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PRE 2010 DOCSCity of Fridley SUBJECT iP E 5' V— AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO d� °,aG�64 L'•... COMMUNITY DEVELOPMENT DIV. I r I PROTECTIVE INSPECTION SEC.20 1 . i /'•'1 CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE - OF APPROVED BY �••" J 612-560-3450 910-F15 8/20/74 JOB ADDRESS 1437 - 76th Avenue N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 28 3 Meadowmoor SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Dahlmeier Construction 8460 Cotta ewood Terrace 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. 6 USE OF BUILDING Residential 7 CLASS OF WORK NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 56' x 26' Dwelling and a 24' x 22' Garage 9 CHANGEOFUSEFROM TO STIPULATIONS Set dwelling at 35' setback at right angles to chord. Provide a hard surface driveway. Provide a verifying survey before capping. House same as 7619 Meadowmoor except 2 feet longer WATER LOCATION: 59' East of Manhole SEWER LOCATION: 70.5' North of Manhole (N. Inv. 889.00) Wye Elev: 889.71 Top of Footing: 893.50 Minimum SEPERATE PERMITS REQUIRED, FOR WIRING, HEATING, PLUMBING AND SIGNS. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Wood Frame 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 PERIOD OF 120 DAYS AT R-1 1456 34,400 Tota 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, WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $31,044 $15.52 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIO OF ANY 0TH TE OR LOCAL LAW REGULATING CON- $64.00 STRUCT N R THE F RMAN E O NSTRUCTION. 300.00 '- PLAN CHECK FEE TOTAL FEE $379,52 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT s HEN. ROPERLY VALIDATED IS Yj UR PERMIT � C DATE LDG IN SP SIGNATURE OF OWNER IIF OWNER BUILDERI (DAT EI APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT Ld'' CITY OF FRIDLEY, MINNESOTA OWNER'S NAME : ck� hlg�-crQ 02)057— _ BUILDER ADDRESS.: ADDRESS : W6CD `�-H4 ecVc) �C�ifi1`Q c 2 NO • . STREET: �t�l G i LOT: BLOCK: _ADDITION: ?!220d KA ©q CORNER LOT: —INSIDE LOT: SETBACK: �� SIDEYARD: of SY, 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: Depth: ;____Height: Square Feet: Cubic Feet: - Front:_ 2- Depth: i Height: C1 Square, Feet; ® Cubic Feet: Type of Construction: -��t- Cs,,,��, Estimated Cost: 600 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: SIGNATURE: (See Reverse -Side For Additional Information.)� a srfmaT *UMWlA*lHG"HrS 59421 708-5004 1010"ESO. REGIST TION NO. 5332 0 = IRON MONUMENT �-j i U,4T-ge Lbc•�-�i®� �9 City of Fridley suadrEcT Permit No. _ AT THE TOP OF THE TWINS rte, 4� y HEATING PERMIT APPLICATION j L'- _-i COFaaVNITv ULVELOEMT DIV. -- 01 9 i PROTECTIVE eP4s1"9CTIOW MPT. CITY HALL FRIDLQV 00MR Rev.DATE PACE CV dP6RGVEO By 910-F17A 0 2/15/73 1 .1 800 Job AV3 %- 76v e we, n T L'w� Address Pone Con res for � A dr es/ l hone 06414^11e - Kind o Building Use Completion DatesM�a Cost GPtAV-fT'Y WARM AIR: RATZ TOTAL Heating/Power Plants Furnace Shell & Duct Work ........... ..$10.00 Steam Hot Water Warm Air Replacement of Furnace ..... ..... .. 6.00 � Repairs &A14erations—up to $500.00 6.00 $!_ Trade Name Repairs & Alterations each add. $500.00 3.00 $___ _ Size No. NZCM WAM4 AYR Capacity Sq. Ft. Furnace Shell & Duct Work to 120,000 BTU ...... . ..$10.00 $ ` � EDR BTU f/q OZWTon. each add. 60,000 BTU ..........' ' ' ' ' ' ' 3.co ' ' ' � $ Total Connected Load 3_7� Replacement of Furnace .. . . .. .. .. 6.00 $ Repairs & Alterations—up to $500.00 600 Kind of Fuel Repairs & Alterations each add. $500.00 3.00 5 Burner STEAM or HOT WATER SYSTEM Trade Names Furnace Shell & Lines—to 400 sq. ft. FDR Steam $10.00 Furnace Shell & Line• -to 640 sq. ft. EDR Hot Nater 10.00 $_ , Size No. Each add. 200 sq. ft. EDR Steam 3.00 $..__ ___ Capacity Sq.Ft Each add. 320 sq. ft. EDR Hot Water 3.00 ; EDR BTU Ton. OIL BURNER—to 3 gal. per hour 6.00 $ _ over 3 gal. per hour—See Fee Schedule GAS BURNER cup to IS,% W BTU) 5.00 oto over 7",M0sl:"TU See Feo Scheduls CAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures x$ 200 $ b L713 Additional Fixtures x .75 $ Gas Range to 139,01 AIR COe:DITIONIUG FAN HEATING SYST77M VENTILATIRG SYSTE°3 ALTERATIONS t IIEPAIRS ROUGH FINAL x® 13.00 $ .50 State Surcharge c� Be* Fee S hide' .ao Suburban Air Conditioning Co. 8419 Center Drive ignature * 5543ZII J City of Fridley Af pl0 'dr`"�a fw Vk=blng and G= Mng Dept. of Ridge. Phone 560-3490 ,� ry DESCRIPTION OF WORK LOOM= �i .� ��` Number, Kind and Location of Fixtures 11 O < r z « N y� N 7 I N WATER NTR. GAS EIEC. Base 1st .4� _ 2nd 3rd 4th • Future Connection Openings + Now Fixture. Old Openings Coaaeetcd with Sewer E] Ccsapool E] PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL 7 Number Fixtures ................. C x $2.00 $,,— Future Fixture Opening ........... x $1.50 $ 3. &--d New Fixture Old Opening .....:.... x $1.50 Catch Basin .................... ` x $3.25, $ Water Heater (Up to 99,000 BTU) .... ( x $3.00 $ erd New Ground Run Old Bldg.......:.. x $3.25 $ Electric Water Heater .............. z $2.00 $ ZA8 FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures ............ • . • x $2.00 ;. Additional Fixtures ................. x $ .75 $ Gas Range to 199,000 BTU .............. REPAIRS & ALTERATIONS—Refer to Code City of Fridley: The undersigned hereby makes application for a permit for the work herei specified, agreeing to do all work in strict accordance with the Citi Ordinance and ruling of the Department of Buildings, and • hereby declares that all the fact and representations stated in this application are true and correct Fridley, Minn v 19._ Owner 4a-, e i e - Kind of Building 2524 f4 og Used as ,, To be completed about / 6 /7 Estimated Cost, $ COO Old—New. Building Permit No. Permit No. L3 o C Signed By -.. Business Phone No.Zif S-2 A� ROUGH .50 State Surcharge Description ............................................. ; TOTAL FEE $c-2fl 6 v of Fridley SUBJECT NO. '25467 AT THE TOP OF THE TWINS BUILDING P E R M I T rpCity ` RECEIPT NO. ______ COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. r NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 ti.__.11.' '•� 612-571-3450 910415 9/5/97 JOB ADDRESS 1437 76 Avenue NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 28 3 Meadowmoor Terrace SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Don Kratt 1437 76 Avenue NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Halek Roofing 6258 Eagle Lake Dr, Maple Grove MN 55369 535-8835 5010 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION LX REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House & Garage (28 Sq) 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 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 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 $2,335 $1.17 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 PROVIS SOF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $74.75 Fire SC $2.34 STRU I OR THE PERFORM NCE OF CONSTRUCTION. e PLAN CHECK FEE TOTALFEE License SC $5.00 $83.26 $IGNATUR OFCONTRACTORORAUTHORIZEDAGENT (DATE) HEN IPROOPERL ALIDATED THIS IS YOUR PERMIT Iifi a BLD07 INSP GATE SIGNATURE OF OWNER of OWNER BUILDERI IDATEI 11 NEW ( ] Effective 1/l/97 ADDN [ ] CITY OF FRIDLEY ALTER [ ) SINGLE FAMILY AND DUPLEXES R-1 AND R-2{ BUILDING PERMIT APPLICATION ConstructionAddress: -3 Legal Description: Owner Name & Address: Dpvu K v`-, '1rt Tel. # Contractor: E tL ,:� MN LICENSE # So c7 Address: -(a.0, Eon U- � �� �� • 01-,VLL- Tel. # 5 3 5 - f S 3S 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 Sq. Ft. OTHER: Construction Type. Estimated Cost: $ `7 2-).�,33 5 (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: — �z APPLICANT:. Tel. # 63 CITY USE ONLY Permit Fee $ "N, ?1 Fire Surcharge $ State Surcharge SAC Charge $ License Surcharge $ (S Driveway Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ TOTAL. STIPULATIONS: $ c53 ,,2L Fee Schedule on Reverse Side .001 of Permit Valuation (1 / 10th %) $.50/$1,000 Valuation $950 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ) CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 3, 9 Q Effective On January 1, 1997 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT '` V y MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR PLUMBING FIXTURE RATES: New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader NO. RATE TOTAL JOB ADDRESS / V3 7 W 4::!� *-f 4/i49� Sump/Receiving Tank Water Treating Appliance Water Heater –Electric Water Heater – Gas** Gas Range** Gas Dryer** Back Flow Preventer Required ( )Yes () No $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 $15.00 Reinspection Fee $42.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge $ .50 TOTAL FEE $ 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 Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. 3—,? , 1998 Owner A -)" -v &–P, Building Used As Ji1114 "Ael/ Estimated Cost 67-� 10-0 PERMIT NO. PLUMBING COMPANY �!/-� 1i'+ fvf o SIGNED BY TEL N0. Approved By Rough–In Date Final Date MINIMUM FEE 11OR ANY PLUMBING/ PLUS THE $.50 STATE SURCHARGE **COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6–A. MINIMUM SIZE 9 SO INCHES. City of Fridley AT THE TOP OF THE TWINS SUBJECT BUILDING PERMIT P 2 7 7 0 6 __ COMMUNITY DEVELOPMENT DIV. tr r ; i PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEV 55432 612-571-3450 RECEIPT [ vv NUMBER 910-F15 REV DATE 9/11/98 PAGE OF APPROVED By JOB ADDRESS 1437 76th Ave NE t LEGAL DESCR. LOT NO. 28 BLOCK 3 TRACT OR ADDITION Meadowmoor SEE ATTACHED SHEET 2 PROPERTY OWNER MAIL ADDRES$ Don Kratt Same ZIP PHONE 780-0217 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO DM Tranby Siding 9131 178th Ave NW Ramsey 5530441-6399 3889 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. B USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION O ALTERATION Ca REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reside ' 9 CHANGE OF USE FROM TO STIPULATIONS Call for building wrap inspection before covering SEPARATE PERMITS ARE REQUIRED 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 AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION ZONING SO. FT. CU. FT. 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 AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT VALUATION 6 700.00 SURTAX $3.35 DOES N01 PRESUME T IVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROWOF AN OTHER STATE OR LOCAL LAW REGULATING CON - STRUO ORT PER RMANCE OF CONSTRUCTION. CT $124.75 Fir SC $6.70 PLAN CHECK FE TOTAL F E Licex- e $ $139.80 SI NATU CONTRACTOR OR AUTHORIZED AGENT IDAT I lu N P 0 /IS Y PERM BLD INSP OA E SIGNATURE OF OWNERUF OWNER BUILDERI IDATEI NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMII..Y AND DUPLEXES R-1 AND R-2 no BUILDING PERMIT APPLICATION �' 1 CIO ConstructionAddress: lq3 -1 -? ':� a-'e� %✓6- Legal Description: Owner Name & Address: /�T/� Tel. # Contractor: PM 0) g }� S l � � y MN LICENSE Address:qt.1 7¢- ,11� ,V;V 4 A",/ S/= Tel. # to 9 Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF BIPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: TOTAL STIPULATIONS: $ 12 � �o W e �y Construction Type: T� r j/ Estimated Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: APPLICANT: Tel. # CITY USE ONLY Permit Fee $ '%� Fee Schedule on Reverse Side Fire Surcharge $ 90 .001 of Permit Valuation (1/10th%) State Surcharge $ 3.-3S- $.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: $ 12 � �o W 7 SUBJECT < City of Fridley 3 1758 AT THE TOP OF THE TWINS P, BUILDING PERMIT r : COMMUNITY DEVELOPMENT DIV. INSPECTION SEC.C9_1 04 f PROTECTIVE 1572-36 NUMBER REV DATE PAGE OF APPROVED BY I CITY HALL FRIDLEY 55432 L 612-571-3450 910415 4/23/01 JOB ADDRESS 1437 76 Avenue NE T LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 28 3 Meadowmoor Terrace 2nd SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Keith Mackedanz 1437 76 Avenue NE 763-786-5406 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. S ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION Cj ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Install two basement egress windows 9 CHANGE OF USE FROM TO STIPULATIONS Provide smoke detectors in all sleeping rooms and on all levels of the dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code. Caulk and flash all exterior openings. Windows to meet the State Egress Code. SEPARATE PERMITS ARE REQUIRED 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 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 $1,000 $.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 4a PLAN CHECK FEE TOTAL E $ .25 SIG 'AA EDAGENT iDATE, 1 ENP OP R V DATE HIS IS YOU P MIT h � r V 0LO 9 Z,SO paT OF SIGNATURE OF NE dF O 0.DERi IDA TE, 7 NEW [] ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address:/ q3 % ? &/,A 100 Legal Description: Owner Name & Address: c Q 57,"M QS c- Tel. # Contractor. Effective 1/1/2001 (763) 572-3604 Bldg Insp MN LICENSE # Address: Tel. # LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length _ Width Hgt/Ground Sq. Ft. Construction Type: Estimated Cost: $ laaO,. 6'O Driveway Curb Cut Width Needed: Ft. + 6 Ft = Flt x $ _ $ DATE: (— -® � APPLICANT: t )4 I " l ce Ke 9 A-7 L / Tel. CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: Call (763) 572-3604 for Permit Fees if mailing in application $ Fee Schedule on Reverse Side $ r /oo .001 of Permit Valuation (1/10th%) $ , SC' $.50/$1,000 Valuation $__________$1150 per SAC Unit $ $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above $ $450.00 Conservation Plan Review $ Fee Determined by Engineering $ Agreement Necessary [ ] Not Necessary [ ] �S-Z, - ""/ �6a�? F O* E(qc4 /e caCl �Ole kaZE olvi Apr 25 07 02:14p Ann -Made S Mackedanz FROM :City of Fridley FAX N0. :7635711287 I JOB ADDRESS: MATERIAL TO BE )3FXNG HAULED 763-786-5406 p.2 Apr. 25 2007' 02:03PM P1 APPLICA710N # 07- Qo�p q0 Crrf OF FRUDLEY M—/ LiMODMCAI-ION FERMff Ave, F:n,& DATE: 4) 2-15 Ce.e�r _ ...�___._.._... . PEtMI'!C REQUE5 Dii: KeiAl X�_'1,aY1 LvIG _._ ..,,Y .�•- i DATES OF DE Y: � 2- r u r-,_ _..� (Up To 3 Dom) THIS PERMIT IS Is TO AL40W A, N YN(..'REASE or- A LE WEIGHT FROM FOURt;4) TONS P:FR. AXLE TO FIVE (5) TON PER AXLE OVER THE FOLLOWING ]DESIGNATED ROUTE: 1� OLD NOTICE: This 't is valid oaly foo- vehicles curoutc to constrwtion address dtaing the hotm; of 8:00 am to 5:00 Pm. i Sea Rew1ution # 01 f004 atad State Stutute Section 164.87 .PERbff FEE: RECEIPT # LO'SO-ED By: Copies Given To I 1 Enginearing f ] =Wwwwon FW- "m &M m u a V4 1 "N'", I --!� 'Ehl! P) �