AF - 34984�
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City of Fridley, Mi.nn.
BUILDING PERMIT
��; Sept. 6, 1968
p�; Chester Maciaszek g�� Sa.me
�� 210 Longfellow St.ft, E. Ad� Sam�
�T°
LOCATION OF BUILDING
Na 6683 s�t Anoka. St . N. E. Part of I.flt
Lot R• a°f 27 _ B�k 2 Addition or Sub-Divisi� Oak Grove Addn 4
Corner Lot _ Inside Lot X Setback 35 � Sideyard 10' / 22 Z'
�W� �BVB� 889.27 892 .27
Top of Footing
DESCRIPTIOIV OF BUILDING
L�'"���
9922
To be Us� as:
Dwei ng �t 27'�, ' �p� 40' g��t 20' gq, �, 1100 �, p� 22, 000
Front Depth Fteight sq. F't. c�ti. P't.
� og ��� Frame ��_ $15, 000 To be Completed
SEWER LOCATTON - 56' South of Manhole
WATER LOCATION - 45' South of Ma.nhole
Ia c�sideratton of the issuaac�e to me of a permit to c
the p�opo�d work in accordance with the d�cription above
�dinances of the dty of Fridley.
.00 Sewer
l above I a�ree to do
wlth af l pro�dsione of
Ia oon�deratton of the �yment of a fee oP $ 33 00 ��t ia hereby graated to Chester
Maciaszek ��� �e builaing or additton as d�cribed above. Thiap�mi t is granted upo�
the exAre� oondition that theperson to wh� it ia graated and his a�ents, emplo� yees an� worl�sen, ffi all work
daa�e in, around and upon eaid buildin�, or any� thereof, shall conform fn all r�pe�ets tfl the oivlinsnces oR
��Y, Minn�ota locat[on, construct[on, alteratlo� maintenance, �pstr a� movlag of buildin�8
v�I�� dty ]imits��� � permit may be revoked at�a�� t�upoa violation of aay � the provJsions o� said
�
Official
�S �
n NOTIC&
Tid� peeade does rrot eowr Hro �, �Hon P�m9. 6+� �. a�rer er wat�. B� auw ts a�
tlro Bu�ee let�a� fer aW*+t+ Pumtb hr 1Ma h�uu.
.� •: -
APPLICgTION FOR BiTILDINC PERMIT
�ITY OF F'EIDLEY9 MIN�IESOTA
OWNEEi @s N�ME (JH,ESTi=R M�S+cIAt?tX �z�� f�F�l� •
e
Ann�s_a�o Raa�Fp,r� a w sr.v.��. .sr,�x�sss ,�
LOCAT�ON OF BUII,DIITG
Noo -Cl. �3 s�r AAia�A s�- -
Lo�� BLOCx � .A3)DITION OR S�'BDTVISIO?V oA�f ��or� �,opiT�u� -
COR�'�TER LOT I�TSIDE LOT (/ SE'I'BA�,R�SID�� /D ��2�? ��
SEWER ELEVATIOri — TOP OF �OCTIIlTG —
Applicatat attach to this £o�a! T�ro �°e�tificate� o�' Su.�vey oi Lot ara.3
propo�ed buildirr.� lo�atio�� drs.�n ors thee� Ce�tifieateso
DE�SrR��'I' i Ol�' OF Bl7ILDING
To Be ���d .9.� e
f /,v6,�.� 8rv�.tt i�v � �'x�o�at � � � D�pth ��� Hei�ht .� �
�quare feet //0?� Cubic FE�t �2_ Db-b�
F�ont Depth Height
Square �eet Cubic Feet
Type of Construction /,vo �,p FeP,4MF. E�timated Cost /s d'�� °=
To Be Completed f�? 0 D�� S.
—�
The undersig�ed hereby mak�� application for a per^mit f°or th� work
herein. speciii�d9 a.g�eei� to do all work in strict accord�.nce with the
City oi Fridley Ordina�.ces and rulings oi th� Departmexat o:� Buildi� 9
and hereby deela,res that all the facts and. rep�et�er�tationa stated in
this applieation are tx�ze �nd correcto 1
DATE SF/°T� lv , l°I 5r ��.G�TgTORE
(Schedule o� Fee Cost� caxn be fourid on the Reve�ee Sideo)
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BUILDING PERMIT FEE SCF�EDIII,E
SECTION 2o The Inspector of Buildings sha119 �aefore issu�ng per�it�
for the erection of any building o� stzu.eture s or ior a:r�y addition to ax�.y
e�ist� �tzu.cture or buildizig9 or ior ariy alteration or repairs to any
exieting building or structure9 upon application therefo�e, :�equ�e the
pa,yment by the �.pplie�.nt for such per�i� oi fee� to the amouta.t here�a.
below �et forth an� in the ma.�.ner hereixs provided to�wit:
IIniform Build° Codea Typ� 19 2, & 4-$'io75 ior each o�e thou�and
cubic feet, or fraction thereoi, iza sucY? cubieal c�ntentso Ty,pe 3 8e 5-
$1050 for eaeh one thouaand cubic feeto
For the purpose of° computi.�g fees for buildi.ng permite 9 the cubic�,l
contents of any buildi.n� or addition to a uniform hei�ht throu�hout by
multiply�.ng the ground area covered from a point six (6) inches below
the floor line of the basement or the cellar to the avera.ge hei�ht of
the upper �urface or to the avera.ge height oi the rooi surface of the
ma.in �a.ble of a pitched roof e
F'or repairs or alterations to an existing structu�e, the fee sha,ll be
at the rate of $3s00 per each iive hundred dollars ($500000� or
fraction thereof in the cost of all proposed worko
In no case sha,ll the �ee char�ed ior an.y pe�mit as set iorth in Section
2 be less than $5o00a
NSSSD Connection Charges ba�ed on location - Area 1 c�r 2e
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`;�� Lot 28 and the North 1/2 of Lot 21, .: ���e�eb . .
, y cex��g► �hat this survey, plan; or re�rt
. . wa� prepared by me o�,under my direct super-
. B1 ock �2, O.ak GD"OV� Addl t1017, , vision aixd that I am a duly.l2efiistered Land
. ��e�or �er �aws, o e S�.te e�f 19�i�x}-
Anoka County, Minnesota �
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City of Fridley, inn
BUILDING PERMIT
��. Ma.y 6, 1969
p��; R. L. Ca11et� g�� Miles_ L�her crp.
�.
� 6683 Anoka St. N. E. Ad� 4500 Lyndale Ave. N.
LOCATION OP BUILDING
No 6683 g{�t An_oka St _ N_ ._ P� op �
Lot �• ao� 27 -?�lock 2 Addition or Sub-Div9si� Oak Grove Addn .
Coraer Lot
Sewer IIevation
Instde L�t �etback Sideyard
Foimdati� IIeval3on
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N° 10220
DESCRIPTION OP BUILDING
To be vsea ss:
Garage �t 24' �� 22' g�t 10' gq, �, 528 �, � 5280
Fra�t I?epth ITefght Sq. Ft Cu. FL
Type of Camstrucl3�t Frame �� r$2, 000. 00 To be Completed
���k �ofa �iesu�aaae�� � oa f�a permit to c
ordinances of the dtq oP Fridiey. P�on above
ag descrlbed above I a�r+ee to do
co�pliaac:e vvlth a�l pra�+Isious of
Ll t�4der813oII oP tYle pSym�IIt of a Yee of .� 8- Q�_� pe177u1t 98 h@Teby �aIIted to Mi 1�a T.�rml��r CO .
t0 Co7letnlCt th@ bt�ilaiII$ OT 8ddil:fOII 88 dBBCCib@d &bOVe. Tl�iBp� t is gran'ted upoII
the espx� cwnaition that the�e�on to whom it is graated aad hfs aget►ts, �ployees an� worlunen, ia all work
floae fn, around and upon said building, or anypart ther�of, shall c�onform in aIl r�pects to the orrlinaac�s of
Fridle3►. Minn�ota lxation, c�nstruction, alteration, maintenancse, repair aad moving of buil
wio�a� dty limiffi��and�th�s perrmit may be revoked at any t�ne upon violation of a�► of the 8��� oP�
� Official
r �
Henry . Muhich
NOTIC6
1Yt psr� doa uet cerer �6s �, � hr �rhto�, P��B. e�+ �9. a�rv ��rdar. B� wro to su
Wa � i�aetar tor ppum � �or f6as hw�.
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.APPLIC�TION FOR BIIILDIIVG PERNlIT
• � C�TY OF FRIDL�Y, MINNE.SOTA. . .
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O�t 'S NAM'� l� < e BIIILDER , .� s �c�
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A�DR�B �� � �°� � .�o�- ��. � . /`".�v o % � ,.S''t /r%� , ADD�S �'{�`+a,D /V' �0�� � .
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I,OClTTON � OF BIIILDING
NO . � � � S'7,'R�E�1.' � ,,�..�.�.,,,�.r� � �? �i ��' • � t� , .
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L0�' N K x?BI�OOK ��-- AUDITION OR SIIBDIVISION �� �:�ro dP f��
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CORNER � L(Y�.' ZN'STDE LOT .t SE°1'BA.CR SZDE�C$RD
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SEWER ELEVATT.Q� TOP OF FOOTING
Applic�.t attat�h �o this �orm Two Cer�i.,fiQates of Survey of. Lot and
prqpoeed b�nild�,Ag.loaation drawn on theee Certiiicates.
DE,SCRIP'I�ION OF BClILDING
To Be 'II�ad �e._ _ - , . , . ,
"�i r � _ � F�ont - � j� . Depth 1 °L Hei�hi / o
, 6quare fe�t �s. 8' Cubic Feet
Front Depth Hei�ht
� 5quaxe feet Cubic Feet
Type of Qpnstru¢tion Estimated Coat 1�-����
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To Be CQmpleted �� c�e ��.
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The und�xei�q,ed h��eby maltes application for a permit for the work �
herHi�a, t�pecs�.�ied, a�eeit� to do all work in strict accordaxr.ae w3,th the
City of F°ridley`Ordi�na�ces and rulin�s of the Department of Buildi.�ngs,
and he�eby deolar�e �hat all the facts and representatio�. atated in
this appl�,a�,ti.oxt �re true and co�rect e
DATE , �/ ( / 6 �' � SiGNATDRE �
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(Schec�ule of Fee Co�ts can be fouYid on the Rever�e Side. )
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SECTION �.� The ip,sp�ctor of Buildin,�a aha119 before is�uin� permite
for the e�eat�.o� of any building or etructure9 or for any addition to any
mxi.atis� s��tature ox buildix�� or .for any alteration or repa�� to ��y;
� exieting buildir� or structure, upon applYCation therefore, requ3,re the
pa�u►ent by the �pplicant for such permit of iees to the amov,nt hsrein..
below set forth a�d in the manner herein provided to-wit:
IIniform $uild.in� Code: Type 1, 2, & 4-�1 075 for each one thpusaaa.d
� � �_ � �� �
aubie feet, or �action thereof, in such cubical c.nntents: T� �& 5,
$9 .50 ;for ��.ch ome thousand cubic feeto -
�;_h
For the purpase of computix� fees for buildin� permita, the aubival
- ctsirt�s�'t$ o�`-�yy��ct�i�d.�.i-t;�a� u�i�'orm Yiei��au��'r"'gsy--�-
multi,plyin� ;�1�e <�pund area covered from a poirzt ais ( 6)�.n.ch�� be�aw -
the floor lfne' of the basement or the cellar to the avera,ge h�i¢�ht of
the upper surfaae or to the average height of the roof sux�ace of.��#Q
maiu gable o� a pitched roof. "
For xepa.i:�s` or alterations to an existin� structure, the fee et�a1J. b�
at the rate of $3.00 per each five hundxed dollaxs ($500.Q0) ox
fraction thereof in the cost of all propoaed worko
' Iu na case shal�, the fee char$ed for any pesmit as set fo�th �n Seo�ion
2 be �ess than $5.00.
NSSSD Coru�.ection Cha,��es based on location - Area 1 or 2.
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��;�. Lot 28 and the North 1/2 of lot 27, .� � �
., I�e�eb� c�ify that this §urvcy, pl�n, or retx�rt
� . B10Ck �2 Odk GY'oVe Addi $10t1 ' R'a'� p�n$r�d by mc or,undcr my dirc�;t sui�cr-
, • ,,. _ vision aad th�t I am s de:Iy Re�isrered La,:u
Surveyo; •n��:`F' �_ lzws, � e St�ite �f Ni:.x}- �
Anoka County, Minnesota : ��- .�f � ; ,�
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THE BELOW MUST BE FILLED IN WHFJV REPLACING FUEL BURNiNG APPLJANCES OR THE
APPLJCATION WILL BE RETURNED
CflMM�N VENT NT BNNECTnR 4ND _�MBIISTIC�N A1R RIFICATIAN
�V{ien ��� i^Q a��a ����°, the undersigned hereby verifies that the
vertting has been examined and is free from rust, deterioration, obstructions,
and is securely supported and firestopped where required. Yes (� No ()
The venting system is plastiGPVC and meets all current codes and manufacturer
speafications induding sizing, length� number of elbows and termination. Yes () No ()
The undersigned also verifies that the replacement unit is a listed assembly
and meets the cument � and manufacturers speafications. This does
indude AGA-GAMA C�tegory I Central Fumace Venting Tables for fan
assisted and natural draft"�ppliances.
� eY_j��e.�,e�•_�en �i� is s¢ed and installed to meet the current codes
and manufac�uurer's spedfications.
V�i1�1 fBQUjf� tp inetall a n�w _em6 �c+ien air_ it wi11 be sr�ed and installed
to meet the current codes and manufacturers speafications.
Yes ( ) No ( )
Yes ( ) No ( )
Yes ( ) No ( )
�� in+llino a�w ��A��, the undersigned hereby verifies that
it is a Gsted assembly and meets the current codes and manufacturers
sp�ifications. This does indude AGA-GAMA Category I Central Fumace
Verrting Tables for fan assisted and natural draft appliances. Yes () No ()
Is the common vent and vent connectors sized and installed correctly after
an app�iance has �en removed from the common vent and vented
separately as per currerrt codes. Yes () No ()
Aneli� ance T�y �nd S'v��Cemmon Ver�t and Ven4 Connecter infermatien
Appliance #1 Type BTU Input Fan Assisted or Nat
AppGance #2 Ty� BTU Input Fan Assisted or Nat
App�ance #3 Type BTU Input Fan Assisted or Nat
_ _ Total Appliances - — - Totai Btu Input -- -- -- -- — --- — --_ -
Common Vent Type Vent Height Diameter inches
Appltance #1 Ver�t Connector Height ft Length ft Diameter in Type
Appliance #2 Verrt Connector Height ft Length ft Diameter in Type
AppUance #3 Vent Connedor Height ft Length ft Diameter in Type �
�.
HEATING CO: d 1'�� ��'C C_ / C�
1 /
Signed By: Date : �T� � "