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PRE 2010 DOCSCity of Fridley, Minn. 6431 University Ave. N. E., Minneapolis, Minn. 55432 BUILDING PERMIT Date: September 6. 1972 Owner: _ Waite Builder Address __131.175th Aygnue N.E. Address C. J. Corporation 6" .29,33 f X1645 701 Columbia Blvd. N.E. LOCATION OF BUILDING No. -PAIL.-_ Street ` 75th Avenue N.E. Part of Lot Lot --.;L4—.-- Block _3_...__._.._.._ Addition or Sub -Division —_ Don's 5th Addition Corne�o of __ =7-W' dotl"1 .H. (central S&tbP9Lh nv , 5 jideyard 10' & 6' Sewer Elevation _�_� GRr-M.,.7..1 gVQndation Elevation Water location- Must be tapped Top of Fobting - 885.71 (Minimum) (At least 3' above high water table) r DESCRIPTION OF BUILDING Water -23' S of N Property Line of 75th To be Used as: Res-idenee,- Front 411611 Depth 25' Height 20' Sq, F, 1038 Cu. FL 20,760 Garage _.— Front 191 Depth 23' Height 10' Sq. Ft. 437 CtL r, 4 ,370 Type of Construction _Frame Est. Cost 23,OQO- To. be Completed 12/1/72 (19.415.00) Provide 2nd print Provide hard surface driveway Provide verification survey In consideration of the issuance to me of a permit to construct the building described above I agree tq do the proposed work in accordance with the description above set forth and in compliance with 21 provisions of ordinances of the city of Fridley. _ In consideration of the payment of a fee of $ 46.00 , permit is hereby granted to C. J. Corporation 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 ordinamew Of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildin►gsR nnthee. city limits and this permit may be revoked at any time upon violation of any of the provisions of said CLARENCE BELISLE NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to no the Building Inspector for separate permits for these hems. APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME: Waite BUILDER: C.J. Corp. ADDRESS: ADDRESS: 701-Cillumbia B1vd.NE.Mp1s. NO:. I � P I STREET: 75th. Ave. NE. LOT: 14 BLOCK: 3 ADDITION: Don's 5th. Add. CORNER LOT: INSIDE LOT: X SETBACK: 35 SIDEYARD: 10 & 6 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: y 1 Residense Front: W 40, Depth: 25• Height: Square Feet: -'eV Cubic Feet: '7 W Garage Front: 19 Depth: 23 Height: Square Feet; - � Cubic Feet: L/ 7 Type of Construction: Frame Estimated Cost; '$ 23000.00 To Be Completed: 12/1/72 The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in atlict 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. C.C.CORP DATE: 8/31/72 SIGNATURE: b (See Reverse Side For Additional Information. Land Planning Arf k -f l Aie"r it Anc. 6875 Highway No. 65 N. E. land 5urveying • • Minneapolis, Soils Testing 41ji�IIE'('If�l� Minn. 55432 Civil Engineering Telephone 784-6066 Municipal Engineering Engineers & Surveyors Area Code 612 Certificate of Survey for �. �prpration� 0 r i I I I o m I �1°t To i 1 I I 75 75T" AVENUE tjALf- i 1. IN IJ I hereby certify that this is a true and correct representation of a survey of the boundaries of the above described land and of the location of qjl buildings t ereonr and all visible encroachments, if any, from or on sold land. As surveyed by me this �TT day of� ri/ A.D. 19]1 SUBURBAN ENGINEERING, INC. Engineers Surveors, L334/ 31 by 9�/ ✓ / �/ cp4u(5 C- EP) 98 8,91.92 Y _ 79 ?95,71 C-47 Zensr 3' 19 e, lYle,,4 WR=Zc %B[ Z. 44 7-5- ® c 4 7-i0..*V ly''o S r i3e 'oipf v t��o Base lot 2nd 3rd 4th • City Of Fridley Appliced" for and C"n i' Dept. of Bldq•. Phone SOD -UW DESCRIPTION OF WORK– 7, "; � /V Number. Kind and Location ®4 71xtu� LMMI.n. I$ i Go Tutus Com•edon Op•niaps Nov nwaft. Old PARTIAL RATE SCHEDULE Sswas Cosepool PLUMBING FIXTURE BATES TOTAL � (o G 0 Number Fixtures ............... • x �� :/ • Future Fixture Opening .... :...... x $1.50 ; New Fixture Olaf Opening .......... x $1.50 = Catch Basial .................... x $3.25 ; l Water Heater ''Up to 99,000 BTU) .... x $3.00 S-3-00 New Ground Run Old Bldg......... x $3.25 $ El•ctrie Water Roat r .............. a $2.00 $ GAS FITTING FEES: NO. RATE TOTAL lot 3 Fixtures • • .............. • • 1_ x $200 ; .2 Additional Fixtures ............... x $ .T6 $ Lias Range to 199,000 BTU............ x $5.00 ;- State Surcharge $ .50 REPAIRS t ALTERATIONS—Refer ft C®d• Description ................. ..........................; '0TOTAL F $ al. SE City of Fridley: The undersigned hereby makes application for a permit for the work herei, specMed, 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 fact and representations stated inthis application are true and correct Owner Kind of Building Used as To be completed about � 3 0 Estimated cost, $ 0 - Old—New. Building Permit No. Permit o.01 /' Signed By =� Business Phune ROUGH for Power Phuft and Heating, Cooling, Vend a&n. Rep riger�otioe and Air Conditioning Sys and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIA: RATE, TOTAL Furnace Shell & Duct Work ... ................ .. $10.00 $ Replacement of Funke ......... ..... .. 6.00 $ Repairs & Alterations—up to $50!1.00 6.00 $ --. --- Repairs & Alterations each add. $600.00 3.00 $—__ MECH. WARM AIR Furnace Shell & Duct Work to 130,000 BTU ........ ..$10.00 $ each add. 6,000 BTU .................... .. 3.00 4 - 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 &W $ OIL BURNER—to 3 gal. per hour over 3 gal. per hour -fie Fee Schedule GAS BURNER (up to 199,000 BTU) . . over 199,000 RTU See Fes Schedule GAS FITTING FEES: 1st 3 Fixtures — Additional Fixtures _ Gas Range to 199,000 _ AIR CONDITIONING FAN HEATING SYSTEM VENTILATING SYSTEM ALTERATIONS & REPAIRS ROUGH 6.00 $-- 5.00 — 5.00 ; NO RATE TOTAL - x$ zoo $ - x .75 $ _ s$ 5A0 $ See Fes Schedule TOTAL FEE $. (SURCHARGE $ _.50) Dept. of BMdgs. City of Fridley: 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 appUcation are true and correct. ley, Owner a✓ �� Kind of Building � 9e Used as To be completed about _—.— Estimated Cost, $_--_'- Building Permit No. Permit No. S 9o// DESCRIPTION OF WORK HEATING or POW 13; PLANTS -steam, Hot Water, arm A —No Trade Name ��,• �C' Size�� Capacity� Ft. E.D.R. BTU H.P. Total Connected Loads 6 FV gind of Fue-� BURNER — Trade Na�_ Size Capaci % (�� afreyl Sq. Ft. E.D.R- JQV,403 . BTU ZSp► (REMARKS—OYER) 'Signed R)ffk WELTER HEATING CO,. --4627 C11CAG0 ' ' 'b INUEAPOLiS, W NESOTA,554®71 Business Phone No.�s'l��/ -11 53-84 fwft pl City of Fridley AppOfor Phmbbie and Gas MI" Pwadt Dept. of Bldon Phone DESCRIPTION OF WORE 1311 N E 75th Ave Number. Kind and Locallon of Fixtaw" i� y. aZZa�� I lilt, M Z S1109 • a D NWAM „TM. • IG GAS [ltG City of Fridley: The undersigned hereby makes application for a permit for the work here!, • a i i a . c sp eciffied. agreeing n to do all work in strict accordance with the Qty Ordinance Base and reeling of the Department of Buildings, and hereby declares that all the fact and representations stated in this application are true and correct lot 1 Ind _ Fridley. Mioa 12 1 -72 I9. 3rd Owner C Jeorp _ nth Kind of Building frame • Fuftn CenDeedgm Openings res • Ncw � 9i . OldCTPO 0 Used as 7'o be completed about 12-22-72 PARTIAL SATE SCHEDULE¢¢ Estimated Cost, $ 10.00 Permit No. C1� Old—New. Building Permit No. PLUMBING & IiXTBTRE RATES: NO. RATE TOTAL n Number Fixtures ................ x $200 S Signe / . Future Fixture Opening ........... x $1.50 S— By mlimmeftsee New Fixture Old Opening .......... x $1.50 i Business Phune No Catch Basin .................... x $3.26 $ Water Beater ''Up to 99,000 BTU) .... x $3.00 f ROUGH New Ground Educe Old Bldg......... x $3.25 S Electak Water Mester.............. x 52Ao $ GAS FITTING TEES. NO. RATE TOTAL lot 3Fixtures ••••• ......•••.•• x52.00 $ Additional Fixtus ................ x $ .75 $ Gas Range to 199.000 BTU ............ 1 x WOO $ 5. - State Surcharge $ .50 REPAIRS @ ALTERATIONS—Refer to Cede _ Iiipt101i o••.•.......•.a.a......a... 5.50 rCla9s "A- Surcharge .50,¢ TEAL FEE 5 01 SUBJECT PERM City of Fridley 5 AT THE TOP OF THE TWINS BUILDING PERMIT r ' • COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. r 3-2 --"'1 CITY HALL FRIDLEY 55432 NUMBER REV DATERAGE 7/21/97 OF APPROVED BY 612-571-3450 910-F15 JOB ADDRESS 1311 75 Avenue NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 14 3 Don's 5th Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Francis Waite 1311 75 Avenue NE 784-1116 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 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 EAi NEW ❑ ADDITION ❑ ALTERATION O REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct an 8' x 8' Deck off back of house 9 CHANGEOFUSEFROM TO STIPULATIONS See notations on plans. WARN11ft Before digging coil for all utility locations 454.0002 'MARA'TE pfAMICs REQUIRED FOR REQUIRED BY LAW WIRING, HEATING, PLUMBING AND MRS. 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 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 $574 $.50 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- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $24.82 SIGNATURE OF CONTRACTOR ORA HORIZED AGENT IDATEI WHEN PROPERLY VAVDATEDTHIS IS YOUR PERMIT BLE/ INSD � GATE IGNATUREw F OWNER IIF OWNER BUILDERI 1DATEI 01 NEW [ ] Effective 1 / 1 /97 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 1A BUILDING PERMIT APPLICATION ConstructionAddress: Legal Description:'` Owner Name & Address:,��,�., , �� Tel. # Contractor: ��--�,, �A,.l� MN LICENSE# Address: /� . i 7� �`' /�.�� srf 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 /7Sq. Ft.� g� OTHER: Construction Type: h -IEstimate4 Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ftx $ _ $ DATE: / �i7APPLICANT: �. %, Tel. STIPULATIONS: CITY USE ONLY Permit Fee $ 3� %� Fee Schedule on Reverse Side Fire Surcharge$ R .001 of Permit Valuation (1/10th%) State Surcharge $_� $.50/$1,000 Valuation SAC Charge $ $950 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 $ Z STIPULATIONS: tared Planning N. 6813 Highway No. 65 E. Laud Surveying . ! g s ��,• Minneapolis, t „ Soils Tasting nQ�%%2ee*47x fine. Minn. S5432 Qvii taghteering R % Telephone 784-6066 ` Municipal Engineering Engineers 8s Surveyors Area Code 612 :- r• Mortgage Loan Survey for Co oration. I 6. I \ "9 t� s t �ica�� inch=QQ feJ I o I ca I o Fav�da�'ion tq �� 18L9N gt1.�'a d`7 mI t 6 It LOT 14 9LOCK- 3 eas�men�. DONS 5th ADDI �N AW V<A COUNTY This Is a true and correct representation of a survey of the boundaries of the land above described and of the location of all buildings, if any, thereon, and all visible encroachments, If any, from or on said land. This survey is made only in connection with a mortgage loon now being placed on the property -and no liability is assumed except to the holder of such mortgage or any other interest acquired by the reason of such mortgage. It is understood and agreed monuments lhPve been laced for the purpose of establishing lot lines or boundary corners. Dated this- i �ay of Seg"'A. D. 19,a /r SUBURBAN ENGINEERING, INC. Engineers Sery gots by 55 �15�f s bt (/ SUBJECT PERMIT NO. City of Fridley r 25 -297 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. • __ _____ COMMUNITY DEVELOPMENT DIV. � PROTECTIVE INSPECTION SEC. r 3�� CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910-F15 7/21/97 JOB ADDRESS 1311 75 Avenue NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 14 3 I I Don's 5th Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Francis Waite 1311 75 Avenue NE 784-1116 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Phalen Siding & Trim Inc 1528 Lincoln Avenue, St Paul, MN 55105 731-2092 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 6216 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION j7 REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reside House & Garage; Reroof House & Garage (20 Sq) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. Install building wrap and have inspection of same unless manufacturer's specifications state it is not required. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED @ $11, 168 $.56 WITH WHETHER SPECIFIED HEREIN R NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE HORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHE TATE CFR LOCAL LAW REGULATING CON. $187.25 Fire $1.12 STRUCTI E PERF O MANCE OF CONSTRUCTION PLAN CHECK FEETOTA F E License $5.0 $193.93 SIG TUREO NT CTOR OR AUTHORIZED AGENT IDATEI EN O IDAT WFHIS la.WUR PERMIT BLOG INSP BATE SIGNATURE OF OWNER,1F OWNER BUILDERI IDATEI f NEW [ ] Effective 1/1/97 ADDN [ ] CITY OF FRIDLEY ALTER [ ) SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: Legal Description: Owner Name & Address: 7z -C._ Tel. # Contractor: MN LICENSE# Address: c /�v �'-. �''�.. / �'!—v Tel. #- 73/--Z0.572- Attach 73/---ZaSZAttach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Construction Type: Length Length DESCRIPTION OF IMPROVEMENT Width Height Width Height Wy�- Estimated _ Sq. Ft. _ Sq. Ft. _ Sq. Fitt TOTAL STIPCILATIONS: (Fee Schedule on Back) �� % (off Driveway Curb Cut Width Needed: Ft. + 6 Ft = Fux $ — $ DATE: APPLICANT: Tel. # CITY USE ONLY Permit Fee $ �� y�,�� Fee Schedule on Reverse Side Fire Surcharge $ 1. %� .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $950 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 STIPCILATIONS: SUBJECT PERMIT NO. City of Fridley 28431 F THE TWINS BUILDING PERMIT `57i-6966 RECEIPT NO. COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. r PROTECTIVE �,� CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED By L 612-571-3450 910415 10/27/98 1013 ADDRESS 1311 75th Avenue NE 1 LEGAL LOT N0. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 14 3 Don's 5th I SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Francis Waite 784-1116 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Owner 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 Rk ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK dining room Remove wall between kitchen and bedroom to expand d±EMR xmmm 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $900 $.50 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $32.00 Fire SC $.90 PLAN CHECK FEE TOTAL FEE 33.40 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT tOATEi WHEN PROPER LAP ALIDATED THIS IS YOUR PERMIT I 7 /rte BLO NSP TTA Cc S,GNATURE OF OWNER OF OWNER SUILOERi DATE. NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2�j BUILDING PERMIT APPLICATION P ConstructionAddress: 1211 Legal Description: Owner Name & Address: Tel. # 7 s- Contractor: MN LICENSE # Address: Tel. # 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: Leriath Width Hgt/Ground Sq. Ft. OTHER: J4,7, -9/ " '—/V Construction Type: Estimated Cost: (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE:./-,— --Z7/- 9 � APPLICANT: Tel. # � >- _ o✓ r� CITY USE ONLY Permit Fee $ JZ• 6V S72. Fee Schedule on Reverse Side Fire Surcharge $ , .001 of Permit Valuation (1/10th%) State Surcharge $ , 7(' $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ STIPULATIONS: w M /?pd 1"' p I