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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 ( ] $