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Na 3ireet �` r �I� _„
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Lot ,�,.�j��_ Block , daitton or Sub-Divisi �
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Corae� Lot _ Ts�side Lot � � Setback 31de3�ard .-.�.—
Sewer IIevation Foundatio� IIevatlon
:,: �"' '����:i:.rr�r..� .i� .
, DESCRIP`flQN .OF BUILDIt� � t r � �,;.-
T s ae: . �,�� ��,,��
� k'mnt��e� Depth.���� I%fght .� �'` l5q• �`t�:�� �. �.;�����"`' :
Vf/�� H t. . F't. Cu. Ft.
° ��, ,! .. ,
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Type of '�natruction ` ` F�t�-� �To be. Co3npleted
In conaideration oE the issuance �o me of a germit to construct the building descrlbed ab�v I agree ta do
the p�oposed work in acc,ordance with the descrlgtion above set forth and ia c�npliance with � provisiona of
drdinanoes oP the dty of FricIIey.
, �
Ia c�siderati� of th8 payment of a fee oP �
perYttit is hereby granted to
to construct the`building or additicxt as described sbove. 7'his �ermdt fs granted nPcn
the exPress crondition that the P�on to whom it is graated and his agents, emP1oyees aad worl�nen, in all work
doae in, around and upon eatd building, or any part thereof, shall conform in sll reapecta io the or8inan� of
F'ridleY. Minnesota location, conatruct%n, alteratiqn, maintenaace� repair and moving of ' builaliags
a��� dty ]im�ttta��a� per�sit maY 1� revaked at anF tUme upon violatton of aap of the P��ama of said
,�""1 ��i �,
i,�,, .
Sufldin8 7IISpeCEor
;s — �,,,' . ..
NO'flC& '; . . _ ,
Tbi� � dea aoe cerer t6s conshadlon, tedaUaHm ter wlebog; pl'oibbtag,� gas 6eaHeg, aewer er watsr. Bs wn h as
dro Bu� 1�' iar s�ate Pamih for lha� N�t. - �
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Lot B1ock�Addition or `�t�bdivisfo� "'�'��:�hJ"���`�/ -� .
Corne�c Lot ����.de Lo �"� Setbeck ° �
�tfi�bL� PEBMtT 1� SC�3BBULS
� ::. . . ,
Section 2. Ttie Inepector o� Buili3iu�,s �hall s befoY'B iEteu3u� ffiIty peimit for
i:he erection of at►y buildin� or structure� os for any addition tc any sui�t-
ia$ bu3ldiag or atructau;e�,, �-or for any altera`i�ons .or sepaiT�a .�to � aap ex�.�ting
"� "" "fiiuildin��"or s�sucture, upon app�icatioi�i tFie�efor; `requi�re �the paymen� by the
applicant for st�ch pe�maL� ;Of feee to the amount ,hereia below 'set .#arth and
_ . .._ .
in �fiein�iane� `fiereia� providec� �b` witi, .�, __.. ..__,. . _ _ ..
: +---.. _..�_ ...
2.1 • Eor anq such pexmit �,Q�, ��ip .�r�c�ion o£.. an� fire-proof bui.,t.diag; ',other
tban a garage� warehou$e, factory or grain elevator, or for the eraction of
aap fir�;��roo'f; addition, for similar occuga�y,, to anp exieting bnildi„og
^ `slia�ll be at the rate � of° ��;4�Q`fd�`°each orie th�sa� eubic� feet; or� �raction
thereof, ia such cubi�al,. �oat��� . . _. ,- .
_ _ _ __ 2;?,r Fp�,,enyr,�auch permit for -,the�-exectfon •o# any,.fire-proof �s�age, .warehouae,
��factory or graiii- eleva�or; `or for the� e�ec�ion of any fire-ptoof �ddition,
for simiiar �cyps,aayj, to, an�r :e�cisting �Lildin� s�ali be at;� the. ra�e of �1.25
. - . _.� . _ .
i�or "eacli�" o�ta� thousand cubic feet, cl�ssi�`ied -as "fireproof" bq Section 502 of
.- �he Minneapol�s:,gui�;dfn� .Code.,. , . . . - _ . ,
fl��JS�S � ' � . . < -
2_ 3., For aay auch permi:t fcr the�erectioa of aay ao�-�ireproof buildiag othes
th�n a garage, warehouse, factosy ar grain elevator, or aay aon-fireproaf
a�dit�oa, for similar occup�ncq, to any enietia� building�- p�rmit $1.Q0 for
each one -thau�saad cubic �e�t-. . .
Gi
2.4. Fa�r aAF euch permi,t ,#c�r tbe erect�on of any noa-fireproaf gara�e,
. _ _ ,, � _ w as� � #acto . . . . .
, ry 'dr'°g�ain� el�v�to�; or for "f�e` erectiori of anq "aoa-�ireproof
_ additioa, for;;eimilar occupancy, to su�r�,exis:t3ng buildfag or for each such
°" � buildii�°°br addittc3a "= n3nety� °��ats �� C$0.90) for each one thoueand cubic feet
or fractioa. .tt�e�eof,, i.p, the cubical canfents thereof , with . a minimum cf $4.00.
For the purpose of camputing fees for building permits, .the.,cykbical c.oateats
of any �Tiuilding �i� �a�tdie��ri Co� S- un3form�fieigYi� �brou�bout l�y n�ltiplying the
gra�an�i-.erea: �overed .fzom a pa�.n,t s�-, ,�(6,��- inches be,�.ow the �loo� liae of the
basea�ea� ; or Cg�;lar�, to. t.Ii�a aver�,�e �e3ght o� tt�,e ,up�er surface os to the
- eve��ge hei.ght , of; ,�ha roef $ur:f�ce ,o.f .the main �able of a�itc�ed rq�f .
2�5. P'or repaire�or�alteraticas to en exiatiag �structure, the �ee eha11 be
at the rate of $3,00 per eaclt Five Hundred Dollara ($500.Q0) or fraction
tl�exeof ia the cost of ei2 propqsed� wc►�k.
Ze6. In na case ehall tbe fee char�ed for any permit as eet forth ia
Sectioa 2 be leee� thap• $4.00. , . . .
- � � n r''1
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.�—
Ci.ty of Fridley, M�
BUILDING P���T
nate: d� 2�., 1965
Cie�l ��'e
Own�:
� � AltBra '�d �• F.
:,�;i ,.a
���
B �c �j' (''ifl11B'fii'q.C'�i013.
2(� QreO
�� i� �
N� 8025
� �1V � S� �� �• �cid.
Lp�p�QN OF BUILDING � v�slo�
O �,�TmTO� aR_�I
Al.� �� � • T • -ais---- �
Na .��---- �
� % _ Adaition or Snb-Div�l�a�
�,�t ____�..-� � �� sia�
c��--��
Fouadatian Elevaii�
geWer Elevatlon
DESCRIPTION OF BUILDING
To be U�d sa: Ft —��'
ne� sei�►t ------ �.
�� A���OEL � �Q. F�. _: +CIL I�.
ny a"�.�-° tt--�-°m'►-.--_- Fro�t �� -$�t ^�_, TO be C�omPlet�ed
1yrpe of Ca��� F�t. � - . (3�.ti�
�� �j,'(�,OII2 �$ �A�
� �� �
In ca��� of tl�e isauanae to me of a P� t� ��� p�1�Ona
t� �g � ffi a�o� �th the d�P
� � � aity oY Frl�9� -
_�. per,o�it 9a herel�Y �� 8 � � �w�si�raetion
7a co�.�t� oE the �t � a fee of ��--- t is �►t�ed upo�
to �� ��� ad8it� as d� �& ���rgmen, ia all wa�k
bo wh�n it is �� and his a��. �°�� � the o�� �
the � �� �t t,h,�e� � ��art {�ereof, shall oonfa�n m �
d°me in' araa� �' u� ° �� cadalauct[o� �at � � ��ola� � ��°�sab ��
� ������r�� �t m�r be rsvo�ed
a� � ..
�i � �n Je+�sen sa�as
as h�. a�' � w� 8i sa�a to n�
NO?i�s � fs� '� �' �
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OW1�R'3
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�.. _ _ _ ____ _ _ _____ ... _ . . _ _ _ _ _ _
: , � . ----,.
. ��� 9��
APpI.xCAZ'ION FOB $UILDING P�T
G�TY OF FRIDI.E�, �SOTA .
LOCATIQN OF BIIILDING ,
of Lp �
LOT ADDITION OR St�DiVI�IbN �,�.� �/,1 Y� �����C�
. . . . . .. . ..,.J� I� - r�4�r�.��� ,�rrn.r�..i�.r.r �
Coraer Lot`��ns�ide � etbeck Side-+�fard _. �` �
. S1�:R �I.B�'�T�ON '� I�4U1�iDATE�R �EV�ON. , �,,,, _
Applicant attach to ti�is form Two Certificates of Susvey of Lot aad proposed
building locatian drawn oa these Certificates. '
DESCRIPTZON �F SDILDIIQG ,
To ba u�ed ss: %��`''� �-'�--° �
�
a.y,.��/ • �� �'ront � � � Death g ( � Hei��t �'. r
`T Sq. Ft.�� � Cu. Ft.
Frant Depth Sef�ht
� Sq.. Ft.� Cu. Ft.
Type of Canetruction ���� . E�ti.a�ated CoaG ��°�
.___.__
To be ccmpiecea % f � �� �,'" .
�he under�igaed hereby makes applicatioa for a permit for t�e wo�k herein apecif3ed,
a�r�eing to do all caork in Btri�t accordsnce with the City of Fridleq Ordineac�s
aad rulinge of th� Department of Buildi�►gs, and herebq declares Chat,all the facts°
and sepres�ntaeiona stated ia Ch3s applicatio�► are true and correct. /j
e/21' �s� � f
Coets can be found oa the Reverse Side),
�
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�r �
I:'i �� � ��,�( ' �; v� ��;�� N:���:���
s�—��=2• The IasPector of Buildings��shail� before ise
erection of a�r buildiqg,or etructure, or for any additiaa ot any�exi�sting builde
�ng or structure, or for any alteratians or repaira to any esisting bu;iding or
structure� ugon appl�cation theref0re, require the
such p�rmit of fees to the am�ouat herein belo�r a��� �for�a�d 3n �&e plicant for
Provided. to•�i"t; . . - . . �_• ��r
=L= �or any suci� pe:mtt for the �erection of any fire�prdof buildiag,
other than a�arage, warego�es factory or
of any f;�e�pr�� �d�t3�, far'similar ��yrgin elevator, or for the erection
ehall be aC the rate o£ $t.40 for each one thouscaadt ubic feet,�or fractioa�
thareof, in euch cubical contents.
�;9–'?s F°= eay sach permit;gor t&e erection of auy fire-proof �ra e
���t-��� -����y- Dr �raia elevator, or for the erectian of an fire� ��
, tor ai,mil.ar occupancy, to en Y Pr'oot
of �1.25 for .sach :c�e t�ousand c.ub3c f et�clae ifi d as8nfireproofat�the rat.e
3ecti� 502 of the Mia�;�apclis Buildin� Cori�, �` .
,;
HOU3ES
2--3 • I�or sny ench . . . . _ �.
°�ex than s ara e ��t for the erectioa of aaq a��fireproog building,.
addit3aa � �•�arehouse, f$ctory �-�ain elevator, or any aon•fit�eproof
one th '�or ��'1� �cupancy, fo any euisting building - permit $l.� gor eacb
��d cubic feet.
G—ARAGES . -
2•�• For any euch -
ware�i �ou�e, fact �rmit for t��e erectioa aE any aou•fireproof gsrege,
addition f� 8� °�' �gia sievator, o= �for tbe erectioa of an
buildia�' �iar °��u�Oy� to any euisti build�i � nO�'firepraaf
ar addition • ntnety cente � '� °r £O=' �e�h such
or fzaction th�aeof, 3a the cubical conteats thereof c�ith the miaimum o
( 0.90) for �ach Qne tbo�� cubic feet
For the �urpos8 � � f $4.00.
o� �� �i��� omputing fees,fot buildia� Permit$y t� cubical contertte�
��� �� °� °�`�lditiou to a ua3form�hei�ht throu
covered from a point 8ix �0'�t bp �r1tiP1Y�� the
baee�eat or cellas.to th�. (6i iuchea below the floor liae of the
hei�t of the roof sux�face ogrthe maia�gBblet� app�tc edf�ce or to the average
roaf.
5
For rageirs or $ltezat3;� to a8 ax3ating atructure th fe
be a he rate of' 3. , � e sha11. :
ehere+�f in the ceet o� �r each Ftve� �nndred Doilare ($S�� Qp� or frectioa
p P Poeed work.
2-�•6• Ia no c�se ehall
Sectioa 2 be lesa th�u qy�pp„
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the fee chargsd for aay Permie aa set �c�r�8 in
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sue�ecr PERM .
City of Fridley 18076
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
r
; � RE
� ��,�����_ COMMUNITY DEVELOPMENT OIV. ��/a�
r � � PROTECTIVE INSPECTION SEC.
l1 = �
-•-.� ��" ;•� CITY HALL FRIDLEY 55432 NUMBER REV. OATE OpGE OF APPROVED BY
i 612-571-3450 910-Ft5 6/20%85 / /
JOB ADDRESS 5417 Altura Road N..E.
1 LEGAL �OT NO. BLOCK TRACT OR ADOITION SEE ATTACHED
DESCR. ZZ 7 Car:7.son's Summit Manor North Addi-tion SHEET
2 PROPERTYOWN R AI D RES 21P PHON
Steven I�ansen .�8�� �as� .Arl i ngtore 776-�1515.
3 CONTRACTOR MAIL ADORESS Z�P PHONE LICENSE NO.
The Remodeler Inc. of Hugo 14667 North Forest Boulevard � 426-8864
4 AHCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENOINEER MAILADDRE33 ZIP PHONE LICENSENO.
B USE OF BUILDINti
7 CLASS OF WORK
� NEW ❑ ADDITION CJ� ALTERATION O REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WORK
Re-roof door and window re air
9 CHANOE qF USE FROM TO
STIPULATIONS
TYPE OF CONST. OCCUPANCY OROUP OCCUPANCY LOAO
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATINO,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONINO 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 DAY3 AT
ANY TIME AFTER WORK IS COMMENCED. • NO. OWLG. UNITS OFFSTREET PARKING
1 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 OROINANCES CiOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $4 OOO �Z .00
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL ,THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW HEGULATING CON-
STRUCTION R THE PERFOR CE OF CONSTRUCTION. � 44. 'rJO
PLAN CHECK FEE TOTAL FEE
�� 46.50
SIGNATURE OF CONTRACTOR OR AUTHOFI2ED AGENT IDATEI - yfa �' �� N PROPE LY A ED T IS IS VOU � RMIT
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SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI BLDG INSP nATE
NEW [ ]
ADDN. [ ] �
pLTER. [�
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Construction Address
Legal Desaription:
Owner N�e & Address :
Contractor
City of Fridley
�R-1 ABD R-2
Building Permit Applieation
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Effective 4/1/8�
Te�. � 77�- �.�'/S'/y
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Address: /y�� 7 /� ° 7��2e�� �./�0 ��U �1�t%
LIVING AREA:
6ARAGE AREA:
DEi:
OTHER:
Attach to this application, a Certificate of Survey of the
lot, �►ith the proposed construction draWn on it to scale.
DESCRIPTI08 OF Il�1PR0�'EMENT
Length Yidth Height Sq. Ft.
Length Width Height Sq. Ft.
Length � Width ` Hgt/Ground Sq. Ft.
Corner Lot [] Inside Lot [] Ft. Yd. Setbaek Side Yard Setbaek
Type of Construction: � � ��s imated Cost: $ �o� e�
� �
Approx. Completion Date:
Alt. A Alt B
Proposed DriveWay iTidth If NeW O�ninB Is Desired: $ �
See Baek Page for Euplanation
DATE: �`( d-�-y� �PPLICA1dT: Tel. � ��6 ��"`� J
CITY IISE ONI.Y
Permit Fee $ �� Fee Schedule on Reverse Side
Plan Check $ -'�� 25� of Building Permit Fee
State Surcharge $ � ��U �.50/$1,000 Valuation
SAC Charge $ $425 per SAC Unit
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $
'�� Agreement Necessarq [ ] Nat Necessary [ ]
TOTAL $
STIPULATIONS:
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BIIII.DING PERMIT FEE SCHEDIILE
The ChieP Building Official ahall, before issuing permits for the erection of any
building or structure, or for aay addition to any euistiag. building or structure, or
for any alteration or repair to ariy existing building or structure, upon application
therefore, require the payment by the applicant Por sueh perm�t-of fees to the amount
herein belo� set forth and in the manner herein provided Co-wit: �
Total Yaluation
�1.00 to �500.00
5501.00 to $2,000.00
�2,001.00 to $25,000.00
$25,001.00 to $50,000�.00
$50,001.00 to $100,000.00
$100,001.00 and up
Fees
$10.00 (Minimum Fee is $15.00)
$10.00 for the first $500 plus $1.50 for each
additional �100 or fraetion thereof, to and ineluding
$2,000.
$32•50 for the first $2,000 plus $6.00 for each
additional $1,000 or fraetion thereof, to and
ineluding $25,000.
$170.50 for the first $25, 000 plus $�4 . 50 for eaeh
additional $1,000 or fraction thereof, to and
ineluding $50,000.
$283.00 for the first $50,000 plus $3.00 for each
additional $1,000 or fraetion thereof, to and
ineluding $100,000.
$433.00 for the first $100,000 plus $2.50 for eaeh
additional $1�000 or Ppaction thereof.
DRIYEiiAY DEPRESSION ESCROii
(Concrete Curb Streets Only)
Alternate "A": Removal and replacement of curb and gutter only - DriveWay width plus
6 feet times $13.50
Alternate "B": Removal and replacement of curb and gutter and install a 3 foot xide
approaeh With 6 inch depth - Driveway Width plus 6 feet times $15.75
11ERIFICATION OF FOIINDATION
Permits for eonstruction Will be issued a minimum of 24 hours from the time of
application to alloW for proper review of the proposed structure and of the
construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it
has been aonstructed Will be required before proceeding with the framing.
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