AF - 35622.
���y ����fl���y
r�' aT Til� TOP OF TN� TW►MQ
i`
.
r �'L-�"���� GOklIWNITY D£VQL.�GOENT DIV.
� _ � i �MtOT[CTIVQ lC�GT19ry p�SiT,
�
` I•'-� � pTr M/►�l f1WDL�Y ��t�
L..«�r� .J W$' B80' �l�0
S
------ �A�� i 1 �
�lumbing ontrac�or
�
Kind �f Buildi�
on vate .
�� �° i ! j � � �j
W
'� I I i
� i W � � _- _��
• W I I
3°I i � i j
�
aaNral � ; i i �
4 �
SYfl ' ��
'1ddYl I i I � O
aro i .
i '781N I I I I �
i 'sao� I �
•nnN�val 1 ( , �
I � _—
�
m SNISYBI I I i �
w
I.�. H�11I�I I I
� x .
'3 � eNrvaol I I i
aooid I
� �
�� V� sa3MON5l I � I I
�0 a°
�� q '1Nf10lI I � I (
,a; d HNiaa
� �j a
'a
�
C.7
�A rS HSI/MI � I I I I 8�I
I '� �
i Z s�N�sl I I I I
�
•wisra
•ont
!ltYa
w�an
d
� �
B
� �
� �
� �
� � � �• �
�
� � � � � �
�t��EGT
Permit No.�
.,
PLUMBI�Vr, PERf�IT APPLICATi��J �
6�
s ' Phone
s
se
. d
►
�.,�, � �6�
Plumbing Fixture Rates; N0. RATE TOTAL
�1
! Number Fi.xtures / x$2 . 00 �- � O
�i �
Future Fixtures x $1.50
�'
" New Fixture-01d Open. x $I.50
� Catch� Bastn
� x $3.25
' Water Heater-99,000 BTU x $3.00
�! Ground Run Old Bldg, x 3.2
________ $ 5
� Elec. Water Heater x $2.00
jGas Fitting Fa�s; '
II lst 3 Fixtures x$2.00
i -
, Additional Fixtures x $ .75
, ..�—
� I
i Gas Range-199,000 BT[T x$5.00 !
!
� � Repairs &-Altexations
I See I
� Description: Code
� State Surchar�e .50
i
I TOTAL FEE . $ o,� �
!The undersigned hereb}r makes application for a permit
for the work herein specified, agreeing to.do all work
in strict accordance with the City Ordinancea and ruling
of the Department of Buildinga, and hereby declare that
all'the facts and repreaentationa atated in this I
app�cation are true and correct.
irjucta. ac
r�9�2�Z��� gi /�
♦
�'7
ate
�
�
.
City �f Fridley
.r ' 4T Ti� TOP O' TN� TttiIN�
1 �
i`
.
r r�.-------� GOMaUN�TY pEVELA�EMT QIV,
� . � i MOTLCTIVQ INfii%gCTipp �6T,
� ,.--_ ; Ctrr Nea�� sai9t;r ��5�
�.....h.� `., �+a-s�o-3+so
Job Address
� � �/ � V`�QC'J /`��
�lumbing Contraeto
o�J ,I � I
Kind of Building
Comp etion Date
�-
�
�
�
� m
w
� '
j� ir.
:O o
�3 0
;p d
u
�� a°
�tl
c� °�
A w'
�
�
�
i
;
��
o��
� ��
� i
O i
i
!
�'
I
i
�
o �
w �
.� +
� '
� �
CS
GT - .
Permit No._
PLUMnI�dr, PERf1IT ,qPPLICI�TI=��d �
�
ss one
�l� en J t I
se
� ' `�j• 3� �. ��
Plumbing Fixture Rates; Np, RATE TOTAL
Numbex Fix tures _% x$2,00 $�.0 O
Future Fixtur�s� �_ X.$1.50
New Fixture-Old Open. x $1.50
Catch� Basin x $3.25
s
Water Heater-99,000 BT[T x $3.00
Ground Run Old Bldg, x$3.25
. -.__.___
Elec. Water Heater x $2:00
Gas Fitting Fa�s:
lst 3 Fixtures x $2.00
. -..�_
Additional Fixtures x $ .75
Gas Range-199,000 BTU x 5.00
$
� � Repairs &-Alterations ,
� � See �
Description: Code
B I� State Surcharge 50
� �
•e i TOTAL FEE $ � �
�!The undersigned hereby makea appl�ication for a permit
for the work herein specified, agreeing to do all work
� in strict accoxdance witT� the City Ordinances and ruling
of the Department of �uildinga, and hereby declare that
all'the facts and xepre�entations stated in thia
. application are true and correct.
� /
� Signatuxe ' Date
. f '!�'':�`
.
Q„
�
�
0
i
i
i
��� o • //�
��ed�Ce
�------ � �
6431 UNIVERSITY AVENUE NE
ANOKA COUNTY ; �
September i9, 1973
R
�I�i�neapol�� �ost pff�t�e Department
�u�er�nte�dent o� Delivery
ls� & Marquette Avenue
M�t�neapolis, Minnesot�. 55402
Gent��men:.
560-3450
FRIDLEY, MINNESOTA 5542t
�: Change of Address
City of Fridley
We are listing the following change of a dress in the
City of Fxic�l�y; �
1�'AME Mr. & Mrs . �
Wallace K. Dahl _ _ . �
T0. 80$1 Broad Avenue N;E.
. LLGAT, DESCRIPTION Lots 21 22 23 24 �
B1• J. Riverview geights
6+1e have rtoti��jed the occupant qf this chan e
�pprecj.ate it very much if you woulci chan e g�nd we wou�d
S your records accordingly.
Yours very truly,
� ���. " , •
I�ARENCE J. ��LISLE
* �uilsling Inspector
�$�t� City ¢f F�rid].ey
�C� C�ty Water Bill�. �
ng Aept.
CiCy ,Assessing D���,
I�j�nneapolis Gas Co.- Brooklyn Park Office
Narthern States pow�r Co.
Northwestern Bell T�elephone
eity Voters Registration
�
i 560-3450
�
�-6�� O �6'l ��Q
� �
ANOKA COUNTY
6431 UNIVER5ITY AVENUE NE September 19, 1973 FRIDLEY, MINNESOTA 55421
Mr. & Mrs. Wallace K. Dahl
614 Fainnont Street N.E. •
Fridley, Minnesota 55432
RE; Chan�e of Address
�lear Sir;
It has been i��regsary for this �ffire �.o chauge the address
of you� house
FROM _�i1_�ai.�.rmont Stree.t N,E,!_____ Tp � . �
— 8081 Broad Avenue N.E.
LEGA;t, DESCRIPTION Lota 21,22,23,24� gl. J. Rive�:view Heights
We have notified the Post Oftice Department, Minneapolis
Gas Company, Northern Srates Pow�r Company, Northwestezn Bell Telephone
Company and various departments in City H:�11 ot this ch�.nge.
CB/mh
Yours v�ry txuly,
�'-' ../L• '' � �_-�C� .. �
CI�AREIr`CE J. BEI.ISLE
Bui.Ldi��g Inspectox
City of Fridley
� I
i
'(-��1_
lI�'�,J
�..JV
�
D
l_._JU
\J
�_JV
0
�r�
�
�
�- �7
l.__J U
�
�
�
C�
�
�
`�-�
�
�
�
��
��
■
�
�
�
W
�
��
��
r.�
�
��
�____:�
�
�
�
�
Q
d�'
M
�
O
�
Lt9
•---•
N
r
�
�
,�;'
��
�
��
:�
�°�
!4
r'
.�>
,�;
y
��:;_
; �:
�
;.�
;.:
Febxua.ry 6, 1974
DahZberg Realty
1I21-80th Avenue NeE.
Minn.eapolis, Minnesota 55432
Attention: �Ir. Sam Dahlberg
Gentlemen:
Please be advised tha� Ci�y secver and water is avai?able
to 8081 Broad Street N.E. (Lots 21 - 24, filock J, River-
view Heights). A 6-incll �vaterma�n. ex%�s in Ely ��reet,
therefore, a service can l�e installed fram Ely Stree� �o
the aboye referenced property. A s�wer lateral exis�s
in Ely Sta.eet from a manhole a.t the centerl�ne of Broad
Street east to the rivere The sewer servi.ce can be in-
stalled from the manhole at the centerline of Broad
Street and Ely Street to tihe a.bove property.
If further informa�ion �s requirecl, please confact our
Engineering Departmenfi.e .
Very truly yours,
GiG' � �%!'/' ` L
F�ichard N. �obiech
Assistant Engineer
RNS/pl
SUBJECT
PERMI
City of Fridley 12519
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
� � REC
� `L _ COMMUNITY DEVELOPMENT DIV.
r j � PROTECTIVE INSPECTION SEC. % P���
1 ` , i
L--__� �����,,, CITY HALL PRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY
Z 812-580-3450 910-F15 5/2/74 � �
JOB ADDRESS
8081 Broad Street N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION
DESCR. 21 .thY'U 2 J Riverview Hei hts
2 PROPERTY OWNER MAIL ADDRESS Z�p
Wallace Dahl
3 CONTRACTOR MAILADDRESS Z�p
Da��ra 3L� �f��S IriC 7171 $Q h A�y n��r.a N F
4 ARCHITECT OR DESIGNER MAIL ADDRESS 21p
5 ENGINEER MAILADDRESS Z�p
6 USE OF BUILDING Residential
7 CLASS OF WORK
� NEW ❑ ADDITION l� ALTERATION ❑ REPAIR
B DESCRIBE WORK .
Remove closet to t�i¢��I�¢/ increase bath for a 4�
9 CHANaE QF USE FROM TO
STIPULATIONS
PHONE
PHONE
PHONE
SEE ATTACHED
SHEET
LICENSE NO.
UCENSE NO.
UCENSE NO.
❑ MOVE ❑ REMOVE
SEPERAT,E PERMlTS REQUIRED FOR �VIRIi��,
HEATlNG, PLUMgIIVG A(�p S���JS.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATINO, � rrt ur �vrv�i.
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING
AUTHORI2ED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR Ih/0RK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNI
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT ySSOO.
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF ON UCTION. � tiS`G.00
TURE �Fn ONTRACTOR OR AUTHORIZED AGENT IDA
Sa.
STALLS
H.A
ROUP OCCUPANCY
CU. FT.
OFFSTREET PARKING
IGARAGES
SAC CHARGE
TOTALFEE
$6.50
ALIDA7ED THIS IS YOU
�� �
APPLICATION FOR RESIDENTIAL, ALTERATION,
OR AllllITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER � S NAME :_ ��j'����P1� c���2�TLDER • Pitj �
ADDRE S S • ADDRES S : _ � ��° /'°� �G ��c'^^—o �� .
NO:.���� STKEET: �i�� � �
LOT��'%� �3 � f BLpCK: r- ADDITION:�j�� �'���� /,�'c-�'�✓�
CORNER LOT: INSIDE LOT:�SETBACKS SIDEYARDi
Applicant attach to this form �ao Cer�ificates of Survey of Zot and proposed
building location drawn on these Certificates.
� To Be Used As:
HESCRIPTION OF BUILDING
Fxontt Depth: Height•
Square Feet• Cubic Feet:
Fron�• Depth: Aeight:
Square Feet; Cubic Fee�: `
�pe of Construc�ion: _� � �
Estimated Cost: $�����
To Be Comgleted: � '—� % .
__� c
� Z� � � Z� �
� �
.
The dexs gned'hereby makes app� tiv�.for a permit for the work herein
specified, agreeing to do all woxk in strict accordance with�the City of
Fridley Ordinances and rulings of the Department oi Buildings, and hereby
declares that aIl the facts and representations s�ated in �his application
are true ancl coxrect.
DATE: __,���_� �' STGNATURE • -�-�r .
.(See Reverse Side For Additio 1 Information.)
�v ° ��' .
�� �� .
. �� /C .
� �� .
. �
• r' �
BUILDING PERMIT FEE SCHEDULE
SECTION 2. The Inspector of Buildings shall, before issuing permits for the
exection o� any building or structure, or for any addition to any existing
building or stru.ctuxe, or for any alteration or repairs to any existing
building or structure,-upon application therefore, require the payment by the
applicant for such permit of fees to the amount herein below set forth and in
the manner herein provided to-wit:
UI�tFORM BUILDING CODE: Type 1, 2& 4-$2.15 for each one thousand cubic
feet, ox fraction thereof, in such cubical contentse Type 3& 5-$1.85 for
each one thousand cubic feet.
ADDITIONAL INFORMATION
Eor the purpose of computing fees for building permits, the cubical contents
of a�y building or addition, is determined by multiplying the gxound area
covered from a point six (6) inches below the floor line of the basement
o� the cellar to the average heiglits of the upper surface or �o the average�
�height of the roof surface of the main gable of a pitched roof.
Fox repaixs or alterations to an ex isting stxucture, the fee shall be afi the
rate of $3.00 per each f�ve hundred dollars ($500.00) or fraction thereof in
the cost of all prop•osed woxk.
Tn no case shall the fee chaYged for any permit as set forth in Section 2 be
less than $5.00.
VERIFICATION OF FOUNDATION
NOTE: Permits far constr�.ction wi11 be issued a minimum of 24 hours fxom the
time of application, to allow for proper xeview of the pxoposed structure and
of the construction site.
�. '
A Certified Survey of the lo�, showing the.location of the foundation, once it
ha� been constructed, will be xequired before proceeding with the framing.
CERTIFICATE OF OCCUPANCY
Application fox a Certificate of Occupancy shall be made ten (10) days prior
to �he use or occupancy of any structure for which a building permit has been
issued; and said structure sha11 not be used ox occup3.ed until a Certificate
of Occupancy has been issued.
�
.'
..
� �..i _ __ — , _—..,__�.._..�...... ��J '
�1
._ �.. . �_��
,. � � � ��rrrT~�^ . ._� .
� • , • y �) �
� /({�. (jh. {(
� . ��S��� ' �° x �� C ! - T , . `i 1
'°.i - '`3"' _ �
' ,�, ---_�L _--�--�...�� -- --- __ __��" �_ ���� #
� � ��-- P�� . ;' Y
. �. � ` � �' `; �
� E. ; ,
� ; , �;
E � ; �-
�. -„ { -�' �; �; . .
., � �
�; �s :�_�. �;.t w ; . T-- 4
a �, .
� �� - � , ,, ` ' � �
"° �S 4 j � _ � • �,. - �, .
w .y, 7; '
*. � � -� �
r '�'
� itv 4 .�S_ � _ ' �4.
, � t� . . _\ � :
, ' � ;
� � �-� . ! . � . ..
:� � ��� � . , i;
�. �� � , ; y � ,. - . .. i:
� ::_.�...._� ; ����,".:� ' � s��. � , �
� ��:� ;-,_ � `' �, � � �
'�s r.'��a ��.�� �.��,.�,..��« a:�.... _,_, , ' _ �;
� ..� ,�–�'`�° '' - - --�� �.,�4 _ _.—_ � ` �,
. � , � r; � .
. r. ; � 1
. - „• � �„� ' .�• , . .
• � �^* C'. �.� . +
,, t - . � �'�i,� __ y - . � �-� �
'Y w �
�r' � � � �
•• i .` .. . . � . - � . �. . � j.
— �'t "'"" S ..." � .�. __ , --. .s , r .. _ '.,e:.T..tT,�.,� . .. a ._ , '_' . P_. c.. .
}v .. .. � . �� - . '�F�� - � � ���jj
. �g„ � tl i � � . � � `� � 1 � * , - \ \ • � f iv
.. , �. - ' � . . . 1
� � � • . � � � �� �
-1' . ',� � � . ._ . . ' ' .� �' �
a , � � � � V i� �
i � :j ,�. * - . � � r'� a �! .� .� , ... . .. � :� .
-� , .. . ��. � � • � t ti
,. � �. �� �.���
A �
�. , , � � � '� � ' � " . � . !�s . '
- . . � �` 1
� � i . �,� � i �� . �
�� � + � ? —�c. �, ;� �'� a � n � � ,
� C. ( x '�,3. 'Y . i
! 19.` �
�. , -
. •�',�'��. -; �- '
� "�R ,� • �. s' � � �, ° � � , ° *� ji
�r � � �� -� '� � �` � ?8 i� � `� '��'�r, 1
� � -'T �Q.^'_� , �,i� �b � i� �°^ • fi.
,�
7� � ' � ~�. � � � ! � �` � � ' 3
� �� � � � _� � ��� �..� � ;! ;
� �
'�°!� j y � � .a i � �,. � ; ��� �^� ,j j
{ ! �y*�.� � ! - � ' �v .� a � '� � • f i
Q: � ` ' F � . e' fl' � . i � � � -1---�'_"'..... ,u.. �_.._.__ �
`t j � �h�,� � � i � _' � _ y,a
� r �
� :. " � � ' � � � .
� { } ` s , I �__.__ __. ---- _.___5�.._.�_______.___..�
----s` w_. _._.�'x..ii_____ '� _., � _ __ 1•,.__....._.. 4 �
� ^...� .�_.. _� _- �-. _ _~.� ____` � ' , •
� � t
��! � i C� �; 4 ' " •
���� � �� �'� � .��,.. -
�' � �, � � �, � ,� -� �, � .
� �-� . � `�:�y - � �
�. � � � � , %�
�" ::'„�.;d€-r�== �'�-'ix-�.�-.Y`��-�', ° .. a : "�� �i,. '., . � � �.. _ � , . . . _ � . . x- � . . � �� M -�F:� i�r
...(,. ... . .;.. .. .
_ y'�`7 r.Kra.'s, w� !_�,...a�_. > s).3 r!°. . .._a..
;��
..�
.�'
��,..
�r
� -�
� ���
CITY OF FRIDLEY
A131 UNIVERSITY AVENUE N.E.. FRIDLEY, MINNESOTA 55�3Z
1, 1983
Mr. R. W. Hartsnan
8081 Broad Avenue N.E.
Fridley, NII�T 55432
Re: On-street Parking
Dear Mr. HartJnan:
TELEPHONE ( 812)571-3050
The City recently recieved a complaint from one of your neighbors about
the place where you park your car on the street. The neighbor stated
that t-he location of your parked vehicle impedes the access to their
driveway because your vehicle is direc�.l.y across from their driveway.
If in fact it does impede their driveway access, it would constitute
a parking violation (please note the enclosed City Code section 506.07,
#Z) .
You were probably not aware of this parking restriction and we hope
that the bringing of this.to your attention will resolve the problem.
Your cooperation in this matter will be appreciated.
Sincerely,
G. CLARY.
Chief Building Official
DGC/mh
ENC: 1
��
Building BUILDING Permit rro.: , -�'
Inspections RESIDENTIAL APPLICATION Received By: �`
763-572-3604 CITY OF FRIDLEY vate xe�'d:° "�
763-502-4977 FAX EFFECTIVE 1-1-08 --�
DATE `S�� '1 �0.� YOUR E-MAIL ADDRESS
SITE ADDRESS � C�, a°°� (�=
THIS APPLICANT IS: �,�OWNER �CONTRACTOR
PROPERTY OWNER/ NAME: � P'e ('� � Jn 1 c!
TENANT ppDRESS: TY t t= STATE�'//// ZIP i�
PHONE: j%� � � � � �
NAME: -
CONTRACTOR ADDRESS:� - STATE ziP
�
; SUBMIT A COPY OF PHOId�-�- ---- `' "-�--------_ -
YOUR STATE LICENSE •
STATE LICENSE # E DATE
! PROPERTY TYPE � �o F��Y/LNYEWECONSTRURCTIONON STORIES
PERMIT TYPE � �DTfION O,GARAGE/SHED ❑ WINIIOWS
� BASEMENT FINISH �ROOF ❑ DRAM TILE
❑ DECK 0 SIDING ❑ OTHER
� SWIMMING POOL
;TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION
, ❑ MAiNTENANCE/REPAIR ❑ REMODELING
I
� DESCRIBE WORK BEING DONE:
I S1ZE OF IMPROVEMENT LENGTH WIDTH HEIGHT S FI'
� ROOFING ❑ HOUSE ONLY
� NUMBER OF SQUARES �1�_ � HOUSE & GARAGE BASEMENT REMODEL[NG SUBMIT:
I. Existing Floor Plan
G � ES ❑ ATTACHED GARAGE 2. Proposed floor plan
� POSED SIZE: � DE'fACHED GARAGE 3. List of suuctvral members to be used
� PROPOSED HEIGHT:
�i SIDING . FOR NEW CONSTRUCTION INCLUDING DECKS,
� ❑ Vinyl �Soffit ADDITIONS & PORCHES SUBMI'f:
❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures
❑ Other ❑ Fascia and proposed project
2. Two sets of construction plans
I WIlYDOWS 3. Energy Calculations
': IN EXISTING OPENINGS DYes ONa LOCATION OF WINDOWS
� OR FOR NEW OPENINGS-DESCRIBE SIZE OF
� OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER QE WINDOWS
i ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AATD MATERIALS:
TOTAL JOB VALUATION ;
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
uau�u 1nr. 177� un�. rr�c, o�.aauaia�u.:.�
OCCUPANCY
�� e d�
$
$ -1
$
$
$
$
$
See Back Page for Fee Schedule
65% of Building Permit Fee
.001 times the total job valuation
.0005 x Permit Valuation Minimum $.50
$5.00 (State Licensed Residential Contractors)
$1825 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$21=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks payable to: City of Fridley Attach
THIS IS AN APPLICATION FOR A PERMIT-NOT VAL[D UNT[L PROCESSED
I hereby apply for a buiiding permit and I aclmowledge that ihe 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 undeastand 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 accordarice with the a proved plan in the case of all work which requires review and approval of plans.
SIGNATURE OF APPLI �'��� PRINT NAME� /°���y� /'t� �I�NJ,(i ��" DATE�
a�
�� -/ / a
APPROVED BY ���%����i DA
Page 2- Building Residential Application
BUILDING 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 pernait of fees to the amount herein below set forth and in the manner herein
provided to-wit:
TOTAL VALUE FEES
$1 to $500 • $23.50 (1VIinimum Fee is $23.50 plus surcharge)
$501 to $2,000 $23,50 for 1�` $500 plus $3.05 for each additional $100 or fraction, to and
includin $2,000
$2,001 to $25,000 $69.25 for 1�` $2,000 plus $14 for each additional $1,000 or fraction, to and
includin $$25,000
$25,001 to $50,000 $391.25 for 1� $25,000 plus $10.10 for each additional $1,000 or fraction,
to and including $50;000
$50,001 to $100,000 $643.75 for 1s1$50,000 plus $7 for each additional $1,000 or fraction to and
including $lOQ,00Q
$100,001 to $500,000 $993.75 for 1�` $100,000 plus $5.60 for each additional $1,000 or fraction to
and including $500,000
$500,001 to $1,000,000 $3,233.75 for the IS` $500,000 plus $4.75 for each additiona( $1,000 or
fraction to and including $1,000,000
$1,000,001 and up $5,608.75 for the 1�` $1,000,000 plus $3.15 for each additional $1,000 or
fraction
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimurn of 24 hours from the time of application to
allow for proper review of proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the existing foundation will be
required before proceeding with the framing. New Hou.ses Onlv
City of Fridley
Building Inspections Department
6431 University Avenue NE
Fridley, MN 55432 '
763-572-3604
Faz: 763-542-4977
4 S� �^ �
�"Y OF FRIDLEY �� "� 481
Application for Ins�tion of �Vater and Sewer �ervice
This form to be completed before a ta.p is made to any existing water
or sewer line. -
Lot ��.' �-�----- Block .---. � -------------- Addition -------------------�-�---------�-------�-�%t,�
Address-------�a �/ ----- -----------__----�.._.� °.-------•----•--.__......_---------------------_._._-----_._.._.......
Owner .----i� ��°�'c-�-__. 4 ._._..__. _ �.__..__
__..
Plumber ----� --- -......._-----__ .._--�--._ .___�"...�_...�-�-����
(this portion of form to be completed by �rson requesting tap)
CHARGE5 TO BE PAID BEFORE TAP IS MADE — WHERE
ASSESSMENT HAS NOT BEIIV LEVIED AGAIl�T5T PROPERTY
Sewer
Connection fee
�Street patch ._
Water Connection fee
Meter deposit
Materials wsed
�street natcl� --
�'-/4.1,c,� Asa� `�� I
�� �
,� �s. `�,
� Where applica.ble " ' f /- o
The above applies for all regular residential size services
IF LATERAL ASSESSMENTS HAVE BEEN LEVIED AGAINST
THE PROPERTY, TF-IERE WILL BE NO CHARGES OTI�R. THAN �
CONNEG°1`TON PER.MITS AND ME°rER DEPOSIT �
The Citj, will, fnraish materials for water service and the plumber
will bill the G�ty for sewer, not to exceed $3.� a foot or a maarimum
of $60.00.
ASSESSMENTS TO BE LEVIED
Water Lateral
Credit for material
Tota1 assessment
Sewer I�a.teral
Credit for material
$------�----._...---.._..._.._...
$..._.._—._.._..__._.._--••
$._.._..._........ _..__..
6Q.00
Total assessment $-----_.._.____..._�_...
��� _• • •___-•
Clerk's signature .- -- ---- - ----- - -.._ _ ... -- ---`-�}-
I hereby authorize the above ta.p ���
1st copy—Public Works Director of Public Works