AF - 44475•
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City of Fridley, Minn.
BUILDING PERMIT
Date: _._.._---.._____�u� ..9.z.. 1969___.._._.__..._..__.__..__
Tom Swanson White Oak Builders
Owner: _.._......_._..___.---.__._....__.—•-----._..._........_..._._._._.._.._.. Buiider _.._..._.._.._..�_----...----_....---....._......_....._...
�����
N° 10328
Address ....._.__.._:...342�_. C.�.�..a.dg.�=.._.__ST-,�--_..N...R... E.,......---_ Address __._.._2198 _Lon..g,. Lake.._Road..._._._._.._....._.___._
LOCATION OF BUILDING
5465 Altura Road .,. p� of Lot ._..._..._.....___.._._..__._._._....__._
No. .._.----...._----_...__..... Street -•----..._........_......_..._.._-------...._._.__.......__..__._....._ ............._.......-- -
17 7 .. Carlson's Summit Ma.nor North
Lot._.._ ............._...._......__ Block ._.._._............._....----•----•---------._. Additaon or Sub-Division .._.._..._.._..._..........__...__.._._._._._.._..._.___.._.....__.._..r
Corner Lot .---- .............-•-•--•-- Inside Lot ._...---•-.------------x•-------..... Setback ...._..............---�5._..._.... Sideyard .........._�,.2 .._.._..._......__..._ .�____�.....
� � � •-
Sewer Elevation .._._......._._._....__-----_..._838_._15 _--. -- ---.---.__._��k�,....�.,�..._...._._.__..._.._.._...._..
... .....--------•----
Top of Footing
DESCRIPTION OF BUILDING
To be Used as:
.P_ we 11 i�n _......-•--•...__ Front 4 �.� .._.._. Depth ...._2�: �..._. Height ..... 2 0�..._. Sq. F'� _.___9 �.0
__._...._._...._............_..__.._----.._.._ Front __.____....___ Depth _._---•----•--. Height _..._ ............._.. Sq. F't. _.._..___...
Type of Construction __.._--•--Frame._......._..._.___.. Es� Cost ......._$17,�_500.00 ...... To be Completed
� � _ 19,400
Cu. F� _.._..�._._
SEWER LOCATION - 6' S. E, of Ma.nhole
WATER LOCATION - 21' S. E, of Ma.nhole
In consideration of the issuance to me of a permit to construct building described above, I agree to do
the proposed work in accordance with the description above fo in compliance with all provisions of
ordinances of the city of Fridley.
_..�. ._. ��_
____ 5100.00 S�wer Connection Chart�e
In co�sideration of the payment of a fee of �....._.._...._30..00._ ���t is hereby granted to___ �ite Oak Blders .
....__.,....._..__.._.__._..._._.�.____._._..... 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 buildinga
within the city ]imits and this permit may be revoked a t any time upon violation of any of the provisions of said
ordinances.
������°�-. �--
Henry F. Muhich x
NOTICE:
Thts p�miit do�t not eov�r th� eonmuefion, inshllaHoe fo� wirina, Plumbing. oas h�aNny, snw�r or waf�r. d� sun To sM
!h� Buildine Inq��o� fe� s�p�nb p�rmits for th�a h�ms.
� . . .
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
�
o� �s N.� _/ d..., �.,.� .�a:...� BUZ�� 4��,�� O,» k13�, i`d �-�es
ADDRESS ,3 �l Z S' Ce er �� d Sr E�!" /✓ t� ADDR�S S eT !'�p' L e T� I� �� %t d
LOCATION OF BUTLDING
NO .��_STREET � � �tJ l� �. Q �
N t e. s��"Z �... «. i�
LOT /'7 BLOCK � ADDITION OR SUBDIVISION /`'lw�Ie�c ����'ti
T � � ,. sT S; ds�
CORNER LOT INSIDE LOT�,SETBACK 3S , SIDEX'ARD L�, Tf,v��► s� d�'
SEWEft ELEVATION TOP OF FOOTING
Applica.nt attach to this form Two Certificates of Survey of Lot and
proposed buildi�.g location drawn on these Certificates.
DESCRIPTION OF BUILDING
To Be Used As: � � •vy �c �AfH � /y/ � c S
}f (�U'sc' Front � � Depth � `� t Heig�ht �� �
Square feet �%CJ Cubic Feet � Q TJ
Front Depth Height
Square feet Cubic Feet
Type of Construction �,�,� �� Estimated Cost /�� .5�l�l�, (�D
To Be Completed ����� �� �
The undersig.ned 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 Buildixigs,
and hereby declares that all the facts and repre�entations stated in
this application are true and correcte �
� �
DATE `� � �� %, /�G � SiGNATURE �
�
(Schedule of Fee Costs can be fourid on the Reverse Sid�o)
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City of Fridfey /,�,1'
B�sPt� ` for �lumbing and �Sas Fifti�g p�r�nit � �.
Dspt. of Bldq�, Phone 560-3450
DESCRIPTION OF WORK �3 �
Nuiub�r, Kind and Locat9oa of Fixtures Locaiina- •��� � s [-C -�� ��r �
� � � z �ii = yn Z Z �c Z U yZ O w 3 � Z • � WATER HTR.
� � $ � � � � � �n �3 � G � . � � � U �3 < � V' � .(�Y� s U' O f N GAS ELEC.
----�— — --- - — —
Bas� � � ^ -
ist j � � --{--- -- -- -- --- — ,
2nd
3rd --- -
4th -�— --- ---
' �utur� Coaa�ctba Op�nings- --Co� act�d with — -- --
* New Fixture, Old Op�niags I Sewsr (�
Cssapool �
PARTIAL RATE SCHEDULE
PLIIMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures �1c� x $2.00 $��� �
Future Ftixture Opening _ x $1.50 $
New Fixture Old Opening x$1.50 �
Catch Basin . . x $3.25 $
Ua
Water Heater (Up ta 99,000 BTLJ) � X$g,pp $�
New Ground Run Old Bldg. _ x$g,�„5 $
Elsctric Watsr H�atsr : $2.00 s
GAS FITTING FEEB: NQ. RATE TOT]►L
� � ��
ist 3 Fixtures .... .. .. x 32.00 ; `
Additional Flxtures . . . . . . . . . . . . . . . . . . x � .75 �
Gas Range ta 199,000 BTU . . . . . . . . . . . . . x a5.00 �
REPAIRS � ALTERIITIONB—R�f�r to Cod�
Description .... ... ................ . .......... ;
� dCJ
TOTAI.. FEE _�
City of FYidley:
The undersigned hereby makes application for a germit for the work herei
specified, agreeing to do all work in strict accordance with the Gity Ordinance
and ruIing of the IJepartment o! Buildings, and hereby declares that all the fact
and representations stated in this application are true and eoneM.
Owner
Kind of Building
Used as
To be completed about
Estimated Cost, �
Ol New . Building Permit No. �� .? J___Permit No. '7` ���
�.
Signed �,��,',���-' 2- ! /C�Gy�c��`
BY-� �: � ^-' r � " ���
Business Phune No.
ROUGH
FINAL � " �'' ��
�
. �1T° 4985
��� �ermit for �'LUM�ING AND �AS FIitNC� ��',� ��'
N.B. When work covered by this permit is ready, the Plumbing Ordinance requires that request for Permit
inspection shall be phoned in to the lumbin Ins ector, 860-3450 ( F� � /� ��� �
P g P giving number of this permit.,
DESCRIPTTON OF WORB II
Number, Sind and Location of Fixtures
Stories
Basement
1St
2nd
3rd
4th
N
� f. j �.. _.�.,r N
�.. N Z 2 VI Z Y =} Y Z
3 u � m F'. m m 3� o°
1
� ► i �
Connected with Sewer-Cesspool
N N W WATER HTR. CLty Of F%�Ldley ����1 � , 19�
� � r
� Z V= Z N U J (9
O Q h N � y X V) p, N Z
� O U m � � f p, � �r � � GAS � ELEC. j� ..
� Owner �'�z 1�-� =1� ^ E � -�,i
Permission is hereby granted t��� �� `1. �• to do the plumbira� and
gas fitting in the building described in the statement reto attached, upon the express condition that
the person to whom this permit is granted, and his agents, employees and workmen, in the plumbing
or gas fitting of said building shall conform in all respects to ordinances of the City of Fridley, and
this permit may be revoked at any time upon the violation of any of the provisions of said ordincrrices.
By Order Of The Inspector Of Buildings
Roughing in Inspection
nspector.
Finallnspection Date
tnspector.
��4Z sna_6-bs-v
�_ _ _ T _ ____ _
_._ _
Location J�� �v S 1�.��r � ��. �Q��
Kind of Building ..-��-��:k�
Used as �t���C,.�C�.t��.
To be Completed , 19_
Estimated Cost
Old-New. Building Permit No. � �� � ��
Date
Inspector of Buildings.
Application for Power Plants and Heating, Cooling, Ventilation, Refrigeration and
Air Conditioning Systems and Devices
Partial Rate Schedule
GRAVITY WARM AIR:
Furnace Shell & Duct Work
Replacement of Furnace .....
R,epairs & Alterations—up to $500.00 ...
Repairs & Alterations each add. $500.00
MECH. WARM A1R
Furnace SheIi & Duct Work to 120,000 BTU
each add. 60,000 BTU ...................................................
Replacement of Furnace
Repairs & Alterations—up to $500.00
Repairs & Alterations each add. $500.00
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. EDR Steam ......
Furnace Shell & Line—to 640 sq. ft. EDA Hot Water
Each add. 200 sq. ft. EDR Steam ................................................
Each add. 320 sq. ft. EDR Hot Water ....................................
OIL BURNER.-._to 3 gal. per hour
over 3 gal. per hour—See Fee Schedule
GAS $UftNER (up to 400,000 BTU) .........
GAS FITTING FEES:
lst 3 Fixtures
Additional Fixtures
Gas Range to 200,000 BTU
VENTILATING SYSTEMS
Duct work etc. not to exceed 2,000 cfm
Each additional 1,000 cfm ..................
AlR CONDITIONING 1
FAN HEATING SYSTEM
ALTERATIONS & REPAIRS
.
/-�� 7�
TOTAL /
Location .....
... ........�.�..� �(�.�.......��2���
$ ................................. �
City of �� ' "
$• ................................ '
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.
$ ................................. Colum 'a Heights 'nn.,.. .........................�..:._�................., 19 .�,�...�..
$ ................................. %,// � ��
Owner ..Lc.:!�........ .�...... .::...�2� ......... ... .. .. .........�...................--�--..................... .
$ .................................
Kind of Building ....... . . ... _ .. ... .
$ ................................. -
$ ................................. Used as .................
. ........................................................................... ..
.... .... . �........ ...... .. ............. r.................................................................. ...
�
Tobe compeletd about ....................................................................................................................................
$ ..............:..................
.... Estimated Cost, $.....�..�.Q ...........................................................................
$ ........................... . .............................................----
$ ................................. O1d�4�Tegti! Building Permit No........I...�i...�3...f...D----........ Permit No.........��..��...�............
$ ................................. `��
� ................................. DESCRIPTION OF WORK
............... $.....................,...........
NO TOTAL
See Fee Schedule
$ .................................
$ ................................:
$ .................................
HEATING or POWE P NTS—Steam, Hot Wate Warm ' o........_/...........
Trade Name .............L..�_.��.~�::::r..:..... ..... .... .. .....:.............................. Size N.o................ .. ..Q.....�a--
y'� /j� —� �
Capacity ....................................... Sq. Ft. E A R.............---.................... BTU..G�.�,..�Q.� H. P.
Total Connected Load...�,o�✓...'��.....�'.�.....;� ............. Kind of Fuel:�/�„�...��T........
BURNER—Trade Name ..................................................................... Size No...................---�-------�-------�---- -
$ ................................. Capacity .................................-�---- Sq. Ft. E D R.............................. .BTU.............................,... H. P.
.... _
$ ................................. �Illf iUR
5----�- ............._._........ signea......................�.��...� ITIbN�"N�..�........:
$ ......................•••••...... By.....................:....::::.:.:._.::.....:....... ��..�.,��r/�....�J,��x...... ....
$.....__ ..............•••..:.... Business Phone lv'
TOTAL FEE s..�..`.�...r...a.....�.,. Business Address .....................
( remarks---over)
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APPLICATION FOR BUILDING P�tMIT
OWNF�'c 'S
ADDRESS
N0.
� �+• � -�. �/.t��
LOT BLOCK J ADDITION OR SUBDIVI
.q i. --- .
CORNEft LOT ?' INSIDE LOT G/ SETBACK �S � SIDEYARD
SEWgi ELEVATI013 TOP OF FOOTING
Applicant attach to this form Two Certificates of Survey of Lot and
proposed building location drawxi on these Certificates.
DESCRIPTION OF BUILDING
To Be IIsed As: �
� Front pth Height �
Squaxe feet Cubic Feet
Front Depth HeightT_� __
Squaare feet �" Cubic Feet
GG
Type of Construction Estimated Co ���� �---
To Be Completed
The undersigned hereby makea application for a permit for the work
herein specified, agreeing to do all work in atrict accordance with the
City of Fridley Ordins.nces and rulings of the Depaxtment of Buildinga,
and hereby declaxes that all the facts and represe�tations at
this application axe true and correct.
DATE � -- � " LP / , .
SiGNATURE
(Schedule of Fee Costs can be found on the Reverse Side.)
NOTE: A Certified Survey of the lot, shawing the location of the foundation,
once it has been constructed, will be required before proceeding with the
framing.
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� . . . � . . . ,. - � . � . . � ►ARM SUtiVFYS
ciTVioTS LAND SUFtVEYOR uecasHOne
7arec�e�rHic M�p�ikc � REGISTF.R�� UN��P. Ln�VS OF STa�E UF MtNf1ES0'iA �va�c���
� � �� � . . LiCEMSAD BY ORDINANCE OF CtTY OP�IdINNCAPUUS � . � � � � �
3300 LYh10llL� AVE. SO. MlNt�It/�POLi� II, hiINN.
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S4b5 A1Cura
Minne�palis, Minnas��a
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De�r Sir:
April 21, 1970
ConnecC d:r�e� w3:th apgrovad Electrical Conduits and abt�itt
�n �1.ectric� i ��rtt�iC .
�'o� ����' �`r°1� m� �.r� �?�e �ve��.�� �;� �61��3€�7.
, Yaurs tr�Iy,
; LF.�NART3 EICHMILLER
Elec��rict.l In�pectar
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OFFICE OF
ANOKA COUNTY AUDITOR
May 5, 1966
"Fane.rt Growing County in Minne.rota"
COUNTY Of ANOKA
ANOKA, MiNNESOTA
427.4760
Mr. James H. Hensley
Fridley Boaxd of Health
6431 University Ave. N.E.
Minneapolis 21, Miruiesota
Dear Mr. Hensley;
The county work crew has reported that they have cleaned up
Lot 17, Block 7, Csrlson's Summit Manor North Addition.
It is not the County's de�ire to leave auch things as this
unattended in a}�y municipality of the eounty, and the County
Boaxd and myself wish to thank you for calling our �ttention
to this condition.
Very t y yours,
enne h W. Campbell
Anoka County Auditor
kwe/lel
cc Mr. Mike E. 0'Bannon
SUBJECT P . � '
City of Fridley . 1262'7
�
AT THE TOP OF THE TWINS g U I L D! N C P E R M I T
; � RECEIPT NO.
� ; L _��� COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC. �� �% �� �
1 � ��.�
l � �r���; � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY
��'�-'�' '� 612-560-3450
910-Ft5 7/11/74 � �
JOB ADDRESS 5465 Altura Road N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION � -� SEE ATTACHED
DESCR. 1% 7 Carlson's SUIl1ICllt MdTlOr �i Aaaition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Michael T. Roback 5465 Altura Road N.E.
3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NQ.
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
XJ NEW ❑ ADDITION ❑ ALTERATION p REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 16' x 22' Garage
9 CHANGE OF USE FROM TO
STIPULATIONS
Council approved variance to set garage 20` back from front
property line instead of ths 35' on July 8, 1974/
Provide a hard surface driveway.
SEPERATE PERMITS REQU{RED �OR 'aVlf�1�+��,
HEATING, PLUMBiNG AND SIGNS.
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARA7E PERMITS ARE RE�UIRED FOR ELECTR{CAL, PLUMBING, HEATING,
VENTILATWG OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONS7RUCTION ZONING S�. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABAfVDONED FOR A PERIOD OF 120 DAYS AT R��.
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GAFiAGES
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 N07. THE GRANTING OF A PERMIT S1�SGS .93
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOIATE OF CANCEL THE pERMITFEE SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION O HE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE TOTAL FEE
SIG T OF ONTRA HO D AG ATED 1 �� • Y� �
� WHEN PROPERIY VALIDATEDTFiIS IS YOUR PER IT �
��
IGNATU OF OWNERI NER BUILDERI ATEI BIDG. WSP � TE
APPLICATION FOR RESIDENTIAL, ALTERATION,
OR AllDITION BUILDING PERMIT
CITY OF FRIDLEY, NIINNESOTA
�_ o _�
OWNER' S NAME • — . ILDER : _�/��� l��E % ^ !� U%� �C°�
ADDRESS : ���� ����C?� �•__ ADDRESS : �"�'�'Y! C
N0:_Slf �o � � STR�ET: ,��/ L�,C' �� � �
I �
LOT: BLOCK: ADDITION: O/V S /�'I a
� o y � ��i�
CORNER LOT: INSIDE LOT:___�SETBACK: �O � SIDEYARD:,� _ .
Appl.icant attach to this form �ao Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
�ESCRIPTION OF BUILDING
To Be Used As :
� �
Fxont: Depth: Z Z. Height:_ l �
Square Feet: Cubic Feet:
Front: Depth: Height:
Square Feet; Cubic Feet:
�pe of Construction: ��/,�� l9'�9 E Estimated Cost: �
To Be Completed: ���7l2v�S _
The undersigned hereby makes applicati�n for a permit fox the work herein
specified, agreeing to do all work in stxict accordance with the City of
Fridley Ordinances and rulings of the Department of Buildings, and hereby
declares that all the f-acts and representations stated in this application
are true and correct. .
a
DATE: ��_� SZGNATURE:
(See Reverse Side For Additional Tnformation.)
�
(�.� 3.
t
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� M_.Y ...�.�._.._.....__..
R;fDU?TMI.�L
!RU'i1Nri%;#
� CITY 1C�T">
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LANF� SUR1l�YOR A u�casHOrrc
REGISTERF.D UNDEP, C.AWS CF �i',:T� OF Mlt4N :..�C7TA � � � �VD1CfAi .
Ll(:Efr3EC� 9Y OR71Nr.'.�_E U� CITY OR M1?4N3APOI.is �
�3007 LYNJRLE AV�.. SC"3. p�SIP+1�d�Ai-'fJLiS 8. tvSiNN. ��
TAYLC?R A-037L� �
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5465 Altura Road
L.17, B1.7, Carlson's Summit Manor
� Addition
i�b/Z�-1 . .
�
._ _
_ _ _ . ._. _ . . __
.
�
SUBJECT IT NQ.
c�ty of Fr�aley � 14i2
�
AT THE TOP OF THE TWINS g U i L D I N G P E R M I T
; � RECEIPT NO
� ; L _._.�_ COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC.
1 �
�4 � /"'1 � CITY�HALL FRIDLEY 55432 NUMBER REV. DATE PAGE Of APPROVED BY
"°"�'� ,'� 612-560-3450 / /
910-F15 6/3/77
JOB ADDRESS 5465 Altura Road N. E.
LOT NO. BLOCK TRACT OR ADD�TION
1 LEGAL SEE ATTACHED
DESCR. 17 7 Carlson's SUT[IICL7.t A73110Y' NOr�l �C�Yl. SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Michael Roback 5465 Altura Road N.E.
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE UCHNSE 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 40" x 48" (_18' Diameter) round above ground pool
9 CHANGE QF USE FROM TO
S1'IPULATIONS
See letter dated June 3, 1977 from Environmental Officer.
SEP
ERA� PERMITS REQU IREO FQR W�G.
NEATIN6, Pt�I�BtNG,. ANO StG1V�S. .
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE FEQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTflUCTION ZONING SQ. 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
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 ORDINANCES GOVERNING THIS TVPE OF WORK WILL BE COMPI.IED $SrJO �`.5O
WITH WHETHER SPECIFIED HEREIN OFi NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- �`%,SO
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE TOTAL FEE
tiS`8.0�
S N �OF NTRA A ORIZEDA NT n7ei HEN PROP RLY VALIDATED THIS IS YOUR PERMIT
� �
S' ATUR FOWNER .OWNERBUILDERI I TEI BLDG.WSP DATE
tt _
', .
CITY OF F�IDLEY •
APPLICATIQN FOR RESIqENTIAL BUILDING PERI�ITS
�NEW, ALTERATIO�JS, ADDITIONS, OR REPAIRS)
� �
OWrdER: �° , j�"�j� �i3ILUER: —^ � Q A s —
� o
Address : �j ,�Address :
TeI. No.. �
No. : ��i �OS- _ _ Street : _ �L7{.i�2/�_ _ /��
LOT: I � BLOCI�: � ADDITION:
CORNER LOT: INSIDE IAT: SiTBACK: SIDEYARDS:
J0�
/U-
Applicant attach to this fonn Ztao Certi.f_icates of Survey of Lot and proposed
building location drawn on these C�rtificates.
DESCRIPTION OF BUILDING �
� :• /
To Be Used As : � C7/� `� �'! �J� �!�OZ/ C ql���'�-� � 7 /` ' ��
/���/ �� ,� � !/ � //
��Gl�!/Y4 � �/�� �`�ront: _ Depth. Height: � -
Square Feet: Cubic Feet:
Fron t: DeptYi : F:e ig ht :
Square Feet: Cubic Feet:
�_L_.,, „1 ° _ .
Type of Construction: �W 9 Estimated Cost: $��,�
�i�L ��u�L
To Be Completed:
Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired $ $
(SEE REVERSE SIDE OF SHEET)
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 Depar nt of Buildings, and hereby
declares that all the facts arid representa �. ns st ted in this application
are true and correct. See rev�rse side or a�di on in rm tion.
DATE: (�7 SIGNATURE: I—
Stipulations •` J�-��`–'_ '
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June 3, 1977
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C1�'Y OF �RIDI�EY
8431 UNIYERSITY AYENUE N.E., FRIDLEY, MI�INESOTA 55432
�," Mr. Michael Roback
f 5465 Altura Road N.E.
� Fridley, Mn. 55421
TELEPHONE ( 812)571-3450
Re: Swimming Pool Construction at 5465 Altura Road N.E.
Dear Mr. Roback:
G
This letter is to make clear this departments requirements for the swimming
pool construction at the above address.
1. As indicated, one (1) skimr►er approved by the National Sanitation
Foundation will be ��rovided.
2. As indicated, two (2) inlets of approved design for fresh and/or
repurified water will be provided.
3. Z'he filter and piunp shall be approved by the N.S.F. and be of
sufficient ca�acity to provide a minimur.►•turnover of at least two (2)
times in 24 hours. This depaxtment recommends a turnover rate of
6-8 hours.
4. A deck of at least three (3) feet wide, measured from the pool water's
edge, shall be provided which extends completely around all private
residential pools. Above ground private residential pools may be
provided with decking of a minimum size of 4 feet by 4 feet at pool
entxy points and provided that such decking has the approval of the
City.
5. Fencing or other effective means including but not limited to walls
or buildings, acceptable to the City, shall be provided to posi�.ively
control all access to public and private residential swimming pools.
Fencing shall meet the following criteria:
(a) 'I�ie fencing shall prevent the entrance of children and be without
hand or foot holds that would enable a person to climb over it.
(b) The fencing shall be at least 6 feet high and entrances shall be
equipped with self-closing and self-latching gates capable of
being locked.
(c) Self-closing and self-latching devices shall be placed at the top
of the gate or otheYwise inaccessible to small children.
(d) The opening between the bottom of the fence and the ground or
other surface shall be not more than four inches.
6. An automatic chlorinator should be provided with a suitable test kit.
7. All electrical and plumbing installations shall be inspected and
approved by the City Inspection Department.
�
�
0
Mr. Michael Roback . �
5465 Altura Road N.E, ' , �
June 3, 1977 Page 2
8. All electrical lines must be 10-20 feet or more away from the pool
surf ace .
9. The pool fill spout�must be air gapped or protected by a vacuum
� breaker.
10. Suitable safety equipment to include but not limited to a ring buoy
and rope that is 1� times the pool diameter, and shepherds crook pole
must be provided and maintained with the pool at all times.
Furtherniore, these and any other requirements must meet the provisions of
the Fridley City Code, Section 1].5, Swimming Pools. _The building permit
is approved contingent on final inspections and approval by the City.
If any problems or questions arise from this letter, please feel free to
contact me at 571-3450, ext. 170.
Sincerely,
STEVEN J. OLSON
Environmental Officer
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� � � , \ y � . � . . � � . . _ .. . . . . .. . . � - . .. � . _
� L.1?, B1:7, Carlson's�Summit Manor
:� Addition
I1�2 i�( .
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_ _._ __ --- --
�
•pansst uaaq sEit ��u�dn�op �Q
z un axdn��o xo pasn aq �ou ZT��Is azn��nZ�s pzES pu� :pans�� �
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June 3,
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. �
1977
8431 UNIVERSITY AVENUE N.E., FRIRLEY, MINM�S4YA 5SA32
Mr. Michael Roback
.
� 5465 Altura Road N.E.
`' Fridley, Mn. 55421
YELEPHONE ( B12)571-3A50
Re: Swimming Pool Construction at 5465 Altura Road N.E.
Dear Mr. Roback:
. This lettEr is to make clear this departments requirements for the swimming
pool construction a� the above address.
1� As inciicated, one (1) skimr.►er approved by the National Sanitation
Foundation will be provided.
2. ✓As indicated, two (2) inlets of approved design for fresh and/or
repurified water will be provided.
3. The filter and piunp shall be approved by the N.S.F. and be of
sufficient capacity to provide a minimum turnover of at least ��ao (2)
times in 24 hours. This department recommends a turnover rate of
6-8 hours.
4.� deck of at least three (3) feet wide, measured from the pool water's
edge, shall be provided which extends completely around all private
residential poois. Above ground private.residential,pools may be
provided with decking of a minimum size of 4 feet by 4 feet at pool
entxy points and provided that such decking has the approval of the
ity.
5 encing or other effective means including but not limited to walls
vr buildings, acceptable to the City, shall be provided to }�ositively
control all access to public and private residential swimming pools.
Fencing shall meet the following criteria:
U (a) '!'tie fencing shall prevent the entrance of children and be without
hand or foot holds that would enable a person to climb over it.
(b) The fencing shall be at least 6 feet high and entrances shall be
equipped with self-closing and self-latching gates capable of
being locked.
(c) Self-closing and self-latching devices shall be placed at the top
of the gate or otherwise inaccessible to small children.
(d) The opening between the bottom of the fence and the ground or
other surface shall be not more than four inches.
6. automatic chlorinator sho.uld be provided with a suitable test kit.
7�° 11 el ' «rit�plumbing installations shall be ir_spected and
.._.. _ __M_ _ ,
approved by the City Inspection Department.
\r
�
. �.�
!
. Mr. Nichael Roback
.t
• 5465 Altura Road N.E..
• ' �June 3.,.1�77 r
. ,
Page 2
.
8.�All electrical lines must be 10-20 feet or more away from the pool
Y`�ur�ace. . �
9.1�The pool fill spout must be air gapped or protecte3 by a vacuum
bre ker. '
10� itable safety equi�ment to include but not limited to a ring buoy
, and rope that is 1� times the pool diameter, and shepherds crook pole
must be provided and maintained with the pool at all times.
Furthermore, these and any other requirements must meet the provisions of
the Fridley City Code, Section 115, Swimming Pools. The building permit
is appr�ved contingent on final inspections and approval by the City.
If any problems or questions arise from this letter, please feel free to
contact me at 571-3450, ext. 170.
Sincerely,
STEVEN . OLSON
Environmental Officer
SJO/mh
014TE l.Y � I /- " f�I�__ HOUR�/ a� .—
TO �o"`,'
WHILE YOU WERE OUT
� ,� � � � �
�_ '
� 1 � '��;�
PHONE ���� 0 � '� ✓
AREA CODE PHONE NUMBER
TELEPHONED RETURNED CALL LEFT PACKAGE
PLEASE CALL WAS IN PLEASE SEE ME
WILL CALL AGAIK WILL RETURN IMPORTANT
� / . � � � � �i�'C
�� �r� �ti�� � �
�
.�
� � �
The AICO-UTILITY Line Form No. 55-046
A�`!'�
, �--.. - -
' �,�,.: � �� t �d s %� �
v: .;
, <CITY ` 0!= FRIDLtY
�
f � ;�PPLICATION rOR PO'rrE�' YLANTS AND HEATING,. COOI.i:dG, V�WTILATION, IZEFRI�RATION ANA
hiR COt�D;TIuNING SYSTcMS AND DEVICES
\ - P�RTI��L �',TE SCHrDULE
Cii2 ;l'ITY :�.���1 a.:R: R;"�� TCi'AL �o:� Address 5��� �1 ��-4. �� �� � /Y � �
�fl,lr�acr:.S��a?.i & �:ez� Work y-. ^. �,0 � �
:�e�2�c�tttetz� af uz'nace i:�� � �e_r,artment of Buildia s
r�aL.dlr� & r'��.ti.ra*_:ons^L� to v5�p. uQ i. u� $ 9
Rcp3�s`s ,�'�3�it4za�or,s each acd. $500.00 -. ��u S �ity of Frid�ey
^.el. �571-345�
��ECx�:�zc�� .�ti.a��;� ai K:
Fsrnac� Siiell d��ct :4ork to 10'v,UOv iT;;
���n aaa. ��,000 sxo
Rep13c�3#aent of <•ltnac�a
�k0y^::ii:^� & A;,�LEY&tlG3;S-:;: tG. t�2v.�OC
F�eoaizs & Alters�ior.s escn acd. SSOC.CO
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v.a� BUP>`..i�42- f�'c:s 1J'J.6�C �� tc 139,cc� STi;
i�F=�Y' i�9,9y � BT;J see �ee Scn�cale)
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uas �::��e �c i99,u�C 3P� __ X
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rrlV iE.�i T�iG 5YS !'�:S S�e Fe: Sc: ecule
V"F\TILATI�G 5Y'S:�.'�'.S
A:.TEFcATI0:r5 � ic�y:aiRS
a12.;�0 $
4_00 S
7.00 $
7 . t� 0 ;
4.U0 $
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4.00 5
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b.CO $
$i0.00 `r
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$ 3.00 $
$ 1.�0 $
Yiv. �'.�. `�
Sca*:e Sar_^.harge
TGiA?., � ;.c
�OUGH I:33P, r°IivSPE:�ZvN FEE
DaLe ($lO.OG)
FI":AL ZiiSP,
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A?2cZCVA:.. FOsZ PEn:�:li ����'�
tilI'vT ;i4 ,?' . .:. F::�: i:u:tTIi7G ?� :�:. i �., v . �.:
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$ �d� 60
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::.e un�ersigned hereby makes applicatior. £or a permit for thE work here:,n
sYecified agreeing to do all work in strict accordance wi*_'r, tne Ci�/ Co:es
2nd rulings of the Department of Buildings, and hereby declures ti-:at a�l the
:acts and representations sta-�ed in this appiication are true a,3 corre�t.
. Fridley, Minrt. �j "'�(3 _ 19�
�:r.:�� � �l � � ,��. r-
K1iI?i OF SUII.vING �r� �1�
liSED P.S ��
'b BE CO:,P:,ETED ABOUT � � � �
E�TI_dhTED COST Q t�
GLU -" NEW.B;JILDTNG PER'•IIT NO. PERMIT NO. � �
-� c� �' ,' � c.i ��' c:� ��L �l 7� _ r.�,
DESCRIPTION OF FURNACE/BUPNER
i?�ATING or POWER F:..ANTS, Steam, Hot Water, Wa�-cn Air- !�o. �
Trade Name Size ?�o.
Capacity Sq__ Ft. EDR BTU HP
:'otal Connected Load Kind �,f Fuel
SJRyER - Trade N«me Size No.
CapdCity Sq. Et. EGR STU KP
Gompany ` d i�ni%`�li��� .L .r �i • ���
Signed By � .���Z 7"" ._
Tel. No. _g . y- �C�7 � �
SuBJECT P
c�ty of Fridley �-16 8 0 7
AT THE TOP OF THE TWINS B U I L D I N G P E R M I T �
f
; � REC 0.
� ; L � ��_ COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC. � � � `
� � �E.�
i
( � ����1 � CITY HALL FRIDLE� SSA32 NUMBER REV. DATE PAGE OF � APPROVEO BV
� "'"�� ,�' 612-571-3450 910-F15
10/4/82 � �
JOB ADDRESS 5465 Altura Road N.E.
1 LEGAL �OT NO. BIOCK TRACT OR ADOITION SEE ATTACHED
DESCR. ].% % Carlson's Summit Manor North SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Ralph Wheeler 5465 Altura Road N.E. 572-9453
3 CONTRACTOR MAIL ADDRESS ZIP PHONE UCENSE NO.
Oa.sis Pool & Spa 3423 Emerald Drive, White Bear 55110 777-0482
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
C� NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 22` x 39' In-ground Swimming Pool �
9 CHANGE QF USE FROM TO
STIPULATIONS
See stipulations on letter dated 10/5/82 by Environmental Officer.
TYPEOFCONST. OCCUPANCYGROUP OCCUPANCYLOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING. V1T1 1/Cement
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
1 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 % SOO 3.75
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
pROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
S UCTION OR T E PERFORMANCE OF CONSTRUCTION. Fj$ SO
' � PLAN CHECK FEE TOTAL FEE
$72.25
SIGNA UAE OF CONTRACTOA OR AUTHOAI ED AGENT IDATEI W Y VA ED THIS IS YOUR PERMIT
a. "
_ /D-G/ � L
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CITY Oi' FRIDLEY Effective Aug. 1, 1981
APPLICATIOf�t FOf� RFSIDCHTI/t� BUlLQ1fJG PC(L'�iITS
(Nc��, Alter�tions, Additions. or Repairs)
OWf�ER: � ��IT �Ji� � p � � V`
ADDRESS: ,.��{ �6 Z, �� � � �ar �
TEL N0: _ S7 � - cl � �?� �
QUI LD�R : i� Cp .5 d..S ��, -� � f s.,�°�
AODRCSS: �3 �-i ��_�i��'� r�(.-
TEL fJO: � -7 �% � O L{ ��,
Construction location
STRI�T NO: �j� C� STItEET: �� ��� U U' C!
t
LOT: BLOCK : J1DnITION :
Corner Lot: Znsii3e Lots �1 Sctback: Sideyards:
11p�licant attach to tl�is forn� two Certificates of bl�rvey of lot and
pzeposed buildi.ng Iocation drawn on certificates to scale.
G � '�;--�:� ' � O�CRIPTIOi�t OF COt•JSTRUCTION
F��� ,,�= p�--� Depth: Hefqht:
_ �
Square i'eetr Qibic Feet:
. Front: Depth: Height:
Square FePt: Cvbic I�eet:
v,;�_� r� �� _..�._. . .
Zype of Cor,struction :�j � ^ I Estimated Costr S
Rb Be O�r.�pleted: 1('") ^ � � -- ��_
lilt. A Alt. 8
Froposed Drivc�,�ay kidth If New Openinq Is Desired: S� S
, , SE� REVERSE SIDE OF SHEET .
Ziie undersicned hereby make� application for a permit fcr the work herein specffied,
agreeing to do ,all work ft, strict accordanec with the City of Fridley Ordinances tna
xuli»gs of the Delk�rbncnt of Duildings, and hereby declares that all the facts and
represe.r� t�tiens stated in this �pplication are true and correct.
D�.�TI:;��S�-- �— �� SIGNATUIiE:
Stipulatioris: � � �
� �J � ��',S o
� �� ��,
��.-� �_
�� Z ��
/. _ p�1 3� , �
`/ �i�
� 4 � ��
.
A ' �
J' —
October 5, 1982
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55a32
TELEPHONE � 612)571-3450
Oesis Pool & Spa
3423 Emerald Drive �
White Beer, MN 55110
Re: Swimming Pool Construction at 5465 Alture Road N.E., Fridley, MN
Deer Sirs:
This letter is to make clear this depsrtment's requirements for the
swimming pool construction at the above address.
1. As indicated, two (2) skimmers approved by the Netionel Sanitation
Foundation will be provided.
2. As indiceted, three f3) inlets of approved design for fresh end/or
repurified wster will be provided.
3. As indicated, e main drein of epproved construction will be
provided.
4. The filter end pump shatl be approved by the N.S.F. and be of
sufficient capacity to provide a minimum turnover of et least two (2)
times in 24 hours. This department recommends a turnover rete of 6— 8
hours.
5. A deck of et leest Lhree (3) feet wide, measured from the pool
waters edge, shall be provided which extends completely around all
private residentiel pools. Above ground privete residential pools mey
be provided with decking of e minimum size of 4 feet by 4 feet et pool
entry points and provided thet such decking hes the approvel of the
City. ,
6. The diving erea will be accepteble provided Lhere is no overhead
obstruction.
7. Fencing or other effective meens including but not limited to wells
or buildings, ecceptable to the City, shall be provided to positively
control ell access to public and private residentiel swimming pools.
Fencing shell meet the following criterie:
(a) The fencing shell prevent the entrance of children and be
without hand or foot holds that would eneble a person to climb aver
it.
(bl The fencing shall be at least 6 feet high and entrences shalt
be equipped Mith self—closing and self—letching gates cepable of
being locked.
(cl Self—closing end self—latching devices shall be ptaced at the
top of the gate or otherwise inaccessible to small children.
(d) The opening between the bottom of the fence and the ground or
other surface shall be not more than four inches.
� Oasis Pool & Spa
_ October 5, 1982
- Re: 5465 Altura Road N.E.
Page 2
8. An automatic chlorinetor should be provided with e suiteble test kit.
9. All electricel and plumbing installations shall be inspected end
epproved by the City Inspection Department.
10. All overhead electrical lines must be a minimum of 10 feet
horizontally from the pool surface, end 1B feet straight line distance
from the waters edge. An alternative is to bury said lines.
11. The pool fill spout must be protected by a vecuum breaker or
air—gepped.
12. Suiteble safety equipment to include but not limited to e ring buoy
and rope that is 1-1/2 times the pool diameter and shepherds crook pole
must be provided and maintained with the pool at all times.
Furthermore, these and any other requirements must meet the provisions of
the Fridley City Code, Section 115, Swimming Pools. The building permit
is approved contingent on final inspections and epproval of the City.
If any questions or problems arise from this letter, please feel free to
contact me at 571-3450.
Sincerely,
�.r-�- _
,.-r�-
VEN J. OLSON, .S.
Environmental Officer
SJO/mh
CC: Mr. Ralph Wheeler
5465 Altura Roed N.E.
_ . _. __
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sue�ecT PERMIT N
City of Fridley _ 16 9 4 3
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AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
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, �� �'��\ � CITY HALL FRIDLEV 55432 NUMBER REV. DATE PAGE OF APPROVED� BY
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612-571-3450 910-F15 1 $ / /
JOB ADDRESS 5465 Altura Road N. E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. ]_% 7 Garlson's Summit Manor North sHeer
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Ralph Wheeler 5465 Altura Road N.E. 572-9453
3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS Z7P PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE IICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
X
8 DESCRIBE WORK
Construct an 11.7' x 10' Addi ion
9 CHANGEOFUSEFROM TO
STIPULATIONS
����`��� V�.�\\�\�
ca�� ����, •�'S��c.
� a���
e'�°�� d`�.�"��C���� .V _
$�.�-4�� �G� E PERMITS REQ�{RED FOR M�
t� ,,.
f�,Q��� S�PTRN , plUM81NG RNO SIGNS.
� H�A
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TYPE OF CONST. OCCUPANCY GROUP OCCUPAN�.{.9AD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
TIiIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTFiUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. OWLG. UNITS OFFSTREET PARKING
I 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 ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $4,350 y5`i.�.H
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $SO. SO NONE
PLAN CHECKFEE TOTALFEE
,$12.63 $65.31,
SIGNAT OPCONiRACTOPORAUTHORI2E nGE T IDATEI WHEN PROPER�Y VAUDA7ED THI�SJS YOUR PERMIT
.� tl - �l/ 3-/6- �-� � /
SiGNATUREOF VNER�IfOWNERBUIIDERI �DATEI BLDG iNSP DA �
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CITY Of FRIDLCY Effective �ug, 1, 1981
APPLICATIOE�t FOk RESIDCNTIII� 8U1LDIi�G PCRi�fITS
(Nc��, A1 terations. Addi tions, or Repa i rs j
OWt1ER: - BUILD�R: ��.�'��
ADDP.ESS: �'fl,�� ,U � , ��%1� �AODRLSS: . -
TEL 1f0: E_� %?- ��5� � TEL N0:
�
Construction Location
. aTr�r Ho: a`''' �� srr�r: J� ��
IAT: �'.��_, BLOOC: �_ ✓ __` ADAITION:
Corner Lot: Insiile Lot: - [� 6etback: Sid�yazds:
_-___.__..._
m�,," ,�U U ,
Ap�licant attach to t)�is fozm t�o Certificates of b�rvey of Iot and
pzoposed buiiding locatien drawn on eertificates to scale.
Q� � I N L OESCRIPTIOit OF COtJSTP.UCTIOH
_ �,�,_ Front: � Deplh: (� Hefqht: �J7J
Square Faet: Qibic Feet:
, Front s Depth: Heiqht:
Square Feet: (� A�bic Feet:
� c�3 s�
�
Zype of Gbr,structfon s Estimated Cost: S�',�—�
Rb Be Cbr.�plctea: � G'� Q,
711t. A !►1 t. 8
Prop�sed Drivc�►�ay i+idth If New Openir�g Is Des3red: �" _
..__--__._.___
- , . . SE� REVER;E SIDL OF SHEET �
Ziie undezsigned hereby mat;es appiicr,tion for a perroit fcz the work herein specified,
agreeing to cb ,all Work it, strict accordanee Wfth the City of Fridley Ordinances and
ru1�u�9� af the Delk�ztanc�t of Duildings, and hereby declares that all the facts ana
represr�tatiens stated in this application are true and correct.
��•fii _�^ �� n `� � �LV[�/���i
Stipulationss
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SUBJ£CT . P I .
City of Fridley o 1 g992
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
; � REC .
� • COMMUNITY DEVELOPMENT DIV.
� ; ,: ------, � `/90 �
r � � PROTECTIVE INSPEC?ION SEC.
1 � �
l---_�,��"��1,,� CITY HALL FRIDLEV 55432 NUMBER REV. DATE . PAGE OF APPqOVED BV
Z 612-571-3450 910-F15
6/3/87 � �
JOB ADDRESS 5465 .�ltura Road N.E�
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 1% 7 Carlsan's Summit Manor North Addn. SHEET
2 PROPERTY OWNER MAIL ADDRESS 21P PHONE
Ra,lph. Wheeler 5465 Altura Road N�E� 572-9453
3 CONTRAC70R MAIL ADDRESS ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAII. ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING '
Res identia,l
7 CLASS OF WORK
O NEW � ADDITION ❑ ALTERATION O REPAIR ❑ MOVE ❑ REMOVE
8 OESCRIBE WORK
Constxuct a 24' x 24' �,ttache.d Gara,ge with_ Basement
9 CHANGE QF USE FROM TO
�STIPULATIONS
Use treated bottom plates,
� � �RNI�� � _
RE�UfR� FQ� =. :_ ,�,
$efcr� 'ng catt local �ti4ifi�s, �,
� ' - EI,ECTRIC - t� �� ��
�T�.LEPj�..,{ $�P'ARA� �, QL!l1���� �
�'i��Q� f D BY LAV� Y�1��► �'
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, T�PE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULI ANp VOID IF WORK OR CONSTRUCTION ,�pNING SQ. 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
! HEREBY CERTIFY THA7 I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORfiECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITN WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PE�IIT $S/271 $4.14
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEC THE. pEFiM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULA7ING CON- .•
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. `=:�i $%4.SO
PLAN CHECK FEE TOTAL FEE
$78.64
si� UREOFCON'FACTORORAUTHO Eon NT �oaiEi WHEN PROPERLY AUDATED THIS IS YOUR PEFMIT
v • G���� 6 _ � - � �z
�-����� � - -�-
SiGNATU OFOWNEAIIFOWNE�78UILDEAI IDATEI LDG �NSP nAT
Naw L l
City of Fridley Effeetive 4/1/86
ADDN. [ ] R-1 AND R-2
AI,TER. �) Building Permit Application
Construction Address:
�'�� �' �. �' �/�u .c° � �'c/
Legal Deseription:
Owner Name & Address:
Contractor:
_ v
Address•
LIYING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
�' G��'�� �Tel . # � �� - 9 j�S 3�
Tel . # �" �! " '
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
Length ��
Length � f
Length
DESCRIPTION OF IMPROVBMENT
_� Width _=a�� Hei
____�__ Width �_�� Hei
Width � ��St�,
�t _ Sq. Ft.
ght Sq. Ft. �._
Ground
�-� �t
Sq. Fi.
_��� � ��f�G � ��2��,3� `� ' s
Corner Lot [] nside Lot [x1 Ft. Yd. Setbaek _._____� Side Yard Setbaek �
0
Type of Construction: �� 4' ���� - Estimated Cost: $ —
��, �S Z'�1.3c
Approx. Completion Date: � � -� - -
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: See Back Page for Explanation
DATE: � �
.�- � % � APPLICANT : �/ , L,L��=�-�-c�/c� Tel . � ��v? - ��5��
A
CITY OSE ONLY .
Permit Fee
Plan Cheek
State Surcharge
SAC Charge
Park Fee
Se�,rer Main Charge
TOTAL
STIPULATIONS:
�
$
$ 4
$
�
$
$
$ � S�, 6�
�--���� � P��,�
Fee Sehedule on Reverse Side
25� of Building Permit Fee
$.50/$1,000 Valuation
$ 525 per SAC Unit
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
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AGREEMENT
I, �� d r,P�/ �J SW q A/,�p 1►� , bwner of the property
located at � y 7� �� �U 1Q'4 !► a, , have no objection to the
� , �/1 � G.��o g� d�xa�
City allowing the construction of a QD cc.b�t /7f/ �i'
located at ��,6 e� /f%/� ���i[�rf°/� �ifJ:�'ithout the required
certificate of survey that the City ordinarily requires for all nPw
construction.
hitness
��� � �
Signature
,�-�7l Co.��. _ /IQ!
Addzess
( a - 87•
Date
0
CITY OF FRIDLEY
Effective Date May 1, 1988
APP�ICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND
AIR CONDITIONING SYSTEMS AND DEVICES
RATE SCHEDULE
QESIDE�iTIAL , � RATE TO'PAL
Furnace Shell and Duct Work,
Burner (Also raplacment furnace)
Gae Pipinq
(pipinq neaded with naw furnace)
Gas Range
Gas Dryer
�'i
$ 20. 00 S oi0
$ 10.00 $
$ 10.00 S
$ 10.00 $
• Air Conditioning (all aizesl S 10.00 $
All Othera/Repairs and Alterations
li of Value of Appliance or Work $
COMMERCIl1L/INDUSTRIAL
lf o! Value o! Applianca or Work
State Surcharqe
mru r�a
Reinapection Fee (515.00)
Rough Inap.
Date
Final Insp.
Date
Approval for Permit -��
MINIMUM FEE FOR ANY REATING PERMIT IS f15.00-
PLUS $.50 STATE SUi{CtiARGE
*Air Conditionera can not be placed in side yard without
written pcnsisaion fras adjoining nciqhbor. �
S
$ .50
�-p
$ -� v /�
S
Job Addzess �� �D � 1� «v r3 �`ci �
Department of Buildings, 6431 University Ave. N.E., Fridley, MN 55432
City of Fridley
Tel. N571-3450
The undersigned hereby makes application for a parmit for the work herefn
specified agreeing to do all work in strict accordance with the City Codea
and rulings of the Department of Buildinga, and hereby declarea that all tha
facts and repreaentationa stated f� thia application are true and correct.
Fridley, Mi�n. 1' r�.�. , 19 �?�
OWNER i �O{`(�`a`.'� C��: ��Z.�G
KIND OF BUILDING
USED AS �Qy\ �Q n�l`c1�
TO BE COMPLETED 1180UT q- a� -$� .
��
ESTIMATED COST � �
OLD - NEY! BUILDING PERMIT NG. PERMIT NO. � ld ��
DESCRIIYPION OF FURNACE/BURNER
HEATING or POWER PIANTS, Steam, Hot Water, Warm A1r- No. ���%�� � CJ
Trade Name �,�('(`\Q.'� Size No. � •
!
Capacity Sy. Ft. EDR BTU�'� HP
'lbtal Connected Load Kind of Puel
BURNER - Trade Name Size No.
Capacity Sq. Ft. EDR BTU HP
Company � �� � �'- a £�
a
Signed B
Tel. No. ���(j�-lc-%���
Fill out back side for stack verification on replacenent furnaces
Building BUILDING Permit No.: L1Sb �
Inspections RESIDENTIAL APPLICATION Received By:}G4: �
763-572-3604 CITY OF FRIDLEY vate �'� C,°
763-502-4977 FAX EFFECTIVE 1-1-2010 �
DATE � O —�Z g�' t?3 YO1UR E-MAIL ADDRESS
SITE ADDRESS � 7 �O S/'► i"� V r c� ie�t �L' _
THIS APPLICANT IS: ❑ OWNER �SJCONTRACTOR
PROPERTY OWNER/ NAME: �n, �-;�.K � �.�
TENANT ADDRESS: S� Wt � � CITY STATE ZIP
PHONE: S % � — � S�
CONTRACTOR NAME:_J U' � U L: J i j-Je ;.M �� � 2-.� S
SUBMIT A COPY OF STATE LICENSE # �Z tSn 7��� Z EXP DATE �� ��
YOUR STATE LICENSE
AND CERT'IFICATE OF ADDRESS: ) I � t � Zea 1 ci✓t I IJ CITY C}S� u>, P �i,n STAT 1 ZIP�,(�
INSURANCE PHONE 7 b 3' � 8 g 6 b FAX % 3% O�'
PROPERTY TYPE INGLE FAMILY/NEW CONSTRUC110N SIZE
� TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE ❑ ADDITTON ❑ GARAGE/SHED ❑ WINDOWS
❑ BASEMENT FINISH �ji00F ❑ DRAIN TILE
❑ DECK �SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDIT'ION
MAINTENANCEJREPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE: 6 '� s� C%..�
SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT S FT
ROOFING p HOUSE ONLY BASEMENT REMODELING SUBMIT:
NUMBER OF SQUARES �� /� � �u OUSE & GARAGE
J'��� """� 1. Existing Floor Plan
GARAGES `�`�1 ❑ A7"I'ACHED GARAGE 2. Proposed floor plan
PROPOSED SIZE: f/ ❑ DETACHED GARAGE 3. List of structural members to be used
PROPOSED HEIGHT:
G FOR NEW CONSTRUCTION INCLUDING DECKS,
' ❑Soffit ADDITIONS. & PORCHES SUBMIT:
❑ Aluminum � S F.� ('� ❑ Trim 1. Site Plan/Survey showing the existing structures
❑ Other � ❑ Fascia and proposed project.
3 S� �o S 2. Two sets of conswction plans
WINDOWS 3. Energy Calculations
IN EXISTING OPEMINGS ❑Yes ❑No LOCATION OF WINDOWS FOR WINDOWS - PROVIDE U-VALUE AND
OR FOR NEW OPENINGS-DESCRIBE SIZE OF MANUFACTURE STICKER ON WINDOW.
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABUR ANll MA'1'k:1Z1AL�:
�. f„(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
$ � d���S See Back Page for Fee Schedule
$ • 65% of Building Permit Fee
$ 2,�' .001 times the total job valuation
$ .0005 x Permit Valuation Minimum $.50
$ ' $S.QO (State Licensed Residential Contractors)
$ $2100 per SAC Unit (Plans to MWCC for determination)
$ ft+6ft= ftx$24=$
$ $450 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement necessary ( ) Non Necessary ( )
$ . Make checks pavable to: City of Fridley Attach
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a
permit but only an application for a permit and work is not to start without a permit on site; that the work will be in accordance with the
approved plan in the case of all k which requires review and approval of plans.
SIGNATUREOF APPLICANir��`2'��"���. PRINTNAME� %K� LU�1%'{n�N/� DATE �D " 20 "/GS