AF - 35623Date:
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Addr
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City of Fridley, 1Vlinn.
�
BIJILDING PER.MIT N° 3 4 5 2
... �.(�. ' ..�. ' �.�....... � � �___--.°�`.-
�.� .. .. . .. :L.. Builder ............................................. °
�ss .:� o�.�..� . . .. ... Address .............................................
�S �)CY'GC� W�CATI OF BUILDINC
No. . !�". � � . . Street .�'� : . �. . . . : �G2�" . . . . . . . . . . . . . Part of Lot . . . . . . . . . . . . . . . . .
� '�°�` _`/`
Lot ��'` --�.............:
.—� "4�. B�ock . . . .�. . . . . . . . . Addition or Sub-Division ��i .!�`:G! :`:. . ! . . . . . . .
Corner LQt ..�....... Inside Lot ..,......... Setback ............ Sideyard .............�
DESCRIRTION OF' BUILDING
To be sed as:
e
c / . e� �i � rP
� ... . ......... Froitt .��..' �epth !.%.:': � Height l..� . � 5q. Ft. ��.. Gti:. Ft.���4�
.................... F'rout ........ Depth ........ Height ........ Sq. Ft. ........ G�. Ft. ........
Type of Construcfi�ton ................... �et. Cost..................... To be Completed ...................
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In consideration of tihe issuance to me oP a permit to construct the building desribed above, I agree to do
��' the proposed work in accordance with the descrlpt3on above set forth and in compliance with all provisions of
ordinances of the city of Fridley. .
�...�... . � ..............
.g���
In consideration of the payment of a fee of $. !: . . . . . . . . .. permit is hereby granted to . . . . . . . . . . . . . . . . . . .
• • • • • . • . • . . . • • . . . . . . . . : . . to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and h3s agents� employees and worl�en, in all work
%� done in, azound and upon said building, or any part thereof, sha11 conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construetion, alteration, maintenance, repair and moving of bufldings with-
in the city limits and tbis permit ma.y be revoked at any time upon violation of any of the provisions of said
ordinances.
. 7. .. j' . .'3� . . . Building 7n�ector
NOTICE:
This permlt doas not cover the construatton, Installatlon o� alteration fo� wt�ing, plumbing� gas heating,
sewe� or watar. Be sure to see the Buliding Inspector tor saparate permtts fo� ihese (tema
�
SUBJECT
City of Fridley PERM .
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T • 2193
r
� �
COMMUNITY DEVELOPMENT DIV. RECEIPT NO.
' �1:------� IfO�S�'��
1 � � PROTECTIVE INSPECTION SEC.
� _ �
1-___� �r���,'� CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY
s�2-5so-3aso 910-F15 � �
6 20/73
JOB ADDRESS 82g5 Broad Avenue N.E.
t LEGAL LOT NO. BLOCK TRACT OR ADDITION
oescR. 35,36 E Riverview HeightsAddition SHEETTACHED
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Reinhart Streich 8295 Broad Avenue N.E.
3 GONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Sussel Companq, 1850 Como Avenue, St. Paul
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
B USE OF BUILDING
Residential
7 CLASS OF WORK
� NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct 22` x 22` Ga�a.ge
9 CHANGE QF USE FROM TO
STIPULATIONS provide a hard surfaee driveway.
SEpEFtATE PER��IOT� R�Q�IRED FOR t�1rRIi�G-.
�IEATING, PLUM�o�v� A�D SIGNS.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING. ' WOU(I. Fi$IILH
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION 20NING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION R�1 /,�,$[�, 4840
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 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 COMPLIEp
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT �2� �-93 Z. �.O
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OH CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. g. OO
� ,i PLAN CHECK FEE TOTAL FEE
d �— ��� ��.o
SIGNATUREOFCONTRACTOROR UTHORIZ AGENT �DATEI E ROPERLY VALIOAT.E�'D THIS YOUR PERMIT �
3 �
,� SIGNATUREOF OWNER UF OWNER BUILDERI IDATEI LDG INSP qATE
- . .. �.: ':;a,j��,.s;;'.�'`�l^,�:
, ... ,.. ... ..
A�PLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
Onl��'� •�=�:�/� ih. %7n.�. f c.Tfpe�� BUILDER:
��.�-�-:�P �,
ADDRESS • �a 9 S' .�F.c� % u�e /�/E . ADDRESS : `d'S� C' �� �7C �� /�
v-�o.�
NO:. 8�9'S STREET: r�v�C�,t-�� /-� cJ
LOT : �s � � BLOCK : ADDITION c _ �i, i !� � c� � � c.c� �c` i � ,�f o S
CORNEIt LOT; INSIDE LOT: SETBACK:
SIDEYARD:
Applicant attach to this torm ZYao Certificatea of Survey o� Lot and propoaed
building locatian drawn on these Certificates.
DESCRIPTION OF BUILDING
To Be Ueed As ; �..�. ���,,,� �'� ��
Front : �- �— Depth : � �
• Height • i o �
Square Feet:_ ��y Cubic Feet • ����
Froat; Depth; Height:
Square Feet; Cubic Feet:
�pe of Constxuction: ��� Estimated Cost; $�i y3 �°
To Be Ctnapleted; �a � �
The undersigued hereby maYce�s applicativn for a permit for t'he work herein
epeaified,� a�xeeing to do all work in st�ict accordance with the City of
Fridley Ordinaaces and ;ruliuga of the Department of Buildings, arid hereby
declares that all the facte and representatfona stated ia tk�ia �pplication
are true aad correct.
.
UATE : � a- i— � 3 S IGNATIIR� • C� � 1� �� sQ �.��
(See verse Side Fax Additioaal Informa�ion.) . � ^.
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THE SUSSEL CO.
1850 COMO AVE. ST. PAUL
CALL: 645-0331
�
�P`ermit by �.!'���.'�' L
�1 Le9al Dascription��_
O Lot
❑ Blk
O Add'n
�.Value � � 3 _
�TYF� Const:
��= �.� c
Slab: ❑ In ❑By Sussel
❑ By Owner Approx. �
�STARTINGS POINTS ONLY
S. P. L.
S. S. P. L.
R.P.L. �
� . Alley
HotuQ
`�-o L � N � �, F. Street
N °�' Other
� Square With�/�t1e � %�
8-Re�ds..
� Mesh
❑ Sod Rem. - By � X f.�t �i� `��
-�f 6-�� a
�— `i
�B'�' Ping
�� Grade Point
�K
El O,H. Dr. Offset ��
,�l S.Q. Location 0 '� �''
� B�� BV Owner �gy Sussel
Existing garage:
❑ Detached No �
❑Attached Yes ❑
I S�ze o� existing; _ x _
iExisting garage will be:
❑ Lett as is
� Co�verted to L.S. - By owner
❑ Removed By: Owner ❑
Junk Musi Be RemoSed By Owner
,'� src. ev� s'B sce�<..
�--� S � o her� movals by Sus-
sel or owner • trees, bushes, etc.
� Show approx, dist. garage to
house and all prop, lines
Stakes visibie • p Yes ,p No
Survey available - I] Yes �,i�o
� SPecia! instructions from
,,,,,,.�. • �-:,.; �
, �-�— �—�__._
, L�/ ��'a8'/-%r /]n! S_ ti.-`�
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• v,P,J�r-Y
: WORK ORDER
NAME
T`� c � P .� C ,
PHONE�#� 1 ��6 c�
JOB ADDRESS S�L 9 � .k:' ,� ... . . _
BLDG CODE AREA � ���
SALESMAN 5�?'rE,et E CONTRACT DATE
-_ stZE Z- Z x z Z
FOR OFFICE USE ONLY
CONTRACTOR L, . T, �
SUSSEL JOB ,# — '�? 8p � S
JOB �# —
� � CONTRACT # 4-Z� ( -- Q,Z
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A�PLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY9 MINNESOTA
�`�:' ... . :, �'.�.
OWNER' S . NAME : _ �c� °a, �i � �--'1� �3'f �- � / �6� BUILDER : �'e. � s' e.O C�
ann�ss :_ � a 9�� ��,o ad A� 1�d �' An��ss : i�,ro �, ��,.-e - �'-,� �"��
NO:. STREET:
�T' BLOCK• ADDITION•
CORNER LOT: INSIDE LOTs SETBACKo SIDEYARD:
Applicaat attach to this form �ao Certificates of Survey of Lot and proposed
building locatian drawn on these Certific�tes.
�ESCRIPTION OF BUILDING
To Be Ueed As; ����� �c( �� �
� m ' �xont : �- �— De th °
P • Height:
Squaxe Feet: �� y Cubic �eet:
Front; Depth: Height:
Square Feet; Cubic Feet:
Type of Constxuction; �tv�c � Estimated Co�t;_$ �/�,� °°—
To $e Ccratpleted; �o c�Qy,�
The undersigned hereby makea applicati�n for a permit for the work here�n
speeified, a�reeing to do all work in �t�ict accordance with the City of
Fridley Ordinance� and rulinga of the �p���ent oi Buildings, and hereby
declares that all th� facts and representationa stated in t�is applicati.on
are trus aad co�reat.
,
DAT� : ��-� S ZGNAT[1It� :, � - � �:�, _ � �,�,�,��
(See Rever�e Side Faz Additio�nal Infoxmationa) � T
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THE SUSSEL CO.
18�0 COMO AVE. ST. PAUL
CALL: 645-0331
. �'~
� P�rmit by:������
Cl Logal Descri�riic�n
❑ Lot ,
� � -- T �.,
WORKc'ORDER
NAME Pa� ��� � � � i►'2 `A�A,� PHONE#�� �'���
JOB ADDRESS ��� � �,��s1� �+��� /�i�
�
BLDG CpDE AREA .__, ��'t����_ � � �
, L;
O Btk SALESMAN 5��'�'�'RZFE CONTRACT DATE SIZE Z-Z � Z Z.. �;
❑ Add'n
� Value
% � __., FOR OFFICE USE ONLY �
�Type Const. �'��� CONTRACTOR � -T• , � �'� ��' �pg � 4
Stab: ❑ In ❑By Sussel SUSSEL JOB # ��Q � CONTR,4CT,# 4'Zd �" 42 �
;
❑ By Owner Approx. �,,� , ,. �
2 STARTIIVGS POINTS OIV�Y ' �O� / %� .���� �� �� _
; _ , : ._ _ ,_ ' ;
S.P.L. �' vZ�, ; . '
S.S.P.L ,.
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• - � ; , ,. _
R.P. L. _ _. . . - -
�_ _
�' Alley „ _ _ � 4 - . ;
..
� .. �� . ___ _ ,
.�� House , , � ,, � . ,: ; '�_: ._ .; - . `�..
�
1 f;
� F, Street - ,
_ ,_
� , �
Other _ �` : �_ � _ • _,_ ,
fi�e��'� i-�i�a+� 5.�. , ..._ � _ , _
@� Square With _ __ ` :_ ; _ __ N ^
, f -
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.. .
„_ . . . , _. , � . � --- , -
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y /� ,q% _ �_. � � _ --- � � ~ �
,�
i � :, . �
�Oo �6'i �rl ° � ' ; ! . . _.. . �. _ . . . :....., ,'
� Sod Rem. - By . , _ ;
�'5'8e�� . , ,._ _ _ . ._ ' __ _ -- _ -_ ,
' _- ' '- -" � " , � . �,
E
, _, _r , �Z, t
� 6-Bag Mix - _.
� � � - - - �
' _ � .. , � -_,_, _ . _ _
i
�4ti1� �amping , ; .�
,
, • - -
� ,, �
� . �- � - � ' � y, �
��� Grade Point r�� - - � -�u�� . _ _ . _� . ' .- -- � __
�
1 ' � - � - - � �� �'n - � �, � � � � F�
i "` - -, � !:'6 � � �
� . . . � � _ , - — � __ , -
� O.H. Dr. Offset 1� • , ,
�-S.D. Location 0 `�'�r � ` �p °
�.Blocks ❑By Owner �By Sussel ; � ' P � : � C� A1 ',
�s - ; -». .,. � -
,. � �. ' ` `
._ _ .. ,_ . � �: � __ _ �_, . , �: ��N� �
_4 �_ �
Existing garage: No � , - ' ' �`• ' , � '
� _ _ , �
� Detached ❑ Attached Yes ❑ _ _ �
a, �
-, , __.
SFZA Of CxiStlllg:—x�— ..� �, � .';.�. � ' � �_ -r:._.: � _I. ��_...�__ � � . , - . . , . '�
_ ' _ _
Exestmg garage w►ill be: �' �. �;_ ; � . ~� _a
C7 Left as is M(�._ � E ' - - - _ , ; � _ , _ � . ;
❑ ConveKed to L.S. - By owner �,� , i._�` `-� L _ � � F �� �. ,--,. � _��� ._ .� _ _.r _ � ' . .z
O Removed By: Owner❑ -�.'.� � � � ��- � � ' ' _ � ��1 NG��''� ��� - '� � i
� .
_ � r � i � ; , --F % . , ; , � ,
Junk Musi Be Removed B Owner � y } .
3 Sussel ❑ �_, i__ _ ,
i � . � � �r �
�I `i"'T ' . — . � . � F ^ — - - — _ .
I ( �
� G � �6� /�� ��q(� �'L ,�:.,� { �.. _ � � .__ � _ � .
+ � , ;� � � e -�� �
��� �� i0��6�iC 1. � . f { �.:. . 4 1 ; � � � �A-. _, b.. �-1� ~ {.
S�cify ot er removals by Sus• �4 � I fi !� ,. �. _o. a_ l. , � ' �, a�� .�- . .-- .,..�-, , �o �T1PE�� _�
sel or owner • trees, bushes, etc. �" �° ""` , "�'""{`�'°°"I°� � 1 �' ! _ �
+ � r_ P �; � .1 �.. � ' _ , t . t
. �
.�Show approx, dist. garage to ' j. ' ' � - - - �
� �� � � � 1 - __ .
� -, I - � • � , � r ;—�-- : ;- ; �-- :-r, ;
house and all prop. lines 1-�� ���- ,�-- i-,� a- '- a s t�_ _
� Stakes visible - ❑ Yes �1 No ' ` - �- - - -
, �
, � � - � -x # � - . .
Survey available - O Yes €�lo ` ' �" 5` fi ' � � , ': * -� '
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�Speciat instructions from � � �� � � - ' � �_, �_ , N_ _ �
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I42
PUBLIC HEARING MEETING OF JUNE 12, 1978 PAGE 5
because a petition was received from adjacent property owners, the City
extended the detachment and annexation past the approved plat, however,
Coon Rapids felt the extension of the detachment and annexation beyond the
proposed plat ti•�as not in order at this time and that the remaining portion
of Lot 17 could be incorporated into a subdivis9on which could remain totally
in Coon Rapids.
Mr. Sobiech stated the Council is requested, therefore, to adopt this
resolution to amend Resolution #24-1978 adopted February 27, 1978 to coincide
with the Coon Rapids resolution so that onTy the Easterly 84.5 feet of
Lot 17, Auditor's Subdivision #103, Revised and Lot 24, Block 4, Mississippi
Oaks is included in the detachment and annexation,
MOTION by Councilman Fitzpatrick to adopt Resolution No. 51-1978 as shown
on Page 5A of the agenda book and includes only the Easterly 84.5 feet of
Lot 17, Auditor's Subdivision #103, Revised and Lot 24, Block 4, Mississippi
Oaks. Seconded by Councilman Schneider. Upon a voice vote, all voting aye,
Mayor Pro Tem Barnette declared the motion carried unanimously.
CONSIDERATION OF FIRST READIP�G OF AN ORDINANCE UNDER SECTION 12.06 OF THE
Mr. Herrick, City Attorney, stated, in 1962, the City elecied to realign
portion of Gardena Avenue and in doing so, vacated one easement and then
to acquire another easement of comparable size. He stated the City made
arrangements with the property�owner io exchange the vacated piece for a
easement.
a
had
new
Mr. Herrick stated the individual is now building a house and the mortgage
company objecied to that proceeding, indicating that when the pr°operty was
' vacated, it didn't become the property of the City, but to one of the
neighbors. Ti�e mortgage company has asked for a quit claim deed from the
neighbor and have the City quit claim a deed to the individual who received
the quit claim deed from the City back in 1962. .
Mr. Herrick stated there is a Charter provision that property can only be
sold by ordinance, therefore, this ordinance is necessary to correct a
title for property that was exchanged in 1962.
MOTION by Councilman Schneider to waive the reading and approve the ordinance
upon first reading. Seconded by Councilman Hamernik. Upon a voice vote, all
voting aye, Mayor Pro Tem Barnette declared the motion carried unanimously.
VISITOR COMPLAINT:
Mr. Hasher, 600 Kimball Street, appeared before the Council regarding a
residence at u.en�. He stated he contacted the City several
times regarding the problems at this address.
Mr. Hasher stated there are three cars that haven't moved in three months,
a bed in the driveway, several other piles of trash and trees that are up
to the curb line.
Mr. Hasher stated he had this property owner in court about 13 years ago
and he has been shot at, and his kids accused of stea1ing mail. He stated,
over this past weekend, the Police were called by this person and they
charged a lad in the neighborhood with theft. He stated he can't sit still
any longer and have these accusations going around.
Mr. Hasher stated he is getting awfully tired of calling City Hall and
being told nothing can be done and if the Police force is afraid, the
City is in bad shape. He stated there are weapons at this residence as
he has seen them being discharged.
Mr. Hasher stated, when he took this person to court, he had to miss five
days work and before the hearing, he was told they were changing the plea
so that the man could get psychiatric help.
i
��
a�. _ . �e�
PUDLIC HFARIhdG MEETING OF JUPJE 12, 1978
. ' �. , -r'�;
_ .s�
1.4 ,�
PA6E 6
Councilman Fitzpatrick stated he was made avrare of the situation at the
beginning of the 4reek and the City staff is beginning an investigation.
Mr. Earl Kochman, 595 Janesville Street, stated his property is adjacent
to the residence at �295 Groad Avenue, and stated last evening he and his
wife sa►�� the prc,perty os•rner at this address take a sliotgun and lay it
against the bed. He stated he didn't know 9f 9t r�as safe to walk out of
his home. Ne stated the Police have been called and he �vatched them drive
up and turn around and then drive away.
Mr. Herrick, City Attorney, stated he can understand that the residents
are upset, however, they have to find out what ordinances or la►vs are
being violated. He felt there are several City depariments that should
do some r.hecking to deiermine if there are violations of thG ordinances
or lativs,
Ms. Connie Kuusisto, 585 Janesville Street, stated the property owner at
8255 Broad Street had called the Police and accused her 14 year old son
of stealing several iiems and also accused liim of stealing dogs and taking
them to South Dakota. She stated her children cannot go in their back
yard without beiny harrassed by this person.
Mr. Rick Hasher, 600 Kimball Street, stated he ��rould like to impress on the
Council that it is time for something to be done. fle si;ated several weeks
ayo, these persons vrere burniny garbage in their drivetvay, and he knows there
is a bGrning ordinance in the City.
Mr. Qureshi, City tlanager, stated the City ►vould certainly investigate all
the complaints nade and if there are any violations, unless they are observed
by an officer of the City, it trould be necessary to have the citizens file
complaints with the prosecutor.
' Ms. Sue Kucher, 385 Territorial Road, stated she vras a secretary at the
Coon Rapids bank ►��here the property oame�� at 8295 6road Avenue does his
banking. She stated when this person comes into public places and starts
causing irouble, it then becomes something the arho7e coimnunity should be
concerned about.
Mayor Pro Tem Barnette stated the staff would investigate these complaints.
Mr. Herrick felt some contact person in the City should be designated.
Ms. Kuusisto stated they have been in contact with Neil Duncan of the Police
Department and would �vork ►vith him regarding this situation.
CLAIMS:
MOTION by Councilman Schneider to authorize payment of Claims Pto. 152F22
through 158993. Seconded by Councilman Hamernik. Upon a voice vote, all
voting aye, Mayor Pro Tem Barnette declared the �tion carried unanimously.
RDJOURNMENT:
MOTION by Councilman Schneider to adjourn the meeting. Seconded by Councilman
Mamernik. Upon a voice vote, all votirig aye, Playor Pro Tem Barnette declared
the motion carried unanin�ously and the Public Hearing Pleeting of 1;he Fridley
City Council of �une 12, 1978 adjourned at 9:05 p,m.
Respectfully submitted,
Carole Haddad
Secy. to i:he City Council
Approved•
Robert Qarnette
Mayor Pr� Tem
� �. I,.ry, .
� .
� FRIDLEY CITY COUNCIL MEETZNG
P�.EASE SIGN NAME ADDRE5S AND ITEM NUMBER INTEP.ESTED IN DATE: �June 12, 1g7g �
NA�'NE ADDRESS
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,ilAPPL1CiATION,FOR SENIOR CITI"LEN WA7ER AND SEWE RATES
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6431 University Avenue �o
Fridley, Minnesota 55432
Telephone: 571-3450
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on appropri ate Seni or Ci i�i zen reduced rates. �c� � L� t �.1%
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____-----.i ,- - �,,G u,��, ��ez,fi, d�C i c e under the penai ti es �f perj �ry, that I am a ci ti ze of �(�t`��
Fridley who c,ualiffes ror a reduced water and se►�rer charge as �rovided in Resolu-
tions �io. 36-i977 and No. 9-1978, and meet ila;�ing requir�ments:
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a. Am 62 years of age ar older or disabled,
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b. ; Occupy a si ngi e fami 1y� or doubl e`"ungal ow uni t. ��- �
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d. Have certified tha� our combined income is �7,000.00 per year or less. (This
certification must be filed ey arly witn the City Clerl�.) ��
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SUBJECT PER
City of Fridley _ 17 7 3 7
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
; � RECEIPT NO.
i �• COMMUNITY DEVELOPMENT DIV. '
r � v � PROTECTIVE INSPECTION SEC. '
� �
' � �
� � /'��1 CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVE BY
�""� � �`' 612-571-3450 91 o-F15 /24/84 � �
JOB ADDRESS 8295 Broad Ave. N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
oescR. 35,36 E Rivervi:evr Hts. SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Marie F. Streich 8295 B�oa,d ave. N.E. Fridley 55432 786-8330
3 CON7RACTOR MAILAODRESS Z�P PHONE LICENSENO.
OWriP•l"
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS 21P PHONE LICENSENO.
6 USE OF BUILDING
Residenta.l �
7 CLASS OF WORK
❑ NEW ❑ ADDITION � ALTERATION ❑ REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WORK
Reroof
9 CHANGE pF USE FROM TO
STIPULATIONS
Roof can be second but not th.ird.
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING. �i5 �ld�.'t
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 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 TFiUE AND CORRECT. ALL PROVISIONS OF LAWS yALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $%QO. OO y�` . rJO
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
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- yj`],S.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECKFEE TOTALFEE
$15.50
SIGNATUREOFCONTRACTORORAUTHORIZEDAGENT (DATEI WHEN PROPERLY V LIDATED THIS IS YOUR PERMIT
` � ��-�
� �.�, � ����..�� � j � . ���.� �
SiGNATUREOfOWNERIIFOWNERBUILDERI IOATEI BLDG iNSP �ATE
NEw L ]
City of Fridley Effeetive 4/1/84
ADDN. [ ] R-1 AHD R-2
pLTER. (� Building Permit AppliQation
Construetion 6ddress: ��s� ��� �� �� `
Legal Description: �,5- � 3� ��r� E %v�� l�f.f' °
Owner Name & Address: ���2i � �- S7-���`�/a _ Tel. # r��-����
Contraator: ���"'� ° Tel. # -
Address•
LIVING AREA:
GARAGE AaEA:
DECB AREA:
OTHER:
Attaeh to this application, a Certifieate of Survey of the
lot, with the proposed construetion draWn on it to seale.
DESCRIPTI08 OF Il�IPROYEMENT
Length Width Height Sq. Ft.
Length Width Height Sq. Ft.
Length Width Hgt/Ground Sq. Ft. _—
��-� �
Corner Lot [�] Inside Lot [] Ft. Yd. Setback Side Yard Setbaek
Type of Construction: �.�T ��� � Estimated Cost: $ �/�� `�
Approx. Completion Date:
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: See Back Page for Explanation
�
DATE: , � APPLICANT: o/T �- � ��2��-°�-�`'�`l� Tel. �
Permit Fee
Plan Cheek
State Surcharge
SLC Charge
Park Fee
Setrer Main Charge
ToTAI.
STIPULATIONS•
CITY IISE OI�1LY
� ��� � Fee Schedule on Reverse Side
$ 25$ of Building Permit Fee
$ �S�G $.50/$1,000 Valuation
$ $425 per SAC Unit
$ Fee Determined by Engineering
i
� Agreement Necessary [ ] Not Necessary [ ]
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THE BELOW MUST BE FlLLED IN WHEN REPLACING FUEL BURNING APPLI�WCES OR THE
APPLJCATION WILL BE RETURNED
� u i� • ► I ► I ► • ► ► • : � ► � � i� : 1 • ► � ' / : L 1 • ►
Vlihen � �n acin� an Yictin0 �ra� _, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions,
and is securely supported and firestopped where required. Yes ( i No (
The venting system is plastiGPVC and meets all current codes and manufacturer
specifications including sizing, length, number of elbows and termination. Yes ( J No (v�
The undersigned also verifies that the replacement unit is a listed assembly
and meets the current codes and manufacturers specifications. This does
indude AGA-GAMA Category I Central Fumace Venting Tables for fan
assisted and natural draft appliances.
The �?��]p �or+�+e��en 9ir is sized and installed to meet the current codes
and manufacturers specfications.
Whet7 �BqUired to ����� a new _emh �ef�ten ai ; it will be si�ed and installed
to meet the current codes and manufacturer's specifications.
Yes (�No (
Yes ( ) No (�
Yes (►�No (
When ip�ne� new ver�tin�i pm, the undersigned hereby verifles that
it is�a listed assembly and meets the current codes and manufacturer's
speciftcations. This does include AGA-GAMA Category I Central Fumace
Venting Tables for fan assisted and natural draft appliances. Yes ( No ()
Is tlie common vent and vent connectors sized and installed co�rectly after
an appliance has been removed from the common vent and vented
separately as per current codes. Yes ( No ()
! • • . � ' • ' . � • ' • 11 11 • � " � . � • " � • � � ' M • � • �11 . • �
Appliance #1 Type � c�a�.�� .e/ f�7�BTU Input So, oo� Fan Assisted or�"�
Appliance #2 Type BTU Input Fan Assisted or Nat
AppUance #3 Type BTU Input Fan Assisted or Nat
Total Appliances Total Btu Input
Common Vent Type J'� S� j� Vent Height �� Diameter ��/ inches .
Appliance #1 Vent Connector Height ft Length ft Diameter in Type
Appliance #2 Vent Connector Height ft Length ft Diameter in Type
Appliance #3 Vent Connector Height ft Length ft Diameter in Type �
� r • ► ..- . ..-
HEATING CO:
Signed By:
/ _ .s . n
�,
Date � ����
Building
Inspections
763-572=3604
DATE�
SITE ADDRESS _
TH1S APPLICANT IS:
BUILDING
RESIDENTIAL A.PPLICATIOl�TT
CITY OF FRIDLEY
� � � Y�UR E-MAIL ADDRESS
❑ OWNER
PROPERTY O'WNER/ xq�: /j�I1.b�.v— S ��L,¢.-�-
TENANT ADDRESS: S� �– �_� �� f� A�
PHONE: s7� �i� �o � } O �
CONTRACTOR
SUBMTf A COPY OF STATE LICENSE �_
YOUR STATE LICENSE ADDRESS:�'
WITH APPLICATION pHONE 7G,.�
PROPERTY TYPE ,� SINGLE FAN
0 TWO FAMII.'
PERMTT TYPE I � �DITTON
� BASENIENT FINISH
❑ DECK
TYPE OF WORK:
DESCRIBE WORK BEING DONE:
SIZE OF IIV�ROVEMENT
tc�vruva�
NUMBER OF SQUARF.S I �
GAItAGES
PROP05£D SIZE:
PROPOSED HEIGHT:
SmIIVG
❑ Vinyl
❑ Aluminum '
❑ Other .
8 eJ 'e ittit e
Pernut No.: �a - , sl
Received B :
I���eG��;N 9 007
r��� .s S 4� 3 2
EXP DATE
S'� CITY ��/ ��-P Y STATE�1 �IP �S �/�
�/ U / � FAX
ONSTRUCf10N
STRUC'I10N
❑ GARAGElSI�D
�ROOF
❑ SIDING
❑ SWA�IIvIIIJG POOL
❑ ADDTTION
� REMODELING
/�U� r�' �/�
�HOUSE & GAR.AGE
O ATTACHED GARAGE
0 DEfACHED GARAGE
�Soffit
O Trim
❑ Fescia
WINDOR'S
IN EXISTING OPENWGS DYes DIJo I.�ATION OF WINDOWS
OR FOR NEW OPENIIJGS-DESCRISE SIZE OF
OPENING CHAIJGES &
-rvrF c�F WII•1DpW TO BE WSTALLED NUMBER OF��
❑ DRAW TILE
� OTHER
pdIDTH HEIGHT
F�
BASEMENT REMODELING SUBMIT•
1. Existing Floor Plan
2. Proposed floor plan
3. List of swctural members to be used
FOR NEW CONSTRUCT[OA1 IIdCLUD1NG DECK.S;
ADDITIONS & PORCI�S SUBA�IIT:
1. Site Ptan/Survey showing the existing structures
and proposed project
Z. Two sets of construction plans
3. Energy Catculations
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USINGT� 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ //!�I OCCUPANCY TYPE
Permit Fee
Plan Review
Fire Surcharge
Sfarcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Dne
�o'�, /j
$
$ /• `la
� , k�o
$ ,�_ Crl?
$
$
$
$
$
$ °%(1, `� 3
See Ba.ck Page for Fee Schedule
65% of Building Permit Fee
.001 times the tota] job valuation
.0005 x Permit Valuation Minimum $.50
$5.00 (State Licensed Residential Contractors)
$1675 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 FQR A PERMIT NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I aclrnowledge 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 applicat�on for a permit and work is not to start without a permit; that the work wiIl be in accordance with the approved
plan in the case of all work which requires review and approval af plans.
SIGNATURE OF APPLICANT a-s � C�Yb(rzt._ PR1NT NAME DATE ��. � Q