AF - 35579�ti�,'.. � .e��.m., �'t.t ;�w < _. . _ _ _. _. . _
H.C. NOIUM AN� ASSOCIATES, INC.
P. 0. BOX 33026-COON RAPIDS, MINN. 55433
CERTiFICATE OF SURYEY: DENNIS MORLEY ��
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�. �RIGA►I�OON PL�CE ' N E,
,? l 7 S The South 11II.00 feet of Lot 11,
Block 2, SPRING LAKE PARK LAKESIDE,
Anoka County, Minnesota. Subject
to road easement over the South
25.0 feet thereof.
LAND SURVEYORS
Telephone
421-1822
5C ALE % �" = 30'
5599- �232/50-51
� DENOTES �RON
1 HEREBY CERTIFY THAT TMIS IS A TRUE AND CORRECT REPRESENTATtON OF A SURVEY OF TME BOUNDARIES
OF THE ABOVE DESCRIBED LAND, ANO TME LOCATION OF ALL BUILDINGS, THEREON, AND ALL VISIBLE EN.
CR�ACMMENIS, IF ANY� FROM OR ON SAID LAND.
AS SURVETED BY ME TH15.....14th......pAY'OF .........February ...................A.D. 19..83........
N.C. HOIUM AND ASSO TE , NC.
.................. ��:......!.. Y""t I!'7............................................
Minn�soto R�yistrofion No. ..44z7.�...........
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SUBJECT pE
City of Fridley 16 9 9
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
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y � PROTECTIVE INSPECTION SEC.
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l---- �����,,� CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY
Z J\ 612-571-3450 910-F15 4/27/83 � /
JOB ADDRESS
1 LEGA LOT NO. B TRACT OR ADDITION SEE ATTACHED
DESC?o th 118 ft. 2 Spri ng Lake Park Lakesi de SHEET
2 PROPERTY N MAIL ADDRESS Z�P 781 -�' j� �ork
3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSENO.
Nedegaard Construction Company 3903 Fass Road St. Anthony 560-0070
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
�l NEW ❑ ADDITION ❑ ALTERATION O REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
N,ew House and garage 52' x 32'
9 CHANGE OF USH FROM TO
STIPULATIONS
1. V Verifying Survey after capping
2. Provide a hard surface driveway
22 ft driveway opening 22 x 13.50 + 297.00
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING. WOOCI FY�dTCie -
THIS PERMIT BECOMES NULL AND VOID IF WORK Oi; 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 AFTER WORK IS COMMENCEO. NO. OWLG. 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 VALUATIOPI� �� jr� SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WOfiK WILL BE COMPLIED �rz..3p
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 66 OOO.00 °
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- q
ST C ION OR TH P RFOR ANCE OF CON'STRUCTION. 260. 'rJO �FZS.00
p eL PLAN CHECK FEE TOTAL FEE
m `� �7 �� 65.13 773.01
SIGNATURE OF CON i RACTOR OR AUTHORIZEO AGENT DATEI H-EN PROP LY �.� ATED TH IS_Y��� ERIy��T
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SIGNATURE OF OWNERIIF OWNER BUILDERI IDATEI -4� BLDG iN5 qATE
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CITY Of fRIDLCY Effective Auq. 1, 1981
AP�LICIITI�� f0fi RESIDLNTI/l� BUlLQl��G PCRi4lTS
(NN�. Alterations. Additions, or Repairsj
Otn�ER: 57�UFN � cYNrNrA �R�A��
annr.FSS: �oo '7 �/� �a.r�
�� Mo: �l Sl— 3/ / 8 -° � �.
,5'7/ — �5'60 - ff�-
BUILD�R: _N�OF��ARI� -4N.s�iPucTro.v eo,
AODRCSS: _ 3q03 F�SS ,Po�O S ,19NTN�th/%�yN.
TEL t�0: �(oo-OO 9,0
Construction Location
• BTRITT NO s 6TJtEET: ,6�,�G� Dpp�t/ IALAC� %j�E
.S�NTN ll� fEgt
LOT: _ A F LoT a? 1 BLOOC a_ Tw Q_ ]1DDITION z_ 5�/Q=IVG 4At«' ,Or4oit GA��aeO'�--_�.
Corner Lot: �_ Insiile i,ot: `__Z( _ 6et�acr: �S' _ Sideyards: ��' �30'
J1p�licant attacA to tl�is forn !wo Certificates of S1�rvey of lot and.
pzoposed builcling location dzawn on certificates to scale.
�ESCRIPTIOi�! OF C01•JSTP.UCTIOi�
�
_,________ Front: $� ` Depths 3� � • Heiqht: /u'
Square Feeta Qibic Feet:
, Front: Depth r Neight:
Squnre Fegt: Q�bic �'eet:
9ype of Cbrstructiona G✓00� - F,Q/!ME Estir►ated Costa �(p�o(o,fX��.�
Zb 8e Oar�pleted: i9l/�b'�($T / /9�3 �
�'�� l�lt. A Alt. 8
Proposed Dzivc�+3ay �iiath If Nc�r Opening Is Des3,red: �� �l, �•��� S s
• • • BEE RiVER�E SIDE OF SHF�T
. , .
Zi�e unaersi ned here � pp " � .
9 by ma3;e., a lication for a perroit fcr the �Ark herein specifi�d,
a9ze�in9 Lo cb ,all vork ir, strict �ccord�ce with the City of Fridley Ozdinances a�zd
rulings of the Delk�rtme�t of Duildings, and hereby declares ti,at all t]�e fact� and
represeat�tiens stated 3n this Applicatie are tzue d co:rect.
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a�Tes S' � � ____— sicNnlv� : ` U� --, —
StiPulat%ns r �
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BUILDING PERMIT FEE SCHEDULE
The Inspectoz of buildiags shall, befoze issuinq pezmits foz the
�zsctfon of any buildinq oz structure, or for any addition to any
•xistinq buiidin9 oz structure, oz foz any altezation oz repairs
to any •:istinq buileinq oz s tzuctnre, npon application therefose,
s�quize the paymeat by the applicant f oz such permit ot �ees to the
aaount btzeia belov set fozth and in the �annez herefA psovided to-witr
TOQ71L V]1I�I1hTICN
i1.00 !n i500.00
SSO1 Zo :2.000
52,001 � S25.000
SZ5,001 to 550,000
550,001 to 5100�000
5100.001 ar,d up
lEES
i20.00 Minimnm Fee 515.00 plus surcharge
510.00 for the first S500 plus S1.50 for each
aaditional 5100 oz fzaction thereof, to and
including 52•000
a32.50 ioz the firct 52.000 plus Sb.00 for each
additional S1.000 or fzaction th eseof, to and
including $25,000
5170.50 for the fizst S25,000 plus 54.50 for
each additional 51,000 cr fraction thereof, to
ana including SS0,000
5283.00 foz the fizst 550, 000 plus S3. 00 for
each edditional 51,000 or fraction thezeof, to
ar►d including 5100, 000
Sa43.00 for the fizst S100, 000 plus S2. 50 foz
each additional 51,000 oz fraction thereof
PIAN t�ECK: 25 percerit of building permit fee
DRIVDeIAY DEPR£SSION ESQtOWa Conczete Wzb Stseets Only
I►lteznate "A": Re�nov�al and zeplacement of cuzb and qutter only ,
Driveway vidth plus 6 feet s 513.50
!►lternate "8": Renoval ar�d zeplacemes�t of cuzb ar�d qutter and install a 3 feot
vide appzeach with 6 inch depth
Driveway vidth plus 6 feet z 515.75
VERIFICATION OF FOUNDATION
Pern►its foz constructioi► vill be issued a �einim�n of 24 hours fran the time of
application to allow foz proper revieW of the proposed stzucture and of the
constru ction site.
A Certifica te of �rvey of the lot, shaoing the Iocation of the founclation once it
has been oonstzvcted will be zequired before proceeding with the frami.r�g.
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N.C. HOIUM aHD ASSOCIATES I
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P, 0. BOX 33026-COON RAPIDS, MINN. 55433
CERTIFICATE OF SURVEY: DENNI$ MORLEY ��
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�. f3R��Ar�ooN P�.�cE � N E,
.� �� S The 5outh 11 ii.00 feet �� Lot 21,
Block 2, SPRING LAKE PARK LAKESIDE,
Anoka County, Minnesota. Subject
to road easement over the South
25.0 feet thereof.
LAND SURVEYORS
Telephone
421-7822
SCA�E � �" = 30'
5599• �23E/50-5J
� DENOTES IRpN
I HEREBY CERTIFY THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF TI1E BOUNDARIES
OF THE ABOVE DESCRIBED LAND, AND THE LOCATION OF ALL BUILDINGS, THEREON, AND ALL VISIBLE EN.
CROACHMENTS, IF ANY, FROMI OR ON SAID LANO.
AS SURVEYED BY ME THIS.....�.:4th.,,,,,DAY'OF February
.............................................A.D. 19.. 83 ........
N.C. HOIUM AND ASSO TE , NC.
.................. `��:......!... r"�.[IY�............................................
Minnesota Regisfrotion No. „ 44�7',;,,,, .
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RECEIPT
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6431 University Ave. N.E.
Fridley, Minnesota 55432
Tel. 571-3450
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RECEIVED OF $ ._-�^�% ''
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ADDRESS
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FOR '' , _ � �-e.r - ;�,5 �.�'a - G' �
.� i/ d'� �'� a' / J� � � �..:. , ,�SF+�
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FUND CODE AMOUNT
�/ 3,�'�e �� c, G u s;�,. �
SIDNEY C. INMAN
Treasurer
By `�� � � -..�
�" - 3 ,s �3 n,o. 9281
FLATP/1�(IT(� MOOR6 SUfiNHEi PONMG� INC, - N 3Y1120f2�Qe
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SuB�ECT
City of Fridley
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
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; �L ___�__ COMMUNITY OEVELOPMENT DIV.
r j � PROTECTIVE INSPECTION SEC.
� _ ,
�l �"'� � CITY HALL FRIOLE� SS132 NUA�BEF nEv
L•��.� � �.J
612-571-34b0 9t0-F15
J08 ADDRESS 7675 Brigadoon Place NE
t LEGAL �07 N0. BIOCK TRACT OR ADDITION
oescR. S 118' of2 2 Blomberg Estates-Spr�
2 PROPERTV OWNER MAIL ADDRESS
Wayne Fuhrman
3 CONTRACTOR MAIL ADDRESS
United Roofing 13436 Hanson Blvd. Andover MN 55304
4 ARCNITECT OR DESIGNER MAIL AODFiESS
5 ENGINEER MAIL AODRESS
8 USE OF BUILDINC3
Residential
7 CLASS OF WOf;K
OATE vAGE Os
6/2/99 � /
,
29593
�� �
PROVED 8�
SEE ATTACMED
Lk Pk Lakeside SHEET
Z�P PMONE
780-6994
Z�P PHONE LICENSE NO
804-5360 20090868
ZIP PHONE LICENSE NO.
Z�P PHONE LICENSE NO
O NEW 0 ADDITION ❑ ALTERATION �c REPAIR D MOVE O REMOVE
8 DESCRIBE WORK
Reroof house and garage (23 Sq) Tear-off
9 CHANdE Of USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPA�
VENTILATING OR AIR CONOITIONING
THIS PERMIT BECOMES NULI AND VOID IF WORK OR CONSTRUCTION zONING SO. fT
AUTHORIZED IS NOT COMMENCED WITHIN 60 OAYS, 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
I MEfiEBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STA��S
AND KNOW THE SAME TO BE TRUE AND CORREC7. ALL PROVISIONS OF LAWS yqLUATION
AND ORDINANCES GOVERNING TMIS TYPE OF WOFiK WILL BE COMPLIED
WI7H WHE7MER SP IFIEO NEREIN OR NOT. TME GRANTiNG OF A PERMIT �ZOI.O
OOES NOT pRESUM TO GIVE AUTMOR�TY TO VIOLATE OR CANCEL THE pERMIT FEE
PROVISI F ANY THER S7ATE O LOCAL LAW REGULAT�NG CON-
STRUCT HE P FORMANCE O CONSTRUCTION $83.25 'F �H3.ZS IF
� PLAN CNECK fEE
License SC $5.00
S�GN4 UpEOfCONC ACTOQOpAUTHOpQEOnGENT 1DATE� ,........ ��____... _
p BU�LDEpi �D�iE�
�
GROUP OCCUPANCrLOAD
CU fT.
OfFSTqEET PAqKING
IGARAGES
$1.01
AC CMARGE
Fire SC $2.01
OTqL FEE
$174.52
THIS IS YO A PERMI
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ADDN
ALTER
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Effective 5/10/99
CITY OF FRIDLEy
SINGLE FAMII,Y AND DUpI,EXES R-1 AND R-2
BUII.,DING PERMIT AppLICATION
Construction Address: ����
Legal Description:
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Owner Name & Address: � � Tel. # ��� � � ���
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Contractor: MN LICENSE # �'��� �
Address: l��s'� t�"��,� �r,�-�� - �� ��� Tel. # ����
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA:
GARAGE AREA:
DECB AREA:
OTI�R:
Construction Type:
DESCRIPTION OF IlVIPROVEMENT
Length Width Height Sq. Ft.
Length Width Height Sq. Ft.
�ng� Width Hgt/Ground Sq. Ft.
Driveway Curb Cut Width Needed:
DATE: �'��
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License 5urcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
APPLICANT:
�3 ��.��� b
$ ,�
$ (�
$ a
$
$ �'` �
$
$
$
$
$ �fZ
� L� � 2 ��; �
Estimated Cost: $
Ft. + 6 Ft = Ft x $ _ $ . �' �
Tel. # � �� �
Fee Schedule on Reverse 5ide
.001 of Permit Valuation (1/lOth%)
$.50/$1,000 Valuation
$1050 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [] Not Necessary [ J
y _ �
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 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 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
$500,�1 to $1,�0,0(�0
$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,�0
$69.25 for first $2,0� plus $14.00 for each additional $1, 000
or fraction thereof, to and including $25,000
$391.25 for first $25,000 plus $10.10 for each additional $1,000
or fraction thereof, to and including $50,000
$643.75 for first $50,000 plus $7.00 for each additional
$1,000 or fraction thereof, to and including $100,�0
$993.75 for first $100,000 plus $5.60 for each additional
$1,000 or fraction thereof, to and including $500,000
$3,233.75 for the first $500,000 plus $4.75 for each additional
$1,000 or fraction thereof, to and including $1, 000, 000
$5,608.75 for the first $1,000,(�0 plus $3.15 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Altema.te "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet tunes $15.50.
Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $23.25.
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of applicarion 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 b�en constructed will
be required before proceeding with the framing.