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PRE 2010 DOCS. CITY OF FRIDLEY NOTE: Applicant should obtain building permit proce,a,,,.o i „fnrMat; nvy-- from Building Inspection BUILDER; Approved Contractors, Inc. Department Secretary. ADDRESS: 1052 Osborne Rd. N.E. Fridley 554NOTE: A Certified Survey of the lot, Street City Zip Code showing the location of the foundati n, TELEPHONE: 1 786 3 680once it has been constructed, will be Home Business required before proceeding with the. framing. PROPERTY OwNER(S) Roger W. Larson Doonaj- "M. Wehlast James E. Wiensch MiL Wa vAlep 85 West 4. Circle Pines, Minn. ADDRESSES) $$04 Lexington New Brighton, Minn. 55112 Street T City Zip Code 614 W. Brown Deer Rd. Milwaukee, Wisc. Street City Zip Code TELEPHONE NO -(S) Rome Business ION OF Property Location on Street or Exact Street Address (if any): County Rd. H or 69th Ave., N.E. Legal Description of Property: The East 3/4 of the NE 1/4 of the NE 1/4 of Section 13 T-30, R-24 City of Fridley, County of Anoka, State of Minnesota Total Area of Property sq. ft-r� Present Zoning C1assif1c&%10n-4 DESCRIPTION OF BUILDING Proposed Building Use: Multiple Each unit � wildingimensione: ,,_,,Front 20 Depth 32 Height 141 units Square Ft. 121 Cubic Ft. Type of Construction: Wood Frame each unit Project Estimated Cost �1, 6, 000.0C+ To Be Completed 7-1-73 1 DATEIr �%L� ` APPLICANT'S SIGNATUM MOM u yr r -A n o vti1T r7 3 00 5� SQ GT /'G� �,� i / e � A 5�'4y,s-y 67 2 z — y93,06173 u Alli ,CSU/!NG �' l/7 3 9 3 : ©_ -F // 7 a 7 o v o YsrsF�AJ- U4Te�� / L j Sf HFOv�.�' 7 u e R100-12 10? SC�c�T r �i FT 30 yo0 Z 000 ,v 10, i i 3o`t-,— � q ?OL y 10\ Fr .5��4—Tt 9 ik So? 70 7—A-1, 11,4LV C- AAL ,d0 ®.S S 7`�-7`� sysp Ol�ft�L� C� B: 9%�4e�Es NnN-RES IDENTIAi BUILDI.NG PERMIT CITY OF FRILLEY ADMINISTRATIVE PRQCESS114G AND PLAN CHECK x VARIANCE REQUIRED: SPECIAL USE REQUIRED: PLOT PLAN: TOTAL AREA GRADE ELEVATION SFT C ®/Z/ si rC Ai�V/lvu.4t / , ( 9,/ C / T Y f.fiG. ADDRESSa0 /�<- �'`�%U� /Vr LEGAL DESCRIPTION: ec t , — T- 3 0 BACKS: FRONT YARD SIDE YARD REAR YARD SUBMIT TO: BUILDING BOARD BOARD OF APPEALS PLAN. COMM. COUNCIL °e H APPROVAL DATE: 5 7 REMARKS: U FIRE REQUIREMENTS: FIRE MARSHALL FIRE-REVENTION BUREAU EXITS (dates App) PnH P4 U �e INSIDE UTILITIES: PLUMBING VENT & HEATING ELECTRICA® a re Ems., U Date Approved s t y r ► �� 0-1 p H v� OUTSIDE UTILITIES & SITE DEVELOPMENT: Date Approved City Engineer WATER SEWER ELEV CURBING DRAINAGE SCREENING & PLANTING 75 -75 le i /4 5 PP-,RPP-,RP4 ,4,V Sewer Connection Charge Receipt No. Permit Fee & Plan Check !v53, o -o Receipt No. 3,65/ Less Deposit:%�� ,ate Receipt No. �/5 y Q,� �?, 7°' Net Permit Fee DueQ4.4��, / % Receipt No. SPECIAL ASSESSMENTS: _ IF LATERAL ASSESSMENTS HAVE NOT BEEN PLACED ON THIS PROPERTY, AN AGREEMENT NUST BE SIG AGREEING TO ASSUME SUCH LATERAL ASSESSMENTS BEFORE A PERMIT WILL BE ISSUED* AGREEMENT NECESSARY Finance Director AGREEMENT UNNECESSARY Regi®texed Ragineerfe Stamp C, Legal Description Check 04 (A) FOUNDATION PERMIT FINAL APPROVAL Building Official Building Official (B) FINAL APPROVALX= Easements, R/W, Special Agreements. -91 City Engineer DATEs oa CERTIFICATE OF OCCUPANCY: PARTIAL: DATE: FINAL: DATE: ca REMARKSs REMARKS V r=r'/2r_ %'/-'- e s_ = UkTX- 3r 70 tui 7- rL%Ccs; r=r'/2r_ %'/-'- e s_ = 15? - Y, -e r -7-eul,-e ttj L L,, D x�! 7V, -5�lyv&vl lelovS ,zf 9 1,,2,e X/ C17 -1v P<�i� e �cc� p7- L , VA 744-& ellecleoc;Fe y, A 0 Al Ot /�/ C//V/ rs A9 6 C/ 7- CIT,v r -6R /f t 1111IM6 ilA,17-S 7107-.4�- ,P6 VNI ZF Permit Fee paid on Permit ;'11,315 for 1560 - 1570 69th Avenue N.E. City of Fridley, Minn.. 1131 6431 University Ave. N.E., Minneapolis, Minn. 55432 BUILDING PERMIT Date: -February 22, 1972 Ad&m 85 Wgst Road, Circle Pines, Mi Address 1092 0shar-ne lRoad t -F Prid1py 786-3680 1640,163821636, LOCATION OF BUILDING No163421632,1At 69th Avenue N.E. Part of Lot parcels 10, Section 13 Addition or Sub -Division Cornea Lot Inside Lot Setback r— Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Each Unit 6 Townhouse Units Front 0_ Depth _ 32 f Height 21 Sq. Ft. _3? 131 Cu. Ft. Front Depth Height ._ _ Sq. Ft. _..__ Cu. Ft. Type of Construction - Wood Frame Est. Cost mm Al I 'Al �_ To be Completed "-3r®ter In consideration of the issuance to me of a permit toconstruct the building described bove, I agree to do the proposed work in accordance with the description above set and in com fiance th all provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $�1, 315, permit is hereby granted to Rice Creek Dev. 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 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 ani city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinOF 01 147 --c-C 2_-/ JkffidV4J*qTctor CLARENCE BELISLE NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to we the Building Inspector for separate permits for these items. �1! Applicatia� for Power Plant and Heals ft ColinqR Ve"Ra&Rv R e�iger0ion and , Air Coming Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work $10.00 $ Replacement of Furnace ... ..... 8.00 $ Repairs & Alterations—up to $500.00 6.00 $ _ Repairs & Alterations each add. $500.00 3.00 $___ _ MECIL WART[ AID Furnace Shell & Duct Work to 120,000 BTU ..... & ..$10.00 $ 6 —0. each add. 60,000 BTU .................... .. 3.00 ; Replacement of Furnace .. I . . .... &00 $ Repairs & Alterations—up to $500.00 .. 8.00 $ Repairs & Alterations each add. $500.00 &W $ 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 3.11(1Each add. 320 sq. ft. IDR 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 189,000 BTU) . . ...... 6... 8.00 $ over 199,000 BTU See Fes Schedule Dept. of Bldgs. Phone 8804480 L P -')3y 3l -, 3 " �'- ' g � /0 - ?/i' 0� 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 Ordbume: and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true7d d correct. I P 'Tdley, Minn Kind of Building Used as To be completed about Estimated Cost, Old -0. Building Permit No. Permit No. �c�'fftV DESCRIPTION OF WORK HEATING or POrglt PLANTS—$team, got Water Warm —No 6' Trade Name���111 size xoj9- � —2 — GAS FITTING FEES: Capacity , Q. FL E D R BTU g r NO RATE TOTAL 1st 3 Fixtures x$ 200 $ 0-U Total Connected Load Kind of Fuel P-/ Additional Fixtures x •75 $ BURNER — Trade Name Size No Gas Range to 199,000 x$ 5.00 $ AIR CONDIT>tONING FAN HEATING SYSTEM VENTILATING SYSTEM ALTERATIONS & REPAIRS ROUGH FINAL div o ° 0 capacity. Sas Fee Schedule VIXJ ,-66.o6 TOTAL FEE am eo (REMARKS -OVER) Sq. Ft. E.D.R BTU HP •� it City of Fridley Applicathm for Phmbbig and Gag t "bg Pwmk apt. of Bldaa. Phone 56"M DESCRIPTION OF WORE Number, Kind and LocaBou of Fixtuw f , ■■■'■+ dam'■'�■■■■■ 1st I (e Ind 3rd Lov+rM - 3r -3(v_ 3e/ -Sa'Z -'?O • *AM "M City of Md1W. • o a eAs ncG The undersigned hereby makes application for a permit for the work herei, 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 tact and representations stated in this application are true and correct PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES- NO. RATE TOTAL Number Pixtures ................ g x $2.00 $ Future Fixture Opening ............ x $1.50 $ New Fixture Olaf Opening .......... x $1.50 $ Catch Basin .................... x $3.25 $ water Beater fUp to 99,000 BTU) .... _� x $$3.0y0� $ � UD New Ground Rua Old Bldg. . . o e ®. . • x $3.25 $ Electric Water Heater .............. a $2.00 $ GAS FITTING FEES. NO. RATE TOTAL 14 3 Fixtures ......... • • • • • • • • x $200 $ . C) 0 , Additional Fixtuim ............... x $ .76 $ �?'� 2-S' 9 &® . () O Gas Range to 199,000 BTU ............ x $5.00 $ State Surcharge $ .50 REPAIRS & ALTERATIONS—gofer to Cedo Dusrlption o...... a.. a.a.e..ce..a..............�...� _ TOTAL FEE 6 14 .9S Fridley,, Minn I9. Omer /l'P e_ =1-1r Kind of Building ��� ����� dr • Used as To be completed about Estimated Cost, $ Old—New. Building Permit No. Permit N Signed By Business Phune No ROUGH FINAb sue�ECT NO. City of Fridley 27026 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. COMMUNITY DEVELOPMENT DIV. _ ____ ~ PROTECTIVE INSPECTION SEC.qAI!Z NUMBER REV DATE PAGE OF APPROVED BY ..'"1 J CITY HALL FRIDLEY 55432 �'j 612-571-3450 910-F15 8698 JOB ADDRESS 1630-1640 69 Ave NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. Parc 1 & 200 Section 13 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Rice Creek Development 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO AAAmerica's Best XXXIRM 2400 Interlachen Drive #222 Spring Park 55384 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 707-0100 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Commercial 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof 6- lex 57 S Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with State Building Code. 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 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 4753 $2.37 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 PERFORMAN OF CONSTRUCTION. 99, ]5 4.75 Fire S\i PLAN CHECK FEE TOTAL FEE 6 Fe 106.87 SIG AT RE OFC NTRACTORORAU RIZEDAGENT ATE( PROPERLY (DATED THIS IS YOUR PERMIT _ 14;INSP �-- / 0( BATE SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI Prepaid Plan Check $ Estimated Cost $ Receipt # Effective 1/1/98 CITY OF FRIDLEY R-3, COMMERCIAL & INDUSTRIAL BUILDING PERMIT APPLICATION T Construction Address O _ /1d vo a 6l '4,"e V6 zoning Legal eeE CrfeK Owner & Address Tel# CaITR=R & ADDRESS e9i4 seer; ��s ��c% fl �O/ ���c v� �5%vii Tel# 7a7 a/oo Architect Reg . # Engineer `` ".�`�`,� f/P 5`r3� Reg . # BUILDING CONSTRUCTION TYPE OF WORK [] New [] Addition [] Alteration -Describe xllGr.06 .6 `444 OFC. AREA: Length Width Height Sq. Ft. WHSE AREA: Length Width Height Sq. Ft. armR AREA: Length Width Height Sq. Ft. Tel # ;207 0/60 Date 516rl?,-9 VALUA IVN Sq. Ft. x $ Cost/Sq. Ft. = Valuation $ ) o� Sq. Ft. x $ Cost/Sq. Ft. = Valuation $ Sq. Ft. x $ Cost/Sq. Ft. = Valuation $ ) TOM VAuJE Building Use Construction Type Occupancy yup Aix Conditioning [] Yes [] No Fire Protection Provided [] Yes [] No Performance Bond Amount $ See Reverse for Schedule Received []Yes []No Permit Fee Plan Check Fire Surcharge State Surcharge SAC Charge Erosion Control Park Fee Spec. Assessments $ Driveway Escrow $ 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) $1000 per SAC Unit (Plans to MCC for determination) $450.00 Conservation Plan Review Fee Determined By Engineering Agreement Necessary [] Not Necessary [] feet x $13.50/foot ATTACH STIPULATIONS City of Fridley Building Inspections Dept. Ph: 763-572-3604 FAX: 763-571-1287 6431 University Ave NE Fridley MN 55432 Mechanical Permit it 6;iom 610 Residential Application City of Fridley See Back Side For Required Information ¢ Date '% 0 Site Address: The applicant is: (cirl a one) Owner Contractor Property Owner: Address:/6✓r2 �✓e'? City: G"� State: Rfit/ zip: A:Elm Phone: Cell: Fax: Contractor Informati n - Company Name: IrQ Contact Person: -i Address City:&Zwz /,"-_State: /LIN zip: ?'S Phone: 6V `1"� Me* Cell:Fax: 46,57 MN Bond# & Exp Date Email:ongea Type of Work (circle one): New Replacement Alterabon/Remodel _ Detailed Description of work: /Z Equipment Installed: MFG: Model: Size/BTU: MFG: Model: Size/BTU: MFG: Model: Size/BTU: Please check all that apply: (gas) $15.00 New Gas Grill $10.00 A/C $25.00 _Fireplace _Fireplace (wood) $35.00 _Gas Unit HTR $10.00 to Air exchanger $15.00 Fumace $35.00 _Pool Heater $35.00 _Air $35.00 _Gas Dryer $10.00 Ventilator $15.00 _Boiler _Chimney Liner $10.00 _Gas Piping $10.00 �= d Duct Work $10.00 Gas Range/Oven $10.00 �' Permit Fee $ (Total from above -Minimum fee $35.0 • Surcharge Total Due $ 0.50 %� i Make check payable to City of Fridley This is an application for a permit- not valid until processed I hereby apply for a mechanical permit and I acknowledge that the information above is complete and ­tw that thA 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. Date: Signature of Applicant: Approval Inspector Signature: Date: 7 6 Please Note: Separate permits are required for Building, Plumbing, and Electrical work -g REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC ❑ NEW HOMES/ADDITIONS ❑ EXISTING HOME ❑ MAKE-UP AIR REQUIRED FOR NEW/EXISTING HOMES 1. Combustion Air (See note below) a. Oil or solid fuel IMC Chapter 7 with MN Amendments b. Natural Gas or Propane/IFGC Chapter 3 with MN Amendments 2. Make-up Air (See note below) a. IMC Chapter 5 with MN Amendments 3. Venting a. Gas appliances IFGC Chapter 5 with MN Amendments b. Fuel other than gas IMC Chapter 8 with MN Amendments REQUIRED FOR NEW HOMES 4. Heat loss & cooling load per room a. Required on new construction IMC 1346.0312 5. Ventilation a. Per MN Energy Code 7670 or 7672 6. Duct Design Per IMC 1346.0603.2 a. ACCA Manual D NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for combustion and make up air calculations AUG -09-2005 13:34 CITY OF FRIDLEY P.03iO4 City of Fridley Building Inspections Dept. Ph: 763-572-3604 FAX: 763-571-1287 6431 University Ave NE Fridley MN 55432 Mechanical Permits Residential Application City of Fridley See Back Side For Required Information Date Site Address: The applicant is: (cirlce one) Owner Contractor Property Owner. Address: CRY: State: Zip. Phone: Cell: Fax: , Contractor Informati�r}m����� Company Name: � Contact Person: Addre— City: State: Zip: XrVZW- Phone: Cell: 417 fflQ ZPtI-Z Fax:�--V �01Z/2,r- Email: • MN Bond# & Exp Date -PS T e- of Work (circle one): New Replacement Alteration/Remodel Detailed Description of work- 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 _Fumace $35.00 _Pool Heater $35.00 _Boiler $35.00 _Gas Dryer $10.00 Ventilator $15.00 _Chimney Liner $10.00 wGas Piping $10.00 Duct Work $10.00 Gas Range/Oven $10.00 Permit Fee $ &6-00 (Total from above -Minimum fee $35.00) Surcharge 050 - Total Due $ VI5 Make check payable to City of Fridley This is an application for a permit- not valid until processed I hereby apply for a mechanical permit and 1 acknowledge that the information above is complete and accurate; that the work wig 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. RUG -09-2005 13:34 CITY OF FRIDLEY PLUMBING BING RESIDENTIAL APPLICATION City of Fridley P. 02, 0.17 j �00�-3 Permit Number Received By Date Received NOTE: IF PROPERTY IS NOT OWNERiOCCUPIED. A LICENSED CONTRACTOR MUST OBTAIN THE PERMIT. DATE YOUR §AAJL ADDRESS— SITE DDRESS SITE ADDRESS THE APPLICANT IS: (CIRCLE ONE) OWNER CONTRACTOR_ NAME PROPERTY OWNER/ ADDRESS TENANT CITY STATE ZIP PHONE# NAME CONTRACTOR ADDRESS CITY Q.L� STATE /f ZIP PHONE # FAX#� 41L _ PERMIT TYPE TYPE OF WORK I 13 NEW DETAILED DESCRIPTION OF WORK FAMILY TWO FAMILY W REPLACEMENT TOWNHOUSE FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED FD(TURES: (INDICATE TOTAL NUMBER OF EACH) BATH SINK/LAV FLOOR DRAINS SHOWER WATER PIPING BATHTUB GAS PIPING (Need City license) SWONMIN© POOL WATER SOFTENER ($35) CLOTHES WASHER KITCHEN SINK WATER CLOSET BACKFLOW PREY. ($16) DISHWASHER LAUNDRY TRAY WATER HTR ($36) FOR IRRIGATION WATER METER OTHER ®0 Permit Fee $ , MINIMUM: -$15.00 or 5% -Of -cost of the improvement -whichever is" Plan Review $ - greater on work less than $300 Surcharge $ .50 TOTAL DUE $ _�� Make checks payable to: City of Fridley I nrn 14 AN APPLICATION FOR A PERMIT — NOT VALID UNTIL PROCESSED I hereby apply for a plumbing pemlit 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 &M4�� DATE PI se type or print SIGNATURE OF APPLICANT $431 UNIVESITY AVENUE NE, FRIDLEY. MN 56432 01.1 CITY OF FRIDLEY PERMIT NO.: 2005-01493 r 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 5 + (763) 572-3604 F 3) 571= 287 ADDRESS �r PIN 133024110002 LEGAL DESC : UNAVAILAB : LOT 0 BLOC PERMIT TYPE : PLUMBING PROPERTY TYPE : TOWNHOUSES isoo CONSTRUCTION TYPE : ALTERATION VALUATION U NOTE: INSTALL A GAS WATER HEATER AS PER INSPECTOR KEVIN HANSON # GAS WATER HEATERS 1 �/ l APPLICANT WATER HEATER - GAS 35.00 COMMERCIAL PLUMBING &, HEATING INCN, STATE SURCHARGE, OTHER 0.50 24428 GREENWAY AVE TOTAL 35.50 FOREST LAKE, MN 55025 PAID WITH CHECK # 7.V28 (651) 464-2988 n` OWNER RICE CREEK TOWNHOUSES CO 1652 69TH AVE NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. Applicant Date Bldg T 6e ---7 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.