AF - 44226SUBJECT PERM
City of Fridley � � `
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T • 12853
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� `y ______ COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEQ �!�/ 7jejl �
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�l /'��1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY
j•"'� � ,'� 812-580-3450
910-F15 1 16 75 � �
108 ADDRESS 6461 Arth'iir Street N.E.
1 LEGA� LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
oescR. 22 4 Ha.rris Lake Estates SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Erco, Incorporated 3231 Central Avenue, Mpls. 789-8878
3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSENO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
� NEW ❑ ADDITION ❑ ALTERATION O REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WORK
Construct a 25' x�46' D�elling and a 20' x 23,6' Garage
8 CHANOE OF USE FROM TO
STIPULATIONS ppovide a hard surface driveway. Provide a verifying survey before
capping. Provide a P.C. Alarm and closer on garage door.
5EWER LOCP,TION:179' North of Ma.nhole (Inv. 878.40)
Wye Elev: 880.O1
Top of Footing: 883v01 Minimum
WATER LOCATION: 13' North of Sewer Service
:�'�PERATE PET�P�ITS RE(�9.�i�'EL� F�R �iIRINI��
f 1��TIR9�� �Ll�l�l1BIIVC �N� SlGNSe
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTIIATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORI2ED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONEO FOR A PERIOD OF 120 DAYS AT R 1. 1 55
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. 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 $28�932 ].4.4%
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 O THE PERFORMANCE OF CONSTRUCTION. � �`SG.00 $325.00
, � PLAN CHECK FEE TOTAL FEE
�� ' � r � � !-/�°7�� 95.47
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT 1oa7e� ,-y_ PROPERLY VALIDA ED T I IS YOUR PERMIT
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SIGNATUREOFOWNER(IFOWNERBUILDERI IDATEI BLDG INSP I]ATE
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r�o����s �f�r�'f����%�- / se�s Nretiwor �.es N.c.
Surv �n �� / Minw�apelis�
re,,; s s ��11 tj�PP�t;1$ � �%1'l�'� Mi�n. SS432
[nginse�inq � °� �el�phone �e4-eobe
cipol ingineeriny Engineere � SLiTVBj�OTB A.eo Coda 611
'ertilfcate of Survey !or ��°�.� � ��`�-%•
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her�br cerli�r tha� �his is o t�u� ond ter►�et rspr�s�Mefio�► f o �erv�y of tb� boundories ef the obovs
cribed land� ond oi fl�e lo�a�ion of all building /l�ar� e� anA oll vi�ible •nc►eoshm�nts, i/ anr, Irom or on
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► ��IOTES I�N N�N�NT . sUSU�dAN �NGINlEItING, INt.
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�.PLICATION FOR RESIDENTIAL, ALTERATION,
OR ADllITiON BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
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OWNER'S NAME• BUILDER: . /�- �� � ���
ADDRESS• ADDRESS• �� � ���
��_ . �18�`-���
N0: STREET
LOT : '� �
CORNER LOT• INSIDE LOT:
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ADDITION: �/��-� � ���%�� ���
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SETBACR• �� SIDEYARD:/�`f / �
Applicant attach to this form 1Yso Certif3.cates of Survey of Lot azid proposed
, building location drawn on these Certificates.
HESCRIPTION OF BUILDING
Be Used As:
�/�G�! � �ront •_ �-� Depth • Height • - ,'9�.
Square Feet: �� �, � Cubic Feetr, �! � <
;
, �� � -
_ Front • � Depth : -` —���c-"°�" Height • (� �%� ---
Square Feet; �.;�` ,, Cubic Feet: F-� �' �
. -T� ,�. f .�
�pe of Construction: T Estimated Cost:_ $,� �, ,, �
To Be Completed: °�- `- '�
The undersigned hereby makes applicati�on for a permit for the work herein
specified, agreeing to do all work in stiict accordance with the City o£
Fridley Ordinances and rulings of the Department of Buildings, and hereby
declares that all the facts and representations st ed in this application
are true sud correct.
DATE : _ __/ �— / � � % °� SIGNATURE:
(See Reverse Side For Additional Information.)
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BUILDING PERMIT FEE SCHEDULE
SECTION 2. The Inspector of Buildings- sha11, 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 repairs to any existing
building or structure, 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 prwided to-wit:
UNIFORM BUIZDING CODE: Type 1, 2� 4-$2.15 for each one thousand cubic
feet, or fraction thereof, i.n such cubical contents. �pe 3& 5-$1.85 for
each one thousand cubic feet.
ADDITIONAL INFORMATION
For the purpose of computing fees for building permits, the cubical contents
of any building or addition, is determined by multiplying the ground area
covered from a point six (6) i.nches below the floor line of the basement
or the cellar to the average heights of the upper surface or to the average R
•height of the roof surface of the ma.in gable of a pitched roof.
For repairs or alterations to an existing structure, the fee shall be at the
rate of $3.00 per each five hundred dollars ($500.00) or fraction thereof in
the cost of all proposed work.
In no case shall the fee charged for any permit as set forth in Section 2 be
less than $5.00.
VERIFICATION OF FOUNDATION
NOTE: Permi.ts for eonstruction will be issued a minimum of 24 hours from the
t3me of application, to allow for proper review of the proposed structure and
of the construction site.
A Certified Survey of the lot, showing the location of the foundation, once it
has been constructed, will be required before proceeding with the framing.
CERTIFICATE OF OCCUPANCY
Application for a Certificate of Occupancy shall be made ten (10) da.ys prior
to the use or occupancy of any structure for which a building perm�t has been
issued; and said structure shall not be used or occup�ed until a Certificate
of Occupancy has been issued.
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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
� .
� �
� ; L _____ COMMUNITY DEVEIOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC.
, . ,
� _ /"'1 � CITY HAIL FRIDIEV 55432 NUMBER REV DATE PAGE Oi
�'"""� � �'' 612-571-34b0 910-F15 10/16/9
� �
JOB ADDRESS 6461 Arthur Street NE
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION
DESCR. 22 4 Harris Lake Estates
2 PROPERTY OWNER MAIL AODRESS 211
Larry Halverson 6461 Arthur Street NE
3 CONTqACTOR MAIL ADDRESS 211
DeMa.rs Construction 8401 166 Cir NW,.Ra.msey, MN 55303
4 ARCHITECT OR DESIGNER MAIL ADDRESS 211
5 ENGINEER
B USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW
MAIL AOORESS
21P
2559C
RECEIPT NO.
��D
APPROVED BY
SEE ATTACHED
SNEET
PHONE
574-1081
PHONE IICENSE NO.
441-7084 6614
PHONE LICENSE NO.
PHONE LICENSE NO.
❑ ADDITION ❑ ALTERATION �] REPAIFi ❑ MOVE O REMOVE
8 DESCRIBE WOHK
Reroof House & Garage (ZS Sq) Tear-off
9 CHANGE OF USE FROM
STIPULATIONS
TO
Underlayment must comply with the State Building Code.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUM8ING, HEATING, �PE OF CONST
VENTILATING OR AIR CONDITIONING.
THIS PEfiMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS. OR IF CONSTRUCTION
O!9 WORK IS SUSPENDED OR ABANDONED fOR A PERIOD OF 120 DAYS AT
ANV TIME AFTER WORK IS COMMENCED. NO. DWLG. UN
I HEREBY CERTIFY THAT I MAVE READ ANO EXAMINEO THIS APPLICATION 1
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS yp�UATION
ANO ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED 2 O8S
WI7H WHETNER SPECIFIED HEREIN OF NOT. THE GRANTING OF A pERMIT ��
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE
PROVISIONS OF A OTH OR LOCAL LAW REGULATING CON- @
STRUCTIO O T PE E OF CONSTRUCTION y�%4. �IS
� PLAN CMECK FE
Li e e
SiGNA URE OF CONTR C OR OR AUTNORi2ED AGENT IDA Ei HE I
_ !c
S�GNATU�iE OF QWNEA iiF OWNER BU1lDER� �OATE� u n� �..e
OCCUPANCV(3ROUP
SQ. FT.
OFFS'
STA�LS
SC �d.00
UPANCVLOAD
CU. FT.
' PARKING
GAFAGES
$1.04
SAC CHARGE
Fire SC $2.08
f TAL FEE
$82.87
1 TNIS IS VOUR PERM
�/h � �
NEW f 1
ADDN [ J
ALTEfZ f./(��
L
ConstructionAddress: �
Legal Description:
Owner Name & Address:
Contractor. � �
Address: � C� ?�
` CITY OF FRIDLEY
S[NGLE FAM[LY AND DUPLEI�ES R-1 AND R-2
BUILDING PERMIT APPLICi1TION
/ � / I ���� � �
r�!:�i1
S8
� c`,�c,���J
Effccti��e 1/1/9�(�
.
. ��� �b
��
Tel. # 7� �(f�/
MN LICENSE # �o � ��/
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
Tel. # � G�� ? d � �
DESCRIPTION OF IMPROVEA'IE\T'T
LIVING AREA: Length � �lidth Height Sq. Ft.
GARAGE AREA: L,ength Width Fieight Sq. Ft.
DECK AREA: Length Wid Hgt/Ground Sq. Ft.
OTHER: � � � r LO� i9- �
` -zSS� �
Construction Type: a� � Estimated Cost: $ o� (�� �
(Fee Schedule on Back)
Driveway Ct�rb Ctiut.Width Needed: Ft. + 6 Ft F x$ - —$
DATE: ( � � � APPLICANT: Tel. # �% � y
yi 7
(�2! �4���/
. CITY USE ONLY �4S�c,i
Permit Fee
�ire Surcharge
State Surcharge
SAC Charge
License Surcharge�
Jriveway Escrow
�rosion Control
:'ark Fee
Sewer Main Chargc
TOTAL
�'['(PULA't'[ON�=
$ /� ..�. Fee Schedule on Reverse Side
� ��f�� .001 of Permit Valuaxion (1/lOth%)� �
�__ /� � $.50/$1,000 Valuation
� $950 per SAC Unit
$ �� D� $5.00 (State Licensed Residential Contractors)
$ Alt. "A" or Alt_ "B" Above
$ �$450.00 Conservation Plan Re��iew
� Fee Determined by Engineering
$ Agreement Necessary [ ) Not Necessary [ ]
� ��, o
�
r��i�,u�,vc� i�F �z�tri� rH c sc�{c�v�.�:
'['lie C(iief Building Official shail, belore issuing pern�iis for tf;e erection c�i� any buildiag or stc-ucture, or. f�ir
aily addition to any existing building or structure, or for any atieration c�r repair to any existing buildin� or
stiucture, upon application therefore, require the payment by ihe applicant for such permit of fees to the amount
herein below set forth and in the manner herein provided to-�vit:
TOTAL VAL,UE
$1 to $500
$SOi to $2,OOU
b2,0U1 to �2�,000
A25,001 to $50,000
550,001 to $100,000
� l Oa, 001 to $500, 000
�500,001 to $1,000,000 �
1,000,001 and�up
FEFS
$21 (Minimum Fee is $21 plus surcharge)
$21 for first $500 plus $2.75 for each additional $100 or
fraction thereof, to and including $2,000
S62.25 for first S2,000 plus $12.50 for each additional �1,000
or fraction thereof, to and including �25,�
$349.75 for first $25,(}00 plus $9.00 for each additional �1,000
or fraction thereof, to and including $�0,000
$574.75 for first $50,000 pius $6:25 for each additionai
�1,000 or fraction thereof, to and including $100,Oti0
$887.25 for first $100,(}00 plus $5.(�. for each add.itionai
$1,000 or �'radion.thereof, _to aud including $500,000
$2887.�5 for the first $500,000'pius $4:25 far each,additional :. �
$1,000 or fraction thereof, to and including $1,Ot?0,000 �-
$5012.25 for the fiist $1,000,�0 plus $2.75 for each additional
$1,0� or fraction thereof
DRIVEWAY DEPRESSION �ESCROW
(Concrete (�urb Streets Only)
ltemate "A": Removal and replacemet�t of curb and gutter only - Dri�e�vay width plus 6 feet times $13:50_
lternate "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 $15.75.
VERIF[CATION OF FOUNDA`I'ION
.rmits for c�nstruction will be issued a minimum of 24 hours from the timc of application to al low �or pro���-
�� ie��� of the �roposed stiucture and of tlie construction site_
�.�ertificate ot� Survev c�f' tt�e (ot, sl�owin`* the location of�the foundation ���ice it }�as it has he�:n constr-uc-tcc.'
:'�� r�c�tiir��cl hc.ti�r� t>>'�,�:�'�(j111�! u�ith thc framin�.
.�: �.
N�vU I ]
Ao�t�� C ]
AI.TER [ j
Construction Address:
t_^,�T'i' ��� i=t'-',Ilil �°�
6�i:j�3 � I;1i"a���.l ,��.� �;�, F�°i?�I��o („��,� `�.I?�
SIPtr,L� Fnmli Td /►,PdP) hI_IF'1_F �.'F'Ei I?_9 I1Flli i:?-3
BUILDItJG P�f�A�lT AI�P'Llr�l; f-I�F�1
��� -�a ���-f a�,�,�
f=Tnr_.Ir.;r± I!1!; nn.j �
fi�;�t �;; �^�tr,F►.j �-ci�t� ir,��
(7P;:�j `_�71-I"^; P',,_�:
Legal Description: �
�wner Name � Address: ,� �i.(.I�(� f� G'lL U�t1 �� f� Ye�. 7�0. 3�;� G� c'� �S
Confrdctor. - � PAF� L1i,ENSE �# � �� '
Address: -.`'�"rL�: I�C��1�tht�' & R � f
C�f�J.N1': __ Tc��. � �%� - i7`�� ,5-?G� !�
�t ►rN� K�rr�LStOr� ���.��.
��II� I��G�IhIG & REr,ntg�t���{�'�� ��}��'�}11F'��,i�{11i�ii�f-�� ��':CNi�i�;tf� �,f 4i�r��c:° nP Ilin
�yUO EY.CCIStOR BLVI'�.' �`�� ����i���sEJ canslr�a�l_ian �r�vvn �n i( fn �r_,�I�,
51'. �OUIS �ARK, IirilV 554�16
fO ��p1u5(� �����tPilOPI t7� IM�f�c7V�M�PJi"
LfVIN� AREA: Length _______ Wi�rh I-leigh9 Sq, Fr,
GA�4G� AR��4:
DECK AFtEA:
Length �Nidfh � W�ight `_._ S�. �'F.
WidtF► _ HgU�r-ourrl �n. �I,
� � /' ,� � /
Construction Type;����'�� �%��' �� � 5Fi �����. � v 'y�
Driveway Curb Cut Width N�eded: �t, + 6 Ft = Ft x�
=$
? �
D�'ITE: . °� J '°',%�AQPLICAMT: t. �� �i' ,.- -'' ���7 �
r� i l r�� �..
�a11(TG^) 57� "c'c►1 f • �
TC�. �f � � '�) ��j' f �'
J ,.,-•1 7,� ur - �rr�i�i Fees If m�iling in applicatio��. ��x to i63-57�1��1287 i� c�sing cre�lit c�rci ane) ti;�e �;�t►I r�ll
you f�� caPd rr�rr���ero -
Permit Fee
�ire Surch�rgE
Staie Surcharge
SAC Charge
License Surcharge
C�►rb Cut Escrow
Erosion Controf
Park Fee
Sewer Main Charge
TOTAL
C1�"'►' �1SE �NL'�' -
$ ��-��� Fee Schedule on i�evErse �ide
$ �•9� .�1�� �f P�rmif �/ali.i�tinn (1llnth%,)
�__ �, � $.50!$1,000 Valuation
$ �,�( ;�r} �,Ar �,�r� i �nit
� � ���' ��.{1� �SI���+ Lir,Pn�t'.�I I��SirJ�'P1fi�( �,�nhlr�r°Itvrcl
� Alt. "A�� �r A,If. ��8�� ,�,h�ve
$
$
�
$ �07 %��
$450.U0 Gonservatior� P(�n (�e�aie�
Fee Determined by Engineering
Agreement hlecessary [ J fVot Neces�'ary []
STIPU�AiI ONS:
6/Z"d 8tib'ON S3'lHS ��JI�CiC�cl l�"l�� I•;HZS:G�Z �G'G�„� ',1���.�