AF - 35104SUBJECT PE
City of Fridley ° 14�44
�
AT THE TOP OF THE TYUINS g U I L D I N G P E R I�t �T
< < RECEIP7 NO.
� • COMMUNITY DEVEIOPMENT DIV.
� �L � PRaTECTIVE INSPECTION SEC. �D
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� ���'� � CITY HALL FRIDLE� 5$432 NUMBER REY. DATE PA6E OF APPROVEO 8Y �
�.._�A.' `� s�.z-seo-3ago
910-F15 6/9/7$ � �
JOB ADDRESS 5801 Arthur Street N.E.
1 LEGAL ��T NO. BCOCK TRACT OR AODITION SEE ATTACHED
DESCR. P't. 49 Aud3.tor` s Subdivi.sion #92 SHEET
2 PROPERTY OWNER MAIL ADDRES8 ' 21P PHONE
B-E Ent�ris�.s Inc. 85 3rd Avenue S.E., New Brighton 636-4164
3�ONTRt�C7'9R' :- MAIL ADDRESS 21P PHONE UCENSE NO.
' -�'�3�@
4 ARCHI'fE4T OR bESIQNER MAfL ADDRES& ZIP PHONE UC�NSE NO.
5 ENiflINEER MAIL ADDRESS ZIP PHONE LfCENSE NO.
8 USE OF BUILDING
Residetitial
7 CLASS OF WORK
I� NEW ❑ ADDITION ❑ ALTERATIOPd ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 50' x 24` Dwelli.ng and a 2U' x 22' Garage u�j�i�l�
TELEPI�4N� - QECTRIC - GA�S E
9 CHANOE OF USE FROM TO �. REQV ��Ep
STIPULATIONS p�nide ahard surfaca driveway. Ptovide sod in the. front and side yarr7s
Proni.c� a verifying survey before capping. P�vide �rritten soil tests aaid
recoanmendations before placing founc7ation. l�esolve all drainage pmblem�
wi'�h Gity F.ngineeri.ng Dept. before placing foundat3on. Pa�vide
combustion air to fu�xtace.
Sh�R LOCATION: 30' N. of Manhole (Imr. 945.45) WYE ELEVATION: 945.56
ZbP C�' FOOTIl�TG: 948. 56 M; *+; mL
WATElt IACATION: 48• N.E.of Manhole, 68.5' South of cateh Yaasi.n on East side
of street.
DRIS�F,W�,Y DEPR�SSON COST: 20' + 6' _�6' x$14.50 =_$377.00
QM ;�, 1�Y DOES NOT GUiIRANTEE TH�
� t�;. +� ic►c�►t�s ��vAnoNS. S��p��T� �ERMlTS R:EQ!lIREQ fOR i�1!
: CAT� IS - FQR �p�0liMIkTtON PURPpS�S ONLY AhEO H�A�i�IG. f�.�1�8tN+� ANI� St��t'S.
us� R s�c� v�r r�b �o�anor� H
� SEPARATE PERMiTS ARE RE�UIRED FOR ELECTRICAL, PLUMBINd. HEATINO, TYPE O CONST. OCCUPANCY CiROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING. WOOa Fr801e
iHIS ?ERM1T BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONW(i SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSRENDEO OFi ABANDONED FOR A PERIOD OF 120 DAYS AT R 1. 9.CU{-440 23,316+3520
ANY TIME AFTER WORK IS COMMENCHD. NO. DWLCi. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMIN�D THIS APPLICAfION 1 STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORREGT. ALL PROVISION3 OF LAWS ypWATION SURTAX
AND OROINANCES GOYERNINO THIS TYPE OF WORK WILL BE COMPLIED.
WITH WHETHER SPECIFIED HEREIN OR NOT. THE ORANTING OF A PERMIT �9►SaO $24. TF
DOES NOT PRE T GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISlO S ANY HER STATE OR LOCAL LAW RECaULATIN(3 CON-
STRUCT R HE RF CE OF CONSTRUCTION. ' $10�.3� �OO.00
' � PLAN CHECKFEE OTALFEE `
6.84 $558. 94 -
SiGNATU EOFCONTiAC D ORAUTHORIZEDAGENT ID TE WHEN P PERLY VAUDATED ,` R PERMIT �
1c�2.� � -a c/'%�)
SIGNATURE OF OWNER IIF OWNER BU�LDERI IDATEI BLUG. iNSP DA7E.
- . . ...v—
CITY or- i=1tIULCY . � . . .
• /�Pf'LIC/�TTUt� r012 i;1:�1►�(�tdTl/1L ��lliylll(�G f'Cl2t�iITa .
• (i'�t�w, �1LTL"RnT1U(JS, IIL�UIT10(d�, or7 Rcrnif�s) ,
• , . . .
oz;���n: — � ' �uxLUrfz: �,� � � �.� � �
Adctres� e j � � ���,r� �_ �� Addres� : �S —�,� �� � C .
`�.e�.' �'cle tao. : � � 6 � �/� e.� ,'
I,�o.: ��(� � Strect: , i �t 1 .
�p�:+; ��' }3IACY.: hDDITIOP� : � � � / V a �,�
C0121JLR L . II�SID� IAT: SLTAIIC}:: SIUL•'YARDS:
Applica'r�t att�ch tv this iazm Tro Certiiicate� oF Survey of LoL- and proposed
bui.lding lacatian dra�+m on these Ccrtiiicatcs. • �
.
DESCRI PTIOhd OF 13UI LDI I�G
,,
To Used 71s:
• Front: ✓v Depth: .�� � Iicight: o?`' _ ' ,
Square Feet: � Cubic Fect: � , , ��G°s
�
T'xont: � Dep�h: � � � Neight: �
Square reet: �� Cubic Feet: � �� ��
. � Estimated Cost: �•_��� .
Type ot: Constr�:ction:
7�b Be CompleL-ed: Alt. A Alt. B
Proposed Drive�.ay k'idth If 11��,* O��eni.ng Is Desired p �' $ $ '
�) (S� 2'.�VEFSE STDE OF SHEEi )
�
The undersigned iiereiay ma}.es ap�lication i'or a pe�mi� for the work lierein
speeii'S.ec�, agr�eing . Yo do all scork in stxict 1CCC�1C��,nce �aith �he City of
Fxidley Ordin:,nccs a�id rulings of thc Dc??�ri:s;icitt ot }�uildings, and hcreby -
dec].are� L•hat all �hc faci:s and re��re::enL-ztions �tatcd in i:his api�licat•z�n .
'axe true and correct. See revar�e si.�cic r c it'onal �nforni�i:ion.
� a
DZ�; � SIGAAi'U}'.1.:
Sta�ulations: � � � ��A+ `��
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BUILDT�JG PERt�IIT FEr SCHEDULE . .
SECTION 2. The Inspector of Buildings shall, before issuing pezmits fox the erection
of any buildinq or structure, or £or any addition to any existing building or stru�ture,
or for any alteration or repairs to any �existing building or structure, upon�applicatio:.
therefore, require the payment by the ap�licant for such permit of.fees to the amount
herein below set forth and in the manner herein provided to-471t: �
NEW CONSTRUCTION: Single FFUnily Homes and Garages: $4.00/1,000 cubic feeY.'
PLAN CIIECY.: 25 percent of building �ermit fee.
DRIVEWF�X DEPRESSION: (Concrete L�rb Streets Only�
Alternate A: Removal and replacement of concrete curb and
gutter only; Driveway width plus 6 feet x$14.50
Alternate B: Remnval and replacement of concrete curb and
gutter and install a 3 foot �ide approach with
� . 6 inch depth; Driveway width plus 6 feet x S17•2�
:11 � ; _ l �' : �
For the purpose of computing fees for building permits, the cubical contents of am:
building or addition, is determined by multiplyi.ng the ground area cover.ed from a
point six (6) inches below the floor line of the basement or the cel.lar to the
average heig�hts of the upper suzface or to the average height of the roof surface
of the main gable of a pitched roof. .
For repairs or alterations to an existing structure, the fee shall be at the rate
of $3.00 ��er each five hundred dellars ($500.00? or fraction thereof in the cost
of all proposed �,rork.
In�no case shall the fee charged for any permit as set forth ia Section 2 be less
tlian $7.50 n1LS $.50 state surcharge.
_VERIFICATIOy OF FOUhDA IT OfV
IVOTE: Permits for construction will be issued a minim�a of 24 hours from the time
of application to allow for proper review of the proposed structure and o� the
construction site.
A Certifica.�e of Survey Qf the lot, showing the location of the foundation once it
has been c�nstructed will be required before praceedir.g with the framing.
: : � ':►
Application for a Certificate of Occupancy shall be made ten (10) days prior to the
use or occupancy of any structure for which a building per.nit has been issued; and
• said structure shall not be used or occupied until a Certificate of Occupancy has
been issued. "
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CITY OF FRI�LEY
8431 UNIVERSITY AVENUE N.E.. FRIDLEV� MINNESOTA b5432
TELEPNONE ( 8�12)571-3450
January 2Z, 1979 ` .
Mr. Bob Erickson
B-E Enterprises Inc.
85 Third Anenue S.E.
New Brighton, NIl�i 55112
Re: Final Inspection at 5801 Arthur Street N.E.
Dear Mr. Erickson:
A final inspection was made on January 22, 1979 of the abave address and
�hhe foll�ving items were noted which must be campleted befare the structure
can be finaled outt
1. Repair collapsed c�bustion air vent to furnace and it should e�ctend
down to within 12 inches of the f�.00r.
2. Extend lower level bath exhaust fan vent to outside. -
3. Cha�ge alean-out plug in recreation z�o3n to a flush type.
4. Provide nuts on anchor bolts.
5. Pravide sod in the front and side yarc3s.
6. Provide a hard surface driveway.
7. Pr�v3.de City with copy of verifying survey of property.
We will expect items 1, 2, 3, 4, and 7 to be completed by February 2, 1979
and ite�ns 5 and 6 to be completed by June l, 1979 when reinspections will
be made to detezmine eompli.ance. If you have any quest3ons on these items
please contact me at 571-3450.
Sincerely,
DARRB, G. CLARK
Comtminity Developonent Adm.
ur �n �
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r.�RRS� ��T� � ��S(�CIAT�S INC.
REG/STEJtEO PROFESS/OiYAL • LANa SURVEYORS
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❑�
Talephw» 581•25�5
SU1TE �B
YILLAGE NOaiN F'ROFESSi�IAI. $WG
! T420 UA9tTV AYEaNJE NORTH
BROOKLYN PARK.11tINkESOTA 55�b43
O'� �'.�' � ,'�!/C�
PROPER'TY OF . Frank Voth .
dts ri�d as tol lo,tis � pa�el No. 1 t The south 80 feet of the vr�at 220 feet of
�ot 49� Audi�ors Subd v sion o. no a oun y� nneso eo u ec to
an easement for road purposes over �he weat 30 feet thereof.
Said south 80 feet bei measured.along west line of said Lot �9.
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c�ty of Fridley 2 9 9 2 4
.
"TT"ET°P°�T"E�'"s gUILDING PERMIT
� � RECEIPT NO.
� `L ���� COAAMUNITY DEVELOPMENT DIV. �� ��
f j �� PROTECTIVE INSPECTtON SEC.
' i '
, ����1 � CITY FIALL FRIOLE� ��� NUMBEA R8V DATE PAGE Of AiVApVEO BY
�""� � �'' 612-57�-3a50 9�aF�s 7/22/99 / /
J08 ADDRESS
5801
1 LEGAL LOT NO. BLOCK TRACT OR AOOITION SEE ATTACNED
OESCR. aI'� of 49 � SMEET
2 PROPERTY OWNER MAIL ADORES$ ZIP PMONE
L le Elmber
3 CONTRACTOR MAIL ADORESS Z�P PMONE LICENSE NO
Moon Roofin 0
1 ARCNITECT OR DESIGNER MAIL AOORESS 21P PMONE LICENSE N0.
S ENGINEER MAIL AODRESS 21P PMONE LICENSE NO
8 USE OF BUILDIN(i
Residential
7 CLA3S OF WORK
O NEW ❑ ADDITION 0 ALTERATION x� REPAIR O MOVE O REMOVE
B DESCRIBE WORK
Reroof hause and ara e 18 Tear-off
9 CHANGE OF USE fROM TO
STIPU�LATIONS
'ifiderlayment must comply with the State Building Code.
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBIN(i, NEATING. �pE bF CONST. OCCUPANCY GqOUP OCCUPANCY LOAO
VENTILATING OR AIR CONDITIONING.
THIS PEfIM1T BECOMES NULL AND VOID IF WOiiK Oti CONSTFUCTION 20NIN�3 SO. FT CU. FT,
AUTMORIZEO IS NOT COMbIENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENOEO OR ABANOONEO FOR A PERIOO OF 120 DAYS AT
ANY TIME AfTEq WORK IS COMMENCED. NO. DWLG. UNITS OfFSTREET PARKING
I HEREBY CERTIfV TMAT I HAVE READ ANO EXAMINEO TFIIS APPLICATION STALLS GARAGES
ANO KNOW TME SAME TO 8E TRUE AND CORRECT. ALL PROVISIONS Of LAWg yp�UAT10N SURTAX
ANO ORDINANCES GOVERNIN(i THIS TYPE OF WORK WILL BE COMPLIED
WITM WMETMER SPECIFIEO HEREIN OR NOT. TME GRANTING OF A pERM1T $1573 ; 79
DOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE Oii CANCEL TME pEqMIT FEE SAC CMARGE
PqOVIS10NS OF AN OTMER STATE OR LOGAL LAW REGULATING CON-
RUCTION O PERfOfiMANCE Of CONSTRUCTION �S%.OS F� @ SC I..S%
,7 A PLAN CMECK FEE TO L fEE
� °�` � �.L Licen °'S . 0 4 . 41
� S�GNATUpE O� CON• i1ACTOp OR AUTNOp�2E0 AGENT IDATE� EN� iiOP VALI T TMIS IS YOUR PERMIT
I
S�GN4TUNE O� OWNEN qi OWNEN BY�LDER� iO�TEi Bl �hSP ryarE
i
NER%( ] `
ADDN
��
Effective 5/10/�
I l CrrY OF FRIDLEY
[] SINGLE FAMII.Y AND DUPLEXES R 1 AND R 2
BUII.DING PERMIT APPLICATION
a��'
�� �l�
. l�c
Consttuction Address: S�� % �je:�%� �� /%` �.
Legal Description:
Owner Nazne & Address: �>� G/ihD�iu� Tel. �# �%�' j 9D `%
..
Contractor: �%iv �o� %%i�sn� �%o�i NIN LICENSE # o�� ��0.�02
Address: 3%l /eri�e/r��e � � �,ac�J�/ Tel. #..�3°�O��o3
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA:
GARAGE AREA:
DECB AREA:
01'I�R:
DESCRIPTION OF IlVIPRO�'EMENT
Length Width
Length Width
Len�gth� Width
� �� �
Height Sq. Ft.
Height Sq. Ft.
Hgt/Ground Sq. Ft.
0
� %� �
consau�aon Tme• `-�v� ��m�P Estimatea cost: $ -�I�OU /S-
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$
_$ �
DATE: ��I APPLICANT: G����� Tel. # S�°��v.,�
Permit Fee
Fire Surcharge
State Surchazge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPLTI.ATIONS:
$ � . �
$ /. S"7
$ �
$
$ .00
$
$
$
$
$ •
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/lOth%)
$.50/$1,000 Valuation
$1050 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreemern Nece,ssary [ ] Not Necessary [ ]
r - ' ,.rh
BUII.DING PERMIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the ere,ction of any building or structure, or for any
addition to any existing build.ing or structure, or for any alteration or repair to any existing building or structure,
upon application therefore, require the payment by the applicant for such �rmit of fees to the amount herein
below set forth and in the manner herein provided to-wit:
TOTAL VALUE
$1 to $500
$501 to $2,000
$2,001 to $25,000
$25,001 to $50,0�
$50,001 to $1�,0�
$1�,001 to $500,000
$500,001 to $1,000,000
$1,000,001 and up
FEES
$23.50
$23.50 for first $500 plus $3.05 for each additional $1� or
fraction thereof, to and including $2,000
$69.25 for first $2,000 plus $14.00 for each additional $1,000
or fraction thereof, to and including $25,000
$391.25 for first $25,000 plus $10.10 for each additional $1,000
or fraction thereof, to and including $50,0(�
$643.75 for first $50,000 plus $7.U0 for each additional
$1,000 or fraction thereof, to and including $100,000
$993.75 for first $100,000 plus $5.60 for each additional
$1,000 or fraction thereof, to and including $500,000
$3,233.75 for the first $5(�,� plus $4.75 for each additional
$1,000 or fraction thereof, to and including $1,�0,000
$5,608.75 for the first $1,0�,000 plus $3.15 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete C�rb Streets Only)
Alternate "A" : Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15.50.
Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $23.25.
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper
review of the proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will
be required before pr�ing with the framing.
_
_
��r��NF
CiVLLrGI
FRIDLEY MUMCIPAL CENTER • 6431 UNIVERSIT'Y AVE. N.E. FRIDLEY,IVIN 55432 •(763) 571-3450 • FAX (763) 571-1287
January 25, 2002
Mr. Lyle Elmberg
5801 Arthur Street NE
Fridley, MN 55432
Re: Final Inspe,ction at 5801 Arthur Street NE
Contractor: Advantage Air, Inc.
Dear Mr. Elmberg:
A mechanical permit was issued on October 16, 2000 to install a furnace at your
address. According to the 1991 Uniform Mechanical Code a final inspection shall be
conducted on the work authorized by this permit. A final inspection was conducted
on October 23, 2000 and the following correcrion was noted:
Size common vent and vent connectors to meet GAMA tables.
The permit fee that was paid covers the inspection to make sure the work was
completed according to the Codes. We need. to recheck the correction before we can
final out the permit. To set up the inspe.ction or to l�ave any questions answered,
please contact the Building Inspection Division at (763) 572-3604.
Sincerely,
0�_ f-�-�'�C�6
3. d' rn
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SuB�ECT
City of Fridley 3 3 51
AT TFIE TOP OF THE TYY�NS g � i L D I N G P E R M I T
f
� � COMMUNITY OEVELOPMENT OIV. /� �
� j y—� 'i���
r � � PROTECTIVE INSPECTION SEC. �c
� . �
i.__- `�r'�';•; CITY NALL FRIOLEV SS�32 NUMBER REV OATE PAGE Of APVRpYED BY�
L J` 763-571-3450 s�aF�s 5/14/03 / �
J08 ADDRESS 5801 Arthur Street NE
t LEGAL �OT N0. BLOCK TRACT OR ADDITION SEE ATTACMEO
DESCR. Pt 49 Auditor's SUb. �92 3MEET
2 PROPERTY OWNER MAIL ADDRES$ ZIP PMONE
Pat & Lyle Elmberg 5801 Arthur Street NE 763-572-3907
3 CONTRACTOR MAIL ADDRESS 21P PMONE LICENSE NO
Sela Roofing & Remodeling Inc 4100 Exc.elsior B1vd, St Louis Park, MN 55416
4 ARCNITECT OR OESI(iNER MAIL ADDRESS 21P PMONE LICENSE NO.
612-823-8046 1050
S ENGINEER MAII ADDRESS ZIP PMONE LICENSE NO
8 USE Of BUILDING
Residential
7 CLASS OF WORK
❑ NEW O ADDITION O ALTERATION 4 REPAIR O MOVE � REMOVE
8 OESCRIBE WOfiK
Reside House & Garage
9 CHANtiE OF USE FROM TO
STIPULATIONS
Per Section 1402, 1997 Uniform Building Code, requires that a weather resistive
barrieX be placed over ex.terior sheathing to grotect the interior wall covering.
Exceptions for this provision would be if shea�hing is an approved weatherproof
panel or when the siding is an approved weather barrier. Viny1 sidi�.g is not
a weatherproof covering un�:ess the ma�ufacturer states this in their application
guidel�nes. Call for inspection of wrap before covering or take pictures. Caulk
and flash all exterior openings.
riPE OF CONST. OCCUPANCV GROUP OCCUPANCY LOAO
SEPARA7E PERMITS ARE REOUIREO FOR ELECTRICAL. PLUMBING, FIEATING,
VENTILATING OR AIR CONDITIONING
TMIS PERMIT BECOMES NULI AND VOIO IF WORK OR CONSTRUCTION ZONING SQ. fT CU FT.
AUTHORIZEO IS NOT COMMENCED WITHIN 80 OAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENDEO OR ABANDONED FOFi A PERIOD OF 120 DAYS AT
ANY TIME AfTEii WORK IS COMMENCEO. NO. OWLG. UNITS OiFSTREET PARKING
I MEREBY CERTIFV TNAT I HAVE READ AND EXAMINEO TMIS APPLICA710N 1 STA�LS GARAGES
ANO KNOW TME SAME TO BE TRUE AND CORRECT. ALl PqOVIS10NS OF LAWS yp�UATION SURTAX
ANO ORDINANCES GOVERNING THIS TYPE OF WOpK WILL BE COMPLIEO
WI7M WMETMEq SPECIFIED MEREIN OF NOT. TNE GRANTING Of A PERMIT �16 s%S3 �8.38
DOES NOT pRESUME TO GIVE AUTMORITY TO VIOIATE OR CANCEL TNE pERM1T FEE SAC CMARGE
PROVISIONS OF ANY OTMER STATE OR LOCAL LAW REGULATING CON- $279. ZS Fire SC �16. %S
STFUC710N OR TME PER.�� NCE OF CONSTRUCTION
PIAN CMECK fEE T07AL FEE
__ ��j � S-� o,� c nse SC $5.00 $309.38
S�G REO�CON•f1ACTOpOpAUTNOA�ZEDpGENf iO�TE� WMEN PROPERLV VAUDATED TMIS IS VO R PEF IT
S�GNATU�7EO�OWNEA���OWNENBU�LDEp� IDATE� BLDG �NSO � I r�bl ��
�
NEW
ADDN
ALTER
[] CITY OF FRIDLEY Effective 1/1/2003
[] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
[] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax
BUILDING PERMIT APPLICATION
Construction Address: S$'�j � �,!'Li +� 2 .sl ° � � �
Legal Description:
Owner Name 8� Address:
S
Tel. # ?6"'3 • S 7 z-3�►o7
Contractor. J MN LICENSE #
Address: aic� �c .FI SIf1R R� �m � Tel. # �/Z- �23 . �J�c�
ST. LOUIS PA+�?�: !.:±��E ; �.�,,.
Attach to t�il�n���tion, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale� qpp� & q����, I��
41Q0 IXCELSIOR BLVD.
DESCRIPTION OF IMPROVEMENT ST. LOUIS PARK, MiV 5541g
ID #0001050
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Length Width Height Sq. Ft.
Length Width Height Sq. Ft.
_ Hgt/Ground Sq. Ft.
S"� � � �i[�S�
Construction Type: �,� ����� Estimated Cost: $ d 6. 7S 3 _
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: S- /`f- v 3 APPLICANT: - r J ��%�� Tel. #�l Z S�' 7-/�Z`�
Call (763) 572-3604 for Permit Fees.if mailing in application. Fax to 763-571-1287 if using credit card and we will
caii you for card number.
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
$ �'"19 �s
$ �I��, �S .�
$ �3.3�
$
$ .��DU
$
$
$
$
$ � �
CITY USE ONLY -
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1275 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 [ ] Not Necessary [ ]
_ •.
BUII.DING 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 structure, or for any alteration or repair to any existing building or structure,
u�n application therefore, require the payment by the applicant for such permit of fees to the amount herein
below set forth aad in the manner -herein provided to-wit:
TOTAL VALUE
$1 to $500
$501 to $2,000
.� �. � �s �
$2,OQ1 to� $25,0(l0
$25,001 to $50,000
$50,001 to $100,0�
$100,001 to $500,000
$5�,�1 to $1,000,000
FEES ,.
$23.50
$23.50 for first $500 plus $3.05 for each additional $100 or
fraction thereof, to and including $2,a10
$69.25 for first $2,000 plus $14.00 for each additional $1,000
or fraction thereof, to and including $25,000
$391.25 for first $25,000 plus $10.10 for each additional $1,000
or fraction thereof, to and including $50,000
$643.75 fo� first $50,000 plus $7.00 for each additional
$1,000 or fraction thereof, to and including $100,000
$993.75 for first $1(m,000 plus $5.60 for each additional
$1,000 or fraction thereof, to and including $500,000
$3,233.75 for the first $500,000 plus $4.75 for each additio�l
$1,000 or fraction thereof, to and including $1,000,000
$1,000,001 and up $5,608.75 for the first $1,0�,000 plus $3.15 for each additional
$1,000 or fraction thereof
cuRS cu�r Escxow
(Concrete Curb 5treets Only)
Removal and replacement of curb and gutter only - driveway width plus 6 feet times $17.00.
Permits for constivction 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.
VERIFICATION OF FOUNDATION
A Certificate of Survey of the lot, showing the location of the e�sting foundation will be required before
proce�ing with�ttie framing. New Houses Onlv
RPR-27-20H4 11 � �4 I-tdUM
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pa�le�sui pu� pazis eq ��u�n }� ��e uo�snqwoa nnau e ���su� o} pa�mba, uayM
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TOTAL P.02
NEW i j
ADbN
�v.T�R C ]
CITY OF FRIDLEY
6431 Univ�rsity Ave N�, FrShcey, MN 55432
SIPIGLE FAIwI�,Y ANb DUPL�CES R�� aND R-z
BUII.DING PERMITAPP�ICATION
Construction ,qddress: (� �
l.egal C�e�criqtivn:
C�nmer Name 8 Address: � � �O���NQ &
�
�� w oa� ��-
Effective iM/2004
(T63) 572-3604 Btdg lnsp
(763j 571�iZ87 Fax
- • -�, �..�. .'-� %.���,
COf1t�aCtOr ��1i1�t"B'�'p(�--- � __ Tel• # �
g�� �� ( MN LlCENSE #
Address: , �L�pppp�� .
Tet, # �/2 - 23 a
Aftach ta this application, a Gertific�te of Survey oF the
bt, with the proposed construction drawn on iE to scale,
D�S�RIpTICaN CJF' IMP��1i�fVl�Pli
LIVING AREq; Length `� y�;dth „`�� 9 S. F�.
Hei ht q
GARAG� qR�q; Length _ Width
dECK AR�A: Lengdt --- Height _ Sq, Fk
OTHER: �-~----- Wi�tt ______,_.r.._ HB�Qround
__ Sq. Ft �
Construction Type• � �° � � ��/��
�
Estimaied Cost: $
.a- _ _ �,
D�iveway Cc1rb Cuf Widih Needed; � F� + s Ft �„�Ft x$
=$
DA'�E: �� ` ApPLICANT• (�, T �,
el.� � �. � �
Call (763) S�Z-3604 F'or permif Fees 1f mailieg in applica�ion. Fax to 763-s?1-�287 if us;ng credit card �nd we w111 ca11
you for card humbe�.
Permit Fee
Fire Surcharge
5tate Surcharge
SAC Charge
License Surcharge
Gurb Cut Escrow
Erosion Controi
Park Fee
Sewer Main �harge
TOTAL
$ l�'�. ��
� fJ
� ��
$
$�� �
� �
�
$
$ .y
� !D�-��
CtTY US� ONLY -
Fee Schedule on t�everse Sid�
,00� of Permit Valuaiion (1/10th%)
$.50!$�,000 Valuation
$1350 per SAC Unit
$5.00 �State Licensed Residentiai Contractors)
Alt, "A" or Alt. "6" Above
$�50.00 Conservation Ptan Review
Fee Qetermined by Engineering
Agreement Necessary [ ] Not Ner,essaty [ �
STIPULATIONS'
"�— ~ —zi't ' d �08Z ' ON ._.._ S3�HS 9NI.����1 d�3S lJd9b : L S20Z ' tiZ ' 1.��0