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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT Date: Owner: Address (:4978 Builder Address _.._.._.... LOCAT NOF IJII ING No..... A�?. ... Street _.._ � .......--;WV -4f. Part ..-..__.- Addition Sub -Division or Sub -Din ....._.... w .........._......-. Block ....._........__._ ......................... _. .,..►�.�......_...�_. Lot .��.:����.._...__.........__-��t Corner Lot... ................_...._........ Inside Lot ....._..-gip_.-.... Setback ..1�..._........_..._........ Sideyard .6. ...................... Sewer Elevation ... _..................................... _......._...._......._...._......._...._....._. Foundation Elevation DESCRIPTION OF BUILDING To be Used �,/ �r f�//� C� QQ�` - fC Sq. Ft. _. �r7 Cu. Ft�i[% c e -- - ---- ----•-_-.: _ Front _._ ---- f-_ Depth .-- - Height .. .. .-- / ++�� / - - .,�+........ Front. Depth .... fighter)../:..._.. Sq. Ft.....�..... Cu. F't..wr�_.0 Type Construction .......wr"�L.... Est. Cos ........44 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. In consideration of the payment of a fee of $..09�' '" —, permit is hereby granted to....._......_ ..................... _.......... ... r�._...._...__.. _ _._�_...._ 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 done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at anyupon violation 6biny of the provisions of said ordinances. ,d.,A?A ,l Building Inspector NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these items. 4 Owners E Address APPLICATION FOR BUILDING PERNIT CITY OF FRIDLEY, KMWOTA LOCATION OF BUILDING No. f Street1� , r , � ,P&r t of Lot Lot '3 BlockAddition or Sub.Div. Corner Lot= ide Lot Set Back ,� Side -Yard SEWER ELEVATION „ Fb, FOUNDATION ELEVATION _ j Applicant attach to this form Certificate of Survey of Lot and proposed building location. DESCRIPTION OF BUILDING To be used as: . Fron � � Depth Sq. Ft. Ou. Ft. y� 0 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 Ordinances and ruling of the Department of Buildings, and hereby declares thaA all the facts and representa- tions stated in this application are true and rrAa DATZ 16 --pi O SIGNATURE (A Schedule of Fee costs can be found on the Reverse Side.) 61f 3 AppReation for Power Plants and Heating, Cooling, Ventilation. Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE Dept. of Bldgs. Phone SII 4-74470 GRAVITY WARM AIR: RATE TOTAL Location 61`(/(7 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 $ D 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. IDA 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 $ /,,5_20 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 FEE $T REMARKS: 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, Minn- �--�/"1 6 - 1 Ce �-Ja - i��✓.r�/�� Kind of Used as To be completed about Estimated Cost, $ Old Building Permit No. DESCRIPTION OF WORK HEATING or POWERPLANTS—Stearn, Hot Water, Warm Air—No� Trade Name lett 4"k Size No-%'� Capacity Sq. Ft. E.D.R ®o BTU H.P. Total Connected Load 3 ,�,�� Kind of Fuel BURNER — Trade Name— Size No a Capacity Sq. Ft. E.D.R BTU H.P. SUBURBAN HEATING & SHEET METAL 8419 CENTER DRIVE N. E, Signed MINNEAPOLIS 21, MINk By 11 POST IM -12-58 Business Phone No $l/ �� D-56 a 2 HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS Weatherstrips A.S.H.V.E. Construction No. Guide Windows I Doors Reference Out. Wall Int. Wall Ceiling Roof Floor e No No 1— FI_I Rnnm 11.nnof6 /i W;rlltlk /a/ 14nioht C7/ II 1 FII Windows a� Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane llghte of crack sq. ft. Ay/ 3A / /o.L APe Width Height No. of Lineal ft. Area No. of Dane of Dane lights of crack sq. ft. 2t ,WL Exp. wall Coef. Btu Infiltration Infiltration Coef.1 Btu Infiltration O Net exp. wall !(� 2,Z Glass S, Ceiling 4416 Z Exp. wall Int. wall Net exp. wall D A0,6-2, Int. wall Ceiling /p d Floor 1 otal Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area / FI 1.4-.•i 10 --,f-R.,. — I I e..�. MA&L e./ indows and Doors—Crackage and Area Btu Width Height No. of Lineal ft. Area No. of pane of pane llghte of crack sq. ft. Ay/ 3A / /o.L APe j yax 0 Exp. wall Coef. Btu Infiltration Infiltration Glass .2020 Exp. wall O Net exp. wall !(� 2,Z Int. wall S, Ceiling O p O Floor Int. wall l otal 13tu. 1.21,0754 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area / FI I laf t --- DL W.J.L -l/ Ll—:—L.&, Windows / Windows and Doors—Crackage and Area Btu Width Height No. of Lineal ft. Area No. of pane of pane lights of crack eq. it. Ay/ 3A / /o.L APe Glass r Exp. wall Coef. Btu Coef. Btu Infiltration p! .2020 Glass O Floor Exp. wall Total Btu. S, Net exp. wall O p O p .p Int. wall Ceiling Floor Tbtal Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Windows and 1 Width H, NO. Of pane Of, r I 1 3flpa Z FRIDLEY, MINN. Insulation Kind a How Applied Room I Length ( Width / / Height / ora—Crackage andArea ht No. of Lineal fL Area no lights of crack sq. ft Coef. Btu Infiltration 70 Glass r Exp. wall Coef. Btu Net exp. wall O Int. wall -4415� Ceiling O Floor p Total Btu. S, Required sq. ft. E.D.R. or sq. ins. W.A. Leader area O p O / Fl.l fie®,® Room I Length /3 r Width //J / Height 92 01 Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane llghte of crack sq. ft. 70 Coef. Btu Infiltration O Glass -4415� Exp. wall Net exp. wall p Int. wall Ceiling Ej O p O Floor Total Btu. Required sq. ft. E.D.R. or sq. iris. W.A. Leader area I El I n___ 1 r __—L / .e i Ql:.raL C/i U—:—L. tZ/ Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. 70 Coef. Btu Infiltration rf, O Glass Exp. wall y Net exp. wall p Int, wall Ceiling a Floor 1 otal btu. a Required sq. ft. E.D.R. or aa. ins. WA. Leader area I /'_ J6� City of Fridley Application for Plumbing and Gas Fitting Permit DESCRIPTION OF WORK Number, Kind and Location of Fixtures PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... x $1.50 $/o s-0 Future Fixture Opening ................ .2 x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ...... ..................... x 3.25 �U' Water Heater (Up to 200,000 BTU) ...... x 2.00 $ y x 3.25 $ 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 z 7u (Jj • F • N WATER HTR. GAS ELEC. y�Z 3 Qi m YI 3 h C LL LL O u GO 3 U� G U� ii O Base 1st 2nd 3rd 4th • Future Connection Openings Connected with I Sewer New .Fixture, Old Openings Cesspool � PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... x $1.50 $/o s-0 Future Fixture Opening ................ .2 x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ...... ..................... x 3.25 $ Water Heater (Up to 200,000 BTU) ...... x 2.00 $ New Ground Run Old Bldg . ............ x 3.25 $ 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 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL FEE $� Dept. of Bldgs, hone SII . - 2-_ YZ/ City of Fridley: The undersigned hereby makes application for a permit for the work here! 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. a ,-Fridley , .Minn Owner 0 Kind of Building Used as To be completed about — Estimated Cost, $ Old New. uilding Permit //;'62 a- 20 -G ROUGH , 2 - 9 A - to FINAL Business Phone • • City of Fridley, Minn. BUR DING PERMIT Date: June 23 ., 1965 Owner: Floyd Johnson Builder N° 8005 L. W. Samuelson Constr. Co. Address 861 66 Avenue N. E. Address 7800 E. River Road N. E. LOCATION OF BUILDING No. 861 Street 66th Avenue N. E. part of Lot Lot 3 Block l Addition or Sub-Dtvwon Meadowlandsx Add. Corner Lot _ Inside Lot setback sideyard Sewer Elevation Foundation Elevation To be Used as: DESCRIPTION OF BUILDING Front Depth Height Sq. Ft. Cu. Ft. Front Depth Sleight Sq. Ft. Cu. Ft. Type of Construction Est. Cost $3,475-00 To be Completed Storm damage repair X"' In consideration of the issuance to me of a permit to construct b above to do the proposed work in accordance with the description above set f ce with provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of 1S 0' . _y permit is hereby granted to 00 L• Samuelson Qonstr. CO. 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 dome in, around and upon said building, or any part thereof; shall conform in all respects to the ordinances of Fridley, Minnesotarding location, 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. Allen Jensen NOTICE: 'lids pom* don not emm 16 conshve0ae, kabMw fw wk+bt, pbmmb & on bedk& away w water. Be are to ae d to BuNft Iesp - hr apwate perm.- IM thea ft"M APPLICATION"FOR BUILDING PERMIT CITY OF FRIDLEY; Mn sOTA OWNER'S NAM,T''?_ycl,.�i �t2I4 BUILDERTy_ ttG �fia`mue ll sari Const. ADDRESS A67.:F6th Ave- N_P_ ADDRESSj900 E;, `R3er Rd. LOCATION OF•BUtLDtNG No.. 861 Street . 66tY Ave.- P4rt' of Lot I.OT� iloCk ADDITION OR SUBDIVISId t Corner Lots Inside .L w_'Setback S de=Yht`d SEWER ELEVATION FOUNDATION SiXV'ATION .:. Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. - DESCRIPTION OF B616iNG•' To be used` as = Dwelling Front Depth Aeight Sq. Ft. Cu. Ft. Front . Depth Heigtit Sq. Ft. Cu. Ft. Type of CanetructiPR. f�ne� Estimated Costes 87r2m00 To be completed as so dTn as gosa• b1® �- T -ho sundersigned 'hereby •makes application for a* peftit-1or the work herein specified, agreeing to;do all work in strict accordanoe'with'the City •of Fridiey,Ordinances '~and "rulings of, the Department of Buildings, and hereby declares that all the facts and representations stated'in this application are a an coir" .` DATE ' .� SIGNATURE (Schedule o Fee Costs can be found on the Reverse Side). "Aw M. f-I-OrIc to be done: SIdIngo3oldes Remove and replace 9 sq* ft%ontg Remove and ralQce brick Put In Vvespy JoInt aoofing: Romovo and replace 22 sq, Jamb and trIm I 1C'.3,Wbing roof stuck 4 RW,#a sieratched Remove and replace 5 arninf; mash -Path: Sai*x and hardware Hake r-oldins 1,6# Peplace firont fuels -*60 LP, TAvng Room Halls Patoh-ronall-tape Paints lIvIng room hen 9 back bedroom kitchen Oellinge basement stalro aepafttt exterior block vall, basement bedr-nom Recroute basement walls Replace garage service door Vas h dirt orf exterior of house J0,61 Ployd, Jo--inson FGl WWI Ave* 'T"T.'T, rridley# TIftneenta 16 �M SUBJECT - City of Fridley P"�l7 7 81 AT THE TOP OF THE TWINS BUILDING PERMIT r ECEIPT � COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY L 612-571-3450 910-F15 11/2/84 JOB ADDRESS 861 66th AVenue N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 3 1 1 Meadowlands SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Simon 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Meehan Brothers, Inc. 2838 Stevens Avenue South 870-0234 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 Ek REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK reroof 9 CHANGE OF USE FROM TO STIPULATIONS 1. Can be second roof, but not third TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. asphalt 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 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 1,300.00 65 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIIFEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- 2[.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE 22.65 SIGNATURE OFTRACTOR OR AUTHORIZED AGENT (DATE) PROPERLY VALIDATED THIS IS YOUR PER IT BLDG INSP DATE SIGNATURE OF OWNER 0F OWNER BUILDER) (DATE) �M NEW [ ] City of Fridley Effective 4/1/84 ADDN. [ ] �R-1 AND R-2 ALTER. [ 7 Building Permit Application Construction Address: �� f� 4" Legal Description: l c� CG r I(Ulry�00 U, Owner Name &Address: �'-s ��w� `' �� f Co�? ��' Tel. # Contractor: `� b"` ��"d c a Tel. # Address: ,:2, n s- �� .c-,- s e, Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT s LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DE_: Length Width Hgt/Ground Sq. Ft. OTHER: $ $425 per SAC Unit Park Fee $ Fee Determined by Engineering Corner Lot [ ) Inside Lot[ ] Ft. Yd. Setback Side Yard Setback Agreement Necessary [ ] Not Necessary [ ] TOTAL Type of Construction:416&-* Estimated Cost: $ Approx. Completion Date: /J"j '9 (9 �i 1 Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation • %!• Z — Y APPLICANT: Tel. A. ,�U-- 02 2j1 DATE. STIPULATIONS: e CITY USE ONLY Permit Fee $ a v Fee Schedule on Reverse Side Plan Check $ 25% of Building Permit Fee State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $425 per SAC Unit Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ STIPULATIONS: e 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 OOCTnOW".,,TS T Furnace Shell and Duct Work, Burner (Also replacement furnace) Gas Piping (piping needed with new furnace) Gas Range Gas Dryer • Air Conditioning (all sizes) All Others/Repairs and Alterations 10 of Value of Appliance or Work COMMERCIAL/INDUSTRIAL 11 of Value of Appliance or Work RATE TOTAL $ 20.00 $-0 10.00 $ $ 10.00 $ $ 10.00 $ $ 10.00 $ State Surcharge TOTAL !EE Reinspection Fee ($15.00) Rough Insp. Date Final Insp. Date C 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 free adjoining neighbor. S Job Address E61 �� �� � � / Ly t /U Department of Buildings, 6431 University Ave. N.E., Fridley, NN 55432 City of Fridley Tel. 1571-3450 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 ue and correct. Fridley, �Minn. � � , 19 OWNER ce-el KIND OF BUILDING �- 0"zi USED AS TO BE COMPLETED ABOUT ESTIMATED COST 300 / /J OLD - NEW BUILDING PERMIT NO. PERMIT NO. D DESCRIPTION OF FURNACE/BURNER HEATING r POWER PLANTS, Steam, Mot Water �=" No. o Trade Name Size No. Capacity Sq. Ft. EDR BTU RP Total Connected Load `bulb Z% Kind of Fuel BURNER - Trade Name Size No. Capacity Sq. Ft. EDR B HP Company 4 Signed By S.5,n AVP.nLip N. Flalrk, SIN 55443 Tel. No. 4 898 'Fill out back side for stack verification on replacement furnaces CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack; I. Has been carefully examined Yes (,—Y --No ( ) 2. Is free from rust or deterioration Yes (,,Y -'No ( ) 3. Has no foreign objects lodged within 4. Is securely supported 5. Meets all current Code requirements for size and total BTU connected 6. Has Total heating BTU's of All other BTU's 0 01 TOTAL � - M Remarks �C S Yes ( ) No ( -)���� Yes (,)---"No ( ) Yes(�o() 4 N C - 5t HEATING & COOLING ?0 - 85th Avenue N. Company Orn;. kj;va Park, MIN 55443 -24-8333 Signed By Date /) SUBJECT - P T NO. City of Fridley 3 0174 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. v ------ COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. F 1 � = ----1 CITY HALL FRIDLEY 55432 NUMBER REV PAGE OF APPROVED BY .j L J`� 612-571-3450 910415 [DATE 9/3/99 JOB ADDRESS 861 66th Avenue NE 1 LEGAL LOT NO. BLOCKTRACT OR ADDITION SEE ATTACHED DESCR. 3 1 Meadowlands SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE ShirleySimon 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Gates Roofing 4640 Ximines Ln Plymouth 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 MX REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house and garage 24 S Tear-off 9 CHANGEOFUSEFROM TO STIPULATIONS Underlayment must comply with the State Building Code. 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 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 2098 $1.05 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHA G PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STR CTION THEPERFORM E OF CONSTRUCTION $83.25 F� .SC 2.10 I �� PLAN CHECK F TOT F E Lic Sc- $5. .40 SIGNATURE OF CON'RA R OR AUTHORIZED AGENT IOATEiEN O A HIS UR P MIT M r S.GNATURE OF OWNER,iF OWNER BUILDER, I -DAT E, BlD NSP TATE NEW[ Effective 5/10/99 ADDN [ ] CITY OF FRIDLEY ALTER [) SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: c' P 66 tb , v Legal Description: Owner Name & Address: Contractor: (w, k' S I Address: 0 Tel. # MN LIC_ ENSE # 6793 Tel. # ,S50-00 q3 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: (tel / �? I Gl Construction Type: Wf) /lei' Estimated Cost: $ Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ DATE: -1 r 5-q_( APPLICANT: 77GO dfflz Tel. # Permit Fee $-� Fire Surcharge $ State Surcharge $ SAC Charge $ License Surcharge $ SO Driveway Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ TOTAL $ STIPULATIONS: CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1050 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 [ ]