HomeMy WebLinkAboutOT 2016-00141 Driveway Replacement CITY OF OAK PARK HEIGHTS PERMIT NO.: 2016-00141
14168 OAK PARK BLVD. N. #2007
OAK PARK HEIGHTS, MN 55082-2007 DATE ISSUED: 06/22/2016
(651)351-1661 FAX: (651) 439-0574
ADDRESS : 5869 OLDFIELD AVE N
PIN : 04.029.20.21.0033
LEGAL DESC : ALBERT'S ADD
: LOT 4 BLOCK 2
PERMIT TYPE : OTHER
PROPERTY TYPE : RESIDENTIAL-OTHER THAN NEW
CONSTRUCTION TYPE : DRIVEWAY
NOTE: PERMIT ISSUED FOR DRIVEWAY REPLACEMENT WITH NO CHANGE TO FOOTPRINT. WORK SHALL BE PER APPROVED
PLAN. IF A CURB STOP IS IN THE DRIVEWAY A COVER IS REQUIRED.CONTACT CITY HALL TO OBTAIN PRIOR TO BLACKTOPPING.
JOB VALUE:$6,400
APPLICANT OTHER PERMIT FEE 25.00
TOTAL 25.00
BROCHMAN BLAKCTOPPING CO. Payment(s)
12770 MCKUSICK RD. CHECK 17036 25.00
STILLWATER, MN 55082-
(651)439-5379
OWNER
BONITA& ERNEST JR POLICHNIA
5869 OLDFIELD AVE
OAK PARK HEIGHTS, MN 55082-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed
according to: (1)the conditions of this permit;(2)the
approval plans and specifications;(3)the applicable city
approvals,Ordinances,and Codes;and,(4)the State Building
Code.This permit is for only the work described,and does
not grant permission for additional or related work which
requires separate permits.This permit will expire and become
null and void if work is not started within 180 days,or if work
is suspended or abandoned for a period of 180 days any time
after work has commenced. The applicant is responsible for
assuring all required inspections are requested in conformance
with the Minnesota State Building Code.
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
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Aspb it Estimate Form Serving the
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Materials used are in compTtnnce with the state highway specifications and thickness meets or exceeds local
building codes. jj t
Approximate square footage: ! �� Total Cost �i�t�.
Unit Pritx$ sq.R
contract The owner hereby agrees to:Pay the contractor for the above described work in the following_manna:
Downpa}mertS 12. Mince opian completion ofpaving S >f2
The contractor agrees to:furnish the labor;materials,equipment,and skills necessary to complete the project
Both the owner and contractor agree that any additional work is extra based on square foot price or labor and
materials.
Owners or .
Purchaser Contractor
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SOMatee MN 55082
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Approximate completion(due to weather or unstable soil contrition.completion date may be delayed)
date:
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Sem reverse aide far Warranty and Texas and Conditions
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