AF - 43936SUBJECT PE I .
City of Fridley 18216
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
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; � R IPT .
� ; y _ COMMUNITY DEVELOPMENT OIV.
r � � PROTECTIVE INSPECTION SEC. J� ���
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, ' �"�1 � CITY HA�L FRIDLEV 55432 NUMBER REV. DATE PAGE Of APPROVEO BY
�.__.11: '•� 612-571-3450 910-F15 9/20/85 � �
JOB ADDFESS 6771 Brookview Drive N. E.
1 LEGAL �OT NO. BLOCK TRACT OFi ADDITION SEE ATTACHED
DESCR. $$2 � Of LCJt 2� B.�.00 1� Brookview ZriC� SHEET
2 PROPERTY OWNER MAI� ADDRESS ZIP PHONE
J.A. Menkveld & Associates. Inc. 1299 Mississippi 5treet N.E., Fridley 757-0094
3 CONTRAC70R MAIL ADDRESS Z�P PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE IICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PMONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
� NEW ❑ ADDITION O ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 24� x 37' Dwelling and a 20' x 20` Garage with a 10' x 10' Deck
9 CHANGE QF USE FROM TO
STIPULATION� provide a hard su�face driveway. Provide sod in the front and side yards.
Provide City copy of verifying suxvey i�e�ore capping,
WATER & 5EWER SERVICES: Need tA be e�tended on 67th Avenue
DRIVEWAY ESCROW: 12' i• 6' = 18' x$13.50 =$243.00
SAG Credit from 1061-67th Avenue N.E. Wrecked 6/6/74 permi.t #12,583
SEPARATE PERMITS ARE REQUIRED FOR EIECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING. WOOC� FY'aTCle
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 TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND,ORDINANCES GOVERNING THIS TYPE OF WpRK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $57, 400 S2$ • 7Q
DOES NOT PFESUME TO GIVE UTHORITY T VIOLATE OR CANCEL THE PERMITFEE SACCHARGE
PR VI O OF AN OTHER TATE OR LO L LAW REGULATING CON-
ST U F PERFO NCE OF TRUCTION. yS`3O%.�� �K'edlt
��y �� PLAN CHECK FEE TOTAL FEE
U
$ 76.75 $412.45 + DW
si R OFCONiRACTOROAAU7H0 iZEDnGENT ion7Ei - WHEN PROPERLY ALIOATED THIS IS YOUR PERMIT
�
O Sr
SIG TURE OF OWNER i1F OWNER BUILDEI?I IDATEI BLDG iNSP � 7E
p� � City of Fridley Effective u/1/84
ADDN. [ ] R-1 AIiD R-2
pLTER. [] - Bu lding Permit Application
,"� � � ,/ , `
Construetion Address: �� ^ i' �!�-�� V � � � � N � � � •
��
Legal Description: c� � � � �� �� � �L- � ����'��� �'�
owner Name & Address : ��.�►����-�Z � �>�-��`�� ��---� ( �J ('' Tel . # �J� ''Q �
Contractor• �� Tel. �
Address:
LIVING AREA:
GARAGE AREA:
DECR AREA:
OTHER•
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction draWn on it to scale.
DESCRIPTIOA OF IMPROVEMENT
Length � Width Height ��
Length ��.� Width ��� Height �
Length ( � Width ��� Hgt/Ground ,�
Sq. Ft. � �
Sq. Ft. ����
Sq. Ft. �
Inside Lot Ft. Yd. Setback `�j �_ Side Yard Setback �� ��
Corner LoL�] � �
Type of Construction: ��-T`��� Estimated Cost: #���, ��v
Approx. Completion Date:
1�'��� �� U ��-- /� �'�4��
Alt. A Alt B
Proposed Drivexay Width If NeW Opening Is Desired: � �
See Back Page for Explanation
DATE: � u'��s �' APPLICANT:
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
SeWer Main Charge
l�ct,,V cLw�Ay
TOTAL
STIPULATIONS:
Tel. # `�� �
CITY DSE ONLY
$ 3►d7. ��% Fee Schedule on Reverse Side
� 7� .�� 25� of Building Permit Fee
� �d �.50/a1,000 Yaluation
� a425 per SAC Unit
$ Fee Determined by Engineering
S
q��Q�lgreement Necessary [] Not Necessary [ j
�
<�f��`�
G;����'
V •
BQILDING PERMIT FEE SCHEDIILE
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 an}• alteration or repair to any existing Duilding or structure, upon application
therefore, require the payment by the applicant for such permit of fees to Lhe amount
herein beloW set forth and in the manner herein provided to-Wit: _
Total Valuation
i1.00 to �500.00
�501.00 to �2,000.00
�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
�10.00 (Minimum Fee is �15.00)
�
�10.00 for the first �500 plus �1.50 for each
additional �100 or fraction thereof� to and including
�2,000.
332•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 �25,000 plus $4.50 for,each
additional �1,000 or fraction thereof, to and
including �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.
��33•00 for the first #100,000 plus �2.50 for each
additional �1,000 or fraction thereof.
DRIVEWAY DEPRESSION ESCRO'W
(Concrete Curb Streets Only)
Alternate "A": Removal and replacement of curb and gutter only - DriveWay Width plus
6 feet times �13.50
Alternate "B": Removal and replacement of curb and gutter and install a 3 foot Wide
approaeh With 6 inch depth - Driveway �aidth plus 6 feet times �15.75
VERIFICATION OF FOUNDATION
Permits for construction �ill 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 been constructed Will be required before proceeding With the framing.
S�, ��o t,. t„ av�3� Z�3 �� K� q2 ��s �0.8?�
SC�,00�— Z�, no �.L. 8�b� tL � b'�� x 4y.��( = 3g,��c, ��
�l� 3 a �°`c G�'eo z �w ��fy I`/ = S, z9c,8'c�
30� � u C AtZ, �C„E2� z t{�v X� 2.1 `t �- �, �7G,du
' • � s�, wio.3'�..
� CA/NE � �lSSOC/ATES
LAND SURVEYORS, /NC.
_, /7720 Highwoy 65 N. E. Sode�vi//e, Minnesolo 55304
- 434-7646
CERTIFICATE OF SURVEY FOR: Jack Menkveld
DESCRIBED AS: The south 82.00 feet of Lot 2, Block 1, Brookview
Second, according to the recorded plat thereof in the
office of the Registrar of Titles, Anoka County,
Minnesota.
Subject to easements of record.
.. ._ __._.
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67 TH A!/E.
SCALE: / /NCN+ � FEET.
O DENOTES //Y /NCN /RON P/PE SET.
� DENOTES f0(/NO /RON MON(/AIEN7.
BEAR/NGS SNOWN ARE ASSf/MED.
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/ HEREBY CERT/fY TNAT TM/S SURYEY, PLAN�
OR REPORT WAS PREPAREO BY A/E O/P GVDER
' MY D/RECT SUPERV/StON AND THAT / AM A
DULY !�'EG/STERED LAND SURVEYOR UNDER
THE LAWS Of TNE STATE OF AI/NNESOTA.
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CITYOF
FRI DLEY
C1V1C CENTER • fri31 UNIVERSITY AVE. N.E. FRIDLEY, MINNESOTA 55432 • PHONE (61?) 571-i4i0
January 27, 1986
Mr. Jack Menkveld
J.A. Menkveld & Associates Inc.
P.O. Box 34004
Blaine, [rII�l 55434
Re: Final Inspection at 6770 Brookview Drive N.E, Fridley
Dear Mr. Menkveld:
A final inspection was conducted on January 22, 1986 of the above
address and the following items were noted which must be completed
before the structure can be finaled out:
1. Fbst address on structure by February 10, 1986.
2. Provide a hard surface driveway by June 15, 1986.
3. Provide sod in the front and side yaLds by June 15, 1986.
4. Provide the City with a copy of the verifying survey by February 10,
1986.
5. Obtain a final test on the pl►�nbing by February 10, 1986.
We will expect the above items to be completed by the scheduled dates
when reinspections will be conducted to determine coinpliance. If you
have any questions on these items, please feel free to contact me at
571-3450.
Sincerely,
L1�RREZ G. Q�RK
Chief Building Official
�c „
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CfIYOF
FRtDLE.Y
CIVIC CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MINNESOTA 55432 • PHONE (612) 571-3450
Ju�ly 28, 1966
J.A. F3enkveld & Associates
1299 r:ississippi Street NE
Friale�•, rt: 55432
Dear rlr. Aenkveld,
It nas oou�e to my attention that you have not yet paid the park fees for your
�►royerty at 6770-f780�790-6796 Brookview Drive NE. Tne sole stipulation
accanpanying the Lot Split that was granteci to you on this property was that
you pay a�.ark fee af $750 per lot with the next three building permits.
I have enclosed a copy of the Action Taken Notice, complete with your
signature agreeing to the above-r�entioned stipulation. Please pay thE
reguirec3 park fees b� August 11, 1986. It you have any questions, please feel
tree to o�ntact me at the Frialey Civic center, 571-3450, extension 166.
Z2,anF: you f or your 000peration.
Re pectfully yours,
Daryl !� ey
�
Planning Assistant
C-86-334
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FR[DLEY
FRIDLEY MUNICIPAI. CENTER • 6431 UNIVERS[TY AVE. N.E. FRIDLEY, MN 55432 •(612) 571-3450 • FAX (612) 571-1287
May 15, 1990
Art Medic
6770 Brookview Drive N.E.
Fridley, MN 55432
Dear Mr. Medic:
Enclosed please find copies of the assessment records for your
property which you requested at the April 25, 1990, Planning
Commission meeting. Page 1 of the records lists those items which
were assessed to your property and indicates that those assessments
are paid in full.
I hope this answers any questions you may have. If you need any
further information, please contact me at 572-3593. �
Sincerely,
Michele McPherson
Planning Assistant
1�II�i: ls
C-90-267
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sue�ecr P NO.
c�ty of Fridley 26 825
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
�
; � RECEIPT NO.
� • COMMUNITY DEVELOPMENT DIV.
r � v � PROTECTIVE INSPECTION SEC. �5��
� �
� � �"'1 �� CITY HALL FRIOLEV SS132 NUMBER REV DATE PAGE OF APPROVED 8Y
�.__..11.• ••� 612-571-3450 910-F15 7/27/98 � �
JOB ADDRESS
6770 Brookview Dr
t LEGAL ��T NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. S. 82' of ot 2 1 Brookview ZriCl SHEET
2 PROPERTV OWNER MAIL ADDRESS 21P PHONE
Art Medick
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
D& B Home Im Circle Pines MN 55014 784-0922 7773
4 ARCNITECT OR DESIGNER MAIL ADDRESS ZIP PMONE LICENSE NO.
5 ENGINEER MAIL ADORESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CIASS OF WORK
O NEW ❑ ADDITION ❑ ALTEfiATION � REPAIfi ❑ MOVE O REMOVE
8 DESCRIBE WOIiK
Reroof (21 Sq) Tear-off
9 CHANGE OF USE FROM TO
STIPULATIONS
, Underlayment must comply with State Building Code.
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD
SEPARA7E PEFMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEAT�NG,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULI AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHOAIZED IS NOT COMMENCED WITHIN 60 OAYS, 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 PAqKING
t HEREBV CERTIFV THAT 1 HAVE REAO AND EXAMINEO THIS APPLlCAT10N 1 STAILS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORREC7. ALL PROVISIONS OF �AWS VAGUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIEO
WITH WHETHER SPECIFIED MEREIN OR NOT. THE GRANTING OF A PERMIT -� ���� � 1�%SI. $. H]
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pEpMITFEE SACCHARGE
PROVISIONS OF ANY OTHER STATE LO L LAW REGULATING CON-
STRUCTION OR E�PERFOR NCE f TRUCTION. �rj(). ]rj FlY SC �1.75
'� �f PLAN CHECK FEE TOT L FEE
r ! � � Licen 5.0 4.37
SIGNATUAE OF CON'RAC Op OA ED ENT IOATEI N ROP VALIDA THIS �� I
% �
S�GNATUREOFOWNERUfOWNERBWLDERi IOATEI BLO �NSP ��4TE
NEW
ADDN
ALTER
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CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: (n l� / �J
Legal Description:
Owner Name & Address
Contractor:
Address: -( ��
LIVING AREA:
GARAGE �AREA:
DECK AREA:
�
` Pc� � C�
Effective 1/1/98
���y �
� ��
�� � /� Tel. #
Y � MN LICENSE # � �-�
Tel. # %�Y` �Z�,.�
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIP'rION OF Il��IPROVEMENT
Length Width Height Sq. Ft.
Length Width Height Sq. Ft.
Length Width Hgt/Ground Sq. Ft.
OTHER: • �/
Construction T e: � -�� Estimated Cost: $ �
YP
(Fee Schedule on Ba )
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ ����
,.. _�, _,
DATE: � APPLICANT:
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
CITY USE ONLY
Tel. # .!/J �-� j G�
$ �i�� ��- Fee Schedule on Reverse Side
$ , S� .001 of Permit Valuation (1/lOth%)
$ , � `� $.50/$1,000 Valuation
$ $100Q ger SAC Unit
$ �. �C�� $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 [ ]
$ �7-
, � ' `
SuBJECT
City of Fridley
AT THE TOP OF TME TWINS g � I L D I N G P E R M I T
r
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.
COMMUNITY OEVELOPMENT DIV.
� i V'�"�� , .
r � � PFiOTEC7IVE INSPECTION SEC.
� .
i-__-�� �"' �'� CI1Y HALL f RIOLE� 55�32 NuMBER
L 612-571-3450 9t0-F15
JOB ADDRESS
6770 Brookview Drive N
t LEGA� �OT NO. � 9LOCK TfiACT Oii ADOITION
DESCR. S. 82 Of
2 PROPERTY OWNER MAIL AOOfiESS
Linda Medeck
3 CONTRACTOR MAIL ADORESS
Wellington Window & Door Co. 3938 Meadowl
d AqCHITECT OR DESIGNER MAIL AOORESS
5 ENGINEER MAIL ADDFESS
6 USE OF BUIIDING
Residential
7 CLASS OF WORK
REV OATE
10/20/98
ZIP
�
ZIP
ZIP
PAGE OF
� �
PMONE
PHONE
�4MIT NO\
28333
O.
7a 73
AvnqOVED Br
SEE ATTACHED
SMEET
IICENSE NO
��
IICENSE NO.
UCENSENO
❑ NEW O ADOITION O ALTERATION QX FiEPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Window renlacement
9 CHANGE Of USE FROM
STIPULATIONS
TO
Install smoke detectors to meet the State Building Code - in each sleeping
room and on each level of house.
TYPE OF CONST.
SEPARATE PERMITS ARE REOUIRED FOR ELECTfiICAL, PIUMBING, MEATING,
VENTILATING OR Alq CONOITIONING
TMIS PERMIT BECOMES NULL AND VOID If WORK OF CONS7pUCT10N ZONING
AUTMORIZEO IS NOT COMMENCED WITHIN 60 OAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENOED OR ABANDONEO fOfi A PER100 OF 120 OAYS AT
ANY TIME AfTER WORK IS COMMENCED. NO DWLG. UNITS
I HEFiEBY CERTIfV THAT I MAVE REAO ANO EXAMINED THIS APPLICATION
AND KNOW THE SAME Tp BE TRUE ANO CORRECi. ALL PROVISIONS Of �AWS VALUATION
AND OROINANCES GOVERNING THIS TVPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OFi NOT. TME GRANTING OF A PEFMIT �ZH7�i
DOES NOT PqESUME TO GIVE AUTMORITY TO VIOIATE OR CANCEL THE pERMITfEE
PROVISIONS OF ANY OTHER STATE OR LOCAI LAW REGUTATING CON-
STRUCTION OA TME PERFOiiMANCE Of CONSTRUCTION �J�F. J.S
� S�GNAfUpE OF CON'aA(;TOQ Op AUTNOA�2ED eGENT IOAiEi �,I���O�/ rif. �i
� !
S�GN4TUAE O� OWNEQ��F OWHEA Bu4DER� iO�tE� ni
fT
STALLS
Y
CU FT.
OfFSTREET PARKING
IGARAGES
SURTAX
��Y�� $1.43
SAC CHARGE
Fir SC ��x��
TO FEE
.25
THiS IS VOUR PEQ�
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ConstructionAddress: �
Legal Description:
Owner Name & Address:
Contractor: � ; �
Address: ,�°1� M 0 �
LIVING AREA:
GARAGE AREA;
DECK A,REA;
OTHER:
CITY OF FRIULEY
SINGLE FAMILY AND DUPI,CXES R-1 AND R-2
BUILDING PLRMIT APPLICATION
Effective 1 / 1 /97
J,J
�� ��
� /�a
J c-', lz ^1 1 _
Attach to this application, a Certificate of Survey of the :
lot, with the proposed construction drawn on it to scale.
DESCRIPTION QF IMPROVEMENT
Length Width Height S9- Ft.
Length � Width Height Sq. Ft.
�ng� Width Hgt/Ground Sq. Ft.
/' � �(%
Consttuction Type: l.� 1L Estimated Cost: $�U `��
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ =�
DATE: �° _ c__ s,�� ApPLICANT:
Tel. # �3 � �3 0 �
CITY USE ONLY ( '
Permit Fee
Fire Surcharge
State Surcharge
SAG Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
�ro�rnl_
S"I'f['ULi��I�tONS:
$ ` C�� Fee Schedule on Reverse Side
��,�7 .001 of Permit Valuation (1/lOth%)
� .�i3 � $.50/$1,000 Valuation
� $950 per SAC Unit
$ ��
� � $5.00 (State Licensed Residential Contrac
$ Alt. "A" or Alt. "B" Above
� $450.00 Conservation Plan Review
$ Fee Determined by E�iginecrir�g
$ Agreement Necessary [ ] Not Necessary
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sue�ecr PE .
c�ty of Fr�a�ey 3 � � � o
AT THE TOP OF TME 7WINS g � I L D 1 N G P E R M�I T
�
; � RECE���1�y
� • COMMUNITY OEVEIOPMENT DIV. �?2-3604� � `
, ; � ----- ,
r � � PR07ECTIVE INSPECTION SEC. /5� �
� � �"'1 � CITY NALI. FRIOLE� 55132 NVMBER AEV O�TE P�GE Oc �PnnOVEO Br
�----�-' �•' 612-571-3450 910-F15 3/29/O1 / /
JOB ADORESS 6770 Brookview Drive NE
t IEGAL �OT NO. BLOCK TqACT OR AODITION SEE ATTACHED
DESCR. Pt 2 1 Brookview 2nd SNEET
2 PROPERTY OWNER MAIL AODi;ESS IIP PHONE
Art/Linda Medeck 6770 Brookview Drive NE 763-571-4673
3 CONTqACTOR MAIL AODRESS ZIP PHONE LICENSE NO
Al1 Ways Decks 310 Wexford Heights Dr, New Bri hton, MN 55112 651-636-6051
d ARCMITECT OR OESIGNEF MAIL ADDiiESS ZIP PHONE LICENSE NO.
20003805
5 ENGINEER MAIL ADOflESS 21P PHONE LICENSE NO
6 USE OF BU1lDING
Residential
7 CIASS OF WORK
O NEW � ADDITION � ALTERATION p REPAIR O MOVE O REMOVE
B DESCRIBE WORK
Construct a 12' x 20 Deck
9 CHANGE OF USE FROM TO
STIPULATIONS
See notations on plan.
TYPEOFCONST. OCCUPANCYGROUP OCCUPANCVLOAD
SEPARATE PERMITS AFE REOUIFED FOR EIECTR�CAL, PLUMBING, HEATING.
VENTIIATING OR AIR CONDITIONING.
TMIS PERMIT BECOMES NUIL ANO VOID IF WORK OR CONSTRUCTION 20NING SO. FT CU FT.
AUTHOR12E� IS NOT COMMENCED Y�!I7HIN 60 OAYS. OR IF CONS7RUCTION
OR WORK IS SUSPENDED OR ABANOONED FOR A PER100 OF 120 OAYS A7
ANY TIME AFTER WpqK IS COMMENCED. NO DWLG. UN17S OFFSTREET PARKING
I MEREBY CERTIFV THAT I MAVE REAO ANO EXAMINEO THIS APPLICATION 1 STALLS GAfiAGES
ANO KNOW THE SAME TO 8E 7HUE AND CORRECT. ALl PROVISIONS Of LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WIIL BE COMPt,lEO �2 � 64O � 1.32
WITH WMET ECIFIE� MEREIN OR NOT. THE GRANTING OF A PERMIT
DOES PRESU E TO GIVE AUTMORITV TO ��OLATE OA CANCEL THE pEqM1T FEE SAC CMARGE
PAO IONS OF A Y OTHER E OR IOCAI LAW REGUTATING CON• $83.25 Fire C�2.63
UCTION OR T PER M CE OF CONS7RUCTION
PLAN CHECK TpTAL F
Lic se C $5.0 $9 .20
S�GNAi E ON"AACTOQ 4uTHOAiZED�GENi iDATEi HE PROPE V ALtDAT T tS IS YOUR P RMiT
•
� �
S�GNATU�7E O� OWNEp��F OWHEQ BUi�DEA� �D�iEi B �ti$o � ����E
N EW ( ] Effective 1 /1 /2001
ADDN [] . CITY OF FRIDLEY (763) 572-3604 Bldg Insp
ALTER [] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address: ( n%�0 �� 1� v �� � r
t
Legal Description:
Owner Name & A�
Contractor:
Address:
Te►. # 7� 3-�? 1, y b7�
MN LICENSE# 20'�4 ��p�
Tel. # �� J-103�- �SJ
�tach o�'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
DECK AREA:
OTHER:
Length Wdth Height Sq. Ft.
Length 12 Width o`ZO Hgt/Ground � Sq. Ft. y
an S;R �Co JO
Construction Type: '�2,�,� ,t �Jc= Estimated Cost: � Z�� �
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: �/�7/�l APPLICANT: �E'"� �i��r Tel. # C�� I" <o3b~6�5 /
�c �.7aYs .�'cSc
CITY USE ONLY -
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
T07AL
STIPULATfONS:
Call (763) 572-3604 for Permit Fees if mailing in application
$ J,c�S Fee Schedule on Reverse Side
$ .001 of Permit Valuation (1/10th%)
$ $.50/$1,000 Valuation
$ $1150 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]
1 ►
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JOB ADDRESS
Atl-Ways Decks, Inc. ,�� � fi L, �� �-► e�e�
310 Wexford Heights Dr. (0770 �jcz�okv��rw Qr'
New Brighton, MN 55112 �r���� �,,,�,�
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• QX Footings witl be 42" deep, 12" diameter • Rail height 36" min. � Step rise will be 8° max.
• Stnacture will be 2 x 10 GT 1 L`' oG • Rail space 4' max. • Posts will be 6 x 6
• Decking will be cedar • Step run will be 9" min. ��;�� j��
� CA/NE � ASSOC/ATES
LAND SURVEYDRS, /NC.
_, /7720 Highwoy 65 N. E. Sode�vi//e, Minnesolo 55304
. 43 4-T646
CERTIFICATE OF SURVEY FOR: Jack Menkveld
DESCRIBED AS: The south 82.00 feet of Lot 2, Block 1, Brookview
Second, according to the recorded plat thereof in the
office of the Registrar of Titles, Anoka County,
Minnesota. ..
Subject to easements of record.
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67 TH A !/E. /V. VI!
SCAL£: / /NCN+ T� fEET.
/ NEREBY CERT/FY TNAT TM/S SURYEY, PLAN�
OR REPORT WAS PREP.IREO BY A/E OR /A1�ER
MY O/RECT S(/PERV/SlON ANO TNAT
DULY REG/STE/9ED LANO S ��Q �
THE LAWS OF TNE �
�5.�2 p�i`
d�' _ �eu.
sue.ietr PERMIT NO.
City of Fridley 3 i 7 2 3
AT THE TOP OF THE TWINS g �� L D I N G P E R M I T
;,
, � �.
� `y __���_ COMMUNITY DEVELOPMENT DIV. ������ / / r)�
r � � PROTECTIVE INSPECTION SEC. (f�0
� � �
� � �"'1 � CITY HA�L FRIDLE� SS�J2 NUMBER pEV O�iE PAGE OF •vvnOVEO Br
�""�'� �'' 612-571-3450 910-F15 4/4/O1 / /
�oe aooRess 6770 Brookview Drive NE
t LEGAL �OT NO. BLOCK TRACT OR ADOITION SEE ATTACHED
DESCR. Pt 2 1 Brookview 2nd Addition SHEET
2 PiiOPERTY OWNER MAIL AODHESS ZIP PHONE
Linda/Pat Medeck 6770 Brookview Drive NE 763-571-4673
3 CON�RACTOF MA{L AD�RESS Z1P PNONE LICENSE NO
Wellington Windows 3938 Meadowbrook Rd, St Louis Park MN 55426 952-933-6300
4 AqCMITECT OR DESIGNER MAIL AOORESS ZIP PHONE UCENSE NO-
Cit License
5 ENGINEER MAI� AOORESS ZtP PNONE IICENSE NO
6 USE OF BUILDING
Residential
7 CIASS Of WORK
O NEW O ADDITION O ALTERATION � REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WOqK
Replace windows within existin openings
9 CHANGEOFUSEFHOM TO
STIPULATIONS
Provide smoke detectors in a11 sleeping rooms and on all leveis of the
dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code. Caulk
and flash all exterior openings.
Per�rit In�p��t�o� ����s
�Illill B� ��i���
To Nomeo��e� 'T� ����
TYPEOFCONST. OCCUPANCVGROUP OCCUPANCVIOAD
SEPARATE PERMITS ARE FEOUIRED FOR EIECTFiICAI, PLUMBING, NEATING,
VENTILATING OR AIR CONOITIONING
THIS PERMIT BECOMES NULL AND VOID �F WORK Oq CONSTFUCTION ZONING SQ. FT CU FT.
AUTHOR�ZED IS NOT COMMENCEO WITHIN 60 OAYS, OR IF CONSTRUCTION
OR WORK iS SUSPENDED OR ABANDONEO FOR A PER100 OF 120 OAYS AT
ANY TIME AfTER WORK IS COMMENCED. NO DWIG. UNITS OffSTREET PARKING
I HEREBY CERTIFV THAT I HAVE READ AND ExAMINED THIS APPLICATION 1 STA�IS GARAGES
AND KNOW THE SAME TO 8E TiiUE ANO CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTA%
ANO ORDINANCES GOVERNING THIS TVPE OF WORK WILI 9E COMPUED
WITM WMETMER SPECIFIE� HEREIN OR NOT. TME GiiANTING OF A PERMIT �3,759 $1.88
DOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE OR CANCEI TME pEqMIT FEE SAC CNARGE
Pi:OVtSIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR TME PERFORMANCE OF CONSTRUCTION �9� . Z.S F1 e SC $3 . 7�
PLAN CMEC E T AL FEE
City ic nse $102.8
S�GNATU�7EO�CON7FA(;TOQOROUTMOA�2EO�GENT iD�TE� HE PR V VALI A D TNIS IS V R ERMIT �C
. , L/II �� (/ ��. .
S�GNATU�7E O� OWNEp��� OwaEA Bw�DEA� �D�iE� -� 8 �ri5� � q�i
NEW Il
ADDN []
ALTER [ j
Effective 1 /112000
CITY OF FRIDLEY (�63) 572-3604 B{dg Insp
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address: c�� � (� ��pd � v� �1' , . /��
Legal Description: _ „ •
Owner Nar� & Address:
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
r cc � u t, L ('Cc Tel. #
� i s�,�6
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft.
Length Width Height Sq. Ft
Length Width Hgt/Ground Sq. Ft
�"/� I-I �D°
Construction Type: �e�1'l;��e✓�1U1� Q� �tJ� wS Estimated Cost: $ ,,%�� -
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: �� APP�ICANT: Tel. # ��� "��.57'��G�
CITY USE ONLY -
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Call (763) 572-3604 for Permit Fees if mailing in application
$_ ���
Fee Schedule on Reverse Side
$ � 7� .001 of Permit Valuation (1/10th%)
$ ) Y�� $.50/$1,000 Valuation
$_ i $1100 per SAC Unit
$ f= � . 'dential Contractors)
$ Alt. "A" or Alt. "6" Above
$
$450.00 Conservation Plan Review
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement Necessary [] Not Necessary []
TOTAL $ gU �
STIPULATIONS: �m ��� �i?`��-�-�� `<z�.� . �/�, � /
/�9 � � �
�' u.�� � �4��� � �=,�,��'�//-��--
� � ��
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sue�etr RMIT NO.
City of Fridley 3 i 74 8
AT THE TOP OF THE TWINS g � I L D I N G P E R M i T
� _�._
; � ���-��0� RECEIPT NO.
COMMUNI7Y DEVEIOPMENT DIV. ����
r � L � � PROTECTIVE INSPECTION SEC.
i_-_-�; �"'1,'� CITY MA�L fRIOIEY 55�32 NUMBEP pEV D�TE P�GE OF APVROVEO Br
L 612-571-3450 9�0-F�5 4/18/O1 / �
JOB ADORESS 6770 Brookview Drive NE
t LEGA� ��T NO. BIOCK TRACT OR AOQITION SEE ATTACHED
oESCa. pt 2 1 Brookview 2nd SHEE7
2 PRQPER�Y OWNER MAI� AOORESS Z�p PNONE
Art Medeck 6770 Brookview Drive NE 763-571-4673
3 CONTqACTOR MAII ADORESS ZIP PHONE LICENSE NO
Wellington Windows 3938 Meadowbrook Rd, St Louis Park, MN 55426 952-933-6300
4 ARCHITECT OR DESIGNER MA1L ADDRESS Z1P PHONE LICENSE NO.
5 ENGfNEER MAII ADORESS ZIP PMONE UCENSE NO
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION O ALTERATION l� REPAIR O MOVE O REMOVE
8 OESCRIBE WORK
Replace Windows Within Existing Openings
9 CHANGE Of USE FROM TO
STIPULATIONS
Provide smoke detectors in all sleeping rooms and on all levels of the
dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code. Caulk
and flash a�l exterior openings.
Perr�it �ns��c#�o� C�rds
1�ii11 �� ��i��d
To �ome���1��� `�v Post
TYPEOfCONST OCCUPANCYGROUP OCCUPANCVLOAO
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING.
VENTILATING OR AIR CONDITIONING
THIS PEfiM1T BECOMES NUII ANO VOID IF WORK OR CONSTRUCTION ZONING SQ. fT CU FT
AUTMORIZEO IS NOT COMMENCEO WITHIN 60 OAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENOED OR ABANOONEO FOR A PERIOD OF 12p DAYS AT
ANY 71ME AFTER WORK IS COMMENCED. NO DWLG. UNITS OFFSTREET PARKING
I HEfiEBY CERTIFY THAT 1 HAVE REA� ANO EXAMtNEO TMIS APPLICAT{ON 1 STALL$ GARAGE$
AND KNOW THE SAME TO BE TRUE ANO COFiRECi. ALl PFOVISIONS OF LAWS yqLUATION SURTAX
AND ORDINANCES GOVERNING THIS TVPE Of WORK WI�L BE COMP�IEO
WITM WMETMER SPECIFlEO MEREIN OA NOT THE GRANTING OF A PERMIT �1�972, �.99
OOES NOT PRESUME TO GIVE AUTHORITY TO VIOIATE OR CANCEL THE pERM1T FEE SAC CMARGE
PROVIS�ONS OF ANY OTHER STATE� OR LOCAL LAW REGULATING coN- �69..LS Fire SC �1.9%
STRUCTION OR TFiE PERFORMANCE OF CONSTRUCTION
PLAN CHECKfEE OiALFEE
City 'cense $72.21
S�GN�iUpE O� CON"RACTOQ OA �UTNOp�2E0 AGENT iO�TE� M N Pq lV VAU TED THiS iS �O PEQMIT
. ✓/ _a�
�� S�GNa�UAE O� OwtiEQ��F OWNEQBU�IDEA� �DAfE� OG �I+S�� ��<<E
��. . .
NEW [ ] Effective 1/1/2000
ADDN [] CITY OF FRIDLEY (763) 572-3604 Bldg Insp
ALTER [ j SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address: _ (7� �: � �o �j` e� ,��(' , ;
Legal Description:
Owner Nao
Contractor:
Address:
LIViNG AREA:
GARAGE AREA:
DECK AREA;
OTHER:
..,,. ".."...."�
Attach to this appfication, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft.
Length Width Height Sq. Ft
Length Width Hgt/Ground Sq. �t
Construction Type: f'1C�l1 t' W ��I1G[U�/s Estimated Cost: $� ���
Dnveway Curb Cut Width Needed: Ft. + 6 ft = Ft x$ _$_
�� /i/j� �����/
DATE: ! /� APPLICANT: / G Tel. # - t �3 --C�3�a
CITY USE ONLY - Cali (763) 572-3604 for Permit Fees if mailing in application
Permit Fee $��,�5 Fee Schedule on Reverse Side
Fire Surcharge $____ �,�j�_ .001 of Permit Valuation (1/10th%)
State Surcharge $ �� $.50/$1,000 Valuation
SAC Charge $_ _ $1100 per SAC Unit
License Surcharge $ �: i� . 'dential Contractors)
Driveway Escrow $ Alt. "A" or Alt. "B" Above
Erosion Control $ $450.00 Conservation Plan Review
Park Fee
Sewer Main Charge
TOTAL
$ Fee Determined by Engineering
$ Agreement Necessary [ ] Not Necessary [ ]
� `1�,�c
'i •
STIPULAT{ONS:�i�J%/�"�� /«"" � � �� ��7z--�C�.
� �
3�6. s. � �, r94� � �'_ c � �����,�� ,��� � - �.��-
�i� �"l�`��� - _ _..�ci-�-�� 4
CITY OF FRIDLEY INSPECTION DIV.
643'I University Ave NE
Fridley, MN 55432
(763) 572-3604, FAX (763) 571-1287
\
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Effective April 1, 2004
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
PLUMBING FIXTURE RATES:
New Fixtures
Old Opening, New Fixture
Beer Dispenser �,
Blow Off Basin �!
Catch Basin �
Rain Water Lead � r
Sump/Receiving ank
Water Treating A liance
Water Heater -Ele tric
Water Heater - Ga '`'`
NO. RATE TOTAL JOB ADDRESS ���� �
Gas Range*"
Gas Dryer'`*
Back Flow Prevente Required ()Yes ) No
Type � � %�� � S A2a�e � 7�0�4
$10.00
$10.00
$10.00
$10.00
$10.00
$10.00
$10.00
$35.00
$35.00
$35.00
$10.00
$10.00
$15.00 ��� �
Reinspection Fee $50.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.25% of Value of Fixture or Appliance
State Surcharge
TOTAL FEE
�/ �-W fJ T �
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the city codes
and rulings of the Building Division, and hereby declares that af1 the fiacts
and representations stated in this application are true and correct.
DATE: _ / /3 D �/ , 20 � ��
OWNER /-f r�1- /,( �Qec�
BUILDING USED AS
ESTIMATED COST
PLUMBING COMPANY
SIGNED BY
v
Approved By Rough-In Date
$ , Sa
PERMIT NO. ��O G ` �����
TEL N0. %6 �'S %I � Lf (0 73
Final Date
MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS 515.00 or 5% OF COST
$ iS. S O OF THE IMPROVEMENT WHICHEVER IS GREATER PLUS THE SURCHARGE
COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. '*PROVIDE COMMON VENT INFO ON BACK SIDE
ADDRESS
PIN
LEGAL DESC
PERMIT TYPE
PROPERTY TYPE
CONSTRUCTION TYPE
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
�63) 572-3604 FAX: (7631571-1287
: 6770 BROOKVIEW DR NE
: 133024230067
: LTNAVAILABLE
: LOT BLOCK
: PLUMBING
: RESIDENTIAL
: ADDITION/ALTERATION
PERMIT O.: 2004-00504 � '�
DATE ISSUED: 04/14/2004 �
VALUATION : $ 0.00
NOTE: COMBUSTION AIR SHALL BE PROVIDED PER UMC CHAPTER 6 AND TABLE 6-A
INSTALL IRRIGATION SYSTEM WITH BACK FLOW PREVENTER (WILKINS 720A)
# BACK FLOW PREVENTERS 1 # ELEC WATER HEATERS
VALUE OF FIXTUREfAPPLIANCE
# GAS WATER HEATERS
0 # NEW FIXTURES (EXIST OPENINGS)
0 # GAS DRYERS
# GAS RANGES 0 # OF NEW FIXTURES
# WATER TRMT APPLIANCES 0
APPLICANT
MEDECK ARTHUR J& LINDA S
6770 BROOKVIEW DR NE
FRIDLEY, MN 55432
OWNER
MEDECK ARTHUR J& LINDA S
6770 BROOKVIEW DR NE
FRIDLEY, MN 55432
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construction
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time after work is commenced.
I hereby certify that I have read and examined this
application and know the same to be true and correct. All
provisions of laws and ardinances governing this type of wor�
will be complied with whether specified herein or not. The
granting of a permit does not presume to give authority to
violate or cancel the provisions of any other state or local law
regulating construction or the performance of construction.
Applican � Date
Bldg Insp - Dat `�` � � ��
PLBG PERMIT MINIMUM FEE
PLBG FIXTURES (NEW OPENINGS)
PLBG FIXTURES (EXIST OPENINGS)
WATER TREATMENT APPLIANCE
WATER HEATER - ELEC
WATER HEATER - GAS
GAS RANGE FEE
GAS DRYER FEE
PLBG REPAIR/ALTERATIONS
STATE SURCHARGE, PLBG FLAT
BACK FLOW PREVENTER
TOTAL
PAID WITH CHECK # 3085
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
0
0
0
0
15.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.50
0.00
15.50