AF - 35514_ �--- ,> .
��� ' �
�
� � � � ��. �
� sue�ecr � .. . . P MVT . �
CiE� �f Fridley � 17:b36
;� �TT��TaPOF,�E,w�NS gUILpIt�� PERMIT
` pEG
� � '' i CbMMUNlTV PEVELOPMENT DIV. . . .. �� � �
. I �.����_�' . . .O
� r � � � GfiOTEGTIV� aM5PECT10N SEC: � ' � �.
� :: .. . .. 3..� 0 Z �
�� * A �'°t � CITY HALL FBI{71,EY $5432 NUMBEP qEV -� DATE ��� CAGE OF pPVROVEO BY �
'4...._J'al '.� 612-571,_345D
9i0-Fi5 8/1J84 / /
roe ,�R�aess " 6340 Ashtr�n Avenue N.E. _
� x L�GAL �OTNO �: BLOCN �-� �TRACTORAD�ITION � � � � SEEATTACHED
�� D SCp 1� -P�+ Z �.S . FY.laI.BY -PAIIC. SHEE7�
� 2�.AkOPERT7QWNEA � MAILADDAESS �. . � ZIP PHONE �. . �
i�tXtixi Vittuwe
� , 9 CONtFACTOR � ��� -�� MAIIADORESS � � ' ZIP �PHONE � LICENSENO
Pi�jearest Constsuction -11501 - 134�i Avenu$-NOrth, Dayton, I�t 421-8257
� �F't1FCHFTECTpRDE51GNER.' h}�iI1ADDRfSS� . � � ZIP PHONE. LICENSENO. -
s ee�ir�fea • +.r,aE�:aooeess SEPERA� 'P�I��I�S �QUIF�����i�2 ����i
� 8 . ITFBUl1,DfNG� . � �. � �. � ..
. $L'9.�d2il�id,�. � - . -... � . . . - - � .
? Cl' SOFWOHK�. . . . . . . . � . . . . ..
� . ��;NEW CJ ;ADDITION ❑. ALTERATION� � � .REPAIR ❑ MOVE ❑ REMOVE �
.. `8. DESGRd$E WO�IIC._ . . . . . . . .
Coast�ruat a 54� � 28' Dwelling .aa�i a 24� sd 22' Garags
`4��5{IA., Ef�li�UBEPROM� . TO ..
'"���.�4%1+�+JS Provide a h�zd:sur#ace driveway. p�pvide,�t+d i.n the front and side yards.
`. °_�� ' 4ia Ci�t�y c�ith copY af verifying survey hefore Capping. Paid $75�.00 Park Fee.
�3'ai� �8d:4fl'in Assessment balance specials.
3� _IA6ATTOi�7: (�,pprox. �� DO�p !n Street) 12b' E. of M.H. (E. Inv. 832:,$3) +
��: 833.33 7�P CiF:<FOOTTNG: 836.33 iti.niaum
NAT�'�'TON: 1�' E. af �.ier Seryice
�rAY vaa��sssTC�aa �sc�z x/A �,� tltr ot �0�► � N01 Gu�`��``riY
��f1�f�G_ .�:a►���• o• �n �T�►� �
,,a,: o�i� ss roa �o�nnon e�arosES or,�r r�;.;
*�efare d�g�tig ¢a� ioc� � �urs�r+- us�t3 rt zMCUU► 'i� nM �+K�"��'
ifIEPHOPI�..�ECTRI�-GAS�Efi�; �an s� !sn�
�} SPP}y ATEPERMli$AAER�OUIREDFORELfQTRtGAL,PLUM&NG�MEATING.� TVPEOFC�� „. ��OCCUPANCYGHOUP � �OCCUPANCV�OAD
. � ��'ikPTlYpfi OR AIR-CpNDIT10NING. ' �-..�.'��g ,�. �
. iHl$.i?EHkftF BLb`Qyl�$ �I�UtL ANb VOI� IF. WQRK QR CONSTRiJCTION zONIN6 : SQ. Fi. � CU. FL �
AuTEK1HIZRA�S NdT�QOqMENCED.WITNIN 60 DAYS, OR IP GONSTAUCTION � � � -
� OR Y�IK IS SUSP�NpED OR�AHANOON�ED�FOR'�A PERIQO Of 120 fiAyS AT � �' � �
� qN1' 31tdE AF7Eq WpqK IS COMMENCED. � � ��
. . � � �� � � NO. DWLG. UNITb . . �.; OFFSTREET PAA�(�NG ��>
� I HEii�6Y CERTIFV THAT I HAVE. READ ANO £%AMINEII Ty�S APP�IC&iION �. STALLS : GARAGES �
� � XRJ6�SNCiWTHE$AMETOBETRUEANDCORHEC7.A��PpQy��pN56F�AW3 yq�UAT10N�. � � SURTA%� �
.. ANO`'DA±DINANCES GOVERNING�� TH1S TYPE OF Wpp!( W���� 8E COMPtIEO � �
. WITH WH�THER 6PEGff1£D HEREIN-OR NO7.�THE GRRMi7N6'UF A PEI{/.,t�i. $67t�'�'�,.,-�. � 533.73 �� �
� � QOE$ NOT .p62ES41M'E. TO GIV�..pUTHORRV TO� VIOtATE 0R`CANCEt' TNE pEHMITfEE� SACCHAFGE - �
7Rf7�YtSIONS OF ANY. OTHQR STATE OR LOCAL LAW ftEGULATING �C6N-�- �� �
TRUG7IQN f.1R TMQ. pERFORMANCE OF�CONSTRUCTIW�k- - �`3�:.T.GIQ. ,. ' �S�SZS.00 � � .
�� � � LANG-�� NFE' � �� TOTALFEE
$ 8�.,25 $879.98
rv,twrr ppCON:Pacroe6qALL. R OM1GENT IDPT W. OPERLY LIDATED THIS IS YOUR PERMIT �
_ . �.. c., .rt _ . . . /� A . . _
GN�'li1 � FOWNERL[
�
. � B.OG w5P �
�
. � ._. _..__ . . _ . . +:,. . . . _ . , �
11EiT [� Cit rof Fridle Bffeetive
9 Y 4!1/84
ADDN. I� H-1 AxD R-2
ALTSR. I 7 Building Permit Applioatioa
ponstre�ctioa Address: ��3� O O. C��,�O,�.r� ,
�
tegal
`. <
Ornsr Diaae i 1lddress : '��lt � - - - - ^ '� n --�� -�+- ' Tel. #
� � �a� � �.. c esr.�� , l� Y-. ;,.,. �� � ' '7
ConLraalori � _ _ • Tel . I �11 \ -8�S
A4dr�sa: \\ S � t� l;i u�'� c�w.� rJ . �a..�,�vv�.u..v.,,
LI9ING ARBA:
OARA�i6 DRBA:
DSt� lRBll:
OTBBR:
Attach to Lhis applicatioa, a Certificate of Surveq of the
lot, vith the propoaed conatruction dravn on it to acale.
DBSCBIPTIOR OF IlIP80YSl4:NT
Length S�� ilidth � Height Sq. Ft.
Leagth '��� Width a�� 6eight Sq. Ft.
Leagth liidtk Bgt/Gmund _ Sq. Ft.
Corner Lot.[�Q Ineide Lot [] Ft. Td. Setback Side 7ard Setbaek
Type ot GoAStruction: �l.�c�� ���.,.� Estimated Cost: ;
Approx. Completion Date: q- 1 S� '$ i• ����
Alt. A Alt B
Propoaed Drivexay Width IP New Opening Is Desired: «� E E
See Back Page for Explanation
DATE: �� 3o-�a`� APPLICANT: �t.^��.._-� Tel. « ya �-$a s �
Permit Fee
Pla� Ch.ok
State Surcharge
�AC Charge
Fark 'F�s
� 5�+�-�la4a-�ar8e
�� rar�c
3TIPULATSON3:
,
� ,�,,;� �
� .,
CITY DSE OlR.Y
� JS'1.OV
� ��I.aS
; '�''�,��
a �t�J.(iO'
� 7'9�.0 Q
'9
= AB�.
:.as�3,�
Fee Schedule on Reverse Side
25f of Building Permit Fee
i.50/E7,000 Ysluation
=425 per SAC Onit '
Fee Deteroined by Englneering
llgr¢ement, @le�a,easary [ ) 6ot Necessary [ 1 .
; ;, `.� ;,
�;
�,•��
- _ _.
HDII.DIAG PBRlSIT F88 SCBBDBLB
The ChieP Building OfPicial ahall, Defore isauipg permits for the erection oP any
building or titructure, or for any additioa to any exiating Duilding or atructare, or
for aay alteration or repeir to any exiating building or atructure, upon application
therefore, require the payment by the applicant for auch permit of feee to the amount
herein belar aet forth end in the oanner dereln provided to-xit:
Sotal �aluatioa
=1.00 to �500.00
;501.00 to =2,000.00
Feea '
— !
;10.00 (Minimum Fee ia ;15.00)
=10.00 for the first =500 plua �1.50 for each
additional =100 or fraction thereof, to and ineluding
=2, 000.
;2,001.00 to �25,000.00 �32•50 for the firet t2,000 plus 36.00 for eaeh
additional =7,000 or fraction thereof, to and
ineluding E25,000.
:25�007.00 to �50,000.00
i50,007.00 to E100,000.00
��ao,aat.00 and up
�770.50 for the first =25,OQ0 plus ;4.50 for each
additioael =1,000 or fractioa thereoP, to and
including �50,000.
;283•00 for the firat E50,000 plus 33•00 for eaeh
edditional E1,000 or fraction thereof, to and
including ;700,0�0.
��33•�0 for the firat i100,000 plus E2.50 for each
additional E1,000 or fraction thereof.
DRIYEfiAZ DBPRS3SION SSCROY
(Cpnerete Curb Streets Only)
Alternate "A": Removal and rbplacement of curb and gutter only - Driveuay width plus
6 feet times =13•50
Alternate "8": Removal and replacement of curb and gutter and install a 3 foot Wide
apprnaeh xith 6 inch dept6 - DriveWay vidth plus 6 feet times �15.75
YSRIFICATION OF FOQtiDATIflH-
Permita for construction vill be iBaued a minimu� oP 24 houra from the time of
application to allow tor proper reviex of the. yropobed structure and of the
coaatruoLion aite.
A Certificate of Survey of tde lot, e6oaing the locatioti of the foundatioa onee it
IIaa Desn oonstructed wili be required before proce�ding:xith the Pramiag.
� � ����� . -- �
�
�Uv��
,
��
lz�y� 3�
4z,r26, i� 7' �vqg,�
a-►2v�z z ly
���z,r q,"�`'i
�Fu�` (a3�X�d.`i� 2
c a+t ,-�.+�',� Y�St"i'�-25'z � x u. u
�/f, �G9',�'i
e�, Rvb, 3i
S, ��g_$il
� � � �N'1�i, 3�
. .1__=-v��.
;
!1W 1lE A
EX7ERT�.i ENVELOPE AVEFtAGE "U" C�IPUTI! 7ZON
; ;
j�623�5'
� �'i, .
9�'lE ADDRE38 '
# 84ot� I ��
i CON7SlAC'iqR P4✓�t�FSr Cour'r►t�G7�o.✓ DA'!'E 4 d 8�- PHONE��,_�
Determine working equare footage of ench. I
l;.
' a.
,
I
i a.
' b.
' �.
I g..
s.
� f..,
, B•
i
h.
', i.
�� 3•
k.
I1
.
Zbtal expoeed wall o.rea...... tS4¢ aq. it. x .IL�.
Rbta,l roof�oeiling e.rea...... ► L36 eq. ft. x �oz .
'ibta� eocposed wall area abave floor �LBD
'ibtal wa�ll wlndow area .......................................•
�1'F�91 CLOOT B.TO&����.��.����.�...�����...���������.���.���.���•
'ibtul elldin� door area ....... ...............................
�.i7.'f&�. %T9p16�9 W8.11 BT8&������. •�������.����.�.�������•
•.r..•
Total wall freanin8 area (avera�e 10��......•..•••••••••..•••••
2b#.s],ziet well area ebove floor ...............................
motel rim jolst area.......������..��.����a�+��������..���•�••
Zbi�l expoaed ioundation srea 10 7•Z
'ibtal foundation door esea........ ............ ..... ........
. ..
'lbtal £wndati.on windoe area (includea sliding doora�.........
'lbtai neb f.oundation axea above �'ade .........................
'lb taI wall f.remtng area ( �vers�e 1096� . . .. . . ... . . . . . . . . . ... . . . .
'lb tal net wall Sraming araa ...................................
Determine "U" value of each wa.11 ae�nont
a. !Ob•l R"U" .3S'L = 3�.5G �I
i b. 3'7.l 7C"Q" .14 = ci:LB I
' o. — Xi�u s I
_�. giRJn � —� �
....�� . � � e� ����—g��1" .O4 = t0.2Z �I
i £. foLt.04 X"U" .043 = 43.SS '
I g. �S�.P X��ri .045 = l'Ob Ii
h. — g��n — = i
I �� ,� w� ,.�q�u .�1. = 4.38 �
� ���T n
�' j �i4. ��')C�4jn • t3 a lZ.3L
� �, k. X"�" = �
1 _.,� X�Ru ---- - = � .
j . ; ,.
+ tLO.I�
3 .............:..............................�tai �
� IP item �j ie the eame ae�.or less ihan ii:em #1, You have met the int�r
i
, " �
a
!� n
�i
t or. sec
I,
�
(�)2•
:
,.__.:e ,. 36235�5 �
' Total expoeod roof.�ceiling area = �Z3 6 , '
m. �btal skyli�t area ..........................<........
n, 7bta1 rooS�ceiling i`rami.i� are (�vernge 790�........... B(o•�$'Z
o. 'lbtul,net inazlated roof�ceilin�; area ................. tt44.4�
Determine 'U" vnlue for each roof�ceilin�; ee@Jnent.
rtl• i, �� �� � s
n. � S'li X"IT" .03 � 'Z. S9
o. I144.48 x"U�� �ot,' - L,8:74
4 ....................................Zbta1 =_ �I,3 3
IS total of ��4 i� the samo or, leas than #2� you have meb thc intc:nt ot SE(% fi006(c�l.
Alternate liuildirig Faivelope Deei�n
4b utilize the total envelopo aysbem method, tho vnlues establiahed by tho eum
ot itome �3 �� #h �+�11 not Ue �reatar ihon i,he sum o£ iteme #1 ond #?.
1. Alv.O 2. _
3. vlua 4. °—
.
�.
r
.b..:_ -_..�, .
C I�;I LIIJG FRU�tE
1-'interior l•_ir FYlm
2-�" Shoetrock
3-3a," Soft ti'dood 3: 8?;" Insui.
4-]�texior ��ir I�YIm�
Tot�zl R
'Potal U
h
�
�
2
1�A
R
__�
•45
31. 30
. 61
�2.97
.03
�623�iS
12° Ineulcition
1-Interio�; Air FY]m
2-s�;" Sheet�rocic
3-Y2" In�ilr�tion
Q..EScteriot A.ir I�Ylm
� 'POta� R
'�. `Potri. u
Frame ti!r• 11 ' �R �
1-Intorior ".ir Pi lm ', • �',
2 ° 5heetrock .45�
3-�" Soft Wood 6.88i
4- /32" Mberbd, Sher:thin�; 2.06�
5-7�16" E4oa. Lon3e Hdbd. .6?1
6-Exterior Air IYlm •17'
Total Ii , 10:92'
Tot�l U .0�,
a
�.b�
•45
3a.00
61
39�' +
.025
Ineul2ted P1n.11 ! R
1-Interior i!.ir Film ' �'�
2-a-" Sheetrocic ' • 45'
3-�n Ineulc�tion 19.00
4_I�/j2�� FiUorbd. Sheothin�;' 2.06
5t7�16" Med, Den��e Hdbd. I .67.
6�EScterior �.ir I�'ilm ; :17�
Tote.l it 23.03
Total U .04�
I.
i
Rim Joiat �� R
1 Interior Aix• 1�Ylm � `� �
2-6" In3ulatiozi ' 19.00 !
3-1�" soft tYooa 1•4� I
4-7�16" Med, Denae Iidbd. ' ,671
5-Exterior Air IYlm '�7�
Tot� l R 22. q0 i
Totnl U •Q4�
1 A Conc, t3loch Uiitnsulnted
Total H 2.12 i
motai u .47 I
1-B Conu. lslxlc Strip,�in�; & 3�4" l�oa.m �neulltioa
Total R 7, 91 &��� SYfeetro��:.
y" -0 Ta�Cal II .13 ,
. .�,_...
PIP�RCRtLPP 1i'00D C:,SII.'E'tiTS
II. R,
vous� zrasuLn�rr� .352 2•a4
TxrnLE I1asUI�1Tm .3z7 3.06
U2�tT S(1. FT. OF IS(�T aRE11
i282e • 5•06
12836 6.56
i2eq2 7.6g
1284s s.BI
11628 2.81
i1636 3•65
11642 4. rl
1164s 4•90
11660 6.15
1�28 3,56
IIP7IT
12� 36
1�42
12p 4ti
1�EO
12�7 2
12429
12436
i2442
12448
1246p
SQ. LT. OP LIQiT AFtEA
4.62
5.41
6.�
7.78
9.37
4. 31
5.59
5.55
7.51
9.42
DOUBLIIiII.tG FiIi+�DOY;S
U R
Sin�;le-�lazed ,85 1.18
Double-gl4zed .47 2,12
U2iIT SQ. I�T. OF LIGHT AREel IIP7IT S�,-.FT, OF` LIC�T i,Fc�A
1��E 3.55 3�16 7.11
lfixc20 4•44 3�c2o ti.88
1Cnc24 5.33 3�24 10.66
16x24/36 6.66 3�24/36 13.33
2ox16 4•44 36x16 8.00
�:=� 5.55 3�.=�7 l0.00
2ox24 6.66 36x24 12.00
�. 24/36 a.:3 3�24/36 15.00
ztc:16 5.33 qox16 8,88
znx2� b.66 qpx2� 11,11
2w.24 8.00 4ox24 13.33
2G:c24/36 w.00 qDx24/36 16.66
28x16 6.22 48x16 10.66
2sn2o � 7.77 48x� 13.33
2sx24 9•33 48X24 16.00
2Gx24/36 11.66 48x24/36 2p.pp
a , ' , �
� �
.. _� �
3623b5�
0
�
_
G7YOF
FRIDLEY
�� CIVIC CENTER • 8431 UN7VERSITV AVE. N.E.. FRIDLEV. MINNESOTA 55�32 • PHONE (612) 571•3450
OctoDer 1T, 1984
Mr. Herbert Enutaon
Pinecrest Construction
11501 - 134 1I2 Avenue Aorth
Dayton, MIN 55327
Re: 6390 Aahton Avenue N.E., Fridley, !@1
Dear Hr. Rnutaoa:
0� October 15, 1984, a final inspection of the per� residenee at 6390 Ashton
Aven� waa conducted.
Bverytding was found to be in compliance to City regulations except xe do
need a verifying aurvey. Please submit this survey by November 15, 1984•
We would like to take this opportunity to put in xriting the verbal agreement
ve have with you xith respeet Lo the development of the vacant lot located
west of this residence.
1. Tbe lot ahould be cleaned of all debria. There exists aome deDris along
the aouth property line that may atop run-oPf from adjacent properties.
2. When a permi6 ia issued for the next house, it will be atipulated that
you will provide a atorm aewer pipe from the southxeat corner to the exiating
storm sewer in 64th Way. Thia yipe will serve to drain your souttnrest corner
and its ad,jacent propertlea. HePore the pipe is installed, plana must be
aubmitted to the City Engineering Department for their reviex and approval.
If you have any questions on these items, please feel free to contact me at
57�-3aso.
Slaoerely.
DARAEI. G. CI.AR&
C4ieP Building OPficial
DfiC/�G
STATE OF MINNESOTA
� D[rARTM[NT OP MUMAN SERVICES
444 LAFAY[TT! ROAD
O`( �` d � ST. PAUL. MINNESOTA 55101
CJ 1 �
Date
� � ��
nin Avthority
�g� J � �
� �treet Address
. `('61 QJ • � 5 `� "32-
City State Zip Code
-c-Yp..
� - � �- F1,6��
D8S-2722 (9-85)
PZ-02722-02
RE: ZONING NOTIFI�ATSON QF APPLICATION_EO& LICENSURE ___
Subject: t V�(N•�-i-o �� ��,�.��,�,p Type of License:
Name of Da Care
�3 0
Street Address
City Sta
Family Day Care
Group Family Day Care
X
5 s y 3� Licensed Capacity (�
Zip Code Phone No. 'Jr�%I - ��j�S
This is to inform you that we are in receipt
licensure under Minnesota Rules, parts 9502.0300
Rule 2)� Family Day Care and Group Family Day Care
this license is subject to compliance with the
Statutes, Sections 245.781 to 245.812 and 252.28,
the Public Welfare Licensing Act and the rules of
Services.
of an application for
to 9502.0445 (formerly
Standards. Issuance of
provisions of Minnesota
subdivision 2, known as
the Department of Human
You should note that under Minnesota Statutes, Section 245.812, Subvision
3� a licensed day care facility serving 12 or fewer persons shall be
considered a permitted single family residential use of property for the
purposes of zoning. Subdivision 4 of the same section indicates that a
licensed day care facility serving from 13 through 16 persons shall be
considered a permitted multi-family residential use of property for
purposes of zoning.
If we do not hear
wi11 consider the
your local zoning
from you within
above-mentioned
code.
Sincerely,
�
Licensing W cer y�,�
S- V
Street Address
30 days after receipt of this letter, we
day care hdme to be in compliance with
COMMt1NiTY HEALTH & SCJi;iAL
SERVICES DEPARTMENT
COUNTY OF ANOKA
COURTHOUSE, FOURTH FLOOR
Name of Agency r a tion
City State Zip Code
��� �
AN EQUAL OPPORTUNtTY EMPLOYER
.�:
. � 5 � sue�ec, � . .. E NO.
.
,� City h� Fridley 2 0 3 0 4
, ATS#&`10POFTHETWINS gUILDING_ PERMIT R EIPTNO.
r
- i� � _� CQMMUNITY OEVELOPMENT DIV. � � Jrt O
� r � ~ ��� PROTECTIVE INSPECtION SEC. � �"�� �.
c� I
i �
� �/"�'\ � CITY I/ALL FRIDLEY 55d92 NUMBER MEV. 00.TE P�GE Of ApPROVqD BY
i •.� 612-571-3450 9i0-Pts 4/17/90 / /
}o�fDUpess 639Q Ashton Avenue N.E.
tEGAL �OTN0. � �BLOCK �� �TRAGTORADDIT�ON � . SEEATTACNED
DESCR. �-r Pt. 2 15 Fridley Paxk SHEET
� �2 PROPERTYOWNEii � MAIIApOHE55 . Z�� PMONE .
MartinJMaviS Viiims 639a .4shtan Avenue N.E, 571-4955
3 COH7FiACTpR � MAILADDRESS ZIP PMONE� � LICENSENO.�
���� � � . � . .
0 APGNITECTQiiDESIGNER MAILAUORESS ZIP PNONE LICENSENO.�
`5.���@NGINEER � � MAILAD�RESS . 21P PHONE LICENSENO.
���. � 8':US£dF 9UILDING � �
Rasidential
� � � -CLASSOFWORK � �
❑ NEW ❑. ADDITION � ALTERATION � ❑ REPAIR ❑ MOVE � ❑ REMOVE
. � � ..B���OE3CRIBEWORK . .
Add escape r�xridoFr iYi ha��qent Faedreaaig� add wall axound bathroom in basement
9 CMANOEOFUSEFROM � T�
STIPULATfONS � � � . � �
windo�r must meet state code Por egress-windoc�s.
� SEPARATE PERMITS ARE REOUIFED FOR�ELECT9ICAL, PLUMBING, NEATING, ���. � �
� YENTILATiNG OR' AIR CANDITIONING. � � �
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTNUCTION ZpN�NG� .. SO.FT.
� AUTHORRED IS NOT COMMENCED WITHIN 6U �AVS,�ORJF CONSTHUCTION �� .
. OR WORK IS SUSPENOED OR ABANDONED FOR A� P@RIOD� OF 120 DAVS AT
ANV 71ME AFTER WORK IS COMMENGED. . � N0. �:DWLG. UN�TS�
�� I HEREBY CERTIFV iHAT I HAVE FEAO.AND EXAMINED THISAPPLICATION �-� �' STALLS
� AND KNOW TNE SAME TO BE 7HIlE AND CORRECT. ALL PROVISIONS O: UWS yp�UATION �
� AND ORpNANCES GOVEFINWG THIS TYPE�AF WORK WIL4�BE COMPl1ED �.1 .�Q
WI7N WHETHER SPECIf1ED HEREIN OR NO7. THE GfiANTING OF A iERMl7 �
DOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE OP CANCEL TNE pERMITE£E .
� PR VISIONS OF �ANY OTHER STATE OR LOCAL LAW REOULATING WN- - . $ZS.00 � �
� S CTION OR� TNE AERFOPMANCE OF CONSTRUCTION.
� � PLAN-0NE� K F
� 5@N�TUPEOFCONiRnCTOROFAJTMO ZEDnG Ni IORT6 WXEN PWOPERLY�VA
5 Na UAEOFOWN PtlFO EPBWLDERi �OATE� � � BLOG��N O �
.. . . . � . . . ` .-= . . � .� �
y�e�J�
:CMARGE
fAL F EE
$ZSer30
� NEi�. [] � � CITY OF FRIDLEY Eff�1VE 1/1/90
AflC,N I} R-1 AND R-2
ATII�R [� Building P�mit l�ppliostion
�ri�, �: -_ � 3%� �s �7� � /� �-� �f/�
ilegalDsscr�n: Lo� ���Qr� d� �- ��4�� �S -�i',���ey /��r�
ow� x��= �: l�Qr?,�ti �- /�% v; 5 l/'%ys�r s a�. ��`7/ s`%�f
�: S�e /f �. � a—�-�-
�aa�.�: a�.t-a �
Attach to this applicati�, a Oertificate of SUrvey of the
x loG, with the pxoposed oonstn�ctia► �awn an it to scale.
0
I.IP.Ctic: ]1R�►: Leriqth Width Height —
@� I�tSA: L�h Width Heic�t —
nECIC A1�AS IBrgth� �� - Width Hgt/(��v�ari
O�l�t: �Q1'J�. 'W�oda �•/ ��n �9SeMr�7`- —
V���! roonl — - -ra.sr -:r-T -,i,-,==s - - -
Sq. Ft.
Sq. Ft.
Sq. Ft.
v�% d
�rner Iot I] Inside Iot [] Ft. Yd Setback Sfde Yazd Setbac)cs
Rj+pe of Cw�stxuCtion: _ ��n�'�� �l'e✓e fI1 ��� � 5 Esti.mated �st: $_,.,� ^ „'`L "�
�IOX. OOR¢�leCl�l I7BYd? • yr i' /1� I b�P �o v t �^fe s%� 5, 6 d�-�-o�� � l(,D �
� . ✓�__ — ���
Psnposed Driveway Width If New Opening Is Desised: Ft. $ S
W�i� + 6' See Back Page
n�z�: � �/7 - 90 r�c�,rn.. ;��� � '/�,�.,, r� �. # 57/- y 9S �
�enait Fee $ � O Q
SY2.�te Surc3�axge $ �
�� S
Driveway Escrnw $
Park Fee $
Sew@i' 14e97.Ti Q1dLqe $
7Ln'i�� $ �
�S� �
szzxTtAZZaas:
«_ MM ��a�- . i
F�ee �+�+� e on Reverse Side
$.50/$1,000 Valuation
Ssoo per sAC vnit
A1C. ^A" OT Alt. ^B° AbWE
gce t]Ptor�ninari ]�Y �lIlBgrj7Yj
� �� � � � �� � �
-- --°
�� ! li /
:�1 • r � t � <•. 1 ��.n- _�.:i:n�_I/ �
7he C2iief Bui].dinq Official shall, before issuing peanits for the erectim of any
building ar stn�cau�e, ar for any additior� to any` existing building ar stt:t�c4ire, or
far any alteration or repair to az�y existing building ar st.n�u+e, t�pon apPlicatioT
tY�e�.�efore, zequir�e the payme��t by the applicant for such permit of fees to the amauit
herein below set forth and in the ioarnser hexein pzwided to-wit:
'lCIrP,L VAI.LJE
$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
a a�
$15 (Miniman Fee is $15 plus �+�*;+■*�)
S15 for fisst $500 plus $2 for each additiaial $100 or
fractic� thereof, to ar�d inciuding $2,000
$45 far fizst $2,000 plus $9 for each �diti�al $1,000
or fraction thereof, to ard includiux� $25,000
$252 far fitst $25,000 plus $6.50 for eac3s additional $1,000
ar fraction tt�eof, to am3 includinq $50,000
$414.50 for first $50,000 plus $4.50 for each additimial
$1,000 ar fracti� thereof, to and includirg S100,000
$639.50 for first $100,000 plus $3.50 for eac3i additional
$1,000 or fracti� theseof, to and includiriq $500,000
$500,001 to $1,000,000 $2039.50 for the fisst $500,000 plus $3 for each additional
51,000 or fraction thereof, to ani includim� $1,000,000
$1,000,001 and up $3539.50 for the first $1,000,000 plus S2 for each additional
$1, 000 or fraeti� thel�eof
nRIVE�IY D�PR�BIaN F�CZiUW
(Ooncrete Rirb Streets Only)
Altetnate "pl�- Ramval a� replaoa��nt of curb azid gutter only - Driveway width plus
6 feet times $13.50.
Alternate "B": Ranovai ard replaoenent of cvxi� ard gutter and install a 3 foot wide
approac3� with 6 itx� depth - Driveway width plus 6 feet tim� $15.75.
' N' ■ M� •. • " '��11 U � •:
Petimits for c�stnictio� will be issued a minimm� of 24 hours f�m the time of
application to allo«� for proper review of the proPo�ed stzuc4ue and of the
corn�tnx.tia, site.
A Certificate of S�uvey of the lot, showing the location of the famdati� ar�ce it has
it has been o�structed will be required before prooeedinq with the framinq.
.. *. ._ ,
City of Fridley
AT TNE TOP OF THE TW4NS
� r
� �
� • COMM4lNItY DEVELOPMENt DIV.
� � ~ � �� PH07EC71V£ �NSPECflON SEC.
l i
i
� � i--'f : CITY NAIL FRIDIEv �� �56�72
�'""�'� �'' b12-571-3460
JOBADDRESS 6390 Ashton Avenue N,E.
1 LECaAL �OTNO. BLOCK� TRAC'
DESCR. l� Pt.. . `LS� F
2 PROCENTYOWNER MAILADDRES$
Martin/Mdvis Vitums 6390
3 CONTRACTOR MAILADDRESS
Same
Su6�EtT � � .
BU ILDiN`G PERMIT
�BEP AEV. �� D�TE v�GE Of
910-F15 3/8/41 / /
xidley Park .
AshtOn A�+enue N.E.
4ECEIPT NO.
3 930 7
SEEATTACHED
SMEET
DHONE
571-4955
PHONE IICENSE �
LICENSE N0.
a usevrnu��wrvu , �
Resi.dential.
7 CLASSOFWORK �
� ❑ NEW ❑ ADDITION g ALTERATtON ❑ REPAIR. ❑ MOVE ❑ FlEMOVE
e DESCPoBE WORK � �
Basement altexations � ceilingy cvalls, closet
8 CHAN6EOFUBEFROM
See notati.ons on plan
r
� SEPARATE PERMITS ARE FEOUIRED FOR ELECTRICAL, PLUMBING, XEATING.
� ...VENTIl.ATINO OP AIR CONDITIONING.
�. ����?MIS PEAMIT BEGOMES NUIL AND VOID IF WORK OR fANBTRUCTION
�.qUTHORKED IS NOT COMMENCED WITHIN 60 OAVS, OR IF CONSTRUCTION
� �: OH WORK�7S SUSPENDED OR ABANDONED fOR A PERIOD OF /20 DAVS AT
. ANY TIME AFTER WORK IS COMNENCED. �
� 1 NEFEBY CERTI:V iNAT I MAVE READ AND EXAMINED THIS APPIICATION
�� ANONNOW THE SAME TO BE TRUE AND CORRECT. ALL PPOVISIONS OF LAWS
. ANp..OAOINANCES GOYERNING THIS TYPE OF WORK WILL BE COMPLIEO
WITN WMETMER SPECIFIEO H€iiEIN OR NOT. TNE GRANTING Of A PERMIT
DOES NOf OPESUME TO.GNE AUTXORITY TO VIOLATE OR CANCEL THE
PROVISI�NS OF ANYATNEP 6UTE OR LOCAL LAW REGULATING CON•
.:' STRUCTION OF TXE PERFORMANCE OF CONSTRUCTION.
�
iL]
1
A7WN
1�SQ0
41 F�EE
$35.00
STALlS
IGARAGES
URTAX
5.75
pCCHARGE
Eire SC $1..
OTALFEE
533,25
ia
.�
��•
.. . � -
_ � _._ „
. _ _���- -_- /���
•. _. .� � r
•• _ -
Effective 1/1/91
I�1 AI�ID I�2
p�,i t e;.� Petmit Appli,�tian
• . � -, �. -
�. ., �,. .,;, -
�:«
. ._r. r � �
�. � S7/-YY'.5S
'lSel • #
Attach to this applicatian, a Oe�.tificate of �vey flf the
lot, with the pmopased oonstrvctian drawn an it to scale.
. ->..�,.• . .
Width Heic�t
Width Heic�t
Width i�gt/Gn
_ Sci. Ft.
_ ScI. Ft.
Sq. Ft.
.�i � � .L, i r
�ner Iot [] Insi.de I��/F ] Ft. Yd Setbac]c Side Ya�r.$etbacks
'Iype of Oos�structiat�• SL E,`'timated c.bst: $� `�(�b C�
Ap�mx. C�iletian Date• .
- .� - - ..- ��_
'' � +`► ` �• /�i_ � � ,,. i - �
' f
P�xmit Fee $ �' O�
Fire surd�atge $ � 'JrU
State s�axge $ • '7�
SAC Q�atge $ �
�riveway F�cxvw $
Park Fee $
Sewer Mdin Ctlazqe S
�
srr�crr�zzar�:
$ ��e o`� �
��!� �:�: .s!_
F�ee Sd�edule m Reverse Side
.001 x Pexmit Valuatim (1/10th $)
S.50/S1,000 Valuatirn
S650 per SAC Unit
Alt. "A" ar' Alt. "B" Above
� r�r�i.,.� bY �J��3
� �LY [ ] � �Y]' [ ]
.�_ ,,
( 2�0
�bu-
�U 1� 2
t�
�d
3� �
:�11� �11, f ' Li•. 1 :�L:G�� 11 :
�e Chief Building Official ehall, befare is�uing petmits far the erectirn of any
buildinl ar' sttiucttu�e, ar far' ariy additian to anY existing buildiT�4 � strvcbat+e, ar
far any altetaticn ar repair to anY mcistix�q buildin9 ar' etruc4it+e. �ai applicatioai
��. �� � P$Y� bY the applicant Por s�rh petmit of fees to the amamt
hexein below aet Parth ard in the mareier herein p��+wit3ed to-wit:
ZVrAL 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
�� a.
$15 (Mirsi� F�ee is S15 plus �,••},A•�)
$15 for Pirst $500 plus S2 far eacii additia�al $100 or
tYaction thel�+eof, tA atfd includi� $2 � 000
$45 far' Pirst $2,000 plu6 $9 far' each additioc�l $1,000
ar fractiCtl t2lereof, to dnd includirg $25, 000
$252 fo�' fiist $25, 000 plt� $6.50 far eac3i additiohal $1, 000
0� $'8iCk1C[S tt1Et�BOf� t0 alld 31IC1udiSg $50�000
$414.50 fox� first $50, 000 plus $4.50 for eac3i additioa�al
$1, 000 ar 8actim theteof, to and iricluding $100, 000
$639.50 far first $100,000 plus $3•50 far eadl additioclal
$1,000 ar fraction thereof, to and inCluditxJ S500,000
$500,001 to $1,000,000 $2039.50 far the fitst $500,000 glus $3 far' each additior�al
$1,000 ar' iractian ttiereof, to atld includirg $1,OOD�000
$1, 000, 001 and u¢> $3539.50 f�' t2�e first $1, 000, 000 plus $2 far eac31 additiaial
$1�000 ar YYaCtiaaf t2�ereOf
�Y �7A�T 88fS�01I
(Ooncr.�ete G1ab Stsee�ts an1Y)
Alternate "A": Removal and xeplao�►t of csu�b and guttet aily - Driveway width plus
6 feet times $13.50.
Altesnate agn: Removal arrl replao�t of au� and gutter and install a 3 foot wide
app2nach with 6 inii de�pth - D�'iveway width plus 6 feet times $15.75.
., . �� ,,. .
Pp2'�t8 f02' 0008�[11C�OR Wlll b2 �SSl7Bd H�inim�m of 24 hOUYB fTffi �IE t110L� of
application to allaa fa� prapex z+eviaw of the p2q,�osed ststbctiue anl of the
oonsttiuctiai site.
A Oettifi�te of �vey of the lot, st�owing the locatian of the fau�ciatian aioe it has
it has bemt oo[�stxtic.�ted will be recluired before p2+ooee�iing with the fra�ing.
.
�
F,
_-
�
� �
�-� �
a �� �
� �`�, � O
�
��� _
����
�
4
�
(�
� !I
----- .
_ _ � --,ti
�
J
Q
�
� 1�
��3
� �.
_
�
�
_.
.�
�
�
__�.
,
a
ti
ti
r
2
7
7
u
'I.
7
U
a
Y
J
J
W
f
�
d
�
H
1-�
W LL
J N
C �
� o
tL
2
<
W
o�
�
u �
�
O
4
O
H
J
d
�
�
$V
i
�1
Y
�� a
d Y
L (l 1 �
O
y T Y C
Y � 1 O
p y L
) U Y �
C C � Y
✓ Y Y
Y G �+ M
m o�g�
_ �ivr�
o .„.
D ry / 4 G Y
6 i'1 L 9 y Y
T � ° �c�.
u v+
y � � U 9 1
N � U C q
M 2 W � O�
� _ ...�
N C V W G
C A � y ? V
p � u u �
.. s �+ �
"'� 9 i C +9
�'f "y w � L
O L y m J
� � ; Y w �
0 O �
w s � �
� i " u :
O 8 4 .� y
� � � .'�� C
O♦ V 0 m Y
y � L � O u
U V t P� Y
d� a�ta
u Y
C M P Y � y
r � � O O
YY � < •
C Z C O G uJ
'� � y i i
.� . �. Lw
.� A 4
mh F F�eo
w q rJ
qy a .p
Z � W
»
O �i �
Y Y M
� Oy
'i�i
��� ;i
J
.abuvy s� �;
aa?� •a�?n
•�ddv s�7 �
]
]ay4� �
'���PYOiIIY
sutseg u
ya1t� �
t.sa ��t, s
siawoyg
suro�uroi
6ut�NF�O '� g
s.(e�t 4eM g. �i
4�NFf � o $
y O
Y
s�r:.� Y
8�
s04i YJM � tg �
� `
si�+TlO
•aa:oj� � � �
� �
� e e 5 i.—
saTao]4 .°1. n n � � '
�
�
F
S
mo
E�
2
F
�
�
F
�
6
2
G
Fyp� .�
U i
e
� �
�N O
C !
? O
< a a
$. °c �J
� N F
Y
a
N
�
�
\
� �,V
\ �y F
/�\ �] T
�� �
� �
i
�
N ,
� a
Z a
u. 4
o °IIIIIIIIiIII I
�"" N N Y1 M N N q N N N N N N
� \ � t � � N � � � ! Y �
o a o O e o o O o 0 0 o a
J O O O O O O O O O O O O O
K1� � N 1� n M1 1� O n O O O O�
� .. .. .� .. Z
N N N V1 N N N q N N N N= N
QJ = �I I I I I I I I I I I I� I
_
N `
W �
� ~
w
o m �
N
::i
F
�
�
�
�
W
V
�m
'
�
G
V �C 4 (C
� J! �+ y
u r
� W F S Ol l�7 C
m"s� �gg" 'm
e a e e e"� > u i i o�.
V C• q�� 4�w 9 Y Y
7 r 6 •• o m a• o � s
Y C • M 9 Y 4�• P• O
�� O O m 7 � h x x i 4� a
• � • � A � � y • � • • • �
s a maus�e �ss vu a
O
O
�
w
N
Fx
C
1
N
V
�. �
C :7
:' K
r �
% V
�c
.� :)
6 N
:. :.1
�C
2 III
00
� N
W •
::d N
L �
�E
.� y
«�i ._]
f LL
� �l�I
N N N
�
u w
P (�
Y
/1 J
N < �
2 U F
Q M Q
61 7 ("
4 r in
u
F . •
s a m
< �
O
N
aC •
6 � �
W M O
� N n
0. N
0 0 �
4 y zo
� � �
>
�+ 4 6
O y
. ry
< w �
.�
H
�
a
9
�
�
�
�
�
J
C
L
>
y
J
u
v
�
W
G
C
lL
LL
O
N
V
V
v �
`
z �
0
H �
K
W
�
�
C
z
i
o �
HQ `
J y
W
U
2 >
% �
0
`�z i
J N
O �
�..i H
N
. >
� N�J
H Z
S O
2 �
< _
N O
2 U
C
L Q
m
W
O
S
a �
0
�
O V
H N
� �
M1 �
�
m
yf
'
H
�
N
�i
�
..
:
Y
Y
2
.
<
�
Y
.�
m
4
i
.�
�
�
V
i
O
C
� .
Y O
d^
C l�
M II1
O�
.1 'f.
7
.. .
M ^I
�E
•
5 � �
� �Y �
_�+�
Y T Y O
Y Y O
Y��
5�'�
Y Y �
4 L ti �
O � Y
Y � 9 4
e�>.
u a
�.
c' tipp. c .'�+ �.
Y Y C �
,��, � � $ .
�
c » w .
w Y C 0
U q M Y
�
��
�9 4 wq ��
n Q � s+
y�� .y C Y
IQ Y •
i •o' rC
Y 9 �w
s sgS
9 C �u` O
O M Y � �
wt M O 0
Y � � Y
�OG '$ C O
J : y A
� �SC �
�I NI pl N) NI
KI NI �I NI pl
�~M �y
" i
y✓ �
�� �
�„ 5
.g a
�M s
�7 �� C � O 4
3 C C h 4� O
��.1 7 "yJ �0 6 •+ a
� O� m (7 f7 t!
ec
�
s
�
�
�
2
Fz
6
� 6
i
N
,. 9
� � :
G
V M1 u S
� g � R � �
NI MI MI
�,/� �
OI � �
O �
0
^1
'" wY
C 0
�.�1 = 4
y� �
N 4 C .
� ��
q :< 4 �
C • O C S
2 m3 � o
Y 09 � 9
w M �
Cd ss O < >
u o,.�.�� a
� � � rl
. u
Q
NI I �
b M N
�
a
L
U �
4
m
O �
Y
•
N
m
O
O
O
�
�
O
F
�
a
N
2
R
�
�
$�����
.
� '� ; o i
� � $ I � a m
� 3 N I
h � �
� y O
i4 p W
� N N �
� N
O
F H
q GI
: 9 z
�g�5 � O
y UY •y
O � T O F T
F � S � � 6
s k �7 $ m 5
� �
Y�Y Y
o^'\ o e
`V �
m
� �
4
6 6 w
FI M ■
i
p� ap M
� +� 6
■ <
1 0
a �
a a �
U H F
F
a'd
�
h
2
N
� �
Z�
2 V
a�
8"
\ <
�a
WO
N
S
N
�.
� F
o�
W
�a
G. o
O
x
= y
w N
i�
J
�
R
T
Y 4
O �m
� �
� C
a�
a° �
u
se
U V
e
�. a
o �y
Y 4
� a
p e
U Y
u
Y
Y
� )
CHIMWEY AND STACK VERIFICATION
The undersigned hereby verifies that the e�cisting chimney or stack;
1. Has been carefully examined Yes ()
2. Is free from rust or deterioration Yes ()
3. Has no foreign objects lodged within Yes ()
4. ls securely supported Yes ()
5. Meets all current Lode requirements for size and
total BTU connected
6. Has Total heating BTU's of
All other BTU's
TOTAL
Rema rk s
Canpany
Signed By
Dn te
No ( )
No ( )
No ( )
No ( )
Yes ( ) No ( )
�
�
�
7
�
�
�
� �
W �
W
a
�y°
<
�
�
Z
m
�
J
a
O
LL
O
<
v
J
a
s
�
�
�
U
a
y W
Z Z
m
N(�J
>
J T Q
O•��
LL j Z a
LL 'c � O
O > >: �
v�� i
�
_
�
O
W
¢
�
�
LL
LL
0
W
�
0
m
O
�
Q
Q
�
H
�
O
Z
W
Q
S
W
2
�
LL
�
z
m
�
J
a
�
���
t��
Y m
.L+
O � � �
� � L
���
r 3 m
��a°2
V
� � �
L � � m
f � � C
.�S mL�
� �
�.� � �
0
c c
.m ° � c
a�e;�,_
� � C �
m � � p
t � m �
� � m o
C
m � �
01 � `O C
` � � m
� m ` �
���o
�
�
�
O
�
�
�
%
�I �
�
C �
� m
�
�
�
o�.
�
N
O
U
m
E
m
W
� m
2 �
m W
� Z
= try
a m
I I I I I I I I I(°I$I I
o$$g$g$gggog $
nauii:��r�o�:ooc ,�
KNHNMNMtiyi4i�9N �
IIIIIIIiIN--Iw I�
v
m
�
� �
i
' u ¢
rf Y g� � '
LL � $ � m m
2 � � c mW � �
� c �c m � � � a
m� ffi' a�e....
�
�• � .. •���0 3
go��3¢r`xx � � �
a ¢o
;�� 3� c E.�m.�.�.m. m m�F
io mci¢v'�333c�c�a�
C�
�
1
.�+
0
C
IL
«m.
m
_ __ -a
c
t
�
O
Q
m
m
o'
a
Q
OI
�
ro
�
<
Q
W
J
a
Q c�
Q �
a �
W `p
O Q 7
�OtLL
� Q O
Q ¢ af
w�
�
� o
�°�
¢<�
�
a
�
7
N
«
�
y
�I
�
W
w
LL
J
f
�
� City of Fridley !
ATTMETOPOFTNETWINS BUILDING PERM�IT
i •
i �• COMMUNITM DEYEIOPMENT DIV.
� �y' � � PNOTECTIVE INSPECTION� SEC.
r �
, 1
� 1 I'�'1 � CITY MAIL FRI��EY SS132 NUMBER AE�
L..'.� � �•� 612-571-3460 910-F15
�ae �ooRess 6390 Ashton Avenue NE
1 IEGAL �OT NO. BLOCK TRACi OR ADOITION
oescA. 1 pt 2 15 Fridley Park
2 PROPERTYOWNEP MAILADDRE56
Mavis Vitums 6390 Ashton Avenue NE
3 CONTRACTOR MAILADDRESS
S J Anderson Construction 299 17 Ave NW, New
� AHCNITECiORDESIGNER MAILADD(iE55
8
7
a
6/3/98 � / /
MN 55112
26134
�30a�
•VVNOVEU B�
SEEATTACMED
SMEET
vE
571-4956
NE IICENSE NO.
65-3545
NE UCENSENO.
20062802
❑ NEW � ADDI710N O ALTERATION �. REPAIR ❑ MOVE ❑ REMOVE
Reroof House
CNAN(3E OF USE FNOM
2nd Laver; 8' x 40'
STIPULATIONS .
Roofing can be the 2nd layer but not the 3rd. Install building wrap
under siding and call for inspection before covering.
SEPARATE PERAf1T5 ARE REOUIRED FOR ELECTRICAL. PLUMBING. NEATING.
VENTILATING OH AIR CONDITIONING.
TNIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCEO WITHIN 80 DAVS. OR IF CONSTRUCTION
OR WORK IS SUSPENOEO OR ABA'NDONED FOF A PERIOD OF 120 DAYS AT
ANY TIME AFTEF WORK IS COMMENCED.
I NEPEBY CERTIFY TXAT 1 HAVE READ AND E%AMINEO TXIS APPLICATION
AND KNOW THE SAME TO 9E TFUE AND CORRECT. RLL PROVISIONSOF LAWS
AND ORDINRNCES GOVERNING THIS TVPE OF WORK WILL BE COMFLIED
WITH WNETHEF SGECIFIED HEAEIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT FRESUME TO GIVE AUTNOHITY TO VIOUTE OR CANCEI TME
PROYISIONS F ANY OTXER TATE N LOCIIL LRW REGl1LATIN�i CON-
STRUCTION THE PERFO' NC F CONSTRUCTION.
'� i ,�- �
SIGNPiUREO�CONPRnCTOAOR JTNOAl2ED�GENT IU}ib
iO�TE�
$O.FT. ICU.FT.
OFFSTREET PARK�NG
S7ALL5 GARAGES
SUHTA%
�1.��
SACCMARGE
Fire SC $2.00
TOTA�FEE
5. 82.75
I,�� T�/ D: HIS I�OiR� M
� �
NEW
ADDN
ALTER
Effecrive 1l1/98
� j CITY OF FRIDLEY �
[�INGLE FAMII.Y AND DUPLEXES R-1 AND R-2 ,1� r�
BUILDING PERMIT APPLICATIQN �(p �b�
ConstrucdonAddress: _
I.egal Description:
Owner Name & Address:
Contractor:
Address:
LIVING AREA:
GARAGE AREA:
DECK AREA:
_Tel. �f �'i %� / ���
LICENSE# �6OGoZ/�l�oZ
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it m scale.
DESCRIPTION OF Il1�PROVEMENT
��
�ng� Width Height Sq. Ft.
�� Width Height Sq. Ft.
Length Width I�gt/Ground _ Sq.�t.
OTHER: � ll5v ' (/C�iY � � �
�sog.vy 1�i` ��-9 g X�d r - �
construcdon Type: � �.i� `� Estimated Cost: $ _ . �'�
(Fee Schedule on Back) �� 3 $`/
Driveway C�rb Cut Width Needed: Ft. + 6 Ft =_Ft x$ =$
DATE:
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Fscrow
Erosion Control
Pazk Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
APPLICANT:
Tel. If
CITY SE ONLY
i
$ ,%) Fee Schedule on Reverse Side
$ �. � .001 of Permit Valuation (1/lOth%)
$ /,� $.50/$1,000 Valuation
$ $1000 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 Necessazy [ ] Not Necessary [ ]
�� -
$
i'
BUII,DING PERMIT FEE SCHEDULE
The Chief Building O�cial shall, before issuing pemuts for the erection of any building or structure, or for
any addidon to any existing building_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 permit of fees to the amount
herein below set forth and in the manner herein provided to-wit:
TOTAL VALUE
$1 #o $500
$501 to $2,000
$2,001 to $25,000
$25,001 to $SQ000
$50,001 to $100,000
$100,001 to $500,000
$500,001 to $1,000,000
$1,000,001 and up
FEES
$21 (Minnnum Fee is $21 plus surcharge)
$21 for fust $500 plus $2.75 for each additional $100 or
fraction ihereof, to and including $2,000
$62.25 for first �,000 plus $12.50 for each addidonal $1,000
or fraction thereof, to and including $25,000
$349.75 for fust $25,000 plus $9.00 for each additional $1,000
or fraction thereof, to and including $50,000
$574.7S for first $50,000 plus $6.25 for each additional
$1,� or fraction thereof, to and including $100,000
$887.25 for first $100,000 plus $5.00 for each additional
$1,000 or fraction thereof,to and including $500,000
$2887.25 for the first $500,000 plus $4.25 for each addi[ional
$1,000 or fraction thereof, to and including $1,000,000
$5012.25 for the first $1,000,000 plus $2.75 for each additional
$1,000 or frac6on thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streeu Only)
Alternate "A": Removal and replaeement of curb and gutter only - Driveway width plus 6 feet times $13:50.
Altemate "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 $15.75.
VERIFICATION OF FOUNDATION
Pernuts for construcdon will be issued a minimum of 24 hours from the time of application to allow for proper
review of the proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the locadon of the foundation once it has it has been constructed
wiil be required before proceeding with the framing.
City oi Fridle�
117 iME iOP OF TME TWINS-
.�
� �' GOMMUNITY DEVEIOPMENT DIV.
� r �..�...,
r � �' � PROTECt�vB INSPECTION SEC.
i �
� � i"'1 : CITY N�IL iR1OLEY.� 3��Z
�._-•�"� �'' 612-571-3460
�oe �opA¢ss 6390 Ashton Avenue NE
t LEGAI �OTNO. lLOCK �� TRAC
oescn. 1 pt 2 15
P PROPERJYOWNEA � MAILAOO�ES$�
Mavis Vitums 6390 Ashton A
J CONTRACTOR � MAIL ADDRESS
Minnesota Rusco Inc 5558 Smet
1
9 CMANGE
MAIL
BU ILD�NG PERMIT
qER 11EV D��E ��GE Of
gio-PtS 3/26/O1 / /
3i705
fION SEE ATTACMED
y Park SNEE�
ZI/ PNONE
NE 763-571-4955
� � ZIP PMONE LICENSE NO
, Minnetonka, MN 55343 952-935-9fi69 2173
� ne PNONE LICENSE NO.
❑ NEW ❑ AODITION ❑ AITERATION C� REPAIR
window within
ro
NO
❑ MOVE O REMOVE
STIPULATIONS �
Provide smoke detectors in all sleeping rooms and on a11 levels of the
dwelling per Section 310.9.1.2 of the 1997 Uniform $uilding Code. Caulk
and flash all exterior openings
SEPANATE PENMITS ARE REOUIRED FOR ELECTRIC�L. FLUMBING. NEATING.
VENTILATING ON AIR CONDITIONING
.�TM�S PERMIT BECOMES NUL� AND VO10 �F WOPK OR CONSTNUCTION
AUiHOfiIZED IS NOT COMMENCED YyrtHIN 80 DAVS. OR IF CONSTRUC7�ON
ON wONN IS SUSPENOEO OR ABANDONED FOR A VER100 OF 120 DAVS AT
ANY TIME AFTER WONK IS COMMENCED.
I MEREBV CEATIFV TMRT I NAVE AE�D pND EXAM�NED TM�S AOi1,ICATION
ANO KNOW THE SpME TO BE THUE AND COPRECT. ALL PIiOV1S10NS OF IAWS
RNO OADIN�NLES GOVENNING TMIS TYPE OF WONK WILL BE COMP41E0
WITH WMETNEA SPECIf1ED NEAEIN OA NOT. TIIE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE �UTMORITY TO VIOLAiE OA CnNCEI TME
PRpV1510N5 Oi ANY 07MER STATE OA LOCAL LAW FEGUTATING CON-
STRUCTION OR THE PERFpqMANCE OF CONSTNUCTION �
SH'iN� LyNF,O� GON'PILTOA OM �U�NOA�ZEO �GEN i
YpEOFC�NST. OCLUP�NCYGAOUP OCCUPANCYLOAD
:ONINO 50. FT. CU. FT.
10. DW�G. UNITS OFFSTREET PARI(ING
1 � - ST�llS GARAGES
�ALUATION � $UMTAX
$4,920 $2.46
'ENMIiFEE . � SACCMARGE
$111.25 Fire SC $4.92
>LAM NECK�. E�. . TOT FEE
Lic se SC $5.0 $123.63
H AUD TM1515YQV ERMiT
� r
�ll�
B iN$G '
N�yy � � Effective 1/1/2000
ADDN [ j CITY OF FRIDLEY 6125723604 Bldg Insp
AL7ER [] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: (P3(� rISYI�I� �• /v��.
Legal Description:
OwnerName&Address: MQ.VlS V/�T��I_S �Q�D ltSyl'IDYI /1,�•N��,re�.# `1�e3� 5?I ��1955
Contractor. �'lrn�I�CSbiZC _ us�
LIC`�ENSE# � � /✓ q
�IVTeI.# -la�a• `f'35' �� l
Attach to this appiication, a Certificate of Survey of the
lot, with the proposed construction drawn an it to scale.
DESCRIPIiON OF iMPROVEMENT
LIVING AREA: Length Width Height Sq. FL
GARAGE AREA: Length
DECK AREA: Length
OTHER:
Width
Width
Height _
HgUGround
Sq. Ft
Sq. Ft
Construction Type:� `a�-U � � ��hab"Estimated Cosi $ "7',�a D , �
j Y� P�) 1 . n� �� :
Driveway Curb Cut Width Needed: _Ft + 6 Ft =_Ftx S = 8
DATE: �' � �'� I APPLICANT: /-! r n n eS D`I�- �l�s�, .�.�LC • Tel. #'F.�f ' i�� �� U�
CITY USE ONLY - Call (612) 5723604 for Pertnit Fees 'rf mailing in application
Pertnit Fee $ � � ��� Fee Schedule on Reverse Side
Fire Surcharge $— ��{ � ,�� �� .001 of Permit Valuation (1/10th%)
State Surcharge $ d � `f �o $.50/$1,000 Valuation
SAC Charge $ $1100 per SAC Unit
License Suroharge $��� $5.00 (State Licensed Residential Contractors)
Driveway Escrow $ Alt. "A" or Alt "B" Above
Erosion Control $ $450.00 Conservation Plan Review
Park Fee $ Fee Determined by Engineering
Sewer Main Charge_ $ Agreement Necessary [] Not Necessary (]
ToTA� $ ia3 . �3
STIPULATIONS: l0� �"'�'�` �G��� ��--�` .
l�y
.�/o. 5', l Y /997 � �' �. �-'���1-�'�-'�.v�
�i�i.�� ,4� ��21� ��•..�.��.�
asno maN •8u�ez3 aq; y�� 8mpaa�oid aio;aq pannbai aq
�m pax�nRSaoa uaaq seq;t seq ar aauo uonEpuno; aqa;o uoueool aq� 8mmoqs `loj a�;o danms;o a1��a� y
•a3?s uopon�saoo ay�;o pus amlonus pasodoid a�l;o ma�nai
iadoid io; ,ao� ol uoueogdde;o atnq aq� tuo� smoq yZ;o mn�mmut a panss� aq fim uopotwsaoa io; s�tm.iad
I�IOI.LVQNf103 30 NIO1.Li�'�I3RI�A
' SZ' £Z$ ��?7 3aa3 9�Id �p?M �CzManuQ - yadap q�m q q3tm q�eoidde
apcm aoo3 £ E ti��? P� s�3nS pue qmo;o luatua�idat p� �notuag :��g�� e7EU.tallF�'
'OS'Si$ samq �aa; 9 snid y3pTm ,iemanuQ -,tiao aa�nS pus qmo 3o ivaLUa�eidai pue �noucag : ��„ aiauaa�iy
( I�O siaaUs q`m� a]aiouo�_ _ _ _
h102I�S� I�IOISS�d�Q �Ii�A��ARIQ
;oaiaqx uopora3 io ppp`T$
Ieaoptppe q�ea io3 ST'£$ Snld ()0��000`I$ isns ay� io3 SL'809`S$
000`000`i$ �mPnl�m pue ol `;oasa� uoi��e� io ppp`T$
�aon?ppa u�ea io; s�•}� snld ppp'ppsg �sn3 aqi io3 SL'££Z`£$
000`OOS$ �?Pni� Pue o3 `;oaiay� uopoe� io ppp`i$
I��n;PPE qoea io; pq•S$ �Id 000`OOi$ lsn3 �03 SL'£66$
000`OOI$ $II?Pnt�m P� oi `;oaia� uoi3oz� io ppp`T$
l�ou?PPe �asa io3 00'L$ Snid OOObS$ lsn3 io3 SL'£b9$
000`OS$ $�pnt�m pue o; `;oasay� uo�i�e.� io
000`i$ l��?7?PP� u�a io3 OI'OT$ �Id 000`SZ$;sn3 io3 SZ'I6£$
-- --- - -- 93(�`S�$-�Pni� �ue �3 `�eaiaL}; ao�ias:�33s----
000` T$ I�op6PP� A�ea .to3 00'bi$ snid ppp'Z$ �sn3 so3 SZ'64$
ppp`Z$ 8a�pni�u� p¢e o3 `3oaiaql uoR�e.g
io ppT$ I¢aopTppe q�ea ao; SO'£$ �Id OQS$ �Sn3 �o3 OS'£Z$
OS' £Z$
5�33
dnpue I00`000`I$
000`000`I$ ol T00`OOS$
000`OOS$ °; i00`OOT$
000`OOT$ 03 IOObS$
OOObS$ � T00`SZ$
000`SZ$ ol i00`Z$
000`Z$ o� i0S$
OOS$ oa i$
�fl'IF�A'IF�.LO.L
:7tx�-oa papTnoad maiaq ia� aq� u� pu� �03 �as n�olaq
utaiaq 1�ome aq� o; saa;;o l?�.iad ��ns io3 aue�gddE at� 6q laaiuf.ed a[p annbas `aio3aiaqa uoqe�i[ddz uodn
`amt�nAS io Smp�nq Suqsnca �fuE o� �dai io uopeia2te �4uz so; io `amian.ns io Surp�nq �s�xa �iue o; uontppe
�iue io; io `azni�s io �u►p�nq �C�;o uopaaaa a� .io; s��ad RmnssT aio;aq `tieqs t¢��r.�p �uip�ng 3a?A� a�I.L
�rncr.��s �� ,r.u�x�a �uQ�ng
�-- �
O
O
O
N
�
�
A
�
c
�
1
C
O
�
>
�
w
Z
O
F N
W
J ;
~ W
2 �
> 0
� Z
Z a
N
J �
O W
O
U t~/1
Ci N
Z �e
W Z
xo
a�
zo
aZ
Z U
K
aa
w Z
�a
oz
a�
�a
o�
�
2 (7
O �
N �
UW
�
J
a
z d
o a
�
>
0
z
O
H
U _
ww
az
N
Z � N !.
r¢a:_
wY�
J . �
� `
� � Z .
v
.�i
� � T�
,_, a� m
�7 CI�
� �
�
m z
�
O r. � p
w
J
�
�
w
�.%
�
W
a
a'
1.�
Z
�I O �
z �
F m
� O
�
a Q
W
J� Z
\ �
� 1 7
� 4
4
� ,
� � a
a �
� N W
� � 0
� p
� W
Z ¢
� �
J
� �
m w - .
J �
O t'� I
r.s bs s�r
�
� °o• °o °o
� o co 0
M �-+ .+
w v� rA
Q
E
�
R
3
Y �y
> li
O V
� �
C Z W f�6
c N J
� N L
v V
N �
C C
O Vd
u �
U �
a F-
�
=a �
�� �
m �c y
= Z �
O �
O � F j
zF-m�..
L
d
C tVp
J E ..
m � � C
Y �
.�a�me�
�! � L `0
. � i�:� 3. y .
�u�.=�oy
-o �"� o
� � � � C
�
m � j ? a
� 'C ta N m Gd0
N
;r m o.v a c
a� tn m
N N � `� a �
'O C p N �n
L N
� lL Q C.7 C:3
�
0
llA
Z
N
N
�
a
S
N
�
16
Z
d
a
�
F-
L
N
m m
C C
A
d N �
� y c
°' a �
L O u�
� U u
� T �
3 " '�
y U d
t N +L+ V
Y
L Y — � \,
� A L l\
,t„ ... p N
.. . m U 1
E �� c �
y U. � l0
o.�.. m �
R � �
� U �
� �
� U V d
C � T �p �
O � � C �j
� U .- O
U � L y i
� �
.a N -O U
a c c a �
`s s 10 a
Y � ° � �
N
m 3 'N L <
£ 16 � c Q�
T O � ��
� � �D �
� o c �
L �'� N �
� C = N
C � m C �
pp d N O �
L � « � �
D � O C �
C 41 y N L
7 = 00 y F
(\-�
N
�
� G
1
V` �
� �
0
�
� �
� �
�
J
W
H
a
N d C ~ a �
a W m
h w i d 2 fA
g
�)
� u� vt bs
0
0
0
u�1
�
O
m
�
0
0
vi
N
v�
N
N
�
Q
m
c
�C
0
D
c
O
U
Q
Y
U
m
Z
0
�
v �
O
C �
0
� a
� �
CI U
"" C
¢ A
� Q
�¢
t4 0
a
� �
� �
� �
�
L p
O �
Q ~
o ,p
� ��
�I
�
m
`m
'C W
i W
7 lL
N
N Q
A ~
� o
Y
`o
3
O
U
C
m
m °�
�L Q
'^ o
7
c �
\ >
m
�` O
E�
� N
U ~
_
�
O
O
^
v
Ui
w
w
�
Z
�
E-
U
w
d
�
Z
w
�
N
Y
f6
0
c
L
�
�
0
�
�
d
>
O
O.
a
¢
�
0
�
3
a �
� N
� 3
T
� D
� T
N :.
m a
C �
;o a
U �
� C
a .�
� O
� �
m
C O
C
u �
N �
N �
C N
O �
'O Q
c
O C
U �
Q 3
COMMON VENT. VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When replacinq an existins� furance, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions,
and is securely supported and firestopped where required. Yes (�o ()
The venting system is plastic/PVC and meets all current codes and manufacturer
specifcations including sizing, length, number of elbows and termination. Yes () No (�
The undersigned also verifies that the replacement unit is a listed assembly
and meets the current codes and manufacturer's specifications. This does
include AGA-GAMA Category I Central Furnace Venting Tables for fan
assisted and natural draft appliances.
The existina combustion air is sized and installed to meet the current codes
and manufacturers specifications.
When required to install a new combustion air, it will be sized and installed
To meet the current codes and manufacturer's specifications.
Yes (XNo ( )
YesONo{)
Yes (�lo ( )
When i�stalling a new ventina svstem, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturers
specifications. This does include AGA-GAMA Category I Central Fumace
Venting Tables for fan assisted and natural draft appliances. Yes (�o ()
Is the common vent and vent connectors sized and installed correctly after
an appliance has been removed from the common vent and vented
separetely as per current codes. Yes (�o ()
Apaliance Tvae and Size/Common Vent and Vent Connector Information
Appliance #1 Type �,✓A�'� BTU Input oo� n Assiste r Nat
Appliance #2 Type �e.3�6� BTU Input �� an Assisted or Nat
Appliance #3 Type BTU Input Fan Assisted or Nat
Total Appliances Totai Btu Input �, e�
Common Vent Type C�S _.fi Vent Height Diameter �o i^ches
Appliance #1 Vent Connector Height ft Length ft Diameter in Type _
Appliance #2 Vent Gonnector Height ft Length ft Diameter in Type _
Appliance #3 Vent Connector Height ft Length ft Diameter in Type _
ALTERATIONS: (Describel u�v�n��i z�- � S� Nf�'/KN�Y
HEATING
42l1DAVEI�JENf
PuTAL.NW 6647t
in�c.
Signed BY� ��— Date : Q�b�
e
.'"
,p'
8
N
�
10
�
C
�
�
.�
W
�
a
0
�
i
�
u
0
�
L
�
1
:
i
I
1
I
I
�
�
�
0
2
?
W
aW
N Z,
Z
O
J a
0 �
�
LL
�
LL C
� 7
U �
�1
m
0
�
C
� N �
�d�
��w
Y V y
O � � «
3 `
d U N
� y � V
"�' L YI C
'; N 16
d
l0 j
� N V N
O O � �
V y C
W �
O�°LtT
� c � �a
a � 10 �
� C C N
O
H � 'N Y
v o •,
E; � c
m rn w
� o � �o
v
G � m O
w ._
m m � m
O� d O C
d v c �'
7 � � �
N N V V
L p, c c
H a m m
�
I
N
� C
`� .
�
l�
:�
1--
�
�
w
a
��
�
�
�
� 4 N
� o
y U
� �
� C �
C � •-
� m W
>
Q
a
O
U
C�
Z
m
�
J
a
Q o�
� 4 I I
� IIIIII
III
JI
Ha
K
�
z
W
K
W
�
�
�
Z
m
�
a
$ �
0 0 0 0 0 0 0 o a °o °o
0 0 0 0 0 0 0� A ,�
�,� N � � � � o 0 0 0 �
H 19 tli d/ V! M W N N N��N
I I ( I I I I I �� I I Z I
N
}
v
w
'�
� d �
� c �
j�' Y �p �VS • � �
4' � m n� "� c
W F� � W
Z � � G � W � d
d cr c' o ��.Z a 4! a: t� . a
C Q� m N y W N N p� y 3
� �C �+ N � d � � s y
'u�, �� O L�� m d d�� LL aa.
y V y O N�l0 � N N /0 A N � F-
ZOmmU�tn���(9C9m
�
� 1^�
V
� ♦[\
� �J
�
�
� N
m
0
Z C
J LL
?:
0
C
. _
C ?
a°
m m
w
� �
W p
2
<? °a
N a
��
� �
I �I
�
Z
O
�
w
¢ °'
rn
o d A
Q � U
7
� n N
¢ °�
¢
` W O (�
O � �
o � �
$'ow
w :� y
O � �'
�j W u„
6 O a: .
C J � . .
R�Q�
W
�
a
O
h'
Q
t0
W
J
Q
F
OZ
Q
a
�
Z
0
U
w
�
U
�
�
K
W
a
0
w
�
0 '
�
a
w
m
_
�
K
Q
�
7
m
�
U
: a�ed :�tg peuB�g
�O� JNLLt13H
eqs�osep ;SNOLLV2l31'lt/
adRl u� �a�aweia � y►6ua� � �y6ieH �opeuuo� 3ua/� qf eoue��ddy
adRl w �a;aweiQ u y�6ua� �y 34�!aH �o�auuo� �uan � eauegddy
adRl ui �a�awerp g ya6ua� � ay6iaH �o�auuo� �ua� �# aouei�ddy
say�w �a�aweia �y6iaH �ua� ad�(1 �uen uowwo�
�„ �ndul �181e�o1 sa�ue!IddH lelal
aeN �o pa�sissy ue j indul f118 ��1 £# ��!Iddy
"`— �eN �o pe3sissy ue� �ndul f118 ad�l Z# �uei�ddy
�eN �o palsissy ue� �ndu� �l8 ��l L# �uei�ddy
uol;euuoju� �o��auuo� �ueA pue �ua� uowwo�/sz�g pue j aaue�� d
() oN () Sa� 'sapoa 3uaLna �ad se �edas
paluan pue �uan uowwoa ay� wa� panowa� uaeq sey eaue��dde ue
�age �t��a��oo pa��e;sui pue paz�s s�o�auuoo luan pue �uan uowwoo ay� s�
() oN () sa� �sa�uei�dde ue�p �e�n�eu pue paLsisse ue; �o; sa�qel Bupua�
a�ewn j �e�;ua� � tio6a;e� yWtl�-y�y apnpui seop sltLL •suoiye�}p�ads
s�a�n�ejnuew pue sapo� lua�m� aya s�aaw pue �(�qwesse pa;s�� e si �
�ey� sa�,�uen �(qa�ay pau6is�apun ay� 'wa�s s u�uen N►eu � �q ! uayM
O oN O sa,� �suoi3eoyioads s,�am�oeynuew pue sapoa �ua� ay; 3aaw o3
papeasw pue pazis aq pim u ��e uo�snqwoa �nau e ��eisu� o� pannba� uayM
( ) oN ( ) sa,� •suoiiea3r�ads s�am�elnuew pue
sapo� �ua�no ay� aaaw o� pa��e3sui pue paz�s si ��e uogsnqwo� upa�xa ayl
t���� SaA •saou¢��dde ge�p �e�naeu pue pa�sisse
ue; �o; sa�qel 6u�3uan aoewn j �e�lua� � AioBe3e� yy�y�-y�y epnpui
saop siyl •suoi�eoyr�ads s�a�n��e}nuew pue sepo� lueLno ay� s�aew pue
�(�qwasse pa�s�� e si;iun �uawaoe�da� aya �ey� sa�}uen os�e pauB�epun ayl
() oN t) sa,� �uogeuiw�al pue snnoq�a;o �aqwnu 'y�6ua� 'Bulz�s Buipn�au� suo�ypads
�am�e;nuew pue sapoo auaLno pe s�aaw pue �/�/oi;se�d s� wa3s�Ss 6upuan ay,�,
( 3 oN () Se�l �pa�mba� a�ayen paddo3sa�y P�e Pa3�oddns �emoas s! pue
'sualoru�sqo 'ua#e�oua�ap '�sru wa; aay av pue pewwexa ueeq sey Bui;uan
ay; 3ey� seyuan �tqe�ay pau6is�apun ay; 'x►ue�ry ups xa e ulae� ai uayN►
OI1V�Idi?J3A 211 N O� ONV Z101�3NN0� 1N3A 1N3A NO O�
. --�- we�FC*
� City of Fridley
•T711ETOPOFTNETWINS g�iLDING PERMIT
f
i +
� a
� • - GOMMUNITY OEVELOiMENT DIV.
� r�.""".
r � � PROTECTIVE INSVECTION SEC.
i
L-.-.� �'',.J CI1V MA�L PRIDIEY SS�J2 MuuBEA
763-571-3450 910-f15
108ADORE55 6390 Ashtan Avenue NE
7 LEGAL LOTNO. BLOCN � TRACTOPADDITION
oescn. 1, pt 2 15 Fridley
t PROPER7YOWNER MAILADORE55
Mavis Vitums 6390 Ashton Avenue NE
J CONTqACTOR M�I�ADDi1E53
Minnesota Rusco Inc 5558 Smetana Dr, Mi
� �RCMITECTOROESIGNEP MAILADDRESS
Residential
7 CIASS OF WOAK
B OESCRIBEWOFK
Replace one
9 CHANGE OF USE iP
•TE � ��GE Oi
12/4/03 / /
4044
/ �
SEEATT�CMEO
Park SHEET
ZIG PNONE
763-571-4955
21P PMONE UCENSE NO
,..,er..,,b�_ tent SSR43 952-935-9669 2173
❑ NEW ❑ ADDITION O ALTERATION � REPAIR
window within
GMONE
❑ MOVE O REMOVE
STIPULATIONS
Provide smoke detectors in all sleeping rooms and on all levels of the dwelling
per Section 310.9.1.2 of the 1997 Uniform Building Code. Caulk and flash all
exterior openings.
Permit inspection �Cards
Will Be Mailed
To Homeowner To Post
SEPARAtE GERMITS ARE REOUIHED FOR ELECTRICAL. PIUMBING. XEATING.
VENTI�ATING OF AIR CON01710NING.
TMIS PEPMIT BECOMES NU�L ANO VO10 �� WONK OR CONSTRUCTION zONING
•UTHORI2ED IS NOT COMMENCED WITHIN 80 �AYS. OR IF CONSTRUCiION
OR WORI( IS SUSPENDE� OR ABANOONEO �ON A PER100 OF tI0 DAYS AT
�NV 11ME AFTER WORK IS COMMENCEO. NO DWLG. i
I HEREBY CEfiTIFY THAi I HAVE PEAO ANO E%�MINEO iMiS APG�IC�TION 1
�NOI(NOW THE S�ME TO BE TRUE ANDGOAAECT. ALl PROVIS�ONS OF LAW$ yALUATION
ANO OADINRNCES GOVENNING TNI$ TYPE OF WOAK WI�L BE COMPLIED @
WITN WNETNEA SVECIFIED MEREIN OF NOT. TME GRANiING OF A GERMIT WZ f Z1O
DOES NOT GRESUME TO GIVE �UTHORITY t0 ��Ol�TE OR CANCEL TMF pEpMITFEE
PAOWSIONS� OF ANY OTHEA STATE OA LOCAI LAW REGUL�TING cor+. $83.25
STRUCTION OA TME PEPfOAMANCE OF CONSTRUCTION
S�GN�IUafO�CON'A�GiOAOA�J*�Oei2f��GfN� iD1i0
.�I, _ r
STALLS �GAPAGES
$1.11
�C LMARGE
lI .Sr. �2.21
)T FEE
91.57 /
NEW " [1
ADDN [1
AITER, I �
z
��
Gcnstcvctiqn Addr
Lega4 Description:
':<
Owner Name & Address:
CITY OF FRIDLEY Effective 1/1/2003
6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bidg Insp
SINGI.E FAMILYAND DUPLEXES R-1 AND R•2 (y��371-1287 Fax
BUILDING PERMIT APPLICATION P%�J(J NOV �¢ ZOO�
���.�mn(5—�y�z
Te�. #'] lD3' �� i '
Contractor: "I I I /1-/11%)rN�> > ��.G�� , � � MN LICENSE # �i/ C.7
pp�,� 553�/3 Tel. # 9�`Z • q�' ����
Address: 5558 5M o fQ,f�GL l� {I/1Je�_,�
l�a,� q52 • 933 • 4s��1
Attach to this application, a Certificate of Survey of tf4�
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
� _--w. �.�-�. -->.�,,.�__. - ��- ,.�.�-°----°�°--°.�.�
LIVING AREA: — Length Width Height Sq. Ft �
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: L,@ngth Width HgUGround Sq. Ft.
OTHER: f1 � n� 61I1A �•.4�dP.n )� Oi,) t/li� �O.tLi ��'I h9x� �
�--
Construction Type:���.� m� � Estimated Cost $ ��i %� ' a o
Driveway Curb Cut Width Needed: _Ft. + 6 Ft` _Ft x$ _$ r SZ/�2�,��J/�f� �1
4) �,( '1�ci Tel. # '�C.�Y/ G �C���i
DATE: I3 APPLICANT: `
Call (763) 572-3604 for Pertnit Fees ff mailing in application. Fax to 763-571-7287 if using credit card and we will
call you for card number.
CITY USE ONLY -
Permit Fee
Fire Surcharge
°�e�3�'targe . ___
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
�_ Fee Schedule on Reverse Side ��
. � 1_ .001 of Pertnit Valuation (1 /10th°�)
$�_ $1275 per SAC Unit
$ � � $5.00 (State Licensed Residential Contractors)
$ Ait. "A" or Alt. "B" Above
g $450.00 Conservation Pian Review
$ Fee Determined by Engineering
$ Agreement Necessary [ J Not Necessary []
g �. 7
<-�. . s
- _ •.