PRE 2010 DOCS0
City of Fridley, Nunn.
BUILDING PERMIT
Date: June 22, 1965
Owner: Frankn Smith Builder W.D. Harstad Co. Inc.
Address 1611 66,1k Avenue N. E. Address 7101 Hwy. 65 N. E.
LOCATION OF BUILDING
No. 1611 Street 66; Avenue N. E. part of Lot
Lot 1 Block 1 Addition or Sub -Division MooreLake Park
Corner Lot _ Inside Lot Setback Sideyard
Sewer Mevation Foundation Mevation
N? '79'79
DESCRIPTION OF BUILDING
To be Used as:
Dwelling Front Depth Height Sq. Ft. Cu. Ft
Att. Garage Front Depth Height Sq. Ft. Cu. Ft.
Type of Construction Fst. Cost $15,500.00 To be Completed
• Dwelling, att. Garage
•
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 forth and in corn, witt'1 provisions of
onvlinances of the city of Fridley. �*--�
'c
In consideration of the payment of a fee of $ 23.00 lit is herby granted to D. W. Harstad Co. 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, in all work
done in, around asci upon said building, or any part thereof, shaII conform in all respects to the ordinances of
Fridley, B+tinnesoffi re��ardiag l oin, slat n� vilati:io anydof thmeo provisionbs o said
within the city limits and this
ordinances.
Allen Jensen
NOTICE
Uh permh dos not cover the eondmthm, htdagdlen fm wMng, piimbleg, Ba hating, ower or water. Be wn to ae
the Betldhig haps for "PM to permhe for thea hone.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME %&d,/�d��
BUILDERt�/�
Cd_�•�✓Ce
ADDRESS
ADDRESS
,O/ W
LOCATION OF BUILDING
No. / / Street 1, 'LP4rt of Lot
LOT / BLOCK /, _,ADDITION OR SUBDIVISION �1I �i v_. / f�,
Corner Lot Inside LOTSetback Bide -Yard
SEWER ELEVATION FOUNDATION ELEVATION
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;
I ►_I,. 1.• L I,��,�� Front Depth
r�-`� _ ^�
Sq. Ft. �/ Cu. Ft. f �`
l
"RN rc (Z' ���_ Front � �- - .Depth ?- Z- Height 1
Sq. Ft._ �% �� Cu. Ft.
Type of Construction_ Estimated Cos
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
(Schedule of Fee Costs can be found on the Reverse Side).
.A
SUBJECT
City of Fridley
7RE 8 0
?AT THE TOP OF THE TWINS
BUILDING PERMIT
I
PT
_ COMMUNITY DEVELOPMENT DIV.
� PROTECTIVE INSPECTION SEC.
r �
'7
1 i i
/-'-1 CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
5/3/91
JOB ADDRESS 1611 - 6612 Avenue NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
1
1
Moore Lake Park First Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Frank Smith 1611 - 663� Avenue NE 571-8541
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
D & D Homs Improvement 7401 Central Avenue N.E. 784-7543
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
ares)_9
Reroof Dwelling (18 Squares) -
9 CHANGE OF USE FROM TO
STIPULATIONS
Roofing can b.e. 2nd layer but not 3rd,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
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
$936
$,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 O ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$25.00
Fire SC $.94
STRUCTION R HE PERFORMANCE Ob CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
p2nav _�
—
6.44
SIGNATURE OF CONTRACTOR ORA TOWED AGENT IDATEI
WHE PROPERLY V I AT O T IS IS YOUR PERMIT
5a r)A E
SIGNATURE OF OWNER OF OWNER BUILDERI (DATEI
NEW [ ]
ADEN [ J
AL'I'T [ ]
R-1 AND R-2
Building Permit Application
Effective 1/1/91
Legal Description:
owner Name & Address: Tel.
Contractor:
ice 7
Tel. # 70/-
Attach to this application, a Certificate of Survey of the
lost, with the proposed construction drawn on it to scale.
DiESCttLL-rAL 1 OF IIaqWVE[ ENT
LIVING AREA: length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DBCR AREA: Length Width Hgt/Grranrl Sq. Ft.
oma•
Gbrner Lot [ ] Inside lot [ ] Ft. Yd Setback Side Yard Setbacks
Type of CbnstYuction: gra d�e ®C/e/l1-4t�2 `Estimated Cost: $
Approx. Ccupletion Date:1�sf5
Proposed Driveway Width If NewIs Desired: Ft. $ $
Width + 6' See Back Page
DATE: APPLICANT: G� `�� Tel • #
Permit Fee $ .00
Fire Surcharge $
State Surcharge $
SAC Marge $
Driveway Escrow $
Park Fee $
Sewer Main Charge $
TOTAL $ �� 4—
STIPULATIONS:
w ju 6 ni' •; i
Fee
Schedule on Reverse Side
.001 x Permit Valuation (1/10th $)
$.50/$1,000 Valuation
$650 per SAC Unit
Alt. "A" or Alt. "B" Above
Fee Determined by Engineering
Agremwrrt Necessary [ ] Not Necessary [ ]