PRE 2010 DOCSCity of Fridley, Minn.
BUILDING PERMIT N® 3265
Date: .... /, i�... 7 4j .................. .
Owner ....................................... Builder .....................
Address...................................... Address...6.........................................
LOCATION OF BUILDING
j
..
No. [.. .. Street :.... .......................... Part o Lot ... I.... ..... ..
..... Addition or Sub -Division
Lot ......`:..... Block .f^.......... :....:...�.:.:: .:....1..
Corner Lot ............ Inside Lot ............ Setback ..: Sideyard "
DESCRIPTION OF BUILDING
To Used as:
.. �!.. z:.... Front. Depth h`Q _ Height ... Sq. Ft.� t:V Cu. Ft. .:'.
.................... Front ..........Depth ........ Height ........ Sq. Ft. ........ Ft. ........
Type of Construction `- .Het. cost. �� �.. Comp ........
.:::::::.::. ....:�:. To be Completed .. .... `':::. .
In consideration of the issuance to me of a permit to construct the building desribed 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.
Sfo
In consideration of the payment of a fee of permit is hereby granted to . 4� jG-P:
......................... 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 with-
in the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances. ry
Building Inspector
NOTICE:
This permit does not cover the construction, Installation or alteration for wiring Ing,
sewer or water. Be sure to see the Building Inspector for separate permits for these Items.
•
Date:
Owner:
Addres
City of Fridley, Minn.
BUDDING PERMIT
Sunl
Address —
N° '712'7
OF BU LDING
No. -��!- Street ��- /� p
Lot _ _ Block _ Addition or Sub -Division '
Corner Lot ._ Inside Lot �y -Setback I Sndeyard If
Sewer Elevation _ __ — Foundation Elevation
DESCRIPTION OF BUILDING
T as:
�t Depth tZ__ _ Height /12 Sq. Ft. Cu. Ft.'5"
Front Depth Height Sq. Ft. Ca. Ft.
Type of Construction P�,-�je® Est. C st _ _ _ 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 and in compliance wit�Y/all provisions of
ordinances of the city of Fridley. A h,
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 upon viplation of any of the provisions of sand
ordinan
Building Inspector
• NOTICE:
ihb permit don not cover the construction, tnstaMan for whdng, phunbing, gas hat►eg, sewer or water. Be sun to see
the Building hmpedor for separate permits for these Rema.
h
OWNER'S
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
ADDRESS
LOCATION OF,BUILDIN(;
No.Street Z/l/kIze' part -of Lot
Lot - Block. Addition or Subdivision.
Corner Lot Inside LotSetback Side -Yard
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this.form Two Certificates of Survey of Lot and proposed build -
ins location drawn on these Certificates.
DESCRIPTION OF BUILDING
To be used as:
.P van Front Depth � Height
Sq. Ft. N., ,( Cu. Ft
Front Depth Height
Sq: Ft. Cu.: Ft. �� C o !,n ®ti
Type of Construction mile-. Estimated Cost
101
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.Departmeut of Buildings, and hereby declares that all the facts and
representations stated in this application are true and.correct.
jSchedule of Fee Costs can be found on the Reverse Side).
ASPHALTSl
Id 0, N S,,-TMU C T 10 N CO.
1631 66th AVENUE N. E. MINNEAPOLIS 32, MINNESOTA
SLI 4-1805
�:V
010,
0
0
City of Fridley, Minn. N?'`), 7637
BUMMING PERMIT
Date:
ChMW:
Address Address
LOCATION OF BUILDING
f7
NO. Street Faft Of Lot
cJ-,
Lot Block Addition or Sub-Mvislon c,�
COMW Lot - Inside Lot Setback Sideyard,
Sewer Elevation Foundation Elevation
To be Used as:
DESCRIPTION OF BUILDING
Front - Depth Might - Sq. Ft. - Cu. Ft
Front - Depth - Height - Sq. Ft. - Cu. Ft
Type of Construction Est Cost To be Completed
In consideration of the Issuance to me of a permit to construct the building described above Ido
the proposed work in accordance with the description above . set forth and in compliance with 21 = to 0'= of
omdinances of the city of Frldley.
n
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
Fddley. Minnesota regarding locatiou, construction, alteration, maintenance, repair and moving of b "
within the city limits and this permit may be revoked at any time upon violation of any of the provisions of sald
ordinances.
ij � lq� 11, 11
manCEs
Thb pwmb don no cove the condmdbn, haft8dim for wkbM pbu"g, gas heathy, saww or waw. Be are to m
the owbung kAPWW- #W Sep"de PWRdft FW these been.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
BUIL
r /
IM� ffir -AWADD.
LOCATION OF -BUILDING
No. Street ,. Part of Lot
LOT BLOCK ADDITION OR SUBDIVISIO--
Corner Lot Inside LOT Setback SideiYard G
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 Dept `Height
Sq. Ft. W*' Ft.
Type of Cai str'uction Estimated. Cost 4,00d
To be completed
The undersigned hereby makes application fora permit for the -work herein specified,
agreeing t -o 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 ip this, application are -true and correct.
DATE �o to SIGNATURE
(Schedule of Fee Costs can be found on the Reverse Side).
sueJEcr
MIT
City of Fridley
25739
AT THE TOP OF THE TWINS
BUILDING PERMIT
RE NO.
COMMUNITY DEVELOPMENT DIV.
INSPECTION SEC.
r PROTECTIVE
T�
---1 ' CITY HALL FRIDLEY 55432
t'j
NUMBER
REV
DATE
12/19/97
PAGE OF
APPROVED BY
612-571-3450
910-F15
JOB ADDRESS 610 - 67th Avenue N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
5
6
Rice Creek Terrace Plat 6
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Mick Jost, 610 67th Avenue, Fridley, MN 55432
574-0346
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO
Hendricks Roofing & Remodeling, 9737 James Ave. S. M ls. MN
881-7274 20032276
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP
PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP
PHONE LICENSE NO.
6 USE OF BUILDING
Dwelling
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION X:] REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Re-roof (tear-off) house and garage
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlay meet must comply with 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 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
$1 918.20
$.96
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-
$62.25
Fire SC $1.92
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTALFEE
License SC $5.00
$70.13
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
PROPERLY V DATED THIS IS YOUR PPER�MMIIT//}/�/
QH,,EN
a
BLDG NSP
/ /JATE
r�ATE
SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI
NEW [ ] Effective 1/1/97
ADDN [ ] CITY OF FRIDLEY
ALTER, SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Oj
BUILDING PERMIT APPLICATION 'A�
ConstructionAddress: ��} 6 A W v I U 1
Legal Description: S a m e
Owner Name & Address:M ' �k' �, Tel. # -f� 32(e
Contractor: / MN LICENSE # ® `3 Z2:7
Address: 3 ka Tel. # YS J 7 -2 --
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: 23 &/ e) X A VU / 918-. L 0
Construction Type: �'� �!� j- Estimated Cost: $_ !�200'
a'h (Fee Schedule on Back) //
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: APPLICANT:(7/10-114h A Tel. # un)
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
011911100
STIPULATIONS:
CITY USE ONLY 2,1
S 40v
$ � 2, 2-,' Fee Schedule on Reverse Side
$ 2— .001 of Permit Valuation (1/10th%)
$ $.50/$1,000 Valuation
$ $950 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 [ ]
CITY OF FRIDLEY INSPECTION DIV. `�%� >R V Effective On January 1. 1997
6431 University Ave NE 1 i 0 o
Fridley. MN 55432 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
572-3604
MARK NUMBER
OF FIXTURES TO BE INb IAutu UN tAUM rLUUM
Water Bath
Closet Urinal Tub Shower
Wash Drink. Floor Catch Auto. Gas Gas Misc.. Water Heater
Sink Tray Fount. Drain Basin Washer Apel. Range Fixt. G Elec
Stories
Basement
Floor 1
Floor 2
Floor 3
Floor 4
PLUMBING FIXTURE RATES:
New Fixtures
Old Opening, New Fixture
Beer Dispenser
Blow Off Basin
Catch Basin
Rain Water Leader
Sump/Receiving Tank
Water Treating Appliance
Water Heater —Electric
NO. RATE TOTAL
Water Heater — Gas**
Gas Range"
Gas Dryer"
Back Flow Preventer Required ( )Yes () No
$ 7.00
$ 4.00
$ 5.00
$ 7.00
$ 7.00
$ 7.00
$ 7.00
$10.00
$ 7.00
$10.00
$10.00
$10.00
Type $15.00
Reinspection Fee $42.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance
0, S-0
State Surcharge 3 .50
JOB ADDRESS (, /:�'
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the city codes
and rulings of the Building Division, and hereby declares that all the facts
and representations stated in this application are true and correct.
/,0// s/ , 1 gw�-`
Owner %/�i`�`��G �14177
Building Used As
Estimated Cost ��- PERMIT NO. le?9y
PLUMBING COMPAN,1Y�/� /�D7"
v TEL N0.
SIGNED BY
Approved By Rough—In Date _ Final Dat (d�
/ v/lcpw l
U1MIA.O!" FFF A ANY ptum3ING/GASPERMIT iS ij20.00
a
City of Fridley
SUBJECT
AT THE TOP OF THE TWINS
BUILDING PERMIT
28864
r
` COMMUNITY DEVELOPMENT DIV.
v
PROTECTIVE INSPECTION SEC.
r �
1 �
NUMBERDATE
f7l
PAGE OF
APPROVED BY
=
I "'1 CITY HALL FRIDLEY 55432
612-571-3450
9/ 0415
1/25/99
JOB ADDRESS 610 67 Avenue NE
1 LEGALLOT
NO.
OLD
TRACT OR ADDITION
SEE ATTACHED
DESCR.
5
6
Rice Creek Terrace Plat 6
I
SHEET
2 PROPERTY OWNERMAIL ADORES$ ZIP
PHONE
Michael Jost 610 67 Avenue NE
574-0346
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO
Golden Hatchet Roofing PO Box 553, Anoka, MN 55303
427-3047 20003158
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
O NEW ❑ ADDITION ❑ ALTERATION [R REPAIR
❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Reroof House & Garage (22 Sq) Tear -off
9 CHANGE OF USE FROM 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 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
ISTALLS
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
@
$.94
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$1,885
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLAJE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISI NS OF ANY OTHER STATE OR LOCAL LA RE LATING CON-
Fir SC $1.88
TRUCT N T P€RFORM OF CONSTRU ON
$59.50
PIAN CHECK FEE
TOT FEE
_
-ZS
Lice S $5. 0
67.32
SIGNkfu E O0: CON'AACTOa OR AUT«Ot+i2E0 AGENT IDATE.
EN RO E Y LIDA ED HIS IS YO R PERMIT
=�- 99
S.GNATURE OF OW NEA OF OWNER BUILOM tOATE,
OnNS�
OA tE
01
uwil
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: O & 7 IVZ7
Effective 1/1/99
11;lkl
Legal Description: sIklale
Owner Name & Address: _�'IiI / e'� TO �' Tel. #
Contractor: ales l /FO eg /c: 6-? MN LICENSE #
Address: ga, A2Y S `�/!/ 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: *1.2 A S -o -
Construction Type:, e--ct/- D��/� l �� Y > D
yp Gjdl Estimated Cost: $
"-C- (Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $
DATE: 1,2APPLICANT:�i'1,'L�2�9 Tel. # 12 7-3057,�'
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge $� (� U
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 [ ]
SUBJECT
PER
City of Fridley
288731
AT THE TOP OF THE TWINS
BUILDING
PERMIT
rrL -------COMMUNITY DEVELOPMENT DIV.
INSPECTION SEC.
PROTECTIVE
1 �
= CITY HALL FRIDLEY 55432
NUMBER
REV
GATE
PAGE OF
APPROVED By
612-571-3450
910-F15
1/28/99
JOB ADDRESS 610 67 Avenue NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
5
6
Rice Creek Terrace Plat 6
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Mick Jost 610 67 Avenue NE
574-0346
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Remling Aluminum Products Rt 1, Box 369, Ottertail,
MN 56571 218-367-2838
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 O ADDITION ❑ ALTERATION CR REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reside House Soffit & Fascia
9 CHANGE OF USE FROM TO
STIPULATIONS
Call for building wrap inspection before covering.
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
R-1
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1 ISTALLS
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 TME RANTING
$6,400
$3.20
HEREIN OR NOT. CIF A PERMIT
DOES NO ESUME TO GIVE A THORITY TO I LATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISI S F A OTH S TE OR LOC L AW REGULATING CON*
$124.75
Fire SC $6.40
STRUCTI N O T PERFO M CE OF CON T C710N
PLAN CHECK FEE
IT TAL FEE
134.35
SI A OF CONTRACT R OR AUTHORIZED AGENT DATE,
P
LYVA IDA THIS IS YOUR PERMIT
S ATURE OF OWNER-i;OWNER BUILDERl "ATEA
UftOtSo -
pitE
NEW [ ] Effective 1/1/99
ADDN [ ] CITY OF FRIDLEY
ALTER [ SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: ( l0 (O 7 � a:,�
Legal Description:
Owner Name & Address:
Contractor:
Address:
Tel. # �'74<- v39'6
MN LICENSE #
Tel. # .21k 36���3fs
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale:
DESCRIPTION OF EMPROVEMENT
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: stimated Cost: $ &LDD
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. +16 Ft = Ft x $ = $
DATE: Zz:uAPPLICANT:
�2/;
9 Tel. # 3.1 7_ 2S -3k
STIPULATIONS:
`/
CITY USE ONLY
Permit Fee
$
10241,2s
Fee Schedule on Reverse Side
Fire Surcharge
$
(o. 70
.001 of Permit Valuation (1/10th%)
State Surcharge
$
3,20
$.50/$1,000 Valuation
SAC Charge
$
$1050 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
$
12y .3 -S -
STIPULATIONS:
JLL-07-2005 11:56 CITY OF FRIDLEY
CITY OF FRIDLEY
Vir1N I) 6439 UnWTsity Ave NE, Fridley, MN 55432
kDDN I j SINtaLE FAMILY AND DUPLEXES R-1 AND R-2
;LTER L 3 BUILDING PERMIT APPLICATION
P.04/06
f2
(763 672-36D4 Bldg hop , jo y
(763) 571-1287 Fax 05,
o
Construction Address: 6fv
Legal Description: 76, S7 ®®3�d
Tel. #
Owner Name & Address:
Contractor. /6 P® sv`r MN LICENSE #
�Jy'7f3- Z�i-I��
/� �/�Cc�aSPNA LA rpAddress
A,tach to this apprIMIJ0171, a Certificate of Survey of the
lat, with the proposed construction drawn on it to `scale.
pESCRiP'TiON OF �� p�
��o p L -s-
LMNG AREA: Length 1Nidth ,^:_ Height �= Sq. Ft
Width Height �_ Sq. Ft
GARAGE ARL' -A: l�+g�►-----�-
DECK AREA: Length6 �� Width � - Hgt(Ground 2 Y 1-4 Sq. Ft
OTHER:
g7 a
Type:
�G FC ✓SP�P�+ yla�✓ Estimated Cost:
Constructior{ Cva
D&eway Curb Cut width Needed: Ft + 6 Ft= Ft x
DATE. -7-17-OS' APPLICANT- _ 7eL
Can (763) 572.3604• for Permit Fees if ftWffing in application. Fax to 763-571-1287 If using credit card and we will call
you for card number. CRY USE ONLY -
Permit Fee
Plan Review
Fare Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
$ a94 P
Fee Schedule on Reverse Side
$
65% of Permit Fee
$
.001 of permit Valuation (1110th°lo)
$
$.501$1,000 Valuation
$
$1450 per SAC Unit
$ z00
$5.00 (State Licensed Residential Contractors)
$
Ait. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
$
Fee Determined by Engineering
$
Agreement Necessary C ] Not Necessary I l
$ rj / STIPULATIONS:
RAit- I id-- I
Poste
I-
s�z�
. ftF-4. r
(20 R . = -
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8329 CENTRAL AVENUE N.E. MINNEAPOLIS, MINNESOTA 55432 ® TELEPHONE (763) 764-3062
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