372 R 66th. Avenue N.E.
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 ❑ ADDITION ❑ ALTERATION QA REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroo£ Dwelling (:20 Squares)
9 CHANGE OF USE FROM TO
STIPULATIONS
Roof can he the 2nd layer but not the 3rd. install ridged galvanized
valley..
On all new roofs or tear-offs
and replacement roft
State, Code requires
that 2 layers of 15 lb, felt,
moppd. together,
be installed to a point 24 inches
UP from exterior
wall line, or the use of other
approved underlayment
membrane.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
ZONING
SO. FT.
CU. FT.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 80 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
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
$1,000
$.50
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
PERMIT FEE
SAC CHARGE
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$25.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
$25.50
OF CONTRACTOR AUUTHHORRIIIZZED AGENT IDDATEii�
HEN PROPERLY IDATED THIS IS YOUR PERMIT
/ySIGNATURE
J/ROOR
rte,
BLDG IN P lAT
SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI
NEW [ ] Effective 1/1/90
ADEN [ ] R-1 AND R-2
ALTER [ ] Building Permit Application
Construction Address:
t) "R (' & -f tj
Legal Description: —L6)7- l o _ � -3, A -A -
owner Name & Address: - - 1 > e v s ► --e Tel. # i
Contractor: v v - v 0.%J et.� v Tel. # � 3S z� s-/?
Address: 2
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVIIG AREA: Length Width Height Sq. Ft.
GARAGE AIM: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER: k-, a ej.Sgvr�--�
Corner Lot [ ] Inside Lot Ft. Yd Setback Side Yard Setbacks
Type of Construction: 0 �r o o :E . Estimated Cost: $ 9 �%
Approx. Completion Date: ,�5- - A 7
Proposed Driveway Width If New Opening Is Desired: Ft. $ $
idth + 6' See Back Page
DATE: APPISCANT:fliiJ�, Tel . #
Permit Fee $ o;� 5-, 0 O
State Su charge $ 4-6
SAC Charge $
Driveway Escrow $
Park Fee $
Sewer Main Charge $
STIPUTATIMS:
CITY USE ONLY
Fee Schedule on Reverse Side
$.50/$1,000 Valuation
$600 per SAC Unit
Alt. "A" or Alt. "B" Above
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
SUBJECT
PER��26$`
City of Fridley
AT THE TOP OF THE TWINS
BUILDING PERMIT
i ?
RECEIPT NO.
_ COMMUNITY DEVELOPMENT DIV.
fr PROTECTIVE INSPECTION SEC.
3 0_3
i
CITY HALL FRIDLEY 55432
�l..__.Jl•'
NUMBER
REV
DATE
PAGE OF
APPROVED BY
'•� 612-571-3450
910-F15
4/8/92
/ /
JOB ADDRESS 372 - 66th Avenue NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
10
3
Rice Creek Terrace Plat 2 SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Elsie Buck 372 - 66th Avenue NE 571-2224
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.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW C�7 ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 211 x 10' Garage and a 12i x 10t Uncovered Deck
9 CHANGE OF USE FROM TO
STIPULATIONS See.notations. on plan, Provide.a hard surface driveway, No roof over.
deck without variance approval -- added.charge if porch varian�� roof
added,
Before digging call for
all utility locations
454-0002
REQUIRED BY LAIN
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
ZONING
SO. 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
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
$47227
$2,11
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
PERMIT FEE
SAC CHARGE
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$81.00
Fire SC $4,23
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
$92,34
SISipN AT�OFCO RArDRyOR ORIZED A ENT IDATEi
HENRO ERY ALI TED THIS IS YOUR PERMI %
B D INSP f1ATE
SIGNATURE OF OWNER (IF OWNER BUILDERI IDATEI
NFW F I Effective 3/1/92
ADDN CITY OF FRIDLEY
ALTER SINGLE -FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Construction Address: -57)0, b 6 1 0 �
Legal Description:
Owner Name & Address: S Tel. #
W vi ly 16'U _(V )a (11
Contractor: MN LICENSE #
Address:
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Attach to this application, a Certificate of Survey of the
K with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height
Length a I Width Height
Length I a, Width /0 _ HgtlGround,
Sq. Ft.
Sq. Ft.
Sq. Ft. 2 0
Comer Lot [ ] Inside Lot 0] Ft. Yd Setback Side Yard Setbacks
Type of Construction: L- I j2,, C(JY C_L Estimated Cost: $
Approx. Completion Date:
Driveway Curb Cut Width Needed:
DATE: APPLICANT:
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Park Fee
Sewer Main Charge
Ft. + 6 Ft =
(Cost on Back)
Ft x $ = $
Tel. #
CITY USE ONLY
$_ e/,. 6 Fee Schedule on Reverse Side
$ .001 of Permit Valuation (1/10th%)
$ 2, t 1 $.501$1,000 Valuation
$ $700 per SAC Unit
$ 0 $5.00. (State Licensed Residential Contractors)
$ Alt. "A" or Alt. "B" Above
TOTAL $2,31
STIPULATIONS:
Fee Determined by Engineering
Agreement Necessary t I Not Necessary [ ]
01
SUBJECT
P NO.
City of Fridley
21732
AT THE TOP OF THE TWINS
BUILDING PERMIT
i
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
v PROTECTIVE INSPECTION SEC.
r
t
NUMBER
REV
GATE
PAGE OF
APPROVED BY
i CITY HALL FRIDLEY 55432
612-571-3450
910-F15
12/9/93
JOB ADDRESS 372 - 66th Avenue NE
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
10
3
Rice Creek Terrace Plat 2 SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Elsie Buck 372 - 66th Avenue NE 571-2224
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.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW � ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a porch over an ex.is, ing deck: 10' x 12'
9 CHANGEOFUSEFROM 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
MOT.
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
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
$1,848
$.92
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-
$43.00
Fire SC $1,84
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
$45.76
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE)
HE P"RLPVAVD#7ED THIS IS YOUR PERMIT
BLDG INP DATE
SIGNATURE OF OWNERIIF OWNER BUILDER) (DATE)Z
01
:: acw; •: ::::::::,;•:..: -. .)0 00;::q.;.p Yc`t:-..(: .. ,i.-..•:OVc.: •:.:::,.�: •�:: (:c:i�•>•:�av:,. • 0000... .. •1, . . • • . • .. .• ..• . .. •.• .. 0,100.1'11 0-10 0 0..0 0........ ,. .,: q.:..� ...i, ...
NEW [ ] Effective 3/1/92
ADDN [ ] CITY OF FRIDLEY
ALTER[ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Construction Address: a 9z C e'�
Legal Description:
Owner Name & A
Contractor:
Address:
Tel. # -,71 �
MN LICENSE #
Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF E"ROVEIVIENT
LIVING AREA: Length Width
GARAGE AREA: Length Width
DECK AREA: Length Width _
OTHER: --Po4 6-�� . /
/nn d3 '
Corner Lot [ ] inside Lot Ft. Yd Set6ck Side Yard Setbacks
Type of Construction: Estimated Cost: $ Ag -le, 0®
Approx. Completion Date:
Driveway Curb Cut Width Needed: Ft. + 6 Ft =
Height
Height
Het/Ground
Sq. Ft.
Sq. Ft.
Sq. Ft.
Ft x $
(Cost on Back)
DATE: - - APPLICANT: Tel. #
Permit Fee $ 3 0
Fire Surcharge $ / ,
State Surcharge $ /
SAC Charge $ —�
License Surcharge $
Driveway Escrow $ -
Park Fee $ C!�!r
Sewer Main Charge $ j!�r
TOTAL $ "�
STIPULATIONS:
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$700 per SAC Unit
$5.00. (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
Oil
SUBJECT
PERMI
City of Fridley�-7
510
AT THE TOP OF THE TWINS
BUILDING
PERMIT
•
RECEIPT NO.
�ti. ------ COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
r � �
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910415
9198
JOB ADDRESS
372 66th Avenue E
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
10
3
Rice Creek Terrace Plat 2
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP
PHONE
Jim Boynton
586-0792
3 CONTRACTOR MAIL ADDRESS
ZIP
PHONE LICENSE NO
Town & Country Roofing 9403 Minnesota Ln N Maple Grove
55369
545-4233
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 a REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof house and garage (23.33 Sq) Tear -off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
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
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
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$2056.80
$1.03
DOES NOT PRESUME TO GIVE AUTHORIT O VI ATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LO AL W REGULATING CON-
STRUC ION OR THE PERFORMANCE OF STR TION.
$74.75
Fire C 2.06
•
PLAN CHECK FEE
TOTAL EE
6SIGNATURE
LIce
5.0
82.84
ONTRA O ORA T RIZE GENT IDA EI
EN P OP
FirmINSP
A
DAT HIS IS Y PER IT
r
TATE
SiGNATUREOF OWNERUF OWNER BUILDERI iDATEi�Zfl
Oil
PLG -13-1998 08:42 FROM CITY OF FRIDLEY TO 8589320 P.01/02
r LWUVC 1/1/Jb
ADDN j ] CITY OF FRIDLEY
ALTS l SINGLE FAMELY AND DUPLEXES R-1 AND R-2 / �u
BUILDING PERMT APPLICATION /l
ConsonrctionAddress:
Legal Description:
Owner Name & Address: `S t yn jQjbjj.3-? UK Au -e SSE Tel. #
Contractor: MN LICENSE #��
Address: Te1. #�
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF ndpROVEMENT
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: $- U gr)1.-%te
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft a Ft x $ W _ _ = S
DATE: APPLICANT: Tel.
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
. STIPULATIONS:
$ %, Fee Schedule on Reverse Side
$ >� .001 of Permit Valuation (1/10th%)
$ O $.501$1,000 Valuation
$ $1000 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 ( ]
$