PRE 2010 DOCSCity of Fridley, Minn.
f
BUILDING PERMIT No 492 1
Date:
Owner: Builder
Address ... _..(! �/' '� ; Address ....... .......... , ...
�'A-
r
E
u
No.Street Part loot
Lot . .:................ _........ Block ..... __...... .:........ .................. Addition or Sub -Division .._-..... ._. �...s:..
Corner Lot ...... ................... -........ Inside Lot --A!.: ......... Setback ....._.. .. .:_........ Sideyard _....�_.... .... ...... .............
-
Sewer Elevation ....._ .............................. ..... ............................ _-................... Foundation Elevation
DESCRIPTION OF BUILDING
To Used as:
f r�ipp
............... ........
Front ...._.. Depth ...... Height .... :............ Sq. Ft ,!a�� Cu. Ft.62 .rr.g
r.. ... r.......... nt ..., Depth ...._.�...._/.Height ..._ Sq. Ft. Cu. Cu. Ft. .....
_ ....
Type Construction -_ ......._...................:... ..:.... Est. Cost... dl ..lf ::......:....... 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 with all provisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of $...1.e ............ _..., 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 olatio_nof 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 hems.
1... _-_r_ '1
APPLICATION FOR BUILDING PMW
CITY OF FRIDLEY, MINNESOTA
Owner 's Name J6 P,4 IMoC- Builder �! e � I�' �a����
Address I I i s 5A °� �. address
No.
of Lot
Lot Block Addition or Subdivision c, P-0
� P-0 �I
Corner Lot Inside Lot Setback a` Side -Yard 1 e #,,
Alt
4
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and proposed building
location.
To be used as:
?/,,
t. 1
DESCRIPTION OF BUILDING
% nArth % Haight
Sq. Ft. ! l -7 Cu. Ft.
r r �
rent ]G7 DenthHeight__ _
Sq. Ft. Q Cu. Ft.
Type of Construction t Estimated Cos4 M„��_�_
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 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.
/'�
DATE .r= h � SIGNATURE
s�
(A Schedule of Fee Costs can be found on the Reverse de.)
0
i
.. ' a
City of Fridley
Application for Plumbing and Gas F'rlting Permit
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures
G7?i1�J
8
-j
�U'd
P
N
WATER HT R.
GAS
ELM
c�
o
S
<3
(�9
�O
W
Base
1st
2nd
_
3rd
—
4th
• Future Connection Openings
Connected with
Sewer
New Fixture, Old Openings
Cesspool
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TQTAL
Number Fixtures ....... .......... x $1.50 $ f °' S
Future Fixture Opening ................ x 1.20 $
New Fixture Old Opening .............. x 1.00 $
Catch Basin ............................ x 3.25 $
Water Heater (Up to 200,000 BTU) ...... x 2.00 $ U
New Ground Run Old Bldg. ............ x 3.25 $
GAS FITTING FEES: NO. RATE TOTAL
1st 3 Fixtures .......................... x $1.50
Additional Fixtures .................... x .50 $
Gas Range to 200,000 BTU .............. x 2.00 $
REPAIRS & ALTERATIONS—Refer to Code
Description................................................
TOTAL FEE $
Dept. of Bldgs. Phone SII 4-7470
--- --
de -.,V- 1,4 W1
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 trued cgrrect.
Fridley,
Owner
Kind of Building
Used as
To be completed about
i
31 19 -Le
Estimated Cost, $
Old—New. Building Permit Permit NA.
s
Signe _ .
A/7
By
Business Phone No Ce -rig-12 3_/
ROUGH
FINAL
X42 2M 7-59
a
Application for Power Pius and. Heating. Cooling, Ventilation. 199 igeraand
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR: RATE TOTAL,
1.
Furnace Shell & Duct Work .......................... 8.00 $
Replacement of Furnace ............................. 5.00 $
Repairs & Alterations—up to $500.00 .................. 5.00 $
Repairs & Alterations each add. $500.00 ............... 2.50 $
MECH. WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ t�
each add. 60,000 BTU ..... .................. 2.00 $ _
Replacement of Furnace ............................. §.00 $
Repairs & Alterations—up to $500.00 5.00 $
Repairs & Alterations each add. $500.00 .............. 2.50 $
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. EDR Steam....... 8.00 $
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $
Each add. 200 sq. ft. EDR Steam ...................... 2.50 $
Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $
OIL BURNER—to 3 gal. per hour ........................ 5.00 $
over 3 gal. per hour—See Fee Schedule
✓
GAS BURNER (up to 400,000 BTU) ............ . ......... 5.00 $
GAS FITTING FEES: NO RATE TOTAL
1st 3 Fixtures ...................... x $1.50 $
Additional Fixtures ................. x .50 $
Gas Range to 200,000 BTU ........... x 2.00 $
AIR CONDITIONING $
FAN DATING SYSTEM See Fee Schedule
VENTILATING SYSTEM
ALTERATIONS & REPAIRS TOTAL FEE
ROUGH
Dept. of Bldgs. Phone SII. 4-7470
J-�p - / 9
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.
(I fey, AEnn_ / z- (/ I / 1194-6
Owner
Kind of �/ ding
^ D
Used as
To be completed about
7_
Estimated Cost, $ d ut�
ir6
lc� 7z'
Permit No. � Permit No.
DESCRIPTION OF WORK
HEATING orWER PLANTS --Ste Hot Wa ,Warm Air No
Trade Nam / C Size No 4 a
Capacity Sq. Ft. E.D.R ``� �� &_�) BTU _ H.P.
Total Connected Load / l �( o Kind of Fue "
BURNER — Trade
Capacity.
(REMARKS—OVER)
�,&.42 ZM 7-59
Size No
Sq. Ft. E.D.R BTU H.P.
RAY N. WELTER HEATING Cp
Sigapd 4637 CHICAGO AVC-.
By MINNEAPpLIS 7, MiNNESWA
Business Phone No
Application for Power Plants and Heating. Cooling. Ventilation. Refrigeration and
Air Conditioning Systems 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 $
MECIL WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ............ $10.00 $
each add. 60,000 BTU ....................... 3.00 $
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 199,000 BTU) ....................... 5.00 $
over 199,000 BTU See Fee Schedule
GAS FITTING FEES: NO RATE TOTAL
1st 3 Fixtures x$ 2.00 $
Additional Fixtures ................. x .75 $
Gas Range to 199,0000 _........... x$ 5.00 $
V AIR CONDITIONING lw -+ 9 /1/ 14< Y9 k9f I $.. _
FAN HEATING SYSTEM
VENTILATING SYSTEM
ALTERATIONS & REPAIRS
ROUGH
FINAL 1'.L ^ / 16 - ?�
See Fee Schedule
$
TOTAL FEE $ ,
Dept. of Bldga. Phone SM -3480 %%
Location A 6 �'-"'Al
City of Fridley:
M
The undersigned hereby makes application for a permit for the work hereir.
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.
Fridley, Minn_ 19 Z -'o
Owner L— j7- N
Kind of Building
Used as
To be completed about z
Estimated Cost, $-
Old—New. Building Permit No. Permit No.
DESCRIPTION OF WORK
HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No
Trade Name Size No
Capacity Sq. Ft. E.D.R BTU H.P.
Total Connected Load Kind of Fuer
BURNER — Trade Name Size No
Capacity Sq. Ft. E.D.R BTU H.P.
(REMARKS -OVER)
Signed
By._ P
<x Business Phone No -
to
CITY OF FRIDLEY 0111W
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE
Number Fixtures
x
rn
Future Fixture Opening
x
LQ
N
x
rdv
Catch Basin
x
$5.00
k
a)
$5.00
Water
x
$10.00
Water Softener
x
$7.00
w
r. .c,
$5.00
a
x
4
a
w
1st 3 fixtures
Heater
N
W
m e
tJ .•1
x
N
Gas Range to 199,000 BTU
H
•r1 cd
H
$
a7
ro ha
W
$5.OQ
each add. $100.00 or fraction
>1
$2.00
State Surcharge
••i
?G
FINAL INSP.
C. C
30
caul
O •'q
o .0
a
O
a)
11
a) al >~
•A
.0
+1
N
C.
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ul
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O
0
+J m
1� N
W
ro-1 N
ro
�d
-.i
ro
3
Sa O
1z W
.0
V!
q
W
ro rd
U fA
� ro
� $
ro
C7
a
�
td
C7
41
O
aS
leC
. to
U P
W
Rl
to
1st
f
2nd
3rd
4th
(R) = Future Connection Opening
Connected with Sewer
(*) = New Fixture, Old Opening
Water
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE
Number Fixtures
x
$3.QO
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
$
ROUGH INSP.
First $100.00
$5.OQ
each add. $100.00 or fraction
$2.00
State Surcharge
TOTAL FEE
FINAL INSP.
REINSPECTION FEE
($10.00)
Job Address ::2— Z-21
Department of Buildings
City of Fridley
Tel. #571-3450
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 Department of Buildings, 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
S
$ MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50
$ .50
$ I/ -D �
("::0 aCJ
TOTAL
OLD - NEW BUILDING PERMIT NO.
PERMIT NO.
Company"�_�
$
$
Signed B
Tel. NO.
9 q
$
S
$
ROUGH INSP.
Date
FINAL INSP.
Date
S
APPROVAL FOR PERMIT
S
$ MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50
$ .50
$ I/ -D �
SUBJECT
PERMIT
City of Fridley
® 60'7
AT THE TOP OF THE TWINS
BUILDING
PERMIT
1 #6
REC T N
'
�y-------COMMUNITY DEVELOPMENT DIV.
1 �
r � � PROTECTIVE INSPECTION SEC.
(`
---1 CITY HALL FRIDLEY 55432
�•-" ,`J
NUMBER
REV.
DAT
9Z@ Z
PAGE OF
APPROVED BV
612-560-3450
910-F15
JOB ADDRESS 252 69th Place N.E.
1 LEGAL
LOT NO.
6
BLOCK
3
TRACT OR{�LZDITIO�f.
Mce l.reek Plaza
SEE ATTACHED
DESCR.
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Len Berg 252 69th Place N.E.
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Vossen Brothers
4 ARCHITECT OR DESIGNER MAILADDRESS
ZIP PHONE LICENSE NO.
SAME
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO.
6 USE OF BUILDING
7 CLASS OF WORK
❑ NEW ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
install swimMng pool 18 x 36
9 CHANGE OF USE FROM TO
STIPULATIONS
AS PER ATTACHED LETTER DATED 6/23/76
SEPERATE PERMITS REQUIRED FOR WING,
MFATING, PLUMBING AND
SIGNS.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
concrete
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SQ. 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 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 OOO
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-
30.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTALFEE
$32.50
SIGNATURE OF CONTRA RORA -. ORIZED AG NT (DATE)
EN PROPERLY I TED THI IS PERMIT
BLDG INSP
/YOL'p
DATE
SIG ATURE OF )WNEFpF(jP OW R BUILDE (DATE)
r �
/ h
'�
QF, dwT
OWNER'S NAME : �PB'') �� —BUILDER:
ADDRESS:_ADDRESS;
APPLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
•-
NO • h /
� �� ::7" STREET: (%
LOT: BLOCK: 3 ADDITION: ,0�� ��® -I-
CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD:
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:
r
In
p rout:�S' Depth: 4 Height:
Square Feet: Cubic Feet:
Front: Depth: Height:
Square Feet; Cubic Feet:
Type of Construction: Cne eA Estimated Cost: $ 52� err'
To Be Completed: x'62 ",f 5
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: A' / � SIGNATURE:
(See Reverse Side For Additional Informs ion.)
6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432
f June 23, 1976
yp4UT�ON
QG• HBO
2
m
%TTs _�gT6
Len Berg
252 -69th Place
Minneapolis, MN
Re: Swimming Pool at 252 -69th Place.
Dear Sirs:
TELEPHONE ( 612)571-3450
This letter is to make clear this departments requirements for the
swimming pool construction at the above address.
1. As indicated, two (2) skimmers approved by the National Sanitation
Foundation will be provided.
2. As indicated, four (4) inlets of approved design for fresh and/or
repurified water will be provided.
3. As indicated, a main drain of approved construction will be provided.
4. The filter and pump shall be approved by the N.S.F. and be of sufficient
capacity to provide a minimum turnover of at least two (2) times in
24 hours. This department recommends a turnover rate of 6-8 hours.
5. A deck, a minimum of 3 feet wide and sloped away from the pool, must
be provided around the entire perimeter of the pool.
6. The diving area will be acceptable provided there is no overhead
obstruction.
7. A fence or other suitable barrier, a minimum of six (6) feet high,
that affords no external hand of foot holds and which is impenetrable
by -toddlers, must be provided around the entire perimeter of the pool.
All gates and other accesses shall be equipped with self-closing and
self -latching devices which are capable of being locked.
8. An automatic chlorinator should be provided with a suitable test kit.
9. All electrical and plumbing installations shall be inspected and
approved by the City Inspection Department.
10. All electrical lines must be 10-20 feet or more away from the pool
surface.
11. The pool fill spout must be air gapped or protected by a vacumn breaker.
12. Suitable safety equipment to include but not'.limited to a ring buoy
and'rope that is 1�times the pool diameter, and shepards crook pole
must be provided and maintained with the pool at all times.
PAGE 2
Len Berg
June 23, 1976
Furthermore, these and any other requirements must meet the provisions of
the Fridley City Code, Section 115, Swimming Pools. The building permit
is approved contingent on final inspections and approval by the City.
If any questions or problems arise from this letter, please feel free to
contact me at 571-3450, ext. 170.
Sincerely,
Y/
STEVEN J. LSO
Environmenta Officer
SJO/bak
c.c. Professional Pool Assoc.
P.O. Box 1099
5645 Glen Avenue
Minnetonka, MN 55434
I
D
. —-0
__ �(_ O S.e�__-t'f�.�.�. 3' ,e _1 et I ; K e..__-a•�df �t � o� Gds,
TAHITIAN
HI -RATE SAND FILTER by PUREX
• SWIMMINGfor Commercial, Semi -Commercial
PRODUCTS and Luxury -Size Residential Pools
®Copyright 1073 Purex Corporetion
TAHITIAN by PU R EX
A new High in Hi -Rate Pool Filtration
COMBINES HIGH PERFORMANCE WITH LOW MAINTENANCE
High Performance:
Flow Rate —Design maintains laminar flow through
permanent filter media bed at design -rate of 20 GPM
per square foot of media surface area.
Efficient Filtration —Unique valve design with large
waterways provide maximum water flow through valve
with minimum pressure drop (less than 3 psi). This
means that pumping energy is conserved in pushing
water through the valve with resultant improvement
in actual filtering efficiency.
Integral Dial Valve—Valve provides 5 "positive lock"
filter positions: 1) filter to pool, 2) backwash to waste,
3) rinse to waste (prevents puff back to pool after
backwash of residual dirt left in laterals), 4) winterize,
5) close (to isolate filter). Valve serves as filter lid,
valve and distributor.
Design Tested—The Tahitian Hi -Rate Filter is the
product of extensive development and field testing.
NSF Approved—The Tahitian Hi -Rate Sand
Filter has been approved by the National
Sanitation Foundation Testing Laboratory for
commercial and residential pool installations.
HR 25
Tahitian Specifications
HR 31
Filament Wound Tank— Filter tank is made of
continuous fiberglass strands coated with
polyester resin for high impact strength and
protection against abrasion.
Flat Filter Bed—The Tahitian Hi -Rate Sand Filter has
maintained the necessary flat bed for effective filtra-
tion
iltration even at 200% design flow rate.
Low Maintenance:
Corrosion Resistant—All exposed tank and valve
parts are made of fiberglass, ABS or PVC plastic
materials for maximum protection against corrosive
elements, including chemicals.
Permanent Media—The Tahitian Hi -Rate Fiter uses
No. 20 silica sand as a permanent filtering media — no
cartridges to replace — no filter elements to re -coat
with diatomoceous earth.
Easy Access for Repairs—Valve is equipped with
quick disconnect plumbing adapter connections
which allow easy access to tank and valve for repair
or replacement without disturbing permanent
plumbing.
sia s�ia
WASTE
_ Pn OPOOL
H a�
— 36l?
PUMP
193k'
W
Distributed By:
0
•
PURER CORPORATION, POOL PRODUCTS DIVISION •
18400 E. Mohr Ave., City of Industry, Calif. 91749
1340 Seaboard Industrial Blvd. N.W., Atlanta, Ga. 30318
Litho In U.S.A.
Recommended
6 Hr.
8 Hr.
12 Hr.
Recom-
Pipe Size
Maximum
Shlp-
Recommended Pump
Model
Media
Quantity _
-
Filter
_Filter
Area
Filter=
Filter
IFiiter
mended
Inches
Overall
Dimensions
ping _
Size & Model No.
In Tree Horsepower
No.
Media
Sq. Ft
U.S.
U.S.
ftyp
U.S. 681
G P M.
ht
NLhs.
Tank
Tank
W
H
@
@
Cu. FtInlet
Outlet
45' head
60' head
NO. 20
AH -4
AH -6
HR 25
GRADE
SILICA
3.0
3.40
24,480
32,640
48,960
68
11/z
11/2
25'/2
35
52
AU -4
AT -4
AU -6
AT -6
SAND
1 H.P.
11/2 H.P.
NO. 20
AH -8
AHC -12
HR 31
GRADE
SILICASAND
5.5
5.24
37,440
49,920
74,880
104
2
2
311/2
39
75
AT -8
LHK-30
2 H.P.
3 H.P.
Distributed By:
0
•
PURER CORPORATION, POOL PRODUCTS DIVISION •
18400 E. Mohr Ave., City of Industry, Calif. 91749
1340 Seaboard Industrial Blvd. N.W., Atlanta, Ga. 30318
Litho In U.S.A.
e .m
Sta-Rite "D" Series swimming pool pumps
•have unusually good priming characteris-
tics, and will handle more air than ordinary
pumps. After priming chamber is initially
filled with water, "D" Series pumps never
need be reprimed, under nearly all oper-
ating conditions. May be installed above or
below pool level.
Sta-Rite "D" Series pump models have cast
iron pump body and seal plate as well as
suction trap and cover. Pump body has
both top and side discharge tappings, either
of which may be used.
Sta-Rite "D" Series swimming pool pumps
are designed for ease of service of normal
wearing parts; in most cases without dis-
assembling or disconnecting piping, wiring,
or mounting. No need to disturb wiring for
most motor parts service. Electrical parts
are readily accessible under protective
canopy. No need to disturb piping to ser-
vice impeller or seal. Motor slides off easily,
after removal of four bolts.
I'D" Series Self -Priming
Swimming Pool Pumps
VoTA-RITE IIVOUSTRIES,v IIVG. 5 3
WATER EQUIPMENT DIVISION
DELAVAN, WISCONSIN EFFECTIVE SUPERSEDES
• Chamblee, Ga. • Kaufman, Texas OCT. 1, 1973 JAN. 1, 1988
• Orlando, Fla. • Los Angeles, Calif.
• East Brunswick, N.J.
m
. .171 .
U ■ �7 �. ,F
1
4 6niinU640 operation. Na-
Designed or c
2919110M mom
lall
full length
'■■■■■
stainless steel motor
=gs,
Automatic -,"overload protection Is
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VoTA-RITE IIVOUSTRIES,v IIVG. 5 3
WATER EQUIPMENT DIVISION
DELAVAN, WISCONSIN EFFECTIVE SUPERSEDES
• Chamblee, Ga. • Kaufman, Texas OCT. 1, 1973 JAN. 1, 1988
• Orlando, Fla. • Los Angeles, Calif.
• East Brunswick, N.J.
"D" Series Self -Priming Swimming Pool Pumps'
Outline Dimensions
Cat. No.
H.P.
A
10
A
30
4" Iron Trap
B C M
6" Iron Trap
B C M
6" Iron Trap
B C M
E
F
G
H
J
K
L
NPT
N
P
DHE
1
15"/,s
15"/,s
9°/,e
5%
127/,a
9'%e
7
13°/,9
9Y,e
T%s
12'/,9
3%
4
11%
7%
318/,9
513/,9
1%
7%
3%
DHF
1'h
16"Xs
16%.
9%6
5%
12'/e
9'%9
7
13%9
9%.
713/,9
12'/9
3%
4
11%
7%
3'%9
613/6
1'h
7%
3%
DHG
2
181%s
18"Xs
10%6
5%
133/6
10"X9
7
14'X6
9'%a
713/9
133/6
31%6
313X.
14%
9%
4%
6%9
2
7%
3%
DHHG
2
19 "As
19%a
10%s
5%
13%9
10"/9
7
14'/9
913X9
7t 3X.
133/9
3'%s
V/16
14%
91h
4%
5%ta
2
71%
3%
DMB
'%
141%6
—
95/is
5%
12'/,e
9'%9
7
13%9
91/6
7"/6
12'/a
3'h
4
11%
7th
3's/s
51%s
1'h
7%
3%
DMC
%
14'%e
15%9
9/e
5%
12'X6
9'%9
7
13%e
9'/9
713/6
12'/9
3'h
4
11%
7%
3'%e
V/6
1'h
7%
3%
DMD
%
158/6
16"X.
9%s
5%
12'/s
9's/.
7
130/9
9%s
7'%s
12'/s
3'h
4
11%
7%
31/6
59/1.
1'h
7%
3%
DME
1
16'%e
15'3/9
9e/e
5%
127/s
918/9
7
138/,9
9'/e
71%e
12'/9
3'h
4
11%6
7'%
3'%e
513/.
1'h
7th
3%
DMF
1'h
16"Xe
16%9
9%6
5th
12'/9
91%6
7
13%s
9'/e
7'3/9
12%6
3'%
4
11%
7th
3'%s
51%9
1'h
7th
3%
DMG
2
1718/,6
171%e
9%e
5th
12'/6
9t3/6
7
138/9
9%.
7'%e
12'/6
3'h
4
11%
77h
31%e
5'%6
1'h
7th
33/9
DMMG
2
18'%a
187/is
9s/e
5th
12'/s
918X9
7
13%e
9%6
7'%s
127/6
3'%
4
11%
7%
319X.
513/8
2
7th
3%
DLB
%
14%
—
8%e
5th
11"/is
His
7
12%6
88/19
713/.
11"X.
37X8
3%
10th
6th
3%
W/16
1'h
7th
3%
DLC
'%
14%
15
88/,.
5th
111t/1.
93/6
7
128/6
88/9
7t3Xe
11'%,9
37X6
3%
10th
6th
3%
5%6
1'h
7%
3%
DLI)
%a
15'%
15
89/,s
5th
II"As
93/s
7
12%6
8s/,e
713/9
11"/9
37X9
3%
10th
6th
3%
5tie
11h
7th
33h
DLE
1
1513X6
1513/8
9%s
5th
127/6
918/8
7
13%a
91X.
713/8
127%e
3'%
4
11%
7%
3'%9
513/6
11%
7th
3%
DLF
1'h
1611/8
16%e
98/e
5th
12'/9
9'%8
7
13%s
9'/e
7t3/e
127/9
3'h
4
11%
7%
318/.
513/s
1'h
7th
33/a
DLG
2
171%e
1 T%6
9%s
5th
127/6
9'%s
7
13%6
9'X6
7'%s
127/,s
3%
4
11%
7%. 1
Ordering Information
Hiah Head Medium Head Low Head
Cat.
No.
HP
Motor
Volt.
Ph.
Suc.
Dis.
App.
Ship.
Wt.
DHE
1
115/230
1
11 "
1'h"
60
DHE3
1
208-220/440
3
1'h"
1'h"
60
DHF
1'%
116/230
1
1'h"
11h"
67
DHF3
1'%
208-220/440
3
t'h"
1 h"
67
DHQ
1 2 1
116/230 1
1
2"
2"
1 108
DHG3
2 1?2211§0108
1%-
1 h"
60
2"
108
DHHG
2
115/236
1
2"
2"
115
DHH03
2 1
230/460 1
3 1
2"
2"
1 116
"D" Series pumps do not Include suction trap or
strainer basket which must be ordered separately
Cat
No.
HP
Motor
Volt.
Ph. Sue. DIG.
App.
Ship.
Wt.
DMB
'%
115
1
1'h"
1'h"
55
DMC
'%
115/230
1
1'h"
1'h"
56
DMC3
'%
208-220/440
3
1'h"
1'h"
56
DMD
%
115/230
1
11%"
1'h"
59
DMD3
%
208-220/440
3
1'h"
1'h"
59
DME
1
115/230
1
1%-
1 h"
60
DME3
1
208-220/440
3
1'h"
1'h"
60
DMF
1'h 1
115/230
1
1'h"
1%'
65
DMFS
1'h
208-220/440
3
1'h"
1'h"
65
DMG
2
115/230
1
1'h"
1'h"
81
DMD3
2
230/460
3
1'h"
1'h"
81
DMMG
2
115/230
1
2"
2"
93
DMMG3
2
230/460
3
1 2"
2"
193
Packaaes
Cat.
No.
HP
Motor
Volt.
Ph.
Suc.
Dis.
App.
Ship.
Wt.
DLB
'%
116
1
11%"
11h"
45
DLC
'%
115/230
1
1'h"
1'h"
46
DLC3
'%
208-220/440
3
1'h"
1'h"
46
DLD
%
115/230
1
1%-
1%-
50
131.133
1 %
208-220/440
3
1'h"
1'h" 1
60
DLE
1
115/230
1
1'h"
1'h"
64
DLE3
1
208-220/440
3
1'h"
1'h"
64
DLF
11%
115/230
1
2"
1'h"
75
DLF3
1'%
208-220/440
3
2"
1 /h"
75
DLG
2
115/230
1
2"
1'h"
79
131.03
2
208-220/440
3
2"
1'h"
79
Package
No.
Description
Suction
Size
Approx.
Ship. Wt.
60
4" Iron Trap w/basket
1'%.
11
94
5" Iron Trap w/basket
1'%.
13
51
6" Iron Trap w/basket
2"
18
11ici�aail�saa•en1 Q��■
aYEYY■ YS■
PRINTED IN U.S.A.
t
I T
ULTIMATE IN CONVERTIBLE SIMPLICITY
(r
1 "HT" VENT-PAK
I OR + -~
"P" VENT-PAK n°
-F s �'
j BASIC MODEL
CG
Comfortzone CG gas series provides convertible
simplicity and controlled inventory.
It's easy! And the Comfortzone CG gas series
makes it easy. It's the two heaters in one concept.
Start with one of our four basic models and add
either a P vent-pak for indoor installation or an HT
vent-pak for outdoor installation.
Minimize your heater inventory. Stock our basic
models and order either HT or P vent-paks to suit
features
■ convertible simplicity
■ set and forget controls
■ Selectra SPA setting
■ drawer mounted
burners and control
■ solid hardtop on HT
series
■ filter (pressure)
switch
■ E -Z light pilot
■ flanged water
connections
■ front and rear "See-
Thru"
■ front and rear drain
valve
■ 100% shut -down gas
valves
■ millivolt control
systems
n copper heat
exchanger—glass-
lined headers
■ balanced velocity
■ jet -tube twin -port
stainless steel
burners
s A.G.A. certified
control system with
operating control,
secondary thermostat
and Hi Limit
e two-year warranty
For proper sizing
see P-1.
s
Ji
{ OR
I
{
CG/HT OUTDOOR CG/P INDOOR
your customers' needs.
Ease of convertibility makes It possible. When
using the P vent-pak, simply set It on top of the
basic CG unit. When using the HT vent-pak, simply
place it on top of the basic CG unit and It is easily
secured.
What could be easier? Comfortzone makes it hap-
pen. Comfortzone—the best thing that can happen
to your pool.
NOTE: Designate Natural Gas Models with Nat. suffix and LP Models with LP suffix.
*AGA Certified for use with Propane Gas, derated 8%.
LP Gas use one size smaller — meter to heater.
P-3
min. gas line"
dimensions
model/
vent-pak
B.T.U.water
input'
conn.
gas
conn.
meter to heater
ship.
wt.
V
L
W
H
S
0-100' 100'-200'
COMFORTZONE (outdoor)
CG-.150/HT- _
150,000
1%2"
1/2"
1"
1%4"
—
28"
15"
42%"
—
200
CG 200/HT
200,000)
11/2"
%2"
11/4"
11/4"
—
28"
18"
42%
—
215
_
250,000
1%"
%2"
1%4"
1%"
—
28"
21"
42%11
—
230
CG-350/HT
350,000
1%2"
Y44"
1%"
1'/2"
—
28"
21"
42%"
—
250
COMFORTZONE (indoor -outdoor)
CG -150/P
150,000
1Y2"
%"
1"
1'/4"
6"
28"
15"
34/4"
23yz"
200
CG -200/P
200,000
111/z"
%"
1%"
1Y4"
7"
28"
18"
34%4"
24%"
215
CG -250/P
250,000
1%"
'/2"
1V4"
1%4"
8"
28"
21"
34'/s"
253/4"
230
CG -350/P
350,000
1Y2"
%"
1%4"
1Y2"
10"
28"
27"
34%"
2W
250
NOTE: Designate Natural Gas Models with Nat. suffix and LP Models with LP suffix.
*AGA Certified for use with Propane Gas, derated 8%.
LP Gas use one size smaller — meter to heater.
P-3
% TAHITIAN by PU R ESC
A new High in Hi -Rate P®®1 Filtration
COMBINES HIGH PERFORMANCE WITH LOW MAINTENANCE
High Performance:
Flow Rate —Design maintains laminar flow through
permanent filter media bed at design -rate of 20 GPM
per square foot of media surface area.
Efficient Filtration —Unique valve design with large
waterways provide maximum water flow through valve
with minimum pressure drop (less than 3 psi). This
means that pumping energy Is conserved in pushing
water through the valve with resultant improvement
in actual filtering efficiency.
Integral Dial. Valve—Valve provides 5 "positive lock"
filter positions: 1) filter to pool, 2) backwash to waste,
3) rinse to waste (prevents puff back to pool after
backwash of residual dirt left in laterals), 4) winterize,
5) close (to isolate filter). Valve serves as filter lid,
valve and distributor.
Design Tested—The Tahitian Hi -Rate Filter is the
product of extensive development and field testing.
Flat Filter Bed—The Tahitian Hi -Rate Sand Filter has
maintained the necessary flat bed for effective filtra-
tion
iltration even at 200% design flow rate.
Low Maintenance:
Corrosion Resistant* All exposed tank and valve
parts are made of fiberglass, ABS or PVC plastic
materials for maximum protection against corrosive
elements, including chemicals.
Permanent Media—The Tahitian HI -Rate Fiter uses
No. 20 silica sand as a permanent filtering media— no
cartridges to replace—no filter elements to re -coat
with diatomoceous earth.
Easy Access for Repairs—Valve Is equipped with
quick disconnect plumbing adapter connections
which allow easy access to tank and valve for repair
or replacement without disturbing permanent
plumbing.
i 2511111111111
Distributed By:
PUREX CORPORATION, POOL PRODUCTS DIVISION
10400 E. Mohr Ave., City of Industry, Calif. 91749 '
1340 Seaboard Industrial Blvd. N.W.. Atlanta, Oa. 30310
Litho In U.S. A.
A
R�eamw
Qeantitp "l-.
Filter
Rher
RInneew
Maldmttm...
overall
' -
p�
Recommended Pump
Stm & Madel No.
Model
No.
Meda
Filter
Media
Area
Sq. FL
Filter, .
Capacity
Films :
Capadt�
Capaot
mended ded
U.S.
Dimensions
a
Weight
In Tree Horsepower
Cc; Ft
U.S. Gal.
U. Hal.
U.S. Ga.
Q.P.M.
Tank: Tank
Idiot Oailet
W H
Lbs-
QQ
45'Wead 60` Feed
N0. 20
AH -4
AH -6
HR 25'
GRADE
SILICA
3.0
3.40
24,480
32,640
48,980
68 -
11/z
1'/z .
25'/r
35
52
AU -4
AT -4
AU -6 .
AT -6
SAND
1 H.P.
1'/z H.P.
HR 31
N0. 20
GRADE
SILICA
5.5
5.24
"
37,440
49,920
74,880
104
2
2
31'/z
39
75
AH -8
AU -8
AT -8
AHC -12
LHK-30
SAND
2 H.P.
3 H.P.
Distributed By:
PUREX CORPORATION, POOL PRODUCTS DIVISION
10400 E. Mohr Ave., City of Industry, Calif. 91749 '
1340 Seaboard Industrial Blvd. N.W.. Atlanta, Oa. 30310
Litho In U.S. A.
A
A
,9c
N
SUBJECT
PER
City of Fridley
AT THE TOP OF THE TWINS
BUILDING PERM
r
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
1 . �
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
`•'-' ,'J 812-580-3450
910-F15
14/20/79
JOB ADDRESS
252 - 69th. Place N.E.
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION SEE ATTACHED
DESCR.
6
3
'^R1ce Creek Plaza North. Addition SHEET
2 PROPERTYOWNER MAIL ADDRESS ZIP PHONE
Len Berg 252 - 69th Place N.E.
3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSE NO.
Patio Village 3918 W. 4% Street, Mpls.. Mn 926-2771
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 ❑ REPAIR ❑ MOVE ❑ REMOVE
X
8 DESCRIBE WORK
Add porch enclosure 27 ' x 2' and a 9' x 6' Deck
9 CHANGE OF USE FROM TO
STIPULATIONS
Porch can not be heated until structure meets the State Energy Code.
SEPERATE PERMITS KOUIRED FOR WIRIK,
HEATING, PLUMBING AND SIGNS.
w��NG
Before digg'i'ngcall
TELEPHONE. locd
ELECTRIC. GASijitieS
EtEC1
REQUIRE Etc.,
TYPE OF CONST.
OCCUPANCY GROUP
OC 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
1 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
$9,5001
$4.75
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,
$57. 00
STRU TION T E PERF RMANC OF CONSTRUCTION.
PLAN CHECK FEE
TOTALFEE
P 2
$61.75
SIGNA URE CONTRACT OR AU HORIZ AGENT IDA7 I
WHEN VALIDATED THIS IS YOUR PERMIT
nP-ROnPERL
BLDG INSP DATE
SIGNATURE OF OWNER IIF OWNER BUILT (DATE)
• CITY OF FRIDLEY
APPLICATION FOR RESIDENTIAL BUILDING PERMITS
(NEW, ALTERATIONS, ADDITIONS,' OR REPAIRS)
OWNER: BUILDER:
Address: Address- 36
Tel. No.
No.: P2 -Street: 77� RG_ /Y/ •6-.
LOT: BLOCK: ADDITION: IC -15 (-Y: c G,,4
CU, 6Vpf7'o o^j
CORNER LOT: INSIDE IAT: SETBACK: SIDEYARDS:
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
Frofit: Depth: l Height:
�_ P � .
Square Feet: 4 Cubic Feet:
Front: f Depth: 6 Height: ��
Square Feet: Cubic Feet:
Type of Construction: �R • Estimated Cost: $ Lf --
-?
To Be Completed: WA* � Alt. A Alt. B
Prdposed Driveway Width If New Opening Is Desired $ $
(SEE REVERSE SIDE OF SHEET)
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. See reverse side for ya9tional information.
,
DATE:'17 SIGNATURE:
117
Stipulations: TTT�
0v
F(C-1-7`5 -5
n
toad P1Gnn,n� 6875 tir�hnoq sGs NE.
Iand Surveyrn9 /�'i�IniteJftif) 21,
So,/,sieslntq / ENGINEERING, INC. A?r,,ncsofG
SUmet d -,0i;6
Citir.l tr ifunrc!pol
�.7J�/neer//4> -- En ineers Survecrrs
9 .Mmv
6
l hereby cerlr y ffiof this is o true Grid correct represeflWion v/'G survey a� be bor.�ndalYes o�'die abase c4sc,��Qed .and,Grid
al's !cc7Aon a�'oll bwlda ys , Iherren , and all risible nrcroochmenfs , ! a y, {ran or at said /Grid. As surveyed by me /hr5 _day
A.o 19._ - SUB UPS" ENGINEERING, ING-
En9rncers E Surreys ors
oda
Building
BUILDING
Permit No.:
Inspections
RESIDENTIAL APPLICATION
Received By:
763-572-3604
CITY OF FRIDLEY
Date Rec'd:
DATE 10-1&4-05' YOUR E-MAIL ADDRESS kra u.seheAm @
corn" ig - het
SITE ADDRESS 252 %g-% KAL C.E N- E .
THIS APPLICANT IS:
❑ OWNER CONTRACTOR
PROPERTY OWNER/
NAMEL . = L.-L-YA RAYMSS
TENANT
ADDRESS: T» Q`AC* N -S. CITY Vitt -LA -1 A-1
ST. ZIP 32
PHONE: —ibs 25-41
CONTRACTOR
NAME: KRAV FC -149 A COT MOCI
STATE LICENSE 11 202.7 ZI199 EXP DATE 3.31.0 r
2.34 Bftfop STCrrYSNflKE.ViEW ST ZIPJSI?.C,
SUBMIT A COPY OF
YOUR STATE LICENSE
ADDRESS:
WITH APPLICATION
PHONE l - y g I . O 9 y FAX CELL --
PROPERTY TYPE
15 SINGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS
❑ BASEMENT FINISH W ROOF ❑ DRAIN TILE
❑ DECK ❑ SIDING ❑ OTHER
❑ SWIMNUNG POOL
TYPE OF WORK:
❑ NEW ❑ ADDITION
ILMAINTENANCE/REPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE: R'E—s"hNGL-E ttoor
SIZE OF IMPROVEMENT LENGTH WIDTH
HEIGHT Sq. Ft.
ROOFING ❑ HOUSE ONLY
27
REMODELING SUBMIT:
NUMBER OF SQUARES
W HOUSE & GARAGE ATTAc+Mb
BASEMENT
GARAGES
❑ ATTACHED GARAGE
1. Existing Floor Plan
2• Proposed floor plan
PROPOSED SIZE:
❑ DETACHED GARAGE
3. List of structural members to be used
PROPOSED HEIGHT:
SIDING
FOR NEW CONSTRUCTION INCLUDING DECKS,
❑ Vinyl
❑Soffit
ADDITIONS.
& PORCHES SUBMIT:
❑ Aluminum
❑ Trim
1. Site Plan/Survey showing the existing structures
❑ Other
❑ Fascia
and proposed project
2. Two sets of construction plans
WINDOWS
IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS
3. Energy Calculations
OR FOR NEW OPENINGS -DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USINTHE 1997 U.B.0 FEE SCHEDULE)
ON
TOTAL JOB VALUATI$ M) �, — OCCUPANCY TYPE
Permit Fee $ See Back Page for Fee Schedule
Plan Review $ 65% of Building Permit Fee
Surcharge $ (.0005) times the total job valuation — Minimum $.50
Fire Surcharge $ �-_ .001 x Permit Valuation (1/10%)
License Surcharge $ eve $5.00 (State Licensed Residential Contractors)
SAC Charge $ $1450 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow $ ft + 6 ft = ft x $20 = $
Erosion Control $ $450 Conservation Plan Review
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( )
Total Due $ Make checks payable to: City of Fridley Attach Stipulations
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 p!rritland work is not to start without a permit; that the work will be in accordance with the approved
plan in thehich r view and approval of plans.
SIGNATURE OF APP RINT NAMEEACW r- gWAUVALATE
IBJ