AF - 35428City of Fridley, Minn.
BUILDING PERMIT
Date: �'.;4i� i J , :j;j
N� '7'74 .
i� � �.��i��� � Builder I1�<<}'� � ..," �� ��.�;
Owner: '' � ._ ....._ ..___.____..._._.��_.
Address �-�....__`,:C�. . i �=i� _ _ =ax. � _: ,� ::, Address t`• c' � ''�y _ "u � :._._ '! •-...�.._ _.._.
No. ____ Street .._... _
Lot .._._ �" _....__ Block � .
Corner Lot _ ..� Inside Lot
Sewer Elevatian
LOCATION OF BUILDING
,� _.._.._____..�... Part of Lot
Addition or Sub-Division . �� '` `"` `''�'� .'�x'"`�' ` �`�+31
Setback ._.._..�__.�___ Sideyard
�...._ Foundation IIevation ..�......_
DESCRIPTION OF BUILDING
To be Used as:
�.— Front —_ Depth .�_.�.� Height ._._....�__ Sq. FL
�_ _�____._....._ Front _._..__�.. Depth __ _ Height ._.._.._�_ Sq. F� �_._..
Type of Construction �_.._�..�.��...�.._.....�.. Est Cost .�:.�.�� �'
-._ _..�_...._.. To be Completed
Cu. Ft _._.
G�. FL
, ' t� � , s >*� . . � b. ,- ,.. ,
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In consideration of the issuance to me of a permit to construct the building described above, I agree to do
th� proposed work in accordance with the description above set fortti and in compliance with all pravisions of
ordinances o! the city of Fridley.
Ea ca�ssideration of the payment of a fee of $`�' •�rt'+'' ., permit is hereby granted to ��� ''�•' ���:: `� µ�;
to construct the building or addition as described above. This permit is granted up�
the express condition that the person to whom it is granted and his agents, employees and workmen, in all wark
done in, around and upon said building, or any part thereof, st�all conform in all respects to the ordinances of
Fridley, Miru►esota regarding lacation, construction, alteration, maintenance, repair and movIxig of buildings
within the dty limits and this permit may be revoked at any tune upa+� violation of any of the pmvisiona of said
ordinances. .
..:.`:''> ve:s?,..,c:;�a Buildint8 �
' NOTICE:
Thts p�emb doa nof eov�r ths eonshnciioa, insfall�Hon fo� wieiny, Plumbing. oas h�atin�, �w�r or wat�r. B� wro to sM ,
th� Buildine ImpKtor for ap�rah p�rmih for th�ss ibma I
OWNER'S
ADDRESS
APP'L�CATION FOR BUILDING PERP�T
. ' . CiZR : OF _FRIDLEX,� MII�ESOTA
. . . LOCATIOPI OF B�ILDING _ .,
No. , . .'• Street �.. Part of LoC .
LOT BLOCR ~ . ADDITION OR SUBDIVISION (' � .
- _._--___.....�
Corue�`Lb���,Insid� LOT'�+'_',� Setback � Sid� �fard
SEWER ELEV�T�ON' � . . , FOUNDATIOA ELEVATION . .
Applicant att�ch to this form Two Certificates of Survey of Lot and proposed
- building location drawa on these Certificates.
To be �used $s:
DESCRIPTIOAT �F BOILDIIIG
Front Depth � Seight� �
Sq. Ft. Cu. Ft.
, , , . Fr�nt ' � Dept � eight
. � . . : Sq. Ft : � � Cu. Ft .
Tqpe of Can�truction E�timated CosC �� ���=°
To be completed �� � � �
The undersigned herebq makes:a�plicatio� for`a�permit for �he work herein apecified,
agreeiag to da all work in �trict accordance�with the City of Fridlep Ordinances
and rul3n�a of the Department of Buildings, and hereby declarea that a11 the facta
and rep�esenta�ions �taCed �ri this.:applieat�on�are•t�ue and correct.
� �. . .. . . ..
DATE .�- � SiGNATURE / / -
� � . . - � , . .
(Schedule of Fee Coats can be found on the Reverse Side):
,-� � , _ _ �--�
BIIILDING PERMIT FEE SCHEDULE
ggCTIpN 2. The Inspector of Buildings shall, before issuia� any germtt for the
erection of any building or atructure, or fer any additioa to any existin� l�uild-
ing or structure, or for any alterations or repairs to any exietiag build3ng or
structure, upon application therefore, require the paqment by the applicant for
such germit of fees to the amount herein below set forth and in the manner here�n
provided to-�rrit;
2.1. For say such permit for the erection of ang fire-proof building,
other than a garage, warehouse, faceory or grain elevator, or for the erection
of any fise-proof addition, for aimilar occupancy, to any existing building,
sha11 be at the rate of $1.40 for each ot�e thousaud cubic feee, or fraction
thereof, in such cubical contents.
2.2. For any auch permit ior the erection of any fire-proo£ garage,
Warehouse, factory or grain elevator, ar for the erection of any fire-proof
addition, for similar occupancy, to any existing building shall be at the rate
of $1.25 for each one Chousaad cubic feet, classified as "fireproof" by
Sectioa S02 of the Minaeapoiia Bullding Code.
HOII$ES
2� 3. Far any su�Y permi� for the erectiou of any r�on-fireproof bu3lding,
other than s garBge, warlehouse, factory or �rain eZevator, or any non-fireproof
addition, for aimilar occupancy, to any existiag building - permit $1.00 for eaah
one thousand cubic feet.
GA�RAGES
2 4� For any such permit for the erectioa of any noa-fireproof garage,
warehouse, faetory or grain elevator, or for .the erection of any non•fireproof
addition, for similar occupancy, to any existiag building or for each such
building ar addition - niaetq cents {$0.90) for each ane thousaad cubic feet
or fraction Che�teof, in the cubical contents thereof with the minimum of $4.00.
For the �urpose of comput�.ng fees for building peranits, the cub3cal contenCs
of any build3ng or addieion to a uniforon height throughout by multiplying the
ground area covered from a point six (6) inches below the floor liae of the
basement or callar to ehe average height of the upper sur£ace or to the average
height of the roof �urface of the maia gable of a pitched roof.
Z.S. Far regaira or alteratious to an existing structure, th� fee shali
be at the rate of $3.00 per each Five Hundred Dollars ($5(}0.00) or fraction
thereof in the cast_of ail propased work:
2� 6. In no case shall the fee charged for any permit as aet forth in
Section 2 be les� than $4.Q0.
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ANOKA COUNTY
S60•3450
6431 UNIVERSITY AVENUE NE Novemlier 28, 1978 FRIDLEY, MINNESOT� 55432
I'tinneapolis Post Office Department
Supexintendent of Delivery
lst & Marquette Avenue
Ati.nneapolis, Minnesota 55402
$e: Change of Address -Effective January 1, 1979
City of Fridley
Gentlemen:
We are listing tha �ollawing change of address in the City of Fridley;
�; Mr•. & Mrs. J. W. Koski
�gpM; 6390 Jefferson Street N. E. , Fridley, NIl�I 55432
T�: 570 Bennett Drive N.E., Fridley, NII�1 55432
. LEGAL DESCRIPTION: � t 1, Block 4, Christie Addition
We have notified the occupant of this change and we would appreciate
it very much if you would change your records accordingiy.
� Sincerely,
G . CLAitK
Ca�nuaity Development Adm.
DGC/mh _ .
CC: City Water Billing Dept. �
• City Assessin� Department
Minneapolis Gas Company - Brooklpn Park Office
Northern States Power Company - •.
Noxtl�western Bell Telephone
City Vorers Ragistxation
Hameo�ner
...
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��� 643i UNIVERSITY AVENUE NE Noveqnber 28, 1978 ���DLEY, MINNESOTA 55421
T`� , .
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.
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.
Mr. & Mrs. J. W. Koski
6390 Jefferson Street N.E. •
Fridley, NIl�I 55432 � � '
Re: Change of House Numbers
Effective January 1, 1979 '
Dear Mr. & Mrs. Koski: a
. It has been necessary for this of�ice to change the address
of your house •
FR02�! 6390 Jef£erson Street N. E. Ta 570 Bennett Drive N. E.
?,EGAL DESCRIPTIOV Lot �1, Block 4, Christie Addition
We have notified the Post Office Department, Minneapolis Gas
Company, Northern States Power Company, Northcvestern Bell Telephone
�ompany and various departments in City hall of this change.
�Sincerely,
. • lX��
DARREL G. CI�AFiC
� Co,-:nnunity Development Adm.
DGC/mh
0
SUBJECT
c�ty of Fridley
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
r
� �
COMMUNITY DEVELOPMENT DIV.
r � y � PROTECTIVE INSPECTION SEC.
� _ �
� �"'1 � CITY HALL FHIDLE� SS432 NUMBER
������ � ,�� 612-571-3450
s�aF�s
JOB ADDRESS
570 Bennett Dr. �
t LEGAL LOT NO. BLOCK TRAGT OR ADDITION
DESCR. I y. Christie
2 PROPERTY OWNER MAIL ADDRES$
Harriet Nelson
3 CONTRACTOR
Nutzmann Bros.Co�
4 ARCHITECT OR DESIGNER
5 ENGINEER
B USE OF BUILDING
Residential
7 CLASS OF WORK
MAIL ADDRESS
736 1 Ave N6J N
MAIL ADDRESS
MAIL ADDRES3
REV
��C PAGE OF
7/31/98 / /
26927
-RECETP"7 NO.
'�i ���
APPROVEO BY
SEE ATTACHED
SHEET
Z�P PMONE
572-3768
Z�P PHONE LICENSE NO.
112 628-0128 2004345
ZIP PHONE LICENSE NO.
Z�P PHONE LICENSE NO.
O NEW ❑ ADDITION 0 ALTERATION �1 REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WORK
Reroof house and garage (28 Sq) Tear-off
9 CHANOE OF USE FROM TO
STIPULATIONS
Underlayment must comply with State Building Code.
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUM8IN(3. NEATING, TYPE OF
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WOFiK OR CONSTRUCTION 20NING
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
019 WOHK IS SUSPENOEO OR ABANDONED FOR A PERI00 OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCE0. NO. DW
I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS Of LAW3 yALUATI
ANO ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 23;
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pEFMIT I
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTqUCT10N. ' [�,
� � PLAN CF
� ��
SIGNATUR F CONiRACTOR OR AUTMORIZED AGENT 10ATEI
S�GNATURE OF OWNEP iiF OWNER BUILDERi _ �DATEi . i
�a�. uuaUrqNp�VqOUP OCCUPANCYLOAD
SO. FT. CU. FT.
UNITS OFFSTREET PARKING
STALLS GARAGES
SURTAX
1.16
SAC CHARGE
ire SC 2.33
FEE TALFEE
N� � � Effective 1/1/98
ADDN [ l CITY OF FRIDLEY /�
�-� [] SINGLE FAMII,Y AND DUPLEXES R-1 AND R-2 a'- 1
BUILDING PERMIT APPLICATION Cp� ��'
. � ��
ConstructionAddress: � %d �p��v e� � v ,
Legal Description:
Owner Name & Address: / �,��r, ��— �'lJ�c. �U�.J Tel. # ���- � 7� 1�
Contractor: _Cl.s���.�r�.w ��e��-1 Gws� - MNLICENSE#f%uoy��S-3
Address:��� J S'--�u.� /V � — /V /.� Tel. # �',��-'��� �
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale. �'
DESCRIPTION OF IlVIPROVEMENT
�.IVING AREA: I.ength Width Height Sq. Ft.
GARAGE AREA: - Length Width IIeight Sq. Ft.
DECB AREA: Length � q � Width Hgt/Ground Sq. Ft.
OTHER:
0
0
C� .
i
Construction Type:" � � ���U� � Estimated Cost: $ ��� � � �
° ° � (Fee Schedul e on Back)
Driveway Curb Cut idth Needed: Ft. + 6 Ft = Ft x$ _$ �
DATE: �� � APPLICAN : d � f�%� �
Tel. ���
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
,
$ �/ ��
$ - -��
$ /
$ .
`$ �_��o
$
$
$
$
$ �3-�
CITY USE ONLY
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.� Conservadon Plan Review
Fee Detennined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
a�
�
_
BUII.DING PERMIT FEE SCHEDULE
The Chief Building Official 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 repair to any existing building or
structure, upon application therefore, require the payment by the applicant for such pemut of fees to the amount
herein below set forth and in the manner herein provided to-wit:
TOTAL VALUE
$1 to $500
$501 to $2,000
$2,001 to $25,000
$25,001 to $50,000 _
$54,001 to $100,000
$100,001 to $500,000
$500,001 to $1,000,000
$1,000,001 and up
FEES
$21 (Minimum Fee is $21 plus surcharge)
$21 for first $SQO plus $2.75 for each additional $100 or
fraction thereof, to and including $2,000 �
$62.25 for first $2,000 plus $12.50 for each additional $1,000
or fraction thereof, to and including $25,000
$349.75 for first $25,0� plus $9.00 for each additional $1,OOQ
or fraction thereof, to and including $50,000
$574.75 for first $50,000 plus $6.25 for each additional
$1,000 or fraction thereof, to and including $100,000
$887.25 for first $100,000 plus $5.00 for each additional
$1,Q00 or fraction thereof, to and including $500,000
$2887.25 for the first $500,000 plus $4.25 for each additional
$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,�0 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Alternate "A": Removal and replacement 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 $15.75.
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper
review of the proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed
will be required before proceeding with the framing.
i•._
SuB�EG7 -. ..
City of Fridley 33576
AT THE TOP Of THE TWINS g U I L D I N G P E R M I T
r
� � EIPT NO.
� �,� _ COMMUNITY DEVEIOPMENT DIV. _s� /��
r � � PROTEC7IVE INSPECTION SEC. �
� � /"'1 � CITY NAII FRIDLE� SS1�$ NUMBER REV OATE PAGE OF APPROVED B'I�
�"""� � ,�' 763-571-3450 910-F15 6/5/03 / /
JOB ADDRESS 570 Bennett Drive NE
1 LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACMED
DESCR. 1 4 Christie Addition SHEET
2 PROPERTY OWNER MAIL A�DRESS ZIP PHONE
J'ennifer & Justin Rhoads 570 Bennett Drive NE 763-572-8426
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO
Same
4 ARCHITECT OR DESIGNER MAIL AODRESS ZIP PHONE LICENSE NO.
S ENGINEER MAIL ADDHESS 21P PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW C,�, ADDITION O ALTERATION O REPAIR O MOVE O REMOVE
X
B DESCRIBE WOfiK
Construct a 16 x 15 a�d a 17'8" x 12' Deck
9 CHANGEOFUSEFROM TO
STIPULATIONS
See notations on plan.
��for� tliggfr�g call fo�
�II t�tility location�
4540002
����1� �� �Y LA�M
SEPARATE PERMITS AFiE REOUIqED FOR ELECTRICAL, PIUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAO
VENTILATING OR AIR CONDITIONING
THIS PEFMIT BECOMES NULL ANO VOID IF WORK OR CONSTRUCTION 20NING SO. FT CU FT
AUTHORIZED �S NOT COMMENCED WITHIN 60 DAYS. Op IF CONSTRUCTION
OR WORK IS SUSPENOED OR ABANOONEO FOR A PERI00 OF 120 DAYS AT
ANY TIME AFTEfi WORK IS COMMENCED. NO DWLG. UNITS OfFSTREET PARKING
I MEFiEBY CERTIFV THAT � HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GAiiAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROV�SIONS OF LAWS ypLUATION SUFTAX
AND ORDINANCES GOVERNING TMIS TVPE OF WOFK WILL BE COMPLIED
WITH WHETMER SPECIFIED MEREIN OR NOT. TME GRANTING OF A PERMIT �5,613 �L.HI
DOES NOT PRESUME TO GIVE AUTHOFi17V TO VIOLATE OR CANCEL THE pERMIT fEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE Oi; LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFOi;MANCE OF CONSTRUCTION �ZZS. ZS Fire SC �S . C 1
PLAN CNECKFEE TOTALFEE
$133.6
SiG ATU�7EOFCON�p4CT A RAUTHq 4EDAGEHT iD�fE� WHEN PROPERIV VALIDATED THIS IS VO R RMIT
.• ` S�GNOT E O� OWNER �f'IOWNEA BU4DEp� iD�iE� � ��
� iaSo ri ' E
NEW [ j
ADDN [ ]
ALTER [ J
Construction Address:
CITY OF FRIDLEY
6431 University Ave NE, Fridley, MN 55432
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ti �evl ne�T ��i Ve.
Effective 1 /1 /2003
(763) 572-3604 Bldg Insp
(7631: 571 �1287 Fax
.
1' � �`
� /�� �'r; �
Legal Description:
Owner Name & Address: �eh�,��e� a. �,�s+�r I��o�ls Tel. #,����� S�a -�4a6
Contractor: �V� ? MN LICENSE #
Address: Tel. #
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 Sq. Ft.
��
GARAGE AREA: Length Width Height Sq. Ft. �
,�pper DECK AREA: Length I'7' $�� Width 1� � HgUGround z`� �� Sq. Ft. �� Z =���
L��.� i b' �s ° r�," 2y�
OTHER:
�� d��i � S a X( a.. � gC l
� `
Construction Type: I re�.-�G � Estimated Cost: $—f��`°`' ��P r�-
Driveway Curb Cut Width Needed: Ft. + s Ft = Ft x =$
DATE: ��y�la� APPUCAN . � Tel. # �7�s'7�--���
Call (763) 572-3604 for Permit Fees if mai ' g in a ication. Fax to 763-5T1-1287 if using credit card and we will
call you for card number.
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
� ��� .�
$ �
$ a.
$
$
$
$
$
$ �
CITY USE ONLY -
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1275 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
TOTAL $ ��11 l STIPULATIONS�
BUII.DING PERNIIT FEE SCHEDULE
The Chief Building Official 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 repair to any existing building or structure,
upon applica.tion 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 to $500
$501 to $2,0�
$2,001 to $25,000
$25,�1 to $SO,ODO
$50,001 to $1�,Ot�
$100,001 to $500,�0
$500,�1 to $1,000,000
$1,000,001 and up
FEES
$23.50
$23.50 for first $500 plus $3.05 for each additional $100 or
fraction thereof, to and including $2,OQ0 �
$69.25 for first $2,000 plus $14.� for each additional $1,0�
or fraction thereof, to and including $25,000
$391.25 for first $25,000 plus $10.10 for each additional $1,000
or fraction thereof, to and including $50,000
$643.75 for first $50,0� plus $7.00 for each additional
$1,000 or fraction thereof, to and including $1�,�
$993.75 for first $100,000 plus $5.60 for each additional
$1,(�0 or fraction thereof, to and including $500,000
$3,233.75 for the first $500,� plus $4.75 for each additional
$1, 000 or fraction thereof, to and including $1,000,�
$5,608.75 for the first $1,000,000 plus $3.15 for each additional
$1,000 or fraction thereof
CURB CUT ESCROW
(Concrete Curb 5treets Only)
/%��
Removal and replacement of curb and gutter only - driveway width plus 6 feet tunes,�].7-@0.
Permits for constivction will be issued a minimum of 24 hours from the time of application to allow for proper
review of the proposed structure and of the construction site.
VERIFICATION OF FOUNDATION
A Certificate of Survey of the lot, showing the location of the existing foundation will be required before
proceeding with the framing. New Houses Onlv
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