PRE2010 DOCS City of Fridley, Minn.
BUILDING PERMIT N° 3810
Date: ... ... `J �..........
Owner ��. yy--Builder
Address Address Address .............................................
LOCATION OF BUILDING
No. 40.. .. Street ..... Part oft . .. ..................
Lot ' .... Block ..... ...... . Addition or Sub-Division �� x. '.•`J•..... ...............
Corner Lot ............ Inside Lot ..h........ Setback ............ deyard ...........................
DESCRIPTION OF BUILDING
To Used as:
....... Front \/...6Depth Lfl.Y... Height ..l. �. Sq. Ft.,./.u:f Cu. Ft. R7.P
.. .. ..... Front ....... Depth Height
p2 .... Sq. Ft. ........ Cu. Ft. ........
Type of Construction ................... Fst. Co .I.J .... To be Completed ....................
In consideration of the issuance to me of a permit to construct the building desribed 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 $��!—�...., 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 with-
in the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
... Buil Inspector
NOTICE:
This permit does not cover the construction, installation or alteration for wiring, plumbin ,/gas heating,
sewer or water. Be sure to see the Building inspector for separate permits for these items. �
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APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
Owners Name 4f jE0Q PJ S . A&IM Builder J_16._,4E .__
Address - Address ,S',A M )
LOCATION OF BUILDING
No.
Streetn.�1.T _ Part of Lot
Lot IZ Block Addition or Sub. Div.
Corner Lot Inside Lot _ Set Back
Applicant attach. to this form Certificate of Survey of Lot and proposed
building:lpcation.
'DESCRIPTION OF BUILDING
To be used as
410* 71? . _ Front _. Dept hs,Height
Sq. Ft. ♦ Cu. Ft. �
Front ..____✓,____Depth Height
Sq. Ft. Cu. .Ft.. r5/
Type of Construction. Estimated cost
To be completed..�...4.�[.� �
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 Signature ...V[....��'F.te.
(A Schedule of, Fee Costs can be found on the Reverse Side)