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City of Fridley . 12362
i' ` AT THE TOP OF THE TWINS B U I L D I N G P E� M 1 T CEIPT NO.
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� • COMMUNITY DEVELOPMENT DIV. � � 8�
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�� � ���i � CITY HALL FRIDLEY 55432 NUMBEii REV. DATE -PAGE OF APPROVED BY
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d5 910-F15 10/17/73 � �
JOB ADQRESS 6615 Anoka, S treet N..�'' .
1 LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
oescR. 18, S� 19 2 Oak Grove Addition SHEET
2 PROPERTY OWNER . MAIL ADORES3 ZIP PHONE
Walter 1Kaciaszek 2727 R3.ce Cxeek Terrace, New Brighton
3 CONTRAGTOR MAIL ADDRESS ��P PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIONER MAII ADDRE3S ZIP PHONE UCENSE NO.
5 EN(itNEER MAILADDRESS ZIP PHONE LICENSENO.
8 USEOFBUILDING R�aiden�ial
7 CLASSOFWORK � N� ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK Construct a 40' x 26 S� 30' Dwelliag and a 19 6' x 30 Garage
9 CNAN(iE OF USE FROM TO '
STIPULATIONS provide a hard � surf�ce drivewaq. Provide a verifying survey before
capping. Record lot aplit with County befoxe any rough in iaspections
�till be made.
���.
SEWER Lt�ATI0N:116' North ofManliole (Inv. 887.42) �° '`;�-
Wpe Elev : 887 . 92 �'"
Top of Footing: 890.92 Minimn�m •
WATER L(?CATION: 11.4' North of Sewer Service
SEPER�ITE PERMITS REQUiR'fD F.4R �Rl��;
HEATtNG� P�.�MBING AND S1GNS.
TYpE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATiNd,
VENTILATING OR AIR CONDITIONINt3. WOOCl FiSII18
THIS PERMIT BECOMES NULL AND. VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION R-1 8 1],1$ ],]�6$O
OR WORK IS SUSPEIdDED OR ABAIdDONEO FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO- DWLG. UNITS OPFSTREET 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 yALUATION SURTAX
AND ORDINANCES (iOVERNINO THIS TYPE OF WORK WILL BE GOMPLIED.
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $20, 091 �.0. OS
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISIOPIS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- (�,L • OO Z%S.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTI� �
PLAN CHECK FEE TOTAL FEE
�;�, ,� � $327.05 �
S UREOFCON AC R A HORI EDAOENT� 1'E) WHEN DP Y 10 D THIS IS U I�P � �
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SIGNATURE OF OWNER IIF OWNER BUILDERI I ATE) DG INS �ATE
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APPI,TCATION FOR RLSIllENTIAL, ALTEItr�TI��V,
UR �1i)llI'I'I01�' BUII�DING PERMIT
C['1'Y' UF 1�1:1 DL�:Y ,�1I UNESOTf1
pWN�A � S NAME : �itr !�� �� /.:�,�'Gl�T �.�',,�fJILDER : __ ����%�
�nnxESS : �„e� � �'/c,E C�L �.� f ���s �� �v�� ��� � /�T��'l/ ,
NO s; _,,,��� S TREET :
LO�t BLOCK; ADDITION: -
CORNER LQT: INSIpE I.OT: SETBACK: SIDEYAI2D:
Ap�licant attach to this form �ao Certificates of Survey of Lot and proposed
buildittg �ocation drawn on these Certificates.
�ESCRIPTIUN OF BUILDING
To Bs U�ed As:
��:
Front � C_ � Depth : � s�, '? �- Height : �? �,�
'� , ,�^ 4:
Squaxe Feet: ih �� � °�a� Cubic Feet � � �; � �'b �
'.�°°. "'� �� � • , ,�''�'
� � -- R1 y�, .>�,�� � �k�F; `� ° �' i Front : �� "� Depth • � � � Height : �
�quare Feet; ��y, `� �Cubic Eeet: � � �, �' ��r �� `�
s , � ,� � r _�
Typ� o£ Constxuction: Estimated Cost: $�'-;�_ �� _;
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�o Be CompleCed:
The undexsigned hexeby makes applicatinn for a permit fox the work hereiA
specified, a$zeeing to do all work in stt'ict accoxdance with the City of
Fxidley Ordina.nces and rulings o� thca llepartment ot Buildings, and hsreby
declares that •�11 the facts and xepxesentations stated in this application
ax� trtte and ���rr�•ct.
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DATE: _ A� SIC;NATURE: � / � � - `
(See� Revexae Side Fox
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Additional Informa,tion.) :
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BUI LDING k'�:It;�TI `f I��:E SCFI�llUL�:
S$(;TION �. The Tnspect«X of B�iildings shall, before issuing p�rmits f.ox the
sx�Ction of any building or strur�t�rc�, or Fo� an.• addition to any exisC�.ng
buildfng ax structure, or for •_uiy :+lterati.on or r�pairs to any existing
building ar structure, upon application ttiereior�, r`qi,ire the payment by the
�.pplicant fox such permit of fees to thu :3mount herein below set fa��h and in
th� manner hexe.in provided to-�•iit:
U1�iIFORM BUILDING COAE: Type 1, 2& 4�$2.15 for each onc: thousand cubic
feet, ox fraction therc:of, in such cubic•sl cont�nts. Type 3& 5-$1.85 �or
eaoh One thousand cubic feet.
�1U1)ITIO,tiAL LUFORb1ATI0N
Fo� the p�rpose of computing fees f�; huilding permits, the cuhical contents
of any buildin� or :�ddition, is determined by multiplying the ground area
cov�x�,d frota, a point six (6) inches below the floox line of the basement
ox Ch� C�1.lax� to th�� average liei�tits ,>f the upper sur£ace ar to the avexage -
h�i�ht o� the xoof surface of tlie main gable of a pitched roof.
�ox x�paix� ox �.lte7cations to an existing structure, the fee sha11 be at the
7Cate oi; $�.00 pex each five hundred dollars ($500.00) ox fraction thereof in
the Co�� af al.l pxopoaed work.
�:a na aase shall, the fee charged for, any penait aa set forth in Sect�ton 2 be
7,�as than $S.Op.
VERIFICATION OF FOUNDATION
NOT�; Pexmits i"ar construction will be issued a minimum of 24 hours from th�
t37ae o� appl.ication, to allow for proper xeview of the proposed structure and
oi �he construotion site.
A Gertified Survey of the lot, showing the location of the foundation, once it
has� been constructed, will be required before proceeding with the fratning.
i'L'RTIFICATE Ui� OCCUPANCY
Application far a CerCii�.cate o� Occupancy shall be made ten (10) da,ys prior
to the u�e or occupancyo uf ,any structure for which a building pex�ait has been
�.�8u�d; �nd sciid structure sha11 not be used or occupied until a Certi�icate
of Oaeup�cy has been issued.
� .
Walter Maciaszek
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.Loi 18 and the South 1/2�. og Lot 19,.
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Bloc�C 2, Oak G�ove Addition,
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vision �d t%at I am duly Re�istered Y,azad
Surveyor�und e s of �e 5tabe of l�i�- '
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aiQl� CEN1"RAL AVE. N.E. (Hwy.65)-BLAiNE.MINNE90TA 65434
ii2 SOUTH MAiN 3T. - CAMBRIDCiE .MINI�SOTA 85008
NORTGAGE LOAN CERTIFICATE: W�LT�R MACIASZEk
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CIVIL ENGINEERS
lANO SURVEYORS
'felephane
784-5480
689-4798
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LEGAL DES�GR�PTION %
LoT I S a►�tc -rH� Sourr-a %, oF Lo-r 19 �
B�ocK 2� OAK CaROV+�. A�ai�oN �
ANOw� CouM-nt � M�N�tESOTA•
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TNIS IS :1 PIAT SHOWING TMB BOUNDARIES OF TH8 IAND A80VE DESCa18ED AND O� TNE LOCATION O� ALl lUIIDINGS, IF ANY,
iMEREON, AND ALL VISIBLE fNCROACHMENTS, IF ANY, FROM OR ON SAID LAND. NO UABMY IS ASSUMBD EXCEPT 10 TME MOIDER
OP A MOtiTGAGE LOAN NOW BEING PLACED ON TH! PROPERTY OR ANY OTHER WTEREST AC�UIfIED iY TME REASON Of SUCM
MOk7GAGE, IT IS UNDERSTOOD AND AGREED NO MONUM9rT$ HAVB BEBd PLACED FOR TM! MJRPOSF O� ESTAB11SMtiiO LOT lJNE3
ON BOUNDARY CORNEItS.
DATItD TFiiS ...ZNID... DAY OP .....................��.!.1.��......................»..... A.D. 147�..
N. G HOIUM AND AS TES, I
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Minnesota Registrotion No. .. :T:7�. �.......
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City of Fridley
4T �¢ ToP oR �c Twu�v
L"""�� GOMMVNITY OEV[L.OrMLNT OiV,
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Plumbing Fixture Rates: N0. RATE TOTAL
Number Fixtures � x $2.00 �
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Future Fixtures � x $1.50 a
New Fixture-Old Open. x $1.50
Catch Bastn x $3.25
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Water Heater-99,000 BTU x$3.00 3�
Ground Run Old Bldg. x$3.25
Elec. Water Heater x$2.00 I
Gas Fitting Fass: I
lst 3 k'ixtures �_ x $2.00 � ��
Additional Fixtures x $ .75
Gas Range-199,000 BT[T x $5.00
Re�airs � Alterationa
See IDescxiption; Code
State Surchart�e ' .50 I
To� �E $ �
The undersigaed herebq makea application for a permit
for �he work herein apecified� agreeing to do all work
in strict accordance w ith the City Ordiaances and rulin
of the Departm�ent af Buildi.nge� and hereby declare that
a11'the �acta and representatione stated in this
application are true correct.
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Steve:
Gar4�ge complaint on an empty lot at corner of 66th and Anoka Street
She said that sfie thinks peop1e dump on this lot because it`is vacant.
Complainant: Mrs. Janey 571-4420
Taken by Doroth�C
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SUBJECT PERMI�
City of Fridley �°f 15 51
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T ��
! � RE .
� • COMMUNITY DEVELOPMENT DIV.
' j y �"���, y
r � � PROTECTIVE INSPECTION SEC. � / ��
' i '
� �""1 � CITY HALL FRIDLEY 55432 NUMBER REV. OATE PAGE OF APPROVED BY
�'""'� � �'� 612-571-3450 910-F15 10/9/79 / /
JOB ADDRESS 6615 Anoka Straet N.E.
1 LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 1,$� $� ], 2 Oak Grove Addit3on SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
7�oma.s Kupp 6615 Anoka Street N.E. 571-8227
3 CONTRACTOR MAILADORESS Z�P PHONE LICENSENO.
Vernon Fultz 6816 - 73rd Avenue North 561-5332
4 ARCHITECT OR DESIdNER MAIL ADDRESS ZIP PHONE UCENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
8 USE OF BUILDINti
Residential
7 CLASS OF WORK
❑ NEW 0 ADDITION ❑ ALTERATION O REPAIR ❑ MOVE ❑ REMOVE
X
8 DESCRIBE WORK
Ins.tall fire lace
9 CHAN(iE OF USE FROM TO
STIPULATIONS
SEPERATE PERMiTS REQUIRED F(�R lAIIR}NG�
HEATING, PLUM�ING AND SIGN�,
��i��6
Be�e digg�lg ca11(ocal uti(ities
1�I:EFHON� - ElECTRIC - GAS Etc.
REQU6RE� E� i.AV4/
SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING, TMPE OF CONST. OCCUPANCY (3ROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONINO. COACr@'F�
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. 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 CEFiTIFY 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 y�`ZiSOQ yfi�..2rJ
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROYISIONS OF ANY OTHER STATE OR LOCAL LAW REOULATIN(i CON- -
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. �.rJ.00
PLAN CHECK FEE TOTAL FEE
$16.25
SiGNA7UAEOFCONiRACTOROR RiZE A ENT tOnTEi WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT
��- �o � �y , � �o
SIG ATURE Of OWNERtlF O NER BUIL E � DATEt d. .q '� BLDG WSP E
� CiTY OF FRIDLEY • � • � �
. « . .
� . . .. ; �
� � APPLICA710N FOR RESIDENTIAl. I3UILDIP�G PERMTTS �� � � r
� � � �- (Wew, Alterations, Additions, or Repairs) .
� OWNER: c�� Gs � ' � �h��r e r^I �i BUILOER: ��,Cv�o j'11 %J � �Z
nanR�ss: ,�/� �r�a„�G� ��- ano�ESS: l�,f�/� - .�3 ~� ��%nre � �a .
TEL d0: S-°%/- Y,�.�'7 - TEL N0: �G�� "� ���
� - - � • � � Canstruction Location . ��
• • /�.li,/ �7iiVi�ii `Y'/%� �G��'\_ r.a.. . .
. STR�T NO s ak"`,y � ,. �
JATa / 0 �,�,2 1�� I�BLOCK: � ADDITION: �'Q"� � 0 J 'Q ``� ``� /V _
Corner Lot: ________ Insiiie Lot: Setback: � Sideyards: •
- . Applicant attach ta this fonn two Certificates of Survey of lot and
� proposed buildi.nq location drawn on certificates to scale. � •.
. . � � . . � DESCRIPTIOIJ OF CONSTRUCTION � � � � � -
' • � :e 1Ir famt: ' Depth:. Height: .
� . - Squa�e.Feet: � Qxbic Feet: . . .
. , Front: . - Depth: � Height:
• � � Square• Feet: � Cubic Feet: � �
. _ � . � _ . ' . . . . " C'j
�ype of Construction : �cc� /1 L Y'� ��, � � Estimated Cost: $ � .
. � •. ' . � . • � .� . � �V� .
'xb Be Oompleted: �, G��S _ _ ' � . . . � . . .
,. r , ' Alt• A Alt. 8•
. Proposed Driveway Width If New Opening Is Desised: �$ _� $
' •• • ' • . . . . . SEE REVERSE SIDE OF SHEET .
..�ie undersigned hereby malces application for a pexmit for the work�herein speciiied.
agreeing to do all work in stxict accordance with the City of Fridley Ordinances and
xulings of the Department of Buildings, and hereby decXares that all the facts and
representa.tions stated an this application are true and correc�.
^ � .
DATE: � SIC�IATIJRE : . -�u • •
.
Stipulations: . . ' ' , .
. • � �e �.S�i'VvMJ� 1 S� C�� . � -
, 1 �' a � -
�6.
• p} �
�y
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• i3Ul LD] tVG PERI4IT FCL= SCHEDULE' ,,. o
SECTION 2. T}�a In�pec�oz of Uuilcling� Lliall, 'bc�ore i�uuing pexmiL•s tor the er�ction
of ar�y building az �truct:uro, ox tor any addi.�i.on to ariy cxi.�Ling buildiny ox strucL•wce,
. ar tor any a].L•eration or zepair�, , L•o •any cxi.�ting bui.lditig or sL•ructure, upon aPI�����tion '
'L•herefoxe, require thc paymenL• by Uie aPp].i.cant far. sucla permit of tces to L•lie raraount
herein below seL• tozth a�id in thc manner hercin providcd �o-wi.�: .
. . .".
NETrJ GOPJSTRUCTION: SingJ.e 1'amily Ilomes and Gazages : $4 . 00/l, 000 cub3.c �ee�. • •
PLI�I� CiiL'CY.: 25 percen� o� bui.].ding Pexmit fee. ' • �
D1tIVL•'I�JAY D�PRI:.SSIOtJ: (Concrete, Curb Streets Only) • °°
' A1LcrnaL•e A: iZemov�l and rep].acemen� oE concrete curb and �
gutter only; Driveway width plus 6 feet x Y1�,�5
.•• Altcrnate B: R,�moval and rep].acement of concrete curb and �
,' . gutter and a.nstal7. a 3 foot wide approach with ''
• . � . . 6 �i.nch depth; Driveway wi.dth ��lus G ieet x $17.85 '
� � � � �ADDITI(?NAL rnrFORMATI�N �
For the purpose of computa.ng fees for building permits, the cubical contents of ariy
builda.ng or addition, is determined by multiplying i:he ground area covered i'rom a
paa.nt sir, (6) inches below L-hc floor line of the basement or th� cellar to the
averaqe heights of the upper surface or to the average hea.ght ot the roof suriaca �
of the raain gabl.e o£ a pitched roof . '
' . . '
For repairs or alterations to an exist3ng structuze, the fee shall be at the rate
, of $3. 00 per each five hundred do3.lars -($500. 00) or fraation tYiereof in the cost
of• aLl. proposed work.
.In •no aase sha]1 the fee charged for any permit as set for�h in Section 2 be ].ess •
'than $�.50 plus $.50 state surcliarge. . , .
� . � - . .._ �__.. . _ .: VERIFIGATIO� OF FOUhDA____TIQN � � �� _� � .�.... _.
�1�10TE: Permits for construction will be issued a minimwn of 24 hours from the time •
of application �o allow for proper review of tiie pro,posed structure and o£ the
constaruction site. .
A Certificate of Survey af the lot, showing the location of the foundation once a,t
has been consiructed will be required before proceeding with the framing.
� �, � � - � GERTIFICAT� OF 0 �ttPnNrv • •'
� APplication for a Certificate of Oceupancy shall be made ten (10) days prior ta the
use or occupancy o£ any s�ructure £or which a bua.ldin
�a.i.d s�ructure sha11 no� be used or occupied until a Cer��.itxcate of�Occupancy�hasd
been xssued.
�
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. . • . . • • .
• � • . • ' •
. ' • • , '
SUBJECT
City of Fridley
AT THE TOP OF THE TWINS g U I L D i N G P E R M I T
r
� �
� • COMMUNITY DEVELOPAAENT DIV.
� � .: ------�
� � PROTECTIVE INSPECTION SEC.
1 . �
� � �""1 � CITY HALL f RIDLEY 55432 NUMBER REV.
�-°='�'• •,, 612-571-3450 91aF15
JOB ADDRESS 6615 Anoka Street NE
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION
DESCR. 18� j�'�. �. 2 OdaC GI:O'S�@ AdC�].'t].OII
2 PROPERTV OWNER MAIL ADDRES�
Daniel Snee 6615 Anoka Stxeet NE
3 CONTRACTOF MAILAODRESS
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS
5 ENGINEER MAILAODRE33
DATE
4/24/91
ZIP
PAGE OF
� �
0778
RECEI O.
�c���� �
APPROYED BY
SEE ATTACHED
SHEET
571�6120.
PHONE LICENSE NO.
PHONE LICENSE NO.
PHONE LICENSE NO.
8 USE OF BUILDIN(3
Residential
7 CLASSOFWORK � N� � ADOITION � ALTERATION O REPAIR ❑ MOVE O REMOVE
8 OESCRIBE WORK
Construct a 16 �x12 � Deck Addi.ti,on
8 CHANdE OF USE FROM
STIPULATIONS
S:ee notations on pla,n
SEPAR�TE Pf.R�il��'g 1�E��l��p ��
WiRldVG, MEA���'V�,, �i.l�.�g�JiV� � c�;�
SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBIN(i, HEATINd,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERI00 OF 120 OAYS AT
ANY TIME AFTER WORK IS COMMENCED. •
I HEiiEBY CERTIFV THAT I NAVE READ AND EXAMINED THIS APPLtCAT10N
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
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL TNE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW RE(iULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
OF CO ACTOR O UTHOR�ZED A6ENT IoA7E1
'.,� �.� D� _ . �-2�1 �
TO
���NrN�
�efote �iggfin� call' for
�l1 utili#y b�ations
��4•0002
REQUI��� �Y LAtl�l
TYPE OF CONST. OCCUPANCY dROUP OCCUPANCY LOAD
20NINti SO. FT. CU. FT.
NO. DWL(i. UNITS OFFSTREET PARKING
1. STALLS (iARAGES
VALUATION SURTAX
$1f45Q $,73
PERMIT FEE SAC CHARGE
$35.00 Fire SC $1,45,
PLAN CHECK FEE TOTAL FEE
37 ,18
��,� WHEN PROP nRL� V T D �S YOlU+� E�iMiT„r �
�. �.
1�TnT [ ] Effective 1/1/91
AD�T [ ] I�1 AND R�-2
AI.TIIt [ ] Buildir�g Permit Applicat3an
Oonstructian Addx+ess: �� �� T� V1(� �4� �`'J `
Legal De�c,riPtiaait �
owr,er xaamee & �,�,��: �a�n l e. � � �v�.�� Ztel. � �% � � / ZC�
oo�acta�': 52 �� �. �
Address:
� � � •, �..
N,� V• H° � '1��
���«� ����.
.��•��;
Attac3i to this applicatian, a Oerkificate of S�vey of the
lat, with the p�,q�ased co�structiaaz c�awn an it to scale.
�
Ienqth
Ler�gth 1(0 `
Width
Width
Width � Z �
.�:
I�eic�t
I�eic,�it
�/G�au�a � '
Sq. F't.
Sq. Ft.
sq. r�t. r� Z �
-- - �� � �p , �6 � I `i5 � �z
Cbrr�x Iat [ J Inside Iat [/J Ft. Yd S�tback Side Yard Setbacks
Type of oonstYUCtiaaz: T�'�c'� c e� w oo � F�timated aost: $ �`,1- 6�°- ��
A�raac. ('aa�letian Date:
Prc�osed Driveway Width If New Opening Is Desirea: Ft. $ $
^ Width + 6' See Hack Page
np,�: � - Z - g / �c�r: �a.. # �7 i- 6�z �
W�k $35-28`t7
P�mi.t Fee
Fire Stiircharge
State Surcharge
SAC (�arge
Drive�ray Fscrvw
Park Fee
Sew�P_t Mait1
. ��
� � �
S I , c,t�
S 473
$
$
M�11 1?_1: •'__�,�
� S�.i�'41�i7 e �1 � S�
. ool x Permit vali�tiaai (1/lath �)
$.so/Si,o00 valuatiaaz
$650 pet SAC Unit
Alt. pAn OZ' Alt. pBn AbOVe
F7� L�',er�ni r�arl � F.e � i r�apri m
� ��Y L J � N�YY L ]
�
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� c�- lo OU
18 �° 2- �
3�,0�
:'1 � � 1� t �.r1�:1 :��5i:; ]��*:I:�i��ll _:
Zt�e Cizief Huildit�g Official shall, before issuir�g permits for the erectia� of ariy
b�tilclit�g ar stn�cture, o� !�or any acklitiori to atzy e�dstit�q buildir�g ar structure, or
fa� any alteratiaaz or re�air to any existir�g bu�uc'iir�g ar st�aire, upon ap�licat�to�
therefore, +��ire tbe PaYment bY the applicant far su�h permit of fees to the aaaoauit
ibere3n below set forth ani 3n the marmer i�erein p�vvided to-wit:
�►PAL VAIIJE
$1 to $500
$501 to $2,000
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,000
$100,001 to $500,000
��
$15 (Minimmn Fee is $15 plus ��,a,�)
$15 far first $500 plus $2 for eac� �ditio�al $100 or
fractiaaz theteof, to ar�d includit�q $2, 000
$45 fos fits�t $2, 000 plus $9 for each additiaa'�al $1, 000
or $actior► t2�ecf, to ar�cl incltxiit�q $25, 000
$252 for fir'st $25, 000 plus $6. 50 far � a�iditiaa'�al $1, 000
ar' fract�iaaz ther+eof, to at�d it�cludit7g $50, 000
$414 . 50 for fiYSt $50, 000 plus $4 . 50 for eac� ad+ditiona,l
$l, 000 a�' fraGtian thereof, to at�d 3nCluding $100, 000
$639.50 for first $100,000 plus $3.50 for �ch additional
$1, 000 a�' fractian thereof, to a=yd 3r�clt�dir�g $500, 000
$500,001 to $1,000,000 $2039.50 for th�e first $500,000 plus $3 for each additional
$1, 000 or fYactio� thereof, to at�d iticlt�dir�g $l, 000, 000
$1,000,001 anci up $3539.50 for t�e first $1,000,000 plus $2 for � Sdditional
$1, 000 ar fractiaal tt�ereof
�tl�f D�Pt2�8IC�T BBQiO�W
(Ooa�ct�ts C�rb Stteets QnlY)
Altetir�ate "A": R,aaaval. ar�d replaoe�eiYt of c�b ani gutter anly - Driveway width plus
6 feet times $13.50.
Alternate °g° ; R,�awal ar�d re�lao�ent of c�rb ard gutter ar�d install a 3 foot wide
appzo3di with 6 itxli depth - Der3.ve�rdy width plus 6 feet t3mes $15.75.
[/c�Zi�+��'s�M •:�. •1° :i�:u�n': M.�'�I
�*�+�+; ts fo� oonstnx,�tia� will be 3asu�ed a minim� of 24 hau^s frc� the time of
applicatia�n to allcw far p�oper review of the p�opo�ed str�cture arid of tl�e
ooa�structiaai site.
A Oertificate of S'�nvey of the lot, et�owin3 the lacatiaaz of th,e famdatian a�oe it i�as
it has been oonstruct�ed will be requi.t�ed before prooeedir�g with the fra�mir�g.
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CITY OF FRIDLEY
6431 University Ave NE, Fridley, MN 55432
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMITAPPLICATION
2 � �
� J
(763j 572-3604 Bldg insp
(763) 571-1287 Fax
� -��w..,�.�
Construction Address �����'� ��+��� �
Legal Description: � 12- cd �- 3�6 � C�l
Owner Name 8� Address: s��� �Lc-s ��r 66��'f�/►'c�,�'s � Tel. #��3-� �`1' ��n0e�e
Contractor. MN LICENSE #
Address: Tel. #
LMNG AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Attach to this application, a Certificate of Survey of the
bt, with the proposed construction drawn on it to scale.
DESCRIPTIOPI OF IMPROVEMENT
Length Width Height Sq. Ft,
Length Width Height Sq. Ft
Length �� Ifl�� � Width �_ Hgt/Ground � Sq. Ft
Construction Type: ���-�� Estimated Cost: $ �'�O a oJ [��� , E'"� �
6
Driveway Curb Cut �dth Needed: Ft + 6 Ft = Ft x$ _$ `
DATE: APPLICANT: Tel. #
� �
Call (763) 572�604 for Perm� Fees ff mailing in �pplication. Fax to 763-571-1287 if using credit cand and we will call
you for card number. �. � �
�► CItY USE ONLY - .�:
Permit Fee
Plan Review
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
$�f�
� v'l v
$ _ .�
$ � ��
$
$
$ �
$
$� ��
R
Fee Schedule or�Reve�se Side,
65%0 of Pe�it Fee .:
.001 of Permit Valuation (1/10th%)
�
$.50/$1,000 Valuation
$1450 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 [ j Not Necessary []
TOTAL $ �!� � STIPULATIONS:
m
BUILDING PERMIT FEE SCHEDULE
The Chief Building Official shall, before issuing �rmits for the erection of any building or structure, or for any
addition to any existing building or stivcture, or for any alteration or repair to any e�isting building or
st�ucture, upon application therefore, require the payment by the applicant for such permit of fees to the amount
herein below set forth and in the manner herein provided to-wit:
TOTAL VALUE
$1 to $5�
$501 to $2,(�0
$2,�1 to $25,00(}
$25,001 to $50,�
$50,(l01 to $lOQ,�
$100,001 to $5�,�
�PStJV�Wl w �V1�i/WyWIJ
FEES
$23.50
$23.50 for first $5� plus $3.05 for each additional $100 or
fraction thereof, to and including $2,�
$69.25 for first $2,�0 plus $14.� for each additional $1,�
or fraction thereof, to and including $25,�0
$391.25 for first $25,000 plus $10.10 for each additional$1,000
or fraction thereof, to and iucluding $SO,U�
$643.75 for first $50,0� plus $7.(� for each additional
$1,000 or fraction thereof, to and including $1�,W0
$993.75 for first $1(�?,� plus $5.60 for each additional
$1,0� or fraction thereof, to and including $500,�
$3,233.75 for the first $5�,� plus $4.75 for each additional
$1,� or fraction thereof, to and including $1,�,�0
$1,0�,�1 and up $5,608.75 for the first $1,�,� plus $3.15 for each additional
$1,� or fraction thereof
DIi;IVEWAY DEPRESSION ESCROW
(Conerete C�urb Streets Only)
Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $17.�.
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of application to allow for pro�r
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 it has been constructed will
be required before proceeding with the frazning. New Houses Onlv '
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Design #� 57740 �� s g��� 512812005
�.o � �
*�* Take this she�t to the Building �at�rials d�sk to purchase your materials. ��*
You have selected a 10' x 6' deck 5' off the graund. e owis a seciaon e ra� ing siy e an
Cedar Frammg Matenal options you have sel�l for your d�k.
4 x 4 Framing Posts
Horizontal Decwng
2" �x 6" Pressure Treafed Deck Boards ��
� ;.
3,6 Verti,cal Handrail to Joist wlo Posts Railing : E, �.� �
2, x 2, x 4 2 P r e s s u r e T r e a t e d S p i n d l e s, B e v e l e d 1 E n
2 x6 x8 Pressure Treated Shapetl Hand Rail
Concrete and Post Footings �Y ;;
Premium Gold Square Dr�ve Screws ;�� �' �:
,���niz�d Framing Fastene� -�.. �_ _ _ � ���;��.�.u���s�. �
�� �� � � � � � ��� �
" n � "'� `�
40 c ive Laad
all the materia� or
are
from
' � . ,� ,� �i •'. ��:
�,r, � � .
�'� �� I ��
(The posts shoam in this picture not includ�l �ith the postless railing type you �I�l�
Illustration intende to s general deck size and shape.
StairWidths: � Some options selected may not be shown for picture clarity.
For Building �ater�rs use oNy : 920072�104�60003000200015020000�02
Toda 's cost for materials estimated in this desi n�ith o tions: $64Z.86
��.���,o����: ����r�e�,����,�,����k��, p ���� �,���,
�° 2u4 railing, �SSUn �1 t�lling p�s, and premlum gr�► teated screewss. � g�SE rice :�� ��7
I p l
.,
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.DDN
�LTER
0�04�" �l 1 � �
� � CITY OF FRIDLEY
[] 6431 University Ave NE, Fridfey, htfN 55432 (763) 572�3604 Bldg lnsp
[] SINGLE FAflflILY AND DUPLIXES R-1 AND R-2 (763) 571-1287 Fax
BUILDING PERMIT APPLICATION
Construction Address:
�c/ �5�32
Legal Description: '
Owmer Name & Address: �i��►� � ��l�S ��� � � Tet. # ��'l'�� I � 2��
Contractor. MN LIGENSE #
� ���
�
Address: Tel. #
C�� ' �'/Z ' S'�l � ��'i
Attach to this application, a Certificate of Sunrey of the .
bt, �rith the proposed cflnstruction drawm on it to'scale. '
LMNG AREA:
GARAGE AREA:
DECK AREA:
OTHER:
DESCRIPTIOPI OF INlPROYEAAENT
Lengih Width Height Sq. Ft
Length Width Height Sq. Ft
Length �� wdth /►' � y Hgt/Ground � Sq. Ft ��
Constn.tction Type: Estimated Cost: $ �,� ��3
Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x� _�
�• i „ 7�
DATE: APPLICANT: . TeL #�'`�J-��/'°Z��
Call (763) 572-3604 for Permii Fees if mai[ing in applicai3on. Fax to 763-57'1-1287 ff using credit card and we vKill call
you for card number. a �'^ , �j. �� " �� �
CITY USE ONLY - �� - �
���� ` °�5��/ j - — �
Permit Fee $ �3.c� � Fee Schedule on Reverse Side�,�� � R 9� = 1, �5
65% of Permit Fee g :
%. / -
.001 of Permit Valuation (1/10th%)
Plan Review
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
� J`^ � /
$ ��v
$ �/
$
$
$
$ �
$
$
� �
$.50/$1,000 Valuation
�1450 per SAC Unit
$5.00 (State Licensed Residential Contra�tors)
Alt. "A" or Alt. "B" Above �
$450.00 Conservation Plan Revievu
Fee Determined by Engineering
Agreement Necessary [ j Not Necessary []
��
v�v
C'/�� �
sr��u�-no�s:
�� p �/% �v �?�
�� ���,� � .... � ___ _
! o o.�" ,�o��s' d'�"�
/ss��.� �/ / �� .
�� ��
BUII�DING PERNIIT FEE SCHEDULE
�
The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any
addition to any existing building or structure, or for any alteration or repair to any existing building or struct�ue,
upon a�plication therefore, require the payment by the applicant for such permit of fee�s to the amount herein
below set forth and in the manner herein provided to-wit:
TOTAL VALUE
$1 to $500
$501 to $2,�
$2,001 to $25,0�
$25,�1 to $50,�0
�✓U�WL W ��W'WV
$1�,�1 to $5�,�
$5�,�1 to $1,0�,�
$1,�,�1 and up
FEF�S
$23.50
$23.50 for 5rst $500 plus $3.05 for each additional $1� or
fiaction thereof, to and. in.cluding $2,000
$69.25 for first $2,OOQ plus $14.� for each additional $1,000
or fra�tion thereof, to and including $25,�0
$391.25 for first $25,� plus $10.10 for each additional $1,�
or fraetion thereof, to and including $50,�
$643.75 for first $50,�0 plus $7.� for each additional
$1,000 or fraction thereof, to and includin.g $100,�
$993.75 for first $lOQ,� plus $5.60 for each ad.ditional
$1,� or fraction thereof, to and �ncluding $5�,�
$3,233.75 for the first $5�,� plus $4.75 for each additional
$1,�0 or fraction thereof, to and including $1,�,�0
$5,608.75 for the first $1,�,0� plus $3.15 for each additional
$1,�0 or fraction thereof
DRIVEWAY DEPRESSION ES(CROW
(Con�rete Curb Streets Only)
Removal and replacement of curb and gutter only - driveway width plus 6 feet times $20.�.
VERIFICATION OF FOUNDATION
Pennits for construction 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 Certific�te of Survey of the lot, showing the loca.tion of the existing foundation will be required before
proceeding with the framing. New Houses Only
,
• CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
(763) 572-3604 FAX: (763) 571-1287
ADDRESS
PIN
LEGAL DESC
PERNIIT TYPE
PROPERTY TYPE
CONSTRUCTION TYPE
REPRIlVTED ON 7/15/200'
: 6615 ANOKA ST NE
: 133024140062
: UNAVAILABLE
: LOT NA BLOCK NA
: BUII..DING
: RESIDENTIAL
: DECK
VALUATION : $ 920.00
NOTE: SEE NOTATIONS ON PLAN.
CALL GOPHER STATE ONE AT 651-454-0002 FOR UTILITY L TIO �
REAR YARD.
1
�
SEJAD KALESIC
6615 ANOKA ST NE
FRIDLEY, MN 55432
PERMIT NO.: 2005-00878
DATE ISSUED:
A 6' X 11' DECK IN
�p�C�T BUII.,DING PERMIT FEE
PLAN CHECK FEE
FIRE SURCHARGE
STATESURCHARGE,VALUE
TOTAL
PAID WITH CHECK # 2749
SEJAD KALESIC
6615 ANOKA ST NE
FRIDLEY, MN 55432
OWNER
AGREEMENT AND SWORN TATEMENT
This permit t�comes null and void ' work or construction
authorized is not commenced wi ' 60 days or if construction
or work is suspended or abando for a period of 120 days
at any time after work is comm ced.
I hereby certify that I have ead and exa�nined this
application and lmow the e to be true and correct. All
provisions of laws and o' ces governing this type of wor�
will be complied with wh er specified herein or not. The
granting of a permit not presume to give authority to
violate or cancel the pro ' ions of any other state or locallaw
regulating construction or the performance of construction.
Applicant Date
Bldg Insp Date
SEPARATE PERNIITS REQUIRED FOR WORK OTf�R THAN DESCRIBED ABOVE.
38.75
25.19
0.92
0.50
65.36
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