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PRE 2010 DOCSBUILDING PERMIT Village of Fridley, Minn. No 2389 Date 0III amp . ....................... . tn.s..� Owner ' ., j7io' all �+?Mo...: Builder . Addressa� ...� .. .. / Address ......................................... j LOCATION OF BUILDING No. ..%r4b..... Street 6 ,7 ,M .... ......... Part of Lot ....................... Lot ..... A ...... 'F . Block ........ .... Addition or Sub -Division .�eek Corner Lot ....... I..... Inside Lot .. 40....... Setback J'47-0411. Sideyard 1z0%ov1. s.......... To be Used as: Type of DESCRIPTION OF BUILDING . Front WZ- o Depth,$#-.� Height 1.,,fi ! .. Sq. Ft A Cu. Ft. ........ Front ........ Depth ........ Height ......... Sq. Ft......... Cu. Ft.......y.. . Est Cost " �,� ...... To be Completed . ,e'%Dii�F��'. In consideratlon of the issuance to me of a permit to construct the building described above, I agree to do the proposed work i#accordance with the description above set forth and in compliance with- all provisions of ordinances of the vi4age of Fridley. .. ........................................... In consideration f the payment of a fee of $.I -k. .. , permit is hereby granted to 94 .. to construct the building or addition as described above. This permit is gra ed upon the express con ' o 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 r garding location, construction, alteration, maintenance, repair and moving of buildings with- in the village limits d this permit may be revoked at any time upon A I ti of any of the provisions of said ordinances. 14it.�Aar . Building Inspector it4. r NOTICE: This permit dges not cover the construction, installation or alteration for wiring, plumbing, gas heating, sewer or water. 81 sure to see the Building Inspector for separate permits for these Item's. 0 City of Fridley, Minn. BUILDING PERMIT N® 4281 Date: ....--......... P/. .............................................. Owner: �. L l�7�Z �-�%..h. ? .. Builder Address....._............._.......-.---_...-----------. ___._..... __._.._..__.... .............. Address_............._............._............._..............._...._......._......._._._. ..((// CATION OF BUILDING No. ....... l -----_..Street--- ... ..4._.o ................. _.... .......... Part pt Lot ......................................... Lot ._.._... ..................... Block ............. Addition or Sub -Division-- .;,lrt:P..C, .-•'--- .....p—,L ••_. CornerLot ................................... Inside Lot ...... .......................... Setback .................... _.............. ........ Sideyard..... _............. _......................... ................. _....... .... Sewer Elevation ................................... _............. _..................................................... Foundation Elevation DESCRIPTION OF BUILDING To be Used as: _.... 1-C. ................. ----.. Front ..................... .....---......-- . Depth ....2.............._ .. Height .../................... Sq. Ft..... •--------...._.. Cu. Ft. .................... - . ...... .......... Front ./ /� ..� 5 `Depth .�_ 'iq;elght 1...®'Sq. Ft. Cu. Ft..: Type of Co truction............................................................ Est. Cosi.''-® To 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 d in compliance with all provisions of ordinances of the city of Fridley. °-)/] �_ / In consideration of the payment of a fee of $..._,..._"....., permit is hereby granted to ... _-_..... _........................ __.................... 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 any time upon violation of any of the provisions of said ordinances. 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. City of Fridley, Minn. N° 7651 • BUILDING PERMIT Date: June 2, 1965 Owner: ri oyd Ordemapn Builder qty Homes, Inc. Address 540 67th_ Avenue No, East Address 3701 Fremont Ave. N. LOCATION OF BUILDING No. 5+0 Street 67th. Avenue N. E. Part of Lot Lot 6 Block - 7 Addition or Sub -Division Rice Creek Terrace Plat 4 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 Height Sq. Ft. Cu. Ft. Type of Construction Est. Cost 6124939#01 To be Completed • Storm Damage Repair CJ In consideration of the issuance to me of a permit to construct the building described above I agree to do W=proposed work in accordance with the description above 7orth and in compliance with ail provisions of dine e s of the city of Fridley. In consideration of the payment of a fee of $ 10.E � ,permit is hereby granted to Quality Homes, Inc. to construct the building or addition as described above. This permit is granted upon the egpresa condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, ar�md and upon said building, or any pari thereof; shall cenform in all respects to the ordinances of hi Fridley, Mianesoffi location, construction, alteration, maintenance, repair and moving of buildings wiordinanios. city limitsnei permit may be revoked at anq time upon violation of any of the provisions of said Alien Jewen Building Inspector NOTICE fhb perndt don Prot sown the sendrucKon, hufAMen for vfk1h9r plumbing, gn hating, sewer or water. Be sun to no the Bothilug bgmter Mr separate permits for thea keno. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S MME Floyd. Ordemann BUILDER QualityHomes, Inc. ADDRESS 540 67th Ave. ADDRESS 3701 Fremont Ave. No, LOCATION OF BUILDING No. Street Part of Lot LOT 6 BLOCK ? ADDITION OR SUBDIVISION RCT #4 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 as; DESCRIPTION OF BUILDING Front Depth Height Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Estimated Cost $12,939.01 To - be completed REPAIRS DUE TO TORNADO The undersigned hereby makes application for a permit for the work herein specified, agreeing -to do all. work-in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings 'and herehy.declares that all the facts and representations stated in this application are true and correct. 17F-0 SIGNATURE (Schedule of Fee Costs can be found on the Reverse Side). Replace roof Replace garage Replace siding New sheetrock throughout Refinish oak floor CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 Effective On August 1, 199$_ APPLICATION FOR PLUMBING AND GAS FITTING PERMIT------ MARK ERMIT - MARK NUMBER OF FIXTURES TO BF 1NSTAI t Fn ON FdCH Fi nnR PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS / C New Fixtures $ 7.00 The undersigned hereby makes application for a permit for the work herein Old Opening, New Fixture $ 4.00 STIT Beer Dispenser �. and rulings of the Building Division, and hereby declares that all the facts ® $ 7.00 i�! Catch Basin ,' W"il Rain Water Leader - 10 Sump/Receiving Tank $ 7.00 ��j �'!��'® P.�YM�Yi� •tte Owner %Q 67TH AVENUE NORTHEAST Water Heater —Electric i! FRIDLEY 55,432 , gr:Yf�k9K ;1�� _iiiLi�U:!.�!�I�L.LII:�a,.;�:� _� $10:00 :I H � :i Hi 16. .I tlHfl✓�_I�i�W IJ�i�i:: iii. /J Estimated Cost -/ 00 — PERMIT NO:" Back Flow Preventer Required ( )Yes Type () No $15.00 /0 0 (b 6`M mM PLUMBING COMPANY Lx , Reinspection Fee $42.00/HrI SIGNED 13Y A&/TEL N0. :9H��j5y!{j�ryjry!!::��ry��ppp'�'��!.��: Y.•� ]Y� � liii� �H{. ee.. PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS / C New Fixtures $ 7.00 The undersigned hereby makes application for a permit for the work herein Old Opening, New Fixture $ 4.00 specified agreeing to do all work In strict accordance with the city codes Beer Dispenser $ 5.00 and rulings of the Building Division, and hereby declares that all the facts Blow Off Basin $ 7.00 and representations stated in this application are true and correct. Catch Basin $ 7.00 Rain Water Leader $ 7.00 &130( 19g� Sump/Receiving Tank $ 7.00 KUHNS DAVID Water Treating Appliance $10.00 Owner %Q 67TH AVENUE NORTHEAST Water Heater —Electric $ 7,00 FRIDLEY 55,432 Water Heater — Gas** _� $10:00 , Building Used As H 571-5958 rj 7 — ,ir9 5rg Gas Range** Gas Dryer** $10.00 $10.00 /J Estimated Cost -/ 00 — PERMIT NO:" Back Flow Preventer Required ( )Yes Type () No $15.00 /0 0 (b 6`M mM PLUMBING COMPANY Lx , Reinspection Fee $42.00/HrI SIGNED 13Y A&/TEL N0. ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Facture orAppliance Approved By Rough—in Date Final Date State Surcharge .50 kA MINIMUM FE FOR ANY PLUMBING GAS PERMIT. ISS $20.0 TOTAL FEE '30. � PLUS THE $-50 STATE SURCHARGE **COMBUSTION Alk SHALL BE PROVIDED PER UMC SECTION (A) AND TABLE 6—A. MINIMUM SIZE 9 SQ INCHES. SUBJECT of Fridley 4 7 AT THE TOP OF THE TWINS BUILDING P E R M I T RECEIPT NO. Ir?City COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. 5-3 r 1 I NUMBER REV DATE PAGE OF APPROVED By = CITY HALL FRIDLEY 55432 JA"' I.J 612-571-3450 910-F15 10/23/9 / / JOB ADDRESS 540 67 Avenue NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 6 7 Rice Creek Terrace Plat 4 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE David Kohns 540 67 Avenue NE 571-5958 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Twin City Exteriors Co Inc 9060 Zachary Ln N #108 Maple Grove MN 55369-4083 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 425-4737 2535 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION 17 REPAIR X ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reside House 9 CHANGE OF USE FROM 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 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 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 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 $5,000 $2.50 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- SC $5.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION 1$99.75 Fire PLAN CHECK FEE TOTAL FEE License SC $5.00 1 $112.25 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI WHEN PROPER^ VALIDATED THIS IS YOUR PERMIT .. BLbgf I GATE S-GNATURE OF OWNERIIF OWNER BUILDERI IDATEI NEW [) Effective 3/1/96 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application �SST3 ConstructionAddress: T� Legal Description: " Owner Name &Address:424112D 62A/925 `5 Tel. #Tg � - Contractor: TVM CITY EXTERIORS CO., INC. MN LICENSE # 2535 Address: 9060 ZACHARY LANE N #108 MAPLE GROVE, M -55369-4083 Tel. # 425-4737 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: Lcngth Width Hgt/Ground Sq. Ft. OTHER: Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: 84!55 / ,1�5 j,�la� � s mated Cost: $ Approx. Completion Date: / / - f g� (Cost on Back) Driveway Curb Cut Width Needed: Ft + 6.Ft$ _ $ APPLICANT:— STIPULATIONS: 775 --`Fee CITY USE ONLY' Permit Fee $ Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ �S`� $.50/$1,000 Valuation SAC Charge $ $900 per SAC Unit License Surcharge $ �� $5.00 (State Licensed Residential Contractors) Driveway 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 [ ] TOTAL $ STIPULATIONS: CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1997 6431 University Ave NE 61 Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING-SYSTEMS AND DEVICES JOB ADDRESS RATE SCHEDULE The undersigned hereby makes application for a permit for the work herein Residential Rate TOTAL specified agreeing to do all work in, strict accordance with the City Codes and Furnace Shell and Duct Work, Burner - rulings of the Building Division, and hereby declares that all the facts and Also Replacement Furnace $ 30.00 $ representations stated in this application are true and correct. (Side Vent - Fill Out Back) Lo I a4 1997 Gas Piping (Needed with new furnace) $ 10.00 $ OWNER. 1 �' M S 5-;7/ s•1 TI Gas Range $10.00 $ BUILDING USED AS Gas Dryer $ 10.00 $ ESTIMATED COST 1,33 L .00 PERMIT NO. *Air Conditioning - All Sizes $ 25.00 $ DESCRIPTION OF FURNACE AND OR BURNER All Others/Repairs & Alterations (LIST ON BACK) 1 % of Value of Appliance or Work $ No, of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name Size No. Commercial/Industrial BTU HP EDR 1.25% of Value of Appliance or Work $ Fuel Total Connected Load State Surcharge .50 Burner Trade Name Size No. BTU HP EDR TOTAL FEE . $ 07 56b HEATING COMPANY BLAINE HTQ•1110ELECT, nyc. MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION ACO , MN 55304 REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 Signed By Tel No. PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr Approved By Rough-In Date Final Date *Air Conditioners can not be placed in a side yard without FILL OUT BACK SIDE R STACK VERIFICATION ON written permission from adjoining property owner. PLACEMENT F ACE `) V Remarks: . List ALTERATIONS Being Done: s'. y�E HEATING CO: Signed By: Date: J CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or slack: 1. Has been carefully examined Yes () No { ) 2. Is free from rust or deterioration Yes () No ( ) -3. Has no foreign objects lodged within Yes () No ( ) 4. Is securely supported Yes () No ( ) 5. Meets all current Code requirements for size and total BTU's connected Yes {) No ( ) 6 Has total heating BTU's of All other BTU's TOTAL BTU's 7. Has a liner. been provided for water heater Yes( ) No (. ) 8. Has combustion air been provided for water heater Yes ( ) No ( ) Remarks: . List ALTERATIONS Being Done: s'. y�E HEATING CO: Signed By: Date: J J IT NO. SUBJECT P City of Fridley 2 7 2 b 5 AT THE TOP OF THE TWINS BUILDING PERMIT REC O. COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. 1 � 1 . � NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910415 8/18/98 JOB ADDRESS 540 67th Avenue NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 6 7 Rice Creek Terrace1 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE David Kuhns 571-5958 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Right WayRoofingInc. 1200 E. 79th St. Bloomington - 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 Glc REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house and garage (23 Sq) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REOUIRED 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 $191$ .96 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- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION 62.25 ire C 1.92 PLAN CHECK FEE TOTA EE Lice C 5.00 .13 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDA EI N P PER LIDAT BLDG SP HIS IS U MI ATE SIGNATURE OF OWNER of OWNER BUILDERI IDATEI IT NO. NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 � S BUILDING PERMIT APPLICATION ConstructionAddress: 5110 low fve . Legal Description: Owner Name & Address: Ocw (Cl lC. t ih n Tel. # 5--4'1- 5I5R Contractor: P-t1a u; W(Y,u (Z(nAhQ MN LICENSE# 000' 1pgq u J Address: �2(�rj .q%l 5�' Tel. # Q653-OQQ6{ 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 DLa ©'%--(, Ca AO 01 r Q. (Z-�rIYL 2?J Construction Type: Estimated Cost: $ biLA-16'60 I �V (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: APPLICANT:Ft0vkA-AAkk, I `a'11L� Tel. # CITY USE ONLY Permit Fee $ -Sr Fee Schedule on Reverse Side Fire Surcharge $ %, 9a .001 of Permit Valuation (1/10th%) State Surcharge $ 9� $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway 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 [ ] TOTAL STIPULATIONS: $-90,1-3 SUBJEtT PER City of Fridley 2 8 0 4 2 AT THE TOP OF THE TWINS BUILDING PERMIT RE PT NO. � COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY L 612-571-3450 910-F15 9/30/98 JOB ADDRESS 540 67th Avenue NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 6 7 Rice Creek Terrace Plat 4 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE David Kuhns 571-5958 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Twin City Exteriors Co. 9060 Zachary Ln N #109 Map1p Grnyp 95369 429-4737 a ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential I CLASS OF WORK O NEW 0 ADDITION 0 ALTERATION Aj REPAIR O MOVE O REMOVE B DESCRIBE WORK Storm damage repair (West side of structure only) 9 CHANGE OF USE FROM TO STIPULATIONS SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD VENTILATING OR AIR CONDITIONING 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 ANY TIME AFTER WORK IS COMMENCED. ' NO DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION ISTALLS GARAGES AND KNOW TME 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 $500 $.50 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- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $21.00 Fire SC $.50 PLAN CHECK FEE TOTAL FEE Lice se SC $5-OOA 1$27.00 SIGNATURE OF CON"RACTOR OR AUTHORIZED AGENT (DATE- WHEN PROPERLY IOATED THIS IS YOUR PERMIT �� F OWNER BLDERI IDATEi46 S,GNATURE OF OWNERJW BLO iNSR ° OAtE NEW [ ] ADDN [ ] ALTER [ ] ConstractionAddress: Legal Description: Owner Name & Address: Contractor: Address: `i CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Effective 1 / 1 /97 Tel. #E .57/- MN LICENSE #,�G%�` 2s3/�Tel. # h/Ol X73% 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: Construction Type: -5f p, A,61419bl ' QPfastimated Cost: $ Q (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: APPLICANT: �S . Tel. # Y";? 57-42.3 % CITY USE ONLY Permit Fee $ , lsb Fee Schedule on Reverse Side Fire Surcharge $ , 56 .001 of Permit Valuation (1/10th%) State Surcharge $ ✓�U $.50/$1;000 Valuation SAC Charge $ % $950 per SAC Unit License Surcharge $__, 06 $5.00 (State Licensed Residential Contractors) Driveway 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 [ ] p C� TOTAL $ STIPULATIONS: