AF - 35378City of Fridley, M��
6431 University Ave. N. E., Miinneapolis, Minn. 55432
BUI�DING PERMiT
��: December 29, 1972
pwner; ic ��c� Miller Homes B„�� SAME
Ada�ess 1600_Rice Creek Road Ad� SAME
�
�19�
LOCAT10iV OF BUiLDING
6151 Benj amin Street p� of Lat
No. _...__-------_..^.._ Streeic �
Lot .�.._. z �_.._........ Black _._.._ _ 3 ____ Addition or sub-Div�sion .�B r i a r d a 1 e
Corner Lot ____._.__..____ Inside Lot ._._.. X Setback 351 Sideyard 6� and 11'
XS��'r IIevation ...__ 915.85 ._ �T���,IIevation 918.62__�'Iinimum ,
Wye Top of Footing
DESCRIP'iION OF BUILDING
To be Used as:
Dwe l l i n� __� �t 3 8' �p� 2 6' Heighi 2 �` sq. �. 9 8 8
G a r ag e _._._._ r�ont 2 �' nePtt� 2 6' Height 1�� sq. � t. 4 8 0
Type of Constructfon Wo o d F r ame �.� �� $ 2 8, 3 S 8 To be Completed
� � 19-, .7 6 0
� � 4,800
June 1973
STIPULATIONS: Provide a hard surface driveway. Provide a verifying survey before
capping. Storm sewer escrvw of $270.12 is due when wa�er meter is taken out.
� o �� l � � + �
WATER LOCATION: Stopbox 10' S. of Sewer. SEWER LOCATION: "Y" 17' S. of Manhole
In consideration of the issuance to me of a permit to construci the building described above, I agree tp do
fi�e pro�sed �ork in accordance with the description above set forih and in compliaace with a]1 provi&ions oi
qrdinanc�s of the city of Fridley. .
��....,��� �,���.P��
$14.18 State Surcharge
In consideration of ihe payment of a fee of $ 4 5,. �SL�_, permit is hereby granted to R� ch a,� Mi l. l e r Home :
to construct the building or addition as described above. This permit is granted upon,
the express condition that iche person to whom it is granted and lais agents, employees and worlt�nea, 9n, aII Work
done in, around and upon said building, or any part thereof, shall conform in all respects •to the ordinances oP
Fridley, Minnesota regarding loca.tion, construction, alteration, maintenance, repair and moving of bwIldirigs
vpithin the city ]imits and this permit may be revoked at any time upon violation oi any of the provisions oP 88id
oridinances.
���� �� �� suilaing xnspector
ARREL CI..�.RK
PIOTICE:
This peemN does not cover taa eonstrue�ion, installation for wiring, plumb3ng, gaa heating, �rn►er or wafer. Be suro to s�
the Buflding Inspa�tor for aeparate permHs for these hetas.
�
I
r
.:tr«�^", ,' _'_' --. -. =., .- �...- _ .-.-. . .' ' __._. ' -
,4,,; - . . . . . . ' . . . . -
_ - r nn ..a,. r,+-�.-�,,, +h�+..�+... . .
to.►�t,:�r���� . ���'��t'�'�i�'l�►�'� , ae�s N;��o� r�a:4s �.�:
ib�id $�Ht�lryin�f ' e' s • � JMieE�tlPapolif�
� _ �Hs T+s�i�t�' � 1` � �7�� '
_ �r%'����lQ���`�� R R . N�fen. �9#39
a,. Cs`.f�� Ertgi�rt�trYisp �' iel,�pfioao 78A-06r8b
, "�`��'c� �'°",� . " Ei�e�inn��r� & �ar�►eyox�, �.�i c� ai�
1'V�art��g�� �L�au Survs� f�� ���,*�F?~ �t.�� �'�
�f��
;:
-,
0
,:�
� � � � � � � l2003
�- - �
� � 2�.t8 0
� � � '� M
+! Q t1�
.� � � � � �
� � �4:b : �
�
� � . ra,�7
� � + �'' � � -
' �; " � 33�"- :oT
� � f 1 "�Q.t?3
�
r+ I
��:''
r��
,� Q
, � a
►--- �;
► �„
r"+ �•.J
�.3 ,
�
A
�«
t
�
�
�
�
�
s�
,_
� � �f� ` � ����� � �������� _" '� �
� � �.
- . � !�i!'tp�Q ��
�....- :-_ :r.., ��i ��� � ;�i�i�� #r�� � .
t
_ '��is h a�f��*e pq�! co�resi ri►p�seertati� o! o s�rvey af the baea�#afia� af ttee land aha�►e dea<r�h� �d o! th's
�osarti+� �tE ltti �wil���s� if ytA�r� �btwrapu� +oebd oPt �i3ihf4 e�r�alw+�ea+tsF if oety� t�o+�`b or o� wid tawd: ,T�i1c �a*vop is
ma�e +�;in s+o�hsctioe Miitbv n�nii��. t��► e�aw ba�w�p ptaa�d � rke Pro�ra���r ae►�f++,o I+obliity �a aas�eenrB
�� eKespt !p� �lts �ri� eFl� it�tb r�rtgpglr .4+' a�►�I vLA�r' inttt#!t titqvii!tsd I�iY l�is _ reaton o1 s�ab p�ar►d�. t! is
�«�a�?°a�' �0 a� at�ai�s bp�i�r bsan piacad far �he'pprpo�a .af �r+o!►li�ASn� br ai,�s or bao►xdory '
` '. ¢�r� bfiii� s#i!�„,r..,r�;�;l�a�i y�d :"�,;�,1Y. i} �+1;,;;�-
�
�, 4 � . • �ui��tux�ii �1+�t�rNa�ri11�Q�', ��C`•
' �,�# . �.� t � � f�+�+►+m �Wr�+� " •�'"
._
.
-� ' � � � ���'���-�
, _
� � .. � _
�';;��°� � .
� .
560-3450
0
c�t o ��� ��e
� �
ANOKA COUNTY
643t UNIYERSITY AVENUE NE December°�, I972 FRIDIEY, MINNESOTA 55421
TO WIiOM IT MAY. CONCERN:
Whereas the City af Fridle�r has i�ssued a building permit to construct a
structuse at /�/ ���i,? � .
Wherea.s the permit is dated prior to January 1, 1973 and tfie City of
Fridley did not collect or receive any "Service Availability Charge".
Theretore if for any reason the Metropolitan Council and or the bletropolitan
Sewer Board assess or bill the City of Fridley a Service Availability Charge for
this structure or sewer hook up, we the undersigned agree to and will pay the
City of Fridiey for said charges. `..' n ^^ r�
Witnes s .
Signa
�
.��..
// � /'�/ti�.i---- —
s
" . -
�
`°" �""�"9 cJ/�("l/ l(�i�,l 6d7S Mighwor Ma. 09 N. t.
�a�d ��.���.^� +��i� ri����l�r�l� •��i�. M,��eoP�,,,
�6�i5 12Si�n� � �Ifl11. js;.�2,
_���� Eng,nE=e,�ng �� � � lelephonn 781-606�
Aqu.1 c,�+oa eng„irr�ing Pi�1��flE''81"5i �L ►S. �.lI'V8�'OCB 4.ea Cade 612
' �
,
� e r t i f i� a t� o f S u x v e y� f o r° � i �,� �? Y�;;;,> �✓� w��"-e� ,� ����:��
�
V'
Z
�
�
�
Z
W
t.�-d
�e=0"
�
�ry
�
,-�
;.. -
�_________�.
N(�4� `N
O�T 20 C � I DALE � _
° ���no�� ►rc�� fmonumtnt ,��n@LCC� l�Ot�t1��
�
-----^�vna�QO Dr�9n��Q � U�i�r�� E04�r�►�tn�
I h�rcby c�aP�fr �hat rh�• o 0 1ru� ond corr+c� �ipr•9��fo��on al o avr�e�y oB �he baunderi�s oA 1he oisovve
d�scribed {and, aosd ol 1fe� loca�imw of oli bruitdi+t •, theraa�n� ond atl vi�iple e�croocArsl�nt�� if any� hon+ Os av
wid lon�. Aa ►urvoyred by me th�s doy o/ ;`� -*�, 1 f i.Q. 19�1.
��
� ��OCQ� ��'�'� �0 �
.
. , �
SIJaURBAN ENQFINiERING, Il�t�.
En�in�era Survero�s
br � �u��—__.
�
.
��wr:= �
�'`' �� �-� � 5 p v �- I-� o�� /V�, l�
7
' ` �� �� L �_ �/, �I l �► � 5-
y (�
-� Q � G � rG oT / I�� (s �Lt� P�, /��I, � !l � , i / 0 ' � �.
f i\ 1 � � `= � r� �/. � /_ �� � ��� � ° �� � 3
� ���s2
� �� r� �� � �C
,_ -
�
r.
f U� S�v7 ti! �J�' S�'�i�=/�
1� .
t
a
0
�
AF.P����TI�� ��A �E�IDEM����, ��T�i�iTI��,
Q� ��A�TTa� ��zLDT�G P�RNlT�
��T� OF �RT����s �INN�sQT�
�W�"S N� : �[TTL�}�lt s%Z i C E-1 A�'D 6`� � LL.��, f-I C7 M�S
. . . e s i As i e w �
,ann�ss: . ��.ss: �c�c�o ��c� ����-� ,i��A��������
��� .� r sl sa�� g E�Ja r� ��t �-r��-
� p er� n�o �r q ■ 7 e w s �! � i w w e
� � �� a � , �r�ocK: ;� , �AA���o�1 � �� ia� v�r�
� LQT: �� LOT: k k. SETBACK$ °?aS � SIDEY�1tD: C° �� 1 I�
,. „ �
��.�,�� ��t� � � �+AV�t�, Certificates �f Su�cveY o� �,aX a�d �ropp��d
�mpi.�.�� �,�ati� d� �. #�� �extif�tc�tese
�
����I��PT��}�V OF �UII.i1ING
-� 'B� ii�� �a :
�`d,►e �� i��,�......�.,_,� 3�a o U�i�= �(�' �ig�t: 2� o
�n a e �.w•+
S��a�7c� �'�8��s � � �a cubi� �'�t3 /� 7ce0
��.Sn�. „', �rc��t �G3 � Dep�h; �G ` Hei.ghCt /i) °
$�us��t �'get; ° � Cubic ��ett 00
D� �i�Ati9�C�.�� a ��i �� a� ��'a8t�.8�j$i:@t� t°+08�2
�� !`i $ �� ��� f
�M! QM ���bnMY � 7 ri •� � % � � t°� P+d � �1
�
�_ .. ,. � , . � � '� ,� �` tl � „� /i b _ 6 ��� �•`"� e m y� �j '�
f�,,�t, � _ / � ��� <` C" ' -,�a
G
��c���d hereby �� a�l�.+ca�tiv� �or, $ pe�uLt far th� w��k bsrei�
�����.� agxea� fi� do al� �p� � stt�c� accosdance witY� the �,� o�
�,�1.�' #���� � �'�tt� aRf �he De�art�te� �f Bu��din��, �} $Ee7eeby
��a.�� � al.l � �acts � ��preseata.�i.o�s stated � t,1�i� �g�3i�cation
� � as�d carrec�„ .
�,�s; ��e e o Z.� /� 7Z SI�NA�: �
....��_ . � �_���, �.� ..,, , �, .�
<
�+��e t�:�tk►a �o� At1d�t���t7. Info�tiou.) �� � °� `'�' �'�' /� �7 ,�` � '
� • (�¢ a ,� r �� .
� �� � `� �
� � ,
�
,� y .. y — . .. k'.: : � _� .
^ � � J �.�� �j�' � 1� ��
BU�L�IN� P�RMIT F�� ��H�pU�E
�F��QN �, 'i'h� IAepecto� pf ���ldiags e�al�, bef�x� �asui�g permit� for �he
������on ot a�y bu�lding ar ��ructure, ox fox any addition to any e�ist�xi$
������ o� stx�Cture, o� fo� any altera�io� o� x�pair� �o any ex���ing
������ o� stxt�tc�uxe, upcm �ppl��ation the�ef�se, xequire the pa��� by ��s
�����g�t fp� �u�h pexp►it o� fees �o the a�tount herein below set �Ax�h ��d izi
��.� m�a�n�ar he�x�#�n p�c�vided � �c��wi � a
UNik'4R�'I $�tJ�LDTNG �0�1�t �.j'Pe X� 2� 4� -$2.15 far each otte fihausa�n.d cubic
�e��a �►� f7�action th�7ce4�, in c�u� cubical coa�ents. TYpe �& 5-$�.�85 fo�
�ac�► s�r�s �ho�aaad ��i�.c �sefi, ' .
' A�DiT�UI�A� IAiF13�TI0N
Fq� �ite pu�'�a1a�e of ��pu�it�� �ees for building pe�nite, the cubical contents
Qi� a�y building or addiCion, i$ detexmiaed by multiply�n� �he �xound area
gpv��d #9c�rtrt � poi�� �� (f�j in�es below �.he floor l.ine Q� the basement
�► �,� ���.j,a� �p �,�e average �ieights of the uppez surface or to the averag� �
�,�� �� �e �QC�f �ilx'�ace o£ Che u�.ia �ab�e pf a pi�ched xoof.
?� ��.� o� al��e���iot�sl' #�t att, existin� ��t�a#re, �iae f�e shall. be �� 'kh�
���� o� $���ti �eg' �t+� ��ge �µtrtc�xed dollax� ($�OU.f}f�) � f.�ctia� �heacsof �,an
t�e cwt�� p� a�.l px��aed wa��'�eR
��+ aat�e �s��l �� #+�s foac � pex�it as se� ��� � S��tiaz� 2 ba
� �a� ��.t�E1. '
w
V�������'iQ�1 �� �t��iNI}A�'I(3N
�i�� ���.ts ��x ��siC.�at�iau w�.��. be �.��ued a ��s�.uaua v� �4 i►c;urs ��am �hs
� a� �p�licat�c�,, �Q a�.�o� �ox Praper �ev�.ew a� the pxopos�ad a��ru�t�ar� a�d
�� �e �tst�uction �i�e�.
' � ����i� �u�� 4� �h� 1+��„ ��� t� �ocat#.� af rh� �ouud�.ti�, ��� ��t
#�� �s��a�A wii3, �a �e�q�ired before nroceediu� wi�i �i� �r�3�.
r.
C£R�'$���.�i� Q� (���P�.N�Y
��.i.�t�.ca�t fcs� � C�ac�i���tat�a �� ficcupaney shall bs m�ad� �e� +�3Q) �,Y� p�iox
�o �� ��e �x �c�upa�g o� �ay �icic�re �ar whi�h a bui.ld�.� pex�ai.� has b���
i�Bt�e�; ,� �$�.d st��t�x'� ��al� pot bs used' a� occup�ed u�t�l a�s�tificate
Qf t�+�up�cy h� b� �Sa�et�.
c ' _
HOUSE HEATING TEST RECORD
�, ADDRESS �` ' .�� �- � - APT. FLOOR =�° CITY S4kBURB
� OCCUPANT �� -�' � r"=� � �
` t ` � OWNER a`� : �
;' HEAT LOSS DATE HTG. INST.
I SOLD BY � �.: �� r' �� - GAS C0. METER BADGE # ti_
INSTALLED BY �' � ��' �
i Elechical Work By Gas Line By � E'�'�
� TYPE OF HEAT GA FA ��`� '
HW STEAM SPACE HTR. UNIT HTR. � OTMER
;' GAS DESIGN
,,.t CONVERSION
MAKE ��' "".' �.� a t 3-;:` ::-t: _ MAKE OF BURNER
Model ,� � ° ��i �`� t` ,,�yt
Model
' Serial Max. BTU Rating �A
s F�: s�,d'' t.
' INPUT �" � a MAKE OF FURNACE `
� � �,
Model
CONTROLS
THERMOSTAT �; t!g='' - Heat Plug Vent Size '�'
Valve �- x KIND OF LINER '�'�. SIZE �" NONE
Limit ^'r - °- ''" � `ti Draft Hood _ yRegularor ° � � _
Limit Settin ���''
I 9�, Fi Iters S�ze N�mber
Fan Setting ' ''"�` Chimney Loeation Inside �`a�'�y Outside "
I Pilot Type .� _' ..r-�` _ � ; � ,, �; = �
� Chimney Construetion k ' - -�>`�`` _
Pilot Make � �" �°�'
Pilot Model Smoke Bomb W����9 '` r
Pilot Timing � °r °'� �°_ '
Draft n�- fiest-Tag '�"
L.W, Cut Off Door Pressuro -"'Lighting Inst. '"�"`�
Pressure ' y"' Pereent CO2 w r� Date Tested �� x4 � F°'
Input CFH '� Pereent 0 � � �'
Company Testfng .
Staek Temp. r�r �' 2 -
Peree�T CO � Yy" Name,c+f=�'ester - �
.
Form 235 ' - -_"-
�
s
>
.
�
r
0
�
�
�
f
�
�.
�
�
m
�
0
e �
P
N �
� �
A �
N p
4 -,
�;
�
m
�
z
c�
� a�
a
�zi
n�
0
2 •
O
�C
1 �
�
�
r � �
� �
����
� � A �
�►���
�� a
�
��'
�
_
� �
M �
�
�
N
v
. .
��
00
�
�
M
n
�
a
n
w
m
�
�
�
�
..
O
�
C
bd
O
M
fi
�C
�a
,�s
�
�
_ . ,�� :
�
�
�
1+4:
�0
�
�'
� �
m
��
�a��
= W �q
°�° °� � ~ �c
s' � `� ��o
��� ��
�� ��
� �
� O .
. �
s
a °A � �
a �
� a � �
M N M �
N �
oy
r
a
I
�
x
�
N
N
�
0
N
�
0
o �
��
o �
�
� r
r
� �
l37 �
U7
iJ7 �
�
o� �
�0
�
� �
�
�
a
�
�d
a
�
�
0
0
0
r
�
�
<° �
M I
W�
�, w
� �
.x M
G �
,y O
� C
ti
A
�
�
E
� �
� y,
� �
� �
�
�r
��
�
O
C
�
N �
�°
8
�
� �
x �
�I
�O
�
�
$
�
!7
�°s
�
O
�
�
� � �� � � �
a a � � x
��o
o $ � � y
����y
jx x � p �
�
��?��
O � � p �
� � � �
�
� �
� �y
�
o y
� �
�
w ;a� o 0
g " g g
!tA tA Ni
� I
1
i
11
0
i
�
�
�
�
�
�
0
0
�
0
�
�I
�
�� �
� a
ti" R� � �r
�a»��
� o$ �
..
0 0 � � �
� � g �
�����
T � � �
m s
N �p ; �
� o : O
� . : �
. �
w c, o� m o
8 g g � g
M
�'r
O
0
0
� y � �
w,
� �, �
m � q �
� � i �
� M I CL
�, g �N �
� c, ^� � a f �
�
� � I I c�'h N
� O I h�'•
� O I ( tU
I r
w
I 1 ,
I ~
�
� ��
�
� � � �
� �
����
R� R' � �
��o�p��
Y � ~ F G
�n � ,� � a
�
����
m � . �
�p •p' .
G o . .
8 . .
w w a► o �
� $ 8 8 �
� I
� �
�
i , ��
I�
� i°.� �
�
���� �i
� �� � �
�• m M� � �
a o���
n � ��
, a �� g
I Rma�
� ��o�
�
� 5���
� �
� � ao�o�
N�'��
�q � b c � �
� � ... � w
N
� ��q�C
I-+ � � o
��
I p
� � �
1 � .�9, �
� � °, m
�� �
a�
r.
!�p M
�� �
� �
� �
� A tt'
» �g
�. � � �
�.
�
z
.
t�
.
D
�
r
�
T
H
_
T
C
�
�
�.
'�
,�
.
�
�
� �
�
�
��
�
N
�.:�
A�
�
�
�
w
�
�
CI
�
°.; ,
�.
f
� � � �.n...'�...�.�.�.....,,,�� � :- , ' �" n.
� � _ �` � 7�. � � �-1✓°�<%�a.r,�, '!` �s`.-�e4;�i .
: � ��� ; � � � ' i`r�,��. ✓
� " . ��..,,.�,�,.� _m.�..r,.ew.l :�p � �5"! �C y-,�`�,'
, .. , l�FJiTa �63 CAL�CUlA� -
'> Q�atlurqrip� G�i� Can�tNCtios No. losulu�n
�� Qrindow� Doon Refereu� Qut. a.n Iat. Qlap Geiling Roof Floor Kind How Applisd
` Yee— o Yea— 19_ ; �
� Fl. `a: .. Room l.ength `7 .� Width t�- Height�° O�d / Fl. Room Length /� Width/.Z... Height �--
Windorvs anid Doors—Crackage and Area Windawe aad Door�-Crackage �nd Ana
� WIOth He1tAt No. ot �- Lln�ai tt. . Ara� ' � 1tc ""\ � � -Wldih Hel<ht � No. o! ' Llneal [6 � � Ar�a
� .� N9. :ot o�ea � � o( oanr � � W�hU : oF ce�c� �p. tt. �" �y � Ne. ot panl � ot Rane //�hb of cract � �O. [t. ' .
: / i F' ,� � �,• � n u''` �--.. ;,,J � �- .�--- �
: �_ � � �
���
' ` Coef. Btu
. Coef. &n
; ' lnbletatioo . ';
Class � � Infiltration � �
� ,� �
a Glaaa ,� �, �-
Eap. wal! .�j ��/. - Fsp. wall .��2-' r� .
Net exp. wall -. � '7 '� ^ 3�" Nct ezp. waU .. � �s -- ,� r
Tnt. wall Iet. •rall .
� '"+�eiling � 1s, 6` � % � Ce��ing ., f._,,� S- �:°� ° G ' �� 4? ,':
'•. ���,or '
'_ Total Btu. Floor �
Total Beu. , � J `� ..,
Required sq. ft: E.D.R. or tq. ias. W.A. Leader area Required sq, ft. E.D.R. or aq. iaa. WA. Leader area /
Fl.� ' • . , Room � l.ength ,_.!�_ Width ,�a . Heighc � ��-- FI.I . :.,,� ("� Room I Leagth /�/ Wid /� _ eig t si `
Qliadowa and Doo�—Crackage aad Area Windowe an+d Doore--Cracl�age and Atea
w10tb lie1�A{ , Ne. o Inea lt. Are� VYldth ltel�ht No. ot Llnnl tt. Are�
No. of pane ot pan� Utqt� at crack p. ft. Ne, ot ptp! Ot D�p� I1sAt� ot er�ek p. tt.
9 � �' � �
�;
Coef. Btu . �
IrJltratioA �-�, In6ltration ,2 -��
Cl�e� �. ,�- �, ,
`� Glaas / �;'�
E�tp. wall ° � A � �
; E:p. wall,..?/ �
Net e:p, wal) � °° % ° °� �, � Net e=p. wall ;7 .,
' Iot. waA . � :
Int. wall
' Ceiling �� � ��"� t°a.: c�' Ceilin r'�' a
. , F'loor _ 6 -� . � ,f� - "
Floor : y
TOiB� ��W , .rf ° ' TOta� �tU. . ° �,;"
Required sq. ft. E.D.R. ot aq. im. W.A.1,eader ana �' Required aq. ft. ED.R. or sq. ids. �i.A. Leader area /
,:: F7. '- . Room Lengt6 ,� Width :, Height r:P � , Y
F1,�:�,�,,, � b��.�; . Room 1 Length a;1�-, Width�°.: Height� -�
Windawa aad Doors—Crackage aad Area Windowa and Doors—Gectcage and Area °"
Wtdth Hd�ht No. ot Lleqtlt. ,Are� WIdtA Hel�ht No. ol L qeal [t. Ate� � �I
Na o! pan• nt paee Il�ht� o[ crack �p. tt. Ne. et pane ot D�na Il�hu ot c ck '
,r� °' ' .�9 / _ �°'Re' � 'a
�:, �
^ �.�-- rq �:... 1� � j- � ��'�"
.. . .... . . � � � � ��r".' �r�K:�� 1�.• P. �',- . � °� ��yaj�. A
„3 "�, � , , / � _ y
Calf. BtU � COeE BM �
IafiltraEion ` i -g � 1n61tration � r� '
Gla�s ^ �
� . , � �K" \ilasa - �� . . . D' r➢ .• c � �s
F.�p. waU ' ,�_ �., Eup. wall � �� ° �z ,�� ,� •.; � ` �, ��
>:
Net e:p. waU :;-0" °-� � ' Net exp. wall "},�
-� lnt. wall . Int. wall ' �'�' ' � r° ,�
: Ceiling � � ''� Ceiling .',e
; kioar Floor � ! .' ^ : . ;
: Tot�l Btu, : ° , �.P Toea) Bea � `� v � ,�-0 �,
te"
": Requmd �q Et. E:D.R. br �q: ins: aiA: Lwdu a�e� �/ .; Reyuired iq. k. E.D.I�. ar �q.,iu� WA. �esder ��ra r
� Fl A,:;f� �, Room � i.ength �d �;- - W;dth � ? Height ,`°� ^r I .�„., , Fl. `j , � = F Room ( Length _ Width Height "J $ - ��
Windows .and Doors--Cracluga aad Area + Windowscand Doon—Crackage and Ares ' T
WMth HNtAt i�to. 04 L�nerl Rtr- Are� - - Wtd4A =tieftAt Nd o[ Llnul �t: Area' ��k
.� Nb. : ot p�n� ' b[ D�n� 1ltkb .- ot crack �p. II. ;� No. ot pan� ot D►ne U�hq ot cnak . p. (t. +?
B � ��' ,.,7 ' � ,,.
�
.. . . . . � °�a`c9 . r , .. � A : _ �.'_ �
_�
Intiltration
�_
��-� �
Btu
lnfi�t�
-._._..L
' h'
,y
Coef. Btn �
�
�.i A ,, �
WA�� e .�f. °% :" �ab! � '" � �
Fsp. wall s -6' � " ,,
� �sp. wsll � ' - ;�
Net e:p, waU °�� °°� / Net e:p. wall '�;� `�
�,`
lnl. wall Iat. wall � :
; Ceiling , r p � r... m Geiling r - �' 6. ' ��
Fioor �,
��oor r^- �,� � �
` Totd Bc�u. � °' l,�- Total Bcu. - .`�
` Reqnired.aq, tt. E.D.R. e► iq. im. Q/.A. Leader are� f Reqtuired eq. h. E.D:R. or �q. ins., WA. LRader are,� '�k
a ��.
��
F . ��y.
z�,v ' �, s � •� a r . -�� . f�
:+ K:e-� . .. . . .
m
� ' ;°,,:. ..,.:. _. . ,, '�... ° � � . '. ..-. �- � � � � . . - .. . �
` ';T � , �
��� � �. : , �.'-, ,,
�� �.� ,� - tt�a� t�s c.�uu.�►�s ; . _ , ; � .1
� v sr� . .- , L
�l �v �s'e'the�atrips A G� _ Cofutruetion No. . _ _ �a�ulstion
�l� A �a _
��,`WindoMia Doore Relersnec Out. Waq Iat. WaU Ceiling Roof Floor Kind . How Applied
k� : ea— c`. a-- 0 19_�. �
`�'' FI.� U,,.. �_ �N Room Length Width °° Hcight � Es,.�' Fl.� Room Length Width . H�ist+�
� ��, �
`�lindows and Doors-Craekage and Ana Windowa and Doors--Crackage and Area
'� ' � �YldtW HelsAt. � �No.�o! �.Wnetl tt. Are� � .. � - . �. VYIdtA Hei�At No. et Llnaal [t. Ares . � .
�'`.'.,' No: ot D�De� � e[ DLO! U�ht� ... ot.crack �a. t�. � . .� ��NO. ot D�na � o[ Osae IIBAt� - of c��Ct W. �t• ,. .
5 . . � .. � . . . . '
, r:' � _.. . ' . .. ' - . - . .
Caef. Bcu _ Coef. Btu
` ' inbltration . In6ltratioa
, ' Glaas �� ��, .`�.,� Glaaa •,
F�cp. wall -, �.;��vs.......o Esp. wall
", Net exp. wall "�0 Net acp. wal) � '
Int. wall � ��- D. Int. • �all
; : Ceilin8 _ Cetling - .
Fl�or �. � U • Floor (
Total Beu; � Toeai Beu.
Required sq. ft. E.D.R. or sq: iaa. W.A. Lnader area / Required sq. ft. E.D.R. or aq. ine. WA. Leader area
�"� t'!,) --`�,�,,�-> ,, ,. A Room ( l.eae�h '� Widch �.� Hei�hr-° ° Ft.1 Room ( L.ength Width e' t
Windows and Doan--�Crackage and Area Windows .and Doors--Cracicage and Ares
Wldth H�I�At . No. ot Llneal ft. Aroa WIdtA Hel�ht No. ot Llneal tt. Aroa
No. ot vane ot p�n� !l/bl� o! crack �p. tt. No. ot pane ot pane Il/bb o! cr�ck W. tt.
�.� � ,
°' � !:
Coef. Btu f. tn
lafiltratioa ' < In6ltration ,
Glsa� � �� , Glaaa
' .. F�ep. wall T � �,,:e.�; _. � . � Exp. wall -
> . Net e:p. wall �' �7 % .3 � Net e:p. wall .
Int. wall �', � �.<; ,�. f. lat. wall
!� (i �-C •
Ceilins � Ceiling
,^� : I�loor �° U � Floor
Total Btn. ` Total Btu.
Required sq. ft. E.D.R. or sq. iue. WA. L.eader area Required nq. ft: E.D.R, or sq. ine.1�.A. Leader eres
Fl" ^ Room Leaeth :. Width ,�... Height .� Fl.� Room � Leagth Width Height
Wiadowe aad Doon--Cracltage aad Area Windows aad [�on---Crachage aad Area
WIdtA Hd�Dt No. of Llne�l tt. Area � Wtdth Hel�ht No. ot inql tt. Are�
Np. of pan• o! Daae 11�6t� ot crack �q• tt. No. ot p�ne ot paae Il�bt� ot chek p. tt ��!
� . 's:
5f.� ' . . .. .. . . . . ..
Coef. $tu Coef. Btn . �
. ; Inbttraiion ..n" �o� �-� _. In6ltration
Glats ° �` Glasa
E:p. wall � .�a .,..,_; � ° Esp. wall
w
, °"a'
t e: . sl
. N I� Net e: . waU - ..
e
P P
.
.
37
, - ,
,
� � int. wall . ": ia. � � � � : ;r„ Q Iot. wall �
Ceiling Ceiling
Floor s�� 6°-' C�'�i Floor
,:' Total Btu. ' e�, `'� Total Btu.
i�: Required �q. ft. ED.R. or tq. im.. W.A. Leadsr are� ./ Required ay. ft. E.D.R. or sq._in�. W.A. l.eader area
Fl. Room � Length Width Height �. F7.� Room I L.ength ^� Width Height
i Windows and Doon—Crackage aad Area _ , Windowa a� Doon—Crac�age and Area _ _ _
�Vldth RH�et No. oi_ Llnaattt.- Aro1 WidtA el�ht No. ot Llneal t4 Are�
i�to. ' ot pane o[ Pan� U�61� ot cnck W. tt. �' No. ot pane ': of paas U�hq at cr�ek tp. R.
I.
i
� :. . � �
•�
Coef. Btu , Coef. Btn
Ir�5ltratioa In6ltration
Glaa Glaes
Eup. wal) . E�cp. waQ .
Net esp. w��l Net exp. wall
� Int. wall Int. wall
Ceil'rng Ceiling.
; : !'loor . Floor r':
;: T.ots) Btu: Tota! Beu. ' �
; Required �q. ft. E.D.R. or �q. ae. W.A. Leader ares Required �q: ft. E.D.R. or sp. ina, W.A. Laidet �re�
,
,- � �� �� � -
, . .
�
.. , ,��
n�
., ,
, , .
,. . . _ ,.. , , . .: _ ;w:.
�F f .. ., . , , , .. k .
��a.. r._,.. �. __ ._ ,,. . ... .. . a., ...T,.A:.� � . ,.. . . . .,. t. . . _
.
�
53-8li-s-915.51
i6��EGT
' City o�f F�idley
�� ��y
�; -
rL-------; COMMIJNITY OEVEL0I�NENT OIV, �LUMB I iVr, PER�1 I T APPL I CAT I���J
�t � MO'TECYIVR r1fI�CT10N OpT.
i �--- � Cmr ►N►t.� s�uD��r �MR
..�.��� t.J N3'i�0'3N0 M�1Sl11 Ii�V. pATE ►i►iE 11 OY
- 0 2 15 3 1 1 800
� Address
6151 N. F. Benjamin S�reet
ier Ad ress one
Richard Miller Homes 786-1600
Contractor
Kind of Buildin
Comp etion Date
�
V I
H j ( I
-,�
� , ,
W �
3 � I � � �
B�fl
� ado
•:�.�
'781N
I
i •saa�
�'MNltldl
m
,, sNiare
! � H�11/�
1 x
�O � sNwaa
'3 o aoo�dl
a
�Q V I saaMOHgI
iz�
O q •tNnod
;�,tl HNIaaI
P�
IA � 9AY!►ll
IM9YM
I 9]INISI
sNisva
��
ANINNEGASCQ
Frame
2-22-74
--;:
i
— �
I �
� G
i_ �
i I
� � � �• �
.,
� ����
� � �� �����
L�
W
.�
if i
�
i�+�
�
�
�
�
I1
i�
I
�'
�i
�
�
I
�:
'
aaress p�
�3� AAAftQUETTE AV�N�l�
s e �,MPLS.o MI N iV.
��es .
stimate ost
10.00 ,
Plumbing Fixture Ratest N0. RATE TOTAL
Number Fix tures x $2.00 ��
Future Fixtures x $1.50
New �ixture-Old Open. � x $1.50
Catch Bgsin x $3.25
Water Heater-99,000 BTU x $3.00
Ground Run Old Bldg. x$3.25
E1ec. Water Heater x $2.00
Gas Fitting Fees:
lst 3 k'ixtures x $2.00
Additional F�tures x $ .75
Gas Range-199,000 BT[J 1 x$5.00 5.00
Repeirs & Alterations
See
Description: Code
State Surchar�e .50
i Class ��A'� �urcharge .50�
I TOTAZ FEE $ 5.50
�
!The undersigned hereby makea application for a permit
for the work herein apecified� a$reeing to do all work
i�n strict accordance wi.th the City Qrdinances and rulin
of the Depaxtment of Bui�.dinge, and hereby declare that
a1l�the tacts and repreeentationa atated in thia
application are true and carrect.
��� � �
� "3 a uw� � � °� Date
i�
A�FIARD MILLHR INC.
�IMAGINEERS
III �
7
June 20, 1973 . �
Fridley City Council � � •
City of Fridley . �
6431 University Avenue N.E. � .
Frtdley, Minnesota .�
Gentlemen: . � :
I would like to request a 90 day extension on 17 building permits for the
following addresses. These houses are all located in Briardale Subdivision.
1616 Rice Creek �oad 1650 Briardale Road
° 1620 Rice Creek Road 6151 6enjamin S�reet
1605 Woodside Court 6141 Benjamin Street
6 9 Woodside Court 6131 BenJ amin Street
6�9 Woodside Court 1601 61st Avenue N.E.
1603 Brlardale Road 1611 61st Avenue N.E.
1613�Briardale Road 1621 61st Avenue N.E.
, 1623 Briar.dale Road ���� ��s� Avenue N:E:
Iam requesting this extension as tf�ere was a lengthly delay in originally
processing these permits and at the time I felt this would not create a
problem. However, there is now a�hortage of ready mix concrete and concret�
bloc(cs and many of the builders have been put on certain rations of these
materials. Therefore, it appears that an extension will be necessary.
I hope that you have had an opportunity to drive through Briardale. I am
personally very proud Qf the houses we have built here and I hope that you
feel they are a credit to the community. .
Thank you for your consideration. � �
�� . . � .
• Sin�j�ery,
hard N. Miller
:cs �
� , � � �, _
, �
786-1600
1600 RICE CREEK ROAD, MINNEAPOLIS, MINNESOTA 55432, ARFA CODE 612-�.8.8�f�4
SUBJECT
City of Fridley � 12�2
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
r {
; � CEIPT NO.
� • COMMUNITY DEVELOPMENT DIV. �
� ►.y__-���-�
r � � PROTECTIVE INSPECTION SEC.
1 i �
� � /"�1 � CITY HALL FRIDLEV 55432 NUMBER REV. DATE PAGE OF APPROVED BY
�.---� � •`� s�2-5so-�o 910-F15 / /
9 25 74
JOB ADDRESS 6151 Benjamin Street N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. ZO 3 Briaxda.le Addition SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Lawrence Esterberg 6151 Benjami.n Street N.E.
3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ X ALTERATION 0 REPAIR � MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a fireplace
9 CHANGEOFUSEFROM TO
STIPULATIONS
SEP
ERATE PEf�MITS REQ�iRED . Ft�R t�f�lNt�,
1=iEA.T41�1(a, PLU�I1k311V� �NI� S9Giy�.
SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING. B?:1C�L
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT R]_
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTFEET 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 W ETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT yfiGOOeOO .SO
DOES PRESUME TO G VE AUTHOHITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
ROVI I S OF ANY O OR OCAL LAW REGULATING CON-
RU T N OR THE P F R AN OF ONSTRUCTION. � �`G.00
PLAN CHECK FEE TOTAL FEE *�
� ! - � $6.50
SIGNATUR£OFCON nC7o oRaUTHORIZEDn E T IDATE) , 1/yHEN PROPERLY V LIDAT D THIS LS YOUR PERMIT
� ���°L"�ti1,L.� i�'� � � �-
SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI BLDG INSP DATE
APpLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITiON BUILDING PERMIT
CITY OF FRIDLEY, MTNNESOTA
ow�x� s �ar� : �U�1��(vC��� . ��,�gUILDER: �El�
annx�ss : C�1 �l �`,��'t � �i a` �. �j, �.. �nn�ss : �,� �
NO : . fO B � ( STREET � �� S A-1'°� � � � , l� � •
LOT: �� BLOCK: � ADDITION: ��I��A�-�-
CORNER LOT: INSIDE LOT: �C SETBACR: SIDEYARD:
Applicant attach to this form Two Certificates of Survey of Lot aad proposed
building location drawn on these Certificates.
HESCRIPTION OF BUILDING
To Be IIsed As.:
�f��PC���- Front:� Depth- Height:
Squaxe Feet: Cubic Feet:
Front: Depth; He3ght:
� Square Eeet; Cubic Feet: •
, Tyge of Construction: �stimated Cost; $ �j�� � �
To Be Completed: 6 �C�• •
The undersigned hereby ma.kes applicati�on fox a permit for the work herein
sgecified, agraeing to do all work in stiict accordance with the City of
Fridley Ordinances and rulings af the Department of Buildings, and hereby
declares that all iche facts and representatiqt�¢ stated in this-app�ication
are true and correct. // /1 �
DATE : ( ' 2 � ` �'�{.� S IGNAT[TRE
�, (See Reverse Side For Additional Information.)
��
�� , � �'"r �' {; � - � � E
� � ' � � k � � , ;�� � .
-_� _ � 1 . �
�
✓
BUILDING PERMIT FEE SCHEDULE
SECTION 2. The Inspector of Buildings shall, before issuing permits for the
erection of any building or structure, or�for any addition to any existing
building or structure, or for any alteration or.repairs to any existing
buildi.ng or structure, upon application therefore, require the payment bp the
applicant for such germ3.t ot fees to the amount herein below set forth and in
the manner herein provided to-wit:
UNIFORM BUILDING CODE: Type 1, 2& 4-$2.15 for each one thousan.d cubic
feet, or fraction thereof, in such cubical contentse Type 3& 5-$1.85 for
each one thousand cubic feet.
ADDITIONAL INFORMATION
For the gurpose af computing fees for building permits, the nubical contents
of atiq building or addition, is determined by multiplying the ground area
covered from a point six (6) inches below the floor line of the basement
or the cellar to the average heights of the upper surface or to the average �
�height of the roof surface of the main gable of a pitched roof.
For repairs or alterations to an �cisting structure, the fea shall be at the
rate of $3.00 per each five hundred dollass ($500.00) or fra�tion thereof in
the cost of all proposed work.
Tn no case shall the fee charged for any permit as set forth in Section 2 be
less than $5.00.
VERIFICATION OF FOUNDATION
NOTE: Permits for construction will be issued 8 mirinnim of 24 Hours from the
time of application, to a11ow for proper review of the proposed stxucture and
of the construction site. .
A Certified Survey of the lot, showing the lvcation of the foundation, once it
bas been constructed, will be required before proceeding wi�h the framing.
CERTIFICATE OF OCCUPANCY
Apglication for a Certificate of Occupancy shall be made ten (10) days prior
to the use or occupancy of any structure for which a buildi.ng permit has been
issued; and said structure shall not be used or occup3ed until a Certificate
of Occupancy has been issued. .
0
�_W:—.r.
-� 1 aF z
�
�
Q�A�.� � 1" =1' i � - i
, � . 7.�4! yA��E.. C�' RQbL=
�— (2°--�
� ��-- ---��
; �� - ,�
�I
� ,_
' 'I
�
�. __._—____.-----.________.. . ___ _ __. ... _.
I _M��_—._.. _^_. _�.
� I
� I
I �
I
� I
� I
� �� .
� i � .•—�--- --_�
i �
+. _.. _. fi ��Zv
� f
� � I
' �'�.�E '
� I 2 ,�
i
i i
i �
��� � .
13�OGK i - --_
I I
i . ,
. . ., ... . .�.�:d
. . , ;
. \
��" �PALE
AfLo�rJ b j
ENT1 t�.�-
Uti1lT � -
� GLA�� WU6L� .
i
�Ar�A�.caa�;� � z�lco�tc3�lst'���.
a o b. n �' o °• o �-..� � ao , e. ..`.. °-: 4 � / �d �� ,
V A v•0. �. O. . 6:a . U ir N ..0 B. �. l
� D <. �' 4i�Aa, a ae,t. 6� a?6
A r
�nb00. L p`4}�pl>n�p44��'[� d4 . �.�J!' �
' r t I
P����\C� �
� �7i2���� i I$'
gia� �e. o , " - o " � ' • �
.. - •E''.- ..�'� `..Co..v'
. �a : � �; t � . �'° ��l/
< ^ e � . � ° • . ° E'/��-c-'1��I�r3T'
. �.A; ♦ . 86.4,�
' I� �; �A�H DuMP � ° ' �� a .� a• ���' FLOOT�t
._1'1 � � m b • a.a �
n. p• y . b' ` p• • 4� ri• � p,• a . G, P O . n L P. ci c
, , . _. .. :o , a. • tr 4 .
'e Q�: Q'P. .bp� n p p!'� •c -°'° c. L
. . ' C . p O ' 6 ' L > 6' p , a d ' � �
- . • . . . —..._. _."_.... _ .. . _ . . . . �.
n : °. , d n a
..' e. • 6 •a:. o 0 0 � .
� �. n � e .
. � e ' 6 p � p �. .
. . b
n a D
, e °� A� e �•e .
e•
• e '. o . . ' e 'a
D�1�WrJ B`l FIF:�-P�ACE.
LAWRE.NCE. Z,'E�TERBE.k'.� 6� 51 �EN�'�\t'�!*J �T hJ.G.
-1 —2� —� F�IDL.t='Y
�----- .
�
Z
ul � �.. �
���
.� Q
�-ti-
���
►.L
� -
.�
���.
�
[�I
Q
�
��
�
(._
U��"J
U!-
W
Lt3
W
�
�W
�H
�
3�
�W
�
d
�
0
�.,�.i;::�; ,<,�. .._ ��.. k.».�_ - � � :
. . ..*-..a .. <k�� �+:w� .b..�z-z3:i#.�;�.�'dF'-t���.J'vYiti�iE.r9,n:4ai��.� � �e`�s'�t9��-sxi.��� 3-�;it�§`.�`�.'t`:�! `�''�.v�°-�i4'�`'' .�. a, .«±n . .
SUBJECT
City of Fridley ° 14880 '
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
r
� �
' ` RECEIPT NO.
� �,L _ COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC. p 9���
1 S , L O�
�' /"��1 � CITY HALL FRIDLEV 55432 NUMBER REV. DATE PAGE OF APPROVED BY
""� � ,�� 612-560-3450
910-F15 8/28/78 � �
JOB ADDRESS 6151 Benjami.n S��'t iQ.1'!�.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 20 3 Briardale A.CZC37.'t7.021 SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
L. J. Esterberg 6151 Henjmmi,n Street N.E.
3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADORESS ZIP PHONE LICENSENO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW � ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a porch
9 CHANGE OF USE FROM TO
STIPULATIONS
Provide �xost �ooti�ngs
SEPE��TE PERMiTS REQUIRED FOR VVIRIidG,
NEAi1N�, P��1MgING ANp SIGNS.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTEfi 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 ], QQQ . JrO
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. 7. JrO
PLAN CHECK FEE TOTAL FEE
�8.��
S�iN ' UREOFCONTRA Toa Ra �t�B- Etu7 �D TE� WHEN PR PERLY VALIDATED THIS IS YOUR PERMIT
' 2 �'1 c�.,��J � � �
S ATURE OF OWNER UF NER BUILOERI ( ATEI - BLDG INSP DATE
. .
0
�
cz�rY or- r-iz�»�cY .
' /�P('L1Cl1TIOi1 rOR f�[:SII)I=NTI/�L LU1LD1rJG PE(Zf'iITS .
' (�VL'-W� �LTLR/1T10fJSs �iDDITI�IJS, Of7 REPAII7S)
Otti'td�R/ � • � - �° � L ��-� � . I3UILll�It: '� ,
Addzess: �/,�% .��ed' �� Address:
No.: �1��
LoT: � r,
C0121�1ER LrJT:
Tel . IQo . : �
Street: ���.c.J %� .
sr,ocr.; � �nDxTZOr� : �i �, A� �°� �
I2�STDE IAT: SLTBACY.: SZD�YRRDS:
Applir.a'r��. attach to L-his fozm �ao Certificates of Survey of Lot and proposed
bui.�.dinq location dra4m ort these Certiticates. •
:
DESCRIATI�i�d OF Bt1ILDI(�G
2o Be Used �s:
�,�� Front: Deptl�: ' ' fIeighfi::
Square Feet: Cubic Feet:
0
Fxontz � llepth: � Neiqht: '
' �quare F`ee�: . � Cubic Feet: �
Type of Construction: ��� '�� Esi:imated Cost: $�
7:b Be Completed: _ _ ��� � Alt. A Alt. B
Prdposed Driveway ��Jid�h If tJew Opening Ts Desired $ $ '
(SP� R�VERSE SIDE OF SKEET)
The undersigned hereY�y makes application for a pezmit for the w�ork herein
spec.ified, agreeing to do a11 t.Tork in strict accardance with �he City of
Fxi.dley Ordinances and rulings of the Devar�ment oi' Buildings, and 2zereby
declares tha� all �he fac�s and represei .tians sta in t', applicat�ion
are true and correct. See xever�e sid f r ac3dit9. in ii orm ti .
DATE,;X � � SZGI�ATU�: `
Stiyulations:
�. � _
U
� �
� � ���`�� _ ��;�
�
� �
/�sf�".��` � `�B �-�
A
_ ��
-� ��
BUILDI(JG PERt�IIT FEt SCHEDULE
5ECTION 2. The Inspector bf Buildings shall,•before issui.ng permits for the erection
of any building or structure, or for any addition to any exisi:ing building or structure,
or for any alteratic�n or. repairs to any existing building or szructure, upon a�plic�tion
therefore, require the payment by the applicant for such peL-mit of fees to the amount
herein below set forth and in the manner herein provided to-wit:
NEW CONSTRUCTION: Single Family Homes and Garages: $4.00/1,000 cubic feet.
PLAN CHECK: 25 percent of building permit fee.
DRIVEWAY DEPRESSION: (Concrete Curb Streets Only)
Alternate A: Removal and replacement of concrete curb and
gutter only; Driveway width plus 6 feet x$14.50
Alternate B: Removal and replacement of concrete curb and �
gutter and install a 3 foot wide approach with
6 inch depth; Driveway width plus 6 feet x$17.20
� I1 � : . l �' . �
For the purpose of computing fees for building permi�s, the cubical contents of any
building or addition, is determined by multiplying the ground area covered from a,
point six (6) inches below the floor line of the basement or th� cellar to the
ave�age heights of the upper surface 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 g.ier 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 $7.50 plus $.50 state surcharge.
' : � � � 1�� �l
NOTE: 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 1ot, showing the lacation of the foundation once it
has been constructed will be required before proceedi.ng with the framing.
«:� ' � � ' f ►
Application for a Certificate of Occupancy shall be made ten (la) days prior to the
use or occupancy of any structure for which a.bui.lding permit has been issued; and
said structure shall not be used or occupied until a Certificate of Occupancy has
been issued.
,
,
OnW
-�
czi�m��
—i cn � c�
��z-�
C W -,I r
���� I
� ����
� �
� � (�� �
� 1� O/
n
�
r
�
�
��
0
;;
,�� . � �,;
- .,- , t�, ',_� �
! : ; , � , , ' � �
; :-- - - ' ' I i ,� �
�_ , � _. ; : �
..;,• _ _ .� ____�_.,__,_� -_ _, � l � J
`� ,I' ;I� � II �
; IL - ' I I� 1
� �� � - -1� _ ;�� �- - ;;� :
' - -----' � � I ,,
j ;.�
' -_..- - _ � , I i,�_ =--_=,' �
� .i � � . � —�
i �; �I ; �h
,, ,4 � --- _a�
' --- --- ; �
� ��, __:_ -.�, � ; ----_�- I
;_� _ _
:_{��__���{ I ��=_-_-1 .
� : . � _ --�--T- _._�. _ -- - -,-, -�-,-- �
f - - � � _.. F.� , I. _. `�
� ; i
t-- - . _ _ i , , � :
�_ . _ _: _ ._ _
_.....----' _ --_ -�_- � � 1
� i._.� . �__ � i� [-! i
' — --- '
u �__� � c-a; i
--_ --_ __ �
-' _ (
��:���=_-_a �,
i � C-` i----! L_' � � ; '
���----= � ' _, ,
�
�' �.___._..
'
�;
I____I � � �.��
; ���
��.�I` I �u
r--.
1._J I�_! � � �?
— i
L—I �_ _� � � �
���1 -j i ` r �,`
I.�.� � _� �1�:
�----1 r--'
;C_i i� ! � L_.f ��
�i�11� �; _-�,;�
;�
L , --� —_ �'
I � '
--��i _- �----, :
�--� ___T-.__ _ __ ;
� �-1 r; ; , T-; �- �-�- f�� ;
I
,i
_��. �_�
--- ;� I
' _�j
�i!
�
� i
I
n
�� 6 �
�
� �, -
� .
�
: �
� i ..
��
�
�
,,
�
,
`., �
�
. , �s .
�
�� �
:. -,.
. .
� �
J ��
� ��
�� � �
S ,�
�
� �
� �
�� 3 � �
� �
0
�\
,
.,
�
,
E
0
;
� R..
,� �
. s .
i i
• , n,� .
. °v•
� . . .
�i
��� ' ,, �� �.
� ? �� N, N; ^ X Z.
� �
f �x Jn -I
6_ �', ('�"
!� N o � '�
� O
n � 0
C� �
�
�
�
.�
1R � -.
e_ -
sus�ecr PE NO.
City of Fridley - 7 6 6 3
AT THE TOP OF THE TWINS B U I L D I N G P E R M I T
i �
' � ECEIPT NO
� ' COMMUNITY DEVELOPMENT DIV.
� ; ,: ----- 0 9
r � � PROTECTIVE INSPECTION SEC.
� i �
�___-� ������,,� CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY
612-571-3450 910-F15 8j16/84 � �
JOB ADDRESS 6151 �nj amnin .S'�S�'t N. E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 2O. 3 Bri,ardale SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Larry Esterberg 6151 Benjamin Stxeet N.E. 571-4483
3 CONTRACTOR MAILADDRESS 21P PHONE LICENSENO.
Florian M. Kauth (Concrete Only) 4747 5th Street N.E., Gbl. Hgts. 572-8558
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
8 USE OF BUILDING
RES].CZP.Il't].d.l.
7 CLASS OF WORK
❑ NEW X ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 OESCRIBE WORK
Construct an 18' x 16' Addition to Dwelling
9 CHANGE QF USE FROM TO
STIPULATIONS �
��.P�RATE PERMiT5 f��c�UIKEn �0� Wr�IN(;,
VVARi����� �-R�AT�r��o Pl.fl�nP�rvr a►vr� �i�r��
Before digging call local utilities
TELEPHONE - EtECTRIC - GAS Etc.
REC�UtRED BY LAW
�
,,$
SEPAR�TE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR'AIF CONDITIONING. TA�OCI FidmO
THIS PERMIT BECOMES NULL AND VOID IF WORK OH CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONEO FOR A PERIOD OF 120 DAYS AT
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 $�1900 yS4.9rJ
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. �M8O.SQ None
PLAN CHECKFEE TOTALFEE
$20.13 $105.58
SIGNATUREOFCONTRACTORORAUTHORIZEDAGENT �DaTE� WHEN PROPERLY LIDATED THIS IS YOUR PERMIT
� ��t�.��� � r(6 �'� i� �
SIGNATURE OF OWNER �IF OWNER BUILDERI 10ATEI BLDG INSP f)q7
IY_. eo . �+
NEiaT [ J
ADDN. b�]
�,T�t. I ]
Construction Address
City of Fridley
�R-1 AAD R-2 .
Building Permit Application
.
� 3.�JV1 � �Ai�/VWV 1 � •_ � � �
•
.
Effective u/1/84
Legal Deacription:
.-�
Owner Name & Address : n � Tel . # �'�` �3
Contractor: r. � a
� • ��, C�1/l ' �#- � � Tel . # Z '��
Address: � '� ��! . • �' `"
Attach to this application, a Certificate of Survey of the
, lot� With the proposed construction draWn on it to seale.
DESCRIPTIOA OF IIsPROYEMENT
LI11ZI�1G AREA: Length Midth Height Sq. Ft.
GARAQE AREA: Length Width Height Sq. Ft.
DECS AREA: Length � iiidth t� Hgt/Groun���'ag� Sq. Ft. ,_ Z �
� � o
OTHER: � r'� � � .. A �' �, °�;� �` .F � `�' =��.
����.,e_ �—, � �`` � � �l l' �-� a
���F' �'�� � �����e� �� �� ��-/�^�. '?�
Corner Lot [] Inside Lot �jC,1 Ft. Yd. Setback Side Yard Setback
Type of Construction: ���r Estimated Cost: � a�r
Approx. Completion Date: �" dv • �� �a�`� � �� �� �
Alt. A Alt B
proposed Driveway Width If New Opening Is Desired: � a
See Back Page for Explanation
�
DATE: � �b �
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
SBwer Main Charge
iOTAL
STIPULATIONS:
APPLICANT: Tel . # �'�' -` ► '" °
CITY DSE ONLY
�� ��� �� Fee Schedule on Reverse Side
�� ���'. �°��- 25¢ of Building Permit Fee
� ���' � a� � �.50/�1, 000 Valuation
� °__' �425 Per SAC Uait '
� Fee Determined by Engineering
� �
� � � �1�� Agreement Necessary [ ] Not Necessary [ ]
��
, e� �
BIIII.DIAG PBRHIT FEE SC�DIILE
The Chief Building Official shall, before issuiag permits for the ereetion of any
building or structure, or Por any additioa to any existing building or structure� or
for aay alteration or repair to any existing building or structure, upoa applicatio n
therefore, require the payment by the applieaat for such permit of fees to the amount
herein beloi+r set Porth and in the manner herein provided to-Wit:
?otal Yaluation
=1.00 to �500.00
�501.00 to a2,000.00
�2,001.00 to a25,000.00
�25,001.00 to �50,000.00
�50�001.00 to �100,000.00
�100�001.00 and up
Fees '
S
�10.00 (l+linimum Fee is �15.00) •
�10.00 for the Pirst �500 plus �1.50 for each
additional �100 or fraetion thereof, to and including
$2,000.
�32•50 for the first �2,000 plus �6.00 for each
additional �1�000 or fraction thereof, to and
including �25�000.
�170.50 for the first �25, OQO plus $�1.50 for each
additional a1,000 or fraction thereof, to and
ineluding �50,000.
�283.00 for the first a50,000 plus �3.00 for each
additional �1,000 or fraction thereof� to and
including �100,000.
�u33.00 for the first �100,000 plus �2.50 for each
additional �1,000 or Praetion thereof.
DRIYEi1AY DEPRBSSION ESCRW
(Concrete Curb Streets Only)
Alternate "A":' Removal and replacement of curb and gutter only - DriveKay width plus
6 feet times 813.50
Alternate "B": Removal and replacement of eurb and gutter and install a 3 foot wide
approach vith 6 inch depth - Driveway Width plus 6 feet times �15.75
VSRIFICATION OF FOIIADATION
Permits Por construction Will be issued a minimum of 24 hours from the time of
application to allox 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 been eonstructed �ill be required before proceeding With the Praming.
�.�'�� ,
� � ���
`� � �a � � �.,�� . � <
� � � ���
��i��
,x5 . .i"�` '..'.�� '.�.�Y . .,��� � � � � � ��� -
'��? °`� `', s f'� � �'x i!�4 '4.�5u
y' " � " .
t 2:'t, ^� :':' *�.' - a---•- -• c- ,
� �o�a �a�p��.�
losd :er��y"N
� fo�4 lpterY
Ci� i 1 [w'iw��r ►w�
M�a�hi'�i EafiFnN�lpa
Mortgage
(��S(
`��
V�
�
�
Q
"'7
z
W
m
d/��I� �(�'fI11 , a�s M�.,.ay �. �s M.�.
� � � Mlww�op�lf��
� %����������1��� P %%i�� M�wn. 35177
T�leOhsw• 1/a -�00•
Eaginesrg fs Surveyors •�M �� ���
Loan Burvey tor KiCN.4k�e ���,p ��yt S
I �
- 1�003
•.� .�
� ii� ►F Q a
z � �_� �
: � ''� (
p � � r,. . r, � � ,
��'
� �' � � : � O
� S r- � �
�o.�� � , -, r
,� ,_, �
� R A7 � �
� a � ,�-,� `� � F�� I
- 3�.4� - 24 0� �� � S
� ��Q03
� �
L 4T 20 gLOCK � �RI�RDA��
-.— r�� o�,� � �,���� r-��
�no� o ���y
�Ris n�•r� ��e,�i� ������ei� �{ ���v�r �I tMe b�vw�•iea M the 1�nd abo�e desc.�b�� �wd d M..
�a�� N ofl �il�in�s� �f �wr� ftiapw� ��H wsi►b M��pocAnt�w�� i/ anp� /r��w o� ow so�d Innd Tl�u aww�r M
�° �Y � nw�����ew Mit4 e wr�►�ya�� lew M�, M;w� plos�d �n N�e Prt����� �� � liebili�� i� oasu�wad
•acp� q�1►� hetd�. d arsA u�rOep �r �y �H,u �wM��t es vin� � tM nefew d aeab
w�d�►ssood � o�n�1 na w�wv�wrwh 1►��� bHn'I�c�� h► et�+p�'�si �f �smbli��i �O�~O�° �1 �s
tKMn- ON�/ tAis_��ir� o� '� ♦ O �Y �9 wr liwes �s b��wdo►�
�
�, � SUSUR�AN iNGINEERING, 1t�i�,
„� S ��: � 11'K [e1iw��''` + i�r�• •
""_ M.1G__G �Lcc .�t���.
-- � -
0
L�
,
�
� o .•�.�_i.ar.c..:.�L�a.am♦a�• .•����aa�'raa�as��isira���`ri��is�d�ss..fr.r.... .
, } . . . , . . .
i
�..
���
�.1
��1
- - � 1�1� �1t�1�D COMNt�N't' �iE��-r'
'� 3��,� ��4`�
.�
_ ► e`Z � ' r :��� _ _ d"
i ,' ��� �
_� i ' �� yF �:. � � � g.� �,, ,
i � M �,� :„,�� ,-m �s��
��s�� :.
,��; �+�E,;�
i , i ��"� �. .. - �� .
I A,'s.'d x � ,a.: A3:
i '�'�h �f :'�"',..
. . � -�'.� '(�+
I � =_v z
`- �, .. � Y .
, , _ .P_
-- - �
� �; 1I � � .�,.
� t
— -----
I!
�.i
---- -- -7
+�-�.— - ,
�, i
� ,��"�' �,_t
, -- - __—
-�- ----��*
- — ..,-----_
��
- — --�-:
�
'i
---•----r
� i� -:'
---- i
f
— �.:�
„
i
'i
�
1 .�'
. �;
���
n
�
�
e � = o
�
c! �
C! �x�
o�e � Qa
�, g �
r� �
� M
,. +' �
� 1
•7'0 „�� nnis t�z
—y
�
µ: pSWu
�a
tS�y � �
OC '
� (
�;
oi 4
�1 r=
1 A�
J �
� �
� k
�:�
Y
;°�`�`�,� . ;
` _��� 4
- o0 0
,� o i
ao :t
-- - ------- `
�
�� :
���-�;
�� ,e
0
:m
�
x
O
:o ��
� ' �
G �' �I `,'
0. I
u i
u (:;�i
;,,;i
w ��!
� ! '
ij
, i
I
�'
C-�
.: F �,
., �c ��', �..
�
I
i
m
�9
�
�' ,
2 a� 0
r r _
� P ��� �
� d�Z �
� ��S -
027
��� J
��� � i
�
�o
a
I
�� I
,� -
%_ �
`� -
�
i �
l:� i ��. N
Z
5 �ai
� �,
m
�,
i � �
`.s i j -
9 I, � �
x ��
i
' � � ,n
T i��
`+ y a ?
o , �
�N I
�p M
�•
9
� �
�
3!:�d
° ' ' s
Z �
x s:
3 � "o, �g
� M r.
W ! �. n
� I n I
0
� lax
GC�MEniT yJ�r.iDoW �SEMENT W�`�wvJ �
- -- ---- .. -I -- _ . ��
_ O O
kuR• 3'-s4y" ,c s�4/�c' Ro . 3'-3`'1�"' Y 5'-�'4i6 �
� 2' 2v�0'S $'' 8N16" �R . Z'ZrJ4�5 5' Q?4/ib��
�
i o
iv
:
0
�
SUBJECT
City of Fridley 21 O 9 9
AT THE TOP OF THE TWINS g � I L D I N G P E R M I T
r
; � R
� `L �_�___ COMMUNI7Y DEVELOPMENT DIV. �/ ���
r � � PHOTECTIVE INSPECTION SEC.
t . i
� i /'�'1 � CITY HALL FRIDLE� 55432 NUMBER REV. OATE PAGE OF APPROVEO BY
�"""�"� �'� 61 Z-571-3450 910-F15 10/7/91 � ' �
JOB ADDRESS 6151 B.enjamin Stxeet NE -
1 LEGAL LOT N0. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 20 3 Briardale SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Dale/Elsa Lindquisfc 6151 Benja,min Stxeet NE 571-4133
3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSENO.
5 ame
4 ARCHITECT OR DESIGNEH MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS - ZIP PHONE LICENSE NO.
B USE OF BUILDING
Residenti 1
7 CLASS OF WORK
❑ NEW � ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a,n 8� x 18' Garage Adcli.tion (worksho�).
9 CHANGE OF USE FROM TO
STIPULATIONS
See nota,t�:ons. on pl�,n,
��� .�' �3�#�
8efore digging ca11 for
aN utility tocaiians
REQUIRE� �BY L
SEPAR�TE PEt���91TS REQUtRED FOR A�
V141R�IVG, HCATI6V�, PtUN�EIIVG �4�dD S9G�S.
SEPARATE PERM�TS ARE REOUIREO FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL ANO VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 OAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
1 HEREBY CERTIFV 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 $2�000
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT S�-e OO
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PqOVIS10NS OF ANY OTHER STAYE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $'45.00 Fire SC y$Z.00
PLAN CHECK FEE TOTAL FEE
$48.00
GNASj,1pEOFCO ACTORORAUTNORI2EDAGENT ID TEi WHEN PfiOPERLY VALID TED THI IS YOUR PERMIT
�/ 0 ��s! /�i' A
SiGNATU OF WNEFI�FOWNE BUILDERI IOAT 1 BLOG WSP n TE
� []
�,nu1 [�
�� [ ]
�i x� �a
siila3ng P�mit �pplicatian
EffeCtive 1,/1/91
���� �: �'�i ���, J,�� �,� �i" • � �d � �, �'� �� . � � �—� �� _
� n�.�Q,.
owner Na�e �
.��.+�!lrn
�. �f - �/�.�
CteYt�ca�,o�': (� [�� �s � h° 'l1el. #
Address:
Attach to this appli�atian, a Qertificate of �vey of the
lat, with the p�opo�e�i cac�st�ian drawn an it to scale.
� _:..• �• . .�-
I.ZVII�1G !1�►: Ien3ti, width iieight sq. Ft.
� 1�: Ierr�h Width He3qht Sq. Ft.
IECTR AREA: I�ngth Width 8gt/Gro�u�d Sq. F't.
c►�: 1 a� rK ���,� , �� �' � 1�'
Cbrner L�t [] Inside Iot [�] Ft. Yd Setback Side Yazd Setbacks
�j�pe of Oo�LStnickiaai: �► �� �%'t-g�i E' Estimated Oost: S,��,��' i`�i.4.y �� r� o�
Approx. �letian Da�te: �. -r.,� �i
Prc�osed Driveway Width If New Openit�g Is Desit�e+ci: Ft. S $
W' + 6' See Back page
DATE : �C� � APPLICANT: � � < � . � (�'�i /— �%/ �0 ,�
Y
P�rmit Fee $_��„ ��
Fire Surd�ge $ _ o � �
State ��rr-],ama S � o �
�
SAC c��azge $
D�riv�ray F:�tvw $
Park Fee $
Sewer 1�lain Q�azge $
• v•
SI'IP[IIATIC�15:
�
€ �' •
�
P�ee Sci�le an l�everse Side
.001 x P�mit Valuatian (1/lOth $)
$.50/$1,000 Valuation
$650 pet SAC Unit
Alt. �A" G�' Alt. MB" Abvve
�ee Dete�mir�ed by �i,�ri �
� �xY [ ] � ���Y [ ]
i: �i� � �. c . �;.r�4 ��,� _ •:�_ � n
�e Qiief Huildirg Official shall, befame iesuinq peYmits for the erectiari of any
building oz st�ucbure, a� fa� atiy aciditi� to anY �dstin9 bu�ilair�cJ aac etn�re, or
for any alteratian a� repair to anY �stin9 buildin4 a�' st�u+e, u�l aPPlication
ti�erefcme, require *he payme�t by tr�e appl3c�nt fc� euch permit of %�s to tr�e a�oo�t
herein belcw c�t fo�ti�i and in ti�e mar�er herein p�wided ta�rit:
RCII�►L V1,IUE
Sl to $500
$501 ta $2,000
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,000
$100,001 to $500,000
� ��
$L5 (M]I� F�„B �S s15 �US �m�rr3,at��
$15 faac fitst 5500 p3us $2 fa� ea�h additianal $l00 or
f�kiCCi th�+.x�eof � to and includirJg $2. 000
$45 for fitst $2, 000 pltg S9 fo�' eadi additianal Sl, 000
or ficactian thereof, to at�d it�cludir�g 525, 000
$252 fo� fit�t S25.OQ0 Plus $6. 50 fa�r each aciciitiacyal Sl, 000
a� �acticn �eieof, to er�d including $50, 000
$414.50 fos first $50.000 Plus $4.50 for eac�i additia�►al
$1, 000 or fTactirn t2'yer�eef, to erid ir�cludinq $100, 000
$639.50 for first $100,000 plt� $3.50 for each ndditional
$1, OOfl or fractian thereef, to at�d incltriin3 $500, 000
$500,001 to $1,000,000 $2039.50 for the fis�t $500,000 plus $3 for each additioa�al
$l, 000 o�t frdCtiCn thez'eof, to eTfd it�cludir�g $l, 000, 000
$1, 000, 001 ani � $3539. 50 for the first $1, 000, 000 plus $2 for each additioa�al
$1,000 os fractian thereof
atlVEi�Y �Pli�BIGN F�G'liOW
(aoc�ets Qni� Str+eets at�lY)
Alternate "A" : R�oval ani r�lao�ent of c�rb and gutter anly - Driveway width plus
6 fee�t ti� $13.50.
Alternate „B" : Re�ov31 and replaa�.rit of airb ani gutter ar�d install a 3 foo�t wide
appm3ch with 6 iTti3i dep�th - D�ivewdy width plus 6 feet times 515.75.
• _a• .- .. .. .�- -. �� �.�. .
Pexmits for oar�truct.ian �rill be issued a minim� of 24 hau^s fr� the ti�me of
application ta �Zlvw far p�vper review of �e p�vpose� etrucb�ire at�d of the
carst��tian site.
A Oertificate of S�nvey of t2ye lot, ehowinq the locatian of the faad�tian arioe it has
it i�as bePn eans�ucted urill be requited before pTOOeedin3 with the fr�m�ing.
� � G F
I
� �0 %
����f�c
� � ►' ; t�
��� ��
�� � �� � � �
� � ��� ¢� i�
���
.y-FiAn
`=sE���''
�a-9�
��y
�D � 7� � >c 1 �d �
/� ��
`
�/�'/ ���J�.��.� s7" � �
,�
�
����
.
� �
� ���i
�
�
��
� ��
�
� �
��
�
�
�
�
�
�
�
3
�
o�
�
�
�
�
��
�-
� '
a
o �
�
� �
�
(
' �4.
� �i
� ��
f 1
i �
� ;
� ��
� �� �
�� �� � a
�! �� �
� �
� �� �
�
� � �! �
� � �
`��'�c
_� .�
� � .�
� �
�� 4
�L
�
�
.�
�
�
�
�
v
�
f � c
i
,,
�
DALE C, LINDQUIST, I�.D.
8151 BENJAIUI��V gT. N.E.
FRlDLEY. MN 55432
�,�/ST/�G
�����
in, ��sr 7a I�� ��sr�i6v �+ ao��u y�l� o�z�c��' /��Pi1G� �9lG.
, , ,
` � r ! i ; ' , .
a , �
I � �
�
` , ,
� ,� X �! ?'RE�r� .Tb, rS�"s �
� � � '
� ; ��/G ��OG'�l ��IYI '
j 1 . j � : :
� ? i � f t I ' k � ' '
�� � !; � ( � � j : [ �
_! i � 1 i � { � g � ;
, � � � ! � � �.� ; � �
�� lu�' 0� Ar � � 1� �l � '
_
A� ��,,,� g � o, a
� _ ._�
kO �7�, d� C�oo r a•✓ 8 a u i`!�.
!- o� 6IJ r.v d G� ty 3 O�es �/hS �
JC x �X l.S �`7�� GJd �,Q_
� s �
.� P�� �� � �►� �,� S,Z,�
�
k
/
S
�
�
�
�
�
�
U
S
L`'
�
�I
li �� �i,
t
�
�.
� ° � �st6 �`��
01� h�►lr �oo ��$ �shrs�r�
'�/a� � A ��� ��/" mc. T �� "'� `vf���
�X� �
�a k G lis LYd/�2 �`I'�I�
D*
m ��s7' 7v !�E {fl.srE
I j
; �� :
a �,J cteJa�y►�y� S/�i � �
— 5/p Rr✓r+RCE � � � �� � � :,
r�s��l. �'hr��t • 1 � � '
— �/es c��� �� - � i
_ aXy �vs �jolarrs ,/G°'��
,!/�°' a:�S�B S'u,��.�o�P C2 I�t�' p� '
' -a� �v,Qm � �T 3
. a �� ���-�r�v f,
aXg'• r�,� SO�s7T, !6" oG
.�xy rk�� ��s�'s , ?�'' oc
,. y� es ���� Cs�MPA9T" �l�6T/�.f � 7a �I Q.� ���` �
� ia�� -F'�����'�' o u7�, de
� .�"1� pi6A1- 1 . / - a� W
� �� ,
�� � X,�( �X'l s,
�
.- Gli�� �
`
a , ` J
2--- sc� P�A� c�++�-� ��
SUBJECT 'ICA�T NO.
City of Fridley 2 2 7 5 2
AT THE TOP OF THE TWINS g � I L D I N G P E R M I T
r
� ` REC IPT NO.
� `L __�__ COMMUNfTY DEVELOPMENT DIV. ��^ �
r � � PROTECTIVE INSPECTION SEC. ,'RO
' i '
� �"�'1 � CITY HALL FRIOLEV 55432 NUMBER REV. OATE PAGE OF APPROVED BV
�.---� • •'� 612-571-3450 9t0-F15 fi/25/94 � �
JOB ADDRESS 6151 Benjamin Street NE
t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 2O 3 Briardale SHEET
2 PROPERTYOWNER MAILADDRESS 21P PHONE
Dale C Lindquist 6151 Benjamin Street NE
3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO.
Same
4 ARCHITECTOR DESIGNER MAILADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADORESS ZIP PHONE LICENSE NO.
B USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW � ADDITION ❑ ALTERATION � REPAIR O MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof House & Garage (28 Square) 2nd Layer
8 CHANGEpFUSEFROM TO
STIPULATIONS
Roofing can be the 2nd layer but not the 3rd.
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 OAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 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 1 540 .77
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 OR THE PERFORMANCE OF CONSTRUCTION. �37. �0 Fire SC � 1..'r��F
PLAN CHECK fEE TOTAL FEE
� $39.s1
NA EOF ONiR�CTORORAUTHORIZEDAGENT IDATE� HE LY LIDATED THIS IS YOUR PERMIpT�
� '� °
SiGNATU E F OWNER UF OWN UILDERi IDATE� BLDG �NS DATE
?�
NEW
ADDN
ALTER
il
[I
{J
Construct�on Address:
� CITY O� FRiDL�Y .
S[i�JGLE FANiI[�Y AND DUPLEXE5 R-i ANI� R-2
�J
Buiiding Permit Application
ti• �I ��u r:v s � ..
Effective 1 /.i /94
-�-� �-� �.
Legat �escrigtion: � -
Owner Name � Address U�-� .r� c� l S Te1 •#��% �� °� 3
. � . . . . • . - . . � : . .�
Contractor: �� � � . � . � . MN�LICENSE #� �
Address: � � � . Te1...# . . .
Attach to this application, a Certificate of Swvey of the
lot, with the prapased construction drawn on it ta scale.
DESCRIPTION OF IMPROVEMENT � � �
LIVING AREA: Lengt�► Width Height � Sq. Ft.
GARAGE AREA,: Length Width Height Sq. Ft.
DECK AREA: I.ength idth Hgt/Ground . Sq. Ft.
OTHER: � O�'rf �S� � r �_ 8 c���� �
�� � �,��� �-
Corner Lot [) Inside Lot [] Ft. Yd Setback Side Yard Setbacks .
Type of Constivction: � 1 � r �' `, �i-S .� • Estimated Cost: $ ���(� �
Approx. Completaon Date:
(Cost on �ackj
Driveway C rb Cu Wi Needed: Ft. + 6 Ft = Ft x$�.
DATE: a � 9 APPI:ICANT: Tel. #L5�71 � 5�l ���
I
Permit Fee
Fire Surcharge
State Surcharge
St�C Charge
License Surcharge
Driveway Escrow
Erosion Controi
Park Fee
Sewer Main Charge
TOTAL
STIP.ULATIONS:
� ���0
$ .s
� —1-�_
$
$
$
S
$
$
$ 3 . ..� /
Fee Schedule on Reverse Side
.001 of Permit Valuation, (1/lOth%)
5.50/$1,�0 Valuation
$$00 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Ptan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
,
[3UtLDIIYG PERMXT FEE SCHEDCILE
"i�he Chief (3uitding Ofticiat stiall, t�etore issuing perrnits for the erc;etion of any bui(ding ��r structure,
or ft�r ariy adciition tc� arry cxisting buiiding or structurc, or for any altcr<iiion or rcl�air to any cxistin�;
l�ui(ding or structure, u�a aPplication tt�crcfore, reyuire tfie payment by thc a��ticaat foc- sucti �ermit
c>f� fccs L<� thc 1iii1OUIl[ f�crcin bclo�v sct t��rit� and in thc manncr t�crcin ��c►vidcxi tc�-��it:
"CO"I'nL VALt1L
� 1 � .: .to' �500 .
$501 to $2,OOp
$2,001 to $25,OQ0
I�i:1�.S
$IS (MiniQium Fec is $YS pius surcharge) .
$15 for f�,rst $Spp pius $2 for each addit�onai $100 or
fraction thereof, to and including $2,OOp
$45 for filst g2,ppp p(u� �9 for eactt addrtioual $1;000
or fraction thereof, to aud including $25,000 .
$25;001 to $50;000 : � $252 for first �225,000 pl�s �6.50 for each addirional $1;OOQ
or fractioII thereof, t�v. and including $50,000
$50,001 to $100,000
$100,001 to $500,000
$SOO,OOi to $L,000,000
$I,OD4,001 and up
$414.50 for first $Sp,ppp plus $q._Sp for each additional
.$1,000 or fracti� t�eof, to and including $100,OQ0
$63950 for first �$100,000 pius �$3_50 for each addirional. '
$1,040 or fradion thereof, to and includin�g -$500,Q00 .
$2039.50 for die first $SOp,ppp plas $3 for each additiona.!
$1,Q00 or fracbion thereof, to and including $1,000,QQ0
$3539_SO for tt�e first $i,ppp,ppp plus $Z for eacf� additionai
$1,0(}0 or fraction �thereof -
DRIVEWAY DEPRESSION ESCROVY
(Concrete C�u�b Strreets On1y)
Alternate "A": Removai and replacement of ce�rb a�d gu�ef a�y _ Di.;�veway width plus 6 feet times
$I3_S0.
Alternate "Q": Removal and rep(acement of curfi and gutter and install a 3 foot wide
appcoach with 6 inch depth - I?riveway width plus G feet times $15_75_
VLR[FiCATION OF FOU[�tDAT[ON
Perrnits for cor�st�uction witl I�e issued a minimum of 24 hours from the time of ap�lication to allow
for �ro�cr rcvicw of tfic proposui structure and of the construction site_
A Cerfificate �f Survey of tlie lot, stiowing the location of die foundation <►nce it has it tias hcer�
co«su-ucic:cl �vill t�c rcyuired before proceecliag with ttie framinfi.
� " F ^`.
e
� n m
� � z
7 � "D
m
�
� � �
O O
� �
o � Z
3 �
o � rn
3 � �
� � o
O tD 0
7 �
cn o
� �.
-�a �
� �
� N
O.
�. m
�
�Q
�.
�
0
w
00 �� y o si �} �� �
0 3 � �` �' �N � O � �
...3 �� o v � ��,�� �
� � � � � � � � �
c n �°1 � m m 3 m�= m
� � � A
� � � !D 3 Z � � �
-"� -°.� S m �3 �
D o- cn m � �
� c � � � � � � a
$ � -a S� �. ''� 'n v y
� w su D —� o A
`° � � u' 3�� � v
N
O ,._�,.. �D � W�D O C
O� � � � O 7� 1"'
� �� �v � m
� o m
V � � �
N Q � �
w � � O
O
�zm �
� � �
< �
N �
Z Z
rn�
�O
m
�
�
Z
v
�
� �
D � oD t � �
� N n rn n
c
m � 3 ��
m s
�' t� t� t� rfl rfl -� O
� o 0 0 0 o p Z
� Z 'rt
°o °o °o °o °o � Z �
� v -fl
D O
�n fn � rfl rfl � � �o �
� � ��
� � �v v �°
� � � � oZ
�
ZN
�Z
�n v
�
m� � � m oo�o � m� o � tmi� c � ��� T � r�i �
� w C Q _i �� -. � � m� W
vr < Q Z m_ IVZ= . D �D � �� A Q v t�i�Z
mC g � � �� � � t�r � � a'�°� � D�
� ��ma• - � - . p. : •�m�" � �i: . .f) .: � � . �� m��.� � .. �� ,.
-�r�ai v 3 �. '� � v � �.Q� � mO
�� � � �� �� � � �� ° � mZ
rn � �
Z'n �� ( � �. � vo.s � tn'n
m � � � �. �e �`� � � N �' 3 � �j rn
�n c i = o G� r n�om� -�_i
D �' � � ,o_�,. � �:� . -� ^ �. . . � � � �. S . '
. ��� �.. �,. f-�. "� �Q�� �
� - � a p �J . ��'.•�' p
� o �• Z
. �p w; -�... • � � � • - � c3 � � �: .
. �,-• . . s .
'. :�. .� �.N .�� � n "�� � � �-�
�p ii n -w
. - � _ . . . ' .,,� . .•. . � • N �.i . . �. � pf A1 ', .' ' -p� . ' �.. '� cD. Q .-O . • ,
O . .� �,�,. Z' � 3 . .. � . � �.m.� � s� .� �� . ��
� . � , .z: . . : : 'o : �'� • � . • ' Q - � a o .oZ .:� � � . . . ...Q y ..�: � _. _ �- ,
O � -n ` m � . _ ,_� . . . � 3 � � � . �
� 2 : � . .o'�. . " �. v �. Z ,C, �'�o , m � � � �
' �a� �j.. � . 70 � .'C� p_ �. r � � � o '
0 �� ,.�., ; . — �' ..+ C..
�.. �rv.:.. � : � .f/� a. � �.� .. .�.
, ' w � : �• . :• �. . . - � n � . �
.� . C� �' . . . . � - . � "'
.� . � � �
� � �. � o
1 � .. . �` �' � _
`� �. , e�. N � � -�
. � �L1� � Q. � '
� (?` _ 3� � � m -. _'
� � : > ' . . D � . n. v, m �
� . .. � , ; : . a� �; . ; � •. c�n ..
�
:a�g�
: �g pau�is
=0� JNI.L�H
�� , , � -s�y. ���+�=�:��c��+�►i�
. G �iJ , � � ��� �--�� � �
� 1- � (� � u-� � C°' � � �p "� --° j �{-' �
:s�uag
()oAi()��
()oNt)��
.�a�eaq ra�r�► �03 pap� �aaq .ne uoAsnquicr� seH
.�a�ea� .�� .w3 Fap�nwd� u�R �aun � s�H
. . . . S�t�.g -�ioi�
. . . stil.i.s �� A� :
: �o s�� S�u � �H �
.$
'L
E
t) oi�t _{} sa� �uuo� s�n3.g I�o� pu�
azis w3 s�uasnannba.� apo� �ua.una ne s�aalN 'S
' �( . )� oN �.'�� �� . � . .. � � � . �!oddns �Ciamaas si '}, .
. {��.} orI �} s�a� . . .. � ��I �Wo.u�laio3. ou s� . •£ . :
.(' `)�. oH ` ( ) sa� . - � . . = voqeloua�p ao �sru wo,� �aa.� si � •Z .
. . C j oN .�., �� . . � � p�u�u�ca ,tprya:r� uaaq seg . i . .... �
� :x��s .io.�aucun�� �uqs�ara aq;1�� saguan �qaiay pau�esrapun ayy -
. V •Q .
-a�guin� �uan apZS s�uZSn ua�{r� paiznba.z g�� q�no.zq� 1�� :gZON
c�ty of Fridley ---�--
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
r
i �
� �
� �V�� COMMUNITY DEVELOPMENT OIV.
1 � � PROTECTIVE INSPECTION SEC
l-__-�� �"" �'� CITY HALL FRIOLE� 35�32 NUUeER REV O�TE PAGE Of
� 612-571-3450 9�aF�s 8/17/00 / /
�oe nooRess 6151 Benja.mi.n St NE
t LEGAL ��T NO. BLOCK TRACT OR AODITION
oescR. 20 3 Briardale
2 PROPEf;TY OWNER MAIL ADDRESS ZIP PHONE
Dale � E1 L' d '
PE
'3132 `
RECEIP NO.
���1�
1VPROYED BY
SEE ATTACHEO
SHEET
sa in qu:LSt 6151 Ben�.a.mz.n S.t NE {763) 571-4133
3 CONTpACTOR MAIL ADORESS ZtP PHONE LICENSE NO
41�ellington Window � Door Co. 3938 Meadowbrook Rd St. Louis Park MN 55426
a ARCHITECT OR DESIGNER MAIL AODRESS ZIP PHONE LICENSE N0.
933-6500
5 ENGINEER MAIL ADDRESS 21P PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADOITOON O ALTERATION X] REPAIR O MOVE O REMOVE
B DESCRIBE WORK
Replacement of Windows
9 CHANGE OF USE FROM
STIPULATIONS
TO
Provide smoke detectors in all sleeping rooms and on all levels of the
dwelling per Section 310,9.1,2 of the I997 Uniform Building Code.
�erm�t inspection Ca���
Niill �� ailed
To Hom�own�r T� �'��t
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICA�, PLUMBING, HEATING, TYPE OF CONST.
VENTILATING Oq Alq CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING
AUTHORIZED IS NOT COMMENCED V�1ITHIN 60 DAYS. OR IF CONSTpUCTION
OR WORK IS SUSPENDED OR ABANDONEO FOR A PERIOD OF 120 DAYS AT
ANY TIME AF7ER WORK IS COMMENCED. NO DWLG. UNITS
I HEREBY CERTIFV THAT I HAVE READ ANO EXAMINED THIS APPLICATION �-
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS yALUATION
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPGIED
WITH WHETHER SPECIFIEO MEREIN OFi NOT. TNE GRANTING OF A pEFMIT �3�HHZ.00
DOES NOT PRESUME TO GIVE AUTMORITY TO VIOLA7E OR CANCEL TME pEqMIT FEE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW FiEGULATING CON•
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION �9%•ZS
PLAN CNECK FEE
FT
STALLS
Licens $.00
$iGN4TUAE OF CON'RACTOQ OA AUTNOpiZED oGENT �OAiEi �„ n�„„�� �
Q���OWNEABwLDEpi iOAiE� Bl G �
e� • - .c
OCCUPANCVLOAD
CU FT.
OFFSTREET PARKING
GAHAGES
SURTAX
r $1.94
SAC CHARGE
Fire SC $3.88
TOT L FEE
�Y $103.07
IAjTE' 7' IS �5�; R PERMIT
/ .vl�`>
NEW [ ]
ADDN [ ]
ALTER [ ]
Construction Address: �
Legal Description:
Owner Name 8� Adc
Contractor: W��
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Effec6ve 1/1/2000
(763) 572-3604 Bldg Ins�p
� �
/ �� �
�� `�� C"L � ��
Tel. # �C� ,.�.> °'� 7 l ' �1��
� v� 6Y`� MN ICENSE #
�� �Oa/ /�,� I`�r e 5 ' —�,�aS fd Tel. # ��.5 � ��6
,
;"�y�lo
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Length Width Height
GARAGE AREA:
DECK AREA:
OTHER:
Length Width Height
Length Width HgUGround
Sq. Ft. �
Sq. Ft.
Sq. Ft.
/ I 9,p csa
Construction Type: ��i(� L�ce(�'1 o w�(�G(�' Estimated Cost: $ ����,
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _�
DATE: � � ,� APPUCANT: Tel. # � � `� ��C�
CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application
��
Permit Fee $ , 7' Fee Schedule on Reverse Side
Fire Surcharge $ ��� _001 of Permit Valuation_(1/10th%)
State Surcharge $ - -_ Ge�� $.50/$1,000 Valuation
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
$ $1100 per SAC Unit
$ . � i � � -�5:00 (vtate-LiseASed-F�esidential Contractors)
$ Alt. "A" or Alt. "B" Above
$ } $450.00 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement Necessary [ ] Not Necessary [ ]
:�
', `. �� I y
STIPULATIONS: /��Jf��� �/Y10�� �C'�����7� ��1 �r!��G-G
�z'_—"�-�'/'��-- �- �,v� � �� �e�"1/��.�'
�" ��'� r�����' r�. ��c. �31�, �. /. �-- �9?�l• . G
o. , . ,�
iap sasnog maN •�u�.r� aq� �inn �utpaa�oad a.zo3aq pannba.z aq
j[IM ��IL1�SQ0� II2aCi SLij �I S� �T 2'JIIO IIOT�BpIIIIO� 3ij� 30 IIOi�L''JOi 2i�j �IIIMOijS `�oi a� �o �an.Tns �o a���a� d
. •a�is uor��tu�sao� a� 3o pu� am��nps pasodo.�d a� 3o n�aTnas
iado�d io� mo� o� uor���dd� �o au� aq� iuoz� smou �Z �o umuxnnai �e panss� aq fin� uor��npsao� io� s��ad
I�IOIZ�Ql�if103 �O l�iOIS�'�I3I?I�A
' SZ' £Z$ ��3 ��� 9 snid q�pTm ��manuQ - q�dap q�ut 9�inn ���o.zdd�
apin� �oo� £��sui pu� .za�nS pue qm� 30 �uaLUa��ida� p� �nouzag :,, gu a��a��
'OS'SI$ ��t ��� 9 sntd �PTn� ��n�anuQ - �Iuo �a�n� pa� qm� 30 �uauta��ida� pu� �nouza2i � ���u ���Id
��iu0 ��uS Q� ��aa�uo�) . .
AAO?I�S"31�i0ISS�d�Q ��'AA�AI?IQ
3oa.za� uor���z� ao ppp ` I$
�aor�ippe ���a io� SI'£$ �id 000`000`i$ �sn.� aul .�03 SL'809`S$
000`000` i$ $ucpnj�ut pue o� `�oa.�a� uor���.r� so ppp` i$
I�o�tPP� �I�� �o� SL'�b$ �id 000`�S$ �sn3 aq� ao3 SL'££Z`£$
� ,.. 000`OOS$ �utpnj�uT p� o� `�oata� uop�E.r� �o pQp` i$
�aor�ipp� ���a io3 09'S$ snid ppp'ppi� �s� .�03 SL'£66$
000`(?OI$ $utpnj�ut pue o� °3oa.za� uoi���.r� ao ppp`I$
�uopipp� u��a .zo3 00'L$ Snid 000`OS$ �sn.3 �03 SL'£b9$
IXl0`OS$ ��Pni�ui pu� o� `�oaaa� uor���.� �.zo
000`i$ I��?�IPP� �I�� Io3 OI'OI$ Snid 0�`SZ$ �sn� �03 SZ'I6£$
�
0'�`SZ$ $�Pni�� P� o� `�oa.za� uor���� .�o
000` I$ I�ouTPP� �I��a io3 00' �bi $�Id 0(?0 `Z$ �s.n� io3 SZ' 69$
000`Z$ $utpnl�uT pu� o� `3oaaa� uoi���.r�
�o OOI$ i�o�IPP� �I��a �TO3 SO'£$ Snid OOS$ ls.n,� .�03 OS'£Z$
OS' £Z$
S��3
dn pu� I00`OQO`i$
000`000`i$ o� I00`OOS$
000`�S$ o� I00`OOI$
000`OOi$ �� I00`OS$
000`OS$ �� I00`SZ$
Q00`SZ$ ol I�`Z$
000`Z$ �� IOS$
UOS$ °� I$
�fl'IdA 'I�'ZO,L
:�inn-o� papinoid ina.za� iauu� aqi uT pu� q�o� �as n�oiaq
uTaiaq �uno�iu� atg o� saa3 �o �tuuad q�ns �o� �u��tidd� a� �q �uaui��d a� a.nnba� `a�o3aiaq� � uot�t�tldd� uodn
`am��tuls io �uip�nq �ur�sixa �uti o� .n�dai io uor��.�a�i� �ur, so3 ao `a.m��na�s i6� �suTp�nq �uilsnca �u� o� uor�iPP�
�Cu� io3 io �atrq�s .�o �uTp�nq �iu� �o uor��aia a� .�o� s��ad �utnsst aio�aq �neqs �t�t,�p �uTp�ng �aiq� atJ,I,
�'If1Q�H�S �'33 ZIy1i2i�d JI�IIQ'II!'lg
Building PLUMBING Permit Ivo.:` — �
Inspections RESIDENTIAL APPLICATION xeceived By:
763-572-�604 � CITY OF FRIDLEY Date Rec'd:�— l�
763-502-4977 FAX EFFECTIVE2-]9-09
DATE �I s y' �° y YOUR E-MAIL ADDRESS
SITE ADDRESS � r S / .�,)-��,.,..� .-�
THIS APPLICANT IS: ❑ OWNER �ONTRACTOR
PROPERTY NAME: "`L"� ` i'"''�
OWNER/ ADDRESS: �' � � � . � /�,fZt_�,...��_ ,�(' CITY ( � i� STA a ZIP °� � �� �
TENANT pHONE: ��a �$ .S'� a_ e/ r 3�
CONTRACTOR NAME:
SUBMIT A COPY OF STATE LICENSE #���9 � S P:'I'1 T@
YOUR STATE �y Overacker Plurribing I�c
LICENSE, BOND AND STATE BOND # 502 E Main St
CERTIFICATE OF ADDRESS: �,n�T _STATE ZIP
INSURANCE pHONE ��ka' 1�11� 55303
(763) 572-8880
PERMIT TYPE � SINGLE FAMILY O TWO FAMILY ❑ TOWNHOUS
TYPE OF WORK: O NEW �PLACEMENT
DETAILED DESCRIPTION OF WORK v���. Ga�s ��-��"� �-�-�
FEES ARE BASED ON $10.00 PER F[XTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM FEE
$35.50.
BATH SINK/LAV FLOOR DRAINS SHOWER WATER PIPING
BATHTUB GAS PIPING (NEED CITY LIC} SWIMM[NG POOL WATER SOFTNER($35)
CLOTHES WASHER KITCHEN SINK WATER CLOSET BACKFLOW PREV. ($15)
_ DISHWASHER _ LAUNDRY 1'RAY �WATER HEATER ($35) FOR IRRIGATION
_ WATER METER _ OTHER
� � � �, r � � y� , °
�G#`'y�'������� � i �",aRi,��Sy,,�P i �'�. � : � �r a n �" � �{
r 7"'�.� � �' �,
v G�.�siit�� p° ry �y1 i� '- k� `' h X8� i: a -�� _ q' t ry � t x x F i.� �.
y����Vn,�j� �'��� � t �� t�ira'iY`�� 4' IA r i' �. 4 S 9 �' 1u �r �
3��� a- �k v'��.,M,:'*M+,1� i '�u.'r"^`w.".,...� � � r� � 4y i� t r�1fYy
' a i' . r d 1 +a t �
� ��l f � ` ; '� � '". S !P .- ,� V ;�, � a '. �.�yn '. � : r i ' j � .
A���Jey1xGy�t�t ` r �I{/t��f �� u � tl� ' q,.�, ��tay� r � i - , � (1,��1 R� �"�'� WR} Fl w�� �l sg'1�, 6 +ed
�J��A�hr'ag�����Y�V� �41 �� Mq .r y�.7
4 C,d / 4� �a` Y $ i � Y F' � 1
� I �r i } � � I � Y✓ � '.� 7 � � rr � � t � t � r t�`j� 5 '.
{y�j �£ '�p j �J� ' h � ! .� 1 �� 1. 4 � - ( � �' �. ! Yf '. 1 � p b � �
i�a�Nok,�M. M1� j �j " t i� I! a h
,
�RS�I' i: i '., I i._ r � `,i qk 3
t ��� j � ' I � � F i l ! I !��i t� '1
fi� ���� ' S �r � ���'� �� � L 4 � � f . �.
�� ki 17 ��� ) r a. �A" Yv 1�ta: "'2 1
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED _
I hereby apply for a plumbing permit and I acknowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is
not a permit but only an application for a permit and work is not to start without a permit on site; that the work will be in accordance
with the approved plan in the case of al1 work which requires review and approval of plans.
SIGNATURE OF APPLICANT ��� PRINT NAME �� c° k ' '� � �' � ''�'y � DATE ��, � /`' �
s ��-�"�',"`:;� �� . � p 1 `�: " � �"i�� ���`>"'�.��i�,i�.� 1'���,�'% �';: �,� ;?.
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977
��
Building
Inspections
763-572-3604
7fi3-StI2-4977 FAX
PI,UM��NG
RESIDENTIAL APPLICATION
CITY aF FRIDLEY
permxc No.�
Rece�Wea $y:.
nat� x���:
DATE ►� YOUR E-MAIL ADDRESS
S1TE ADDRESS ! 51 .��rr..t.r. � n �'-
THIS APPUCAI�ST IS: fl OWNER �ONTRAC'fOR
PROPERTY �� .t.,.� Q.E�
owMER� wn��ss: 4•. s1 � � _ -- - - - � .$k h � cirY��eC�c�,. sr,a� �p S `r 3�
TBNANT PHONE• ") is 3 .. '�'7 f _ �{ + 3 � ��
CiDNTRAC'I'OR �tAtwsE:
�� A��' � $TATE LICEIVSB �1_ Terry Otreracker Plumbin�, Inc.
Yot� STaTE 502 E Main Street �p DA7E
i.7GEN3E. $OND AND 5TAT$ B4ND # EXP DA?E
CERi'IFTCATEOF Anoka, MN 55303
ADDR£SS: t STATE ZIP
1NSURANCE PHC?NE `76�� �%2-8�0 —r.c�� . .- —
PERMIT'['!'PE
TYPE OF WOAK:
❑ SINGLE FAMiLY
C] NE�t
DETAILED DESCRIPTIQI�3 OF WORK
fl TWp FAMiLY ❑ TOWNHOUSE
�KKEPLACEMENT
FEES ARE BASED Q3� 510.00 PER FIXTl1RE; EKCEPT WH£R£ NQ7'ED_ FIX'fliRES: ([NOICATH TDTAL NUMBER OF EACH $ELAW�. M17VINIUM FEE
535,54.
BATH S[NK/LAV FLQQR DRAIMS SHt}W�It liVATEIt PIP�IG
BATHT[iB GAS PIPING (NEED CITY UC� � SWIE+Ii19ING POOL WATER 3QFTNER (S34)
~ CLOTHES WASHER KiTCHF1V SiNK WATER C40SET —' BACKFLdW PREV. ($2 S)
DISHWASHER � LAI.'NDRY 7RAY _WATER HEA'f�R (S35} �iOR IRRIGAT3ON
— '� WA?ER MEiER ? OTHBR
Ly7 r- t .J,S.� :-.c!���• .. . . . ' " .. � . i .!" . .�.. : ; i 4.yl�,t:..� :. ^ypj+ . S �
r' �� :`'}�. pi -:al�'J:r! }: : �'; • . , . � . • •,j; .�:r.: r 5!;, . : f.`. u:.`pn; �:I
•yek"3^ `l :��•� .y... , .•!• � .y� .::�. w�+: �^.
•q"'•' _ ��.. _,.�i.`�: : ^ni. t..,
' ��4 . ' %.'.: �r�.4..,•�y
��� r���'�. . . "'w..:� ::w<. '�-�if�.':�'��`�;;�.s K:.;iL
. +
e
���' �.4
y.: «,�•�n.. ,e �,:u;�i.. - ' �. �s w: '
. .
.
;, ,
� r.. ..,.,.,, ,,..., _>.. ,.... . . � _ .��{,
q -<,
:
,.}. .`.
.. .
. . , � .�: • . . . . .. . .
=' • '�' .
. ..
�a '.,1� ...:. .. :� � �t . . .. ... ... ' � . • .' � � . � ..��+ =R Y� A�i:..�'�L•.\, l
,.',�i;z'� 'a.,, . j �. a,•Y, - .. � �: . .. •,i'� � ..�;�� �.? %�'i�ii�rL�:��P.2:.'`v,• _t- �.,�i� .�t�#
'+� � '-�: }`s-� ��'�' . • . . .�. - . .l.U.. �..:`,?'s4...,j > r `��:.,�,�.3 �g','#�'.�� t�
aV !l. . {� 7C�j `;v •.t�(N. y!: �n"�{'jY.:�.t•`:c-rY�' I.L ? c:�,•%."°"
� � :;. . � � :;''..` �° .�;�:.a : �.��.L78{�q...;' a .A�
��d. 'i•, �� . . ".�..' ✓w•""'. . -•i" :,j�•�`c4•"�r,��{�°.%.�i'�'iy��;�;.��. r1,,,�d ii. �•i'�
.e�'+„?u\t:a.1*.,,'•7yi:^Y..'' ..5:'±. ;'' •;t�... :Se1'h%:�sm.l�. , AZ�'; :"L'�,��:�.�.y'. ,�,. ��
1'S 'es.;.i�, ' • . - _ , x.�.,'^.^1G...�;�,�`:I,r... .gd'f ` �
':'� . . .. . .,T'�. '{.(••4• . •Y . ii'Si 5. .
�'a .z�., . 'P �M�. , � . (1 .
..,, -t� .:t';.:'.'r;"' f.._ ,�k,•:�•"`i.:`',
__ . . .. . -. , .tl�at`:«' �1','r.,�y:•`; .,,�r.�'��Y:�'• �F.l�
. �'. . � • i :7+�v. :..�• Y� : C''�.. •:. :.;;'i8��: �""�i>+, o?H,
�'� ry� � . �.i,�k.: � �y .`s�, ,, .
�: Y?ti r; ce..? . - . . . , . . . ' ' . :'oi.: .,y :4v� . ',�'�� t-'.�,
�•.fi7i. . . . . , i. � s:.'i J.,�,�:::r:• {
, ":t.`.'� ^f..7�`l., ,�i a..,,.a �Y
. , • ,'t^•• J .:�t:«.J.� :+C.�.� r '7..
���.�•' . . ��
. . f��'.� :$.
. i'
. •,�' a
. .,. . .S• •�.
��-
. '"-rP� � s•Z �T•y�,`• ..:Y.
�:f ;.i;
�.«. yti
•�tF '`d•: . 4 �-
a . �'���z��
b�•,;o. . . . 5�• �.ji°:',�,�i.: } ..,.�<:i� �:v' t°-E;�r,. ;.r.fi.
�'rSt �°r.ii. . , -�s �i ^n ,�^' . , � • . . . �2. ��v' �:1.�..dt;:�F; •�'_;F.� '��.. '�.:f
� '�5�.��7; � �+�� J � . . '��2 . . ..�_:E.,1,�� �.�... ,�� .� y. :
'i'(. .f. :) s.�•
THIS IS AiV APP4ICATIflAt FOFt A PEEiMIT-NiOT VALID L:NT1L PROCESSED
i bereby agply for s plumbin� permit and I at�aowledge ttiat the inforntiatian above is camplEte snd accurete; thac the wo�ic will be im
confor�aac:e with the ordinancxs and cocies af the City of Fridley aad with rhe Mineiesota Car�tn►aticm Codes; tbat I timderstand this is
not a permit but anly aa applicadon for a petmit aad work is aot tp start without a peimit on site; ttsas the wa:lc a+ill be ia ac�ordance
wit3� the approved pSan in tbe case af a!1 work wFiich requires review and approval of }alans.
SIGNANRE OF APPLICAI�T .�'1�rtsCtl/ �'%i�1J�- PRINT NA!V� �/'� � K i� ����� DA'i'E �!� t ti
City of Fridley
Building Inspections Deparlment
l5431 Universiry Avenue NE. F�a��y, MN 55432
763-572-3604
FAX: 763-54?-4977
Z' d 6888-ZGS-E9L XFi� 13f �13SH1 dH Wd9E = 6 0 T OZ S T �dd