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PRE 2010 DOCSN° 8�8 0 . Village of Fridley, Mian. BUHMING PERMW Office of INSPECTOR OF BUILDINGS Owner, ii Architect i Builder Fridley, r LOCATION OF BUILDING NO— r Street 66 zkPart of Lot Lot Block`Addition or Sub -Division DESCRIPTION OF BUILDING Front, Depth - Height Stories ' Manner of Construction-1�'- To be used as °<. r•' c �';: , ,p e x To be completed ��" � � Estimated Coat Permit is hereby granted tom to 277,--c - c f the building described in the above statement. This permit is granted upon the express condition that the person to whom 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 upon violation of any of the provisions of said ordinances. �EJ1--, +~ = " f�` �` a ctor 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 permits I hereby agree to do the proposed work in accordance with the description above set forth acid 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. Subscribed and sworn to before me at Fridley, Minnesota,, this day o "' .D. 19 ®'� ,:__,.<_ • O Ci City of Fridley, Minn. BUILDING PERMIT Date: August 4, 1965 � -Z' ! 9' "�; 7 N? 8308 Owner: ALTON BRANDEN Builder H. J. BLGISTRAND & SONS, INC. Address 552 - 66th Ave. N. E. Address 1220 Arcade Street Fridley, Minnesota St. Paul, Minnesota LOCATION OF BUILDING No. 552 street 66TH AVENUE N. E. Part of Lot Lot 4 Block Addition or Sub -Division Reargt. of bots 1-2-3 Re Cr Terre Corner Lot _ Inside Lot Setback Sewer Elevation To be Used as: Sideyard Foundation Elevation DESCRIPTION OF BUILDING Front Depth Height Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Est. Cost � $5, 000 o 00 To be Completed Repairs - Storm Damage In consideration of the issuance to me of a permit to construct the building described above I agree to do theproposed work in accordance with the description above set forth and in compliance with afl provisions of ordinances oP the city of Fridley. In consideration of the payment of a fee of $ 10.00 , permit is hereby granted to H.J . BLCl,STRAND & SONS, INC 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, ffi all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesotagg location, construction, alteration, maintenance, repair and moving of buildings within city limits this permit may be revoked at any time upon violation of any of the provisions of sold ordinances. ALLEN G. JENSEN NOTICE: 06 pencil don not cner the comtmatbop, wee for wkb& plumbies, an h*dl , awn or water. Be s m to ae Na Building bgwdw for aeparato pmft for Nus Mena. CITY OF FRIDLEY APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES PARTIAL RATE SCHEDULE ���'��, ), GRAVITY WARM AIR: RATE TOTAL Job Address Furnace Shell & Duct Work $12.00 $ Replacement of Furnace 7.00 7.00 $ $ Department of Buildings Repairs & Alteration, -up to $500.00 4.00 $ City of Fridley Repairs & Alterations each add. $500.00 Tel. #571-3450 hIECHANICAL R'ARDi AIR: The undersigned hereby makes application for a permit for the work herein Furnace Shell & Duct Work to 100,000 BTU $12.00 $4`J specified agreeing to do all work in strict accordance with the City Codes 4.00 $ and rulings of the Department of Buildings, and hereby declares that all the each add. 50,000 BTU 7.00 $ facts and representations stated in this application are true and correct. Replacement of Furnace Repairs & Alterations -up to $500.00 7.00 4.00 $ $ Fridley, Minn. . 19_ Repairs & Alterations each add. $500.00 STEAM OR HOT WATER SYSTEM: OWNER a i 07 , Z %B ® 0 -J0' /_. Boiler & Lines up to 100,000 BTU $12.00 $ KIND OF BUILDING 9,4", each addn. 50,000 BTU 4.00 $ Boiler only up to 100,000 BTU 7.00 $ USED AS each addn. 50,000 BTU 6.00 $ TO BE COMPLETED ABOUT OIL BURNER- to 3 gal. per hour $10.00 $ each add. 3 gal. per hour 10.00 $ ESTIMATED COST � o 0- a CD GAS BURNER- from 100,600 BTU to 199,999 BTU $10.00 $ LD " O - NEW BUILDING PERMIT NO. PERMIT NO.. v (over 199,999 BTU see Fee Schedule) $ GAS FITTING FEES: lst 3 Fixtures x $ 3.00 $ DESCRIPTION OF FURNACE/BURNER Additional Fixtures x $ 1.00 $ Gas Range to 199,000 BTU x $10.00 $ HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. AIR CONDITIONING $Size No. voae> Trade Name /� `moi �� f : C' y FAN HEATING SYSTEMS See Fee Schedule VENTILATING SYSTEMS $ $ o Capacity Q O O Sq. Ft. EDR BTU (�� O O © HP /.2- ALTERATIONS $ REPAIRS State Surcharge $ $ .50 Total Connected Load A a Kind of Fuel A)rY&,G 9AS TOTAL FEE $-/9—. _6:__0 BURNER - Trade Name Size No. ROUGH INSP. REINSPECTION FEE Capacity Sq. Ft. EDR BTU HP Date (.$10.00) FINAL INSP. ® '^ Company Date Signed By APPROVAL FOR PERMIT p Tel. No. 7 i l'a 7 1 MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50 J - $12.00 CITY OF FRIDLEY APPLICATION FOR 1 POWER PLANTS AND HEATING. COOLING, VENTILATION, REFRIGERATION AND Boiler only up to 100,000 BTU AIR CONDITIONING SYSTEMS AND DEVICES PARTIAL RATE SCHEDULE $ OIL BURNER- to 3 gal. per hour $10.00 $ each add. 3 gal. per hour 10.00 25,'to� GRAVITY WAR:'I AIR: RATE TOTAL Job Address Furn ace• Shell & Duct Work $12.00 $ Replacement of Furnace 7.00 7.00 $ $ Department of Buildings Repairs & Alterations -up to $500.00 4.00 $ City of Fridley Repairs & Alterations each add. $500.00 $ AIR CONDITIONING �} Tel. #571-3450 ?fECHANICAL WARM AIR: Furnace Shell & Duct Work to 100,000 BTU each add. 50,000 BiJ Reolace.*rent of Furnace Repairs & Alterations -up to $500.00 Repairs & Alterations each add. $500.00 STEk\1 OR HOT WATER Sl7S-101: The undersigned hereby makes application for a permit for the work herein $12.00 $ specified agreeing to do all work in strict accordance with the City Codes 4.00 $ and rulings of the Department of Buildings, and hereby declares that all the 7.00 $ facts and representations stated in this application are true and correct.. / 7.00 $ 4.00 $ Fridley, Minn. Boiler &Lines up to 100,000 BTU $12.00 $ each ad n. 50,000 BTU 4.00 $ Boiler only up to 100,000 BTU 7.00 $ each addn. 50,000 BTU 6.00 $ OIL BURNER- to 3 gal. per hour $10.00 $ each add. 3 gal. per hour 10.00 $ GAS BURNER- From 100,000 BTU to 199,999 BTU $10.00 $ M. (over 199,999 B—.i see Fee Schedule) $ GAS FITTING FEES: ist 3 Fixtures x $ 3.00 $ 5 6-0 Additional Fixtures x $ 1.00 $ Gas Range to 199,000 BTU x $10.00 $ AIR CONDITIONING �} $ FAN HEATING SYSTEMS See Fee Schedule $ VENTILATING SYSTEMS \ $ ALTERATION'S & REPAIRS- J $ State Surcharge $ .50 TOTAL FEE $ _ r1 OWNER t� KIND OF BUILDING USED AS LSC ) TO BE COMPLETED ABOUT ESTIMATED COST ✓ ® �` OLD NEW BUILDING PERMIT NO. PERMIT NO. DESCRIPTION OF FURNACE/BURNER HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. Trade Name O�� L Size No. Capacity Total Connected Load BURNER - Trade Name Sq. Ft. EDR BTU &I d_tV HP Kind of Fuel Size No. ROUGH INSP. REINSPECTION FEE Capacity Sq. Ft. EDR ____ BTU HP Date (.$10.00) Company d _ FINAL. _INSP. Dat Signed By 1l APPROVAL FOR PERMIT Tel. No. 7�� MINL%:UM FEE FOR ANY HEATIInG PERMIT IS $7.50 City of Fridley SUBJECT PERM14295 AT THE TOP OF THE TWINS PERMIT i BUILDING R CEIPT N ' COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. ' 1 � ; CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-560-3450 910-F15 8/17/77 JOB ADDRESS 552 66th Avenue N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 1-3 Bl. 1 & 1,2,3 Bl. Rice Creek Terrace Plat 2 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE William Bonner 552 - 66th Avenue N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Sawhorse Construction 2001 Laramie Tr. Br. Park 561-1408 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 a ❑ NEW X ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 14' x 12' Addition to Dwelling 9 CHANGEOFUSEFROM TO STIPULATIONS WPINfNC9 Tete � /N Before digging Call local utilities AC . ACCi� :OF CRY imp flA is W ��' 10S ,t Yl Na TELEPHONE - ELECTRIC - GAS Etc. v u R S'. ULD rk o P91ON THe t REQUIRED BY LAW d� ��asrrE SEPERATE PERMITS REQUIED FOR WIRING, HEATING, PLUMBING AND SIGNS. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. Wood Frame 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 R-1 168 2016 ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING '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 $3,795 $1.90 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- STRUCTIO OR E PERFORMAN CONSTRUCTION. $8.06 L-7 /71 PLAN CHECK FEE LFEE6 TOT$99 l SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) EN PROP RL1Y '/ALJ E HIS IS YOUR PERMIT • �'� y DG. )NSP DATE SIGNATURE OF OWNER IIF OWNER BUILDER) )DAT - n CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL BUILDING PEhMITS (NEW, ALTERATIONS, ADDITIONS, OR REPAIRS) OWNER: A, iL..l_-.Lracan ® BUILDER: Address: (n (� �i�L-(\) Address: ®(� 1 �F-12�r�- � 1 L=. sZ r RK Tel. No. '=4. -� No.: �z Street: • %Z�-`06L a4 LciT /} _ LOT: . Z BLOCK: `` ADDITION: 121 o C G ��- ►� ��CZiZ C�� Y� r ,' CORNER LOT: INSIDE IAT: SETBACK: SIDEYARDS: 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.. ►L� (?Lx� Front: `f Depth: I Height: I Z Square Feet: M) Cubic Feet: .0/ Front: Depth: Height: Square Feet: Cubic Feet: Type of Construction: Estimated Cost: $ To Be Completed: 0 C -T 3O Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired - $ $ (SEE REVERSE SIDE OF SHEET) 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. See reverse side for additional information. DATE: IB/I(" I -n SIGNATURE: Stipulations: �B4OG 4 '?6- CITY OF FRIDLEY APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION•AND • AIR CONDITIONING SYSTEMS AND DEVICES PARTIAL RATE SCHEDULE $ Replacement of Furnace GRAVITY WARM AIR: RATE TOTAL Job Address Furnace Shell & Duct Work $12.00 7.00 $ $ Repairs & Alterations each add. $500.00 Replacement of Furnace 7.00 $ Department of Buildings Repairs & Alterations -up to $500.00 4.00 $ City of Fridley Repairs & Alterations each add. $500.00 each addn. 50,000 BTU Tel. #571-3450 MECHANICAL WARM AIR: AIR CONDITIONING FAN HEATING SYSTEMS VENTILATING SYSTEIMS .ALTERATIONS $ REPAIRS ROUGH IMP. Date FINAL INSP. Date ►� APPROVAL FOR PERMIT $ See Fee Schedule $ S State Surcharge $ .50 TOTAL FEE $_Z'W 0 REINSPECTION FEE 11046,0 ($10.00) MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE 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. 11-15--72 , 19_ OWNER KIND OF BUILDING USED AS TO BE COMPLETED ABOUT ESTIMATED COST OLD - NEW BUILDING PERMIT NO. PERMIT NO. DESCRIPTION OF FURNACE/BURNER HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. Trade Name Size No. Capacity Sq. Ft. EDR BTU HP Total Connected Load Kind of Fuel BURNER - Trade Name Size No. Capacity Sq. Ft. EDR p QyBTU HP Company Signed By Tel. No. Furnace Shell & Duct Work to 100,000 BTU $12.00 $ each add. 50,000 BTU 4.00 $ Replacement of Furnace 7.00• 7.00. $ $'V Repairs & Alterations -up to $500.00 Repairs & Alterations each add. $500.00 4.00 $ S EN161 OR HOT WATER SYSMI: Bailer & Lines up to 100,000 BTU $12.00 $ each addn. 50,000 BTU 4.00 $ Boiler only up to 100,000 BTU 7.00 $ each addn. 50,000 BTU 6.00 $ OIL BURNER- to 3 gal. per hour $10.00 $ each add. 3 gal. per hour 10.00 $ GAS BURNER- from 100,000 BTU to 199,999 BTU $10.00 $ (over 199,999 BTU see Fee Schedule) $ GAS FITTING FEES: 1st 3 Fixtures x $ 3.00 $ Additional Fixtures x $ 1.00 $ Gas Range to 199,000 BTU x $10.00• $ AIR CONDITIONING FAN HEATING SYSTEMS VENTILATING SYSTEIMS .ALTERATIONS $ REPAIRS ROUGH IMP. Date FINAL INSP. Date ►� APPROVAL FOR PERMIT $ See Fee Schedule $ S State Surcharge $ .50 TOTAL FEE $_Z'W 0 REINSPECTION FEE 11046,0 ($10.00) MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE 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. 11-15--72 , 19_ OWNER KIND OF BUILDING USED AS TO BE COMPLETED ABOUT ESTIMATED COST OLD - NEW BUILDING PERMIT NO. PERMIT NO. DESCRIPTION OF FURNACE/BURNER HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. Trade Name Size No. Capacity Sq. Ft. EDR BTU HP Total Connected Load Kind of Fuel BURNER - Trade Name Size No. Capacity Sq. Ft. EDR p QyBTU HP Company Signed By Tel. No. SUBJECT IT_ s M City of Fridley 7:214 6 6 AT THE TOP OF THE TWINS BUILDING PERMIT i � R COMMUNITY DEVELOPMENT DIV. _ fr PROTECTIVE INSPECTION SEC. /1 CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY A 612-571-3450 910-F15 7/29/92 JOB ADDRESS 552 - 66th Avenue NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 4 1 1 Rearrangement of Lots 1,2,3, Rice Creek TeryEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Bill Bonner 552 , 66th. Avenue NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. All American Roof ing- Remodelin 1427 poppyseed 5160 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 786-6676 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 Reroo£ House & Garage C26 Scquaresl Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with.State Building Code. 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 $� $• 69 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT IF 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- $33.00 Fire SC $1.38 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE 11 , License SC $5.00 $ 40.07 SI N TURE OF CONTRACTOR OR AUTHORIZED AGENT (DATEI HEN O LY VAIIID D THIS IS YOUR PERMIT BLDG )NSP DATE SiGNATURE OF OWNER iIF OWNER BUILDER) IDATEi NEW [ ] Effective 3/1192 ADDN [ ] CITY OF FRIDLEY ALTER [ j SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: Legal Description: SD OF L0775 /, -? 3, Owner Name & Address: a , L_ I -j o -n n- e r Tel. # Contractor: piu-A e nc-P tJ R'��i ii1)(2- Pepmc)Ae( (n (� MN LICENSE # , d Address: ) �{�� pop p4 se eg f,+0 -n- Tel. # 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: f e u 5 e a e o2 to s 6 -Fe C� - of F Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback _ Type of Construction: E, I� e� a s s Approx. Completion Date: )JL4 t_9 2- Driveway Curb Cut Width Needed: Ft. + b Ft = Side Yard Setbacks Estimated Cost: $ -e-�rc�- /,.319�3 to (Cost on Back) Ft x $ _ $ DATE: APPLICANT: P S p t f +r 5 r 4 C Tel. # Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge $ i, 3 $ te9 $ 00 Driveway Escrow $. Park Fee $ Sewer Main Charge $ TOTAL STIPULATIONS: C11Y 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 [ j Not Necessary [ j CITY OF FRIDLEY PERMIT NO.: 2004-02138 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: (763) 572-3604 FAX: (763) 571-1287 PRINTED WITHOUT ISSUING 11/19/2004 ADDRESS : 552 66 AVE NE PIN : 143024130004 LEGAL DESC : UNAVAILABLE : LOT BLOCK PERMIT TYPE : BUILDING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION : $ 21,000.00 NOTE: SEE NOTATIONS ON PLAN. CALL GOPHER STATE ONE AT 651-454-0002 FOR UTILITY LOCATIONS. PROVIDE SMOKE DETECTORS IN ALL SLEEPING ROOMS AND ON ALL LEVELS OF THE DWELLING PER R317 OF THE 2000 INTERNATIONAL RESIDENTIAL CODE. APPLICANT BUILDING PERMIT FEE 335.25 SPOTLESS&SEAMLESS EXTERIOES FIRE SURCHARGE 21.00 STATE SURCHARGE, VALUE 10.50 (612) 237-5209 TOTAL 366.75 OWNER BONNER WILLIAM J JR & R R 552 66TH AVE NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions Of any o er state or local law regulating constructi or the p rform ce of construction. Applicant Date Bldg IrisVACjZ&44 1344/ SEPARATE PERMITS REQU FOR WORK OTHER THAN DESCRIBED ABOVE. 1' NEW [ ] CITY OF FRIDLEY tttective 4111zuu4 ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION qq IRR1nryp Construction Address: Legal Description: Owner Name 8 Address: Q Tel. #L S `l l - t 2�j Contractor. MN LICENSE # Z®4 �R lq q 6 Address: \11' 't �lb�`` i 1.� i � oe (yn0 SS%tt Tel. # rot2) 23x1-52-0.C� LMNG AREA: GARAGE AREA: DECK AREA: OTHER: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT ' Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length Width Hgt/Ground Sq. Ft Construction Type: 9- - AWestimated Cost: $ Driveway Curb Cut Width Needed: FL + 6 Ft = Ft x $ —=$ DATE: APPLICANT: Tel. # Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call you for card number. .DEITY USE ONLY - TOTAL $ ei Z o STIPULATIONS: Z.Z 3 • �� Permit Fee -- Fee Schedule on Reverse Side Plan Review — 65% of Permit Fee Fire Surcharge $��, Grp .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $1350 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Curb Cut 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 [ J TOTAL $ ei Z o STIPULATIONS: