PRE 2010 DOCSLl
City of Fridley, Minn.
BUILDING PERMIT NO. 732 �d
Dater
Owner: Builder 6 I
le,
Address Address
�1] / %0 P
`a OF L
at
No. Street _T_ op P"11 Lqt
Lot _ .___ _ Block ___ _ Addition or —
Corner Lot Pde Lot �`"� Setback a ___ Sideyard
Sewer Elevation /� EY *ion Elevation
,o P 6F od /f&/G
DESCRIPTION OF BUILDING
T Used i�1
q
Front Depth �,d Height 12 Sq. Ft. . Cu. Ft.
Front Depth 'vet
��. 4 Cu. n�. GA
Type o ction Est. Cost 7� ' ' __ 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 ,#orth a�}d in c omp�iance with all provisions of
ordinances of the city of Fridley- 91 �.� /J� A � "/ Co 9,.,—.
In consideration of the payment of a fee of $ -� , permit is hereby granted to
to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Ridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the dty limits and this permit may be revoked at any time upon viola�on of any of the provisions of said
ordinances / �1
NOTICE:
IWO pemb don not cover the construction, hntslliden for vArhM phnnbing, gn hed1m sewer or wdw. Be sun to sw
t1m Building Inspector for aparate permits for these item.
_. .
APP'LICATION.FOR BUILDING PEP.MIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME/'
ADDRESS ADDRESS �r�/ ��`/ G S /✓�. /a%/jJ�Se
-
LOCATION OF BUILDING
No. Street Part of Lot
Lot_ Block Addition or Subdivision A(1/ �✓.�.�� r: a®ef.
Corner Lot Inside Lot vg Setback 3s"_0 Side -Yard
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Two Certificates of Survey of Lot.and,proposed build-
ing location drawn on these Certificates.
DESCRIPTION OF BUILDING
To be used as:
Front Height
Sq. Ft. Cu. Ft.
Front Dapth Height.
Sq. Ft. Cu. Ft.
Type of Construction Estimated Cost
To be Completed
The undersigned hereby makes application for a permit for the work herein.specified,
agreeing to do all work in strict accordance with the City of Fridley Ordinances and
rulings of the Department of Buildings, and hereby declares that all the facts and
representations stated in this application are true.and correct.
DATE_
{Schedule of Fee Costs can be found on the Reverse Side).
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