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PRE 2010 DOCSPermit Fee paid on Permit #11,315 for 1560-1570 69th Avenue N.E. City of Fridley, Minn. 33 6431 University Ave. N.E., Minneapolis, Minn. 55432 BUILDING PERMIT Date: —-ehr„arv_ ,22,_ 1972 Owner: __Rice Creek Development Company Builder Approved Contractors,_ Inc. Address 85 Wgst Road, Circle Pines, Minn*Adams 1052 Osborne Road N.E., Fridley 786-3680 16402164201644 LOCATION OF BUILDING 1646,1648,1650 No Street 68th Avenue N.E. Part of Lot %t Parcels 10 A.100, Section 13 Addition or Sub -Division Cormer Lot Inside Lot Setback ____ Sideyard Sewer Elevation I Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Each Unit Townhouse 11nits Front 201 Depth ._ 32' Height 21 t Sq. Ft, 1213' Cu, Ft Front Depth Height .— Sq. Ft. --- Cu. Ft. Type of Construction Wood Frame Est Cost See #11, 315 To be Completed 1 year In consideration of the issuance to me of a permit to constru the building described abo , I agree to do 'the proposed work in accordance with the description above se and in corn 'ance wi provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of -'4P1 l;'A1.5 permit is hereby granted to Rimae_ Creep Aevco. 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 CT RFNCE BELISLE 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 hems. APp{icatia� for Power Plaels and Heating, Cooling, Ven nattne Refrigeration and Air Conditioning Sr to m and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work .. $10.00 $ Replacement of Furnace ..... 6.00 $ Repairs & Alterations—up to $500.00 6,00 Repairs & Alterations each add. $500.00 3.00 MECH. WARM AM Furnace Shell & Duct Work to 120,000 BTU .. & . ..$10.00 0 V each add. 60,000 BTU .................... 3.00 i Replacement of Furnace .. .... 6.00 $ Repairs & Alterations—up to $500.00 .. 6.00 $ Repairs & Alterations each add. $500.00 .... 3.00 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam $10.00 $. -- Furnace Shell & Line—to 640 sq. ft. EDR Hot Water 10.00 $_. Each add. 200 sq. ft. EDR Steam 3,00 Each add. 320 sq. ft. EDR Hot Water 3.00 $— OIL BURNER—to 3 gal. per hour 6.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 198,000 BTU) Cp 6.00 d , O (J over 199,000 BTU See Fee Schedule GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures x$ 200 $ —� Additional Fixtures x .75 $ Gas Range to 199,000 x$ 5.00 $ AIR CONDITIONING Co ®/U. O O S60-00 FAN HEATING SYSTM See Foo Schedule VENTILATING SYSTEM o9 $./W 6 , n G ALTERATIONS & REPAIRS TOTAL FEE ROUGH FIN$I. — 'A (SURCHARGE $ _.50) Dept. of Bldgs Phone MO -3M IVA i ofL'l.' 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. Owner Kind of Building A h I MON To be completed about Estimated Old --6 Building Permit No. Permit No. 51 71 n DESCRIPTION OF WORK HEATING or PO PLANTS—Steam, Hot Water, �-No 6 Trade Name_ �?L1Ll� Size No. +Jbn 2 - CP Z Capacity Sq. Ft. E.D.R BTiT HP. _ Total Connected Load Kind of Fue BURNER — Trade Name Size No Capadty Sq. Ft. EMit BTU BIP. (REMARKS-OVIR) i CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT PARTIAL RATE SCHEDULE to PLUMBING FIXTURE RATES: NO. RATE m Number Fixtures x C3.00 U Future Fixture Opening x m $ Water x yy y CCd Catch Basin x $5.00 �ici E Water Heater - to 99,000 BTU x qW $ 100,000 BTU to 199,000 BTU x W $ Water Softener Heater $7.00 N New Ground Run Old Building x $5.00 m Electric Water Heater 4J $5.00 N X� 0 a) ti 1st 3 fixtures x $3.00 $ Additional Fixtures O O TI ++ x $10.00 N REPAIRS $ ALTERATIONS O S 1� •ani 1� m N $5.00 $ each add. $100.00 or fraction U3 U D as rNd R7 y 3 A w° 'M w U M 3 C�7 � O as 1ec 1st 2nd C 3rd 4th (R) = Future Connection Opening Connected with Sewer M = New Fixture, old Opening Water PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures x C3.00 $ Future Fixture Opening x $2.00 $ New Fixture, Old Opening x $2.00 $ Catch Basin x $5.00 $ Water Heater - to 99,000 BTU x $5.00 $ 100,000 BTU to 199,000 BTU x $10.00 $ Water Softener x $7.00 $ New Ground Run Old Building x $5.00 $ Electric Water Heater x $5.00 $ GAS FITTING FEES: 1st 3 fixtures x $3.00 $ Additional Fixtures x $1.00 $ Gas Range to 199,000 BTU x $10.00 $ REPAIRS $ ALTERATIONS First $100.00 $5.00 $ each add. $100.00 or fraction $2.00 $ State Surcharge $ .50 TOTAL FEE $ REINSPECTION FEE ($10.00) dob Address //" L/ P- �r� e'<'W Citi- J�/ �,� I bepartdtent of buildings City of Fridley tel. #511-1450 the undersigned hereby makes appiication 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 Buildingso and hereby declares that all the facts and representations stated in this application are true and correct Fridley, Mn. OWNER KIND OF BUILDING USED AS TO BE COMPLETED ABOUT ESTIMATED COST OLD - NEW BUILDING PERMIT NO. PERMIT NO. 73 �O Company�- Signed Byr v.isn ate, _ N -moi Tel. No. y f S ROUGH INSP. Date FINAL INSP. Date APPROVAL FOR PERMIT MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7..50 PLUS $.50 STATE SURCHARGE SUBJECT O. City of Fridley 25555- AT THE TOP OF THE TWINS BUILDING PERMIT r NO. COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. �J/7 r NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 9/30/97 JOB ADDRESS 1640,1642,1644,1646,1648,1650 68 Avenue NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. Par. 1062 0 Section 13 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Jim Bern Mgmt 8162 Bloomington Ave S, Bloomington MN 55425 854-7788 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Horizon Roofing 1333 Larc Ind. Blvd, Burnsville MN 55330 890-3900 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Frame - 6 Unit 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION Ck REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof 6 Unit Townhouse - 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 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 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 6 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 $9,400 $4.70 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 C ARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $162.25 F re SC $9.40 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FE FEE )rAL $176.35 SIGNATUREOF CON TRACTOR OR AUTHORIZED AGENT IDATEI EN R V LID THIS I$ R URb4IT /D BLD INSP Y' r,AATETE S,GNATURE OF OWNER of OWNER BUILDERI IOATEI Prepaid Plan Check $ Estimated Cost $ Receipt # Effective 1/1/97 CITY OF FRIDLEY R-3, COMMERCIAL & INDUSTRIAL BUILDING PERMIT APPLICATION 6 uoc �- / Construction Address /b(/0 - /650 Zoning Legal owner & Address .J/r, aRMACIOR & ADDRESS Architect TYPE OF WORK z tb�lnt��3 Lfl�e 1 Reg. # Erginee-� BUILDING CONSTRUCTION [] New [] Addition [] Alteration -Describe. o/7 C i eT AC �) ��4Yc oFc. AREA: Length Width WDM AREA: Length Width amER AREA: Length Width Height sq. Ft. Height SI- Ft. Height sq. Ft. Y)� 66 Building Use Air Conditioning [].Yes [] Performance Bond Amount $ Permit Fee Plan Check Fire Surcharge State Surcharge SAC Charge Erosion Control S Park Fee construction Type occ�cy Group No Fire Protection Provided []Yes []No See Reverse for Schedule Received [l Yes [] No Spec. Assessments $ Driveway Escrow $ TOTAL $ 4.15� '47�2 See Fee Schedule on Reverse Side In Excess of Prepaid Amount - See Reverse Side .001 x Permit Valuation (1/10th %) $.50/$1,000 Valuation (See Sched- for > $1 Million) $950 per SAC Unit (Plans to MWCC for detenn'mtion) $450.00 Conservation Plan Review Fee Determined By RiginPeriin4 Agent Necessary [] Not Necessary [] feet x $13.50/foot ATTACH STIPULATIONS Tel # ;3 Date �' qll APPLICANT cri VALUATION Sq. Ft. x $ Cost/Sq. Ft. = Valuation Ft. x $ cost/Sq. Ft. _ Valuation $ _ Sq. Ft . x $ Cbst/Sq'. Ft. = Valuation $ ) TOM VALKIE Building Use Air Conditioning [].Yes [] Performance Bond Amount $ Permit Fee Plan Check Fire Surcharge State Surcharge SAC Charge Erosion Control S Park Fee construction Type occ�cy Group No Fire Protection Provided []Yes []No See Reverse for Schedule Received [l Yes [] No Spec. Assessments $ Driveway Escrow $ TOTAL $ 4.15� '47�2 See Fee Schedule on Reverse Side In Excess of Prepaid Amount - See Reverse Side .001 x Permit Valuation (1/10th %) $.50/$1,000 Valuation (See Sched- for > $1 Million) $950 per SAC Unit (Plans to MWCC for detenn'mtion) $450.00 Conservation Plan Review Fee Determined By RiginPeriin4 Agent Necessary [] Not Necessary [] feet x $13.50/foot ATTACH STIPULATIONS 63-8b-416051 CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT PARTIAL RATE SCHEDULE ro PLUNSIXG FIXTURE RATES: T0. RATE a N: z ber FiXt•::es x $3.00 o r^st%=e Fixture Cpening x d $ Water x m m Catch Basin x $5.00 w e M vs m A m ro l+ a W $ Water Softener Heater o ++ '+ x r. $ H M $4 $ .0 C B U � 1st 3 fixtures N $3.00 $ additional Fixtures x $1.00 $ Cas Range to 199,000 BTU x $10.00 $ REPAIRS F ALTERATIONS First $100.00 $5.00 $ each add. $100.00 or fraction $2.00 �_ $ State Surcharge $ .50 TOTAL FEE w M M U 0 c 12 N 3 0° �i v wro a 3 as lee I '_st 2:%d 4 :moi f (R) - il:ta:e Connection Opening Connected with Sewer (!} - New Fixture, Old Opening Water PARTIAL RATE SCHEDULE PLUNSIXG FIXTURE RATES: T0. RATE TOTAL N: z ber FiXt•::es x $3.00 $ r^st%=e Fixture Cpening x $2.00 $ New Fixture, Old 0penirg x $2.00 $ Catch Basin x $5.00 $ :cater :eater - to 99,000 BTU x $5.00 $ 100;000 B=J to 199,000 BTU x $10.00 $ Water Softener x $7.00 $ New Ground Ran Old Building x $5.00 $ Electric hater Heater x $5.00 $ GAS FITTING FEES: 1st 3 fixtures x $3.00 $ additional Fixtures x $1.00 $ Cas Range to 199,000 BTU x $10.00 $ REPAIRS F ALTERATIONS First $100.00 $5.00 $ each add. $100.00 or fraction $2.00 �_ $ State Surcharge $ .50 TOTAL FEE $ _ 8.00 REINSPECTION FEE ($10.00) Job Address 1640 68 Ave. NE Department of Buildings City of Fridley Tel. #571-3450 The undersigned hereby makes application for a perit 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 reprosontations stated in this application are true and correct Fridley, Mn. 2-11-81 , 19 O'ANER MARTIN KIND OF BUILDING fr ame USED AS res. TO BE COMPLETED ABOUT 2-18-81 ESTIMATED COST 50 • o0 OLD - NEW BUILDING PERMIT NO. PERMIT NO. 852 Company) �!� f�a/ d�arv�li- Signed By MINNEGIASCO Tel. No. ROUGH INSP. Date FINAL INSP. i 4-1' 0 Date , APPROVAL FOR PERMIT MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE City of Fridley Building Inspections Dept. Ph: 763-572-3604 FAX: 763-571-1287 6431 University Ave NE Fridley MN 55432 G�� Mechanical Permit#� - /, G 7l Residential Application City of Fridley See Back Side For Required Information Date 6jr Site Address: The applicant is: (cirl a one) Owner Contractor Property Owner: - /% Address: /6_2- 4¢A,-) 4WM1W City: State: A-141 Zip: �� Phone: Cell: Fax: Contractor Inform ati n - Company Name: �l , Contact Person: r Address: City: iTW','y J�e' State: /d?A/ Zip: EjDZgC Phone: 6-s7 x/ wee Cell:&& 4e ��% Fax: 6 e{ �L5 Email: a MN Bond# & Exp Date .Z�l Type of Work (circle one): New Replacement Alteration/Remodel Detailed Description of work: Ak,PJ 6 Equipment Installed: MFG: Model: Size/BTU: MFG: Model: Size/BTU: MFG: Model: Size/BTU: Please check all that apply: _Fireplace (gas) $15.00 New Gas Grill $10.00 _A/C $25.00 _Fireplace (wood) $35.00 _Gas Unit HTR $10.00 _Air to Air exchanger $15.00 _Furnace $35.00 _Pool Heater.$35.00 _Boiler $35.00 _Gas Dryer $10.00 Ventilator $15.00 _Chimney Liner $10.00. _Gas Piping $10.00 r �.. . Duct Work $10.00 Gas Range/Oven $10.00. •, t, •;:' L Permit Fee $ (Total from above -Minimum fee $35.00 Surcharge ,$ 0.50 Total Due $ Make check payabl&to City of Fridley This is an application for a permit- not valid until processedGA:�;J' I hereby apply for a mechanical permit and I acknowledge that the information above is complete and I� accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and 7� with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in case of all work which requires review and approval of plans. Signature of Applicant: Date: Approval Inspector Signatu r&5 Dat -�S Please Note: Separate permits are required for Building, Plumbing, and Electrical work RUG -09-2005 13:34 CITY OF FRIDLEY P.02iO4 PLUMBING 1iNu�� X09 RESIDENTIAL APPLICATION Received By City Of Fridley Date Received NOTE: IF PROPERTY 13 NOT OWNERIOCCUPIED- A LICENSED' CONTRACTOR MUST OBTAIN THE PERMIT. Z DATE YOUR AIL ADDRESS I^��i Ad . 2.0 SITE ADDRESS THE APPLICANT 1S: (CIRCLE ONE) OWNER CONTRACTOR NAME PROPERTY OWNER/ ADDRESS TENANT C17Y STATE ZIP PHONE # NAME O C�1 ENSE # K 2 ADDRESS 'yva CONTRACTOR CITY Qxti STATE /k ZIP_ PHONE # FAX#�Z PERMIT TYPE SINGLE FAMILY TWO FAMILY TOWNHOUSE ME OF WORK p NEW Ee REPLACEMENT DETAILED DESCRIPTION OF WORK , FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED FDCTURES: (INDICATE TOTAL NUMBER OF EACH) BATH SINK(LAV FLOOR DRAINS SHOWER WATER PIPING _BATHTUB GAS PIPING (Need City license) SWIMMING POOL WATER SOFTENER ($35) CLOTHES WASHER KITCHEN SINK —-WATER CLOSET BACKFLOW PREV, ($1S) DISHWASHER LAUNDRY TRAY ✓ WATER HTR ($35) FOR IRRIGATION WATER METER OTHER Permit Fee $ 00 MINIMUM $15.00 or 5% -of -cost of the improvement -whichever -is Plan Review $ greater on work less than $300 Surcharge $ .50 TOTAL DUE $ �3�� Make checks payable to: City of Fridley ----�- - n-' i+rra.ws�ua�w ryR/i MKIVI11 —NV I VALID UNTIL PROCESSED I hereby apply for a plumbing permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit that the work will be in accordance with the approved plan in the Case of all work which requires review and approval of plans. &, � NAME OF APPUCANT ` Z/ DATE PI se type or print SIGNATURE OF APPLICANT $431 UNIVESITY AVENUE NE, FRIDLEY. MN 56422 RUG -09-2005 13:34 CITY OF FRIDLEY P-03,104 City of Fridley Building Inspections Dept. Ph: 763-572-3604 FAX: 763-571-1287 6431 University Ave NE Fridley MN 55432 Mechanical Permit# 0?orO - 0/&/0 Residential Application City of Fridley See Back Side For Ranidrarl infnrmnf;nn Date � & Site Address: The applicant is: (cirice one) Owner Contractor Property Owner. Address: City: State: zip: Phone: Cell: Fax: Contractor Informat Company ��JJ Name: �� Contact Person: Address: Z City: State: Zip. Phone:_ ft'/Wil?AP.4- Cell:,4/Z 60 kP1'7 Fax: Z4/24' - 1166/0: Email: a /7, MN Bond# & Exp Date .p Type of Work (circle one): New Replacement Alteration/Remodel Detailed Description of work: V 1110 Equipment Installed: MFG: Model: Size/BTU: MFG: Model: Size/BTU: MFG: Model: — Size/BTU-Please check all that apply: _Fireplace (gas) $15.00 _New Gas. Grill $10.00 A1C $25.00 Fireplace (wood) $35.00 _Gas Unit HTR $10.00 Air to Air exchanger $15.00 _Furnace $35.00 _Pool Heater $35.00 —Boller $35.00 _Gas Dryer $10.00 Ventilator $15.00 _Chimney Liner $10.00 w Gas Piping $10.00 Duct Work $10.00 Gas Range/Oven $10.00 Permit Fee $ (Total from above -Minimum fee $35.00) Surcharge . _ - _ —._... - - _ .... _.. 0:50 - Total Due $' Make check payable to City of Fridley u ms is an appltcarlon Tor a permit- not vara until processed I hereby apply for a mechanical permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that i understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in case of all work which requires review and approval of plans. Signature of Applicant: Approval Inspector Signature:, Building Inspections 763-572-3604 DATE �i O SITE ADDRESS �- TENANT PROPERTY OWNER/ TENANT CONTRACTOR PLUMBING Permit No.:� COMMERCIAL APPLICATION Received By: CITY OF FRIDLEY Datedo#:-� YOUR E-MAIL ADDRESS SUITE NO. ADDRESS: CITY STATE ZIP PHONE: SUBMIT A COPY OF STATE LICENSE # / EXP DATE A / c� YOUR STATE ADDRESS: y C�2CZ�it/� T��CITY I�STATO QIP �j 0Z� LICENSE WITH P11O _ FAX APPLICATION PERMIT TYPE Iu MSTITUTIONAL ❑ MULTI -FAMILY ❑ SWIMMING POOL TOWNHOUSE ❑ COMMERCIAL/INDUSTRIAL ❑ OTHER TYPE OF WORK: ❑ NEW REPLACEMENT ❑ ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK C F - CLOTHES WASHER _ DISHWASHER _ DRINKING FOUNTAIN FAUCET FLAMMABLE WASTE TANK _ FLOOR DRAINS GAS PIPING _ GREASE TRAP _ KITCHEN SINK _ LAUNDRY TRAY LAVATORY Total Job $ Valuation _ RPZ VALVE BACKFLOW PREV _ ROOF DRAINS _ SHOWER _ SLOP SINK _ SWIMMING POOL URINAL WATER HEATER _ WATER METER WATER PIPING _ WATER SOFTENER _ WATER CLOSET All fees are based on valuation, including the cost of labor and materials. o, Permit Fee $ (1.25% of Job Valuation / Minimum fee: $35) Surcharge $ CS5 Valuation X .0005 Total Due $ 3� s Make Checks Payable to: City of Fridley THIS IS AN APPLICATION FOR A PERMIT NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work which requires review and approval of plans. NAME OF APPLICANT DATE SIGNATURE OF APPLICANT City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977